Category: Mental Health

Categories : Mental Health NeurologyTags :

Scientists may have Found out How Rapid-acting Antidepressants Work

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Photo by Marek Piwnicki

Rapid-acting antidepressants, including ketamine, scopolamine and psilocybin, have been found to have immediate and lasting positive effects on mood in patients with major depressive disorder but how these effects arise is unknown. New research led by the University of Bristol and published in Science Translational Medicine explored their neuropsychological effects and found that all three of these drugs can modulate affective biases associated with learning and memory.

Negative affective biases are a core feature of major depressive disorder. Affective biases occur when emotions alter how the brain processes information and negative affective biases are thought to contribute to the development and continuation of depressed mood.

The research team used an affective bias test, based on an associative learning task, to investigate the effects of rapid-acting antidepressants (RAADs) in rats.

They found that all the treatments were able to reduce negative affective biases associated with past experiences but there were additional characteristics of the dissociative anaesthetic, ketamine, and the serotonergic psychedelic, investigational COMP360 psilocybin (Compass Pathways’ proprietary formulation of synthetic psilocybin), which could explain why the effects of a single treatment can be long-lasting.

The findings suggest that these sustained effects are due to adaptive changes in the brain circuits which control affective biases, and these can influence how past experiences are remembered.

The effects at low doses were very specific to affective bias modulation and were localised to the prefrontal cortex of the brain, a region known to play an important role in mood.

Emma Robinson, Professor of Psychopharmacology in the School of Physiology, Pharmacology & Neuroscience at Bristol, and lead author, said: “Using a behavioural task we showed that drugs that are believed to have rapid and sustained benefits in depressed patients, specifically modulate affective biases associated with past experiences, something which we think is really important for understanding why they can improve a patient’s mood so quickly.

“We also found differences in how ketamine, scopolamine and COMP360 psilocybin interact with these neuropsychological mechanisms which may explain why the effects of a single treatment in human patients can be long-lasting, days (ketamine) to months (psilocybin).

“By using an animal model, we have been able to investigate these important interactions with learning and memory processes and neural plasticity and propose a two-stage model that may explain the effects we observe.”

In the task, each animal learnt to associate a specific digging material with a food reward under either treatment or control conditions.

The treatment condition is designed to generate a change in the animal’s affective state and a choice test is used to quantify the affective bias this generates.

Acute treatment with the RAADs ketamine, scopolamine, or psilocybin prevented the retrieval of the negative affective bias induced in this model.

However, the most exciting finding was at 24 hours after treatment when low, but not high, doses of ketamine and psilocybin led to a re-learning effect where the negatively biased memory was retrieved with a more positive affective valence.

Only psilocybin, but not ketamine or scopolamine treatment also positively biased new experiences.

Exploring in more detail the re-learning effects of ketamine in the studies, the researchers found they were protein synthesis-dependent, localised to the medial prefrontal cortex and could be modulated by cue-reactivation, consistent with their predictions of experience-dependent neural plasticity.

The study’s findings propose a neuropsychological mechanism that may explain both the immediate and sustained effects of RAADs, potentially linking their effects on neural plasticity with mood.

Source: University of Bristol

Categories : Mental Health Metabolic DisordersTags :

Feeling Depressed Linked to Short-term Increase in Bodyweight

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Increases in symptoms of depression are associated with a subsequent increase in bodyweight when measured one month later, new research from the University of Cambridge has found.

The study, published in PLOS ONE, found that the increase was only seen among people with overweight or obesity, but found no link between generally having greater symptoms of depression and higher bodyweight.

Research has suggested a connection between weight and mental health – with each potentially influencing the other – but the relationship is complex and remains poorly understood, particularly in relation to how changes in an individual’s mental health influence their bodyweight over time.

To help answer this question, researchers at Cambridge’s Medical Research Council (MRC) Epidemiology Unit examined data from over 2,000 adults living in Cambridgeshire, UK, who had been recruited to the Fenland COVID-19 Study.

Participants completed digital questionnaires on mental wellbeing and bodyweight every month for up to nine months during the COVID-19 pandemic (August 2020 – April 2021) using a mobile app developed by Huma Therapeutics Limited.

Questions assessed an individual’s symptoms of depression, anxiety and perceived stress.

A higher score indicated greater severity, with the maximum possible scores being 24 for depression, 21 for anxiety and 40 for stress.

