Infection Polygenic Factors Account for a Small Proportion of the Relationship Between Infections and Mental Disorders.

BACKGROUND: Several recent studies have suggested a role for infections in the development of mental disorders; however, the genetic contribution to this association is understudied. METHODS: We use the iPSYCH case-cohort genotyped sample (n = 65,534) and Danish health care registry data to study the genetic association between infections and mental disorders. To test the hypothesis that these associations are due to genetic pleiotropy, we estimated the genetic correlation between infection and mental disorders. Polygenic risk scores (PRSs) were used to assess whether genetic pleiotropy of infections and mental disorders was mediated by actual infection diagnoses. RESULTS: We observed that schizophrenia, attention-deficit/hyperactivity disorder, major depressive disorder, bipolar disorder, and posttraumatic stress disorder (rg ranging between 0.18 and 0.83), but not autism spectrum disorder and anorexia nervosa, were significantly genetically correlated with infection diagnoses. PRSs for infections were associated with modest increase in risk of attention-deficit/hyperactivity disorder, major depressive disorder, and schizophrenia in the iPSYCH case-cohort (hazard ratios = 1.04 to 1.10) but was not associated with risk of anorexia, autism, or bipolar disorder. Using mediation analysis, we show that infection diagnoses account for only a small proportion (6%-14%) of the risk for mental disorders conferred by infection PRSs. CONCLUSIONS: Infections and mental disorders share a modest genetic architecture. Infection PRSs can predict risk of certain mental disorders; however, this effect is moderate. Finally, recorded infections partially explain the relationship between infection PRSs and mental disorders.

Associations of Maternal Diabetes During Pregnancy With Psychiatric Disorders in Offspring During the First 4 Decades of Life in a Population-Based Danish Birth Cohort.

Importance: Maternal diabetes has been suggested as a risk factor for attention-deficit/hyperactivity disorder and autism in offspring, but evidence on its association with the full spectrum of psychiatric disorders remains lacking. Objective: To investigate the associations between maternal diabetes diagnosed before or during pregnancy and 10 types of psychiatric disorders in offspring during the first 4 decades of life. Design, Setting, and Participants: This population-based cohort study used data from several Danish nationwide medical and administrative registries in Denmark on all 2 413 335 live births from 1978 to 2016. Data were analyzed between October 1, 2019, and July 15, 2021. Exposures: Any maternal diabetes diagnosis during pregnancy (56 206 offspring [2.3%]) and 3 diabetes subtypes (pregestational type 1 diabetes, 22 614 offspring [1.0%]; pregestational type 2 diabetes, 6713 offspring [0.3%]; and gestational diabetes, 26 879 offspring [1.1%]). Main Outcomes and Measures: Outcomes included 10 types of psychiatric disorders: any psychiatric disorder, substance use disorders, schizophrenia, mood disorders, anxiety disorders, eating disorders, personality disorders, intellectual disorders, developmental disorders, and behavioral disorders. Hazard ratios (HRs) and 95% CIs were computed using Cox proportional hazards regression models. Covariates included maternal and paternal history of any psychiatric disorder, offspring sex, calendar period of birth, singleton status, and several maternal characteristics during pregnancy (ie, age, parity, educational level, smoking, cohabitation, residence, and body mass index). Sibship design and competing risk analyses were also conducted. Results: A total of 2 413 335 individuals (1 239 148 male participants [51%]; age range, 1-39 years; median age, 19.0 years [IQR, 5.8-20.8 years]) were included in this study. During the 39-year follow-up time, 151 208 offspring (6.4%) received a diagnosis of a psychiatric disorder. Offspring born to mothers with any diabetes diagnosis during pregnancy were at increased risk of developing any psychiatric disorder (HR, 1.15; 95% CI, 1.10-1.20), schizophrenia (HR, 1.55; 95% CI, 1.15-2.08), anxiety disorders (HR, 1.22; 95% CI, 1.09-1.36), intellectual disabilities (HR, 1.29; 95% CI, 1.11-1.50), developmental disorders (HR, 1.16; 95% CI, 1.03-1.30), and behavioral disorders (HR, 1.17; 95% CI, 1.08-1.27) compared with offspring born to mothers without a diabetes diagnosis during pregnancy. No association was observed for substance use disorders, mood disorders, eating disorders, and personality disorders. Conclusions and Relevance: This study shows a pattern that suggests that prenatal exposure to maternal diabetes during pregnancy was associated with increased risk of psychiatric disorders overall and most specific psychiatric disorders in offspring in their first 4 decades of life.

