Sex hormone fluctuation and increased female risk for depression and anxiety disorders: From clinical evidence to molecular mechanisms

Frontiers in Neuroendocrinology, Journal Year: 2022, Volume and Issue: 66, P. 101010 - 101010

Published: June 15, 2022

Women are at twice the risk for anxiety and depression disorders as men are, although underlying biological factors mechanisms largely unknown. In this review, we address sex disparity both etiological mechanistic level. We dissect role of fluctuating hormones a critical factor contributing to increased in women. provide parallel evidence humans rodents that brain structure function vary with naturally-cycling ovarian hormones. This female-unique plasticity associated vulnerability primarily driven by estrogen level changes. For first time, hormone-driven molecular mechanism, namely chromatin organizational changes, regulates neuronal gene expression but may also prime (epi)genome psychopathology. Finally, map out future directions including experimental clinical studies will facilitate novel sex- gender-informed approaches treat disorders.

Language: Английский

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Zuranolone for the Treatment of Postpartum Depression

American Journal of Psychiatry, Journal Year: 2023, Volume and Issue: 180(9), P. 668 - 675

Published: July 26, 2023

Postpartum depression (PPD) is a common perinatal complication with adverse maternal and infant outcomes. This study investigated the efficacy safety of zuranolone, positive allosteric modulator synaptic extrasynaptic GABAA receptors neuroactive steroid, as an oral, once-daily, 14-day treatment course for patients severe PPD.In this double-blind phase 3 trial, women PPD were randomized in 1:1 ratio to receive zuranolone 50 mg/day or placebo 14 days. The primary endpoint was change from baseline total score on 17-item Hamilton Depression Rating Scale (HAM-D) at day 15; key secondary endpoints HAM-D days 3, 28, 45 Clinical Global Impressions severity (CGI-S) 15. Adverse events monitored.Among 196 (zuranolone, N=98; placebo, N=98), 170 (86.7%) completed 45-day study. Treatment compared resulted statistically significant improvement depressive symptoms 15 (least squares mean [LSM] score, -15.6 vs. -11.6; LSM difference, -4.0, 95% CI=-6.3, -1.7); also reported 45. CGI-S significantly improved placebo. most (≥10%) somnolence, dizziness, sedation. No loss consciousness, withdrawal symptoms, increased suicidal ideation behavior observed.In demonstrated improvements generally well tolerated, supporting potential novel, rapid-acting oral PPD.

Language: Английский

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Neuroanatomical changes observed over the course of a human pregnancy

Nature Neuroscience, Journal Year: 2024, Volume and Issue: 27(11), P. 2253 - 2260

Published: Sept. 16, 2024

Abstract Pregnancy is a period of profound hormonal and physiological changes experienced by millions women annually, yet the neural unfolding in maternal brain throughout gestation are not well studied humans. Leveraging precision imaging, we mapped neuroanatomical an individual from preconception through 2 years postpartum. Pronounced decreases gray matter volume cortical thickness were evident across brain, standing contrast to increases white microstructural integrity, ventricle cerebrospinal fluid, with few regions untouched transition motherhood. This dataset serves as comprehensive map human gestation, providing open-access resource for imaging community further explore understand brain.

Language: Английский

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Perioperative Adjunctive Esketamine for Postpartum Depression Among Women Undergoing Elective Cesarean Delivery

JAMA Network Open, Journal Year: 2024, Volume and Issue: 7(3), P. e240953 - e240953

