[Body image and associated factors among students from the municipal school network in a city in southern Brazil]. / Imagem corporal e fatores associados em estudantes da rede municipal de ensino em uma cidade no sul do Brasil.

A negative perception of body image is related to worsening of physical and mental health. This cross-sectional study sought to describe the relationship between body image and demographic, socioeconomic and behavioral factors in ninth grade students from 25 municipal elementary schools in Pelotas, Rio Grande do Sul. A total of 810 students participated (85% of those eligible), aged 13 to 22 years (mean age 14.9 years). Data were collected through a standardized and pre-coded questionnaire and the relationship between the outcome (satisfied/indifferent or dissatisfied with body image), and independent variables were analyzed using Multinomial Logistic Regression. The prevalence of body dissatisfaction of 31%, higher among girls who tried smoking or alcohol, suffered bullying, perceived themselves as fat/thin and tried to lose/gain weight. There was greater indifference among those who attributed little or no importance to image. In boys, there was a higher incidence of dissatisfaction among those who tried smoking, suffered bullying, gave little/no importance to image, saw themselves as fat and tried to gain weight. There was greater indifference in boys who attributed little importance to image and were obese. A third of the sample were dissatisfied, which was associated with various behavioral factors.

A percepção negativa da imagem corporal está relacionada à piora da saúde física e mental. Estudo transversal objetivou descrever a relação entre imagem corporal e fatores demográficos, socioeconômicos e comportamentais nos estudantes do nono ano de 25 escolas municipais de ensino fundamental em Pelotas, Rio Grande do Sul. Participaram 810 estudantes (85% dos elegíveis), de 13 a 22 anos (média de 14,9 anos). Dados foram coletados mediante questionário padronizado e pré-codificado e a relação entre o desfecho (estar satisfeito, indiferente ou insatisfeito em relação à imagem corporal), e variáveis independentes, foi analisada por Regressão Logística Multinomial. Prevalência de insatisfação corporal de 31%, maior entre as meninas que experimentaram fumo ou álcool, sofreram bullying, se percebiam como gordas ou magras e tentavam perder ou ganhar peso. Maior indiferença nas que atribuíram pouca ou nenhuma importância à imagem. Nos meninos, mais chances de insatisfação entre os que experimentaram fumo, sofreram bullying, atribuíram pouca ou nenhuma importância à imagem, se percebiam gordos e tentavam ganhar peso. Maior indiferença nos meninos que atribuíram pouca importância à imagem e estavam obesos. Cerca de um terço da amostra apresentou insatisfação, que esteve associada a alguns fatores comportamentais.

Gene - maltreatment interplay in adult ADHD symptoms: main role of a gene-environment correlation effect in a Brazilian population longitudinal study.

Childhood maltreatment correlates with attention-deficit/hyperactivity disorder (ADHD) in previous research. The interaction between ADHD genetic predisposition and maltreatment's impact on ADHD symptom risk remains unclear. We aimed to elucidate this relationship by examining the interplay between a polygenic score for ADHD (ADHD-PGS) and childhood maltreatment in predicting ADHD symptoms during young adulthood. Using data from the 2004 Pelotas (Brazil) birth cohort comprising 4231 participants, we analyzed gene-environment interaction (GxE) and correlation (rGE). We further explored rGE mechanisms through mediation models. ADHD symptoms were assessed at age 18 via self-report (Adult Self Report Scale - ASRS) and mother-reports (Strength and Difficulties Questionnaire - SDQ). The ADHD-PGS was derived from published ADHD GWAS meta-analysis. Physical and psychological child maltreatment was gauged using the Parent-Child Conflict Tactics Scale (CTSPC) at ages 6 and 11, with a mean score utilized as a variable. The ADHD-PGS exhibited associations with ADHD symptoms on both ASRS (ß = 0.53; 95% CI: 0.03; 1.03, p = 0.036), and SDQ (ß = 0.20; 95% CI: 0.08; 0.32, p = 0.001) scales. The total mean maltreatment score was associated with ADHD symptoms using both scales [(ßASRS = 0.51; 95% CI: 0.26;0.77) and (ßSDQ = 0.24; 95% CI: 0.18;0.29)]. The ADHD-PGS was associated with total mean maltreatment scores (ß = 0.09; 95% CI: 0.01; 0.17; p = 0.030). Approximately 47% of the total effect of ADHD-PGS on maltreatment was mediated by ADHD symptoms at age 6. No evidence supported gene-environment interaction in predicting ADHD symptoms. Our findings underscore the significant roles of genetics and childhood maltreatment as predictors for ADHD symptoms in adulthood, while also indicating a potential evocative mechanism through gene-environment correlation.

