Emotional scars : impact of childhood trauma on depressive and anxiety disorders

The aim of this thesis was to investigate the effect of childhood trauma and childhood life-events on the development and course of depressive and anxiety disorders, and to identify risk factors contributing to these associations. In brief, our findings indicate that childhood trauma is an important risk factor for the development of depressive and/or anxiety disorders, especially depressive and comorbid disorders, and predicts a more chronic course of illness. Emotional neglect, as core component of childhood trauma, is of particular relevance and has a predominant and strong negative impact on onset and course of depressive and anxiety disorders. Our mediation analyses demonstrate the lifelong scarring through which childhood trauma may affect cognitive style, personality traits and ultimately psychopathology in adulthood. The findings of this thesis are keys to increased awareness of the negative impact of childhood trauma on psychosocial functioning, personality profile, and psychopathology. Based on our findings, recommendations for Chapter 7 Summary 136 clinical practice and future research have been formulated.The infrastructure for the Netherlands Study of Depression and Anxiety (www.nesda.nl) is funded through the Geestkracht program of the Netherlands Organisation for Health Research and Development (Zon-MW, grant nummer 10-000-1002) and is supported by participating universities and mental health care organizations (VU University Medical Center, GGZ inGeest, Arkin, Leiden University Medical Center, GGZ Rivierduinen, University Medical Center Groningen, Lentis, GGZ Friesland, GGZ Drenthe, Scientific Institute for Quality of Healthcare [IQ healthcare], Netherlands Institute for Health Services Research [NIVEL] and Netherlands Institute of Mental Health and Addiction [Trimbos]).UBL - phd migration 201

Childhood trauma in adult depressive and anxiety disorders: an integrated review on psychological and biological mechanisms in the NESDA cohort

Background: Childhood trauma (CT) has adverse consequences on mental health across the lifespan. The understanding of how CT increases vulnerability for psychiatric disorders is growing. However, lack of an integrative approach to psychological and biological mechanisms of CT hampers further advancement. This review integrates CT findings across explanatory levels from a longitudinal adult cohort ? the Netherlands Study of Depression and Anxiety (NESDA).Methods: We reviewed all studies (k = 37) from the NESDA cohort (n = 2981) published from 2009 to 2020 containing CT findings related to psychopathology and potential psychological and biological mechanisms of CT.Results: CT was associated with a higher risk of anxiety and depressive disorders with the strongest associations in the comorbid group. CT predicted the onset of these disorders, recurrence, and poorer outcomes (more co morbidity and chronicity). CT was associated with maladaptive personality characteristics and cognitions (e.g., higher neuroticism and negative self-associations), mild stress systems dysregulations (heightened levels of cortisol and inflammation), advanced biological aging (increased epigenetic aging and telomere attrition), poorer lifestyle (higher smoking rate and body mass index), somatic health decline (e.g., increased metabolic syndrome dysregulations), and brain alterations (e.g., reduced mPFC volume and increased amygdala reactivity). Limitations: Literature review of one cohort using mixed analytical approaches.Conclusion: : CT impacts the functioning of the brain, mind, and body, which together may contribute to a higher vulnerability for affective disorders. It is essential to employ an integrative approach combining different sources of data to understand the mechanisms of CT better.Stress-related psychiatric disorders across the life spa

Severe depression as a neuropsychiatric side effect induced by dolutegravir

Immunogenetics and cellular immunology of bacterial infectious disease

Characteristics of suicidal outpatients with mood, anxiety and somatoform disorders: The role of childhood abuse and neglect

Stress-related psychiatric disorders across the life spa

The effects of neuroticism, extraversion, and positive and negative life events on a one-year course of depressive symptoms in euthymic previously depressed patients versus healthy controls

