JAMA Psychiatry最新文献

{"title":"Observational and Genetic Analyses of Traumatic Experiences and Endometriosis","authors":"Dora Koller, Solveig Løkhammer, Oksana Goroshchuk, Veronika Denner, Brendan Stiltner, Marina Mitjans, Jun He, Hugh S. Taylor, Rebecca B. Lawn, Karestan C. Koenen, Renato Polimanti","doi":"10.1001/jamapsychiatry.2024.4694","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2024.4694","url":null,"abstract":"ImportanceAlthough psychological traumas have been associated with endometriosis, limited information is available regarding the role of trauma type and genetic predisposition.ObjectiveTo examine the relationship between traumatic experiences and endometriosis using observational and genetically informed analyses.Design, Setting, and ParticipantsFor this case-control study, the analyses were performed between May 13, 2023, and September 30, 2024. Genotypic and phenotypic information was combined from UK Biobank individual-level data (up to 8276 patients with endometriosis and 240 117 female controls) with genome-wide information available from a large meta-analysis (European ancestry: 21 779 patients and 449 087 female controls; East Asian ancestry: 1713 patients and 1581 female controls) and the FinnGen cohort (16 588 patients and 111 583 female controls of European descent).Main Outcomes and MeasuresPhenotypic associations via multiple regression; latent-class analysis (LCA) to investigate the co-occurrence patterns of different traumatic experiences in endometriosis cases and controls; genetic correlation and polygenic risk scoring (PRS) analyses to assess pleiotropy linking traumatic events to endometriosis.ResultsUp to 8276 women with endometriosis (mean [SD] age, 53.2 [13.0] years) and 240 117 female controls (mean [SD] age, 56.5 [9.6] years) were investigated in the study. Women with endometriosis were more likely to report childhood and adulthood traumatic experiences and stressful events (eg, contact trauma odds ratio [OR], 1.28; 95% CI, 1.02-1.26). Our LCA highlighted the association of endometriosis with emotional and physical trauma (225 [8%] vs 3948 [5%]; <jats:italic>P</jats:italic> < 2.2 × 10<jats:sup>−16</jats:sup>) and sexual trauma (414 [5%] vs 3158 [4%]; <jats:italic>P</jats:italic> = 2.9 × 10<jats:sup>−3</jats:sup>). Unaffected women (controls) were more likely assigned to the “no trauma” latent class (563 [20%] vs 18 949 [24%]; <jats:italic>P</jats:italic> = 7.4 × 10<jats:sup>−14</jats:sup>). Our genetic correlation (rg) analyses linked endometriosis to multiple trauma-related outcomes, including posttraumatic stress disorder (meta-analysis rg = 0.31, <jats:italic>P</jats:italic> = 7.1 × 10<jats:sup>−16</jats:sup>; FinnGen rg = 0.26, <jats:italic>P</jats:italic> = 4.7 × 10<jats:sup>−15</jats:sup>) and childhood maltreatment (meta-analysis rg = 0.23, <jats:italic>P</jats:italic> = 1.3 × 10<jats:sup>−6</jats:sup>; FinnGen rg = 0.16, <jats:italic>P</jats:italic> = 1 × 10<jats:sup>−4</jats:sup>). Endometriosis PRS was associated with increased odds of the disease (β = 0.31, <jats:italic>P</jats:italic> < 2.2 × 10<jats:sup>−16</jats:sup>), but no interaction was observed with different types of trauma events.Conclusions and RelevanceThe present study comprehensively investigated the impact of childhood and adulthood traumatic experiences and stressful events on endometriosis. In particular, our findings highl","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"61 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143125203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective Treatment for Mental and Substance Use Disorders in 21 Countries.","authors":"Daniel V Vigo, Dan J Stein, Meredith G Harris, Alan E Kazdin, Maria Carmen Viana, Richard Munthali, Lonna Munro, Irving Hwang, Timothy L Kessler, Sophie M Manoukian, Nancy A Sampson, Ronald C Kessler","doi":"10.1001/jamapsychiatry.2024.4378","DOIUrl":"10.1001/jamapsychiatry.2024.4378","url":null,"abstract":"<p><strong>Importance: </strong>Accurate baseline information about the proportion of people with mental disorders who receive effective treatment is required to assess the success of treatment quality improvement initiatives.</p><p><strong>Objective: </strong>To examine the proportion of mental and substance use disorders receiving guideline-consistent treatment in multiple countries.</p><p><strong>Design, setting, and participants: </strong>In this cross-sectional study, World Mental Health (WMH) surveys were administered to representative adult (aged 18 years and older) household samples in 21 countries. Data were collected between 2001 and 2019 and analyzed between February and July 2024. Twelve-month prevalence and treatment of 9 DSM-IV anxiety, mood, and substance use disorders were assessed with the Composite International Diagnostic Interview. Effective treatment and its components were estimated with cross-tabulations. Multilevel regression models were used to examine predictors.