Policy and Food Consumption: What Nutrition Guidelines Are Swiss Children Meeting and What Determines Adherence?

Objectives: To describe the adherence of the children to the Swiss Society for Nutrition (SSN) dietary guidelines, assess determinants of adherence, and compare these findings with a previous study in the same population. Methods: Data from 312 children ages 5-12 were collected through a survey and a 2-day food record. The associations of children- and parent-related factors with adherence of the children to guidelines were assessed by logistic regression analyses. Results: SSN guidelines were not met for any food category, although there were improvements: vegetables (4.5% in this study vs. 0% in the previous study), sweets, snacks, and soft drinks (SSD) (12.5 vs. 9.5%), and fruit (45.5 vs. 10.4%). Higher Body Mass Index (BMI) in children was associated with higher adherence to guidelines for protein intake. Higher parental BMI was associated with higher adherence to vegetables. Parental lower educational level was associated with higher adherence for cereal. Conclusion: Despite improvements since the last eating behavior assessment in this population, children consume too little fruit, vegetables, cereal, and milk and dairy products, and too much SSD and proteins. Further efforts are needed to promote healthy eating to children and achieve adherence to guidelines.

Longitudinal Associations Between Sexual Communication With Friends and Sexual Behaviors Through Perceived Sexual Peer Norms.

The role of peers in adolescents' sexual behaviors is not yet fully understood. We investigated the association between sexual communication with friends (at T1) and subsequent changes in adolescents' experience with sexual behaviors (between T1-T3), and examined whether this association was explained by adolescents' perceptions of three sexual peer norms (at T2): (1) peers' sexual behaviors (descriptive norms), (2) peers' approval of sexual behaviors (injunctive norms), and (3) peer pressure to have sex. The data source was Project STARS, a longitudinal study on adolescent sexual development in the Netherlands, collected via online self-report questionnaires from 1,116 adolescents (11.5-17.9 years). Adolescents who communicated more frequently with their friends about sexuality-related topics at T1 reported significantly larger increases in their experience with different sexual behaviors between T1-T3. More sexual communication with friends also predicted adolescents subsequently perceiving more 1) peer sexual behaviors, 2) peer approval of sex, and 3) peer pressure to have sex. These stronger perceptions, in turn, predicted larger increases in their sexual behaviors between T1-T3. After adjusting for the three norms simultaneously, the main association between sexual communication with friends and sexual behavior change weakened but remained significant. Inspection of specific indirect effects showed this link was explained by injunctive norms only. No gender differences were found.

Bidirectional Associations Between Adolescents' Sexual Behaviors and Psychological Well-Being.

PURPOSE: Assessing bidirectional longitudinal associations between early sexual behaviors (≤16.0 years) and psychological well-being (global self-esteem, physical self-esteem, depression) among 716 adolescents, and the direct and buffering effect of parent-adolescent relationship quality. METHODS: We used data from Project STARS (Studies on Trajectories of Adolescent Relationships and Sexuality), a longitudinal study on adolescent sexual development in the Netherlands. Participants were 11.0-16.0 years old (mean age at T1 = 13.3 years). Self-reports from four waves of online questionnaires were used. Bidirectional longitudinal associations were assessed by linear mixed-effects models. RESULTS: At most waves, boys had significantly higher levels of psychological well-being than girls, but genders did not differ in experience with sexual behaviors. Engagement in early sexual behaviors did not predict lower levels of psychological well-being over time, and lower levels of psychological well-being did not predict more engagement in early sexual behaviors over time. Parent-adolescent relationship quality did not moderate these associations in either direction, although we found a significant direct effect, in which a higher-quality parent-adolescent relationship predicted more optimal levels of the three indicators of adolescents' psychological well-being (but not lower levels of early sexual activity) over time. CONCLUSIONS: Our results show that, among Dutch adolescents, early sexual behaviors and psychological well-being were not interrelated. This may be explained by socio-cultural aspects of the Dutch society, such as more normalization of sexual behaviors during adolescence. As a result, early sexual activity in and of itself was not related to lower psychological well-being over time. Yet, cross-cultural differences in links between adolescents' sexuality and well-being should be further investigated.

