Category: Mental Health

Categories : Mental HealthTags :

Psilocybin Shows Promise in Treatment-resistant Depression

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Mushroom
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The largest and most rigorous clinical trial to date of psilocybin (a psychoactive ingredient in magic mushrooms), suggests the possibility that COMP360 psilocybin with psychological support could be a beneficial therapeutic strategy for people with treatment-resistant depression (TRD). The trial results were published in the New England Journal of Medicine.

Prompted by promising preliminary findings, this funded multi-centre, randomised, double-blind, phase 2b clinical trial was launched in 2018 to determine the safety and potential antidepressant effects of a single dose of COMP360 psilocybin (25mg or 10mg), compared to 1mg, with psychological support in people with TRD.

The trial, which included 233 people with TRD across 10 countries who received a single dose of 25mg COMP360 psilocybin experienced a highly statistically and clinically significant rapid reduction in symptoms of depression compared to 1mg at three weeks. This offers hope that COMP360 psilocybin with psychological support could be an effective antidepressant treatment paradigm for some people with TRD, if proven effective and safe in larger studies. COMPASS Pathways, the company that developed the psilocybin formulation., will be running a larger phase 3 programme of COMP360 psilocybin therapy in TRD, which is on schedule to begin in 2022.

KEY RESEARCH FINDINGS

  • 25mg COMP360 psilocybin with psychological support led to a statistically and clinically significantly reduction in symptoms of depression in people with TRD compared to 1mg at week 3.
  • 37% of people with TRD in the 25mg group met criteria for response at week 3 (≥ 50% decrease in depressive symptoms).
  • Approximately 30% of people with TRD in the 25mg group met criteria for remission at week 3 (29.1%).
  • 20% of people with TRD in the 25mg group met criteria for sustained response at week 12.
  • COMP360 psilocybin was generally well-tolerated.

Dr John R. Kelly, Psychiatrist and Clinical Senior Lecturer, Trinity College said: “This is the largest and most rigorous clinical trial of psilocybin to date. It shows a promising antidepressant signal for 25mg COMP360 psilocybin with psychological support and has paved the way for phase 3 clinical trials, which will determine whether it translates into a much-needed complementary treatment strategy in the psychiatry clinic.”

Source: Trinity College Dublin

Categories : Mental HealthTags :

Morning Blue Light Exposure Eases PTSD Symptoms and Aids Sleep

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After being treated with a course of blue light exposure in the morning, people with post-traumatic stress disorder (PTSD) experienced better sleep, a reduction in the severity of PTSD symptoms and had more effective treatments overall, according to a new study recently published in Frontiers in Behavioral Neuroscience.

Sleep is crucial for maintaining physical and mental health, and inadequate sleep over time can impact all aspects of life with serious implications for long-term health, relationships, cognitive abilities such as learning, and healing.

The influence of sleep disruption on PTSD symptom severity is well established. Those who seek treatment to allay their PTSD symptoms often face a vicious cycle where poor sleep interferes with the effectiveness of treatments, negating any lessening of symptoms, which in turn contributes to sleep disruptions. To reduce and eliminate the emotional impact of traumatic memories, the patient needs quality sleep to integrate healing mechanisms achieved through cognitive or exposure therapy treatments.

“This research is exciting and unique because it points to an easy-to-use method for helping those with PTSD to retain the benefits of therapy long after the treatment ends,” said psychiatry professor William “Scott” Killgore, PhD, senior author on the paper, “Morning blue light treatment improves sleep complaints, symptom severity, and retention of fear extinction memory in post-traumatic stress disorder.”

Dr Killgore and the SCAN Lab team conducted a comprehensive assessment of daily morning blue-wavelength light exposure on individuals with clinically significant levels of PTSD. The goal was to ascertain if blue light therapy would help improve sleep and PTSD symptoms and sustain learned fear extinction memories, an analogue of therapeutic treatment for trauma.

Study participants committed to 30 minutes of morning light exposure daily for six weeks, with half of the participants using blue-wavelength light and half using amber light. Researchers examined the neurobiological, autonomic and behavioural outcome changes during the study.

The 43 participants who received blue light therapy not only demonstrated significant improvements in the severity of their PTSD symptoms, but also reported improvements in sleep and showed an increased retention of fear extinction memories. The control 39 controls receiving amber light did not show the same retention of the extinction memories, but rather showed a return of the original fear memories.