Evaluation of genomic factors and early childhood stimulation on intelligence in children from a Brazilian birth cohort: The primary role of independent factors.

BACKGROUND: Childhood cognitive abilities are a predictor of health outcomes and adult income potential. Identifying factors associated with childhood intelligence and their interactions is essential in behavioral research. We assessed the impact of genetic variants and early child stimulation (ECS) on child intelligence and examined their possible interaction as potential modifiers of IQ in a population-based longitudinal study. METHODS: Participants of the 2004 Pelotas Birth Cohort study (N = 4231) underwent intelligent quotient (IQ) by WISC-III assessment at 6 years of age. At 24 and 48-months, mothers answered five ECS marker questions, whose sum was used to create a score. The polygenic score for intelligence (IQ-PGS) was constructed from the GWAS-weighted estimate of cognition. Association was assessed using multiple linear regression models adjusted for maternal, family, and child confounding variables. To explore the possible influence of skin color and ethnoracial classification, the regression models were stratified according to the skin color variable, as a sensitivity analysis. RESULTS: In the adjusted analysis, IQ-PGS (ß = 0.79, 95% confidence interval [95% CI] 0.26;1.31) as well as ECS (ß = 2.34; 95% CI: 1.76;2.92) were associated with IQ in this sample. The association between IQ-PGS and IQ was significant only in the white Brazilian group in the sensitivity analysis. However, there was no interaction between IQ-PGS and ECS on IQ (p(IQ-PGS x ECS) = 0.46). CONCLUSIONS: ECS did not modify the impact of genetic potential on intellectual development during childhood, suggesting that genetic factors and ECS exert independent effects on the IQ levels of children.

Early risk factors for conduct problem trajectories from childhood to adolescence: the 2004 Pelotas (BRAZIL) Birth Cohort.

Conduct problems are associated with an increased risk of a wide range of physical, mental, and social problems. However, there is still uncertainty about how early risk factors differentiate different developmental patterns of conduct problems and whether findings replicate across diverse social contexts. We aimed to identify developmental trajectories of conduct problems, and test early risk factors, in the 2004 Pelotas Birth Cohort in Brazil. Conduct problems were measured at ages 4, 6, 11, and 15 years from caregiver reports on the Child Behaviour Checklist (CBCL) and Strengths and Difficulties Questionnaire (SDQ). Conduct problem trajectories were estimated using group-based semi-parametric modeling (n = 3938). Multinomial logistic regression was used to examine associations between early risk factors and conduct problem trajectories. We identified four trajectories: three with elevated conduct problems, including early-onset persistent (n = 150; 3.8%), adolescence-onset (n = 286; 17.3%), and childhood-limited (n = 697; 17.7%), and one with low conduct problems (n = 2805; 71.2%). The three elevated conduct problem trajectories were associated with a wide range of sociodemographic risk factors, prenatal smoking, maternal mental health, harsh parenting, childhood trauma, and child neurodevelopmental risk factors. Early-onset persistent conduct problems were particularly associated with trauma, living without a father figure, and attention difficulties. The four trajectories of conduct problems from ages 4 to 15 years in this Brazilian cohort have similar longitudinal patterns to those identified in high-income countries. The results confirm previous longitudinal research and developmental taxonomic theories on the etiology of conduct problems in a Brazilian sample.

