Suggested move to plant-based diets risks worsening brain health nutrient deficiency

Suggested move to plant-based diets risks worsening brain health nutrient deficiency

And UK failing to recommend or monitor dietary levels of choline, warns nutritionist

August 29, 2019

Science Daily/BMJ

The momentum behind a move to plant-based and vegan diets for the good of the planet is commendable, but risks worsening an already low intake of an essential nutrient involved in brain health, warns a nutritionist in the online journal BMJ Nutrition, Prevention & Health.

To make matters worse, the UK government has failed to recommend or monitor dietary levels of this nutrient -- choline -- found predominantly in animal foods, says Dr Emma Derbyshire, of Nutritional Insight, a consultancy specialising in nutrition and biomedical science.

Choline is an essential dietary nutrient, but the amount produced by the liver is not enough to meet the requirements of the human body.

Choline is critical to brain health, particularly during fetal development. It also influences liver function, with shortfalls linked to irregularities in blood fat metabolism as well as excess free radical cellular damage, writes Dr Derbyshire.

The primary sources of dietary choline are found in beef, eggs, dairy products, fish, and chicken, with much lower levels found in nuts, beans, and cruciferous vegetables, such as broccoli.

In 1998, recognising the importance of choline, the US Institute of Medicine recommended minimum daily intakes. These range from 425 mg/day for women to 550 mg/day for men, and 450 mg/day and 550 mg/day for pregnant and breastfeeding women, respectively, because of the critical role the nutrient has in fetal development.

In 2016, the European Food Safety Authority published similar daily requirements. Yet national dietary surveys in North America, Australia, and Europe show that habitual choline intake, on average, falls short of these recommendations.

"This is....concerning given that current trends appear to be towards meat reduction and plant-based diets," says Dr Derbyshire.

She commends the first report (EAT-Lancet) to compile a healthy food plan based on promoting environmental sustainability, but suggests that the restricted intakes of whole milk, eggs and animal protein it recommends could affect choline intake.

And she is at a loss to understand why choline does not feature in UK dietary guidance or national population monitoring data.

"Given the important physiological roles of choline and authorisation of certain health claims, it is questionable why choline has been overlooked for so long in the UK," she writes. "Choline is presently excluded from UK food composition databases, major dietary surveys, and dietary guidelines," she adds.

It may be time for the UK government's independent Scientific Advisory Committee on Nutrition to reverse this, she suggests, particularly given the mounting evidence on the importance of choline to human health and growing concerns about the sustainability of the planet's food production.

"More needs to be done to educate healthcare professionals and consumers about the importance of a choline-rich diet, and how to achieve this," she writes.

"If choline is not obtained in the levels needed from dietary sources per se then supplementation strategies will be required, especially in relation to key stages of the life cycle, such as pregnancy, when choline intakes are critical to infant development," she concludes.

https://www.sciencedaily.com/releases/2019/08/190829184143.htm

Medical marijuana laws impact use among sexual minorities differently than heterosexuals

Daily marijuana use is seven times higher among bisexual women than heterosexual women

September 4, 2019

Science Daily/Columbia University's Mailman School of Public Health

Bisexual women had higher rates of past-year and daily marijuana use compared to heterosexual women, according to a study just published at Columbia University Mailman School of Public Health. Gay/lesbian women were also more likely to report daily marijuana use and past year medical marijuana use than heterosexual women. While previous research has explored the association between state-level medical marijuana laws (MMLs) and marijuana use (MU) and MU disorder (MUD) among the general U.S. population, this is the first to explore this relationship for lesbian, gay and bisexual (LGB) individuals, including gender differences. The findings are online in the journal Drug and Alcohol Dependence.

"Our work builds on the Institute of Medicine report highlighting the importance of conducting additional research on LGB populations across the life course," said Morgan Philbin, PhD, assistant professor of Sociomedical Sciences at Columbia's Mailman School. ""While research has explored how LGB discrimination polices may impact substance use, less work has explored how substance use policies may impact LGB men and women differently than heterosexuals."

The researchers analyzed data from 126,463 adults 18 and older in the 2015-2017 National Survey on Drug Use and Health to study the odds of past-year marijuana use, any past-year medical marijuana use, daily/near-daily marijuana use, and marijuana use disorder. They also tested the interaction between residence in a state with medical marijuana laws and sexual identity.

When the researchers examined the relationship between state MML status and MU outcomes they found that gay/lesbian women in MML states had higher daily/near-daily (300+ days/year) MU than gay/lesbian women in non-MML states while bisexual women in MML states had higher past-year use than bisexual women in non-MML states; both lesbian/gay and bisexual women in MML states had higher medical MU than those in non-MML states.

"We further extended these findings to estimate daily/near-daily MU prevalence, which was seven times higher among bisexual women than heterosexual women and 2.3 times as high for bisexual men compared to heterosexual men," noted Silvia Martins, MD, PhD, associate professor of Epidemiology and senior author.

Past-year marijuana use was 10 percent among heterosexual women, 26 percent among gay/lesbian women and 40 percent among bisexual women. Daily use was lower among heterosexual women (1.5 percent) compared to lesbians (6 percent) and bisexual women (10 percent). Similar patterns emerged for past-year marijuana use disorder.

Past-year marijuana use for medical reasons was reported by slightly more than one percent of heterosexual women, 5 percent of lesbian/gay women and 5.5 percent of bisexual women.

Compared to heterosexual men (17 percent), past-year use marijuana was higher among bisexual men, (30 percent) and gay men (29 percent). Daily marijuana use among men was highest among bisexual men (9 percent) followed by gay (7 percent) and heterosexual men (4 percent). Any past-year medical marijuana use was 2 percent among heterosexual men, 5 percent among gay men and 4 percent among bisexual men.

Rates of daily marijuana use or marijuana use disorder for gay men did not differ significantly in states that had passed medical marijuana laws compared to states that had not passed these laws.

While beyond the scope of these analysis, the difference in policy effects of medical marijuana laws for bisexual women compared to heterosexual women may be a result of the high levels of stigma faced by bisexual women, according to the researchers. This could result in self-medication with medical marijuana even in states without MMLs if LGB adults are in part using marijuana to alleviate sexual minority stress.

"Our results support existing literature by demonstrating that bisexual women have higher marijuana use disorder compared to heterosexual women. This is part of a larger health burden, as bisexual women are twice as likely to have co-occurring mental health and substance use disorders yet often have little contact with service providers," observed Philbin.

"This study represents an important contribution to the literature on the structural determinants of substance use for LGB individuals and demonstrates the need to allocate resources that target sexual minority women, especially as medical marijuana laws and recreational marijuana laws continue to change at the state level," said Martins. "Future surveys that capture how individuals identify will help us pinpoint how state-level marijuana policies may differentially impact specific sub-populations, ultimately advancing the development of more health-promoting policies for all."

https://www.sciencedaily.com/releases/2019/09/190904113222.htm

Teens taking oral contraceptives may be at increased risk for depressive symptoms

October 2, 2019

Science Daily/Brigham and Women's Hospital

Investigators report that there was no association between oral contraceptive use and depressive symptom severity in the entire population they studied (ages 16 through 25). However, they found that 16-year-old girls reported higher depressive symptom severity compared with 16-year-old girls not using oral contraceptives.

Ever since birth control pills first became available, researchers have been trying to understand the connection between oral contraceptive use and mood. A new study led by investigators at Brigham and Women's Hospital and University Medical Center Groningen (UMCG) and Leiden University Medical Center in the Netherlands adds important, new information by surveying young women about depressive symptoms.

