Early Parental Loss and Development of Adult Psychopathology

Breier, Alan; Kelsoe, John R.; Kirwin, Paul D.; Beller, Stacy A.; Wolkowitz, Owen M.; Pickar, David

doi:10.1001/archpsyc.1988.01800350021003

Cited by 160 publications

(95 citation statements)

References 51 publications

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“…Consistent with this view are findings which suggest that quality of parental care, stability of home life and relationship with the surviving parent are mediators of the pathogenic effect of loss. 38,39 Physical or sexual abuse could also be more prevalent in a home environment disrupted by events leading to and following parental separation. In our study, we did not obtain data on these variables which are very difficult to evaluate retrospectively.…”

Section: Discussionmentioning

confidence: 99%

Environment and vulnerability to major psychiatric illness: a case control study of early parental loss in major depression, bipolar disorder and schizophrenia

Agid¹,

et al. 1999

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The current focus on identifying genes which predispose to psychiatric illness sharpens the need to identify environmental factors which interact with genetic predisposition and thus contribute to the multifactorial causation of these disorders. One such factor may be early parental loss (EPL). The putative relationship between early environmental stressors such as parental loss and psychopathology in adult life has intrigued psychiatrists for most of this century. We report a case control study in which rates of EPL, due to parental death or permanent separation before the age of 17 years were evaluated in patients with major depression (MD), bipolar disorder (BPD) and schizophrenia (SCZ), compared to individually matched, healthy control subjects (MD-Control, 79 pairs; BPD-Control, 79 pairs; SCZ-Control, 76 pairs). Loss of parent during childhood significantly increased the likelihood of developing MD during adult life (OR = 3.8, P = 0.001). The effect of loss due to permanent separation (P = 0.008) was more striking than loss due to death, as was loss before the age of 9 years (OR = 11.0, P = 0.003) compared to later childhood and adolescence. The overall rate of EPL was also increased in BPD (OR = 2.6, P = 0.048) but there were no significant findings in any of the subcategories of loss. A significantly increased rate of EPL was observed in schizophrenia patients (OR = 3.8, P = 0.01), particularly before the age of 9 years (OR = 4.3, P = 0.01). Comparison of psychosocial, medical and clinical characteristics of subjects with and without a history of EPL, within the larger patient groups from which the matched samples were drawn (MD, n = 136; BPD, n = 107; SCZ, n = 160), yielded few significant findings. Among the controls (n = 170), however, subjects who had experienced EPL, reported lower incomes, had been divorced more frequently, were more likely to be living alone, were more likely to smoke or have smoked cigarettes and reported more physical illness (P = 0.03-0.001). Long term neurobiological consequences of early environmental stressors such as maternal deprivation have been extensively studied in many animal species. Recently, enduring changes in hypothalamic-pituitary-adrenal axis function, including corticotrophin releasing factor gene expression, have received particular attention. Analogous processes may be implicated in the effect of EPL on human vulnerability to psychopathology, via alterations in responsiveness to stress. Genetic predisposition may influence the degree of susceptibility of the individual to the effects of early environmental stress and may also determine the psychopathological entity to which the individual is rendered vulnerable as a consequence of the stress.

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Section: Discussionmentioning

confidence: 99%

Environment and vulnerability to major psychiatric illness: a case control study of early parental loss in major depression, bipolar disorder and schizophrenia

Agid¹,

et al. 1999

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“…Increased psychiatric symptoms and disorders are observed in adults who have severe, unpredictable early life stressors (Rutter 1984). A provocative study (Breier et al 1988) reported the effects of parental loss during childhood on the development of psychopathology in adulthood. They examined a number of adults who had suffered a parental loss during childhood and found that the subjects with psychiatric disorders and symptoms had significant biological and immunological changes related to early parental loss relative to control groups.…”

Section: Neurodevelopment Factorsmentioning

confidence: 99%

Consensus paper of the WFSBP Task Force on Biological Markers: Biological Markers in Depression

