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1.
Clin Psychol Rev ; 112: 102463, 2024 Jun 27.
Article in English | MEDLINE | ID: mdl-38968690

ABSTRACT

Identifying factors that impact psychological treatment outcomes in older people with common mental health problems (CMHP) has important implications for supporting healthier and longer lives. The aim of the present study was to synthesise the evidence on predictors of psychological treatment outcomes in older people (aged 65+). PubMed, Scopus, Web of Science and PsycINFO were searched and 3929 articles were identified and screened, with 42 studies (N = 7978, M age = 68.9, SD age = 2.85) included: depression: k = 21, anxiety: k = 11, panic disorder: k = 3, mixed anxiety & depression: k = 3, PTSD: k = 2, various CMHP: k = 2, with CBT being the most common treatment (71%). The review identified 28 factors reported as significant predictors of treatment outcome in at least one study, across different domains: psychosocial (n = 9), clinical (n = 6), treatment-related (n = 6), socio-demographic (n = 4), neurobiological (n = 3). Homework completion was the most consistent predictor of positive treatment outcome. Baseline symptom severity was the most frequently studied significant predictor and across all conditions, with higher baseline symptom severity largely linked to worse treatment outcomes. No significant effects on treatment outcome were reported for gender, income and physical comorbidities. For a large majority of factors evidence was mixed or inconclusive. Further studies are required to identify factors affecting psychological treatment outcomes, which will be important for the development of personalised treatment approaches.

2.
BJPsych Open ; 10(1): e10, 2023 Dec 13.
Article in English | MEDLINE | ID: mdl-38088162

ABSTRACT

BACKGROUND: Psychoeducation is a common element in psychological interventions for youth depression and anxiety, but evidence about its use with youth perinatally is limited. AIMS: This review aims to understand outcomes and mechanisms of psychoeducation for the indicated prevention and treatment of perinatal depression and anxiety in youth. METHOD: For this review, we synthesised published quantitative and qualitative evidence. Seven databases (ASSIA, Medline, PubMed, PsycINFO, PsycArticles, Scopus and Web of Science) were searched for studies published before 10 August 2021. We also had consultations with a youth advisory group (N = 12). RESULTS: In total, 20 studies met the inclusion criteria. Seven quantitative studies examined multicomponent interventions that included psychoeducation, and one study evaluated psychoeducation as a standalone intervention for postnatal depression. Multicomponent interventions showed significant effects on postnatal depression in two out of six studies, as well as being effective at reducing prenatal anxiety in one study. Standalone psychoeducation for postnatal depression was also effective in one study. Evidence from 12 qualitative studies, corroborated by commentaries from the youth advisory group, suggested that psychoeducation could increase knowledge about symptoms, generate awareness of relevant services and enhance coping. CONCLUSIONS: Psychoeducation may be an important foundational ingredient of interventions for perinatal depression and, potentially, anxiety in adolescents and young adults through stimulating help-seeking and self-care.

3.
Glob Ment Health (Camb) ; 10: e73, 2023.
Article in English | MEDLINE | ID: mdl-38024806

ABSTRACT

Common mental health problems (particularly depression and anxiety) are common among adolescents during the perinatal period. Previous research has identified the distinctive needs of this group and called for contextually appropriate psychosocial interventions. The current study conducted in Malawi aimed to explore risk and protective factors for common mental health problems, and barriers to accessing mental health care, among perinatal adolescents, to develop a contextually relevant intervention for preventing and treating perinatal depression and anxiety. An exploratory qualitative study was conducted in antenatal and postnatal clinics in Zomba district, Malawi in January-March 2022. In-depth individual interviews were completed with perinatal adolescents aged ≤19 (n = 14); their family members (n = 4); and healthcare workers (n = 8). Interview data were subjected to thematic framework analysis. Data were organised around two themes: "psychosocial risk and protective factors" (potential causes of common mental health problems among adolescents); and "health care services" (maternal and mental health services available, and adolescents' experiences of using these services). Interventions need to go beyond targeting symptoms of depression and anxiety to addressing the wider contextual risk factors and barriers to care at the different socioecological levels.

