RESUMEN
This study evaluates the association of birth conditions with attention deficit/hyperactivity disorders (ADHD) in adults using data from two birth cohorts in the city of Pelotas Rio Grande do Sul State, Brazil. In 1982 and 1993 all births in the city were identified and have been prospectively monitored. In the follow-ups at 30 and 22 years of the 1982 (n = 3,574) and 1993 (n = 3,780) cohorts, respectively, participants were examined, and trained psychologists applied the Mini-International Neuropsychiatric Interview (M.I.N.I.). Those individuals who met the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria were defined as positive for ADHD. Poisson regression with robust variance adjustment was used to estimate the prevalence ratio (PR) adjusted for sex, maternal skin color, family income, maternal age, maternal schooling during pregnancy, maternal marital status, parity, and maternal smoking during pregnancy. The prevalence of adult ADHD was 4.4% and 4.5% in the 1982 and 1993 cohorts, respectively. The prevalence of ADHD was higher in those born with lower weight, but no linear trend was observed, and those born with weight between 3,000 and 3,499 grams (PR = 1.40; 95%CI: 1.05-1.86) had the highest risk. For gestational age, we observed an inversely proportional relationship for the presence of ADHD: preterm infants had a 33% higher risk (95%CI: 0.90-1.96) of being considered as having ADHD than those born at 39 or more weeks, but as the confidence interval included nullity, this association may have occurred at random. These results indicate that birth weight and gestational age may be associated with adult ADHD.
Este artigo avaliou a associação das condições de nascimento com o transtorno do déficit de atenção com hiperatividade (TDAH) em adultos utilizando dados de duas coorte de nascimento da cidade de Pelotas, Rio Grande do Sul, Brasil. Em 1982 e 1993, todos os nascimentos ocorridos na cidade foram identificados e prospectivamente acompanhados. Nos acompanhamentos aos 30 e 22 anos das coortes 1982 (n = 3.574) e 1993 (n = 3.780), respectivamente, os participantes foram examinados e psicólogos treinados aplicaram a Mini-International Neuropsychiatric Interview (M.I.N.I.). Aqueles indivíduos que preencheram os critérios diagnósticos do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-5) foram definidos como positivos para TDAH. A regressão de Poisson com ajuste robusto da variância foi usada para estimar a razão de prevalência (RP) ajustadas para sexo, cor da pele materna, renda familiar, idade materna, escolaridade materna durante a gestação, estado civil materno, paridade e tabagismo materno durante a gestação. A prevalência do TDAH adulto foi de 4,4% e 4,5% nas coortes de 1982 e 1993, respectivamente. A prevalência de TDAH foi maior naqueles que nasceram com menor peso, mas não foi observada tendencia linear. Além disso, aqueles que nasceram com peso entre 3.000 e 3.499 gramas (g) (RP = 1,40, IC95%: 1,05-1,86) apresentaram maior risco para o transtorno. Para a idade gestacional, observamos uma relação inversamente proporcional acerca da presença de TDAH, os pré-termos apresentaram risco 33% maior (IC95%: 0,90-1,96) de ser considerado com TDAH do que os nascidos com 39 ou mais semanas, mas como o intervalo de confiança incluiu a nulidade, essa associação pode ter ocorrido ao acaso. Tais resultados indicam que o peso ao nascer e a idade gestacional podem estar associados ao TDAH adulto.
El presente estudio evaluó la asociación de las condiciones de nacimiento con el trastorno por déficit de atención con hiperactividad (TDAH) en adultos utilizando datos de dos cohortes de nacimiento de la ciudad de Pelotas. En 1982 y 1993 se identificaron todos los nacimientos de la ciudad y se les ha hecho un seguimiento prospectivo. En los seguimientos a los 30 y 22 años de las cohortes de 1982 (n = 3.574) y 1993 (n = 3.780), respectivamente, los participantes fueron examinados y psicólogos capacitados aplicaron la Mini-International Neuropsychiatric Interview (M.I.N.I.). Aquellas personas que cumplieron con los criterios de diagnóstico del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM-5) se definieron como positivos para TDAH. Se utilizó la regresión de Poisson con ajuste robusto de la varianza para estimar la razón de prevalencia (RP) ajustada por sexo, color de piel materna, ingreso familiar, edad materna, educación materna en la gestación, estado civil materno, paridad y tabaquismo materno en la gestación. La prevalencia del TDAH en adultos fue de 4,4% y 4,5 %, en las cohortes de 1982 y 1993, respectivamente. La prevalencia de TDAH fue mayor en aquellos que nacieron con menor peso, pero no se observó una tendencia lineal, y aquellos que nacieron con peso entre 3.000 y 3.499 gramos (RP = 1,40; IC95%: 1,05-1,86) presentaron el mayor riesgo. Para la edad gestacional, se observó una relación inversamente proporcional para la presencia de TDAH, los niños prematuros presentaron un 33 % más de riesgo (IC95 %: 0,90-1,96), de ser considerado como teniendo TDAH que los nacidos con 39 o más semanas, pero como el intervalo de confianza incluyó la nulidad, esa asociación puede haber ocurrido al azar. Tales resultados indican que el peso al nacer y la edad gestacional pueden estar asociados con el TDAH en adultos.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad , Embarazo , Lactante , Femenino , Humanos , Adulto , Recién Nacido , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Recien Nacido Prematuro , Cohorte de Nacimiento , Brasil/epidemiología , Edad MaternaRESUMEN
