Category: Mental Health

Categories : Mental Health Obstetrics & GynaecologyTags :

Simple Cognitive-behavioural Intervention Reduces Postpartum Depression

On By ModernMedia
Photo by Burst on Pexels

Results from a large clinical trial published in Nature Medicine show that an intervention for anxiety provided to pregnant women living in Pakistan significantly reduced the likelihood of the women developing moderate-to-severe anxiety, depression, or both six weeks after birth. The unique intervention was administered by non-specialised providers who had the equivalent of a bachelor’s degree in psychology – but no clinical experience. The results suggest this intervention could be an effective way to prevent the development of postpartum mental health challenges in women living in low-resource settings.

“In low resource settings, it can be challenging for women to access mental health care due to a global shortage of trained mental health specialists,” said Joshua A. Gordon, MD, PhD, Director of the National Institute of Mental Health, part of the National Institutes of Health.

“This study shows that non-specialists could help to fill this gap, providing care to more women during this critical period.”

Led by Pamela J. Surkan, PhD, ScD, of Johns Hopkins Bloomberg School of Public Health, Baltimore, the study was conducted in the Punjab Province of Pakistan between April 2019 and January 2022.

Pregnant women with symptoms of at least mild anxiety were randomly assigned to receive either routine pregnancy care or a cognitive behavioral therapy (CBT)-based intervention called Happy Mother-Healthy Baby. The researchers assessed the participants (380 women in the CBT group and 375 women in the routine care group) for anxiety and depression six weeks after the birth of their child.

The researchers found that 9% of women in the intervention group developed moderate-to-severe anxiety compared with 27% of women in the routine care group.

Additionally, 12% percent of women in the intervention group developed depression compared with 41% of women in the routine care group.

“Postpartum depression not only harms mothers, it is also associated with poorer physical growth and delayed cognitive development in their children,” said Dr Surkan.

“The link between maternal and child health highlights the critical importance of developing effective ways to address postpartum anxiety and depression.”

The Happy Mother-Healthy Baby intervention was created using input from pregnant women in a hospital in Rawalpindi, Pakistan.

Pregnant women took part in six intervention sessions where they learned to identify anxious thoughts and behaviors, such as thoughts about possible miscarriage, and to practice replacing them with helpful thoughts and behaviors.

The first five sessions were conducted in early to mid-pregnancy, and the sixth session occurred in the third trimester.

Prior research suggests that up to 30% of women in the Global South, which includes South America, Africa, and most of southern Asia, report experiencing anxiety during pregnancy.

Anxiety during pregnancy predicts the development of anxiety and depression after birth, making the prenatal period a prime target for intervention.

However, it can be challenging for women living in low-resource settings to access trained clinical care.

The findings from this study demonstrate that an intervention such as Happy Mother-Healthy Baby could be an effective way to help prevent the development of postpartum depression and anxiety in settings where specialist clinical care may be hard to access.

“In the future, we can build on these findings through implementation research. Having identified an intervention that works, the next step is to figure out the best ways to deliver effective treatment to the people who need it, bridging the gap between science and practice,” said Dr Surkan.

Source: NIH/National Institute of Mental Health

Categories : Mental Health Obstetrics & GynaecologyTags :

Antidepressants Impact Prefrontal Cortex Development

On By ModernMedia
Photo by William Fortunato on Pexels

A new study published in Nature Communications suggests that use of antidepressants can impact early post-natal brain development, potentially contributing to the development of mental health disorders. The study, led by researchers at the University of Colorado Anschutz Medical Campus, focused on the effect of fluoxetine, commonly used in medications such as Prozac and Sarafem for treating depression and perinatal depression, on the developing prefrontal cortex of mice.

Since fluoxetine works by increasing the levels of serotonin in the brain, the researchers looked at the impact serotonin has on prefrontal cortex development.

“While it is known that serotonin plays a role in the brain development, the mechanisms responsible for this influence, specifically in the prefrontal cortex, have been unclear, ” said lead author Won Chan Oh, PhD, assistant professor in the Department of Pharmacology at CU Anschutz.

Changes in gestational and early postnatal serotonin levels can arise from many causes including maternal deprivation or abuse, diets high or low in tryptophan, or the use of medications such as selective serotonin reuptake inhibitors (SSRIs) that can readily cross the placenta or be passed to offspring through breast feeding. Disbalances of 5-HT during brain development are associated with increased risk of neurodevelopmental disorders such as autism spectrum disorder and long-lasting behavioural deficits, but the underlying mechanisms remain elusive.

