Patterns of lifetime female victimisation and psychotic experiences: a study based on the UK Adult Psychiatric Morbidity Survey 2007

Purpose

Research has shown that sexual trauma represents a specific threat for psychosis, particularly among females. Sexual trauma among females, however, has also been shown to enhance the risk for further revictimisation. Females are likely to exhibit distinct lifetime trauma profiles, i.e. female sexual trauma victims are often more likely to experience particular forms of re-victimisation, such as intimate partner and domestic violence.

Methods

This study used data from the Adult Psychiatric Morbidity Survey (2007) to profile lifetime histories of sexual trauma and domestic violence among female participants (N = 4,111).

Results

The latent class analysis revealed four lifetime victimisation classes: (i) a multiple victimisation class; (ii) an intimate partner victimisation class; (iii) a sexual victimisation class; and (iv) a victimisation-free class. Multivariate logistic regression revealed that there was a strong association between class membership and a diagnosis of psychosis and that the victimisation classes were significantly associated with all psychotic-like experiences. Compared to the victimisation-free class, the multiple victimisation class displayed an increased likelihood of experiencing all psychotic experiences except mania. The intimate partner victimisation class was also associated with an increased likelihood of experiencing all psychotic experiences; however, the odds ratios for this class were lower than those recorded for the multiple victimisation class.

Conclusions

These findings reflect female-specific variation in both victimisation history and psychosis-related vulnerability. Acknowledging such sex-specific variation may advance our understanding of the complex associations that continue to emerge between trauma and psychosis for both males and females.     

The demands of biochemical genetic disorders: a survey of mothers of children with mitochondrial disease or phenylketonuria

A telephone survey of mothers of children with mitochondrial disease (n = 29) or phenylketonuria (PKU) (n = 29) revealed that mothers of children with mitochondrial disease report greater stress and worry, less satisfaction with social supports, greater difficulty meeting their child's extra care needs, and more impact on multiple aspects of their personal lives. They also reported more missed days of work and used a greater number of health care services and personal resources. Interventions must be developed that address the demands of biochemical genetic disorders, particularly those with the uncertain trajectory of mitochondrial disease.     

Primary Effusion Lymphoma (PEL)‐Like Lymphoma in a Child With Congenital Immunodeficiency

Primary effusion lymphoma (PEL) is a rare lymphoma that occurs more frequently in immunocompromised adults and has a poor survival. We report a 9‐year‐old female with combined immunodeficiency with an Epstein–Barr virus positive/human herpes virus 8 negative PEL‐like lymphoma. The treatment with systemic chemotherapy for non‐Hodgkin lymphoma, zidovudine, and interferon‐α failed to control disease progression. This is the first reported pediatric case of PEL‐like lymphoma. Increased diagnostic awareness and more effective treatment strategies are needed for this rare lymphoma.     

Raloxifene blocks estradiol induction of the serotonin transporter and 5-hydroxytryptamine2A receptor in female rat brain

Sex steroids have potent effects on mood, mental state and cognition. Our previous findings and those of others suggest that these effects may be due at least in part to estradiol actions on central serotonergic mechanisms. Specifically, estradiol-17beta in its acute positive feedback mode for gonadotropin release in the female rat induces expression of the genes for the 5-hydroxytryptamine(2A) receptor (5-HT(2A)R) and the serotonin transporter (SERT) in the dorsal raphe nucleus (DRN). This is accompanied by an increase in the densities of 5-HT(2A)R and the SERT in forebrain regions which in the human are concerned with the control of mood, mental state, cognition and emotion. Here we report that raloxifene, a benzothiophene and selective estrogen receptor modulator (SERM), completely blocked estradiol stimulation of brain 5-HT(2A)R and SERT expression in acutely ovariectomized rats. Raloxifene also blocked the estrogen-induced surge of luteinizing hormone. Treatment of acutely ovariectomized rats with raloxifene alone increased the density of SERT sites in the mid-frontal cortex and decreased the density of 5-HT(2A)R in the posterior olfactory tubercle. The inhibitory effects of raloxifene on acute estrogen-induction of central serotonergic mechanisms were similar to those of tamoxifen even though there are major differences between the two SERMs in their affinity for the two estrogen receptor subtypes and their actions on the uterus. These findings provide robust evidence that estradiol induction of the 5-HT(2A)R and the SERT in brain is mediated by nuclear estrogen receptors. Our data may provide the basis for obtaining a better understanding of the effects of sex steroids on mood and mental state in the human and the possible rational development of congeners of sex steroids for the treatment of mental disorders.     

Breast milk transmission of flaviviruses in the context of Zika virus: A systematic review

Background

Since the Zika virus epidemic in the Americas began in 2015, Zika virus transmission has occurred throughout the Americas. However, limited information exists regarding possible risks of transmission of Zika virus and other flaviviruses through breast feeding and human milk. We conducted a systematic review of the evidence regarding flaviviruses detection in and transmission through milk, specifically regarding Zika virus, Japanese encephalitis virus, tick‐borne encephalitis virus, Powassan virus, West Nile virus, dengue virus, and yellow fever virus.

Methods

Medline, Embase, Global Health, CINAHL , Cochrane Library, Scopus, Popline, Virtual Health Library, and WorldCat were searched through June 2017. Two authors independently screened potential studies for inclusion and extracted data. Human and nonhuman (animal) studies describing: 1) confirmed or suspected cases of mother‐to‐child transmission through milk; or 2) the presence of flavivirus genomic material in milk.

Results

Seventeen studies were included, four animal models and thirteen observational studies. Dengue virus, West Nile virus, and Zika virus viral ribonucleic acid was detected in human milk, including infectious Zika virus and dengue virus viral particles. Human breast‐feeding transmission was confirmed for only yellow fever virus. There was evidence of milk‐related transmission of dengue virus, Powassan virus, and West Nile virus in animal studies.

Conclusions

Because the health advantages of breast feeding are considered greater than the potential risk of transmission, the World Health Organization recommends that mothers with possible or confirmed Zika virus infection or exposure continue to breast feed. This review did not identify any data that might alter this recommendation.