</p><p><strong>Main outcomes and measures: </strong>The main outcome was proportion of effective treatment received, defined at the disorder level using information about disorder severity and published treatment guidelines regarding adequate medication type, control, and adherence and adequate psychotherapy frequency. Intermediate outcomes included perceived need for treatment, treatment contact separately in the presence and absence of perceived need, and minimally adequate treatment given contact. Individual-level predictors (multivariable disorder profile, sex, age, education, family income, marital status, employment status, and health insurance) and country-level predictors (treatment resources, health care spending, human development indicators, stigma, and discrimination) were traced through intervening outcomes.</p><p><strong>Results: </strong>Among the 56 927 respondents (69.3% weighted average response rate), 32 829 (57.7%) were female; the median (IQR) age was 43 (31-57) years. The proportion of 12-month person-disorders receiving effective treatment was 6.9% (SE, 0.3). Low perceived need (46.5%; SE, 0.6), low treatment contact given perceived need (34.1%; SE, 1.0), and low effective treatment given minimally adequate treatment (47.0%; SE, 1.7) were the major barriers, but with substantial variation across disorders. Country-level general medical treatment resources were more important than mental health treatment resources. Other than for the multivariable disorder profile, which was associated with all intermediate outcomes, significant predictors were largely mediated by treatment contact.</p><p><strong>Conclusions and relevance: </strong>In addition to the gaps in treatment quality, these results highlight the importance of increasing perceived need, the largest barrier to effective treatment; the importance of training primary care treatment clinicians in recognition and treatment of mental disorders; the need to improve the continuum of care, es","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":""},"PeriodicalIF":22.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health Disorder Trends in Denmark According to Age, Calendar Period, and Birth Cohort.","authors":"Natalie C Momen, Christoffer Beck, Mette Lise Lousdal, Esben Agerbo, John J McGrath, Carsten B Pedersen, Merete Nordentoft, Oleguer Plana-Ripoll","doi":"10.1001/jamapsychiatry.2024.3723","DOIUrl":"10.1001/jamapsychiatry.2024.3723","url":null,"abstract":"<p><strong>Importance: </strong>Research suggests an increase in mental disorder incidence in recent years, but this trend remains unexplained, and there is a lack of large studies based on a representative sample that investigate mental disorders over the full spectrum.</p><p><strong>Objective: </strong>To explore sex- and age-specific incidence of any mental disorder and 19 specific disorders according to birth cohort and calendar period.</p><p><strong>Design, setting, and participants: </strong>This was a population-based cohort study among 5 936 202 individuals aged 1 to 80 years living in Denmark at some point between January 1, 2004, and December 31, 2021. Data were derived from the Danish Civil Registration System and analyzed from February to August 2024.</p><p><strong>Exposures: </strong>Birth cohort (8 categories from 1924 to 2011) and calendar period (six 3-year categories from 2004 to 2021).</p><p><strong>Main outcomes and measures: </strong>Incidence rates of mental disorders from 2004 to 2021 by sex and age, according to birth cohort and calendar period, including the first years of the COVID-19 pandemic, using Danish health register data.</p><p><strong>Results: </strong>The population comprised 2 933 857 female individuals and 3 002 345 male individuals, who were followed up for 83.8 million person-years, with median ages at start and end of follow-up of 30.2 and 46.2 years, respectively. There was an overall mental disorder incidence rate of 55.27 every 10 000 person-years. For diagnoses of any mental disorder, higher incidence rates were observed for more recent birth cohorts and calendar periods in the younger ages. Over older ages, incidence rates did not vary so greatly. An increase was observed in rates of most types of mental disorders, especially among young people, and decreases for other types (eg, substance use disorders). Prominent sex differences were also observed. For example, for schizophrenia, a large increase was seen in incidence rates for female individuals in more recent birth cohorts at younger ages, but no change for male individuals, leading to a higher peak incidence for female individuals than for male individuals in the most recent periods. For personality disorders, a large increase was observed in incidence for female individuals over time and a slight decrease for male individuals.