The latest medical research on Psychiatry

Exposure to war is associated with poor mental health outcomes. Adverse and traumatic experiences can lead to long-lasting DNA methylation changes, potentially mediating the link between adversity and mental health. To date, limited studies have investigated the impact of war on DNA methylation in children or adolescents, hampering our understanding of the biological impact of war exposure.

To identify salivary DNA methylation differences associated with war exposure in refugee children and adolescents.

This cohort study included Syrian refugee children and adolescents, and their primary caregiver were recruited from tented settlements in Lebanon. Data collection was carried out in 2 waves, 1 year apart, from October 2017 to January 2018 and October 2018 to January 2019. Children and their caregiver were interviewed, and children provided saliva samples for DNA extraction. Data analysis was conducted in 2022, 2023, and 2024.

War exposure assessed by interviewing children and their caregiver using the War Events Questionnaire.

Salivary DNA methylation levels were assayed with the Infinium MethylationEPIC BeadChip (Illumina). Epigenetic aging acceleration was estimated using a set of preexisting epigenetic aging clocks. A literature search was conducted to identify previously reported DNA methylation correlates of childhood trauma.

The study population included 1507 children and adolescents (mean [SD] age, 11.3 [2.4] years; age range, 6-19 years; 793 female [52.6%]). A total of 1449 children provided saliva samples for DNA extraction in year 1, and 872 children provided samples in year 2. Children who reported war events had a number of differentially methylated sites and regions. Enrichment analyses indicated an enrichment of gene sets associated with transmembrane transport, neurotransmission, and intracellular movement in genes that exhibited differential methylation. Sex-stratified analyses found a number of sex-specific DNA methylation differences associated with war exposure. Only 2 of 258 (0.8%) previously reported trauma-associated DNA methylation sites were associated with war exposure (B = -0.004; 95% CI, -0.005 to -0.003; Bonferroni P = .04 and B = -0.005; 95% CI, -0.006 to -0.004; Bonferroni P = .03). Any war exposure or bombardment was nominally associated with decreased epigenetic age using the Horvath multitissue clock (B = -0.39; 95% CI, -0.63 to -0.14; P = .007 and B = -0.42; 95% CI, -0.73 to -0.11; P = .002).

In this cohort of Syrian refugee children and adolescents, war exposure was associated with a small number of distinct differences in salivary DNA methylation.

The significant cost burden of eating disorders (EDs) could be lessened with quicker access to treatment. Little is known about the time it takes to reach treatment. We aimed to examine the time to access treatment in New Zealand.

468 respondents of the Costs of Eating Disorders online survey provided data including demographics; diagnoses; treatment journey, length of time to seek help; time to diagnosis after seeking help; GP referral to a specialist after diagnosis; and waiting time to see an EDs specialist.

Half the sample took more than a year to seek help. Those with bulimia nervosa (BN) and binge-eating disorder (BED) took significantly longer to seek help than those with anorexia nervosa and Other EDs. Once participants sought help, half the sample was diagnosed within 1 week. GPs referred most participants to an EDs specialist. Of those placed on a waiting list to see an EDs specialist, just under half were seen within 6 weeks, with no significant differences by diagnosis in waiting time.

Improving the acceptability of seeking help, particularly in those with BN and BED, early recognition of symptoms, and improving treatment pathways are key to minimising longer term impacts.