母親的憂鬱會使兒童「老化」


  【24drs.com】新研究顯示,有嚴重憂鬱母親之孩童的白血球端粒長度可能比較短,而會發生一些行為問題;白血球端粒長度是細胞老化的指標之一。
  
  舊金山加州大學(UCSF)的Janet Wojcicki博士等研究者寫道,曝露在心理壓力及憂鬱,與成年人的端粒長度較短有關,可能是透過終身的氧化壓力因子而有關聯。
  
  
  Wojcicki博士表示,當人們考慮兒童的行為議題時,思考的是心理因素以及可能會如何影響學校的表現和同儕的互動,但是,不一定認為這些行為問題類型可能是由於細胞層次受到影響。
  
  她表示,這一點研究發現是有趣的,實際上對於端粒長度可能有不利的影響,如同我們所知,這與慢性疾病以及發炎過程有關。
  
  這項研究線上發表於6月16日Translational Psychiatry期刊。
  
  Wojcicki博士解釋,曝露於母親的憂鬱情況下,孩童的後續憂鬱和行為問題風險增加,拉丁裔青年的風險更高;我有兩組肥胖與代謝疾病風險高的拉丁裔孩童縱向世代,我正在評估母親的精神健康和孩童的飲食與肥胖問題之間的關聯。
  
  我們已經決定探討孩童的行為問題,雖然在成人研究有關於端粒長度和壓力曝露的新發現,但孩童方面的研究則太少了。
  
  研究者評估了白血球端粒長度,研究對象是相對具有同質性的低收入拉丁裔孩童,包括108名4歲和92名5歲孩童,這些孩童出生於舊金山的兩家醫院,5歲孩童有許多在4歲時有進行過檢測。
  
  研究者也探討母親的端粒長度,並篩檢母親的產前與產後憂鬱,以及孩童在3歲、4歲和5歲時的行為異常,如對立違抗行為。
  
  在3歲、4歲和5歲時有對立違抗行為的孩童,端粒長度比那些沒有這類行為的大約450名同儕短(P < .01)。
  
  4歲和5歲時端粒長度較短的獨立遇測因子,包括3歲、4歲和5歲時有對立違抗行為(B = -359.25;95%信賴區間[CI]為633.84 - 84.66;P = .01);3歲時曝露於母親的臨床憂鬱症狀(B = -363.99;95% CI,651.24 - 764.74;P = .01);母親的端粒長度較短(B = 502.92;95% CI,189.21 -816.63);以及孩童出生時,父親較年輕(B = 24.63;95% CI,1.14 - 48.12)。
  
  Wojcicki博士表示,我們是第一個提出母親的臨床憂鬱症與學齡前孩童的端粒長度較短以及對立違抗行為之關聯的研究,但這方面的知識還不足以正式應用,我們並未建議定期檢測。
  
  她表示,對於怎樣的端粒長度才算健康以及如何介入,目前還沒有良好規範,我認為,生理健康與精神健康的方法之間通常沒有關聯,而我們發現這些只有4、5歲孩童的生物老化這個事實,我想,生物老化和心理病理學存在著新關聯。這強調了有必要嚴肅面對各種程度的此類行為干擾,以尋求治療和介入。
  
  伯靈頓佛蒙特大學附設兒童醫院的David C. Rettew醫師表示,這是篇有趣的研究,不過,端粒的理論已經不算新了。
  
  Rettew醫師表示,知道心理壓力與端粒長度之間的關聯有一段時間了,對於這麼幼小研究樣本的端粒長度縮短的研究發現,提醒我們需要盡早幫助這些家庭。
  
  這篇研究也再度強調,我們之前關於心理或生物的觀點在科學上真的站不住腳,環境事件改變了身體也改變了腦部,如果你加以考慮,它會如何運作呢?
  
