RESUMO
Millions of women worldwide use oral contraceptives (i.e., birth control pill; OCs), often starting during puberty/adolescence; however, it is unknown how OC use during this critical period of development affects the brain, especially with regard to emotional working memory. Here, we examined stress reactivity, and brain structure and function in OC users using the Trier Social Stress Test and structural and functional magnetic resonance imaging (MRI). Our results show that OC use during puberty/adolescence gives rise to a blunted stress response and alters brain activation during working memory processing. OC use, in general, is also linked to increased prefrontal brain activation during working memory processing for negatively arousing stimuli. OC use is also related to significant structural changes in brain regions implicated in memory and emotional processing. Together, these findings highlight that OC use induces changes to brain structure and function and alters stress reactivity. These findings may provide a mechanistic insight for the increased vulnerability to mood-related mental illness in women after OC use.
Assuntos
Encéfalo/efeitos dos fármacos , Anticoncepcionais Orais Combinados/farmacologia , Estresse Fisiológico/efeitos dos fármacos , Estresse Psicológico/metabolismo , Adolescente , Adulto , Afeto/efeitos dos fármacos , Fatores Etários , Encéfalo/anatomia & histologia , Encéfalo/diagnóstico por imagem , Encéfalo/fisiologia , Estudos de Casos e Controles , Anticoncepção/métodos , Emoções/efeitos dos fármacos , Função Executiva/efeitos dos fármacos , Feminino , Humanos , Hidrocortisona/análise , Hidrocortisona/metabolismo , Memória/efeitos dos fármacos , Memória/fisiologia , Saliva/química , Saliva/metabolismo , Estresse Psicológico/diagnóstico por imagem , Estresse Psicológico/patologia , Estresse Psicológico/fisiopatologia , Adulto JovemRESUMO
SummaryMental health professionals form an important component of the response teams currently working in the Democratic Republic of the Congo to treat what is historically the second-largest Ebola outbreak. They provide psychological treatment to patients under extraordinary conditions, helping them cope with anxiety and the daily death of other patients.Declaration of interestNone.
RESUMO
Studies have shown that, in addition to being associated with a high mortality rate, Ebola Virus Disease (EVD) is also related with mental health problems. This study aimed to determine prevalence of mental health problems and associated factors among survivors and individuals affected by EVD. A systematic review of peer-reviewed empirical studies was conducted using EMBASE, PubMed, PsycINFO and PsyARTICLES. A random effects meta-analysis was performed on the proportions of people diagnosed with depression after an EVD outbreak. Of 205 studies initially identified, 21 were included in the systematic review and 10 in the meta-analysis. Results indicated that EVD is associated with depression, anxiety, post-traumatic stress disorder, obsessive-compulsive disorder, among others. Results revealed that one person out of five affected to EVD has been diagnosed with depression (standardized mean difference 19.92%, 95% CI 10.43%; 34.70). The I2 provided evidence of heterogeneity in the results. This study demonstrated the evidence of the impact of EVD on the mental health of survivors and individuals affected by EVD. Further studies should consider the mental health consequences of EVD to plan culturally sensitive prevention and intervention programs based on the experience of communities affected by EVD.