The association between maternal fears about their infant/toddler during the COVID-19 pandemic and depression and anxiety: a birth cohort study

Objective: To assess the association between maternal fears about their infant/toddler and depression and anxiety during the COVID-19 pandemic. Methods: In 2019, all mothers who gave birth in hospitals in Rio Grande, RS, Brazil were asked to respond to a standardized questionnaire (baseline). We followed them between May-June 2020 (first follow-up point), August-December 2020 (second follow-up point), and from October 2021 to March 2022 (third follow-up point), and asked them if they were: (1) afraid that their infant/toddler would become infected with COVID or get sick (yes/no), (2) afraid that they would contaminate their own child with COVID, and/or (3) worried about the pandemic's effects on their child's future. At baseline and at all follow-up points, we assessed depressive symptoms using the Edinburgh Postnatal Depression Scale and anxiety symptoms using the Generalized Anxiety Disorder Scale, creating symptom trajectories using group-based trajectory modelling. We used multinomial logistic regression to calculate adjusted relative risk ratios (RRR). Results: A total of 1,296 mothers participated. Worrying about the pandemic's effects on their child's future and the fear of contaminating their own child with COVID-19 increased the risk of raising depressive symptoms to a clinical level (RRR = 4.97, 95%CI 2.32-10.64 and RRR = 3.87, 95%CI 1.58-9.47, respectively) and anxiety to a moderate level (RRR = 2.91, 95%CI 1.69-5.01 and RRR = 1.86, 95%CI 1.03-3.35, respectively). Conclusion: Fear for their children increased maternal depressive and anxiety symptoms during the pandemic.

The association between maternal fears about their infant/ toddler during the COVID-19 pandemic and depression and anxiety: a birth cohort study.

OBJECTIVE: To assess the association between maternal fears about their infant/toddler and depression and anxiety during the COVID-19 pandemic. METHODS: In 2019, all mothers who gave birth in hospitals in Rio Grande, RS, Brazil were asked to respond to a standardized questionnaire (baseline). We followed them between May-June 2020 (first follow-up point), August-December 2020 (second follow-up point), and from October 2021 to March 2022 (third follow-up point), and asked them if they were: (1) afraid that their infant/toddler would become infected with COVID or get sick (yes/no), (2) afraid that they would contaminate their own child with COVID, and/or (3) worried about the pandemic's effects on their child's future. At baseline and at all follow-up points, we assessed depressive symptoms using the Edinburgh Postnatal Depression Scale and anxiety symptoms using the Generalized Anxiety Disorder Scale, creating symptom trajectories using group-based trajectory modelling. We used multinomial logistic regression to calculate adjusted relative risk ratios (RRR). RESULTS: A total of 1,296 mothers participated. Worrying about the pandemic's effects on their child's future and the fear of contaminating their own child with COVID-19 increased the risk of raising depressive symptoms to a clinical level (RRR = 4.97, 95%CI 2.32-10.64 and RRR = 3.87, 95%CI 1.58-9.47, respectively) and anxiety to a moderate level (RRR = 2.91, 95%CI 1.69-5.01 and RRR = 1.86, 95%CI 1.03-3.35, respectively). CONCLUSION: Fear for their children increased maternal depressive and anxiety symptoms during the pandemic.

Secular trends and social inequalities in child behavioural problems across three Brazilian cohort studies (1993, 2004 and 2015).