Depressive symptoms -- such as crying, sleeping excessively, and eating issues -- can be far subtler than diagnosed clinical depression. But by surveying a cohort of more than 1,000 women every three years, investigators have amassed a unique trove of data about these subclinical symptoms. In a study published in JAMA Psychiatry, investigators report that there was no association between oral contraceptive use and depressive symptom severity in the entire population they studied (ages 16 through 25). However, they found that 16-year-old girls reported higher depressive symptom severity compared with 16-year-old girls not using oral contraceptives.

"One of the most common concerns women have when starting the pill, and teens and their parents have when an adolescent is considering taking the pill, is about immediate depressive risks," said corresponding author Anouk de Wit, MD, PhD, MPH, in training, formerly of the Brigham's Department of Psychiatry. De Wit is now a trainee in the Department of Psychiatry at UMCG. "Most women first take an oral contraceptive pill as a teen. Teens have lots of challenging emotional issues to deal with so it's especially important to monitor how they are doing."

"Depressive symptoms are more prevalent than clinical depression and can have a profound impact on quality of life," said co-author Hadine Joffe, MD, MSc, vice chair for Psychiatry Research for the Brigham's Department of Psychiatry and executive director of the Connors Center for Women's Health and Gender Biology. "Ours is the first study of this scale to dive deep into the more subtle mood symptoms that occur much more commonly than a depression episode but impact quality of life and are worrying to girls, women and their families."

To conduct their study, de Wit, Joffe and colleagues analyzed data from female participants in the prospective cohort study, Tracking Adolescents' Individual Lives Survey (TRAILS), a longitudinal study of teens and young adults from the Netherlands. Each participant filled out a survey with questions about depressive symptoms, such as crying, eating, sleeping, suicidal ideation, self-harm, feelings of worthlessness and guilt, energy, sadness, and lack of pleasure. Their responses were used to generate a depressive symptom severity score.

Across the entire cohort of 1,010 participants ages 16 to 25 analyzed, the team found no association between oral contraceptive use and depressive symptom severity. However, they did find that, on average, 16-year-old participants who were using oral contraceptives had depressive symptom severity scores that were 21 percent higher than those who were not taking oral contraceptives. They reported more crying, more sleeping and more eating problems than their counterparts.

The authors note that the association between oral contraceptive use and depressive symptoms may be bidirectional: oral contraceptive use may contribute to symptom severity, more severe symptoms may prompt teens to begin taking oral contraceptives, or both. Observational studies, such as this one, cannot determine the direction of causality.

"Because of the study design, we can't say that the pills cause mood changes, but we do have evidence suggesting that sometimes the mood changes preceded the use of the pill and sometimes the pill was started before the mood changes occurred," said de Wit.

Another limitation that the authors note is that the Dutch are a relatively homogenous population -- it remains to be seen if these results would be the same in a more diverse population. The authors also point out several strengths to the study, including its large size and established, well-characterized cohort. In addition, the research focuses on symptoms that may be of concerns to teens, parents and clinicians.

"The magnitude of the association was small, and these depressive symptoms are mild enough that they did not constitute clinical or major depression. However, these mood changes were seen in oral contraceptive-using adolescents, who are a vulnerable population," said Joffe. "These concerns much be weighed against the bigger risk of lack of contraception leading to unintended pregnancies in teenagers and pregnancy complications including a potential postpartum depression."

Other forms of birth control known as long-acting reversible contraceptives (LARC), such as intrauterine devices (IUDs), deliver hormone exposure to the local uterine. The investigators are interested in following up to determine if hormone exposure that does not go throughout the whole body and brain is less associated with depressive symptoms.

"Oral contraceptive users, parents and health care providers should be aware of the increased likelihood of presence of depressive symptoms as it may affect quality of life and adherence to oral contraceptive use," said de Wit.

https://www.sciencedaily.com/releases/2019/10/191002110426.htm

Even mother's mild depressive symptoms affect the child's emotional well-being

September 23, 2019

Science Daily/National Institute for Health and Welfare

Even mild long-term depressive symptoms among mothers are connected with emotional problems among small children such as hyperactivity, aggressiveness and anxiet

According to recent research, even mild long-term depressive symptoms among mothers are connected with emotional problems among small children such as hyperactivity, aggressiveness and anxiety.

The study investigated how the depressive symptoms of both parents affected the child by the age of two and five.

The father's depressive symptoms affected the child's emotional problems only if the mother was depressed as well. The mother's symptoms, however, affected the child even if the father was not depressed.

Moderate depressive symptoms can be observed in over 20% of parents in Finland. Most serious symptoms are seen in less than 9% of mothers and around 2.5% of fathers.

"Depression among parents both during and after pregnancy not only affects the person suffering from depression but also has a long-term impact on the well-being of the newborn child. Even in cases of mild depression, it is important that the symptoms are identified and the parents are offered support as early as possible, if necessary already during the pregnancy," explains Visiting Researcher Johanna Pietikäinen from the Finnish Institute for Health and Welfare (THL).

"In families, depression experienced by the mother has a key impact on the child's well-being. In Finland, the maternity clinic system functions well, but attention should be paid to depressive symptoms among mothers over a longer period: from the pregnancy through to the end of the child's first year of age," she adds.

One parent's depression also puts the other at risk

The depression of one parent is a factor that can put the other parent at risk of depression as well. In addition, depressive symptoms among mothers and fathers are quite long-term: they can start already during pregnancy and continue past the child's first birthday.

"It is important to monitor the mental well-being of both parents during pregnancy and after the birth of the child, and if one parent shows symptoms of depression then the symptoms of the other parent should also be examined. Currently, however, fathers' psychological well-being is not necessarily covered by depression questionnaires in maternity clinics, for example," Pietikäinen points out.

Prior depression is the most significant risk factor

Long-term depression is an indication that the depression may have been experienced already before the pregnancy. Previous experience of depression was, in fact, one of the key risk factors for moderate or severe depressive symptoms.

Other significant risk factors included sleep deprivation during pregnancy, stress, anxiety and a bad family environment. These most prominent risk factors were predictors for depression among both mothers and fathers.

https://www.sciencedaily.com/releases/2019/09/190923111249.htm

Stable home lives improve prospects for preemies

Medical challenges at birth less important than stressful home life in predicting future psychiatric health

August 26, 2019

Science Daily/Washington University School of Medicine

Researchers have found that as premature babies grow, their mental health may be related less to the medical challenges they face after birth than to the environment the babies enter once they leave the neonatal intensive care unit.

As they grow and develop, children who were born at least 10 weeks before their due dates are at risk for attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder and anxiety disorders. They also have a higher risk than children who were full-term babies for other neurodevelopmental issues, including cognitive problems, language difficulties and motor delays.

Researchers at Washington University School of Medicine in St. Louis who have been trying to determine what puts such children at risk for these problems have found that their mental health may be related less to medical challenges they face after birth than to the environment the babies enter once they leave the newborn intensive care unit (NICU).

In a new study, the children who were most likely to have overcome the complications of being born so early and who showed normal psychiatric and neurodevelopmental outcomes also were those with healthier, more nurturing mothers and more stable home lives.

The findings are published Aug. 26 in The Journal of Child Psychology and Psychiatry.

"Home environment is what really differentiated these kids," said first author Rachel E. Lean, PhD, a postdoctoral research associate in child psychiatry. "Preterm children who did the best had mothers who reported lower levels of depression and parenting stress. These children received more cognitive stimulation in the home, with parents who read to them and did other learning-type activities with their children. There also tended to be more stability in their families. That suggests to us that modifiable factors in the home life of a child could lead to positive outcomes for these very preterm infants."

The researchers evaluated 125 5-year-old children. Of them, 85 had been born at least 10 weeks before their due dates. The other 40 children in the study were born full-term, at 40 weeks' gestation.