4.
J Eur Acad Dermatol Venereol ; 37(10): 2028-2040, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37319102

ABSTRACT

BACKGROUND: Skin is a target organ and source of the corticotropin-releasing hormone-proopiomelanocortin (CRH-POMC) system, operating as a coordinator and executor of responses to stress. Environmental stress exacerbates and triggers inflammatory skin diseases through modifying the cellular components of the immune system supporting the importance of CRH-POMC system in the pathogenesis of psoriasis. The aim of this study was to analyse the association of CRH-POMC polymorphisms with psoriasis and evaluate transcript expression of lesional psoriatic and normal skin in RNA-seq data. METHODS: Samples of 104 patients with psoriasis and 174 healthy controls were genotyped for 42 single nucleotide polymorphisms (SNPs) of CRH-POMC using Applied Biosystems SNPlex™ method. The transcript quantification was performed using Salmon software v1.3.0. RESULTS: This study demonstrated the associations between melanocortin 1 receptor (MC1R) polymorphisms rs2228479, rs3212369, dopachrome tautomerase (DCT) polymorphisms rs7987802, rs2031526, rs9524501 and psoriasis in the Tatar population. Very strong association was evident for the SNP rs7987802 in the DCT gene (pc = 5.95е-006) in psoriasis patients. Additionally, the haplotype analysis provided AT DCT (rs7992630 and rs7987802) and AGA MC1R (rs3212358, 2228479 and 885479) haplotypes significantly associated (pc ˂ 0.05) with psoriasis in the Tatar population, supporting the involvement of DCT and MC1R to the psoriasis susceptibility. Moreover, MC1R-203 and DCT-201 expression levels were decreased in psoriasis lesional skin compared with healthy control skin. CONCLUSIONS: This study is the first to identify genetic variants of the MC1R and DCT genes significantly associated with psoriasis in Tatar population. Our results support potential roles of CRH-POMC system genes and DCT in the pathogenesis of psoriasis.


Subject(s)
Pro-Opiomelanocortin , Psoriasis , Humans , Pro-Opiomelanocortin/genetics , Pro-Opiomelanocortin/metabolism , Psoriasis/genetics , Psoriasis/metabolism , Skin/metabolism , Corticotropin-Releasing Hormone/genetics , Corticotropin-Releasing Hormone/metabolism , Receptor, Melanocortin, Type 1/genetics , Adrenocorticotropic Hormone/metabolism
5.
Longit Life Course Stud ; 13(3): 412-431, 2022 05 01.
Article in English | MEDLINE | ID: mdl-35920619

ABSTRACT

Background: Life course trajectories of affective symptoms (depression and anxiety) are heterogenous. However, few studies have investigated the role of early life risk factors in the development of these trajectories. The present study aimed to: (1) derive latent trajectories of affective symptoms over a period of more than 50 years (ages 13-69), and (2) examine early life risk factors for associations with specific life course trajectories of affective symptoms. Method: Participants are from the MRC National Survey of Health and Development (NSHD) (n = 5,362). Affective symptoms were measured prospectively at ages 13, 15, 36, 43, 53, 60-64 and 69. A latent variable modelling framework was implemented to model longitudinal profiles of affective symptoms. Twenty-four prospectively measured early life predictors were tested for associations with different symptom profiles using multinomial logistic regression. Results: Four life course profiles of affective symptoms were identified: (1) absence of symptoms (66.6% of the sample); (2) adolescent symptoms with good adult outcome (15.2%); (3) adult symptoms only (with no symptoms in adolescence and late life) (12.9%); (4) symptoms in adolescence and mid adulthood (5.2%). Of the 24 early life predictors observed, only four were associated with life course trajectories, with small effect sizes observed. Conclusions: People differ in their life course trajectories of anxiety and depression symptoms and that these differences are not largely influenced by early life factors tested in this study.