AIMS: Previous epidemiological evidence identified a concerning increase in behavioural problems among young children from 1997 to 2008 in Brazil. However, it is unclear whether behavioural problems have continued to increase, if secular changes vary between sociodemographic groups and what might explain changes over time. We aimed to monitor changes in child behavioural problems over a 22-year period from 1997 to 2019, examine changing social inequalities and explore potential explanations for recent changes in behavioural problems between 2008 and 2019. METHODS: The Child Behaviour Checklist was used to compare parent-reported behavioural problems in 4-year-old children across three Brazilian birth cohorts assessed in 1997 (1993 cohort, n = 633), 2008 (2004 cohort, n = 3750) and 2019 (2015 cohort, n = 577). Response rates across all three population-based cohorts were over 90%. Moderation analyses tested if cross-cohort changes differed by social inequalities (demographic and socioeconomic position), while explanatory models explored whether changes in hypothesized risk and protective factors in prenatal development (e.g., smoking during pregnancy) and family life (e.g., maternal depression and harsh parenting) accounted for changes in child behavioural problems from 2008 to 2019. RESULTS: Initial increases in child behavioural problems from 1997 to 2008 were followed by declines in conduct problems (mean change = -2.75; 95% confidence interval [CI]: -3.56, -1.94; P < 0.001), aggression (mean change = -1.84; 95% CI: -2.51, -1.17; P < 0.001) and rule-breaking behaviour (mean change = -0.91; 95% CI: -1.13, -0.69 P < 0.001) from 2008 to 2019. Sex differences in rule-breaking behaviour diminished during this 22-year period, whereas socioeconomic inequalities in behavioural problems emerged in 2008 and then remained relatively stable. Consequently, children from poorer and less educated families had higher behavioural problems, compared to more socially advantaged children, in the two more recent cohorts. Changes in measured risk and protective factors partly explained the reduction in behavioural problems from 2008 to 2019. CONCLUSIONS: Following a rise in child behavioural problems, there was a subsequent reduction in behavioural problems from 2008 to 2019. However, social inequalities increased and remained high. Continued monitoring of behavioural problems by subgroups is critical for closing the gap between socially advantaged and disadvantaged children and achieving health equity for the next generation.

Genetic risk for attention-deficit/hyperactivity disorder predicts cognitive decline and development of Alzheimer's disease pathophysiology in cognitively unimpaired older adults.

Attention-deficit/hyperactivity disorder (ADHD) persists in older age and is postulated as a risk factor for cognitive impairment and Alzheimer's Disease (AD). However, these findings rely primarily on electronic health records and can present biased estimates of disease prevalence. An obstacle to investigating age-related cognitive decline in ADHD is the absence of large-scale studies following patients with ADHD into older age. Alternatively, this study aimed to determine whether genetic liability for ADHD, as measured by a well-validated ADHD polygenic risk score (ADHD-PRS), is associated with cognitive decline and the development of AD pathophysiology in cognitively unimpaired (CU) older adults. We calculated a weighted ADHD-PRS in 212 CU individuals without a clinical diagnosis of ADHD (55-90 years). These individuals had baseline amyloid-ß (Aß) positron emission tomography, longitudinal cerebrospinal fluid (CSF) phosphorylated tau at threonine 181 (p-tau181), magnetic resonance imaging, and cognitive assessments for up to 6 years. Linear mixed-effects models were used to test the association of ADHD-PRS with cognition and AD biomarkers. Higher ADHD-PRS was associated with greater cognitive decline over 6 years. The combined effect between high ADHD-PRS and brain Aß deposition on cognitive deterioration was more significant than each individually. Additionally, higher ADHD-PRS was associated with increased CSF p-tau181 levels and frontoparietal atrophy in CU Aß-positive individuals. Our results suggest that genetic liability for ADHD is associated with cognitive deterioration and the development of AD pathophysiology. Findings were mostly observed in Aß-positive individuals, suggesting that the genetic liability for ADHD increases susceptibility to the harmful effects of Aß pathology.

Can caregivers' mental disorders be associated with childhood obesogenic eating behavior? / Os transtornos mentais dos cuidadores podem estar associados a comportamentos alimentares obesogênicos na infância?

Abstract Objective: to assess the association between caregivers' mental disorders and schoolchildren's obesogenic eating behavior. Methods: cross-sectional study used a public school-based sample of children and their primary caregivers. Caregivers had to report depressive episodes or generalized anxiety disorder (GAD) during the Mini-International Neuropsychiatric Interview (MINI). Children's obesogenic eating behavior were assessed using food responsiveness (FR) and emotional overeating (EOE) subscales of the Children's Eating Behaviour Questionnaire (CEBQ). Bivariate analysis was conducted using the t-test, ANOVA, Pearson correlation, and adjusted linear regression model was used (including variables caregivers: sex, age, economic indicator, and schooling; schoolchildren: sex and nutritional status). Results: study includes 596 children-caregiver dyads (309 boys and 287 girls). Among caregivers, 24.7% had experienced current depressive episodes, 38.7% had past depressive episodes, and 17.2% had GAD. We observed, after adjusted analysis, that having a caregiver in a current depressive episode, increases schoolchildren's obesogenic behavior of, for FR at 0.235 points (β=0.235; CI95%=0.022-0.449;) and EOE at 0.337 points (β=0.337; CI95%=0.162-0.512). Conclusion: caregivers' current depressive episodes were associated with higher averages of obesogenic eating behavior (caregiver-reported), both in consuming palatable food without feeling hungry (FR) and in increasing food intake in response to negative emotions (EOE).

