Transient Gastric Irritation in the Neonatal Rats Leads to Changes in Hypothalamic CRF Expression, Depression- and Anxiety-Like Behavior as Adults

A disturbance of the brain-gut axis is a prominent feature in functional bowel disorders (such as irritable bowel syndrome and functional dyspepsia) and psychological abnormalities are often implicated in their pathogenesis. We hypothesized that psychological morbidity in these conditions may result from gastrointestinal problems, rather than causing them.Functional dyspepsia was induced by neonatal gastric irritation in male rats. 10-day old male Sprague-Dawley rats received 0.1% iodoacetamide (IA) or vehicle by oral gavage for 6 days. At 8-10 weeks of age, rats were tested with sucrose preference and forced-swimming tests to examine depression-like behavior. Elevated plus maze, open field and light-dark box tests were used to test anxiety-like behaviors. ACTH and corticosterone responses to a minor stressor, saline injection, and hypothalamic CRF expression were also measured.Behavioral tests revealed changes of anxiety- and depression-like behaviors in IA-treated, but not control rats. As compared with controls, hypothalamic and amygdaloid CRF immunoreactivity, basal levels of plasma corticosterone and stress-induced ACTH were significantly higher in IA-treated rats. Gastric sensory ablation with resiniferatoxin had no effect on behaviors but treatment with CRF type 1 receptor antagonist, antalarmin, reversed the depression-like behavior in IA-treated ratsThe present results suggest that transient gastric irritation in the neonatal period can induce a long lasting increase in depression- and anxiety-like behaviors, increased expression of CRF in the hypothalamus, and an increased sensitivity of HPA axis to stress. The depression-like behavior may be mediated by the CRF1 receptor. These findings have significant implications for the pathogenesis of psychological co-morbidity in patients with functional bowel disorders

Social and occupational factors associated with psychological distress and disorder among disaster responders: a systematic review

BACKGROUND: When disasters occur, there are many different occupational groups involved in rescue, recovery and support efforts. This study aimed to conduct a systematic literature review to identify social and occupational factors affecting the psychological impact of disasters on responders. METHODS: Four electronic literature databases (MEDLINE®, Embase, PsycINFO® and Web of Science) were searched and hand searches of reference lists were carried out. Papers were screened against specific inclusion criteria (e.g. published in peer-reviewed journal in English; included a quantitative measure of wellbeing; participants were disaster responders). Data was extracted from relevant papers and thematic analysis was used to develop a list of key factors affecting the wellbeing of disaster responders. RESULTS: Eighteen thousand five papers were found and 111 included in the review. The psychological impact of disasters on responders appeared associated with pre-disaster factors (occupational factors; specialised training and preparedness; life events and health), during-disaster factors (exposure; duration on site and arrival time; emotional involvement; peri-traumatic distress/dissociation; role-related stressors; perceptions of safety, threat and risk; harm to self or close others; social support; professional support) and post-disaster factors (professional support; impact on life; life events; media; coping strategies). CONCLUSIONS: There are steps that can be taken at all stages of a disaster (before, during and after) which may minimise risks to responders and enhance resilience. Preparedness (for the demands of the role and the potential psychological impact) and support (particularly from the organisation) are essential. The findings of this review could potentially be used to develop training workshops for professionals involved in disaster response. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40359-016-0120-9) contains supplementary material, which is available to authorized users

Prevention and treatment of PTSD following childbirth: neurobiological perspectives

Background: Traumatic birth experiences may give rise to PTSD following childbirth (PTSD-FC). The perinatal period is associated with neurobiological alterations in HPA axis- and oxytocinergic systems also implicated in the response to trauma. However, little is known about neurobiological alterations in PTSD-FC and how these may play a role in the prevention and treatment of PTSD-FC. Recent research indicates a potential role for oxytocin. Aim and Objectives: To provide a synthesis of evidence on epidemiology, prevention, and treatment of PTSD-FC including neurobiological alterations and treatment-potential of hormones such as oxytocin. Method: Literature searches were performed in PubMed, Psychinfo, and Web of Science. Results: The prevalence for PTSD-FC ranges from 3-4% in community samples to up to 19% in high risk samples. Clinical trials in the treatment or prevention of PTSD-FC are scarce and do not include neurobiological alterations but the related domains of PTSD and the perinatal period provide findings relevant for PTSD-FC. A systematic search for exogenous oxytocin trials in women with PTSD-FC generated no findings. However, direct neurobiological and psychological effects of oxytocin were positive in trials with PTSD patients albeit negative in trauma-exposed individuals. In postpartum women an oxytocin-related increase of neural processing in reward-related areas was found as well as improved therapist- and infant relationships in women with postpartum depression although their mood worsened. Interpretation: Knowledge of epidemiological factors of PTSD-FC is adequate but research of treatment and prevention of PTSD-FC is scarce and lacks neurobiological data. Exogenous oxytocin has not been studied in PTSD-FC but treatment-relevant neurobiological and psychological changes have been found in PTSD and postpartum depression although negative oxytocin findings should also be acknowledged. Conclusions: This review provides recommendations and cautionary notes for future research into the neurobiological aspects of preventing and treating PTSD-FC

The reason why orthopaedic surgeons perform total knee replacement: results of a randomised study using case vignettes

10.1007/s00167-015-3961-5KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY2482697-270

Does Mindful Parenting Mediate the Association between Maternal Anxiety during Pregnancy and Child Behavioral/Emotional Problems?

© 2019, The Author(s). Objectives: Maternal anxiety during pregnancy is a risk factor for child behavioral/emotional problems. Knowledge about explanatory factors mediating this link is scarce. Maternal anxiety during pregnancy may be an indicator of adverse postnatal environmental conditions, including maternal anxiety and poor parenting, possibly affecting child behavior. This study investigated whether maternal anxiety and mindful parenting in early childhood mediate the association between maternal anxiety during pregnancy and child behavioral/emotional problems. Methods: This study was based on a sample of 118 mother-child dyads who participated in a cohort study that followed participants from pregnancy until 4 years after birth. At 21 weeks’ gestation and when the child was 4 years old, mothers completed questionnaires to assess state anxiety (State-Trait Anxiety Inventory) and general anxiety (Symptom Checklist-90 anxiety subscale). At age 4 years, mothers reported mindful parenting (Interpersonal Mindfulness in Parenting Scale) and child behavioral/emotional problems (Child Behavior Checklist). Results: Maternal state anxiety during pregnancy was positively associated with child internalizing problems and negatively with mindful parenting. Maternal general anxiety during pregnancy was related with more child internalizing and externalizing problems but not with mindful parenting. The association between maternal state anxiety during pregnancy and child internalizing problems was sequentially mediated via concurrent maternal general anxiety and mindful parenting. Conclusions: These findings suggest that maternal anxiety during pregnancy continues into early childhood and, because of this, it subsequently affects child internalizing behavior via poor mindful parenting. Replication studies are needed before developing interventions for tackling maternal anxiety during pregnancy and promoting mindful parenting.status: Published onlin