The children completed standardized tests to assess their cognitive, language and motor skills. Parents and teachers also were asked to complete checklists to help determine whether a child might have issues indicative of ADHD or autism spectrum disorder, as well as social or emotional problems or behavioral issues.

It turned out the children who had been born at 30 weeks of gestation or sooner tended to fit into one of four groups. One group, representing 27% of the very preterm children, was found to be particularly resilient.

"They had cognitive, language and motor skills in the normal range, the range we would expect for children their age, and they tended not to have psychiatric issues," Lean said. "About 45% of the very preterm children, although within the normal range, tended to be at the low end of normal. They were healthy, but they weren't doing quite as well as the more resilient kids in the first group."

The other two groups had clear psychiatric issues such as ADHD, autism spectrum disorder or anxiety. A group of about 13% of the very preterm kids had moderate to severe psychiatric problems. The other 15% of children, identified via surveys from teachers, displayed a combination of problems with inattention and with hyperactive and impulsive behavior.

The children in those last two groups weren't markedly different from other kids in the study in terms of cognitive, language and motor skills, but they had higher rates of ADHD, autism spectrum disorder and other problems.

"The children with psychiatric problems also came from homes with mothers who experienced more ADHD symptoms, higher levels of psychosocial stress, high parenting stress, just more family dysfunction in general," said senior investigator Cynthia E. Rogers, MD, an associate professor of child psychiatry. "The mothers' issues and the characteristics of the family environment were likely to be factors for children in these groups with significant impairment. In our clinical programs, we screen mothers for depression and other mental health issues while their babies still are patients in the NICU."

Rogers and Lean believe the findings may indicate good news because maternal psychiatric health and family environment are modifiable factors that can be targeted with interventions that have the potential to improve long-term outcomes for children who are born prematurely.

"Our results show that it wasn't necessarily the clinical characteristics infants faced in the NICU that put them at risk for problems later on," Rogers said. "It was what happened after a baby went home from the NICU. Many people have thought that babies who are born extremely preterm will be the most impaired, but we really didn't see that in our data. What that means is in addition to focusing on babies' health in the NICU, we need also to focus on maternal and family functioning if we want to promote optimal development."

https://www.sciencedaily.com/releases/2019/08/190826104830.htm

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Mothers' pregnancy-related anxiety may alter how infants' brains respond to sad speech

November 12, 2019

Science Daily/Aalto University

A study has shown a potential link between pregnancy-related anxiety and how a baby's brains respond to sad speech. Researchers at Aalto University and the University of Turku in Finland showed that mothers with high anxiety scores at 24 weeks of pregnancy gave birth to babies who had reduced brain responses to sad-sounding speech. The effect was significantly smaller at 34 weeks of pregnancy, suggesting the effects of pregnancy-related anxiety may be transferred more easily to the unborn baby in mid- rather than late pregnancy. Studying a larger group would make it possible to understand the behavioral implications of the observed changes.

"Areas of the baby's brain that deal with emotion and speech were less active when listening to sad speech if the baby's mothers had reported high pregnancy-related anxiety" said Dr Ilkka Nissilä, a research fellow at Aalto University who is one of the authors of the study.

Pregnancy-related anxiety refers to worries specifically concerning the pregnancy, such as worries about changes in appearance, labor and birth, the health of the developing child and future parenting. Previous studies have already shown a link between anxiety during pregnancy and neurodevelopment in infants, which prompted the researchers to investigate emotional speech and anxiety in this study.

"While we can observe a change in brain response, we can't say for sure how it is related to behavior, or how the changes we've observed affect the child over time " said Dr Nissilä. "What we know for certain is that a larger study with more subjects is needed to understand how such observations made using neuroimaging are related to the development of the babies as they grow up."

Professor Hasse Karlsson, professor of integrative neuroscience and psychiatry at the University of Turku said "One of the advantages of the FinnBrain study is that the babies will be followed up for several years. This makes it possible to later find out if this finding is related to any clinically relevant outcomes."

The study examined the data of 19 mother-baby pairs from Finland. The brain scanning was done with a technique called diffuse optical tomography or DOT, which uses a set of light sources and detectors attached on the side of the baby's head to measure changes in blood flow [AM5] in the brain. The method allows the study to take place while the baby is in its mother's lap, and is almost silent, as opposed to the fMRI scans often used in functional neuroscience experiments which require lying still in a loud scanner. The DOT equipment meant that the researchers could easily play speech sounds to the babies whilst simultaneously scanning their brains. They hope to be able to improve the DOT technology further for future work by making it wireless.

https://www.sciencedaily.com/releases/2019/11/191112090637.htm

Preterm children have similar temperament to children who were institutionally deprived

November 12, 2019

Science Daily/University of Warwick

A child's temperament is affected by the early stages of their life, research suggests. Researchers from the University of Warwick, the University of Tennessee, University of Southampton and Kings College London have found children who were born very preterm (under 32 weeks gestation) or very low birthweight (under 1500g) had similar temperamental difficulties in controlling their impulses, to children who experienced institutional deprivation.

The paper 'A Comparison of the Effects of Preterm Birth and Institutional Deprivation on Child Temperament', published today, 12 November in the journal Development and Psychopathology, highlights how different adverse experiences such as preterm birth and institutional deprivation affect children's temperament in similar ways, resulting in greater risk for lower self-control.

The team of researchers, from the University of Warwick, University of Tennessee, University of Southampton and King's College London looked at children who were born very preterm, or very low birth weight from the Bavarian Longitudinal study, and children who experienced at least six months of institutional deprivation -- a lack of adequate, loving caregivers -- in Romanian institutions from the English and Romanian Adoptees study, who were then compared to 311 healthy term born children and 52 non-deprived adoptees, respectively.

The researchers found that both groups of children had lower effortful control at 6 years.

This is the first study that directly compares the effects of severe preterm birth and extended institutional deprivation, and suggests that self-control interventions early in life may promote the development of children after both risk experiences.

Prof Dieter Wolke from the Department of Psychology at the University of Warwick comments: "Both, early care either in an incubator or deprivation and neglect in an orphanage lead to poor effortful control. We need to further determine how this early deprivation alters the brain."

Lucia Miranda Reyes, from the Department of Child and Family Studies at the University of Tennessee comments: "These findings suggest that children's poor effortful control may underlie long-term social problems associated with early adverse experiences; thus, improving their self-control may also help prevent these later problems."

https://www.sciencedaily.com/releases/2019/11/191112110211.htm

Teens who have loving bond with mother less likely to enter abusive relationships

A strong positive relationship with their mother protected teens even when the mother's marriage is full of conflict

October 30, 2019

Science Daily/University at Buffalo

A mother's warmth and acceptance toward her teenagers may help prevent those children from being in an abusive relationship later in life, even if her own marriage is contentious, according to a new University at Buffalo study.

Previous research shows that adolescents who are exposed to marital conflict at a young age are at an increased risk to experience abuse in their romantic relations. However, the new study discovered that the child's relationship with their mother serves as a buffer by potentially promoting the teen's feelings of self-worth, says Jennifer Livingston, PhD, lead investigator and associate professor in the UB School of Nursing.

"Children form internal working models about themselves and others based on the quality of their relationship with their parents," said Livingston. "If the primary caretaker is abusive or inconsistent, children learn to view themselves as unlovable and others as hostile and untrustworthy. But positive parenting behaviors characterized by acceptance and warmth help children form positive internal working models of themselves as lovable and worthy of respect."

The results could help in the development of interventions that prevent teens from experiencing physical, emotional or sexual relationship abuse. More than 30% of adolescents are the victim of some type of abuse by a romantic partner, says Livingston, who is also a faculty member in the UB Clinical and Research Institute on Addictions (CRIA).