Resumo Objetivos: avaliar associação entre transtornos mentais do cuidador e comportamento alimentar obesogênico de escolares. Métodos: estudo transversal com amostra de crianças da rede pública de ensino e seu cuidador principal. Episódio depressivo atual e transtorno de ansiedade generalizada (TAG) do cuidador foi avaliado pela Mini-International Neuropsychiatric Interview (MINI). Comportamentos alimentares obesogênicos das crianças foi avaliado pelas subescalas resposta à comida (FR) e sobreingestão emocional (EOE) Children's Eating Behaviour Questionnaire (CEBQ). Análise bivariada foi realizada por meio de teste-T, ANOVA e correlação de Pearson. Modelo de regressão linear ajustado (incluiu variáveis cuidadores: sexo, idade, indicador econômico e escolaridade; escolares: sexo e estado nutricional). Resultados: foram avaliadas 596 díades crianças-cuidadores (309 meninos e 287 meninas). Entre os cuidadores, 24,7% apresentaram episódio depressivo atual, 38,7% episódio depressivo passado e 17,2% TAG. Observamos, após análise ajustada, que ter um cuidador em episódio depressivo atual aumenta o comportamento obesogênico dos escolares, em 0,235 pontos para FR (β=0,235; IC95%=0,022-0,449) e em 0,337 pontos para EOE (β=0,337; IC95%=0,162-0,512). Conclusão: episódio depressivo atual do cuidador foi associado a maiores médias de comportamentos alimentares obesogênicos dos escolares, tanto no consumo de alimentos palatáveis mesmo sem fome (FR) quanto aumento da ingestão alimentar em resposta a emoções negativas (EOE).

ADHD in childhood predicts BMI and body composition measurements over time in a population-based birth cohort.

BACKGROUND/OBJECTIVES: Obesity has been reported as an attention-deficit hyperactivity disorder (ADHD) comorbidity. So far, few studies have aimed to explore the potential causal relationship between ADHD and obesity, as well as used other measures of body composition like fat-free mass (FFM) and fat mass (FM) as measures of obesity. This study aimed to test the association between ADHD and body composition (body mass index [BMI] and others) and to evaluate the potential causal relationship with obesity. SUBJECTS/METHODS: Data from the 1993 Pelotas (Brazil) birth cohort at age 11-, 15-, 18-, and 22-year follow-up was used. We performed a cross-lagged panel model (CLPM) analysis between ADHD symptoms and BMI to explore the causal relationship between both traits. Finally, we tested whether ADHD, inattention, and hyperactivity symptom scales were associated with BMI, FM, and FFM at 22 years. RESULTS: In the CLPM, higher ADHD scores at age 11 predicted higher BMI at age 15 (ß = 0.055, 95% CI [0.037; 0.073]). ADHD symptoms at age 11 was also associated with a decrease in the FFM (ß = -0.16, 95% CI [-0.28; -0.05]), and an increase in the BMI (ß = 0.17, 95% CI [0.10; 0.23]) and FM (ß = 0.17, 95% CI [0.06; 0.29]) at 22 years. At 22 years of age, ADHD was associated with FFM and FM. Moreover, an increase in BMI was observed with an increase in several symptoms of ADHD in general (ß = 0.06, 95% CI [0.004; 0.12]), and hyperactivity symptoms (ß = 0.15, 95% CI [0.05; 0.25]). CONCLUSION: ADHD at 11 years predicted a higher BMI at 15 years, and body fat composition in adulthood, suggesting higher scores on ADHD symptoms in early life may be a critical point for body composition in early adulthood. The hyperactivity symptoms may play an important role in the BMI increase.

