Studies for prevalence and causal relationship established that addressing comorbidities of mental illnesses with medical disease will be another revolution in psychiatry. Increasing number of evidence shows that ther...Studies for prevalence and causal relationship established that addressing comorbidities of mental illnesses with medical disease will be another revolution in psychiatry. Increasing number of evidence shows that there is a bidirectional connection between mood disorders and some medical diseases. Glucocorticoid/insulin signal mechanisms and immunoenflammatory effector systems are junction points that show pathophysiology between bipolar disorder and general medical situations susceptible to stress. A subgroup of mood disorder patients are under risk of developing obesity and diabetes. Their habits and life styles, genetic predisposition and treatment options are parameters that define this subgroup. Medical disease in adults had a significant relationship to adverse life experiences in childhood. This illustrates that adverse experiences in childhood are related to adult disease by two basic etiologic mechanisms:(1) conventional risk factors that actually are compensatory behaviors, attempts at selfhelp through the use of agents and foods; and(2) the effects of chronic stress.展开更多
BACKGROUND The use of antidepressant therapy alone has a limited efficacy in patients with childhood trauma-associated major depressive disorder(MDD).However,the effectiveness of antidepressant treatment combined with...BACKGROUND The use of antidepressant therapy alone has a limited efficacy in patients with childhood trauma-associated major depressive disorder(MDD).However,the effectiveness of antidepressant treatment combined with psychodrama in these patients is unclear.AIM To evaluate the effectiveness of antidepressant treatment combined with psychodrama.METHODS Patients with childhood trauma-associated MDD treated with antidepressants were randomly assigned to either the psychodrama intervention(observation group)or the general health education intervention(control group)and received combination treatment for 6 mo.The observation group received general health education given by the investigator together with the“semi-structured group intervention model”of Yi Shu psychodrama.A total of 46 patients were recruited,including 29 cases in the observation group and 17 cases in the control group.Symptoms of depression and anxiety as well as coping style and resting-state functional magnetic resonance imaging were assessed before and after the intervention.RESULTS Symptoms of depression and anxiety,measured by the Hamilton Depression Scale,Beck Depression Inventory,and Beck Anxiety Inventory,were reduced after the intervention in both groups of patients.The coping style of the observation group improved significantly in contrast to the control group,which did not.In addition,an interaction between treatment and time in the right superior parietal gyrus node was found.Furthermore,functional connectivity between the right superior parietal gyrus and left inferior frontal gyrus in the observation group increased after the intervention,while in the control group the connectivity decreased.CONCLUSION This study supports the use of combined treatment with antidepressants and psychodrama to improve the coping style of patients with childhood trauma-associated MDD.Functional connectivity between the superior parietal gyrus and inferior frontal gyrus was increased after this combined treatment.We speculate that psychodrama enhances the internal connectivity of the cognitive control network and corrects the negative attention bias of patients with childhood trauma-associated MDD.Elucidating the neurobiological features of patients with childhood trauma-associated MDD is important for the development of methods that can assist in early diagnosis and intervention.展开更多
This review serves to analyze the relationship between childhood trauma and addiction;provide an overview of the science behind addiction;analyze issues with current addiction treatment methods and protocols;as well a...This review serves to analyze the relationship between childhood trauma and addiction;provide an overview of the science behind addiction;analyze issues with current addiction treatment methods and protocols;as well as to provide a list of proposed changes to modernize addiction treatment to a level of quality which will prove much more successful in the treatment of addicts.展开更多
Children from all walks of life are subjected to traumatic experiences.Having one traumatic experience,while unfortunate,generally does not have much impact on the child’s future,as one might expect.This review exami...Children from all walks of life are subjected to traumatic experiences.Having one traumatic experience,while unfortunate,generally does not have much impact on the child’s future,as one might expect.This review examines the long-term psychoneuroendocrinologocal implications of repeated or prolonged exposure to traumatic events during childhood,particularly during the formative years which include chronic illnesses,terminal illnesses,psychological disorders,neurological disorders,and more which has resulted in an average reduced life expectancy of 20-years.Proposed modifications for screening tools,prevention,and interventions are explained and introduced.In conclusion,this review proposes a modified and universal approach to screening,prevention,and treatment for those at high risk and those already afflicted by childhood trauma based on the latest in evidence-based research.展开更多