 The protective effects of a mother's love

 The research, published this month in the Journal of Interpersonal Violence, surveyed more than 140 adolescents whose parents were married or cohabitating at the time of their birth.

The families are part of an ongoing study on the development of children of alcoholic parents. Half of the participants had at least one parent, most often the father, with an alcohol problem. The researchers examined the group due to the connection between alcoholism in fathers and family dysfunction.

"Although parental alcoholism has not been directly linked to teen dating violence, children growing up in alcoholic families experience greater exposure to marital conflict and harsh parenting in comparison to children from non-alcoholic families," said Livingston. "Clearly not all children from alcoholic families are involved in dating violence, suggesting that there are protective factors at play as well. These protective factors need to be identified to advance prevention efforts."

The participants completed surveys in eighth grade and during their junior or senior year of high school, reporting on their exposure to conflict between their parents, perception of their relationship with their mother, and any involvement in dating violence.

The study discovered that children who experienced above average levels of positive parenting behaviors from their mother in eighth grade were less likely to be involved in dating violence as a teenager, even when there were high levels of conflict in their parents' marriage.

Lower levels of warmth, responsiveness and support by the mother did not weaken the harmful effects of marital conflict on her children.

"The joint influence of parent-to-parent conflict and maternal-child interactions suggests the need for a multipronged approach to intervention that promotes communication and conflict resolution in the marriage and positive parenting behavior with the children," says Livingston. "Parents who are better able to communicate and resolve disagreements will have less conflict in the household and can model appropriate conflict resolution skills to their children. The ability to successfully resolve conflicts should also reduce stress and enable parents to be more responsive to their child's needs."

Future studies may examine the difference in the effects of marital conflict on male and female children, or if the protective effects of positive parenting persist if the mother is the alcoholic parent.

https://www.sciencedaily.com/releases/2019/10/191030100043.htm

Significantly fewer pregnant women take antidepressants

October 29, 2019

Science Daily/Aarhus University

A pregnancy is not always a happy event and as many as 10-15% of pregnant women in Denmark have depressive symptoms. A new study now shows a significant decrease in the use of antidepressants by pregnant women -- with consumption falling by more than 33% since 2011.

A new study carried out by the National Centre for Register-based Research and the Department of Clinical Medicine at Aarhus University now shows a significant decrease in the use of antidepressants by pregnant women -- with consumption falling by more than 33 per cent since 2011. The decrease in the use of ADs after 2011 was mainly driven by a decrease in the prescribing of serotonin reuptake inhibitors (SSRIs) and in particular citalopram, the main type of SSRI used in Denmark, explains Postdoc Julie Werenberg Dreier from the National Centre for Register-based Research at Aarhus University.

"Research from Denmark and other countries has documented a striking increase in the use of antidepressants over the past two decades. Now, for the first time, we can see a significant decline in the use of antidepressants by pregnant women," says Julie Werenberg Dreier. She is behind the study together with Yuelian Sun, who is the first author of this study and an associate professor at the Department of Clinical Medicine at Aarhus University and Jakob Christensen, who is clinical associate professor at the Department of Clinical Medicine at Aarhus University and consultant at the Department of Neurology at Aarhus University Hospital.

Both emphasise that it is important to find an explanation for the sharp decline. The study has shown that age of pregnant women and psychiatric disorders of pregnant women are unlikely to explain the declining trend of antidepressant use during pregnancy. In August 2011, the US Food and Drug Administration issued a safety warning concerning high doses of citalopram on heart, which could be one of potential explanations. However, more research are needed to confirm the association.

Jakob Christensen points out that additional studies should follow-up by looking into the pregnant women's health -- in particular when it comes to psychiatric health, which can include symptoms that are difficult to discern.

"There's no doubt about the fall since 2011 because antidepressants are only available from the pharmacy with a prescription, and the fall is so significant that it's more than relevant to take a closer look at whether pregnant women with depressive symptoms get the correct treatment, and in this way prevent the consequences of depression in the best possible way."

The register-based study is based on 1.2 million pregnancies in the period from 1997 to 2016. Of these, almost 30,000 women (2.4 per cent) collected at least one prescription for antidepressants during pregnancy. When the consumption was at its highest in 2011, almost one in twenty pregnant women collected prescriptions for antidepressants. The study has just been published in the scientific journal Brain and Behavior.

Jakob Christensen is also a clinical pharmacologist who has spent a number of years conducting research into the consequences of treatment with medicines during pregnancy. He says:

"In general, the use of antidepressants during pregnancy is considered to be safe, but questions have arisen concerning a slightly increased risk of congenital malformations and psychiatric symptoms in children where the mother has taken antidepressants during pregnancy. It's natural to suppose that some women have chosen not to take the medicine because they were worried that the child could be harmed," says Jakob Christensen. But he points out that choosing not to take the medicine is not always the best option.

Yuelian Sun adds:

"However, there were not episodes occurred around 2011 causing change on safety concern to unborn babies. On the contrast, safety concern of citalopram to pregnant women from physicians could also lead to declining of antidepressant use among pregnant women."

Depression in pregnant women is not uncommon, and the depression can continue and worsen after childbirth. This has been well-documented in previous research studies, says Jakob Christensen.

"This risk for the child must then be balanced with the risk of depression in the mother. An untreated depression can have major consequences for both the mother and the newborn child, for example by not thriving or in a worst case in the form of suicidal thoughts," he says.

https://www.sciencedaily.com/releases/2019/10/191029105619.htm

Women scientists author fewer invited commentaries in medical journals than men

October 23, 2019

Science Daily/Harvard T.H. Chan School of Public Health

Women scientists were 21% less likely to author invited commentaries in medical journals during a five-year period than men with similar scientific expertise, seniority, and publication metrics, according to a new study led by researchers from Harvard T.H. Chan School of Public Health and in collaboration with Elsevier. They found that the disparity was larger for women who were further progressed in their careers, reaching as high as 40% for the most senior authors.

In medical journals, publication of an invited commentary is a recognition of expertise and can raise an author's profile.

"I was genuinely surprised by the size of the gender gap we found," said first author Emma Thomas, a doctoral student in the Department of Biostatistics. "As a young female scientist, I hoped that we might achieve gender parity in authorship of invited articles naturally as more women progressed to the top of the scientific pipeline. Our results suggest that may not be the case."

The study will be published online in JAMA Network Open on October 23, 2019.

The researchers analyzed data on all invited commentaries published in English-language medical journals from 2013 through 2017, made available by Elsevier from its Scopus database. The researchers compared the gender of each "case" -- authors of invited commentaries -- to the gender of a group of "controls" -- other researchers who had similar scientific expertise to the case author, identified through text mining of their published abstracts. The final dataset included 43,235 cases across 2,459 journals.

The researchers found that female researchers were approximately 21% less likely than their male peers to publish an invited commentary. The gender disparity was larger for researchers who had been actively publishing for longer. Overall, just 23% of invited commentaries in the dataset had female corresponding authors.

"These findings challenge the common assumption that gender disparities in authorship of prestigious scientific articles exist because there are fewer women with sufficient experience and expertise to write these articles," said senior author Francesca Dominici, Clarence James Gamble Professor of Biostatistics, Population, and Data Science and co-director of the Harvard Data Science Initiative. "Our results also show that women's voices are not heard as often as men's. This lack of diversity in perspectives can hamper the progress of health research, since diversity of thought is a key driver of innovation."