The team then used statistical modelling to explore whether having poorer mental wellbeing than usual was related to changes in bodyweight one month later.

The researchers found that for every increment increase in an individual’s usual score for depressive symptoms, their subsequent weight one month later increased by 45g.

This may seem small but would mean, for example, that in an individual whose depressive symptoms score rose from five to 10 (equal to an increase from ‘mild’ to ‘moderate’ depressive symptoms) it would relate to an average weight gain of 225g (0.225kg).

This effect was only observed in those individuals with overweight (defined as BMI 25-29.9kg/m2) or with obesity (BMI of over 30kg/m2). Individuals with overweight had on average an increase of 52g for each increment point increase from their usual depressive symptoms score and for those with obesity the comparable weight gain was 71g.

The effect was not seen in those individuals with a healthy weight.

First author Dr Julia Mueller from the MRC Epidemiology Unit said: “Overall, this suggests that individuals with overweight or obesity are more vulnerable to weight gain in response to feeling more depressed. Although the weight gain was relatively small, even small weight changes occurring over short periods of time can lead to larger weight changes in the long-term, particularly among those with overweight and obesity.

“People with a high BMI are already at greater risk from other health conditions, so this could potentially lead to a further deterioration in their health. Monitoring and addressing depressive symptoms in individuals with overweight or obesity could help prevent further weight gain and be beneficial to both their mental and physical health.”

The researchers found no evidence that perceived stress or anxiety were related to changes in weight.

Senior author Dr Kirsten Rennie from the MRC Epidemiology Unit said: “Apps on our phones make it possible for people to answer short questions at home more frequently and over extended periods of time, which provides much more information about their wellbeing. This technology could help us understand how changes in mental health influence behaviour among people with overweight or obesity and offer ways to develop timely interventions when needed.”

Although previous studies have suggested that poor mental health is both a cause and consequence of obesity, the research team found no evidence that weight predicted subsequent symptoms of depression.

The research was supported by the Medical Research Council.

The original text of this story is licensed under Creative Commons CC BY-SA 4.0.

Source: University of Cambridge.  Note: Content may be edited for style and length.

Journal Reference:

  1. Julia Mueller, Amy L. Ahern, Rebecca A. Jones, Stephen J. Sharp, Alan Davies, Arabella Zuckerman, Benjamin I. Perry, Golam M. Khandaker, Emanuella De Lucia Rolfe, Nick J. Wareham, Kirsten L. Rennie. The relationship of within-individual and between-individual variation in mental health with bodyweight: An exploratory longitudinal study. PLOS ONE, 2024; 19 (1): e0295117 DOI: 10.1371/journal.pone.0295117
Categories : Mental Health NeurologyTags :

Targeted Neurostimulation Makes People More Hypnotisable

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Hypnotisability appears to be a stable trait that changes little throughout adulthood, much like personality and IQ. But now, for the first time, Stanford Medicine researchers have demonstrated a way to temporarily heighten hypnotisablity, potentially allowing more people to access the benefits of hypnosis-based therapy.

In the new study, published in Nature Mental Health, the researchers found that less than two minutes of electrical stimulation targeting a precise area of the brain could boost participants’ hypnotisability for about one hour.

“We know hypnosis is an effective treatment for many different symptoms and disorders, in particular pain,” said lead author Afik Faerman, PhD, a postdoctoral scholar in psychiatry. “But we also know that not everyone benefits equally from hypnosis.”

Focused attention

Approximately two-thirds of adults are at least somewhat hypnotisable, and 15% are considered highly hypnotisable, meaning they score 9 or 10 on a standard 10-point measure of hypnotisability.

“Hypnosis is a state of highly focused attention, and higher hypnotisability improves the odds of your doing better with techniques using hypnosis,” said David Spiegel, MD, a professor of psychiatry and behavioural sciences and a senior author of the study.

Spiegel has devoted decades to studying hypnotherapy and using it to help patients control pain, lower stress, stop smoking and more. Several years ago, Spiegel led a team that used brain imaging to uncover the neurobiological basis of the practice. They found that highly hypnotisable people had stronger functional connectivity between the left dorsolateral prefrontal cortex, which is involved in information processing and decision making; and the dorsal anterior cingulate cortex, involved in detecting stimuli.