Published: March 6, 2024

Importance Postpartum depression (PPD) is one of the most common mental health conditions during perinatal and postpartum periods, which can have adverse effects on both mother infant. Objective To investigate efficacy perioperative adjunctive esketamine administration after cesarean deliveries in prevention PPD. Design, Setting, Participants A single-center, double-blind, placebo-controlled, randomized clinical trial was conducted from January 1, 2022, to 2023, at Fujian Provincial Hospital among 298 women aged 18 40 years, with an American Society Anesthesiologists grade I III classification singleton full-term pregnancies who were scheduled for elective deliveries. Primary analyses performed a modified intention-to-treat basis. Interventions Patients randomly assigned (n = 148) control 150) groups. Those group received single intravenous injection 0.25 mg/kg immediately fetal delivery, followed by 50 mg as adjuvant patient-controlled analgesia 48 hours surgery. Saline given patients. Main Outcomes Measures The primary outcome assessments PPD symptoms using Edinburgh Postnatal Depression Scale (EPDS) day 7. Positive screening defined score 10 or more points EPDS. In addition, EPDS analyzed continuous variable evaluate depressive symptoms. Secondary outcomes included Numeric Rating (NRS) postoperative pain, along safety evaluations including events days 14, 28, 42. Results total pregnant included, 150 (median age, 31.0 years [IQR, 29.0-34.0 years]) 148 28.0-34.0 years]). prevalence significantly lower patients compared controls (23.0% [34 148] vs 35.3% [53 150]; odds ratio, 0.55; 95% CI, 0.33-0.91; P .02) also showed change scores (difference least-squares means [SE], −1.17 [0.44]; −2.04 −0.31; effect size, 0.74; .008). However, there no differences between groups incidence positive results changes baseline There NRS rest movement except 72 postoperatively, when (median, 3.0 2.0-3.0] 3.0-3.5]; median difference, 0 [95% 0-0]; .03). Conclusions Relevance These suggest that period delivery improve early period. this antidepression may not be universally applicable low scores. Trial Registration Chinese Clinical Registry Identifier: ChiCTR2100054199

Language: Английский

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Why the estrous cycle matters for neuroscience

Biology of Sex Differences, Journal Year: 2022, Volume and Issue: 13(1)

Published: Oct. 28, 2022

Abstract Background Ovarian hormone fluctuations over the rodent estrous cycle and human menstrual are known to significantly impact brain physiology disease risk, yet this variable is largely ignored in preclinical neuroscience research, clinical studies, psychiatric practice. Methods To assess importance of information for analysis sex differences we re-analyzed our previously published data with or without information, giving a side-by-side comparison analyses behavior, structure, gene expression, 3D genome organization female male mice. We also examined compared variance groups across all neurobehavioral measures. Results show that accounting increases resolution studies allows for: (a) identification masked differences; (b) mechanistic insight(s) into identified differences, different outcomes, from behavior molecular phenotypes. confirm previous findings either mixed- staged-female are, on average, not more than males. However, variability not, at all, predictive whether plays an important role regulating outcome interest. Conclusions argue “bringing back” main stage order enhance quality data, advance health women other menstruators, make research gender-inclusive. strongly encourage community incorporate their study design analysis, whenever possible, debunk some myths tend de-emphasize discourage inclusion critically biological variable. Highlights fluctuation impacts major risk factor, has been overlooked From regulation, allowing differences. Female does equal (and of) effect should be used as proxy effects ovarian hormones Neuroscience researchers advised foster equitable, female- gender-inclusive research. Studies especially improving women’s mental health.

Language: Английский

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Mapping global epidemiology of thyroid nodules among general population: A systematic review and meta-analysis

Frontiers in Oncology, Journal Year: 2022, Volume and Issue: 12

Published: Nov. 10, 2022

An emerging public health issue is brought on by the worldwide increase of thyroid nodules (TNs). The goal current study to determine global prevalence TNs among general population.We screened articles published from January 2000 May 2022. TN was calculated with DerSimonian-Laird random effects model arcsine transformation.A total 20,358 entries were found in our research, and 102 them met inclusion criteria. A 9,276,178 individuals have been diagnosed as TNs; overall 24.83% (95% CI 21.44-28.55), regardless diagnostic techniques. become more prevalent during 2012-2022 (29.29%) compared 2000-2011 (21.53%, p = 0.02). In addition, we discovered that women (36.51%) likely than men (23.47%, < 0.01). Interestingly, obesity correlated TNs. Additionally, age-specific-stratified results.This meta-analysis shows that, country development economic status, are spreading widely over world. Our findings showed a strong correlation between rising older age, female sex, elevated weight. To stop epidemic world, increased awareness, understanding disease, quick action required.