Oh and his student, Roberto Ogelman, a neuroscience PhD candidate, found serotonin directly influences nascent and immature excitatory synaptic connections in the prefrontal cortex, which if disrupted or dysregulated during early development can contribute to various mental health disorders.

“Our research uncovers the specific processes at the synaptic level that explain how serotonin contributes to the development of this important brain region during early-life fluoxetine exposure,” adds Oh. “We are the first to provide experimental evidence of the direct impact of serotonin on the developing prefrontal cortex in mice.”

To study the effect, the researchers looked at the impact of deficiency and surplus of serotonin on brain development in mice. They discovered that serotonin is not just involved in overall brain function but also has a specific role in influencing how individual connections between neurons change and adapt, contributing to the brain’s ability to learn and adjust.

“Understanding this correlation has the potential to help with early intervention and the development of new therapeutics for neurodevelopmental disorders involving serotonin dysregulation,” said Oh.

The researchers plan to continue studying the impact of fluoxetine, next examining its impact on a developing brain later in life.

Source: Colorado University Anschutz Medical Campus

Categories : Mental HealthTags :

New Tool Predicts Burnout Risk

On By ModernMedia
Photo by Mulyadi on Unsplash

It is not uncommon for people to “hit the wall” at work and experience burnout for short or long periods of time.

“We have found that approximately 13 per cent of Norwegian employees are at high risk of burnout,” says Leon De Beer, Associate Professor of Work and Organizational Psychology at the Norwegian University of Science and Technology (NTNU) Department of Psychology.

De Beer has contributed to a new study on burnout published in the Scandinavian Journal of Psychology with colleagues from the Healthy Workplaces research group.

They are working on a new tool that can identify people at risk of burnout. 

Signs that you might be at risk of burnout

If you are facing demands and stress at work that seem to be intractable, and you have frequently experienced the following symptoms in recent weeks, it might be a sign that you are on the verge of burning out:

  1. You feel mentally exhausted at work.
  2. You struggle to feel enthusiastic about your job.
  3. You have trouble concentrating when working.
  4. You sometimes overreact at work without meaning to.

Early intervention is key

It is important to identify the early signs of burnout in order to mitigate the harmful effects. The warning signs are often present before things have gone too far, as long as we manage to identify them.

“Not addressing the risk of employee burnout in time can have long-term consequences,” says De Beer.

The physical and psychological effects of burnout include cardiovascular disease, pain related to musculoskeletal injuries, sleeping problems, and depression. Organisations can also lose talented employees and experience an increase in sickness absence and lost productivity.

A new tool may become standard

De Beer’s research group has trialled a new measurement tool to identify the early warning signs of burnout. In the past, it has not always been that easy.

“Previously, we have not had a detailed enough measurement tool for use in both the field of practice and research that identifies workers who are at risk of burnout,” says De Beer.

There is currently no international standard for assessing burnout.

The new tool is called the Burnout Assessment Tool, or BAT among researchers who have a penchant for amusing abbreviations. The BAT consortium, of which the researchers are a part, is now testing the instrument in more than 30 countries.

https://burnoutassessmenttool.be/start_eng/

Start ENG

“Our studies show that BAT is a good tool for identifying the risk of burnout,” says De Beer.

Burnout is the body’s response to stress

BAT measures four main groups of risk factors: exhaustion, mental distancing, cognitive impairment and emotional impairment.

Burnout is not really an illness, but a feeling of being mentally or physically exhausted — the body’s response to a lasting, demanding situation.

Burnout is normally defined as a work-related syndrome, but there is evidence that work-life balance also plays a role. Stress and burnout don’t necessarily stop when you go home at the end of the day, as these effects often extend into other areas of life and vice versa.

Some may experience years of burnout

For some people, burnout can be stopped in its tracks and solutions found to improve their situation. For others, however, burnout can last for years if the problem isn’t addressed.

“We can deal with burnout through individual treatment, but it is of little use if people return to a workplace where the demands are too high and there are few resources. It is then highly likely that the employee will become ill again. Therefore, it is important to create good working conditions and structures that safeguard the health of employees,” says Professor Marit Christensen at NTNU’s Department of Psychology.