Subject(s)
Affective Symptoms , Life Change Events , Adolescent , Adult , Aged , Anxiety/epidemiology , Anxiety Disorders , Health Surveys , Humans , Middle Aged , Young Adult
6.
J Psychiatr Res ; 151: 217-224, 2022 07.
Article in English | MEDLINE | ID: mdl-35500449

ABSTRACT

Affective disorders are associated with accelerated cognitive ageing. However, current understanding of biological mechanisms which underlie these observed associations is limited. The aim of this study was to test: 1) Whether cortisol acts as a pathway in the association between depressive or anxiety symptoms across adulthood and midlife cognitive function; 2) Whether cortisol is associated with later depressive or anxiety symptoms, and cognitive function. Data were used from the National Child Development Study (NCDS), a sample of infants born in mainland UK during one week of 1958. A measure of the accumulation of affective symptoms was derived from data collected from age 23 to 42 using the Malaise Inventory Scale. Salivary cortisol measures were available at age 44-45. Cognitive function (memory, fluency, information processing) and affective symptoms were assessed at the age of 50. Path models were run to test whether salivary cortisol explained the longitudinal association between depressive or anxiety disorder symptoms and cognitive function. Direct effects of affective symptoms are shown across early to middle adulthood on cognitive function in midlife (memory and information processing errors). However, there were no effects of affective symptoms on cognitive function through cortisol measures. Additionally, cortisol measures were not significantly associated with subsequent affective symptoms or cognitive function at the age of 50. These results do not provide clear evidence to suggest that cortisol plays a role in the association between affective symptoms and cognitive function over this period of time. These findings contribute to our understanding of how the association between affective symptoms and cognitive function operates over time.


Subject(s)
Affective Symptoms , Hydrocortisone , Adult , Birth Cohort , Child , Cognition , Cohort Studies , Depression , Humans , Hydrocortisone/metabolism , Longitudinal Studies , Middle Aged , Young Adult
7.
J Affect Disord ; 295: 416-421, 2021 12 01.
Article in English | MEDLINE | ID: mdl-34507221

ABSTRACT

BACKGROUND: Childhood maltreatment, including neglect, can affect an individual's mental health. However, there is a gap in current literature investigating the long-term, dynamic effects of childhood neglect on adult affective symptoms (AS). METHOD: Data were used from the National Child Development Study (a British 1958 birth cohort). Childhood neglect was prospectively measured at ages 7 and 11. Five distinct trajectories of AS have been derived previously, using data from the Malaise Inventory Scale (at ages 23, 33, 42 and 50): 'no symptoms', 'persistent mild/moderate symptoms', 'low and increasing symptoms', 'high and increasing symptoms' and 'high and decreasing symptoms' (John et al., 2019). Multinomial logistic regressions were used to explore whether childhood neglect was associated with AS trajectory membership, while adjusting for a number of covariates. RESULTS: Results revealed that childhood neglect was significantly associated with 'high and decreasing', 'high and increasing' and 'persistent mild/moderate' AS trajectories from young adulthood through midlife. There was no association with the 'low and increasing' AS trajectory. When testing for at age specific effects, neglect experienced at age 7 only, or at age 11 only, was predictive of 'high and decreasing symptoms' trajectory, whereas neglect experienced at both ages was predictive of 'persistent mild/moderate symptoms' trajectory. CONCLUSIONS: Childhood neglect has negative long-lasting effects on trajectories of adult mental health. This finding has important implications for early intervention for individuals who have experienced childhood neglect.


Subject(s)
Affective Symptoms , Child Abuse , Adult , Child , Cohort Studies , Ethnicity , Humans , Longitudinal Studies , Mental Health , Middle Aged , Young Adult
8.
J Affect Disord ; 286: 267-274, 2021 05 01.
Article in English | MEDLINE | ID: mdl-33752041

ABSTRACT

BACKGROUND: Childhood neglect is more common within low-income families and can have long-term effects on mental health. Despite this, the extent to which it can mediate the well documented longitudinal inverse relationship between childhood socio-economic position (SEP) and adult affective symptoms is yet to be investigated. METHOD: Data (9595 males and 8959 females) from participants of the National Child Development Study (NCDS) were used to investigate the extent to which prospectively measured neglect mediates the relationship between SEP (age 11) and affective symptoms (ages 23 and 50). RESULTS: Neglect partially mediated the relationship between childhood SEP and affective symptoms at ages 23 (b = -0.02, [-0.02, -0.02]) and 50 (b = -0.02, [-0.02, -0.01]), after controlling for other family-related adversities. In addition, gender moderated the direct effect of SEP on affective symptoms at both ages 23 (b = -0.06, t = -4.87, [-0.08, -0.03]) and 50 (b = -0.05, t = -3.86, [-0.07, -0.02]), with the relationship being stronger for females; but did not moderate the indirect effect of neglect at either age 23 (b = 0.01, t = 1.09 [-0.01, 0.02]) or 50 (b = 0.00, t = -0.60 [-0.02, 0.01]). CONCLUSIONS: Neglect in childhood should be viewed as having serious implications for the mental health of both men and women. Greater investments into social support interventions that reduce incidences of neglect are also warranted.


