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      The role of childhood trauma in patients with chronic urticaria

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          Abstract

          OBJECTIVE

          Chronic urticaria (CU) is a common skin disease in which the etiology involves immunological and psychological factors. Childhood traumas may disrupt the development of the neuro-immuno-cutaneous-endocrine system and start a complex pathophysiological process with inflammatory abnormalities, potentially leading to the development of skin disease. In light of this information, we believe that childhood trauma may play a role in the onset and severity of disease in CU patients. Our study aimed to discover a potential relationship between CU and childhood traumatic experiences.

          METHODS

          This study was conducted with 53 controls and 50 CU patients. The participants were given a questionnaire form that included sociodemographic information, Beck Anxiety Scale, Beck Depression Scale, and Childhood Trauma Questionnaire (CTQ-28).

          RESULTS

          The rates of childhood trauma were found to be 68% in the patient group, and 54.7% in the control group. The patient group demonstrated higher scores for moderate to severe anxiety and depression. The mean emotional abuse score was significantly higher in early onset (<35 ages) urticaria patients in comparison to late onset urticarial (≥35 ages) and the control group. It was found that depression scores were positively correlated with all abuse sub-types, excluding sexual abuse, and total CTQ-28 scores. Anxiety scores were positively correlated with emotional abuse, physical neglect, emotional neglect, and total CTQ-28 scores.

          CONCLUSION

          Childhood traumas are associated with the early onset and severity of disease in CU patients as well as the accompanying depression and anxiety.

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          Most cited references27

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          Initial reliability and validity of a new retrospective measure of child abuse and neglect.

          This report presents initial findings on the reliability and validity of a new retrospective measure of child abuse and neglect, the Childhood Trauma Questionnaire. Two hundred eighty-six drug- or alcohol-dependent patients were given the Childhood Trauma Questionnaire as part of a larger test battery, and 40 of these patients were given the questionnaire again after an interval of 2 to 6 months. Sixty-eight of the patients were also given a structured interview for child abuse and neglect, the Childhood Trauma Interview, that was developed by the authors. Principal-components analysis of responses on the Childhood Trauma Questionnaire yielded four rotated orthogonal factors: physical and emotional abuse, emotional neglect, sexual abuse, and physical neglect. Cronbach's alpha for the factors ranged from 0.79 to 0.94, indicating high internal consistency. The Childhood Trauma Questionnaire also demonstrated good test-retest reliability over a 2- to 6-month interval (intraclass correlation = 0.88), as well as convergence with the Childhood Trauma Interview, indicating that patients' reports of child abuse and neglect based on the Childhood Trauma Questionnaire were highly stable, both over time and across type of instruments. These findings provide strong initial support for the reliability and validity of the Childhood Trauma Questionnaire.
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            The role of childhood trauma in the neurobiology of mood and anxiety disorders: preclinical and clinical studies.

            Epidemiologic studies indicate that children exposed to early adverse experiences are at increased risk for the development of depression, anxiety disorders, or both. Persistent sensitization of central nervous system (CNS) circuits as a consequence of early life stress, which are integrally involved in the regulation of stress and emotion, may represent the underlying biological substrate of an increased vulnerability to subsequent stress as well as to the development of depression and anxiety. A number of preclinical studies suggest that early life stress induces long-lived hyper(re)activity of corticotropin-releasing factor (CRF) systems as well as alterations in other neurotransmitter systems, resulting in increased stress responsiveness. Many of the findings from these preclinical studies are comparable to findings in adult patients with mood and anxiety disorders. Emerging evidence from clinical studies suggests that exposure to early life stress is associated with neurobiological changes in children and adults, which may underlie the increased risk of psychopathology. Current research is focused on strategies to prevent or reverse the detrimental effects of early life stress on the CNS. The identification of the neurobiological substrates of early adverse experience is of paramount importance for the development of novel treatments for children, adolescents, and adults.
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              The Devastating Clinical Consequences of Child Abuse and Neglect: Increased Disease Vulnerability and Poor Treatment Response in Mood Disorders

              A large body of evidence has demonstrated that exposure to childhood maltreatment at any stage of development can have long-lasting consequences. It is associated with a marked increase in risk for psychiatric and medical disorders. This review summarizes the literature investigating the effects of childhood maltreatment on disease vulnerability for mood disorders, specifically summarizing cross-sectional and more recent longitudinal studies that demonstrate childhood maltreatment is more prevalent and associated with increased risk for first mood episode, episode recurrence, greater comorbidities, and increased risk for suicidal ideation and attempts in individuals with mood disorders. It summarizes the persistent alterations associated with childhood maltreatment, including alterations in the HPA axis and inflammatory cytokines, which may contribute to disease vulnerability and a more pernicious disease course. We discuss several candidate genes and environmental factors, for example alcohol/substance use, that may alter disease vulnerability and illness course and neurobiological associations that may mediate these relationships following childhood maltreatment. Studies provide insight into modifiable mechanisms and provide direction to improve both treatment and prevention strategies.
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                Author and article information

                Contributors
                Journal
                North Clin Istanb
                North Clin Istanb
                North Clin Istanb
                Northern Clinics of Istanbul
                Kare Publishing (Turkey )
                2148-4902
                2536-4553
                2023
                20 February 2023
                : 10
                : 1
                : 79-86
                Affiliations
                [1 ]Department of Psychiatry, Inonu University Faculty of Medicine, Malatya, Turkiye
                [2 ]Department of Dermatology, Inonu University Faculty of Medicine, Malatya, Turkiye
                Author notes
                Correspondence: Dursun Turkmen, MD. Inonu Universitesi Tip Fakultesi, Dermatoloji Anabilim Dali, Malatya, Turkiye. Tel: +90 530 223 69 55 e-mail: dursunturkmen44@ 123456gmail.com
                Article
                NCI-10-079
                10.14744/nci.2021.10170
                9996659
                36910444
                186a92e8-580f-47a3-b2b1-48a05a97368d
                © Copyright 2023 by Istanbul Provincial Directorate of Health

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0)

                History
                : 15 March 2021
                : 08 April 2021
                : 06 May 2021
                Categories
                Original Article

                anxiety,childhood abuse,chronic urticaria,depression,neglect

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