“It made sense that people who naturally coordinate activity between these two regions would be able to concentrate more intently,” Spiegel said. “It’s because you’re coordinating what you are focusing on with the system that distracts you.”

Shifting a stable trait

With these insights, Spiegel teamed up with Nolan Williams, MD, associate professor of psychiatry and behavioural sciences, who has pioneered non-invasive neurostimulation techniques to treat conditions such as depression, obsessive-compulsive disorder and suicidal ideation.

The hope was that neurostimulation could alter even a stable trait like hypnotisability.

In the new study, the researchers recruited 80 participants with fibromyalgia, a chronic pain condition that can be treated with hypnotherapy. They excluded those who were already highly hypnotisable.

Half of the participants received transcranial magnetic stimulation, in which paddles applied to the scalp deliver electrical pulses to the brain. Specifically, they received two 46-second applications that delivered 800 pulses of electricity to a precise location in the left dorsolateral prefrontal cortex. The exact locations depended on the unique structure and activity of each person’s brain.

“A novel aspect of this trial is that we used the person’s own brain networks, based on brain imaging, to target the right spot,” said Williams, also a senior author of the study.

The other half of participants received a sham treatment with the same look and feel, but without electrical stimulation. Hypnotisability was assessed by clinicians immediately before and after the treatments, with neither patients nor clinicians knowing who was in which group.

The researchers found that participants who received the neurostimulation showed a statistically significant increase in hypnotisability, scoring roughly one point higher. The sham group experienced no effect.

When the participants were assessed again one hour later, the effect had worn off and there was no longer a statistically significant difference between the two groups.

“We were pleasantly surprised that we were able to, with 92 seconds of stimulation, change a stable brain trait that people have been trying to change for 100 years,” Williams said. “We finally cracked the code on how to do it.”

The researchers plan to test whether different dosages of neurostimulation could enhance hypnotisability even more.

“It’s unusual to be able to change hypnotisability,” Spiegel said. A study of Stanford University students that began in the 1950s, for example, found that the trait remained relatively consistent when the students were tested 25 years later, as consistent as IQ over that time period. Recent research by Spiegel’s lab also suggests that hypnotisability may have a genetic basis.

Bigger implications

Clinically, a transient bump in hypnotisability may be enough to allow more people living with chronic pain to choose hypnosis as an alternative to long-term opioid use. Spiegel will follow up with the study participants to see how they fare in hypnotherapy.

The new results could have implications beyond hypnosis. Faerman noted that neurostimulation may be able to temporarily shift other stable traits or enhance people’s response to other forms of psychotherapy.

“As a clinical psychologist, my personal vision is that, in the future, patients come in, they go into a quick, non-invasive brain stimulation session, then they go in to see their psychologist,” he said. “Their benefit from treatment could be much higher.”

Story Source: Stanford Medicine

Categories : Mental Health Obstetrics & GynaecologyTags :

Perinatal Depression Triples the Risk of Suicidal Behaviour

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Maternal suicide is an alarming public health issue and the second most common cause of death during the postnatal period. New research from Karolinka Institutet in Sweden shows that mothers with clinically diagnosed perinatal depression had a three times higher risk of suicidal behaviour compared to mothers without perinatal depression. The findings were published in JAMA Network Open.

Some 13–36% of maternal deaths are attributable to suicide, and the consequences are devastating to the newborn and the family. Maternal suicide is linked to a complex interplay of risk factors, including history of psychiatric disorders, socioeconomic disparities, and inadequate access to healthcare service. It is of paramount importance to identify high-risk populations for preventing maternal suicide and suicidal attempt.

Our findings suggest that women with clinically diagnosed PND are at an increased risk of suicidal behavior, particularly within one year after PND yet throughout 18 years of follow-up. This highlights the pressing need for vigilant clinically monitoring and prompt intervention for this vulnerable population to prevent such devastating outcomes, regardless of pre-pregnancy history of psychiatric disorders.

