Modifiable predictors of depression following childhood maltreatment: a systematic review and meta-analysis

Although maltreatment experiences in childhood increase the risk for depression, not all maltreated children become depressed. This review aims to systematically examine the existing literature to identify modifiable factors that increase vulnerability to, or act as a buffer against, depression, and could therefore inform the development of targeted interventions. Thirteen databases (including Medline, PsychINFO, SCOPUS) were searched (between 1984 and 2014) for prospective, longitudinal studies published in English that included at least 300 participants and assessed associations between childhood maltreatment and later depression. The study quality was assessed using an adapted Newcastle-Ottawa Scale checklist. Meta-analyses (random effects models) were performed on combined data to estimate the effect size of the association between maltreatment and depression. Meta-regressions were used to explore effects of study size and quality. We identified 22 eligible articles (N=12 210 participants), of which 6 examined potential modifiable predictors of depression following maltreatment. No more than two studies examined the same modifiable predictor; therefore, it was not possible to examine combined effects of modifiable predictors with meta-regression. It is thus difficult to draw firm conclusions from this study, but initial findings indicate that interpersonal relationships, cognitive vulnerabilities and behavioral difficulties may be modifiable predictors of depression following maltreatment. There is a lack of well-designed, prospective studies on modifiable predictors of depression following maltreatment. A small amount of initial research suggests that modifiable predictors of depression may be specific to maltreatment subtypes and gender. Corroboration and further investigation of causal mechanisms is required to identify novel targets for intervention, and to inform guidelines for the effective treatment of maltreated children

Effect of variations in dietary sodium intake on sodium excretion in mature rats

Effect of variations in dietary sodium intake on sodium excretion in mature rats. Sprague-Dawley rats weighing 400g or more were studied to determine whether their continued weight gain affects renal sodium handling. Rats maintained on a wide range of sodium intakes gained 3.9 ± 0.4 g/day. The intercept of a linear regression of intake against urinary excretion provided an estimate of the minimum daily requirement for sodium intake of 247 ±33 µEq/day. When more than this required amount was ingested, the animals excreted the excess quantitatively in the urine. When less was ingested they continued to gain weight at a slower rate, 1.6 ± 0.6 g/day, and remained in positive sodium balance. Nonetheless, they developed a sodium deficit manifested as retention of a sodium challenge. Thus, on an adequate dietary intake the normal physiological state of Sprague-Dawley rats of this size is one of chronic sodium retention rather than neutral sodium balance. In contrast, when inadequate sodium is ingested a deficit develops in the absence of external losses. These observations have important implications for the interpretation of studies of renal sodium handling in these animals.Effet de variations de l'apport sodé alimentaire sur l'excrétion sodique de rats matures. Des rats Sprague-Dawley pesant 400g ou plus ont été étudiés pour déterminer si leur prise de poids continue affecte l'élimination sodée rénale. Des rats maintenus à des apports sodés très variés gagnaient 3,9 ± 0,4 g/jour. L'interception de la régression linéaire de l'apport en fonction de l'excrétion sodée fournissait une estimation de l'apport quotidien minimum nécessaire en sodium, 247 ± 33 µEq/jour. Lorsque plus que cette quantité nécessaire était ingéré, les animaux excrétaient quantitativement cet excès dans les urines. Lorsqu'ils ingéraient moins, ils continuaient à prendre du poids plus lentement, 1,6 ± 0,6 g/jour, et restaient en balance sodée positive. Néanmoins, ils développaient un déficit sodé se manifestant par la rétention d'une surcharge sodée. Ainsi, lors d'un apport alimentaire adéquat, l'état physiologique normal des rats Sprague-Dawley de cette taille est une rétention chronique du sodium, plus qu'une balance sodée neutre. A l'opposé, lorsqu'insuffisamment de sodium est ingéré, un déficit se développe en l'absence de pertes externes. Ces observations ont des implications importantes pour l'interprétation des études de l'élimination rénale du sodium chez ces animaux

Intimate Partner Violence and Reproductive Health Among Methamphetamine-Using Women in Los Angeles: A Qualitative Pilot Study

Among women, methamphetamine (meth) use has been associated with intimate partner violence (IPV); however, few studies have looked at the context of IPV. This qualitative pilot study explored the experiences of meth-using women in Los Angeles County regarding (1) IPV in their most recent primary relationship, (2) use of contraception and reproductive health services, and (3) meth use during pregnancy. Participants (n=30) were recruited through community advertising and at 3 addiction treatment centers to participate in 15–20 minute, semi-structured interviews recorded with handwritten transcripts. The team analyzed transcripts for key themes. Participants reported IPV (n=19, 63%) as recipients (50%), perpetrators (40%), and/or both (27%), occurring mainly during active meth use or withdrawal. While most (n=25) continued meth use during at least one pregnancy, some (n=5, 17%) identified pregnancy as a motivation to quit or reduce use, suggesting an opportunity for intervention. Though most women knew about free and low-cost reproductive health services, few accessed them, with 33% citing aspects of meth use itself as a barrier. One third (45/133) of reported pregnancies were terminated by abortion. Most women (67%) began using before age 18, suggesting need for screening and intervention among adolescents