The beginnings of mental illness, prenatal and early childhood_Research Roundup from APA Monitor

Here’s a sample of the new research findings assembled from multiple studies in a Feb/2012 issue of Monitor from the Am Psych Assn.  Among other things, notice the links being made between early trauma, the stress reactions prompted by such trauma, and how an early traumatic experience makes treatment for depression much harder.  The article also provides an overview of links between prenatal infections and both schizophrenia and autism, with an emphasis throughout on the impact of stress on the immune system and inflammation.

  • Alan Brown, MD, MPH, a professor of psychiatry and epidemiology at Columbia University and the New York State Psychiatric Institute, has found that a variety of early-life events significantly increase schizophrenia risk (Progress in Neurobiology, 2011). The risk is three times greater in people whose mothers had the flu during pregnancy, for example, while maternal iron deficiency during pregnancy increases the offspring’s risk of the disease fourfold. “These aren’t small effects,” Brown says.
  • Schizophrenia isn’t the only mental illness linked to prenatal events. Using data from a Dutch birth cohort, Brown found that people whose mothers were undernourished while pregnant had a significantly increased risk of major affective disorders, such as mania and depression, severe enough to require hospitalization (American Journal of Psychiatry, 2000).
  • A study by Charles Nemeroff, MD, PhD, of the University of Miami, and colleagues suggests that depressed people who experienced an adverse event in early life may be less likely to respond to SSRIs than depressed patients who did not endure an early-life stressor (Proceedings of the National Academy of Sciences, 2003). That makes sense if an overactive immune response is working against serotonin in the brain, Pace says. “If inflammation really is driving that problem, then something like Zoloft isn’t going to be as effective while inflammation is running wild.” For that reason, Pace says, “it’s important to get a sense of whether or not somebody has had an early-life traumatic experience.” Such a patient may be more likely to respond to psychotherapy than to antidepressants alone, for instance. Pace and other researchers are now exploring alternative therapies for reducing inflammation and treating depression. He has found evidence that compassion meditation decreases the stress hormone cortisol as well as inflammation, at least in healthy subjects (Psychoneuroendocrinology, 2009). Testing the technique in depressed patients is the next step.
  • Scientists are also investigating the use of anti-inflammatory drugs to treat depression, either alone or in conjunction with traditional antidepressants. Others have begun to test anti-inflammatories for treating autism and schizophrenia. The research is still in early stages, but initial results are promising, Patterson says. He predicts that it won’t be long before anti-inflammatory medications are prescribed to treat mood and behavioral disorders. “Watch out for those studies coming along,” he says. “If you modify the immune status, you should be able to modify behavior.”
  • Other researchers have shown that adverse events during pregnancy, including infections, toxin exposure and maternal stress, can boost the fetus’s future risk of problems such as depression, anxiety, autism, mood disorders and attention-deficit hyperactivity disorder. Events in early childhood are also linked to persistent mental health problems. Childhood maltreatment, for example, increases the odds of developing depression or post-traumatic stress disorder in adulthood.

READ IT ON APA’s Monitor:

via The beginnings of mental illness.

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