Hang Yu, PhD student

In this nationwide population-matched cohort study with a maximal follow-up of 18 years, 86 551 women with PND from 2001 to 2017 and 865 510 unaffected women individually matched on age and calendar year at delivery. Sibling comparison was employed to account for familial confounding. It was found that women with a clinical diagnosis of PND have an elevated risk of suicidal behaviour compared to population-matched women or their full sisters without PND. Attenuated yet still substantially elevated risks were observed when comparing with full sisters without PND who share partial genetic and familial environmental factors with affected women. Importantly, such excess risk was apparent among women regardless of their history of psychiatric disorders, suggesting that PND is linked to an added risk of suicidal behaviour beyond that the risk associated with psychiatric disorders occurring before the perinatal period. Moreover, the risk elevations were particularly high shortly after the PND diagnosis, and despite of the rapid decline over time, remained throughout 18 years of follow-up.

Source: Karolinska Institutet

Categories : Mental HealthTags :

Losing a Parent in Childhood and Separation Anxiety in Women

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Women who lost a parent as children may be more likely to experience separation anxiety with romantic partners during adulthood, according to a study published in Stress and Health. In addition to feeling distressed when separated from their partners, these women may also experience anxious attachment, or worry that significant others will not be available at times of need.

The study included 60 women who lost one or both parents in their youth and 60 who had living parents. Based on participants’ answers to questionnaires, women who lost a parent reported higher levels of anxious attachment and adult separation anxiety from a partner. The groups did not differ, however, in terms of avoidant attachment, or the desire to maintain autonomy and emotional distance from their parents during childhood and from their partners during adulthood.

In women who lost a parent, adult separation anxiety and anxious attachment peaked in the initial five years of romantic relationships and gradually declined after a decade.

“A future study is suggested to delve into how the duration of a romantic relationship impacts separation anxiety and anxious attachment among women who have experienced early parental loss in childhood,” said corresponding author Ora Peleg, PhD, of the Max Stern Yezreel Valley College and the Academic College Emek Yezreel, in Israel.

Source: Wiley

Categories : Mental Health Surgeries & ProceduresTags :

No Mental Health Benefit from Bariatric Surgery for Young Patients

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Sleeve gastrectomy. Credit: Scientific Animations CC4.0

Young people who have had surgery for obesity do not improve their mental health despite significant and permanent weight loss. At the same time, bariatric surgery also increases the risk of early alcohol problems. This is according to the largest long-term study of young people who have undergone bariatric surgery, the results of which were published in Lancet Child and Adolescent Health.

The researchers studied mental health problems – before and after surgery – among all young people in Sweden who underwent bariatric surgery between 2007 and 2017. The study was conducted using register data, which enabled the scope of the study and facilitated comparisons with other groups in society. 

The study recruited 1554 adolescents (< 21 years) with severe obesity underwent bariatric surgery between 2007 and 2017, 1169 (75%) of whom were female. At time of surgery, the mean age was 19·0 years [SD 1·0], and the mean BMI was 43·7 kg/m2 (SD 5·5). They were matched with 15 540 adolescents from the general population.

It was found that young people who underwent surgery were more likely to have received treatment and medication for mental health problems already five years before the surgery.

“Although mental illness generally increases between the ages of 15 and 21, for this group the need for treatment increased faster than for young people in general”, says Kajsa Järvholm, Associate Professor of Psychology at Lund University.

Unfortunately, this pattern continued even after obesity surgery; the young people who had the surgery continued to have a greater need for mental health treatment than their peers. 

“Obesity surgery has very positive effects on weight, blood sugar and blood pressure control, but when it comes to mental health, it does not get better or worse after bariatric surgery”, says Martin Neovius, Professor of Clinical Epidemiology at Karolinska Institutet.

Additional findings from the new study include an increase in dependency diagnoses, particularly on alcohol, in the surgical group, both in comparison to pre-surgery and to young people in general.

The study is the largest long-term study in the world of young people who have had obesity surgery.

Source: Karolinska Institutet

Categories : Mental HealthTags :

Mental Wellbeing in the Workplace

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The state of South Africa’s mental well-being is a cause for concern

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In Aon’s 2024 Global Medical Trend Rates Report, mental health is listed as a major contributor to morbidity, disability, injury and premature mortality; also increasing the risk of other health conditions. The state of South Africa’s mental wellbeing is cause for concern. The world has witnessed several major events that have also had widespread impacts on people’s mental health. Events such as the COVID-19 pandemic, natural disasters, economic uncertainties, social unrest and warfare have heightened stress levels and contributed to an increased focus on mental well-being. 

