Gender differences in DSM-5 versus DSM-IV-TR PTSD prevalence and criteria comparison among 512 survivors to the L׳Aquila earthquake

Background: Post-traumatic StressDisorder(PTSD)hasdemonstratedgender-specific prevalenceand expressionsacrossthedifferentDSMdefinitions, sinceits first introductioninDSM-III.TheDSM-5 recentlyintroducedimportantrevisionstoPTSDsymptomatologicalcriteria.Aimofthepresentstudyis to explorewhethergendermoderatesratesofDSM-5PTSDexpressioninanon-clinicalsampleof survivorstoamassiveearthquakeinItaly. Methods: 512survivorsoftheL'Aquila2009earthquake,previouslyinvestigatedforthepresence DSM-IV-TRPTSD,werereassessedaccordingtoDSM-5criteriainordertoexploregenderdifferences. All subjectscompletedtheTraumaandLossSpectrum-SelfReport(TALS-SR). Results: Femalesshowedsignificantly higherDSM-5PTSDratesandratesofendorsementofalmostall DSM-5 PTSDcriteria.Significant genderdifferencesemergedinalmosthalfofPTSDsymptomatological criteria withwomenreportinghigherratesin8ofthem,whilemeninonlyone(anewsymptominDSM- 5: recklessorself-destructivebehavior). ConsideringtheimpactofthethreenewDSM-5symptomsonthe diagnosis, significant genderdifferencesemergedwiththesebeingcrucialinalmosthalfofthePTSD diagnoses inmalesbutinaboutone-fourthinfemales.ByusingROCcurves,DSM-5criteriaEandD showedthehighestAUCvaluesinmales(.876)andfemales(.837),respectively. Limitations: The useofself-reportinstrument;noinformationoncomorbidity;homogeneityofstudy sample; lackofassessmentonfunctionalimpairment. Conclusions: This studyprovidesacontributiontotheongoingneedforreassessmentonhowgender moderatesratesofexpressionofparticulardisorderssuchasPTSD

Epigenetic modulation of BDNF gene: Differences in DNA methylation between unipolar and bipolar patients

Background The brain derived neurotrophic factor (BDNF) gene and its epigenetic regulation have been repeatedly implicated in the pathophysiology of mood disorders. Following previous investigation in the field, we further investigated differences in BDNF promoter gene methylation in patients with mood disorders, comparing unipolar and bipolar subjects, on the basis of illness phase, gender, age and psychotropic prescription. Methods 154 patients (43 MDD; 61 BD I; 50 BD II), on stable pharmacological treatment, and 44 age-matched, healthy controls were recruited. BDNF methylation levels from peripheral blood mononuclear cells (PBMCs) were compared by analysis of variance followed by Bonferroni's post-hoc test. Results Similar, higher levels of BDNF gene promoter methylation were found in BD II and MDD patients, compared to BD I subjects (P<0.01). When stratified on the basis of mood status, methylation levels of depressed patients were significantly higher, compared to the levels of manic/mixed patients (P<0.01). While gender and age did not seem to influence methylation levels of BDNF gene promoter, patients on lithium and valproate showed overall lower levels. Limitations: Cross-sectional analysis using PBMCs with further investigation with larger samples, including drug-na\uefve patients, needed to replicate findings in neuronal cells. Conclusions Present data confirm our previous results of higher methylation levels in BD II (compared to BD I) and MDD patients (compared to controls). A closer relationship between BD II and MDD, compared to BD I patients as well an association of lower methylation levels with the presence of mania/mixed state, compared to the depressive phase, was observed