</p><p><strong>Conclusions and relevance: </strong>This comprehensive investigation of mental disorders incidence in Denmark indicates sex- and age-specific patterns according to birth cohorts and calendar periods. While trends may partly be explained by increases in incidence, several other factors may contribute, such as diagnostic practices, health sector capacity, and risk factors for mental disorders.</p>","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"161-170"},"PeriodicalIF":22.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Error in Figure.","authors":"","doi":"10.1001/jamapsychiatry.2024.4165","DOIUrl":"10.1001/jamapsychiatry.2024.4165","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"208"},"PeriodicalIF":22.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Capturing the Full Range of Buprenorphine Treatment Response.","authors":"Allen J Bailey, Victoria R Votaw, Roger D Weiss, R Kathryn McHugh","doi":"10.1001/jamapsychiatry.2024.3836","DOIUrl":"10.1001/jamapsychiatry.2024.3836","url":null,"abstract":"<p><strong>Importance: </strong>Reliance on abstinence-based treatment success rules may fail to capture the full continuum of treatment response to buprenorphine plus medical counseling (BUP+MC) for opioid use disorder (OUD).</p><p><strong>Objective: </strong>To describe patterns of reduction in illicit opioid use of patients both labeled as a success and nonsuccess based on an abstinent-based treatment outcome rule.</p><p><strong>Design, setting, and participants: </strong>This study is a secondary data analysis of 4 harmonized randomized clinical trials on BUP+MC for OUD from multiple sites that included 869 patients with OUD. These data were analyzed on April 23, 2024. By week 12, 643 participants of the sample original remained (74%).</p><p><strong>Intervention: </strong>All studies included patients randomized to BUP+MC or BUP plus enhanced MC (eg, delivered with adjunctive cognitive behavioral therapy).</p><p><strong>Main outcomes and measures: </strong>Weekly self-reported days of illicit opioid use through 12 weeks of treatment. Abstinence was confirmed by urine drug screen.</p><p><strong>Results: </strong>This study included 869 adults with OUD aged 18 to 69 (mean, 34.2 [SD, 10.45]) years; 287 patients were female (33%), 52 identified as Black (6%), 70 identified Hispanic (8%), 713 identified as White (82%), and 34 identified as other racial groups (4%). Only 377 patients (43%) would have been labeled a success using an abstinence-based success rule. However, the total sample reported a decrease from a mean baseline rate of illicit opioid use nearly every day (6.21 [SD, 1.50] days per week) to a mean of less than 1 day per week at week 12 (0.54 [SD, 1.28]). Importantly, even those who were labeled as nonsuccessful reported a substantial reduction in opioid use from a mean of 6.29 (SD, 1.42) days per week to 1.51 (SD, 1.76) days per week.</p><p><strong>Conclusion and relevance: </strong>In this study, about half of patients receiving BUP+MC achieved near complete abstinence; however, many more experienced a partial treatment response characterized by a substantial reduction in illicit opioid use that falls short of abstinence. Future studies are needed to characterize how these reductions are associated with functional and long-term outcomes. Dissemination of BUP+MC as part of standard buprenorphine prescribing practices is an essential next step given the robust average response of this intervention.</p>","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"201-203"},"PeriodicalIF":22.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linking Genome-Wide Association Studies to Pharmacological Treatments for Psychiatric Disorders.","authors":"Aurina Arnatkeviciute, Alex Fornito, Janette Tong, Ken Pang, Ben D Fulcher, Mark A Bellgrove","doi":"10.1001/jamapsychiatry.2024.3846","DOIUrl":"10.1001/jamapsychiatry.2024.3846","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Large-scale genome-wide association studies (GWAS) should ideally inform the development of pharmacological treatments, but whether GWAS-identified mechanisms of disease liability correspond to the pathophysiological processes targeted by current pharmacological treatments is unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate whether functional information from a range of open bioinformatics datasets can elucidate the relationship between GWAS-identified genetic variation and the genes targeted by current treatments for psychiatric disorders.