Stress-related genetic components in attention-deficit/hyperactivity disorder (ADHD): Effects of the SERPINA6 and SERPINA1 genetic markers in a family-based brazilian sample.

SERPINA6 and SERPINA1 were recently identified as the main genes associated with plasma cortisol concentration in humans. Although dysregulation in the Hypothalamus-Pituitary-Adrenal (HPA) axis has been observed in Attention Deficit/Hyperactivity Disorder (ADHD), the molecular mechanisms underlying this relationship are still unclear. Evaluation of the SERPINA6/SERPINA1 gene cluster in ADHD may provide relevant information to uncover them. We tested the association between the SERPINA6/SERPINA1 locus, including 95 single nucleotide polymorphisms (SNPs), and ADHD, using data from a Brazilian clinical sample of 259 ADHD probands and their parents. The single SNP association was tested using binary logistic regression, and we performed Classification and Regression Tree (CART) analysis to evaluate genotype combinations' effects on ADHD susceptibility. We assessed SNPs' regulatory effects through the Genotype-Tissue Expression (GTEx) v8 tool, and performed a complementary look-up analysis in the largest ADHD GWAS to date. There was a suggestive association between ADHD and eight variants located in the SERPINA6 region and one in the intergenic region between SERPINA6 and SERPINA1 after correction for multiple tests (p < 0.032). CART analysis showed that the combined effects of genotype GG in rs2144833 and CC in rs10129500 were associated with ADHD (OR = 1.78; CI95% = 1.24-2.55). The GTEx assigned the SNPs as eQTLs for genes in different tissues, including SERPINA6, and the look-up analysis revealed two SNPs associated with ADHD. These results suggest a shared genetic component between cortisol levels and ADHD. HPA dysregulation/altered stress response in ADHD might be mediated by upregulation of corticosteroid binding globulin (CBG, encoded by SERPINA6) expression.

Educational performance and conduct problem trajectories from childhood to adolescence: Observational and genetic associations in a Brazilian birth cohort.

Background: Educational difficulties are an important potential influence on both the onset and course of children's conduct problems. This study evaluated the association between school failure and children's conduct problems in Brazil, a context with high rates of both conditions, using both observational and genetic approaches. Methods: Prospective, population-based, birth cohort study in Pelotas city, Brazil. Parents reported on conduct problems four times between ages 4-15 years, and group-based trajectory analysis was used to classify 3469 children into trajectories of childhood-limited, early-onset persistent, adolescence-onset, or low conduct problems. School failure was measured as having repeated a school grade up to age 11, and a polygenic risk score (PRS) predicting educational attainment was calculated. Multinomial adjusted regression models were used to estimate the association between school failure (observational measure and the PRS) and conduct problem trajectories. To consider possible variation in effects of school failure by social context, interactions were tested with family income and school environment (using both observational and PRS methods). Results: Children repeating a school grade had increased odds of being on to childhood-limited (OR: 1.57; 95% CI 1.21; 2.03), adolescence-onset (OR: 1.96; 95% CI 1.39; 2.75), or early-onset persistent trajectory (OR: 2.99; 95% CI 1.85; 4.83), compared to the low conduct problem trajectory. School failure also predicted increased risk for early-onset persistent problems versus the childhood-limited problems (OR: 1.91; 95% CI 1.17; 3.09). Using a genetic PRS approach, similar findings were observed. Associations varied according to the school environment: school failure had larger effects on children in better school environments. Conclusion: School performance, whether measured in terms of repeating school grades or genetic susceptibility, was consistently associated with trajectories of child conduct problems into mid-adolescence. We also found a larger association for children in better school environments.

Association between Polygenic Risk Scores for ADHD and Asthma: A Birth Cohort Investigation.