South Africans are distressed and struggling with their mental health:

  • In Sapien Labs’ Mental State of the World 2022 report, South Africa was ranked as the country with the highest percentage (35.8%) of its population that are distressed and struggling with mental health.
  • Another prominent trend highlighted in the Sapien Labs report is the declining mental well-being of each successively younger generation. This is reflected in the Western Cape Government’s report on anxiety, depression and adolescent suicide which found that 9% of all teenage deaths are due to suicide.
  • According to the World Health Organisation (WHO) more than 700 000 people die by suicide every year, with South Africa rated as the country with the ninth highest suicide rate in the world at 23.5 per 100k, with suicide alarmingly being the fourth leading cause of death among 15 – 19-year-olds.
  • A WITS University study found that a quarter (25.7%) of South Africans are depressed with only a quarter of these affected individuals seeking assistance.

According to Jacqui Nel, business unit head of healthcare at Aon South Africa, depression is likely to be the world’s leading burden of disease by the year 2030, if not sooner. “It is easy to measure an individual’s weight, Body Mass Index (BMI), glucose and cholesterol levels, but it is much harder to measure what is going on in a person’s mind. The top challenge that human resource professionals are concerned with is keeping the workforce engaged and productive in the face of ongoing retrenchments, the spiralling cost of living, load shedding and the fact that 44% of South Africans have impaired credit records. All these factors are converging to create enormous contributory pressures when it comes to anxiety levels experienced by employees,” says Jacqui.

One of the leading trends in the mental well-being of employees is burnout, which places employees at risk of developing depression. It was classified as an occupational phenomenon in 2019 by the World Health Organisation (WHO) with its occurrence rate increasing on an annual basis, and it has only escalated since the onset of the pandemic and the radical changes to work models since then. “Employees that are burnt out feel exhausted, distance themselves from their colleagues and their job and show a reduction in professional efficacy,” Jacqui explains.

Finding a sustainable work-life balance model

These factors are clear indicators that there is something radically amiss in our work-life balance, and we need to do better as a society and employers in embracing a more sustainable work-life model that is cognisant of the forces that are at play in the workforce environment. “It starts by building resilience, agility and a sense of belonging at an individual and organisational level, and most of all, better support structures,” Jacqui explains.

Workforce Resilience

Workforce resilience describes a person’s fundamental sense of security at work, a strong sense of belonging with the employer and the adaptability and motivation they need to reach their full potential.  “Workforce resilience matters because businesses that put their people first are more likely to thrive. By creating a workplace environment that provides security, motivation and belonging, employees and colleagues are better able to weather and process the fiercest of storms and pressures,” Jacqui explains.

Workforce Agility

Workforce agility describes a workforce that thrives on and embraces change rather than being threatened by it, a workforce that can develop future skills at speed and naturally pivots to stand out from the competition – all the while balancing investment and people risk with agility, creating value for the employer and the customer, alike.

“By investing in impactful Employee Assistance Programmes (EAP), employers empower their employees to better measure their progress and manage risk, enabling a diverse, inclusive and agile workforce. Workforce agility is the difference between merely surviving and thriving,” says Jacqui.

“It may even extend beyond an EAP, with organisations implementing programmes that are specific to the organisation’s challenges. Insights that are underscored by data and analytics, will be able to identify employee trends and concerns, enabling employers to wisely spend money where it is most required within the wellness of employees,” she adds.

Belonging

Belonging describes a connection to a community of peers and the support that each individual feels in relation to their working environment. “It is important because it enables a positive working life experience and underpins personal and professional growth, providing a voice and an opportunity to use it and be heard, regardless of role or rank. All the while, supporting wellbeing whilst driving diversity and innovation,” Jacqui explains.

“Fostering a sense of belonging in an employee starts by assessing how well the personality traits of a possible candidate align with the cultural fit of the organisation during the recruitment phase. It also extends to how well employees are supported during their time in the organisation, allowing them to naturally become agents of change and role models for the organisation’s culture by living the company ethos and way of operating to inspire adoption throughout,” Jacqui explains.

At the heart of this entire process, is the implementation of a well-rounded Employee Assistance Programmes (EAP) that is designed to support employees in dealing with personal and work-related stressors that may affect their well-being, mental health and productivity. This could include:

  • Confidential counselling sessions.
  • Assessments of an employee’s situation and referral to the correct counselling and support.
  • Crisis intervention for employees who are dealing with trauma such as bereavement, have been victims of violent crime or gender-based violence.
  • Offering work-life services that could range from finding childcare to legal assistance or financial planning.
  • Offering educational workshops and seminars on aspects such as personal finance through to health and wellbeing.
  • Wellness programmes that promote healthy habits and stress reduction and management techniques.
  • Consultation for managers and supervisors.