Language: Английский

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Perinatal mental health literacy: knowledge, attitudes, and help-seeking among perinatal women and the public – a systematic review

BMC Pregnancy and Childbirth, Journal Year: 2022, Volume and Issue: 22(1)

Published: July 19, 2022

Abstract Background The perinatal period is a time of increased vulnerability to mental health problems, however, only small proportion women seek help. Poor literacy (MHL) major barrier seeking help for problems. This study aimed collect the existing evidence MHL associated with problems (PMHP) among and public. review analysed which tools were used assess as well findings concerning individual components MHL. Methods Four electronic databases (PubMed, PsycINFO, Web Science, CINAHL) from their inception until September 1, 2020. Not quantitative studies reporting on (knowledge, attitudes, help-seeking), but also overall levels relating PMHP taken into account. Two independent reviewers involved in screening extraction process data descriptively. Results Thirty-eight 13,676 retrieved articles satisfied inclusion criteria. majority selected examined related ( N = 28). most frequently component set was help-seeking. A lack uniformity assessing found. common focus these postpartum depression. It found that ability recognize identify relevant symptoms lacking both Perinatal had low intentions preferred informal sources while variety structural personal barriers Stigmatizing attitudes Conclusions There need educational campaigns interventions improve public whole.

Language: Английский

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Neglected medium-term and long-term consequences of labour and childbirth: a systematic analysis of the burden, recommended practices, and a way forward

The Lancet Global Health, Journal Year: 2023, Volume and Issue: 12(2), P. e317 - e330

Published: Dec. 6, 2023

Over the past three decades, substantial progress has been made in reducing maternal mortality worldwide. However, historical focus on reduction accompanied by comparative neglect of labour and birth complications that can emerge or persist months years postnatally. This paper addresses these overlooked conditions, arguing their absence from global health agenda national action plans led to misconception they are uncommon unimportant. The limitation postnatal care services 6 weeks after is also a contributing factor. We reviewed epidemiological data medium-term long-term arising childbirth beyond weeks, along with high-quality clinical guidelines for prevention, identification, treatment. explore complex interplay human evolution, physiology, inherent predispositions contribute complications. offer actionable recommendations change current trajectories neglected conditions help achieve targets Sustainable Development Goal 3. third Series four papers about perinatal period beyond.

Language: Английский

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Effects of kangaroo mother care on maternal and paternal health: systematic review and meta-analysis

Bulletin of the World Health Organization, Journal Year: 2023, Volume and Issue: 101(06), P. 391 - 402

Published: June 1, 2023

To investigate the effect of kangaroo mother care for low-birth-weight and preterm infants on parents' mental physical health.

Language: Английский

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The impact of the Covid-19 pandemic on postnatal depression: analysis of three population-based national maternity surveys in England (2014–2020)

The Lancet Regional Health - Europe, Journal Year: 2023, Volume and Issue: 30, P. 100654 - 100654

Published: May 15, 2023

Few studies have evaluated postnatal depression before and during the Covid-19 pandemic using comparable data across time. We used from three national maternity surveys in England to compare prevalence risk factors for pandemic.Analysis was conducted population-based carried out 2014 (n = 4571), 2018 4509), 2020 4611). Weighted estimates (EPDS score ≥13) were compared surveys. Modified Poisson regression estimate adjusted ratios (aRR) association between sociodemographic, pregnancy- birth-related, biopsychosocial factors, depression.Prevalence of increased 10.3% 16.0% (difference +5.7% (95% CI: 4.0-7.4); RR 1.55 1.36-1.77)) 23.9% +7.9% 5.9-9.9); 1.49 1.34-1.66)). Having a long-term mental health problem (aRR range 1.48-2.02), antenatal anxiety 1.73-2.12) 1.44-2.24) associated with depression, whereas satisfaction birth 0.89-0.92) social support 0.73-0.78) decreased pandemic.This analysis indicates that had an important negative impact on women's may accelerated existing trend increasing depression. Risk consistent pandemic. Timely identification, intervention follow-up are key supporting women at risk, it is essential mechanisms strengthened times heightened such as pandemic.NIHR Policy Research Programme.

Language: Английский

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