Culturally independent

The researchers studied a representative sample of 500 Norwegian workers. Norway is roughly on par with the EU average when it comes to mental health, but somewhat better when it comes to work-related matters.

A lower percentage of the Norwegian population struggles with exhaustion in connection with work. Somewhat fewer people than the EU average report health hazards at work, and we experience a better work-life balance.

“Using a recognised method, we found that around 13 per cent of the 500 surveyed workers were at high risk of burnout,” says Professor Christensen.

The tool can help identify who requires the most urgent follow up so that the risk of burnout can be reduced.

We do not yet know whether the prevalence of burnout in Norway is high in an international context. The Norwegian study is among several BAT studies that are currently taking place, so these answers will be available at a later date.

The tool is intended to be culturally independent, and it certainly works well in Norway. The researchers also found that the tool works regardless of gender.

“For entertainment and educational purposes, interested parties can use our online tool to test if they are at risk of burnout,” says Professor Christensen.

“Please note that the tool only gives an indication of risk and does not provide any type of formal diagnosis or medical advice. If you are concerned about your levels of work-related stress, we encourage you to visit a health care provider to discuss the matter,” says Professor Christensen.

Source: Norwegian University of Science and Technology

Categories : Mental HealthTags :

Questions Remain over Ketamine’s Promise for Treating Depression

On By ModernMedia
Photo by Sydney Sims on Unsplash

Using the old anaesthesia drug ketamine to pull people out of the depths of severe depression has gone from fringe idea to widespread use in just a few years. Sparked by promising studies and stories of lives transformed, clinics offering intravenous infusions of ketamine have popped up in the US. Some also offer a newer, more expensive, nasal spray version.

But major questions remain about who ketamine can help, why some people get tremendous relief within days or weeks while others don’t, and the costs and benefits of different ways of delivering the drug.

New findings just came out from a study that seeks to answer some of those questions. They add more evidence about the power of IV ketamine to help some of the most severely ill people with depression or bipolar disorder who haven’t gotten relief from other treatments, including many who have frequent suicidal thoughts.

Called Bio-K, the study involved 74 people treated at four clinics in Michigan, Maryland and Minnesota. After just three infusions of ketamine over 11 days, 52% of participants saw their severe depression ease so much they achieved remission. Another 15% responded somewhat.

Half of those who had thought often of suicide before receiving ketamine experienced a dramatic drop in those impulses. The results are published in the Journal of Affective Disorders.

“These participants are very representative of the sickest patients we see, with more than 80% reporting suicidality that would have excluded them from other depression treatment studies,” said University of Michigan Health psychiatrist and study leader Sagar Parikh, MD.

“As in other studies of ketamine, the initial response to treatment was a strong predictor of who would do well,” he added. “Two-thirds of those who responded after one infusion went on to achieve remission, while those who hadn’t responded measurably after two infusions were unlikely to start to respond after an additional one.”

Who responds and why?

What’s the difference between them and those who responded? That’s a key focus of Bio-K, which is funded by donors to the U-M Eisenberg Family Depression Center.

A third of all Bio-K participants didn’t respond to ketamine by the end of the three infusions provided under the study, leaving them to cope with one more failure in a series of attempted treatments.

The team’s in-depth interviews with some of these non-responders show how difficult that can be, as the team reported in a paper last year.

By studying molecules in blood samples from the study’s participants, the Bio-K team hopes to find biomarkers that could predict who is most likely to get relief from ketamine, and who should try other options.

The study is evaluating cell signaling proteins, inflammatory markers and molecules that can indicate rates of cell metabolism in mitochondria. Early results from those analyses should be available in the next year.

From research to clinical use

In the meantime, the strength of the response in Bio-K participants helped fuel the founding of an IV ketamine clinic at University of Michigan Health, says Parikh, who oversees the clinic.

U-M now accepts referrals from providers across the region who have patients with treatment-resistant depression and need another option after trying at least four medications.

Patients come to the main U-M medical campus around eight times during the span of a month for infusions under the care of psychiatrists, anaesthesiologists and other clinicians.

Parikh and his colleagues even wrote a guide for other hospitals on how best to set up and run such a clinic.

A newer version

Meanwhile, the nasal spray form of ketamine, called esketamine and sold under the name Spravato, has captured attention in recent years for its potential to ease disabling and life threatening symptoms without requiring an IV.

