Giovanni Abrahão Salum Junior

Association between anxiety symptoms and problematic alcohol use in adolescents.

BACKGROUND Anxiety disorders are highly prevalent, affecting approximately 10% of individuals throughout life; its onset can be detected since early childhood or adolescence. Studies in adults have shown that anxiety disorders are associated with alcohol abuse, but few studies have investigated the association between anxiety symptoms and problematic alcohol use in early ages. OBJECTIVE To evaluate if anxiety symptoms are associated with problematic alcohol use in young subjects. METHODS A total of 239 individuals aged 10-17 years were randomly selected from schools located in the catchment area of Hospital de Clínicas de Porto Alegre. The Screen for Child Anxiety-Related Emotional Disorders (SCARED) was used to evaluate the presence of anxiety symptoms, and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), to evaluate alcohol use. RESULTS One hundred twenty-seven individuals (53.1% ) reported having already used alcohol. Of these, 14 individuals showed problematic alcohol use (5.8% ). There was no association between lifetime use of alcohol and anxiety symptoms, but mean SCARED scores in individuals with problematic alcohol use was higher if compared to those without problematic use, even after adjustment for age and gender (29.9±8.5 vs. 23.7±11.8, p < 0.001). CONCLUSIONS Despite the limitation of a cross-sectional design, our study suggests that anxiety symptoms are associated with problematic alcohol use early in life.

Gene Expression In Blood of Children And Adolescents: Influence of Environmental Stressors On Major Depressive Disorder

Background Studies investigating major depressive disorder (MDD) in childhood and adolescence are relevant to understand relative contributions from either genetic and environmental factors on MDD, since early stages of disease have less influence of illness exposure. We aimed to investigate peripheral mRNA expression of 12 genes related to HPA axis (NR3C1, FKBP5), inflammation (TNF, TNFR1, TNFR2, IL1B), neurodevelopment (DISC1, PDE4B, QKI), and neurotransmission (SLC1A4, GLUL, COMT) in blood of children and adolescents with MDD and to test if history of childhood maltreatment (CM) or prenatal alcohol (PA) and tobacco (PT) exposure (environmental stressors that influences psychiatry disorders risk) could affect MDD via gene expression. Methods mRNA levels in whole blood were compared among 20 children and adolescents with MDD diagnosis (MDD group), 48 subjects without MDD diagnosis but with high levels of depressive symptoms (DS group) and 61 healthy controls (HC group). We also performed a mediation model in which CM/PA/PT exposure was the independent variable, MDD was the outcome and gene expression was the intermediary variable. Results NR3C1, TNF, TNFR1 and IL1B expression levels were significantly lower in MDD group compared to the other groups. The direct effects of CM, PA and PT exposure on MDD were not significant. Moreover, there was not an indirect effect of PA or PT exposure on MDD. However, there was an indirect effect on the aggregation of these four genes expressions, mediating the relationship between CM and MDD. Discussion In the largest study investigating gene expression in children with MDD, we demonstrated that the NR3C1, TNF, TNFR1 and IL1B expression are related to the MDD and conjunctly mediated the effect of history of CM on risk of developing the disorder, supporting a role of glucocorticoids and inflammation as possible effectors of environmental distress on this disorder.