The authors suggest that journals could expand and diversify their pool of commentary writers by using text mining software to identify researchers with relevant expertise who might not otherwise have been considered.

https://www.sciencedaily.com/releases/2019/10/191023172110.htm

Women CEOs judged more harshly than men for corporate ethical failures

Female leaders receive less negativity for general business failures, study says

October 24, 2019

Science Daily/American Psychological Association

People are less likely to support an organization after an ethical failure if the business is led by a woman, according to a study published by the American Psychological Association. However, organizations led by women endure less negative backlash for competence failures than those headed by men.

"Our study found that consumers' trust in, and willingness to support, an organization after a failure varied based on the gender of the organization's leader and the type of incident," said Nicole Votolato Montgomery, PhD, of the University of Virginia and lead author of the study. "Women incur greater penalties for ethical transgressions because of persistent gender stereotypes that tend to categorize women as having more communal traits than men, such as being more likable, sensitive and supportive of others. Even in leadership settings, women are still expected to be more communal than their male counterparts."

The study was published in the Journal of Personality and Social Psychology.

Across three experiments, Montgomery and co-author Amanda P. Cowen, DBA, examined how gender would influence perceptions of female-led and male-led organizations after experiencing a competence failure, such as a product flaw, or an ethical failure, such as if the product flaw was known but not disclosed to the public for a long period of time.

In the first experiment, 512 participants read a business news article about an auto manufacturer and then filled out a survey about their intent to buy a vehicle from the company. One-third of the participants read about an ethical failure, one-third read about a competence failure and the final third only read the company description. Afterward, the participants were asked how likely they were to purchase a car from the company the next time they were in the market for a vehicle and reported their trust in the organization (e.g., "I feel that XYZ automobiles is very dependable/undependable, very competent/incompetent or of low integrity/high integrity").

"When participants were told that the company had previously been made aware of a fuel sensor problem and failed to take immediate action, an ethical failure, they reported less intent to purchase from the company when the CEO was a woman than when the CEO was a man," said Montgomery. "However, when participants were told that the company was previously unaware of the product issue, a competence failure, they reported greater intent to buy the products when the CEO was a woman than when the CEO was a man."

The purchase intentions for the group that read only the company description did not vary based on the CEO's gender.

The second experiment further examined how gender stereotypes influence consumers' judgments by altering how female and male CEOs were described. The researchers added descriptions of the CEO either to highlight communal traits that are typically associated with females (e.g., "helpful, sensitive to the needs of employees and customers, able to listen carefully to customers' concerns") or agentic traits that are typically associated with males (e.g., "skilled, strongly independent, able to work well under pressure").

The 416 participants in this study read the same news article as in the previous experiment and completed the same survey questions about their buying intentions and trust in the company. In this experiment, participants also were asked to report their attitudes toward the brand, their response to online advertisements for the company, if they would recommend the company to others and the effectiveness of the company's leader.

Similar to the previous experiment, when participants read about an ethical failure where the CEO was described using traits consistent with stereotypes (e.g., the female leader was described as being communal and the male leader was described as being agentic), participants were less likely to buy from the company led by the female CEO. In contrast, when the CEO was described using traits inconsistent with stereotypes (e.g., the male leader was described as being communal and female leader was described as being agentic), the participants said they were less likely to buy from the male-led company than the female-led company in the aftermath of an ethical failure, the researchers said.

"When leaders are described in ways that reinforce stereotypes, we continue to find that people penalize female-led organizations more for ethical failures, but we can reduce these penalties for female-led organizations by highlighting agentic traits of their leaders," said Cowen.

For the final experiment, Montgomery and Cowen explored whether consumers' judgments would change if the women CEOs led businesses that operated in industries that are viewed as more stereotypically feminine -- in this case, a child products company, versus the automotive company.

Participants indicated they would be less likely to purchase from a female-led organization in both stereotypically male (e.g., automotive) and stereotypically female (e.g., child products) industries after an ethical failure, according to the researchers. However, participants' responses to competence failures differed depending on the industry.

"In the auto industry, which is typically viewed as more male, participants penalized female-led organizations less than male-led organizations for competence failures," Cowan said. "However, the opposite was true for a child products company. In that setting, participants who read about a competence failure penalized female-led organizations more than male-led organizations. This further demonstrates how gender stereotypes influence our expectations of leaders and their organizations."

Montgomery and Cowen believe their findings may have implications for leaders' career outcomes.

"Organizational performance affects how leaders are evaluated, how they are compensated and ultimately, whether they retain their positions," Montgomery said. "Our research suggests that when ethical failures occur, female leaders may aid their organizations' recovery efforts by exhibiting agentic traits that are more consistent with male stereotypes."

https://www.sciencedaily.com/releases/2019/10/191024093604.htm

Animal study shows how stress and mother's abuse affects infant brain

October 21, 2019

Science Daily/NYU Langone Health / NYU School of Medicine

A new study in rats shows the extent of brain damage in newborn rodents from even short-term abuse by their mother.

Past studies in animals and humans have established how a mother's abuse can lead to brain shrinkage in her infants' amygdala and hippocampus, parts of the brain that process fear and memory, researchers say.

The new study, led by researchers from NYU School of Medicine, goes even further, say its authors, to pull apart the effects of abusive parenting from the related stress that follows it. Together, both can negatively impact the growth and development of the infant brain, researchers say.

The study shows how the stress from abuse was sufficient on its own to damage the hippocampus, while the pairing of stress with the presence of an abusive mother was required to restrict growth of the amygdala and to prompt her pups to unnaturally keep their distance and limit their time spent together.

"Our study further unravels the complexity of an abusive mother's relationship to their child, especially during the pivotal first weeks of life when they are bonding," says study senior investigator Regina M. Sullivan, PhD, a professor in the Department of Child and Adolescent Psychiatry at NYU Langone Health. "The results explain two key consequences of abusive parenting and how presence of the abusive parent can trigger related behavioral problems beyond just the stress it creates in the infant."

Publishing in the Proceedings of the National Academy of Sciences (PNAS) online Oct. 21, the study analyzed the social behaviors and brains of rat pups that had been exposed to a week of daily rough handling in their nest by their mothers. These results were then compared with those of rat pups that had been injected with just stress-inducing drugs when left alone with a nurturing mother, an anesthetized mother showing no maternal behavior, or a still object. The investigators induced the rough handling by withholding sufficient nesting materials new rodent mothers normally find in the wild, which is a common technique for recreating abusive behavior.

Among the study's key findings, abused infants were hesitant to stay with the mother and nurse, and did so for shorter periods of time whether their mother was awake or not. These effects were replicated when researchers injected unabused, normal pups with the stress hormone corticosterone. Moreover, the negative impact from abuse could largely be blunted by chemically blocking corticosterone action in the infant brain and by exposing stressed pups to nonabusive mothers.

"Mothers and other close caregivers have special access to the infant brain and consistent abuse, if left to continue, may do lasting damage," says Sullivan. "But our findings also suggest that mothers or their surrogates have the innate ability to help mitigate the damage through good parenting," Sullivan adds.

Study researchers caution that their research results need not worry caregivers who have caused stress in their baby a few times. Sullivan says the evidence suggests it takes more than a few isolated instances of stress to cause long-lasting damage to a child's brain. Some level of stress hormones, she adds, are needed for healthy brain growth and development.

Moving forward, the researchers say they next plan to study specific effects of other hormones released by an infant rat during a stressful situation, designed to recreate living with insufficient resources for child rearing, such as housing, food insecurity, or lack of access to their mother.

https://www.sciencedaily.com/releases/2019/10/191021151532.htm

New way to think about brain's link to postpartum depression

Research in animals shows brain's immune system is activated by stress during pregnancy

October 21, 2019

Science Daily/Ohio State University

Chronic stress during pregnancy triggers an immune response in the brain that has potential to alter brain functions in ways that could contribute to postpartum depression, new research in animals suggests.