The spray involves a form of the drug manufactured by a pharmaceutical company in a way that isolates just one variety of the ketamine molecule, which allowed the company to seek a specific FDA approval.

Parikh notes that U-M was one of the sites for the original small study that led to Spravato’s approval by the FDA, and another larger study sponsored by Janssen, the drug’s manufacturer, that recently concluded. In addition to serving as the local principal investigator for these studies, Parikh also briefly served as a consultant to the company.

Based on the experience in these studies, U-M hopes to start offering Spravato alongside IV ketamine on a clinical basis. Even though it’s not given through an intravenous drip, the nasal spray still requires careful observation of patients under the FDA’s approval conditions.

IV vs nasal spray

Even as researchers search for biomarkers to predict ketamine response, clinicians find themselves with a conundrum: Which patients should start with IV ketamine, and which with Spravato? And how do the two compare head to head in actual response to treatment?

That’s what researchers at Yale University, U-M and their colleagues will soon try to find out, through a new study just funded by the federal Patient-Centered Outcomes Research Institute.

The study, which will begin enrolling up to 400 people at six sites nationwide later this year, will randomly assign people with treatment resistant depression to either the IV or nasal spray form of the drug. They’ll then receive that treatment for about four weeks, and have their symptoms monitored during treatment and for months afterward.

Such a head-to-head study might help inform insurers that haven’t yet started covering one or both forms of ketamine, Parikh noted.

More about the Bio-K results

In the meantime, the treatment response results from the Bio-K study and other studies can help more patients and clinicians understand the impact of IV ketamine.

Although Bio-K accepted people who were suicidal, which many antidepressant medication studies do not, it did not include people who use cannabis or those who have an active substance use disorder, schizophrenia or psychosis. But participants had to have failed to respond to at least two antidepressant or mood stabilising medications after at least eight weeks, or failed to respond to six sessions of ECT, the treatment based on electric stimulation of the brain that has been seen as the last resort for many patients.

The study found that it did not matter if they got their infusions slowly over 100 minutes or in a standard session of 40 minutes.

At the start of the study, the average score of participants on a standard depression scale called MADRS was 28; that average dropped to 11 at 24 hours after the third infusion. A score of 10 or below is considered depression free, or remission, and a drop in score of at least 50% of the total score is considered response. In all, 67% achieved what is considered response, and 52% reached remission.

Source: Michigan Medicine – University of Michigan

Categories : Exercise Mental HealthTags :

New Study Suggests that Pumping Iron can Help Fight the Blues

On By ModernMedia
Photo by Jonathan Borba on Unsplash

A new study has demonstrated the impact that resistance exercise training can have in the treatment of anxiety and depressive symptoms. The findings, published in Trends in Molecular Medicine, provide evidence to support the benefits of resistance exercise training can have on anxiety and depression and offers an examination of possible underlying mechanisms.

The research was carried out by Professor Matthew P. Herring at University of Limerick and Professor Jacob D. Meyer at Iowa State University.

“We are tremendously excited to have what we expect to be a highly cited snapshot of the promising available literature that supports resistance exercise training in improving anxiety and depression.

“Notwithstanding the limitations of the limited number of studies to date, there is exciting evidence, particularly from our previous and ongoing research of the available studies, that suggests that resistance exercise training may be an accessible alternative therapy to improve anxiety and depression.

“A more exciting aspect is that there is substantial promise in investigating the unknown mechanisms that may underlie these benefits to move us closer to maximizing benefits and to optimising the prescription of resistance exercise via precision medicine approaches,” Dr Herring added.

Professor Meyer, a co-author on the study, said: “The current research provides a foundation for testing if resistance training can be a key behavioural treatment approach for depression and anxiety.

“As resistance training likely works through both shared and distinct mechanisms to achieve its positive mood effects compared to aerobic exercise, it has the potential to be used in conjunction with aerobic exercise or as a standalone therapy for these debilitating conditions.

“Our research will use the platform established by current research as a springboard to comprehensively evaluate these potential benefits of resistance exercise in clinical populations while also identifying who would be the most likely to benefit from resistance exercise.”

Source: University of Limerick

Categories : Environmental Effects Mental HealthTags :

Is There a Link Between Body Temperature and Depression?

