Gut feelings: the relations between depression, anxiety, psychotropic drugs and the gut microbiome.

The gut microbiome is involved in the bi-directional relationship of the gut - brain axis. As most studies of this relationship are small and do not account for use of psychotropic drugs (PTDs), we explored the relations of the gut microbiome with several internalizing disorders, while adjusting for PTDs and other relevant medications, in 7,656 Lifelines participants from the Northern Netherlands (5,522 controls and 491 participants with at least one internalizing disorder). Disorders included dysthymia, major depressive disorder (MDD), any depressive disorder (AnyDep: dysthymia or MDD), generalized anxiety disorder (GAD) and any anxiety disorder (AnyAnx: GAD, social phobia and panic disorder). Compared to controls, 17 species were associated with depressive disorders and 3 were associated with anxiety disorders. Around 90% of these associations remained significant (FDR <0.05) after adjustment for PTD use, suggesting that the disorders, not PTD use, drove these associations. Negative associations were observed for the butyrate-producing bacteria Ruminococcus bromii in participants with AnyDep and for Bifidobacterium bifidum in AnyAnx participants, along with many others. Tryptophan and glutamate synthesis modules and the 3,4-Dihydroxyphenylacetic acid synthesis module (related to dopamine metabolism) were negatively associated with MDD and/or dysthymia. After additional adjustment for functional gastrointestinal disorders and irritable bowel syndrome, these relations remained either statistically (FDR <0.05) or nominally (P < 0.05) significant. Overall, multiple bacterial species and functional modules were associated with internalizing disorders, including gut - brain relevant components, while associations to PTD use were moderate. These findings suggest that internalizing disorders rather than PTDs are associated with gut microbiome differences relative to controls.

Environmental factors shaping the gut microbiome in a Dutch population.

The gut microbiome is associated with diverse diseases1-3, but a universal signature of a healthy or unhealthy microbiome has not been identified, and there is a need to understand how genetics, exposome, lifestyle and diet shape the microbiome in health and disease. Here we profiled bacterial composition, function, antibiotic resistance and virulence factors in the gut microbiomes of 8,208 Dutch individuals from a three-generational cohort comprising 2,756 families. We correlated these to 241 host and environmental factors, including physical and mental health, use of medication, diet, socioeconomic factors and childhood and current exposome. We identify that the microbiome is shaped primarily by the environment and cohabitation. Only around 6.6% of taxa are heritable, whereas the variance of around 48.6% of taxa is significantly explained by cohabitation. By identifying 2,856 associations between the microbiome and health, we find that seemingly unrelated diseases share a common microbiome signature that is independent of comorbidities. Furthermore, we identify 7,519 associations between microbiome features and diet, socioeconomics and early life and current exposome, with numerous early-life and current factors being significantly associated with microbiome function and composition. Overall, this study provides a comprehensive overview of gut microbiome and the underlying impact of heritability and exposures that will facilitate future development of microbiome-targeted therapies.

[Quality of life and oral health in children]. / Levenskwaliteit en mondgezondheid van kinderen.

In recent years, research on the influence of oral health on quality of life among children has become increasingly popular Half of the children and adolescents will have had moments of diminished oral health and that can lead to functional problems, pain and decreased quality of life. While measuring oral health-related quality of life of children, reports of parents are frequently used as a proxy. Diminished oral health not only has an impact on the child's quality of life, but also on that of his family members. Results from studies on oral health-related quality of life in children may be used as the basis for useful guidance for parents and children on improving oral health and quality of life.

Dental treatment under general anaesthesia: the short-term change in young children's oral-health-related quality of life.

AIM: This was to assess the short-term change in children's oral-health-related quality of life (OHRQoL) and family impact after dental treatment under general anaesthesia (GA) in the Netherlands. STUDY DESIGN: A pretest-posttest design was used. METHODS: Children (< 8 years) referred to a clinic for specialized paediatric dentistry and who needed treatment under GA were selected to participate and divided across two groups. Fifty out of 80 parents/children couples participated, one group of parents filled out the questionnaires on behalf of their child before and after treatment (N = 31), and the other group only after treatment (N = 19). The questionnaires used were the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) and Parental Perceptions Questionnaire and Family Impact Scale (PPQ and FIS, forming the OHRQoL score). The oral health was assessed using the decayed-missing-filled surfaces or teeth index (dmfs/dmft) for the primary dentition from the status praesens after treatment. RESULTS: There was a significant difference between the pre- and posttest-scores in group A for both the short version and the long version (short: t = 5.088, df = 20, p < 0.001 and long: t = 6.279, df = 20, p < 0.001). There was no statistically significant difference in CFSS-DS scores before and after treatment (group A) (t = 1.815, df = 13, p = 0.093). CONCLUSIONS: The children's OHRQoL improved after treatment under GA according to their parents. As expected, dental fear did not change and should be dealt with after treatment to avoid a child's dental fear to persist in the future. A shorter version of the PPQ and FIS seems useful to assess OHRQoL in very young children.

Changes in children's dental fear: a longitudinal study.

AIM: The study aimed to evaluate the development of dental fear in a low fear group and a fearful group of children aged between 8 and 13 years of age and to assess the differences between these groups over time taking into account general variables, such as gender, and treatment variables, such as restorations. Furthermore it was evaluated to what extent general variables and treatment variables predict the change in dental fear or dental fear at later age. STUDY DESIGN: A three-year longitudinal study. METHODS: 401 parents completed the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), 218 of them repeating this after a 3-year interval. Dental records were used to collect the clinical data, starting from the children's first dental appointment and the CFSS-DS was used to assess the child's dental fear. RESULTS/STATISTICS: Analysis of variance for repeated measures showed an interaction effect between fear level and mean total CFSS-DS score. Regression analyses applied to the mean total CFSS-DS score at the second measurement moment and the change in total CFSS-DS score between both measurement moments revealed that little variance could be explained by the treatment variables over the various periods, such as extractions in the first period, and that child-characteristic variables could not predict much variance. Independent-samples t-tests showed a significant difference in means for extractions over the whole period between the fearful group (mean=1.73, SD+/-1.18) and low fear group (mean= 0.68, SD+/-2.01) (t=-4.05, p<0.001, n=218). Also the frequency of Behavioural Management Problems (BMP) over the whole period differed between these groups (fearful group: mean=1.40, SD+/-1.90 and low fearful group: mean= 0.40, SD+/-0.93) (t= -4.58, p<0.001, n=218). CONCLUSION: The effect of treatment variables and subjective experiences on child dental fear seems to diminish over time. Findings support the theoretical framework of conditioning and gradual exposure in children to prevent dental fear.

Referring children to a Special Dental Care Centre in the Netherlands: parents' experiences and expectations.

AIM: The aim of the present study was to assess the relation between treatment at the family dentist versus referral and different aspects of treatment at a Special Dental Care Centre (SDCC), including the choice to return to their family dentist or not. The same study was performed for a group of patients recently referred to and still treated at a Special Dental Care Centre ( SDCC). METHODS: A questionnaire was sent to the parents of 852 children for whom complete dental records were available. Treatment was completed for 111 children (study 1) and 170 children were recently referred and had just started treatment (study 2). RESULTS/STATISTIC: In total 281 questionnaires were returned and filled out. Parents of children who returned to their general dental practitioner (GDP) were more satisfied with their GDP treatment than parents of children who did not return to their GDP (study 1: Z=- 3.65, p<0.001; study 2: Z=-2.86, p=0.004). CONCLUSION: The decision to return to the family dentist or not after treatment at a SDCC centre was based on their satisfaction with their treatment.