Showing posts with label sex differences. Show all posts
Showing posts with label sex differences. Show all posts

Tuesday, June 4, 2024

PTSD is More Heritable in Females Than Males, Study Finds

Females appear to be genetically more prone to posttraumatic stress disorder (PTSD) than males, according to a report published today in AJP in Advance. This analysis of twins and siblings confirms that PTSD is moderately heritable, with environmental effects unique to the individual who experiences trauma also contributing to the disorder.

“There are well-established sex differences in the prevalence of PTSD, whereby females are approximately twice as likely as males to develop PTSD, a disparity that is robust against trauma type, diagnostic criteria, and methodology,” wrote Ananda Amstadter, Ph.D., of Virginia Commonwealth University and colleagues. This disparity underscores the need to examine genetic differences in PTSD risk across the sexes, they continued.

The researchers made use of data from Swedish national registries to investigate the genetic and environmental factors influencing PTSD among 16,242 twin pairs and 376,093 sibling pairs who were within two years of age of each other; all subjects were born between 1955 and 1980. A total of 148,823 unique individuals were diagnosed with PTSD; the lifetime prevalence of the disorder was higher among females than males (27.8% vs. 11.8%).

The study revealed a modest influence of genetics on the development of PTSD, with that influence being greater among females (35.42%) than among males (28.60%). Unique environmental effects—that is, influences that were not necessarily shared by twins or siblings—accounted for the remaining variance.

Amstadter and colleagues found that the genes that influence PTSD in women and men are not entirely the same, suggesting one line of future research should investigate the genetic influences of sex hormones—estrogen and testosterone—which may play a role in the disorder.

They noted, as well, that one recent meta-analysis of trauma-focused PTSD treatments found a higher rate of treatment response for women versus men. “Although the source of these differential psychosocial treatment effects is not yet known, they constitute a growing area of research,” Amstadter and colleagues wrote. “One such future direction includes the exploration of genetic influences on treatment response.”

For related information, see the Psychiatric News article “Genetic Makeup May Affect PTSD Risk.”

(Image: Getty Images/iStock/Vertigo3d)




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Wednesday, September 19, 2018

Anxiety Linked to Cognitive Decline in Older Adults, Study Shows


Symptoms of anxiety in women appear to be associated with a decline over time in executive function—the ability to plan ahead and organize one’s thoughts, according to a report in The American Journal of Geriatric Psychiatry.

Among both men and women 65 years and older, anxiety appears to predict a decline in verbal memory, which refers to the ability to remember words.

“Adequate treatment of anxiety symptoms could potentially beneficially influence the risk for developing neurodegenerative disease,” wrote Sebastian Köhler, Ph.D., an associate professor of psychiatry at Maastricht University, and colleagues.

Köhler and colleagues analyzed data on 918 participants who were 50 years of age or older in the Maastricht Aging Study, a longitudinal population-based study of factors associated with cognitive aging in the Netherlands.

The researchers measured the anxiety symptoms of the participants at baseline, using the anxiety subscale of the Symptom Check List-90 (SCL-90). The researchers recorded anxiety scores along a continuous scale of severity; they classified patients in the highest quartile as having “high anxiety.” The participants also underwent neuropsychological testing, which measured executive function, memory, speed of information processing, and verbal fluency. During a 12-year follow-up, the cohort was tested every three years.

Overall, being in the highest quartile on anxiety symptoms (“high anxiety”) did not predict a faster decline in executive functioning over time. However, among women, increasing severity of anxiety was associated with a worse cognitive trajectory. A similar sex-specific effect was found for processing speed and verbal fluency.

In contrast, faster decline in verbal memory was associated with “high anxiety” irrespective of sex but was more pronounced in those 65 years and older.

“Further longitudinal research is needed to fully understand the relationship between anxiety and cognition including potentially mediating mechanisms,” the researchers wrote.

For more information, see the Psychiatric News article “Worsening Anxiety in Older Adults May Precede Alzheimer's.”

(Image: iStock/SolStock)

Friday, February 23, 2018

Varenicline May Lower Heavy Drinking, Smoking in Men With AUD


Varenicline, an FDA-approved smoking-cessation medication (Chantix), may be effective in treating both alcohol use disorder (AUD) and smoking in men, according to a study in the February issue of JAMA Psychiatry.

“Men appeared to derive benefit from varenicline, compared with placebo, on measures of heavy drinking, whereas women did better taking placebo,” wrote lead author Stephanie S. O’Malley, Ph.D., director of the Division of Substance Abuse Research in Psychiatry at Yale School of Medicine.

Researchers conducted the phase 2, randomized, double-blind, placebo-controlled trial at two outpatient clinics (New York City and New Haven, Conn.) from September 19, 2012, to August 31, 2015. The researchers recruited men and women aged 18 to 70 who were seeking treatment for AUD. Individuals who met the criteria for alcohol dependence (according to the DSM-IV-TR), reported heavy drinking (≥5 standard alcoholic drinks for men and ≥4 drinks for women) two or more times a week and cigarette smoking two or more times per week were included in the trial.

O’Malley and colleagues randomly assigned 131 participants to receive either 2 mg of varenicline or placebo daily for 16 weeks. Medication was titrated in the following standard doses: 0.5 mg once daily for three days, 0.5 mg twice daily for four days, and 1 mg twice daily for the remainder of the 16-week treatment. Daily medication adherence was monitored through a combination of pill counts returned from blister packs and self-reported compliance.

Over the course of the trial, participants attended 12 medical management sessions during which they met with a medical professional to discuss the tolerability of the assigned medication, medication adherence, and the importance of drinking goals as well as the development and implementation of strategies for changing drinking behaviors. The participants were also asked about their drinking and smoking behavior, adverse effects of the medication, changes in mood, and more.

The mean change from baseline in the percentage of heavy drinking days in the overall sample by the end of the study was not different between the placebo and medication groups, but varenicline appeared to have different effects on drinking in men and women. Compared with placebo, varenicline resulted in a greater decrease in percentage of heavy drinking days in men and a smaller decrease in percentage of heavy drinking days in women. Even though the subjects were not seeking or provided smoking-cessation counseling, varenicline resulted in significantly higher rates of smoking abstinence compared with placebo (13% vs 0%) at the end of treatment.

“This study adds to the growing body of evidence suggesting varenicline to be well tolerated in those with active substance use disorders,” wrote A. Eden Evans, M.D., Ph.D., and John F. Kelly, Ph.D., both of the Center for Addiction Medicine at Massachusetts General Hospital and Harvard Medical School., in an accompanying editorial in JAMA Psychiatry. “These findings highlight the importance of the National Institutes of Health’s emphasis on systematically evaluating sex or gender in treatment effects and add to the converging evidence of the need for more specific and targeted treatments for women and men.”

For related information, see the Psychiatric News article “APA Releases Practice Guideline for AUD Pharmacotherapy.”

(Image: iStock/Bunyos)

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