“While the limitations of the research include its modest sample size and difficulties monitoring compliance, the possibilities of utilising a treatment that is relatively simple, drug-free and inexpensive can offer hope for the large population of people living with the intense challenges of post-traumatic stress disorder,” Dr Killgore said.

Source: University of Arizona Health Sciences

Categories : Gender Mental HealthTags :

Women with Autism have a Greater Mental Illness Risk

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Autistic young men and women are more affected by psychiatric conditions and have an increased risk of hospitalisation as a result of their mental illness. Autistic women are particularly vulnerable, as shown in a study published in JAMA Psychiatry.

Autistic people have an increased risk of suffering from mental illness. Current data indicates that autistic women are more vulnerable than autistic men, but few studies have been able to establish that there are sex differences.

The researchers, from Karolinska Institutet, conducted a register-based cohort study with more than 1.3 million people in Sweden who were followed from the age of 16 to 24 between 2001 and 2013. Just over 20 000 of these were diagnosed with autism.

“We saw an increased risk of eleven different psychiatric conditions, including depression, anxiety disorders, self-harm and difficulty sleeping,” says Miriam Martini, a doctoral student in psychiatric epidemiology at Karolinska Institutet and first author of the study.  

High hospitalisation rates 

Something that Miriam Martini finds particularly worrying is that 32 out of 100 autistic women had been hospitalised as a result of their mental illness, compared with 19 out of 100 autistic men. For non-autistic people, the corresponding figure was less than five out of 100.   

The study focuses on young adults who are at a crucial time in their life when many mental health problems increase, while the transition to adulthood often means poorer access to care, says Miriam Martini.   

“Healthcare for young adults needs to be expanded, especially for autistic women, so that mental illness can be detected in time to avoid worsening of symptoms resulting in hospitalization,” says Miriam Martini.  

The reason why autistic women are more affected by mental illness than autistic men is not clear, but in the study, the researchers point to several possible factors. Previous research has shown that autistic women to a greater extent use compensatory behaviours to camouflage their autism, which may be due to the fact that women generally tend to adapt to the expectations of those around them. This delays diagnosis and the provision of assistance, which can negatively affect their mental health.  

Overlooked by the healthcare system 

Another possible explanation may be that it could be difficult to detect autism in women using diagnostic criteria.  

“It may be that autism manifests differently in women than in men, which means that women are not detected using today’s diagnostic criteria. This is something we need to do more research on,” says Miriam Martini.  

Source: Karolinska Institutet

Categories : Mental HealthTags :

The Stigmatisation of Functional Seizures under the Spotlight during Mental Health Awareness Month

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Functional seizures (FS) – observable paroxysms of altered behaviour or movement with or without a loss of consciousness – is a serious mental illness and can have negative effects on the quality of life and functioning of people with the disorder and their families.

But a study conducted by researchers in the Department of Psychology at Stellenbosch University (SU), has found that conditions such as FS are still highly stigmatised with patients often being dismissed as malingering, faking or lying due to a lack of medical causes. The study, ‘Stigma in functional seizures: A scoping review’, was recently published in Seizure, an international journal on epilepsy.

During the month of October – which is Mental Health Awareness Month – there has been a renewed effort to reduce this kind of stigma. “We need to change our attitudes towards mental health to reduce this stigma, and this month is an opportunity to do that collectively,” says Shayni Geffen, Project Leader: Advocacy and Awareness at the South African Federation for Mental Health.

As part of their investigation, the SU researchers conducted a systematic scoping review of academic literature on FS. They found that even though the stigmatisation of FS is prevalent, it remains understudied, especially in low-income countries. “In most data sources stigma was often an afterthought, with very few sources specifically exploring this topic.

“Overall, our data suggested that stigma around FS is more prevalent and pronounced than is the case with epileptic seizures. A lack of knowledge of the disorder contributes to stigma and discriminatory practices. Stigma remains a barrier to receiving a diagnosis and accessing treatment.

“Literature suggests that it can take years for patients to finally get a diagnosis of FS, but once they receive the diagnosis, it is often met with negative stereotypes and perceptions that lead to stigmatisation and treatment resistance.”

According to the researchers, the most prominent theme emerging from their analysis is that of healthcare practitioners stigmatising people with FS.

“Patients with FS indicated that they were ‘rejected and dismissed by doctors as malingerers, time-wasters or attention-seekers’.”