OBJECTIVE: Shared genetic mechanisms have been hypothesized to explain the comorbidity between ADHD and asthma. To evaluate their genetic overlap, we relied on data from the 1982 Pelotas birth cohort to test the association between polygenic risk scores (PRSs) for ADHD (ADHD-PRSs) and asthma, and PRSs for asthma (asthma-PRSs) and ADHD. METHOD: We analyzed data collected at birth, 2, 22, and 30 years from 3,574 individuals. RESULTS: Subjects with ADHD had increased risk of having asthma (OR 1.92, 95% CI 1.01-3.66). The association was stronger for females. Our results showed no evidence of association between ADHD-PRSs and asthma or asthma-PRSs and ADHD. However, an exploratory analysis suggested that adult ADHD might be genetically associated with asthma. CONCLUSION: Our results do not support a shared genetic background between both conditions. Findings should be viewed in light of important limitations, particularly the sample size and the self-reported asthma diagnosis. Studies in larger datasets are required to better explore the genetic overlap between adult ADHD and asthma.

Caffeine-related genes influence anxiety disorders in children and adults with ADHD.

Attention-deficit/hyperactivity disorder (ADHD) and anxiety disorders (AD) frequently co-occur, increasing morbidity and challenging treatment. Caffeine is a central nervous system stimulant and acts in the brain through adenosine receptors, influencing attention, alertness, and anxiety. In the present study, we performed a gene-set analysis to verify if genes related to caffeine response are associated with anxiety disorders in 240 children and 406 adults with ADHD. We demonstrated an association between the gene-set with AD in children (P = 0.0054) and with the number of anxiety disorders in adults (P = 0.0197). In order to test if this effect is a result of anxiety in general or is related to AD comorbid with ADHD, we evaluated the association between caffeine gene-set with AD in an adult control sample. The gene-set was neither associated with the AD presence (P = 0.3008) nor with the number of AD (P = 0.5594) in this control sample. We also test this gene set with ADHD (n = 55,374) and AD (n = 18,186) GWAS summary statistics, and we did not observe significant results with ADHD (P = 0.5587) or AD (P = 0.3930). These findings suggest the caffeine-related genes play a role in the etiology of an anxiety disorder phenotype present in children and adults with ADHD.

A WhatsApp-Based Intervention to Improve Maternal Social Support and Maternal-Child Health in Southern Brazil: The Text-Message Intervention to Enhance Social Support (TIES) Feasibility Study.

Participatory learning and action cycles with women's groups have been recommended by the WHO to promote maternal and newborn health, but few studies have tested its feasibility and acceptability in mobile health (mHealth) interventions among mothers of toddlers. This was a mixed-method feasibility assessment of an 8-week WhatsApp-based maternal support group for mothers of toddlers (12-18 months of age) enrolled in a birth cohort study in Southern Brazil. Daily messages and weekly activities were sent by moderators to promote maternal-child outcomes: child nutrition, child sleep, nurturing care, and maternal psychosocial well-being (assessed pre- and post-intervention via self-reported questionnaire). The implementation and engagement of the mothers in the program were assessed by message extraction. Acceptability was evaluated through in-depth interviews (n = 5) and open-ended surveys (n = 10). 1481 messages were exchanged in 3 WhatsApp groups (n = 30 mothers). Mothers were most active on weekdays (68.6% of messages sent on Tuesdays and 72.6% on Thursdays), afternoons (2:00-4:00pm), and evenings (9:00-11:00 pm). Engagement was higher at weeks 1-4. Mothers enjoyed and considered topics relevant. Group interaction was perceived as low, which influenced their participation. The prevalence of depression symptoms decreased from pre- to post-intervention (9% to 5%; P = .04). A moderated mobile-based support group for mothers of toddlers was feasible. mHealth services to promote maternal support are a promising strategy to improve maternal-child outcomes, but engagement and use of the service remains a challenge. Program managers should work with community members to identify ways to support engagement and participation throughout the intervention.

Sleep-related traits and attention-deficit/hyperactivity disorder comorbidity: Shared genetic risk factors, molecular mechanisms, and causal effects.

