The c.1460C>T Polymorphism of MAO-A Is Associated with the Risk of Depression in Postmenopausal Women

Objective. The aim of the study was an evaluation of possible relationships between polymorphisms of serotoninergic system genes and the risk of depression in postmenopausal women. Methods. We studied 332 women admitted to our department because of climacteric symptoms. The study group included 113 women with a diagnosis of depressive disorder according to the Hamilton rating scale for depression; the controls consisted of 219 women without depression. Serum 17β-estradiol concentrations were evaluated using radioimmunoassay, while polymorphisms in serotoninergic system genes: serotonin receptors 2A (HTR2A), 1B (HTR1B), and 2C (HTR2C); tryptophan hydroxylase 1 (TPH1) and 2 (TPH2), and monoamine oxidase A (MAO-A) were evaluated using polymerase chain reaction-restriction. Results. We found that the 1460T allele of MAO-A c.1460C>T (SNP 1137070) appeared with a significantly higher frequency in depressed female patients than in the control group (P = 0.011) and the combined c.1460CT + TT genotypes were associated with a higher risk of depression (P = 0.0198). Patients with the 1460TT genotype had a significantly higher 17β-estradiol concentration than patients with the 1460CT genotype (P = 0.0065) and 1460CC genotype (P = 0.0018). Conclusions. We concluded that depression in postmenopausal women is closely related to the genetic contribution of MAO-A

Females and Autism

Females with autism are often undiagnosed, misdiagnosed, or receive a diagnosis of autism at a later age than males. This can result in adverse outcomes in their well-being, mental health, education, employment, and independence. Furthermore, the autism spectrum in females is associated with adverse outcomes after puberty, including anxiety, depression, high incidence of suicide, eating disorders, and high rates of other medical problems. The term “autism spectrum disorder” (ASD) and “autism spectrum condition” (ASC) and autism are used interchangeably, including in the citations of this article, and in the article itself. The term “autism spectrum condition” (ASC), coined by Simon Baron-Cohen, is used in the literature to respect both females and males on the autism spectrum who feel that the term “disorder” is stigmatizing, whereas ASC presents both the strengths and difficulties of individuals on the autism spectrum. Autism has traditionally been considered a male-dominated diagnosis, and its current features linked with descriptions in the major diagnostic classification systems are based primarily on males. While researchers continue to question the epidemiology, prevalence, and presentation of autism, there is an emerging awareness and growing clinical recognition that autism in females has a unique symptomatology and may, in fact, be more common in this population than previously acknowledged. Cultural and social aspects may also impact on the autistic characteristics presented by autistic females. Autism may also manifest itself differently, and more subtly, especially in individuals who are not recognized early in life or who do not have profound intellectual or communication difficulties. The current diagnostic assessments have mainly been developed for an autistic male population, and thus may lack the required sensitivity to identify autistic females. It is argued that these assessments may have an inhibitory potential in confirming the diagnosis of autism in females, as they do not reflect the unique presentation of autism in females, demonstrated by greater compensatory capacity and an ability to develop sophisticated methods of “camouflaging” and masquerading in order to blend in with neurotypical peers. Sex and gender stereotypes and differences in patterns of autistic behavior may contribute to females being overlooked in a diagnostic setting. Timely diagnosis and support, however, can reduce the difficulties that females with autism experience. Timely diagnosis can reduce abuse, exploitation, and certain co-occurring conditions, allowing us to better inform females’ needs in education, leisure, social relationships, and employment, so as to promote their well-being and independence

Project Extension for Community Health Outcomes (ECHO) Autism: A Successful Model to Increase Capacity in Community-Based Care

Individuals with autism spectrum disorder (ASD) struggle to access high-quality health care due to the shortage of trained providers. ECHO (Extension for Community Healthcare Outcomes) Autism is a unique educational program that allows ASD experts to provide knowledge and skills to professionals in local communities to deliver evidence-based care to children with ASD and their families. The model teaches clinicians how to screen and diagnose ASD, as well as manage common co-occurring medical and mental health issues. ECHO Autism is particularly useful for addressing the complex needs of children with ASD and reducing disparities often present in rural and underserved communities. The model can be disseminated globally due to its flexibility in accommodating local and regional differences in social norms and constructs. This article provides an overview of the format of the ECHO Autism model, data supporting the model’s efficacy, and discusses future research directions