On By ModernMedia
Photo by Inzmam Khan

People with depression have higher body temperatures, suggesting there could be a mental health benefit to lowering the temperatures of those with the disorder, a new UC San Francisco-led study found. The study, published in Scientific Reports, only indicated an association, not a causative effect in either direction.

It’s also unknown whether the higher body temperature observed in people with depression reflects decreased ability to self-cool, increased generation of heat from metabolic processes or a combination of both.

Researchers analysed data from more than 20 000 international participants who wore a device that measures body temperature, and also self-reported their body temperatures and depression symptoms daily.

The seven-month study began in early 2020 and included data from 106 countries. The results showed that with each increasing level of depression symptom severity, participants had higher body temperatures.

The body temperature data also showed a trend toward higher depression scores in people whose temperatures had less fluctuation throughout a 24-hour period, but this finding didn’t reach significance.

The findings shed light on how a novel depression treatment method might work, said Ashley Mason, PhD, the study’s lead author and associate professor of psychiatry at UCSF Weill Institute for Neurosciences.

A small body of existing, causal studies has found that using hot tubs or saunas can reduce depression, possibly by triggering the body to self-cool, for example, through sweating.

“Ironically, heating people up actually can lead to rebound body temperature lowering that lasts longer than simply cooling people down directly, as through an ice bath,” said Mason, who is also a clinical psychologist at the UCSF Osher Center for Integrative Health.

“What if we can track the body temperature of people with depression to time heat-based treatments well?”

“To our knowledge, this is the largest study to date to examine the association between body temperature – assessed using both self-report methods and wearable sensors – and depressive symptoms in a geographically broad sample,” added Mason. “Given the climbing rates of depression in the United States, we’re excited by the possibilities of a new avenue for treatment.”

Source: University of California – San Francisco

Categories : Mental HealthTags :

Higher Than Expected Levels of Psychosis Spectrum Symptoms among Youth

On By ModernMedia
Photo by Andrew Neel on Unsplash

A new study published in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging has found evidence that Psychosis Spectrum Symptoms (PSS) are often present in youth accessing mental health services.

From a profile of the initial 417 youth aged 11–24 participating in the study, 50% were shown to meet the threshold for Psychosis Spectrum Symptoms, a number that study co-lead Associate Professor Kristin Cleverley says was higher than expected, meaning there is a large number of children with these symptoms accessing mental health services.

Cleverley, of the Lawrence Bloomberg Faculty of Nursing Cleverley, says that what is novel about this study is that researchers are assessing early indicators that might predict whether someone is more at risk of developing Psychosis Spectrum Disorder, and examine whether there is a point at which earlier intervention for that youth could be more effective.

“Traditionally, early psychosis care starts when there is a serious presentation of psychotic symptoms, which usually occurs in the late teen years,” says Cleverley. “The current approach to identifying children at risk of developing a psychotic disorder is only about five percent effective, but with this study we can start to assess certain patterns or changes in function that can signal if an earlier intervention may be beneficial.”

Psychosis Spectrum Disorder can be extremely disabling, and is linked to cognitive impairment, long-term disability, and higher rates of death by suicide than other mental illnesses. Even without a diagnosis of psychosis, Psychosis Spectrum Symptoms can severely affect youth.

This study is one of three projects being led as part of the Toronto Adolescent and Youth (TAY) Cohort Study that is set to follow 1500 youth over the course of five years. The goal of the cohort study is to better understand the populations of youth seeking mental health treatment, how their mental health symptoms and functioning change over time, and whether early predictors of psychosis spectrum disorder can be determined.

This study was co-designed with patient and caregivers in addition to involving extensive engagement from clinicians. A novel aspect of the TAY Cohort Study is youth are given access to a patient-facing dashboard of their research results that is also integrated into their clinical record.

“We wanted to ensure that the study was embedded in the clinical program so that research assessments could be immediately utilised within clinical practice, including supporting decisions about interventions or services,” says Cleverley.

This longitudinal study will include a follow-up every six months, and will provide researchers access to information about whether symptoms in these youth become chronic or episodic, and whether these changes are related to developmental milestones or environmental stressors, or changes to mental health services.

“Our goal with this research is really to characterise this population better so that we can identify new strategies that will complement existing strategies for early identification of youth at risk of psychosis,” says Cleverley. “It also creates an important opportunity for graduate students and researchers to develop sub-studies for this sample that will enable further research to improve youth mental health outcomes.”