Mother- and Father-Adolescent Relationships and Early Sexual Intercourse.

OBJECTIVES: To assess the prospective associations between mother-adolescent and father-adolescent relationship quality and early sexual intercourse initiation (ie, ≤16 years) among a large sample of Dutch adolescents. METHODS: Two waves of data from the Rotterdam Youth Monitor, a longitudinal study in the Netherlands, were used. The analysis sample consisted of 2931 adolescents aged 12 to 16 years (Meanage@T1 = 12.5 years, SD = 0.61; Meanage@T2 = 14.3 years, SD = 0.60). Variables were assessed by means of self-report questionnaires. Prospective associations between mother-adolescent and father-adolescent relationships and early sexual initiation were assessed by logistic regression analyses, stratified by gender, controlling for various potential confounders. RESULTS: We found that only girls (not boys) having a higher-quality relationship with mothers were significantly less likely to have initiated early sexual intercourse between T1 and T2. Bivariate findings showed that both girls and boys having a higher-quality relationship with their father at T1 were significantly less likely to have engaged in early sexual intercourse between T1 and T2, but when assessed multivariately, these associations were no longer significant, neither for boys nor for girls. CONCLUSIONS: Our findings suggest that a higher-quality relationship between adolescents and their parents, especially between mothers and daughters, may help to protect against early sexual initiation. Pediatricians and other health care professionals should be able to explain to parents that early sexual intercourse initiation can be associated with negative health outcomes, but that parents can play an important role in promoting healthy sexual behaviors.

Early Sexual Intercourse: Prospective Associations with Adolescents Physical Activity and Screen Time.

OBJECTIVES: To assess the prospective associations of physical activity behaviors and screen time with early sexual intercourse initiation (i.e., before 15 years) in a large sample of adolescents. METHODS: We used two waves of data from the Rotterdam Youth Monitor, a longitudinal study conducted in the Netherlands. The analysis sample consisted of 2,141 adolescents aged 12 to 14 years (mean age at baseline = 12.2 years, SD = 0.43). Physical activity (e.g., sports outside school), screen time (e.g., computer use), and early sexual intercourse initiation were assessed by means of self-report questionnaires. Logistic regression models were tested to assess the associations of physical activity behaviors and screen time (separately and simultaneously) with early sexual intercourse initiation, controlling for confounders (i.e., socio-demographics and substance use). Interaction effects with gender were tested to assess whether these associations differed significantly between boys and girls. RESULTS: The only physical activity behavior that was a significant predictor of early sexual intercourse initiation was sports club membership. Adolescent boys and girls who were members of a sports club) were more likely to have had early sex (OR = 2.17; 95% CI = 1.33, 3.56. Significant gender interaction effects indicated that boys who watched TV ≥2 hours/day (OR = 2.00; 95% CI = 1.08, 3.68) and girls who used the computer ≥2 hours/day (OR = 3.92; 95% CI = 1.76, 8.69) were also significantly more likely to have engaged in early sex. CONCLUSION: These findings have implications for professionals in general pediatric healthcare, sexual health educators, policy makers, and parents, who should be aware of these possible prospective links between sports club membership, TV watching (for boys), and computer use (for girls), and early sexual intercourse initiation. However, continued research on determinants of adolescents' early sexual initiation is needed to further contribute to the strategies for improving adolescents' healthy sexual development and behaviors.