RESUMO
People with a migration background are a risk group for psychiatric disorders. Innovative, transnational and sustainable projects are necessary to ensure adequate care for refugees and asylum seekers. Selected projects of the University of Munich, the Charité Berlin and the University of Konstanz show promising approaches in addition to other initiatives.
Assuntos
Atenção à Saúde/organização & administração , Transtornos Mentais/terapia , Programas Nacionais de Saúde , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Doença Aguda , Assistência Ambulatorial/organização & administração , Serviços Médicos de Emergência/organização & administração , Etnopsicologia/organização & administração , Alemanha , Hospitais Psiquiátricos , Hospitais Universitários , Humanos , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Psicoterapia/organização & administração , Encaminhamento e Consulta/organização & administração , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologiaRESUMO
Prenatal exposure to maternal stress can have lifelong implications for psychological function, such as behavioral problems and even the development of mental illness. Previous research suggests that this is due to transgenerational epigenetic programming of genes operating in the hypothalamic-pituitary-adrenal axis, such as the glucocorticoid receptor (GR). However, it is not known whether intrauterine exposure to maternal stress affects the epigenetic state of these genes beyond infancy. Here, we analyze the methylation status of the GR gene in mothers and their children, at 10-19 years after birth. We combine these data with a retrospective evaluation of maternal exposure to intimate partner violence (IPV). Methylation of the mother's GR gene was not affected by IPV. For the first time, we show that methylation status of the GR gene of adolescent children is influenced by their mother's experience of IPV during pregnancy. As these sustained epigenetic modifications are established in utero, we consider this to be a plausible mechanism by which prenatal stress may program adult psychosocial function.
Assuntos
Metilação de DNA/genética , Regiões Promotoras Genéticas/genética , Receptores de Glucocorticoides/genética , Parceiros Sexuais/psicologia , Violência , Adolescente , Adulto , Criança , Proteína 1 de Resposta de Crescimento Precoce/genética , Proteína 1 de Resposta de Crescimento Precoce/metabolismo , Feminino , Humanos , Relação entre Gerações , Masculino , Troca Materno-Fetal/genética , Gravidez , Efeitos Tardios da Exposição Pré-Natal/genética , Receptores de Glucocorticoides/metabolismo , Receptores de Glucocorticoides/fisiologia , Estudos Retrospectivos , Adulto JovemRESUMO
The amount of weight that women are advised to gain during pregnancy has changed significantly in the past few decades. In the past, recommendations were aimed at curtailing weight gain because of problems surrounding delivery (i.e., cephalopelvic disproportion or toxemia). More recently, concern for development of maternal obesity has been used to justify curtailed weight gain. Factors that should be considered for determining the appropriate gain for an individual woman are discussed.