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;Associations between GWAS-identified genetic variation and pharmacological treatment targets were investigated across 4 psychiatric disorders-attention-deficit/hyperactivity disorder, bipolar disorder, schizophrenia, and major depressive disorder. Using a candidate set of 2232 genes listed as targets for all approved treatments in the DrugBank database, each gene was independently assigned 2 scores for each disorder-one based on its involvement as a treatment target and the other based on the mapping between GWAS-implicated single-nucleotide variants (SNVs) and genes according to 1 of 4 bioinformatic data modalities: SNV position, gene distance on the protein-protein interaction (PPI) network, brain expression quantitative trail locus (eQTL), and gene expression patterns across the brain. Study data were analyzed from November 2023 to September 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Gene scores for pharmacological treatments and GWAS-implicated genes were compared using a measure of weighted similarity applying a stringent null hypothesis-testing framework that quantified the specificity of the match by comparing identified associations for a particular disorder with a randomly selected set of treatments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Incorporating information derived from functional bioinformatics data in the form of a PPI network revealed links for bipolar disorder (P permutation [P-perm] = 7 × 10-4; weighted similarity score, empirical [ρ-emp] = 0.1347; mean [SD] weighted similarity score, random [ρ-rand] = 0.0704 [0.0163]); however, the overall correspondence between treatment targets and GWAS-implicated genes in psychiatric disorders rarely exceeded null expectations. Exploratory analysis assessing the overlap between the GWAS-identified genetic architecture and treatment targets across disorders identified that most disorder pairs and mapping methods did not show a significant correspondence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;In this bioinformatic study, the relatively low degree of correspondence across modalities suggests that the genetic architecture driving the risk for psychiatric disorders may be distinct from the pathophysiological mechanisms currently used for targeting symptom manifestations through pharmacological treatments. Novel approaches incorporating insig","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"151-160"},"PeriodicalIF":22.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological Interventions for Pediatric Posttraumatic Stress Disorder: A Systematic Review and Network Meta-Analysis.","authors":"Thole H Hoppen, Lena Wessarges, Marvin Jehn, Julian Mutz, Ahlke Kip, Pascal Schlechter, Richard Meiser-Stedman, Nexhmedin Morina","doi":"10.1001/jamapsychiatry.2024.3908","DOIUrl":"10.1001/jamapsychiatry.2024.3908","url":null,"abstract":"<p><strong>Importance: </strong>Pediatric posttraumatic stress disorder (PTSD) is a common and debilitating mental disorder, yet a comprehensive network meta-analysis examining psychological interventions is lacking.</p><p><strong>Objective: </strong>To synthesize all available evidence on psychological interventions for pediatric PTSD in a comprehensive systematic review and network meta-analysis.</p><p><strong>Data sources: </strong>PsycINFO, MEDLINE, Web of Science, and PTSDpubs were searched from inception to January 2, 2024, and 74 related systematic reviews were screened.</p><p><strong>Study selection: </strong>Two independent raters screened publications for eligibility. Inclusion criteria were randomized clinical trial (RCT) with at least 10 patients per arm examining a psychological intervention for pediatric PTSD compared to a control group in children and adolescents (19 years and younger) with full or subthreshold PTSD.</p><p><strong>Data extraction and synthesis: </strong>PRISMA guidelines were followed to synthesize and present evidence. Two independent raters extracted data and assessed risk of bias with Cochrane criteria. Random-effects network meta-analyses were run.</p><p><strong>Main outcome and measures: </strong>Standardized mean differences (Hedges g) in PTSD severity.</p><p><strong>Results: </strong>In total, 70 RCTs (N = 5528 patients) were included. Most RCTs (n = 52 [74%]) examined trauma-focused cognitive behavior therapies (TF-CBTs). At treatment end point, TF-CBTs (g, 1.06; 95% CI, 0.86-1.26; P < .001), eye movement desensitization and reprocessing (EMDR; g, 0.86; 95% CI, 0.54-1.18; P < .001), multidisciplinary treatments (MDTs) (g, 0.88; 95% CI, 0.53-1.23; P < .001), and non-trauma-focused interventions (g, 0.95; 95% CI, 0.62-1.28; P < .001) were all associated with significantly larger reductions in pediatric PTSD than passive control conditions. TF-CBTs were associated with the largest short-term reductions in pediatric PTSD relative to both passive and active control conditions and across all sensitivity analyses. In a sensitivity analysis including only trials with parent involvement, TF-CBTs were associated with significantly larger reductions in pediatric PTSD than non-trauma-focused interventions (g, 0.35; 95% CI, 0.04-0.66; P = .03). Results for midterm (up to 5 months posttreatment) and long-term data (6-24 months posttreatment) were similar.