Background:Aggression is a commonly hostile behavior linked to the hippocampal activity.Childhood trauma(CT)exposure has been associated with altered sensitization of the hypothalamic-pituitary-adrenal(HPA)axis and hi...Background:Aggression is a commonly hostile behavior linked to the hippocampal activity.Childhood trauma(CT)exposure has been associated with altered sensitization of the hypothalamic-pituitary-adrenal(HPA)axis and hippocampal volumewhich could increase violent aggressive behaviors.Additionally,Catechol-O-methyltransferase(COMT),the major dopamine metabolism enzyme,is impli-cated in stress responsivity,including aggression.Hence,CT exposure may affect aggression through the effect on the hippocampal function,which might also be modulated by the COMT variations.Objectives:This study examined whether both CT and haplotypes of COMT moderate hippocampal function and thus affect human aggressive behavior.Methods:We obtained bilateral hippocampal functional connectivity maps using resting state functional magnetic resonance imag-ing(MRI)data.COMT haplotype estimation was performed using Haploview 4.2 and PHASE 2.1.Then we constructed a moderated mediation model to study the effect of the CTQ×COMT on aggressive behavior.Results:Three major haplotypes were generated from thirteen single nucleotide polymorphisms(SNPs)within the COMT gene and formed three haplotypes corresponding to high,medium,and low enzymatic activity of COMT.The results showed interactive re-lationships between the Childhood Trauma Questionnaire(CTQ)and COMT with respect to the functional connectivity(FC)of the bilateral hippocampus(HIP)-orbital frontal cortex(OFC).Specifically,CT experience predicted lower negative HIP-OFC coupling in the APS and HPS haplotypes corresponding to the medium and high enzymatic activity of COMT,but greater FC in the LPS haplotypes corresponding to the low enzymatic activity.We also observed a conditional mediation effect of the right HIP-OFC coupling in the link between COMT and aggressive behavior that was moderated by CT experience.Conclusions:These results suggest that CT and COMT have a combined effect on aggressive behavior through hippocampal function.This mediation analysis sheds light on the influence of childhood experience on aggressive behavior in different genetic backgrounds.展开更多
文摘Studies for prevalence and causal relationship established that addressing comorbidities of mental illnesses with medical disease will be another revolution in psychiatry. Increasing number of evidence shows that there is a bidirectional connection between mood disorders and some medical diseases. Glucocorticoid/insulin signal mechanisms and immunoenflammatory effector systems are junction points that show pathophysiology between bipolar disorder and general medical situations susceptible to stress. A subgroup of mood disorder patients are under risk of developing obesity and diabetes. Their habits and life styles, genetic predisposition and treatment options are parameters that define this subgroup. Medical disease in adults had a significant relationship to adverse life experiences in childhood. This illustrates that adverse experiences in childhood are related to adult disease by two basic etiologic mechanisms:(1) conventional risk factors that actually are compensatory behaviors, attempts at selfhelp through the use of agents and foods; and(2) the effects of chronic stress.
文摘BACKGROUND The use of antidepressant therapy alone has a limited efficacy in patients with childhood trauma-associated major depressive disorder(MDD).However,the effectiveness of antidepressant treatment combined with psychodrama in these patients is unclear.AIM To evaluate the effectiveness of antidepressant treatment combined with psychodrama.METHODS Patients with childhood trauma-associated MDD treated with antidepressants were randomly assigned to either the psychodrama intervention(observation group)or the general health education intervention(control group)and received combination treatment for 6 mo.The observation group received general health education given by the investigator together with the“semi-structured group intervention model”of Yi Shu psychodrama.A total of 46 patients were recruited,including 29 cases in the observation group and 17 cases in the control group.Symptoms of depression and anxiety as well as coping style and resting-state functional magnetic resonance imaging were assessed before and after the intervention.RESULTS Symptoms of depression and anxiety,measured by the Hamilton Depression Scale,Beck Depression Inventory,and Beck Anxiety Inventory,were reduced after the intervention in both groups of patients.The coping style of the observation group improved significantly in contrast to the control group,which did not.In addition,an interaction between treatment and time in the right superior parietal gyrus node was found.Furthermore,functional connectivity between the right superior parietal gyrus and left inferior frontal gyrus in the observation group increased after the intervention,while in the control group the connectivity decreased.CONCLUSION This study supports the use of combined treatment with antidepressants and psychodrama to improve the coping style of patients with childhood trauma-associated MDD.Functional connectivity between the superior parietal gyrus and inferior frontal gyrus was increased after this combined treatment.We speculate that psychodrama enhances the internal connectivity of the cognitive control network and corrects the negative attention bias of patients with childhood trauma-associated MDD.Elucidating the neurobiological features of patients with childhood trauma-associated MDD is important for the development of methods that can assist in early diagnosis and intervention.
