Can early life stress contribute to how COVID-19 affects a patient? That’s a question being asked by a McLean Hospital researcher in a national mental health study of college students in his native Pakistan that will be conducted over the next two years.
The project is one of two undertaken by Alaptagin Khan, MBBS, FRSPH, a research associate in the Developmental Biopsychiatry Research Program. A second study aims to examine a potential link between COVID-19 and a gene involved in the entire continuum of stress-related and anxiety disorders.
“Epidemiological, family, and molecular genetic studies have provided strong evidence for the role of genetic factors, as well as stressful or traumatic life events, especially in childhood, in developing psychiatric disorders, such as major depression and PTSD,” said Khan. “And these genetic and environmental factors interact with each other in a complex manner that is not yet clearly understood.”
Since joining McLean in 2012, Khan has focused his research on identifying sensitive developmental periods when exposure to childhood adversity has the greatest impact on the risk for developing major depression, suicidal ideation, PTSD, personality disorders, and substance use disorders.
This presence of sensitive exposure periods may lead to a more precise clinical and neurobiological understanding of susceptibility and resilience and can help define times when interventions can have the most potent effects.
As the research director of Pakistan’s first-of-its-kind Childhood Trauma Research Center at Lady Reading Hospital, Peshawar, Khan oversees a team of psychiatrists and psychologists working with victims of childhood abuse, collecting epidemiological and genetic data.
With the onset of COVID-19, an online survey was developed in collaboration with Khyber Medical University and Lady Reading Hospital to explore a possible association between psychosocial stress and COVID-19.
Participants were asked about their medical and mental health, their current stress level, and any life events that could result in increased stress levels. They were also asked whether they had been exposed to COVID-19 and whether they experienced symptoms.
This community-based data will then be compared with the responses of patients who became seriously ill with COVID-19 to help understand the role of stress in contracting and recovering from serious infection.
Khan is also conducting a second study, in collaboration with Khyber Medical University, to examine the FKBP5 gene as a target for possible interactive effects in COVID-19 patients. The goal is to enroll up to 4,000 patients and collect their medical information as well as information on psychological determinants of health—including early life adversity.
Symptom severity will be compared between patients who carry one of two or more alternative forms of the FKBP5 gene and those with protective variations, looking at childhood adversity and other psychosocial factors as variables.
Researchers hope to learn whether “having more early life adversity makes you more prone to responding poorly to COVID-19 infection,” Khan explained.
Also, “by having more early life adversity, are you going to have more severe symptoms because your stress response has been dysregulated?”
The project was made possible through a multisite collaboration between McLean Hospital and Khan’s collaborators at Khyber Medical University (Dr. Hafsah Mohammad, Dr. Khalid Rehman), Lady Reading Hospital (Dr. Mian Mukhtar ul Haq), Women Medical College (Dr. Jasim Anwar), Shaheed Benazir Bhutto Women University (Ms. Farrukh Habib), and Khyber Teaching Hospital (Dr. Shahzad Rauf).
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