Source: University of Toronto

Categories : Mental HealthTags :

A Mechanism that Links Anxiety to Testosterone

On By ModernMedia
Photo by Inzmam Khan

A groundbreaking study has unveiled a significant link between anxiety disorders and a brain receptor known as TACR3, as well as testosterone. published last month in the journal Molecular Psychiatry.

Anxiety is a common response to stress, but for those dealing with anxiety disorders, it can significantly impact daily life.

Clinical evidence has hinted at a close connection between low testosterone levels and anxiety, particularly in men with hypogonadism, a condition characterised by reduced sexual function.

However, the precise nature of this relationship has remained unclear until now.

Prof Shira Knafo, head of the Molecular Cognitive Lab at Ben-Gurion University, led this new study which discovered male rodents exhibiting exceedingly high anxiety levels had notably lower levels of a specific receptor called TACR3 in their hippocampus.

The hippocampus is a brain region closely associated with learning and memory processes. TACR3 is part of the tachykinin receptor family and responds to a substance known as neurokinin.

This observation is what prompted the researchers to investigate the link between TACR3 deficiency, sex hormones, anxiety, and synaptic plasticity.

The rodents were classified based on their behavior in a standard elevated plus maze test measuring anxiety levels.

Subsequently, their hippocampi were isolated and underwent gene expression analysis to identify genes with varying expressions between rodents with extremely low anxiety and those with severe anxiety.

One gene that stood out was TACR3. Previous research had revealed that mutations in genes associated with TACR3 led to a condition known as “congenital hypogonadism,” resulting in reduced sex hormone production, including testosterone.

Notably, young men with low testosterone often experienced delayed sexual development, accompanied by depression and heightened anxiety.

This pairing led researchers to investigate the role of TACR3 further.

Prof. Knafo and her team were aided in their research by two innovative tools they crafted themselves.

The first, known as FORTIS, detects changes in receptors critical for neuronal communication within living neurons.

By utilizing FORTIS, they demonstrated that inhibiting TACR3 resulted in a sharp increase in these receptors on the cell surface, blocking the parallel process of long-term synaptic strengthening, known as LTP.

The second pioneering tool employed was a novel application of cross-correlation to measure neuronal connectivity within a multi-electrode array system.

This tool played a pivotal role in uncovering the profound impact of TACR3 manipulations on synaptic plasticity.

Synaptic plasticity refers to the ability of synapses, the connections between brain cells, to change their strength and efficiency.

This dynamic process is fundamental for the brain’s adaptation to the environment.

Through synaptic plasticity, the brain can reorganize its neural circuitry in response to new experiences.

This flexibility allows for the modification of synaptic connections, enabling neurons to strengthen or weaken their communication over time.

Essentially, synaptic plasticity is a key mechanism by which the brain encodes and stores information, adapting continuously to the ever-changing external stimuli and internal states.

Importantly, it revealed that deficiencies stemming from TACR3 inactivity could be efficiently rectified through testosterone administration, offering hope for novel approaches to address challenges related to anxiety associated with testosterone deficiency.

TACR3 is seemingly a central player in bridging anxiety and testosterone.

The researchers have unravelled the complex mechanisms behind anxiety and opened avenues for novel therapies, including testosterone treatments, that could improve the quality of life for individuals grappling with sexual development disorders and associated anxiety and depression.

Source: Ben-Gurion University of the Negev

Categories : Mental HealthTags :

Financial Stress Linked to Worse Biological Health

On By ModernMedia
Photo by Alex Green on Unsplash

People who experience stressful life events or circumstances are more likely to have worse biological health, as indicated by biomarkers involved in the interaction between our immune, nervous and endocrine systems, according to a new study by UCL researchers.

The study, published in the journal Brain, Behavior and Immunity, found that not only major stressful experiences such as bereavement but chronic challenges such as financial strain were detrimental to the healthy interaction of these systems.

Communication between our immune, nervous, and endocrine systems is necessary to maintain good health. Disruption of these processes is linked to a wide range of mental and physical illnesses, from cardiovascular disease to depression and schizophrenia.

When a threat like stress occurs, signals between the immune, nervous, and endocrine systems are activated and spur physiological and behavioural changes.

In this new study, the researchers analysed blood concentrations of four biomarkers in 4934 people aged 50 and over who were participants of the English Longitudinal Study of Ageing. Two of these were proteins involved in the innate immune response to inflammation (C-reactive protein and fibrinogen), and two were hormones involved in the physiology of the stress response (cortisol and IGF-1).