Este artigo avaliou a associação das condições de nascimento com o transtorno do déficit de atenção com hiperatividade (TDAH) em adultos utilizando dados de duas coorte de nascimento da cidade de Pelotas, Rio Grande do Sul, Brasil. Em 1982 e 1993, todos os nascimentos ocorridos na cidade foram identificados e prospectivamente acompanhados. Nos acompanhamentos aos 30 e 22 anos das coortes 1982 (n = 3.574) e 1993 (n = 3.780), respectivamente, os participantes foram examinados e psicólogos treinados aplicaram a Mini-International Neuropsychiatric Interview (M.I.N.I.). Aqueles indivíduos que preencheram os critérios diagnósticos do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-5) foram definidos como positivos para TDAH. A regressão de Poisson com ajuste robusto da variância foi usada para estimar a razão de prevalência (RP) ajustadas para sexo, cor da pele materna, renda familiar, idade materna, escolaridade materna durante a gestação, estado civil materno, paridade e tabagismo materno durante a gestação. A prevalência do TDAH adulto foi de 4,4% e 4,5% nas coortes de 1982 e 1993, respectivamente. A prevalência de TDAH foi maior naqueles que nasceram com menor peso, mas não foi observada tendencia linear. Além disso, aqueles que nasceram com peso entre 3.000 e 3.499 gramas (g) (RP = 1,40, IC95%: 1,05-1,86) apresentaram maior risco para o transtorno. Para a idade gestacional, observamos uma relação inversamente proporcional acerca da presença de TDAH, os pré-termos apresentaram risco 33% maior (IC95%: 0,90-1,96) de ser considerado com TDAH do que os nascidos com 39 ou mais semanas, mas como o intervalo de confiança incluiu a nulidade, essa associação pode ter ocorrido ao acaso. Tais resultados indicam que o peso ao nascer e a idade gestacional podem estar associados ao TDAH adulto.
This study evaluates the association of birth conditions with attention deficit/hyperactivity disorders (ADHD) in adults using data from two birth cohorts in the city of Pelotas Rio Grande do Sul State, Brazil. In 1982 and 1993 all births in the city were identified and have been prospectively monitored. In the follow-ups at 30 and 22 years of the 1982 (n = 3,574) and 1993 (n = 3,780) cohorts, respectively, participants were examined, and trained psychologists applied the Mini-International Neuropsychiatric Interview (M.I.N.I.). Those individuals who met the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria were defined as positive for ADHD. Poisson regression with robust variance adjustment was used to estimate the prevalence ratio (PR) adjusted for sex, maternal skin color, family income, maternal age, maternal schooling during pregnancy, maternal marital status, parity, and maternal smoking during pregnancy. The prevalence of adult ADHD was 4.4% and 4.5% in the 1982 and 1993 cohorts, respectively. The prevalence of ADHD was higher in those born with lower weight, but no linear trend was observed, and those born with weight between 3,000 and 3,499 grams (PR = 1.40; 95%CI: 1.05-1.86) had the highest risk. For gestational age, we observed an inversely proportional relationship for the presence of ADHD: preterm infants had a 33% higher risk (95%CI: 0.90-1.96) of being considered as having ADHD than those born at 39 or more weeks, but as the confidence interval included nullity, this association may have occurred at random. These results indicate that birth weight and gestational age may be associated with adult ADHD.
El presente estudio evaluó la asociación de las condiciones de nacimiento con el trastorno por déficit de atención con hiperactividad (TDAH) en adultos utilizando datos de dos cohortes de nacimiento de la ciudad de Pelotas. En 1982 y 1993 se identificaron todos los nacimientos de la ciudad y se les ha hecho un seguimiento prospectivo. En los seguimientos a los 30 y 22 años de las cohortes de 1982 (n = 3.574) y 1993 (n = 3.780), respectivamente, los participantes fueron examinados y psicólogos capacitados aplicaron la Mini-International Neuropsychiatric Interview (M.I.N.I.). Aquellas personas que cumplieron con los criterios de diagnóstico del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM-5) se definieron como positivos para TDAH. Se utilizó la regresión de Poisson con ajuste robusto de la varianza para estimar la razón de prevalencia (RP) ajustada por sexo, color de piel materna, ingreso familiar, edad materna, educación materna en la gestación, estado civil materno, paridad y tabaquismo materno en la gestación. La prevalencia del TDAH en adultos fue de 4,4% y 4,5 %, en las cohortes de 1982 y 1993, respectivamente. La prevalencia de TDAH fue mayor en aquellos que nacieron con menor peso, pero no se observó una tendencia lineal, y aquellos que nacieron con peso entre 3.000 y 3.499 gramos (RP = 1,40; IC95%: 1,05-1,86) presentaron el mayor riesgo. Para la edad gestacional, se observó una relación inversamente proporcional para la presencia de TDAH, los niños prematuros presentaron un 33 % más de riesgo (IC95 %: 0,90-1,96), de ser considerado como teniendo TDAH que los nacidos con 39 o más semanas, pero como el intervalo de confianza incluyó la nulidad, esa asociación puede haber ocurrido al azar. Tales resultados indican que el peso al nacer y la edad gestacional pueden estar asociados con el TDAH en adultos.
