Prolactin secretory rhythm in women: immediate and long-term alterations after sexual contact

BACKGROUND Prolactin (PRL) is one of the most versatile hormones in the mammalian body, affecting reproductive, sexual and other functions. In rats, mating or vaginocervical stimulation activates a characteristic PRL secretory pattern for several days, which is essential for successful reproduction. Although the underlying mechanisms appear to be different, PRL is also crucial for human fertility. We have detected a PRL increase in women induced by sexual intercourse. Extending these findings, the current study aimed at analyzing the PRL secretory rhythm after sexual contact, in order to elucidate whether human females also show long-term alterations of the PRL secretory pattern. METHODS In a pilot study, serial blood samples were taken from women (n= 7) in mid-cycle to assess changes in PRL secretory rhythm induced by sexual intercourse, during a period of 32 h. RESULTS Compared with control condition, sexual intercourse with orgasm induced not only the well-established immediate PRL increase of ∼300% but also an additional PRL elevation around noon of the next day (P< 0.05). These fluctuations were measured on top of the regular circadian rhythm of PRL, manifested as a surge early in the morning. CONCLUSIONS We are able to demonstrate a long-term change in the PRL secretory rhythm after sexual intercourse with orgasm in females, suggesting memory effects. We hypothesize that the additionally secreted PRL could be beneficial for decidualization and implantation. Further studies with more participants are required to investigate in detail the implications of such effects on reproductive success in human

Agitation predicts response of depression to botulinum toxin treatment in a randomized controlled trial

In a randomized, controlled trial (n = 30), we showed that botulinum toxin injection to the glabellar region produces a marked improvement in the symptoms of major depression. We hypothesized that the mood-lifting effect was mediated by facial feedback mechanisms. Here we assessed if agitation, which may be associated with increased dynamic psychomotor activity of the facial musculature, can predict response to the treatment. To test this hypothesis, we re-analyzed the data of the scales from our previous study on a single item basis and compared the baseline scores in the agitation item (item 9) of the Hamilton Depression Rating Scale (HAM-D) between responders (n = 9) and participants who did not attain response (n = 6) among the recipients of onabotulinumtoxinA (n = 15). Responders had significantly higher item 9 scores at baseline [1.56 + 0.88 vs. 0.33 + 0.52, t (13) = 3.04, d = 1.7, p = 0.01], while no other single item of the HAM-D or the Beck Depression Inventory was associated with treatment response. The agitation score had an overall precision of 78% in predicting response in a receiver operating characteristic (ROC) analysis (area under the curve, AUC = 0.87). These data provide a link between response to botulinum toxin treatment with a psychomotor manifestation of depression and thereby indirect support of the proposed facial feedback mechanism of action. Moreover, it suggests that patients with agitated depression may particularly benefit from botulinum toxin treatment

The German COVID-19 Survey on Mental Health: Primary Results

First cases of COVID-19 were reported in Wuhan, China in early December 2019. Preliminary data from China indicated that the pandemic and its associated lockdown measures may have a substantial impact on mental health and well-being, with evidence of increased levels of psychological distress, anxiety, depressive symptoms and insomnia.1,2 In March 2020, the German government agreed upon a substantial catalogue of measures including contact bans that came into effect on 22 March. Such measures are unprecedented for the majority of people and may affect their lives tremendously. Thus, the current survey was immediately developed to systematically assess mental health in response to these measures. Methods The survey was approved by the local ethics committee at Hannover Medical School, Germany and included web-based self-report measures as outlined below. First wave data were taken during the height of lockdown measures in Germany from 1 April to 15 April 2020. Results Demographics A total of 3,545 volunteers took part in this cross-sectional survey. Mean age was 40.36 years (SD = 11.70; 83.1% female, 15.2% male), mean educational years 15.87 (SD = 4.19), 9.9% were unemployed and 23.9% reported living alone. Acute or chronic disease was reported by 36.7% (physical) and 24.7% (mental) of subjects. Distress, Anxiety and Depression Psychosocial distress as measured with the PHQ stress module (items 12a-12j of PHQ-D) was at M = 6.36 (SD = 0.89), implying mild psychosocial distress (range 5-9). Depression and anxiety as assessed by PHQ-4 was at M = 3.80 (SD = 3.03) and significantly higher than in a reference sample (t(6008) = 32.78, p = 0.00).3 The mean well-being score (WHO-5) was 50.7 (SD = 23.8) (range 0-100), with normal individuals having a mean score of 75 and subjects with major depression 37.5.4 The majority of subjects (60%) indicated very good or fair, 26.9% poor or very poor subjective coping with the pandemic and corresponding measures. Calculation of gender differences revealed higher scores for depression and anxiety (t(3459) = 4.93, p = 0.00) and poorer coping in women (U = 678156, p = 0.00). Sleep, irritability &amp; violence Using comparative questions on a 5-point Likert scale 45.3% of participants reported worsened sleep compared to pre-pandemic times. Of all participants 50.9% reported being more easily irritated (compared to 12.2% feeling less easily irritated) and 29% reported experiencing more anger and aggression (compared to 12.8% experiencing less). Of these 65.5% directed their anger and aggression at others, while 32.6% directed it at themselves. Most importantly, 5% of all participants reported experiencing interpersonal violence (IPV) on a verbal (98.4%), physical (41.9%) or sexual (30.2%) level. In case of verbal violence, 77.3% reported experiencing more verbal violence lately (compared to 3.4% experiencing less). Regarding physical violence, 19.5% reported experiencing increased levels (compared to 2.8% experiencing less) and in case of sexual violence more people reported experiencing increased sexual violence lately (11.1%) compared to 1.7% that experienced less. Discussion This is one of the first and largest surveys on mental health during COVID pandemic in a European society. Although the cohort reflects a relatively well educated and financially secure sample, there is evidence of substantial mental burden with increased levels of stress, anxiety, depressive symptoms, sleep disturbance and irritability. Most importantly and also most concerning is the finding of a one-month prevalence of 5% IPV, which is already close to one-year prevalence rates5 and for which there were indices that this has currently increased. We think it is of vital importance to continuously monitor the mental health of the general public during this pandemic and its aftermath and to carefully screen for IPV and its risk factors such as stress, sleep problems and anger.6 </jats:sec