Comprehensive psychoneuroendocrinology最新文献

Background

Patients with panic disorder (PD) show alterations of the immune reactivity to acute stress, which could serve as a marker for effective treatment. Nevertheless, the effect of immune reactivity under acute stress before treatment on therapy outcome remains unclear.

Methods

A total of N = 16 PD patients performed the Trier Social Test. Blood sample collection of anti-inflammatory cytokine IL-10 accompanied the TSST. The Mobility Inventory was handed out for the assessment of avoidance behavior before and after treatment. Area under the curve with respect to the ground (AUC_G) and increase (AUC_I) were calculated for assessed cytokine levels and were used as predictors for therapy outcome in regression analyses.

Results

AUC_G significantly predicts avoidance behavior in company after treatment (β = −0.007, p = .033) but not avoidance behavior alone (β = −0.003, p = .264). AUC_I does not significantly predict therapy outcome.

Conclusion

Higher concentrations of anti-inflammatory cytokine IL-10 under acute stress before treatment predicts less avoidance behavior in company after therapy. Immune markers seem to play a crucial role in the maintenance of mental disorders such as PD. Underlying mechanisms and IL-10 as a marker for individualized treatments should be investigated in future studies.

Background

Despite decades of advancement to support interventions for managing work-related stress, mental health issues have significantly escalated among healthcare professionals. Effort-reward imbalance (ERI) and overcommitment in the workplace are linked to several psychiatric disorders. However, the underlying biological mechanisms remain unclear. This study investigated whether ERI and overcommitment among healthcare professionals were linked to Allostatic Load (AL) and whether AL mediates the relationship between ERI, overcommitment and mental health issues.

Methods

One hundred forty-two nursing workers (n = 142; 90.1 % female, mean age: 39.5 ± 9.6) were randomly recruited from a university hospital in Sao Paulo, Brazil, and applied the ERI scale that assesses work effort, reward, and overcommitment. The Perceived Stress Scale (PSS), The Beck Depression Inventory (BDI), and the Self-Report Questionnaire for psychiatric symptoms (SRQ-20) evaluated the mental health outcomes. Ten neuroendocrine, metabolic, immunologic and cardiovascular biomarkers were analyzed, and values were transformed into an AL index using clinical reference cutoffs.

Results

Linear regression adjusted for covariates showed that higher scores for overcommitment were associated with higher AL indexes, which in turn were associated with higher SRQ-20, but not with PSS and DBI scores. As expected, higher scores for effort, lower for reward, and higher ERI were associated with higher scores for PSS, SRQ-20, and DBI, but not with AL index. Direct effect estimates showed that overcommitment was directly associated with higher SRQ-20 scores, and indirectly via AL.

Conclusion

Our study reveals that overcommitment, rather than ERI, was linked to increased AL in healthcare workers. Additionally, AL mediates the relationship between overcommitment and higher psychiatric symptoms, highlighting a key mechanism by which work stress can lead to mental health problems. Individual's responses to high work demands need to be considered when designing predictive models and interventions for mental health issues.

Work-related stress is a major public health issue. Given the relationship between acute stress responses and health, finding strategies to deal with the unpleasant symptoms brought on by stress is essential. Massage therapy is a popular stress-reduction technique, but its effectiveness has yet to be shown. In that matter, this study investigates the effects of a 17-minute session of seated Amma massage on young healthy people. Subjective stress perception, anxiety and self-confidence were assessed before and after the massage using the Spielberger State Anxiety Scale (STAI-Y, Spielberger et al., 1983) and the Competitive State Anxiety Inventory (EEAC, Cury et al., 1999), together with cardiovascular parameters. Cortisol, CGRP, IL-6, and oxytocin plasma levels were measured before and after the massage to investigate its possible mode of action. This study enrolled 59 people: 33 receiving the massage, and 26 controls only seated on the massage chair.

Interaction Time x Group demonstrates significant differences for all psychological measurements (STAI, EEAC) before and after the Amma massage, showing a beneficial effect of this treatment, in particular on perceived anxiety and self-confidence. No evidence was found of any correlation between cortisol plasma levels and psychological outcomes. No relationship was shown between the decrease of perceived stress and measured CGRP or IL-6 release, but the data demonstrated that heart frequency could be slightly decreased. The oxytocin plasma levels were significantly increased by the massage and could be responsible for the recovery of psychological outcomes.

We conclude that seated acupressure Amma massage could be a useful tool to ameliorate quality of life at work.

Healthcare is presently experiencing a global workforce crisis, marked by the inability of hospitals to retain qualified healthcare workers. Indeed, poor working conditions and staff shortages have contributed to structural collapse and placed a heavy toll on healthcare workers’ (HCWs) well-being, with many suffering from stress, exhaustion, demoralization, and burnout. An additional factor driving qualified HCWs away is the repeated experience of moral distress, or the inability to act according to internally held moral values and perceived ethical obligations due to internal and external constraints. Despite general awareness of this crisis, we currently lack an organized understanding of how stress leads to poor health, wellbeing, and performance in healthcare workers. To address this critical issue, we first review the literature on moral distress, stress, and health in HCWs. Second, we summarize the biobehavioral pathways linking occupational and interpersonal stressors to health in this population, focusing on neuroendocrine, immune, genetic, and epigenetic processes. Third, we propose a novel Psychoneuroimmunological Model of Moral Distress and Health in HCWs based on this literature. Finally, we discuss evidence-based individual- and system-level interventions for preventing stress and promoting resilience at work. Throughout this review, we underscore that stress levels in HCWs are a major public health concern, and that a combination of system-level and individual-level interventions are necessary to address preventable health care harm and foster resilience in this population, including new health policies, mental health initiatives, and additional translational research.