Subject(s)
Adult Survivors of Child Abuse , Child Abuse , Adult , Affective Symptoms , Child , Female , Humans , Male , Mental Health , Middle Aged , Poverty , Young Adult
9.
Aging Ment Health ; 25(9): 1642-1648, 2021 09.
Article in English | MEDLINE | ID: mdl-32363904

ABSTRACT

OBJECTIVES: There is an association between affective symptoms and cognition. However, the direction of this association remains unclear. This study aimed to test bidirectional relationships between affective symptoms and cognition from middle to late adulthood. METHOD: Data were available from the MRC National Survey of Health and Development (NSHD), a prospective birth cohort of 5362 people born in 1946. Affective symptoms and cognition were measured at ages 53, 60-64, and 69. Latent scores of affective symptoms were derived and cross-lagged models were fitted for affective symptoms with verbal memory and processing speed. RESULTS: Results revealed an inverse cross-sectional association between affective symptoms and verbal memory (ß=-0.18, SE=0.04, p<.001) and processing speed (ß=-0.13, SE=0.06, p=.05) at age 53, but not at ages 60-64 or 69. Affective symptoms at age 53 predicted lower verbal memory at age 60-64 (ß=-0.58, SE=0.27, p=.03), and affective symptoms at age 60-64 predicted lower verbal memory (ß=-0.64, SE=0.29, p=.03) and processing speed (ß=-1.27, SE=0.41, p=.002) at age 69. Verbal memory and processing speed did not predict subsequent affective symptoms. CONCLUSION: Affective symptoms predict poorer verbal memory and processing speed over a period of 16 years, but not vice versa.


Subject(s)
Affective Symptoms , Cognition , Adult , Aged , Cohort Studies , Cross-Sectional Studies , Humans , Neuropsychological Tests , Prospective Studies
10.
Br J Psychiatry ; 218(5): 254-260, 2021 05.
Article in English | MEDLINE | ID: mdl-32662372

ABSTRACT

BACKGROUND: Affective symptoms are associated with cognition in mid-life and later life. However, the role of cardiometabolic risk in this association has not been previously examined. AIMS: To investigate how cardiometabolic risk contributes to associations between affective symptoms and mid-life cognition. METHOD: Data were used from the National Child Development Study (NCDS), a sample of people born in Britain during one week in 1958. Measures of immediate and delayed memory, verbal fluency and information processing speed and accuracy were available at age 50. Affective symptoms were assessed at ages 23, 33 and 42 years and a measure of accumulation was derived. A cardiometabolic risk score was calculated from nine cardiometabolic biomarkers at age 44. Path models were run to test these associations, adjusting for sex, education, socioeconomic position and affective symptoms at age 50. RESULTS: After accounting for missing data using multiple imputation, path models indicated significant indirect associations between affective symptoms and mid-life immediate memory (ß = -0.002, s.e. = 0.001, P = 0.009), delayed memory (ß = -0.002, s.e. = 0.001, P = 0.02) and verbal fluency (ß = -0.002, s.e. = 0.001, P = 0.045) through cardiometabolic risk. CONCLUSIONS: These findings suggest that cardiometabolic risk may play an important role in the association between affective symptoms and cognitive function (memory and verbal fluency). Results contribute to understanding of biological mechanisms underlying associations between affective symptoms and cognitive ageing, which can have implications for early detection of, and intervention for, those at risk of poorer cognitive outcomes.