OBJECTIVES: To evaluate the shared genetic components, common pathways and causal relationship between ADHD and sleep-related phenotypes. METHODS: We used the largest genome-wide association summary statistics available for attention-deficit/hyperactivity disorder (ADHD) and various sleep-related phenotypes (insomnia, napping, daytime dozing, snoring, ease getting up, daytime sleepiness, sleep duration and chronotype). We estimated the genomic correlation using cross-trait linkage disequilibrium score regression (LDSR) and investigated the potential common mechanisms using gene-based cross-trait metanalyses and functional enrichment analyses. The causal effect was estimated using two-sample Mendelian randomisation (TSMR), using the inverse variance weighted method as the main estimator. RESULTS: A positive genomic correlation between insomnia, daytime napping, daytime dozing, snoring, daytime sleepiness, short and long sleep duration, and ADHD was observed. Insomnia, daytime sleepiness, and snoring shared genes with ADHD, that are involved in neurobiological functions and regulatory signalling pathways. The TSMR supported a causal effect of insomnia, daytime napping, and short sleep duration on ADHD, and of ADHD on long sleep duration and chronotype. CONCLUSION: Comorbidity between sleep phenotypes and ADHD may be mediated by common genetic factors that play an important role in neuronal signalling pathways. A causal effect of sleep disturbances and short sleep duration on ADHD reinforced their role as predictors of ADHD.

Maternal mental health before and during the COVID-19 pandemic in the 2019 Rio Grande birth cohort.

OBJECTIVE: To describe and compare measures of maternal depression, anxiety, and posttraumatic stress symptoms before and during the coronavirus disease 2019 (COVID-19) pandemic in a Brazilian birth cohort. METHODS: All hospital births occurring in the municipality of Rio Grande (southern Brazil) during 2019 were identified. Mothers were invited to complete a standardized questionnaire on sociodemographic and health-related characteristics. Between May and July 2020, we tried to contact all cohort mothers of singletons, living in urban areas, to answer a standardized web-based questionnaire. They completed the Edinburgh Postnatal Depression Scale (EPDS) and Generalized Anxiety Disorder 7-item (GAD-7) in both follow-ups, and the Impact of Event Scale (IES) in the online follow-up. RESULTS: We located 1,136 eligible mothers (n=2,051). Of those, 40.5% had moderate to severe stress due to the current pandemic, 29.3% had depression, and 25.9% had GAD. Mothers reporting loss of income during the pandemic (57.2%) had the highest proportions of mental health problems. Compared to baseline, the prevalence of depression increased 5.7 fold and that of anxiety increased 2.4-fold during the pandemic (both p < 0.001). CONCLUSION: We found a high prevalence of personal distress due to the ongoing COVID-19 pandemic, and a clear rise in both maternal depression and anxiety.

Interest in food and triglyceride concentrations in children and adolescents with autistic spectrum disorder

Abstract Objective: To investigate eating behavior and serum concentration of triglycerides in children and adolescents with autistic spectrum disorder. Methods: Cross-sectional study conducted in the neurodevelopment nucleus, from October 2018 to April 2019 in a neurodevelopment center in the city of Pelotas/RS. Blood samples were collected, and serum was essayed for triglycerides by colorimetric enzymatic reaction. The Children's Eating Behavior Questionnaire was applied to the parents. The comparison between two or three categories of variables was performed with nonparametric tests. Linear regression was used to access the association between the log triglyceride serum concentration and the score above or below the median score of the food response and emotional overeating subscales. Results: Sixty patients were evaluated. The average age was 8.6 ± 3.2 years and most were white (75 %), male (80 %), and overweight (66%). Half of the sample had elevated triglycerides. Triglyceride concentrations were higher among overweight children and adolescents with higher median scores on the "food response" and "emotional overeating" subscales. In the adjusted analysis, the association between triglycerides and higher scores on subscales reflecting interest in food remained significant. Conclusion: Children and adolescents with autistic spectrum disorder present high triglyceride concentrations associated with a greater interest in food. Knowledge of this eating behavior may provide more effective nutritional intervention in this population.