文摘This review serves to analyze the relationship between childhood trauma and addiction;provide an overview of the science behind addiction;analyze issues with current addiction treatment methods and protocols;as well as to provide a list of proposed changes to modernize addiction treatment to a level of quality which will prove much more successful in the treatment of addicts.
文摘Children from all walks of life are subjected to traumatic experiences.Having one traumatic experience,while unfortunate,generally does not have much impact on the child’s future,as one might expect.This review examines the long-term psychoneuroendocrinologocal implications of repeated or prolonged exposure to traumatic events during childhood,particularly during the formative years which include chronic illnesses,terminal illnesses,psychological disorders,neurological disorders,and more which has resulted in an average reduced life expectancy of 20-years.Proposed modifications for screening tools,prevention,and interventions are explained and introduced.In conclusion,this review proposes a modified and universal approach to screening,prevention,and treatment for those at high risk and those already afflicted by childhood trauma based on the latest in evidence-based research.
基金supported by the Natural Science Foundation of China (Grant Nos 31600920,91232718,and 91132301)the Strategic Priority Research Program of the Chinese Academy of Sciences (Grant No.XDB02030300)+1 种基金the Natural Science Foundation of Guangdong Province (No.2019A1515012134)the Shenzhen Basic Research Project (Grant No.20220526002851001,JCYJ2017081802123707 and 20200807225058001)。
文摘Background:Aggression is a commonly hostile behavior linked to the hippocampal activity.Childhood trauma(CT)exposure has been associated with altered sensitization of the hypothalamic-pituitary-adrenal(HPA)axis and hippocampal volumewhich could increase violent aggressive behaviors.Additionally,Catechol-O-methyltransferase(COMT),the major dopamine metabolism enzyme,is impli-cated in stress responsivity,including aggression.Hence,CT exposure may affect aggression through the effect on the hippocampal function,which might also be modulated by the COMT variations.Objectives:This study examined whether both CT and haplotypes of COMT moderate hippocampal function and thus affect human aggressive behavior.Methods:We obtained bilateral hippocampal functional connectivity maps using resting state functional magnetic resonance imag-ing(MRI)data.COMT haplotype estimation was performed using Haploview 4.2 and PHASE 2.1.Then we constructed a moderated mediation model to study the effect of the CTQ×COMT on aggressive behavior.Results:Three major haplotypes were generated from thirteen single nucleotide polymorphisms(SNPs)within the COMT gene and formed three haplotypes corresponding to high,medium,and low enzymatic activity of COMT.The results showed interactive re-lationships between the Childhood Trauma Questionnaire(CTQ)and COMT with respect to the functional connectivity(FC)of the bilateral hippocampus(HIP)-orbital frontal cortex(OFC).Specifically,CT experience predicted lower negative HIP-OFC coupling in the APS and HPS haplotypes corresponding to the medium and high enzymatic activity of COMT,but greater FC in the LPS haplotypes corresponding to the low enzymatic activity.We also observed a conditional mediation effect of the right HIP-OFC coupling in the link between COMT and aggressive behavior that was moderated by CT experience.Conclusions:These results suggest that CT and COMT have a combined effect on aggressive behavior through hippocampal function.This mediation analysis sheds light on the influence of childhood experience on aggressive behavior in different genetic backgrounds.