RESUMEN
INTRODUCTION: This article presents the methods used to design a prospective cohort study with older adults from a rural area in the far south of Brazil (EpiRural Cohort Study), as well as to describe the cohort profile. METHODS: The cohort study began in 2017 and evaluated older adults (≥60 years) living in rural area. The first follow-up of the cohort was carried out between September 2018 and March 2019. Data collection at baseline and first follow-up was performed through an electronic questionnaire containing demographic, socioeconomic and health-related questions, such as alcohol and cigarette consumption, morbidities and self-perceived health status. RESULTS: At baseline, 1130 older adults were sampled, 1029 of whom were interviewed (91.1%). The age of almost 17% was 80 years or more, and 55.2% were male. At first follow-up, 862 individuals were followed (83.8%) and the characteristics of the older adults interviewed compared to those not interviewed at follow-up were similar. Between baseline and follow-up, the proportion of individuals aged 70-79 years increased, as well as the proportion of those who had consumed alcoholic beverages in the previous week and who had hypertension. The male-to-female ratio, those who were living alone, working, smokers, diabetics, who had stroke and who reported their health as being very good/good were comparable between the baseline and follow-up. CONCLUSION: With a reasonable follow-up rate, it was possible to transform a cross-sectional study into a prospective cohort study. However, new strategies will be needed to help locate participants more successfully and ensure a good response rate in future follow-ups.
Asunto(s)
Envejecimiento , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Estudios de Cohortes , Estudios Transversales , Femenino , Humanos , Masculino , Estudios Prospectivos , Encuestas y CuestionariosRESUMEN
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.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad , Transcortina , alfa 1-Antitripsina , Trastorno por Déficit de Atención con Hiperactividad/genética , Brasil , Marcadores Genéticos , Genotipo , Humanos , Hidrocortisona/metabolismo , Polimorfismo de Nucleótido Simple , Transcortina/genética , alfa 1-Antitripsina/genéticaRESUMEN
Abstract Ayahuasca (AYA) is a psychedelic beverage with therapeutic potential for many mood and anxiety disorders. Although there are some preclinical studies, no published reports have tested the behavioral effects of AYA gavage in animal models. This investigation aimed to characterize the behavior of Wistar rats after acute ingestion of AYA for 40 min in the open field test (OFT). The sample consisted of three experimental groups treated with different dosages of AYA (125, 250, or 500 mg kg-1) and a control group. Each group consisted of 10 participants. After gavage, the number of crossings of the OFT grid lines, latency to enter the central area of the device, grooming frequency, and time spent in the central perimeter of the device were immediately evaluated. Analyses were based on one-way ANOVA and a linear-regression mixture model for longitudinal data. AYA intake did not interfere with habituation. The 500 mg kg-1 group showed a decrease in the time spent in the center of the device and in the number of crossings compared to the control group in the last 10 min. These results suggest that gavage with AYA did not interfere with the results, and the behavioral effects were perceived only between 30 and 40 min after gavage. Taken together, the results indicate that three aspects should be considered in OFT studies of AYA acute effects: the moment when the observation starts, the observation period, and the AYA dosage.
Asunto(s)
Animales , Masculino , Ratas , Conducta/clasificación , Banisteriopsis/efectos adversos , Investigación Conductal/instrumentación , Prueba de Campo Abierto , Trastornos de Ansiedad/tratamiento farmacológico , Alucinógenos/efectos adversosRESUMEN
Early life stressors, such as childhood trauma, have been associated to alterations in immune response that can last until adulthood. In this context, interleukin 1ß (IL-1ß) emerges as a pro-inflammatory cytokine with a pivotal role. Also, considering the temperament differences in stress susceptibility, and even immune dysfunction, studies investigating the complex interaction between these factors are scarce. Thus, the aim of the present study was to evaluate the moderating role of temperament traits in the relationship between childhood trauma and serum IL-1ß levels. This cross-sectional study consisted of 325 individuals, men and women, aged 18-35, enrolled from a population-based study in the city of Pelotas, Southern Brazil. Our main results indicate that higher serum levels of IL-1ß were associated with trauma severity (p < 0.01), and the variance of anger could explain 29% of IL-1ß increase in individuals who suffered severe trauma (p < 0.05). The effect of anger was considerably stronger in men than in women (46% and 25%, respectively). Moreover, the variance of sensitivity also explained 15% of IL-1ß increase (p < 0.05) as well as the variance of volition explained 11% of IL-1ß decrease (p < 0.05) in individuals who suffered severe trauma in the general population. Our results indicate that emotional individual differences can moderate the impact of childhood trauma on low-grade inflammation in young adults.