Maternal atopic conditions and autism spectrum disorder: a systematic review.

Autism spectrum disorder (ASD) is a disabling neurodevelopmental condition with complex etiology. Emerging evidence has pointed to maternal atopy as a possible risk factor. It is hypothesized that maternal atopic disease during pregnancy can lead to increased levels of inflammatory cytokines in fetal circulation via placental transfer or increased production. These cytokines can then pass through the immature blood-brain barrier, causing aberrant neurodevelopment via mechanisms including premature microglial activation. The objective of this study is to systematically review observational studies that investigate whether a maternal history of atopic disease (asthma, allergy, or eczema/atopic dermatitis) is associated with a diagnosis of ASD in offspring. A search was conducted in Ovid MEDLINE, PsycINFO, and Embase databases for relevant articles up to November 2021; this was later updated in January 2022. Observational studies published in peer-reviewed journals were included. Data were synthesized and qualitatively analyzed according to the specific atopic condition. Quality assessment was done using the Newcastle-Ottawa Scale. Nine articles were identified, with all including asthma as an exposure, alongside four each for allergy and eczema. Findings were inconsistent regarding the association between a maternal diagnosis of either asthma, allergy, or eczema, and ASD in offspring, with variations in methodology contributing to the inconclusiveness. More consistent associations were demonstrated regarding maternal asthma that was treated or diagnosed during pregnancy. Evidence suggests that symptomatic maternal asthma during pregnancy could be associated with ASD in offspring, underscoring the importance of effective management of atopic conditions during pregnancy. Further research is needed, particularly longitudinal studies that use gold-standard assessment tools and correlate clinical outcomes with laboratory and treatment data.PROSPERO Registration Number and Date: CRD42018116656, 26.11.2018.

IRP commission: sexual minorities and mental health: global perspectives.

Sexual orientation is a key determinant of the identity of human beings. It has also been seen as a social determinant of health. People whose sexual orientation is non-heterosexual or sexual minorities or sexually diverse are included in the broad umbrella term LGBT (Lesbian, Gay, Bisexual, and Transgender) which is a commonly used acronym in activism, social policy, and subsequently cultural literature. For this reason, this Commission focuses primarily on sexual orientation i.e. lesbian, gay and bisexual (LGB) groups. We have used terms non-heterosexual, sexual minorities or sexual variation interchangeably. We have not considered asexual individuals as research in the field is too limited. We are cognisant of the fact that topics relating to mental health and sexual orientation discussed in this Commission will intersect with other issues of personal, cultural and social identity, and will thus be relevant to individuals including many transgender individuals. The inclusion of mental health issues relevant to gender-diverse individuals as well as gender identity is important and deserves its own separate detailed discussion. The exact number of sexually diverse individuals in a population is often difficult to estimate but is likely to be somewhere around 5% of the population. Rates of various psychiatry disorders and suicidal ideation and acts of suicide in LGB populations are higher than general population and these have been attributed to minority stress hypothesis. Elimination of inequality in law can lead to reduction in psychiatric morbidity in these groups. However, these are all diverse groups but even within each group there is diversity and each individual has a distinct and unique experiences, upbringing, responses to their own sexual orientation, and generating varying responses from families, peers and friends as well as communities (including healthcare professionals). The mental healthcare needs of sexual minority individuals vary and these variations must be taken into account in design, development and delivery of healthcare and policies. Improving access to services will help engagement and outcomes and also reduce stigma. The commission recommends that there is no role for so-called conversion therapies and other recommendations are made for clinicians, researchers and policymakers.

Prevalence of depression and anxiety symptoms and their correlation with posttraumatic growth among HIV-positive patients enrolled in an HIV/AIDS clinic at a tertiary hospital from July 2015 to October 2015

OBJECTIVES: This study evaluated the prevalence of anxiety, depression, and posttraumatic growth (positive psychological change as a result of the struggle with highly challenging life circumstances) among patients with HIV/AIDS as well as determine the correlation between these variables alongside select sociodemographic variables.METHODOLOGY: Fifty eight patients enrolled in an HIV/AIDS clinic at a tertiary hospital were selected via convenience sampling and asked to complete a sociodemographic questionnaire, the Posttraumatic Growth Inventory (PTGI) and the Hospital Anxiety and Depression Scale (HADS) from July to October 2015.RESULTS: Ninety three percent of the participants reported moderate to high levels of posttraumatic growth, with a mean score of 4.70 (SD = 0.86). 20.7% (11.2 - 33.4, CL=95%) of patients screened positive for depression while 55.2% (41.5 - 68.3, CL=95%) of patients screened positive for anxiety. A statistically significant negative corellation was demonstrated between posttraumatic growth and depression (r=-0.29, p-value= 0.027) but not for anxiety (r=.027, p-value= 0.118).CONCLUSION: There is a high prevalence of patients in the sample that exhibit depression and anxiety symptoms. Despite this, most patients report a capacity to experience positive changes in the aftermath of a life-threatening, chronic, and stigmatizing illness, correlating with a decrease in depressive symptomatology. As such, initiatives promoting posttraumatic growth are valuable in the comprehensive care for patients afflicted with HIV/AIDS.