Impact of Prenatal Stress on Offspring Psychopathology and Comorbidity With General Medicine Later in Life

  • Jill M. Goldstein
    Address correspondence to Jill M. Goldstein, Ph.D., Massachusetts General Hospital, Founders Building, 5th floor, Room 514B, 55 Fruit St., Boston, MA 02114.
    Departments of Psychiatry and Medicine, Harvard Medical School, and the Departments of Psychiatry and Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts
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      Stress affects every chronic disease we know, and psychiatric disorders are prime examples of this phenomenon. However, “stress” may likely be one of the most overused and sometimes loosely defined concepts in medicine and in other fields. The term has been used to describe both the stimuli causing a reaction (or “stressors”) and the responses to stimuli/stressors. It includes a multitude of modalities (either noxious or positive) that can be physical, chemical, social, and/or psychological, including perception of the stressor alone. The notion of “stress” in relation to human biology was defined by an adrenal response and coined more than 80 years ago by Hans Selye (
      • Selye H.
      The significance of the adrenals for adaptation.
      ). In fact, Selye, a basic scientist, endocrinologist, and biochemist, described stress as a physiologic hypothalamic-pituitary-adrenal (HPA) response, inducing hormonal, autonomic nervous system (ANS), immunologic, and blood pressure outcomes that impacted multiple organ systems, including cardiovascular, pulmonary, and renal systems driven by the brain. In addition, he first described the nature of stressors as physical, chemical, or psychological in nature.
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