Subject(s)
Cardiovascular Diseases , Cognitive Aging , Adult , Affective Symptoms , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Cognition , Cohort Studies , Humans , Longitudinal Studies , Middle Aged , Young Adult
11.
R Soc Open Sci ; 7(5): 191433, 2020 May.
Article in English | MEDLINE | ID: mdl-32537188

ABSTRACT

The transition from primary to secondary education is a critical period in early adolescence which is related to increased anxiety and stress, increased prevalence of mental health issues, and decreased maths performance, suggesting it is an important period to investigate maths attainment. Previous research has focused on anxiety and working memory as predictors of maths, without investigating any long-term effects around the education transition. This study examined working memory and internalizing symptoms as predictors of children's maths attainment trajectories (age 7-16) across the transition to secondary education using secondary longitudinal analysis of the Avon Longitudinal Study of Parents and Children (ALSPAC). This study found statistically significant, but very weak evidence for the effect of internalizing symptoms and working memory on maths attainment. Greater parental education was the strongest predictor, suggesting that children of parents with a degree (compared with those with a CSE) gain the equivalent of almost a year's schooling in maths. However, due to methodological limitations, the effects of working memory and internalizing symptoms on attainment cannot be fully understood with the current study. Additional research is needed to further uncover this relationship, using more time-appropriate measures.

12.
Ann Hum Biol ; 47(2): 116-124, 2020 Mar.
Article in English | MEDLINE | ID: mdl-32429762

ABSTRACT

Background: Little is known about what factors can modify the relationship between affective symptoms and cognitive function across the life course.Aim: To investigate a number of factors that can contribute to resilience in cognitive function in relation to affective symptoms, using data from the National Child Development Study.Subjects and methods: Adult affective symptoms were measured using the Malaise Inventory Scale (ages 23, 33, 42 and 50). Measures of immediate and delayed memory, verbal fluency and information processing accuracy (age 50) were used to derive measures of resilience in cognitive function-better than predicted cognition, when accounting for experiences of affective symptoms. Factors contributing to resilience in cognitive function were informed by a literature review and included sex, childhood cognitive ability, education, household socio-economic position (SEP), midlife SEP, and APOE genotype. Linear regression and structural equation modelling approaches were used for analyses.Results: Higher childhood cognitive ability, educational level, midlife SEP and female sex contributed to better than predicted cognitive function in relation to affective symptoms (i.e. resilience), with particularly consistent effects for memory. No effects on resilience were revealed for APOE genotype.Conclusion: Understanding factors contributing to resilience in cognitive function in those with affective symptoms can inform interventions to promote healthy cognitive ageing for those at risk.


Subject(s)
Affective Symptoms/psychology , Cognition , Resilience, Psychological , Adult , Age Factors , England , Humans , Middle Aged , Scotland , Wales , Young Adult
13.
Brain Behav Immun ; 84: 164-172, 2020 02.
Article in English | MEDLINE | ID: mdl-31785399

ABSTRACT

BACKGROUND: The aim of the present study was to test whether C-Reactive Protein (CRP), a proxy measure of inflammation, is elevated in people with higher childhood and adulthood affective symptoms and whether elevated CRP predicts midlife cognitive function. METHODS: Data were used from the National Child Development Study (n = 6276). Measures of memory, verbal fluency, information processing speed and accuracy were available in midlife (age 50). Affective symptoms were assessed in childhood (ages 7, 11, 16) and in adulthood (ages 23, 33, 42, 50). The level of plasma CRP was measured at age 44. Pathway models, unadjusted and fully adjusted for sex, education, childhood socioeconomic position, childhood cognitive ability and affective symptoms at age 50, were fitted to test direct associations between affective symptoms and midlife cognitive function, and indirect associations via the inflammatory pathway (CRP level). RESULTS: In a fully adjusted model, there were significant indirect associations between adulthood affective symptoms and immediate memory (ß = -0.01, SE = 0.003, p = .03) and delayed memory (ß = -0.01, SE = 0.004, p = .03) via CRP. In addition, there were significant indirect associations between affective symptoms in childhood and immediate memory (ß = -0.001, SE = 0.00, p = .03) and delayed memory (ß = -0.001, SE = 0.001, p = .03), via adulthood affective symptoms and associated CRP. Independent of CRP, there was a significant direct association between adulthood affective symptoms and information processing errors (ß = 0.47, SE = 0.21, p = .02). There were no direct or indirect associations between affective symptoms and verbal fluency or information processing speed. CONCLUSIONS: CRP at age 44 is elevated in people with higher affective symptoms from age 7 to 42, and elevated CRP is associated with poorer immediate and delayed memory at age 50.