Mößner

Mikova

Koutsilieri

et al. 2007

The World Journal of Biological Psychiatry

226

126

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Biological markers for depression are of great interest to aid in elucidating the causes of major depression. We assess currently available biological markers to query their validity for aiding in the diagnosis of major depression. We specifically focus on neurotrophic factors, serotonergic markers, biochemical markers, immunological markers, neuroimaging, neurophysiological findings, and neuropsychological markers. We delineate the most robust biological markers of major depression. These include decreased platelet imipramine binding, decreased 5-HT1A receptor expression, increase of soluble interleukin-2 receptor and interleukin-6 in serum, decreased brain-derived neurotrophic factor in serum, hypocholesterolemia, low blood folate levels, and impaired suppression of the dexamethasone suppression test. To date, however, none of these markers are sufficiently specific to contribute to the diagnosis of major depression. Thus, with regard to new diagnostic manuals such as DSM-V and ICD-11 which are currently assessing whether biological markers may be included in diagnostic criteria, no biological markers for major depression are currently available for inclusion in the diagnostic criteria.

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“…42,43 Much descriptive work has been published on the relationship between adult psychopathology and early adversities such as parental loss in childhood, inadequate parental care, divorce, 'affectionless' or dysfunctional parenting, childhood physical and sexual abuse, and other childhood traumas. These studies have consistently found early life stressors to be associated with increased risk for mood and anxiety disorders and personality pathology in adulthood.…”

Section: Effects Of Early Life Stress In Humansmentioning

confidence: 99%

Update on stress and depression: the role of the hypothalamic-pituitary-adrenal (HPA) axis

Mello¹,

Mello²,

Carpenter³

et al. 2003

Rev. Bras. Psiquiatr.

135

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Over the past 50 years, relationships between stress and the neurobiological changes seen in psychiatric disorders have been well-documented. A major focus of investigations in this area has been the role of the hypothalamicpituitary-adrenal (HPA) axis, both as a marker of stress response and as a mediator of additional downstream pathophysiologic changes. This review examines the emerging literature concerning the relationship between stress, HPA axis function, and depression, as well as the role of early life stress as an important risk factor for HPA axis dysregulation. The more recent studies reviewed suggest that the prominence of HPA axis hyperactivity in adults with depressive and anxiety disorders may constitute a link between the occurrence of adversity in childhood and the development of adult psychopathology Stress. Depression. Hypothalamus. Pituitary-adrenal system. Corticotropin releasing hormone (CRH). HPA axis. Child abuse. Childhood trauma.Nos últimos cinqüenta anos, as relações entre estresse e mudanças neurológicas nas doenças psiquiátricas foram bastante documentadas. Um dos maiores focos de investigação nesta área tem sido o eixo hipotálamo-hipofisário-adrenal (HHA), tanto como marcador da resposta ao estresse, quanto como um mediador das mudanças fisiopatológicas em resposta ao estresse. Esta revisão examina a literatura emergente no que concerne às relações entre estresse, eixo HHA e depressão, assim como o papel do estresse precoce como fator de risco para a disfunção do eixo HHA. Os estudos mais recentes sugerem um papel de destaque para a hiperatividade deste eixo em adultos com depressão e transtornos de ansiedade. Esta hiperatividade pode se constituir na ligação entre ocorrência de adversidades na infância e o desenvolvimento da psicopatologia no adulto.Estresse. Depressão. Hipotálamo. Sistema pituitário-adrenal. Hormônio liberador de corticotropina (HLC). Eixo HHA. Abuso contra crianças. Trauma infantil. Abstract Keywords ResumoDescritores and the neurobiological changes seen in psychiatric disorders had been well-documented.A major focus of investigation in this area has been the role of the hypothalamic-pituitary-adrenal (HPA) axis, both as a marker of the stress response and as a mediator of additional downstream pathophysiologic changes. The HPA axis functions in close concert with the locus coeruleus-norepinephrine (LC-NE) system, which is involved in extensive reciprocal innervation of regions throughout the central nervous system (CNS). Stressors detected via the primary sensory organs generate signals which pass through mediating systems located in

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Early Parental Loss and Development of Adult Psychopathology

Cited by 160 publications

References 51 publications

Environment and vulnerability to major psychiatric illness: a case control study of early parental loss in major depression, bipolar disorder and schizophrenia

Environment and vulnerability to major psychiatric illness: a case control study of early parental loss in major depression, bipolar disorder and schizophrenia

Consensus paper of the WFSBP Task Force on Biological Markers: Biological Markers in Depression

Update on stress and depression: the role of the hypothalamic-pituitary-adrenal (HPA) axis

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