“There has been a significant increase in awareness and understanding of mental health issues as efforts by mental health advocates, employer groups and individuals have contributed to destigmatising mental health. This increased awareness has led to more open conversations about mental health in various sectors of society and it is here where Employee Assistance Programmes (EAP) play a crucial role in supporting employers and opening the doors for candid conversations and getting the needed help and support. The services of a trusted and skilled advisor are key in helping organisations develop and operate an EAP that is fit for your business and your people and their unique circumstances. “

“While there is a cost involved that is carried by the business, the results far outweigh the investment.  It’s about providing employees and management with the means to weather the storms of an increasingly complex world of work, find a balance in their personal lives and come out on the other side with resilient and agile people who have a strong sense of belonging and purpose. This is about supporting employees to manage stress, improve productivity, and enhance their overall quality of life and wellbeing, which in turn improves workplace dynamics, contributing to a positive and productive work environment where skilled and valued employees want to be,” Jacqui concludes.

Categories : Mental Health Substance UseTags :

Cannabis Users Found to Have Higher Levels of Empathy

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A study of regular cannabis users and non-users found that users tend to have a greater understanding of the emotions of others, based on psychological assessments. Brain imaging tests also revealed that cannabis users’ anterior cingulate – a region generally affected by cannabis use and related to empathy – had stronger connectivity with brain regions related to sensing the emotional states of others within one’s own body.

The study, published in the Journal of Neuroscience Research, included 85 regular cannabis users and 51 non-consumers who completed psychometric tests and a subset of 46 users and 34 nonusers who underwent functional magnetic resonance imaging exams.

“Although further research is needed, these results open an exciting new window for exploring the potential effects of cannabis in aiding treatments for conditions involving deficits in social interactions, such as sociopathy, social anxiety, and avoidant personality disorder, among others,” said co-author Víctor Olalde-Mathieu, PhD, of the Universidad Nacional Autónoma de México.

Source: Wiley

Categories : Mental HealthTags :

Stopping Long-term ADHD Meds is Common among Young People

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A pair of new studies has show that many patients stop taking ADHD medications within the first year, while those who take higher doses of ADHD medications long term seem to have a higher risk of some cardiovascular diseases. This is according to two new studies led by researchers from Karolinska Institutet and published in The Lancet Psychiatry and JAMA Psychiatry.

The Lancet Psychiatry study found that more than half of all teenagers, young adults and adults who received ADHD medication had stopped taking it within the first year. The proportion was slightly lower in children, whose decisions are made for them by carers, yet 35% still stopped their medication within a year.

Young adults risk falling between the cracks

The researchers analysed prescription data from over 1.2 million patients who started ADHD medication in Australia, Denmark, Hong Kong, Iceland, the Netherlands, Norway, the UK, Sweden and the USA. The pattern was the same in all countries/regions.

“It’s unlikely that so many people discontinue their treatment because their ADHD symptoms have remitted, meaning that the high rate of early discontinuation may be a major barrier to effective treatment,” says Zheng Chang, senior researcher at Karolinska Institutet who led both studies. “We haven’t been able to analyse the direct causes in this study, but common reasons for discontinuing ADHD medication are adverse reactions and lack of effect.”

The highest rate of medication discontinuation occurred among 18 to 19-year-olds. This is when they leave child and adolescent psychiatry and enter adult psychiatry, a transition where they risk falling between the cracks. This is a shortcoming that the healthcare services must remedy, researchers say.

“We need to improve the transition to adult psychiatry and spread knowledge about the fact that problems associated with ADHD often persist over time,” says Isabell Brikell, research coordinator at Karolinska Institutet, and one of the first authors of the study in The Lancet Psychiatry. “In addition, new digital tools such as simple SMS-based inventions could be used to help people with ADHD manage their medication.”

Denmark sticks out

A country that sticks out in the statistics is Denmark, which had a much lower proportion of children who discontinue their treatment within a year – 18%, as opposed to the mean of 35%. Compared with other Nordic countries like Sweden and Norway, the prescription of ADHD drugs is lower, which could suggest that medication is only prescribed to those with severe ADHD and the greatest need, researchers say.