The team used a sophisticated statistical technique, latent profile analysis, to identify clusters of biomarker activity. Three groups were identified and labelled as low risk to health, moderate risk, and high risk. The researchers then looked at how earlier exposure to stressful circumstances might affect people’s likelihood of being in the high-risk group.

They found that exposure to stressful circumstances overall, ranging from being an informal carer to experiencing a bereavement or divorce in the last two years, was linked to a 61% increase in likelihood of belonging to the high-risk group four years later.

Separately, the effect was also cumulative, as the likelihood of belonging to the high-risk group increased by 19% for each stressor experienced, for those who experienced more than one stress-inducing circumstance.

People who reported only financial strain – the perception that they may not have enough financial resources to meet their future needs – were 59% more likely, four years later, to belong to the high-risk group.

Lead author, PhD candidate Odessa S. Hamilton (UCL Institute of Epidemiology & Health Care), said: “When the immune and neuroendocrine systems function well together, homeostasis is maintained and health is preserved. But chronic stress can disrupt this biological exchange and lead to disease.

“We found that financial stress was most detrimental to biological health, although more research is needed to establish this for certain. This may be because this form of stress can invade many aspects of our lives, leading to family conflict, social exclusion, and even hunger or homelessness.”

Experiencing stress over a prolonged period of time can disturb the communication between the immune and neuroendocrine systems. That is because our response to stress is similar to our response to sickness, activating some of the same pathways (for instance, both responses trigger the production of immune system signals called pro-inflammatory cytokines).

The researchers also looked at genetic variants previously found to influence our immune-neuroendocrine response and found that the association between stressful life circumstances and belonging to the high-risk group four years later remained true irrespective of genetic predisposition. 

Source: University College London

Categories : Mental HealthTags :

Visions of Nonphysical World are Common Among Cognitively Healthy American Indians

On By ModernMedia
Photo by Bruce Christianson on Unsplash

Visual hallucinations are common among people with Lewy body dementia and other types of dementia. Identifying visual hallucinations is an important component of a wide variety of medical and psychiatric diagnoses and treatments, but without cultural context, some patients’ symptoms can be misinterpreted or misdiagnosed.

There is little in medical literature about normal spiritual experiences in American Indian participants in the context of a neurocognitive evaluation. University of Minnesota Medical School researchers sought to understand how the culture and spirituality of the American Indian Ojibwe tribe affect a doctor’s assessment of normal aging.

Publishing in JAMA Network Open, the research team found that visions of the nonphysical world are common among cognitively healthy Ojibwe individuals and can represent normal spiritual experiences. 

“Consideration of a patient’s cultural background and belief system can help avert erroneous disqualification for disease-modifying therapy, exclusion from clinical trials and all the negative ramifications associated with a misdiagnosis of psychiatric disease,” said William Mantyh, MD, an assistant professor at the University of Minnesota Medical School and  behavioural neurologist with M Health Fairview.

In partnership with an Ojibwe Tribal Nation in Minnesota, the study recruited 33 cognitively healthy tribal elders aged 55 years or older. The research found 48% of participants reported frequent transient visions of the nonphysical world that generally were benevolent and involved spiritual beings and/or ancestors. 

According to the research team, clinicians would benefit from careful consideration of cultural or spiritual context to avoid misdiagnosis of neuropsychiatric disease. 

“Today’s environment of infrequent or insufficiently short cognitive evaluations – an average 16-minute face-to-face visit with a physician and increasing use of pre-visit symptom checklists increase the risk of falsely attributing a spiritual experience to a hallucination,” said Dr Mantyh. 

Dr Mantyh and his research team’s overarching goal is to ensure accurate diagnosis of neurodegenerative disease in American Indian communities. To reach this goal, the research team is including American Indian participants in the development of a new Alzheimer’s disease blood test. So far, more than 250 participants have been included. These new Alzheimer’s disease blood tests, up to 95% accurate, directly detect the proteins related to Alzheimer’s disease in the blood, but they also look at a patient’s APOE ε4 gene. APOE ε4 is the most significant genetic risk factor for Alzheimer’s disease, but its effect on Alzheimer’s disease depends on a patient’s ancestry. 

Source: University of Minnesota