The study is the first to show evidence of this gestational stress response in the brain, which is unexpected because the immune system in both the body and the brain is suppressed during a normal pregnancy.

The Ohio State University researchers who made the discovery have been studying the brain biology behind postpartum depression for several years, creating depressive symptoms in pregnant rats by exposing them to chronic stress. Chronic stress during pregnancy is a common predictor of postpartum depression, which is characterized by extreme sadness, anxiety and exhaustion that can interfere with a mother's ability to care for herself or her baby.

Stress is known to lead to inflammation, which prompts an immune response to protect against inflammation's harmful effects. Based on what they already know about compromised brain signaling in rats stressed during pregnancy, the scientists suspect the immune cells in the brain responding to stress may be involved. If that's the case, the immune changes may create circumstances in the brain that increase susceptibility to depression.

In unstressed pregnant rats, the normal suppression of the immune system in the body and the brain remained intact throughout pregnancy. In contrast, stressed rats showed evidence of neuroinflammation. The study also showed that the stressed rats' immune response in the rest of their bodies was not active.

"That suggests there's this disconnect between what's happening in the body and what's happening in the brain," said Benedetta Leuner, associate professor of psychology at Ohio State and lead author of the study. She speculated that the signaling changes her lab has seen before in the brain and this immune response are happening in parallel, and may be directly related.

Leuner presented the findings Saturday (Oct. 19, 2019) at the Society for Neuroscience meeting in Chicago.

In this work, rats are exposed to unpredictable and varied stressful events throughout their pregnancies, a practice that adds a component of psychological stress but does not harm the health of the mother or her offspring.

In the stressed animals, the researchers found numerous pro-inflammatory compounds that indicated there was an increase in the number and activity levels of the primary immune cells in the brain called microglia. Their findings also suggested the microglia were affecting brain cells in the process.

Leuner's lab previously determined in rats that chronic stress during pregnancy prevented motherhood-related increases in dendritic spines, which are hair-like growths on brain cells that are used to exchange information with other neurons. These same rats behaved in ways similar to what is seen in human moms with postpartum depression: They had less physical interaction with their babies and showed depressive-like symptoms.

Leuner and colleagues now plan to see whether the brain immune cells activated during gestational stress are responsible for the dendritic spine elimination. They suspect that microglia might be clearing away synaptic material on dendrites.

Leuner has partnered on this research with Kathryn Lenz, assistant professor of psychology at Ohio State, whose work explores the role of the immune system in brain development.

Though pregnancy was known to suppress the body's immune system, Lenz and Leuner showed in a previous study that the same suppression of the immune system happens in the brain during pregnancy -- the number of microglia in the brain decreases.

"By layering gestational stress onto a normal pregnancy, we're finding this normal immunosuppression that should happen during pregnancy doesn't occur, and in fact there's evidence of inflammatory signaling in the brain that could be bad for dendritic spines and synapses," Lenz said. "But we've also found changes in the microglia's appetite. Every characteristic we've looked at in these cells has changed as a result of this stress."

The researchers are now trying to visualize microglia while they're performing their cleanup to see if they are eating synaptic material. They are also manipulating inflammatory changes in the brain to see if that reverses postpartum depression-like behavior in rats.

"We've seen the depressive-like symptoms and neural changes in terms of dendritic spines and synapses, and now we have neuroimmune changes suggesting that those microglia could be contributing to the neural changes -- which we think ultimately underlie the behaviors," Leuner said.

The research was supported by the National Institutes of Health

https://www.sciencedaily.com/releases/2019/10/191021151538.htm

Mothers' behavior influences bonding hormone oxytocin in babies

October 17, 2019

Science Daily/Max Planck Institute for Human Cognitive and Brain Sciences

A new epigenetic study now suggests that mothers' behavior can also have a substantial impact on their children's developing oxytocin systems.

Oxytocin is an extremely important hormone, involved in social interaction and bonding in mammals, including humans. It helps us relate to others. It strengthens trust, closeness in relationships, and can be triggered by eye contact, empathy, or pleasant touch. It's well known that a new mother's oxytocin levels can influence her behavior and as a result, the bond she makes with her baby. A new epigenetic study by Kathleen Krol and Jessica Connelly from the University of Virginia and Tobias Grossmann from the Max Planck Institute for Human Cognitive and Brain Sciences now suggests that mothers' behavior can also have a substantial impact on their children's developing oxytocin systems.

Childhood marks a dynamic and malleable phase of postnatal development. Many bodily systems are coming online, maturing, or getting tweaked, often setting our psychological and behavioral trajectories well into adulthood. Nature plays an obvious role, shaping us through our genes. But we are also heavily influenced by our interactions, with other people and with our environment. "It is well known that oxytocin is actively involved in early social, perceptual, and cognitive processes, and, that it influences complex social behaviors," says Tobias Grossmann. "However, in this study we ask whether the mother's behavior might also have a decisive influence on the development of the baby's oxytocin system itself. Advances in molecular biology, epigenetics in particular, have recently made it possible to investigate the interaction of nature and nurture, in this case infant care, in fine detail. That is exactly what we've done here."

The scientists observed a free play interaction between mothers and their five-month-old children. "We collected saliva samples from both the mother and the infant during the visit and then a year later, when the child was 18 months old. We were interested in exploring whether the involvement of the mother, in the original play session, would have an influence on the oxytocin receptor gene of the child, a year later. The oxytocin receptor is essential for the hormone oxytocin to exert its effects and the gene can determine how many are produced," explains Kathleen Krol, a Hartwell postdoctoral fellow in Connelly's Lab at the University of Virginia who conducted the study together with Tobias Grossmann at MPI CBS in Leipzig.

"We found that epigenetic changes had occurred in infant's DNA, and that this change was predicted by the quality of the mother's involvement in the play session. If mothers were particularly involved in the game with their children, there was a greater reduction in DNA methylation of the oxytocin receptor gene one year later. Decreased DNA methylation in this region has previously been associated with increased expression of the oxytocin receptor gene. Thus, greater maternal involvement seems to have the potential to upregulate the oxytocin system in human offspring," explains the scientist. "Importantly, we also found that the DNA methylation levels reflected infant temperament, which was reported to us by the parents. The children with higher methylation levels at 18-months, and presumably lower levels of oxytocin receptor, were also more temperamental and less well balanced."

The results of this study provide a striking example of how we are not simply bound by our genes but are rather the products of a delicate interplay between our blue prints and experiences. Early social interaction with our caregivers, certainly not excluding fathers, can influence our biological and psychological development through epigenetic changes to the oxytocin system. These and related findings highlight the importance of parenting in promoting cross-generational health.

https://www.sciencedaily.com/releases/2019/10/191017111705.htm

Stress during pregnancy may affect baby's sex, risk of preterm birth

October 15, 2019

Science Daily/Columbia University Irving Medical Center

A new study has identified markers of maternal stress -- both physical and psychological -- that may influence a baby's sex and the likelihood of preterm birth.

It's becoming well established that maternal stress during pregnancy can affect fetal and child development as well as birth outcomes, and a new study from researchers at Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian now identifies the types of physical and psychological stress that may matter most.

The study was published online in the journal PNAS, the Proceedings of the National Academy of Sciences.

"The womb is an influential first home, as important as the one a child is raised in, if not more so," says study leader Catherine Monk, PhD, professor of medical psychology at Columbia University Vagelos College of Physicians and Surgeons and director of Women's Mental Health in the Department of Obstetrics & Gynecology at NewYork-Presbyterian/Columbia University Irving Medical Center.