Subject(s)
Affective Symptoms , C-Reactive Protein , Cognition Disorders , Inflammation , Adolescent , Adult , Affective Symptoms/etiology , C-Reactive Protein/analysis , Child , Cognition , Cognition Disorders/etiology , Humans , Inflammation/blood , Inflammation/complications , Memory , Middle Aged , Young Adult
14.
J Affect Disord ; 259: 424-431, 2019 12 01.
Article in English | MEDLINE | ID: mdl-31610999

ABSTRACT

BACKGROUND: Little is known about the link between affective symptoms and cognitive function across the life course. This study aims to investigate whether affective symptoms in adolescence and adulthood predict trajectories of cognitive function from middle to late-adulthood. METHODS: Data from the MRC National Survey of Health and Development (NSHD), a cohort of 5362 individuals born in mainland UK in 1946, were utilised. Linear mixed models were used to model cognitive trajectories (memory and processing speed) over a three-decade period (from 43 to 69) and to test effects of affective symptoms in adolescence (ages 13-15) and adulthood (ages 36 and 43) on cognitive function at first testing (age 43) and decline in cognitive function (from 43 to 69). Models were adjusted for sex, childhood cognition, childhood socioeconomic position, and education. RESULTS: A quadratic model best fitted memory and processing speed data. Models revealed that adolescent affective symptoms were associated with lower memory (b = -1.11, SE = 0.53, p = .04) and processing speed (b = -18.17, SE = 7.53, p = .02) at first cognitive testing, but not with rates of decline from 43 to 69. There were no significant associations between adult affective symptoms and cognitive trajectories. LIMITATIONS: Missing data is a potential limitation of this study. This was dealt with using maximum likelihood estimation and multiple imputation. CONCLUSIONS: Findings suggest that adolescent, but not adult, affective symptoms are important predictors of cognitive function in midlife, but not rate of cognitive decline. This highlights the importance of early intervention to manage mental health in adolescence to protect later cognitive function.


Subject(s)
Affective Symptoms/psychology , Cognitive Aging/psychology , Cognitive Dysfunction/psychology , Adolescent , Adult , Aged , Cognition , Cohort Studies , Female , Health Surveys , Humans , Male , Memory , Middle Aged , United Kingdom , Young Adult
15.
Br J Psychiatry ; 215(5): 675-682, 2019 11.
Article in English | MEDLINE | ID: mdl-30894229

ABSTRACT

BACKGROUND: Affective disorders are associated with poorer cognition in older adults; however, whether this association can already be observed in mid-life remains unclear. AIMS: To investigate the effects of affective symptoms over a period of 30 years on mid-life cognitive function. First, we explored whether timing (sensitive period) or persistence (accumulation) of affective symptoms predicted cognitive function. Second, we tested how different longitudinal trajectories of affective symptoms were associated with cognitive function. METHOD: The study used data from the National Child Development Study. Memory, verbal fluency, information processing speed and accuracy were measured at age 50. Affective symptoms were measured at ages 23, 33, 42 and 50 and used to derive longitudinal trajectories. A structured modelling approach compared a set of nested models in order to test accumulation versus sensitive period hypotheses. Linear regressions and structural equation modelling were used to test for longitudinal associations of affective symptoms with cognitive function. RESULTS: Accumulation of affective symptoms was found to be the best fit for the data, with persistent affective symptoms being associated with poorer immediate memory (b = -0.07, s.e. = 0.03, P = 0.01), delayed memory (b = -0.13, s.e. = 0.04, P < 0.001) and information processing accuracy (b = 0.18, s.e. = 0.08, P = 0.03), but not with information processing speed (b = 3.15, s.e. = 1.89, P = 0.10). Longitudinal trajectories of repeated affective symptoms were associated with poorer memory, verbal fluency and information processing accuracy. CONCLUSIONS: Persistent affective symptoms can affect cognitive function in mid-life. Effective management of affective disorders to prevent recurrence may reduce risk of poor cognitive outcomes and promote healthy cognitive ageing. DECLARATION OF INTEREST: None.