  資料來源:http://www.24drs.com/
  
  Native link:Mom's Depression 'Ages' Children

Mom's Depression 'Ages' Children

By Fran Lowry
Medscape Medical News

Young children with mothers who are severely depressed are more likely to have shorter white blood cell telomere length, a hallmark of cellular aging, and to exhibit behavior problems, new research shows.

"Exposure to psychological stress and depression are associated with shorter telomere length in adults, possibly through associated lifelong oxidative stressors," investigators led by Janet Wojcicki, PhD, from the University of California, San Francisco (UCSF), write.

"When people think about behavioral issues with children, they think about the psychological components and how that might impact school performance and interaction with peers, but they don't necessarily think that these types of behavioral problems can impact at the cellular level," Dr Wojcicki told Medscape Medical News.

"This is the interesting point of our finding, that there can actually be a deleterious impact on shortening telomere length, which, as we know, is associated with chronic disease and inflammatory processes," she said.

The study was published online June 16 in Translational Psychiatry.

Novel Finding

"Exposure to maternal depression increases risk for future depression and behavior problems in children, and Latino youth are at high risk. I have two longitudinal cohorts of Latino children at high risk for obesity and metabolic disease and am evaluating the relationship between maternal mental health and child feeding and obesity issues," Dr Wojcicki explained.

"We also decided to look at behavioral problems in children, because although there have been novel findings about telomere length and exposure to stress in adults, few studies have been done in children," she said.

The investigators assessed the length of telomeres from the white blood cells of a relatively homogeneous group of low-income Latino children. The study population included 108 4-year-olds and 92 5-year-olds. The children were recruited at birth from two San Francisco hospitals, and many of the 5-year-olds were the same children who were tested at age 4.

The researchers also looked at the telomeres of their mothers and screened for prenatal and postnatal maternal depression, as well as behavioral disorders, including oppositional defiant behavior, in the children at ages 3, 4, and 5 years.

Children who had oppositional defiant behavior at 3, 4, or 5 years had shorter telomere length than those who did not have such behavior by ~450 base pairs (P < .01).

Independent predictors for shorter telomere length at 4 and 5 years of age included oppositional defiant disorder at age 3, 4, or 5 years (B = -359.25; 95% confidence interval [CI], 633.84 - 84.66; P = .01); exposure to maternal clinical depression at age 3 years (B = -363.99; 95% CI, 651.24 - 764.74; P = .01); shorter maternal telomere length (B = 502.92; 95% CI, 189.21 - 816.63); and younger paternal age at the child's birth (B = 24.63; 95% CI, 1.14 - 48.12).

"Our study is the first to link maternal clinical depression and oppositional defiant behavior with shorter telomere length in the preschool years. But this knowledge isn't really ready for prime time use, and we don't recommend regular testing," Dr Wojcicki said.

"There are no good norms yet in terms of what is a healthy telomere length and how to intervene, but I think that there is often a disconnect between approaches to physical health and mental health, and the fact that we are seeing this biological aging as early as 4 and 5 years of age and that there is an association between biological aging and psychological pathology is, I think, novel. It emphasizes the need to take these behavioral disturbances seriously on all levels and to seek treatment and evaluations," she said.

A "Wake-up Call"

"The study is interesting, although the telomere story is not so new anymore," David C. Rettew, MD, from the University of Vermont Children's Hospital, Burlington, told Medscape Medical News.

"While the link between psychological stress and telomere length has been known for some time, the finding of telomere shortening in such a young sample should be a wake-up call that we need to be helping these families as early as possible," Dr Rettew said.

"The study also highlights once again that our previous views of something being either psychological or biological really don't hold water scientifically. Environmental events change the body and change the brain. If you think about it, how else could it work?"

The study was funded by the NH-NIDDK, Hellman Family Foundation, Robert Wood Johnson, the NASPGHAN Foundation, UCSF, and NIH/NCRR. Dr Wojcicki and Dr Rettew report no financial relationships.

Transl Psychiatry. Published on June 16, 2015.

    
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