Because stress can manifest in a variety of ways, both as a subjective experience and in physical and lifestyle measurements, Monk and her colleagues examined 27 indicators of psychosocial, physical, and lifestyle stress collected from questionnaires, diaries, and daily physical assessments of 187 otherwise healthy pregnant women, ages 18 to 45.

About 17% (32) of the women were psychologically stressed, with clinically meaningful high levels of depression, anxiety, and perceived stress. Another 16% (30) were physically stressed, with relatively higher daily blood pressure and greater caloric intake compared with other healthy pregnant women. The majority (nearly 67%, or 125) were healthy.

Fewer Baby Boys with Mental Stress?

The study suggested that pregnant women experiencing physical and psychological stress are less likely to have a boy. On average, around 105 males are born for every 100 female births. But in this study, the sex ratio in the physically and psychologically stressed groups favored girls, with male-to-female ratios of 4:9 and 2:3, respectively.

"Other researchers have seen this pattern after social upheavals, such as the 9/11 terrorist attacks in New York City, after which the relative number of male births decreased," says Monk. "This stress in women is likely of long-standing nature; studies have shown that males are more vulnerable to adverse prenatal environments, suggesting that highly stressed women may be less likely to give birth to a male due to the loss of prior male pregnancies, often without even knowing they were pregnant."

Other Impacts of Stress

·      Physically stressed mothers, with higher blood pressure and caloric intake, were more likely to give birth prematurely than unstressed mothers.

·      Among physically stressed mothers, fetuses had reduced heart rate-movement coupling -- an indicator of slower central nervous system development -- compared with unstressed mothers.

·      Psychologically stressed mothers had more birth complications than physically stressed mothers.

Social Support Matters

The researchers also found that what most differentiated the three groups was the amount of social support a mother received from friends and family. For example, the more social support a mother received, the greater the likelihood of her having a male baby.

When social support was statistically equalized across the groups, the stress effects on preterm birth disappeared. "Screening for depression and anxiety are gradually becoming a routine part of prenatal practice," says Monk. "But while our study was small, the results suggest enhancing social support is potentially an effective target for clinical intervention."

An estimated 30% of pregnant women report psychosocial stress from job strain or related to depression and anxiety, according to the researchers. Such stress has been associated with increased risk of premature birth, which is linked to higher rates of infant mortality and of physical and mental disorders, such as attention-deficit hyperactivity disorder and anxiety, among offspring.

How a mother's mental state might specifically affect a fetus was not examined in the study. "We know from animal studies that exposure to high levels of stress can raise levels of stress hormones like cortisol in the uterus, which in turn can affect the fetus," says Monk. "Stress can also affect the mother's immune system, leading to changes that affect neurological and behavioral development in the fetus. What's clear from our study is that maternal mental health matters, not only for the mother but also for her future child."

https://www.sciencedaily.com/releases/2019/10/191015171554.htm

Scientists find gender-distinct circuit for depression

October 9, 2019

Science Daily/Michigan State University

Depression affects women nearly twice as much as men, but unraveling the brain's blueprint that regulates this behavior, let alone identifying specific molecular differences between sexes, has proven difficult.

Michigan State University researchers, however, have found and flipped a switch in the brain, revealing a single circuit in mice that activates during stress and is controlled by testosterone. The results, published in Biological Psychiatry, focus on the activity between neurons in the ventral hippocampus, which become active under stress and emotion, and their activation of nucleus accumbens neurons, critical players in reward and motivation.

"What makes these findings stand out is not only identifying this new circuit," said A.J. Robison, MSU physiologist and lead author of the study, "but also observing and confirming how it drives different behaviors in males and females."

Oddly enough, many circuit-specific animal model studies involving depression-related behaviors don't include female subjects. This gap exists despite sex differences in several depression-related brain regions, including the hippocampus, Robison added.

To help close this void, Robison and a team of MSU scientists focused on this hippocampus-accumbens circuit and saw that the activity in male brains during stress was significantly lower than in females, and this required testosterone. When they removed testosterone, however, the male mice began expressing depression-like behaviors.

Conversely, the team observed increased circuit activity in female brains, but when testosterone was introduced, the neurons quieted, and the female mice became resistant to the depression-like behaviors.

"Even with our best antidepressants, such as Prozac, we don't know exactly how they work," Robison said. "This is the first time we've found a circuit that drives this sexually different behavior; other scientists can now explore how this could translate to identifying new therapeutic targets in humans."

Robison's group used chemogenetic tools to manipulate specific circuit activity in the mouse brain in this study. Such tools may inform the development of "genetic medicine" for the treatment of human diseases in the future. 

https://www.sciencedaily.com/releases/2019/10/191009132324.htm

New diagnostic criteria may enable earlier detection of cognitive impairment in women

Tailoring verbal memory test criteria to patient's sex may improve diagnostic accuracy in mild cognitive impairment

October 9, 2019

Science Daily/University of California - San Diego

Study finds when verbal memory test cut-offs were tailored to patient sex, more female patients and fewer male patients were considered to have amnesic mild cognitive impairment. This could change the way aMCI diagnoses are determined and make it easier to catch the condition in its early stages.

Women make up two-thirds of patients with Alzheimer's disease -- so why is it that women are less likely than men to be diagnosed with its precursor, amnestic mild cognitive impairment (aMCI)? This was the question guiding a new study by University of California San Diego School of Medicine researchers studying how the life-long female advantage in verbal memory performance might be masking early symptoms of dementia in women.

In a study published October 9, 2019 by Neurology®, the medical journal of the American Academy of Neurology, the team studied the data of nearly 1,000 patients who participated in the Alzheimer's Disease Neuroimaging Initiative (ADNI) and found that when verbal memory test cut-offs were tailored to patient sex, more female patients and fewer male patients were considered to have aMCI. This could change the way aMCI diagnoses are determined and make it easier to catch the condition in its early stages.

"The point of the study was to see if we adjusted for this sex difference in verbal memory and made the cut point for impairment more conservative in women, would we be able to detect them earlier in the disease trajectory?" said first author Erin Sundermann, PhD, assistant project scientist in the Department of Psychiatry at UC San Diego School of Medicine. "That's important because currently the interventions that we have are likely most effective in the earlier stages."

Verbal memory includes the ability to remember words, recall stories and memorize verbal information. While it is well established that women show a life-long advantage in verbal memory performance, standard cutoffs for impairment on most verbal memory tests are determined using data gathered across both sexes. Most diagnostic criteria for a dementia diagnosis take several factors into account, like age and education level, but do not often consider sex.

Sundermann and team calculated sex-specific diagnostic criteria by taking the differences in verbal memory performance into account, which led to a more conservative score cut-off for impairment in women. Using the new criteria, about 10 percent of the female patients in ADNI who had previously been considered "cognitively normal" were now classified as aMCI.

What's more, when the scientists looked at biomarkers associated with dementia, they found that these newly diagnosed aMCI cases showed biomarker profiles more similar to those of the other female patients with aMCI than participants who were considered cognitively normal. Conversely, the new criteria for men determined that about 10 percent of men previously considered to have aMCI were now classified as cognitively normal, and, biologically, those men more closely resembled healthy controls than other men with aMCI.

"This suggests that adjusting for sex in verbal memory norms can improve diagnosis in both men and women and can detect women earlier in the disease trajectory and avoid false diagnosis in men that lead to stress and unnecessary treatment," Sundermann said.

This can also lead to improved study design for clinical trials and dementia research, by improving participant criteria and selection, leading to more accurate studies on disease progression and intervention.

https://www.sciencedaily.com/releases/2019/10/191009162435.htm

Modern family roles improve life satisfaction for parents

October 8, 2019

Science Daily/University of Zurich

Increased equality has a positive effect on mothers and fathers. Thanks to greater freedom to strike an individual balance between caring for children and working in paid employment, mothers and fathers today are happier with their lives than parents were 20 or 30 years ago, a study by sociologists has shown.