Subject(s)
Cognition Disorders , Cognitive Aging , Adult , Affective Symptoms , Aged , Child , Cognition , Humans , Longitudinal Studies , Memory Disorders , Middle Aged , Young Adult
16.
Behav Brain Res ; 360: 158-168, 2019 03 15.
Article in English | MEDLINE | ID: mdl-30472114

ABSTRACT

Despite evidence of a relationship between Apolipoprotein E (APOE) ε4+ and later-life cognitive decline, the lifespan effects of carrying an ε4+ allele on cognitive ageing are not well understood. Evidence of ε4+ advantages in early-life are inconsistent, but not inconsiderable. We explored the proposal that APOE ε4+ cognitive advantages arise only in response to complex and sensitive tasks targeting specific executive functions. We systematically manipulated executive demand within verbal fluency, decision-making, prospective memory, and sustained attention tasks. Participants aged 18-25 years (21 ε4+, 63 ε33) also completed a measure of subjective effort. Under low executive demand, ε4+ made fewer verbal fluency word repeats compared to ε33 carriers. Under high executive demand, ε4+ showed lower costs associated with performing concurrent tasks, greater switching errors, and more verbal fluency root repetition errors. Overall, ε4+ appeared to be showing working memory updating advantages under conditions of low executive demand, more effective resource allocation under elevated levels of executive demand, and errors indicating different strategy use compared to ε33 carriers, including speed-accuracy trade-offs.


Subject(s)
Apolipoproteins E/genetics , Decision Making/physiology , Executive Function/physiology , Genotype , Adolescent , Adult , Analysis of Variance , Attention/physiology , Female , Humans , Male , Memory, Episodic , Neuropsychological Tests , Photic Stimulation , Reaction Time/genetics , Verbal Behavior/physiology , Young Adult
17.
J Affect Disord ; 241: 348-355, 2018 12 01.
Article in English | MEDLINE | ID: mdl-30144717

ABSTRACT

BACKGROUND: Affective problems increase the risk of dementia and cognitive impairment, yet the life course dimension of this association is not clearly understood. We aimed to investigate how affective problems across the life course relate to later-life cognitive state. METHODS: Data from 1269 participants from the Medical Research Council National Survey of Health and Development (NSHD, the British 1946 birth cohort) were used. Prospectively-assessed measures of affective symptoms spanning ages 13-69 and categorised into case-level thresholds. Outcomes consisted of a comprehensive measure of cognitive state (Addenbrooke's Cognitive Examination (ACE-III)), verbal memory, and letter search speed and accuracy at age 69. RESULTS: Complementary life course models demonstrated that having 2 or more case-level problems across the life course was most strongly associated with poorer cognitive outcomes, before and after adjusting for sex, childhood cognition, childhood and midlife occupational position and education. LIMITATIONS: A disproportionate loss to follow-up of those who had lower childhood cognitive scores may have led to underestimation of the strength of associations. DISCUSSION: Using a population-based prospective study we provide evidence that recurrent lifetime affective problems predicts poorer later-life cognitive state, and this risk can be already manifest in early old age (age 69). Our findings raise the possibility that effective management to minimise affective problems reoccurring across the life course may reduce the associated risk of cognitive impairment and decline.


Subject(s)
Affective Symptoms/epidemiology , Cognition Disorders/epidemiology , Adolescent , Adult , Aged , Child , Cohort Studies , Ethnicity , Female , Follow-Up Studies , Health Surveys , Humans , Male , Middle Aged , Prospective Studies , Psychiatric Status Rating Scales , United Kingdom/epidemiology , Young Adult
18.
J Affect Disord ; 229: 437-442, 2018 03 15.
Article in English | MEDLINE | ID: mdl-29331705