Background

Evidence suggests that countries with higher Covid-19 infection rates experienced poorer mental health. This study examined whether hair cortisol reduced over time in New Zealand, a country that managed to eliminate the virus in the first year of the pandemic due to an initial strict lockdown.

Methods

A longitudinal cohort study assessed self-reported stress, anxiety and depression and collected hair samples that were analyzed for cortisol, across two waves in 2020. The sample consisted of 44 adults who each returned two 3 cm hair samples and completed self-reports. Hair cortisol was assessed per centimetre.

Results

Hair cortisol reduced over time (F (5, 99.126) = 10.15, p < .001, partial eta squared = 0.19), as did anxiety and depression. Higher hair cortisol was significantly associated with more negative life events reported at wave two (r = 0.30 segment 1, r = 0.34 segment 2, p < .05), but not anxiety or depression.

Conclusions

Strict virus control measures may not only reduce infection rates, but also reduce psychological distress, and hair cortisol over time.

Background

Oxytocin is a neuropeptide known for its prosocial properties and role in social bonding, and intervention with intranasal oxytocin is posited to modulate affective and social cognition (i.e., hot cognition). Serotonin (5-HT) neurotransmission is also involved in emotional and social behaviors and appear to work in concert with oxytocin. However, this interaction so far remains elusive in humans. Therefore, we here investigate the relation between brain 5-HT 4 receptor (5-HT₄R) levels and oxytocin-modulated hot cognition.

Methods

Using a double blind, placebo-controlled, randomized crossover design, 35 healthy women received a dose of 24 IU intranasal oxytocin or placebo one month apart. The women were naturally cycling and to control for hormonal fluctuations across the menstrual cycle, intervention days were placed during the early follicular phase. Following intervention cognitive domains including affective memory, affective bias in emotion processing, moral emotions and social information preference were assessed. In a subgroup (n = 25), Positron Emission Tomography (PET) was used to image 5-HT₄R brain binding at baseline with the [¹¹C]SB207145 radiotracer.

Results

No effect of oxytocin intervention relative to placebo was observed for any of the cognitive outcomes. Likewise, regional brain 5-HT₄R binding at baseline was not associated with cognitive responses to oxytocin intervention.

Conclusion

Our data suggest that intervention with intranasal oxytocin does not have an overall effect on hot cognition in healthy women and further that 5-HT₄R brain architecture does not mediate cognitive effects of oxytocin in the healthy state.

Background

The biological embedding theory posits that early life experiences can lead to enduring physiological and molecular changes impacting various life outcomes, notably academic performance. Studying previously revealed and objective biomarkers of early life stress exposure, such as telomere length (TL), glucocorticoid receptor gene DNA methylation (DNAme), and the volume of brain structures involved in the regulation of HPA axis functioning (the hippocampus, the amygdala, and the medial prefrontal cortex), in relation to academic performance is crucial. This approach provides an objective measure that surpasses the limitations of self-reported early life adversity and reveals potential molecular and neurological targets for interventions to enhance academic outcomes.

Methods

The participants were 52 children of Mexican or Central American origin aged 11.6–15.6 years. DNA methylation levels and TL were analyzed in three cell sources: saliva, whole blood, and T cells derived from whole blood.

Results

Overall, the concordance across three systems of stress-related biomarkers (TL, DNAme, and the brain) was observed to some extent, although it was less pronounced than we expected; no consistency in different cell sources was revealed. Each of the academic domains that we studied was characterized by a unique and distinct complex of associations with biomarkers, both in terms of the type of biomarker, the directionality of the observed effects, and the cell source of biomarkers. Furthermore, there were biomarker-by-sex interaction effects in predicting academic performance measures.

Conclusions

Assessed in an understudied youth sample, these preliminary data present new essential evidence for a deepened understanding of the biological mechanisms behind associations between exposure to early life stress and academic performance.

Breastfeeding has long been known to improve infants' health and mental development and to enhance the mother-infant bond, but much less research focused on the biological composition of breast milk and its associations with the infant's biomarkers and social development. In this exploratory study, we measured oxytocin (OT) and secretory immunoglobulin-A (s-IgA), the most abundant antibody in breast milk, and evaluated their associations with the same biomarkers in infant saliva and, consequently, with infant social engagement behavior. Fifty-five mother-infant dyads were home-visit and OT and s-IgA were assessed from breast milk and from infant saliva before and after a free-play interaction. Infant social behavior was coded offline using the Coding Interactive Behavior (CIB) and maternal anxiety self-reported. A path model revealed that mother's breast milk s-IgA impacted child social engagement via its links with child OT. In parallel, maternal breast milk OT was linked with infant social behavior through its association with the infant's immunity. This path was moderated by maternal anxiety; only in cases of high anxiety breast milk OT was positively connected to infant s-IgA. Our study, the first to measure OT and s-IgA in both breast milk and infant saliva in relation to observed social behavior, underscores the need for much further research on the dynamic interplay between breast milk composition, infant biomarkers, maternal mental health, and infant social outcomes. Results may suggest that biological systems in breast milk integrate to prepare infants to function in their social ecology through bio-behavioral feedback loops that signal the degree of stress in the environment.

This is the story of my 50-year career in medicine and research, and the people who influenced and helped me most along the way. I recount the way in which I became interested in oxytocin early in my career as a child psychiatrist, and how it led me back to Columbia University, my alma mater, to study oxytocin's role in mother-child innate behaviors. I recount how oxytocin/oxytocin receptor signaling was central to my basic and clinical research and present a new theory on mother-infant emotional behaviors that challenges 400 years of brain-centric science. My history underscores the important and unique perspective women bring to science and why women are especially needed in the sciences. I hope to inspire young women (and young men) who are beginning their careers in research.