“Sweden has a relatively high prescription rate of ADHD medication compared with many other European countries, so it is possible that we over-prescribe here,” says Zheng Chang.

In another study conducted with over 275 000 Swedish ADHD patients published in JAMA Psychiatry, Dr Chang and his research group examined ADHD medication use for up to 14 years. They were then able to show that ADHD medication when taken for a longer time and in higher doses than average is associated with a higher risk of some cardiovascular diseases, primarily hypertension and arterial disease. 

The risk of cardiovascular disease increased by approximately 4% per annum. The risk increase was greatest in the first few years of treatment and then levelled off, and it was only statistically significant at doses higher than 1.5 times the average daily dose (the defined daily dose, DDD). This means that those treated with lower doses are not likely to develop cardiovascular disease, according to the researchers.

Follow-up of patients advised

“There is a long list of drugs that have been linked to a comparable increased risk of hypertension when used long-term such as the one found here, so patients should not be alarmed by these findings,” says Le Zhang, postdoc researcher in Dr Chang’s research group and first author of the JAMA Psychiatry study. “However, in clinical practice, the raised risk should be carefully weighed against the recognised benefits of treatment on a case-by-case basis. Doctors should also regularly follow up the ADHD patients to find signs and symptoms of cardiovascular disease while they’re on medication over the long-term.” 

Since this is an observational study, it is not possible to conclude that it is the ADHD medication that leads to an increased risk of cardiovascular disease. As the researchers point out, it could depend on other medications, symptom severity or lifestyle factors.

Source: Karolinska Institutet

Categories : Mental HealthTags :

Major Study Finds No ‘Smoking Gun’ Mental Health Harm from Internet

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Links between internet adoption and psychological well-being are small at most, despite popular assumptions about negative psychological impacts of internet technologies and platforms, according to an international study involving two million people published in the journal Clinical Psychological Science.

The study examined data from people aged 15 to 89 in 168 countries, yet found smaller and less consistent associations than would be expected, if the internet were causing widespread psychological harm, according to the Oxford Internet Institute research team.

Professor Andrew Przybylski, Oxford Internet Institute and Assistant Professor Matti Vuorre, Tilburg University and Research Associate, Oxford Internet Institute, carried out the study, which shows the last two decades have seen only small and inconsistent changes in global well-being and mental health. 

Professor Przybylski says, “We looked very hard for a ‘smoking gun’ linking technology and well-being and we didn’t find it.”

Professor Vuorre notes, “We studied the most extensive data on well-being and internet adoption ever considered, both over time and population demographics. Although we couldn’t address causal effects of internet use, our descriptive results indicated small and inconsistent associations.”

Results filtered by age group and gender did not reveal any specific demographic patterns among internet users, including women and young girls. In fact, for the average country, life satisfaction had increased more for females over the period.

According to Professor Przybylski, “We meticulously tested whether there is anything special in terms of age or gender, but there is no evidence to support popular ideas that certain groups are more at risk.”

The team maintains, “We put our findings under a more extreme test to see if there are matters which we have missed and we did find increased mobile broadband adoption predicted greater life satisfaction, but this association was too small to be of practical significance.”

But, the team insists, technology companies need to provide more data, if there is to be conclusive evidence of the impacts of internet use. The research says, Research on the effects of internet technologies is stalled because the data most urgently needed are collected and held behind closed doors by technology companies and online platforms. 

“It is crucial to study, in more detail and with more transparency from all stakeholders, data on individual adoption of and engagement with Internet-based technologies. These data exist and are continuously analysed by global technology firms for marketing and product improvement but unfortunately are not accessible for independent research.

In today’s study, the researchers contrast two different studies of data on well-being and mental health against the countries’ per capita internet users and mobile broadband subscriptions and use, to see if internet adoption predicts psychological well-being.  In the second study they use data on rates of anxiety, depression and self-harm from 2000–2019 in some 200 countries and analyse their associations with internet adoption.

Wellbeing was assessed using data from face to face and phone surveys by local interviewers in the respondents’ native languages. Mental health was assessed using statistical estimates of depressive disorders, anxiety disorders and self-harm in some 200 countries from 2000 to 2019, as estimated by aggregated health data from WHO member states.

Source: Oxford University