</p><p><strong>Conclusions and relevance: </strong>Results from this systematic review and network meta-analysis indicate that TF-CBTs were associated with significant reductions in pediatric PTSD in the short, mid, and long term. More long-term data are needed for EMDR, MDTs, and non-trauma-focused interventions. Results of TF-CBTs are encouraging, and disseminating these results may help reduce common treatment barriers by counteracting common misconceptions, such as the notion that TF-CBTs are harmful rather than helpful.</p>","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"130-141"},"PeriodicalIF":22.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Private Equity Ownership of US Opioid Treatment Programs.","authors":"David T Zhu, Zirui Song, Sneha Kannan, Christopher L Cai, Simar S Bajaj, Suhas Gondi","doi":"10.1001/jamapsychiatry.2024.4011","DOIUrl":"10.1001/jamapsychiatry.2024.4011","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"204-206"},"PeriodicalIF":22.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"War Exposure and DNA Methylation in Syrian Refugee Children and Adolescents.","authors":"Demelza Smeeth, Simone Ecker, Olga Chervova, Fiona McEwen, Elie Karam, Stephan Beck, Michael Pluess","doi":"10.1001/jamapsychiatry.2024.3714","DOIUrl":"10.1001/jamapsychiatry.2024.3714","url":null,"abstract":"<p><strong>Importance: </strong>Exposure to war is associated with poor mental health outcomes. Adverse and traumatic experiences can lead to long-lasting DNA methylation changes, potentially mediating the link between adversity and mental health. To date, limited studies have investigated the impact of war on DNA methylation in children or adolescents, hampering our understanding of the biological impact of war exposure.</p><p><strong>Objective: </strong>To identify salivary DNA methylation differences associated with war exposure in refugee children and adolescents.</p><p><strong>Design, setting, and participants: </strong>This cohort study included Syrian refugee children and adolescents, and their primary caregiver were recruited from tented settlements in Lebanon. Data collection was carried out in 2 waves, 1 year apart, from October 2017 to January 2018 and October 2018 to January 2019. Children and their caregiver were interviewed, and children provided saliva samples for DNA extraction. Data analysis was conducted in 2022, 2023, and 2024.</p><p><strong>Exposure: </strong>War exposure assessed by interviewing children and their caregiver using the War Events Questionnaire.</p><p><strong>Main outcomes and measures: </strong>Salivary DNA methylation levels were assayed with the Infinium MethylationEPIC BeadChip (Illumina). Epigenetic aging acceleration was estimated using a set of preexisting epigenetic aging clocks. A literature search was conducted to identify previously reported DNA methylation correlates of childhood trauma.</p><p><strong>Results: </strong>The study population included 1507 children and adolescents (mean [SD] age, 11.3 [2.4] years; age range, 6-19 years; 793 female [52.6%]). A total of 1449 children provided saliva samples for DNA extraction in year 1, and 872 children provided samples in year 2. Children who reported war events had a number of differentially methylated sites and regions. Enrichment analyses indicated an enrichment of gene sets associated with transmembrane transport, neurotransmission, and intracellular movement in genes that exhibited differential methylation. Sex-stratified analyses found a number of sex-specific DNA methylation differences associated with war exposure. Only 2 of 258 (0.8%) previously reported trauma-associated DNA methylation sites were associated with war exposure (B = -0.004; 95% CI, -0.005 to -0.003; Bonferroni P = .04 and B = -0.005; 95% CI, -0.006 to -0.004; Bonferroni P = .03). Any war exposure or bombardment was nominally associated with decreased epigenetic age using the Horvath multitissue clock (B = -0.39; 95% CI, -0.63 to -0.14; P = .007 and B = -0.42; 95% CI, -0.73 to -0.11; P = .002).</p><p><strong>Conclusions and relevance: </strong>In this cohort of Syrian refugee children and adolescents, war exposure was associated with a small number of distinct differences in salivary DNA methylation.</p>","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"191-200"},"PeriodicalIF":22.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Framework for Suicide Risk Screening After Overdose: The Advanced Trauma Life Support (ATLS) Trauma Survey Framework.","authors":"Matthew Robert Dernbach, Randi N Smith, Joseph E Carpenter","doi":"10.1001/jamapsychiatry.2024.3833","DOIUrl":"10.1001/jamapsychiatry.2024.3833","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"105-106"},"PeriodicalIF":22.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}