Item does not contain fulltextWe investigated a) the concurrent impact of positive and negative life events on the course of depressive symptoms in persons remitted from depression and healthy controls, b) whether the impact of life events on symptom course is moderated by the history of depression and the personality traits of neuroticism and extraversion, and c) whether life events mediate possible relationships of history of depression and personality traits with symptom course. Using data from the Netherlands Study of Depression and Anxiety, we examined 239 euthymic participants with a previous depressive disorder based on DSM-IV and 450 healthy controls who completed a) baseline assessments of personality dimensions (NEO Five-Factor Inventory) and depression severity (Inventory of Depressive Symptoms [IDS]) and b) 1-year follow-up assessments of depression severity and the occurrence of positive and negative life events during the follow-up period (List of Threatening Events Questionnaire). Remitted persons reported higher IDS scores at 1-year follow-up than did the controls. Extraversion and positive and negative life events independently predicted the course of depressive symptoms. The impact of life events on symptom course was not moderated by history of depression or personality traits. The effect of extraversion on symptom course was partly caused by differential engagement in positive life events

The specificity of childhood adversities and negative life events across the life span to anxiety and depressive disorders

Contains fulltext : 90618.pdf (publisher's version ) (Closed access)Background: Although several studies have shown that life adversities play an important role in the etiology and maintenance of both depressive and anxiety disorders, little is known about the relative specificity of several types of life adversities to different forms of depressive and anxiety disorder and the concurrent role of neuroticism. Few studies have investigated whether clustering of life adversities or comorbidity of psychiatric disorders critically influence these relationships. Methods: Using data from the Netherlands Study of Depression and Anxiety (NESDA), we analyzed the association of childhood adversities and negative life experiences across the lifespan with lifetime DSM-IV-based diagnoses of depression or anxiety among 2288 participants with at least one affective disorder. Results: Controlling for comorbidity and clustering of adversities the association of childhood adversity with affective disorders was greater than that of negative life events across the life span with affective disorders. Among childhood adversities, emotional neglect was specifically associated with depressive disorder, dysthymia, and social phobia. Persons with a history of emotional neglect and sexual abuse were more likely to develop more than one lifetime affective disorder. Neuroticism and current affective disorder did not affect the adversity-disorder relationships found. Limitations: Using a retrospective study design, causal interpretations of the relationships found are not warranted. Conclusions: Emotional neglect seems to be differentially related to depression, dysthymia and social phobia. This knowledge may help to reduce underestimation of the impact of emotional abuse and lead to better recognition and treatment to prevent long-term disorders

Psychological Symptoms and Quality of Life After Simultaneous Kidney and Pancreas Transplantation

Background.Patients that have undergone successful simultaneous pancreas/kidney (SPK) transplantation attain normoglycemia and are free from dialysis. However, only a minor improvement in quality of life (QOL) has been demonstrated. Here, we evaluated the role of psychological symptoms in QOL after SPK transplantation.Methods.We assessed patients with type 1 diabetes and end-stage renal disease waitlisted for SPK transplantation (pre-SPK, n = 47), and recipients of an SPK transplant (post-SPK, n = 72). Matched patients with type 1 diabetes without end-stage renal disease were included as reference group (type 1 diabetes [T1D] reference group, n = 42). The brief symptom inventory (BSI) was used to measure psychological symptoms. The Short Form-36 (SF-36) was used to determine QOL.Results.Post-SPK patients scored slightly better on the SF-36 than pre-SPK patients ("General health" 47.2 +/- 23.1 versus 37.5 +/- 18.1 [P = 0.017]). In the T1D reference group, this score was 60.6 +/- 22.3. Post- and pre-SPK patients had similar BSI scores (0.54 +/- 0.55 and 0.45 +/- 0.42, respectively [P = 0.34]). This score was better in the T1D reference group (BSI score 0.32 +/- 0.33). The BSI score inversely correlated with the SF-36 (r = -0.61, P < 0.001).Conclusions.Psychological symptoms are prevalent in both pre-SPK and post-SPK patients and could play an important role in the reduced QOL observed in these groups.Diabetes mellitus: pathophysiological changes and therap

Fetal, neonatal and developmental outcomes of lithium-exposed pregnancies

Stress-related psychiatric disorders across the life spa