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1 Institute of Developmental Sciences Developmental origins of mental health: new insights into mechanisms and interventions Mark Hanson

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Page 1: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016

1

Institute of

Developmental Sciences

Developmental origins of mental health: new

insights into mechanisms and interventions

Mark Hanson

Page 3: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016

3May 2017

Or the present?

Page 4: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016

Or somewhere in between?

Page 5: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016

Development: does that mean that the

underlying mechanisms are genetic?

“To understand the molecular mechanisms

of depression, collect genetic data from

more than 100,000 people” says Steven

Hyman

Nature 13 Nov 2014. Special issue on

depression

Page 6: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016

The Dutch Hunger Winter 1944/5

Page 7: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016

Later consequences of famine exposure at

different gestational periodsEarly Mid Late

Young adult

• cong. neural def. +

•♂ obese +

40-60 years

• brain anomalies +

• schizophrenia +

• antisocial person.dis +

• major affective disorder +

• depressive symptoms + +

• ↓ perceived mental health + +

•♀ obese + +

• atherogenic lipid profile + (?)

• BP ↑ low protein % +

• BP ↑ after stress +

• coronary heart disease +

• impaired glucose tolerance + + +(?)

• micro albuminuria +

Page 8: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016

Genetic

Developmental

Environment

Epigenetic

Page 9: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016

Mechanisms of epigenetics

Zaidi S K et al. Mol. Cell. Biol. 2010;30:4758-4766

Page 10: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016
Page 11: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016

Lillycrop et al. I.J. Epidem. 2015;44:1263-1276

HES1 methylation at birth and childhood neuropsychological function.Wechsler Pre-School and Primary Scale of Intelligence

(WPPSI IQ) at age 4 years.

Spatial span length at age 7 years

Delayed matching to

sample at age 7 years

Infant externalising

score at age 1yr

Page 12: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016

12

J. Child Psychol. Psychiat. 2016

Page 13: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016

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Page 14: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016

Li, Y.M., Ou, J.J., Liu, L., Zhang, D., Zhao, J.P. and Tang, S.Y., 2016. Association between maternal

obesity and autism spectrum disorder in offspring: A meta-analysis. Journal of autism and developmental

disorders, 46(1), pp.95-102.

Five observational studies were included in the meta-analysis. The pooled adjusted odds ratio was 1.47 (95 % CI 1.24–1.74). The results support an increased risk of autism spectrum disorder in children of women who were obese during pregnancy. However, further study is warranted to confirm these results.

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Page 17: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016

Appleton, A. A. et al (2013). Patterning in placental 11-B hydroxysteroid

dehydrogenase methylation according to prenatal socioeconomic

adversity. PloS one, 8(9), e74691.

Page 18: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016

Poore K, Hanson M, Faustman M, Neira M. Avoidable early life environmental exposures. The Lancet Planetary Health (2017) Vol 1.

Page 19: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016

19Nature Scientific Reports, April 2017.

Page 20: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016
Page 21: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016
Page 22: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016
Page 23: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016
Page 24: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016

Hanson M, Barker M, Stephenson J

et al. The Lancet Diabetes and

Endocrinology, Oct 13 2016

Page 25: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016

Summary➢DOHaD research confirms the importance of early life

environment to neurocognitive development & mental health

➢A range of factors, many of which are avoidable, are

implicated, including under- and overnutrition, obesity, stress,

smoking and environmental toxicants

➢The heritable nature of underlying processes is not simply

via fixed genetics, but epigenetic mechanisms involved in

developmental plasticity

➢These may provide early biomarkers of risk and for

assessing efficacy of interventions

➢A life course approach emphasises the importance of

interventions in the preconception period, e.g. in adolescents

➢Such interventions need to be developed with young people

themselves, to generate motivation and demand for services

and support

Page 26: Mark Hanson - Maternal Mental Health Alliance€¦ · Mark Hanson. 2 Mental Health ... Hanson M, Barker M, Stephenson J et al. The Lancet Diabetes and Endocrinology, Oct 13 2016