ABSTRACT

BACKGROUND: Catechol-O-methyltransferase (COMT) polymorphisms play an essential role in dopamine availability in the brain. However, there has been no study investigating whether a functional four-SNP (rs6269-rs4633-rs4818-rs4680) haplotype is associated with affective symptoms over the life course. METHODS: We tested this using 2093 members of the Medical Research Council National Survey of Health and Development (MRC NSHD), who had been followed up since birth in 1946, and had data for COMT genotypes, adolescent emotional problems (age 13-15) and at least one measure of adult affective symptoms at ages 36, 43, 53, or 60-64 years. First, differences in the levels of affective symptoms by the functional haplotype using SNPs rs6269, rs4818, and rs4680 were tested in a structural equation model framework. Second, interactions between affective symptoms by COMT haplotype were tested under an additive model. Finally, a quadratic regressor (haplotype2) was used in a curvilinear model, to test for a possible inverted-U trend in affective symptoms according to COMT-related dopamine availability. RESULTS: Women had a significant interaction between COMT haplotypes and adolescent emotional problem on affective symptoms at age 53. Post hoc analysis showed a significant positive association between adolescent emotional problems and affective symptoms at age 53 years in the middle dopamine availability group (valA/valB or met/met; ß = .11, p = .007). For men, no significant interactions were observed. CONCLUSIONS: Combination of the COMT functional haplotype model and inverted-U model may shed light on the effect of dopaminergic regulation on the trajectory of affective symptoms over the life course.


Subject(s)
Affective Symptoms/genetics , Catechol O-Methyltransferase/genetics , Haplotypes/genetics , Adult , Dopamine , Female , Genotype , Humans , Male , Middle Aged , Models, Genetic , Polymorphism, Single Nucleotide , Prospective Studies , Recurrence
19.
Front Psychol ; 8: 1736, 2017.
Article in English | MEDLINE | ID: mdl-29075213

ABSTRACT

Very few molecular genetic studies of personality traits have used longitudinal phenotypic data, therefore molecular basis for developmental change and stability of personality remains to be explored. We examined the role of the monoamine oxidase A gene (MAOA) on extraversion and neuroticism from adolescence to adulthood, using modern latent variable methods. A sample of 1,160 male and 1,180 female participants with complete genotyping data was drawn from a British national birth cohort, the MRC National Survey of Health and Development (NSHD). The predictor variable was based on a latent variable representing genetic variations of the MAOA gene measured by three SNPs (rs3788862, rs5906957, and rs979606). Latent phenotype variables were constructed using psychometric methods to represent cross-sectional and longitudinal phenotypes of extraversion and neuroticism measured at ages 16 and 26. In males, the MAOA genetic latent variable (AAG) was associated with lower extraversion score at age 16 (ß = -0.167; CI: -0.289, -0.045; p = 0.007, FDRp = 0.042), as well as greater increase in extraversion score from 16 to 26 years (ß = 0.197; CI: 0.067, 0.328; p = 0.003, FDRp = 0.036). No genetic association was found for neuroticism after adjustment for multiple testing. Although, we did not find statistically significant associations after multiple testing correction in females, this result needs to be interpreted with caution due to issues related to x-inactivation in females. The latent variable method is an effective way of modeling phenotype- and genetic-based variances and may therefore improve the methodology of molecular genetic studies of complex psychological traits.

20.
J Affect Disord ; 218: 105-114, 2017 08 15.
Article in English | MEDLINE | ID: mdl-28463711

ABSTRACT

BACKGROUND: The prevalence of divorce in Western countries has increased in recent decades. However, there is no recent systematic review and/or meta-analysis of studies testing for long-term effects of parental divorce on offspring affective disorders. The present study conducted a systematic review and meta-analysis of studies published since 1980 testing for the association between parental divorce and offspring depression and anxiety in adulthood. METHOD: PUBMED, Science Direct, Medline, PsychInfo, and PsychArticles databases were searched for eligible studies. Random-effect meta-analyses were used to synthesize effect sizes and to test whether associations of parental divorce with offspring affective disorders differed among three publication periods (i.e., before 1996, 1996-2005, 2006-2015). RESULTS: In total, 29 studies were eligible for the systematic review, and 18 studies were included in the meta-analyses (depression: n=21,581; anxiety: n=2472). There was significant association between parental divorce and offspring depression (OR=1.56; 95%CI [1.31, 1.86]), but not anxiety (OR=1.16; 95%CI [0.98, 1.38]). The effect of parental divorce on offspring depression was not weaker in the reports published in more recent decades. LIMITATIONS: There is limited research in relation to offspring anxiety in adulthood. CONCLUSIONS: Parental divorce is associated with an increased risk of adult offspring depression, with no indication of the effect being weaker in recent publications.


Subject(s)
Adult Children/psychology , Anxiety/psychology , Depression/psychology , Divorce/psychology , Mood Disorders/psychology , Adult , Female , Humans , Male , Parents/psychology , Time
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