The mother looks after the children, the father works full time -- these traditional roles stubbornly remained the norm for a long time. But in recent decades, the normative expectations of mothers and fathers have changed. Motherhood is no longer seen as an obligatory part of female identity and fulfillment. It is no longer automatically expected that mothers will give up paid work, and it is becoming increasingly normal for fathers to have a more active role in raising and caring for children.

Discrepancy between public discourse and empirical data

Together with sociologists from Germany, researchers at the University of Zurich (UZH) have now investigated what effect these changed societal expectations have had on the life satisfaction of mothers and fathers. For their empirical work, they evaluated data from the long-term study of the Socio-Economic Panel at the Institute for Economic Research Berlin (DIW), which are representative for Germany. It contains data on more than 18,000 women and almost 12,000 men who were surveyed between 1984 and 2015. "While in the last few years the prevailing message in the media is that modern parents are under great stress or even regret having become parents, our analysis shows the opposite," says first author Klaus Preisner from the UZH Institute of Sociology

In surveys in the 1980s, most mothers were less satisfied with their lives than women without children. The idea of having a "little bundle of joy" that would bring great happiness -- which stemmed in part from the taboo against speaking negatively of motherhood in any way -- did not translate to reality for many women. "With the increasing freedom to choose whether or not to have a child and to shape parenthood more individually, the 'maternal happiness gap' has closed. Today we no longer find a difference in the life satisfaction of mothers and of women without children," says Preisner.

Life satisfaction of both parents increased

The picture is different for men: In the past, in contrast to women, men were not expected to take an active role in childcare, to take parental leave or to reduce their working hours after having children. Although that situation is different today, the life satisfaction of men has barely changed as a result. What's more, there is no difference in life satisfaction between fathers and men without children. "Fathers who step up to meet the new expectations placed on them are increasingly rewarded with public praise for their commitment," adds Preisner.

Alongside changed normative expectations in Germany, new political measures have been introduced, such as support for parental leave after the birth of a child and childcare for small children outside the family. One the one hand, such changes mean mothers and fathers can choose more freely how they want to arrange their family lives with regard to childcare. On the other, the roles and responsibilities are more equally distributed between mothers and fathers nowadays. Both these aspects have a positive effect on parents' life satisfaction.

Parents and children benefit from modern policy measures

The greater freedom of choice and the increased equality of mothers' and fathers' roles has been encouraged -- and in some cases even made possible at all -- by modern policies for families. Parental leave enables mothers and fathers to share childcare responsibilities and to be involved in their children's upbringing. In addition, subsidized childcare outside the home, such as it exists in Germany, also makes it easier for families to combine parenthood and employment. Klaus Preisner also sees another advantage: "These family-friendly political measures are not only significant for equality between the sexes. They are just as important for their role in improving life satisfaction of parents and thus ultimately of children."

https://www.sciencedaily.com/releases/2019/10/191008104647.htm

Prenatal stress could affect baby's brain

October 8, 2019

Science Daily/King's College London

New research from King's College London has found that maternal stress before and during pregnancy could affect a baby's brain development.

In their study published in Biological Psychiatry, MRC Doctoral Researcher in Perinatal Imaging and Health, Alexandra Lautarescu and Head of Advanced Neuroimaging, Professor Serena Counsell, for the first time looked at the relationship between maternal stress and brain development in 251 premature babies.

They found evidence for impaired development of a white matter tract, the uncinate fasciculus, in babies whose mothers experienced more stress in the prenatal period.

The mothers completed a questionnaire which asked them about their experiences of stressful events, which ranged from everyday stress such as moving house or taking an exam to more severe stressors like experiencing bereavement, separation or divorce. A score of severity of stress was calculated based on how many stressors they experienced as well as how severe those stressors were. This is what was related to the baby's brain. The researchers used a medical imaging technique called diffusion tensor imaging that was specifically developed to look at the structure of the white matter. The white matter tract has previously been implicated in anxiety disorders -- adults that have an anxiety disorder may show changes in this tract.

"We found that in the mums that were more stressed during pregnancy and the period before birth, white matter was altered in the babies," said lead researcher Alexandra Lautarescu from King's College London.

Scientists say the study highlights the importance of providing support for expectant mothers, as previous studies have shown that interventions such as cognitive behavioural therapy can help mitigate adverse outcomes in the baby. Clinicians have an important role to play when speaking with expectant mothers. While questions are asked about depressive symptoms, few questions are asked about general stress and anxiety. Women who deal with stressful life events during pregnancy are not picked up by their GPs or by their health care providers very often.

"It is not diagnosed as often as it should be during pregnancy and we are trying to emphasise that maternal mental health during pregnancy can impact the baby's brain development which may impact on their outcomes later in life," Alexandra Lautarescu said. "No one is asking these women about stress and hence they don't receive any support.

"Antenatal services need to be aware that it is important to think about stress of the mums and we need to have some kind of support there for the mums who identify that they are stressed. If we try to help these women either during the pregnancy or in the early post-natal period with some sort of intervention this will not only help the mother, but may also prevent impaired brain development in the baby and improve their outcomes overall."

There is some evidence to suggest that if mothers experience poor mental health during pregnancy that leads to adverse outcomes in the baby -- obstetric outcomes, lower birth weight or premature birth. A mother's poor mental health may also lead to altered early behavior such as more frequent crying.

Further studies are needed to understand whether the observed changes in the brain development of these babies will lead to adverse outcomes later in life.

https://www.sciencedaily.com/releases/2019/10/191008094309.htm

Severe morning sickness associated with higher risk of autism

October 3, 2019

Science Daily/Kaiser Permanente

Children whose mothers had hyperemesis gravidarum -- a severe form of a morning sickness -- during pregnancy were 53% more likely to be diagnosed with autism spectrum disorder, according to Kaiser Permanente research published in the American Journal of Perinatology.

"This study is important because it suggests that children born to women with hyperemesis may be at an increased risk of autism," said lead study author Darios Getahun, MD, PhD, of Kaiser Permanente Southern California Department of Research and Evaluation. "Awareness of this association may create the opportunity for earlier diagnosis and intervention in children at risk of autism."

Hyperemesis gravidarum occurs in less than 5% of pregnancies. Affected women experience intense nausea and are unable to keep down food and fluids. This can lead to dangerous dehydration and inadequate nutrition during pregnancy.

To determine the extent of the association between hyperemesis gravidarum and autism spectrum disorder, researchers reviewed electronic health records of nearly 500,000 pregnant women and their children born between 1991 and 2014 at Kaiser Permanente in Southern California. They compared children whose mothers had a diagnosis of hyperemesis gravidarum during pregnancy to those whose mothers did not.

Other findings from the research included:

·      Exposure to hyperemesis gravidarum was associated with increased risk of autism when hyperemesis gravidarum was diagnosed during the first and second trimesters of pregnancy, but not when it was diagnosed only in the third trimester.

·      Exposure to hyperemesis gravidarum was associated with risk of autism regardless of the severity of the mother's hyperemesis gravidarum.

·      The association between hyperemesis gravidarum and autism spectrum disorder was stronger in girls than boys and among whites and Hispanics than among blacks and Pacific Islanders.

·      The medications used to treat hyperemesis gravidarum did not appear to be related to autism risk.

The results are consistent with the hypothesis that women experiencing hyperemesis gravidarum have poor nutritional intake, which may, in turn lead to potential long-term neurodevelopment impairment in their children. The study cannot, however, rule out other possible explanations, such as perinatal exposures to some medications and maternal smoking.

https://www.sciencedaily.com/releases/2019/10/191003092046.htm