“From our review it became apparent that the negative attitudes of healthcare practitioners towards patients with FS persist, often because of a lack of knowledge, general awareness, understanding and medical training with regards to this disorder.”

But it’s not just health practitioners who treat patients with FS in this way; family members, friends and acquaintances also stigmatise them.

“Patients with FS also experience stigmatisation within their own families and their broader social circles. Their relatives feel burdened and experience more stigma than caregivers of patients who have an epileptic seizure.”

The researchers add that patients with FS can also hold stigmatising views about their diagnosis.

“Some data sources suggested that patients often experience their diagnosis negatively and equate it to being told they are ‘crazy’, ‘faking’, or that it is ‘all in my head’.”

Functional seizures profoundly impact the social functioning of those affected by the condition and make it difficult for them to find a job, the researchers say.

“Furthermore, our review suggests a dearth of knowledge focusing on the nuanced cultural and contextual influences on the stigma around FS, leaving a gap in literature pertaining to the development and implementation of interventions that are culturally and contextually sensitive and aimed at minimising this stigma.”

According to the researchers, a lack of funding and recognition by governments likely contributes to FS remaining poorly understood and stigmatised.

“The stigmatisation of FS is not only a medical or societal issue, but also a governmental matter. If politicians recognise FS as an important and highly prevalent disorder, it would be much easier for patients to access governmental aid and for scientists to have funding for their research.”

They emphasise the need for more research that focuses specifically on the stigmatisation of FS, and on factors that contribute to this, as well as accessible interventions and guidelines addressing it through education and training.

“People with FS must be supported, and we must increase our knowledge about the condition.”

“We also need more investigations into how patients with FS experience stigma, as well as into the perceptions of their family, friends, and caregivers.”

“Finally, healthcare professionals should be educated and trained so that their attitudes, perceptions and quality of interventions regarding patients with FS can improve.”

Provided by: Stellenbosch University

Categories : Mental HealthTags :

Long Hours Worsen Depression Risk in New Doctors

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As work hours increase, new doctors are at greater risk of depression, according to a study in the New England Journal of Medicine. Working 90 or more hours a week was associated with changes in depression symptom scores three times larger than the change in depression symptoms among those working 40 to 45 hours a week.

Additionally, compared to those working normal hours, those working more hours had greater odds of scores equating to moderate to severe depression.

By means of advanced statistical methods, the researchers emulated a randomised clinical trial using data on more than 17 000 first-year medical residents, accounting for many other factors in the doctors’ personal and professional lives. Less than 5% met the criteria for moderate to severe depression.

They found a “dose response” effect between hours worked and depression symptoms, with an average symptom increase of 1.8 points on a standard scale for those working 40 to 45 hours, ranging up to 5.2 points for those working more than 90 hours. They conclude that, among all the stressors affecting physicians, working a large number of hours is a major contributor to depression.

The data come from the Intern Health Study, based at the Michigan Neuroscience Institute and the Eisenberg Family Depression Center. Each year, the study recruits new medical school graduates to take part in a year of tracking of their depressive symptoms, work hours, sleep and more while they complete the first year of residency, also called the intern year.

The impact of high numbers of work hours

Though the interns in the study reported a wide range of previous-week work hours, the most common work hour levels were between 65 to 80 hours per week.

The authors say their findings point to a clear need to further reduce the number of hours residents work each week on average.

“This analysis suggests strongly that reducing the average number of work hours would make a difference in the degree to which interns’ depressive symptoms increase over time, and reduce the number who develop diagnosable depression,” said Amy Bohnert, PhD, the study’s senior author and a professor at the U-M Medical School. “The key thing is to have people work fewer hours; you can more effectively deal with the stresses or frustrations of your job when you have more time to recover.”

Yu Fang, MSE, the study’s lead author and a research specialist at the Michigan Neuroscience Institute, notes that the number of hours is important, but so are the training opportunities that come from time spent in hospitals and clinics. “It is important to use the time spent at work for supervised learning opportunities, and not low-value clinical service tasks,” she says.

Source: Michigan Medicine – University of Michigan

Categories : General Interest Mental HealthTags :

Working with Robots Increases Job Burnout for Humans

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Having jobs be replaced by robots is a common fear for workers in all sectors of the economy. Working alongside robots may contribute to job burnout and workplace incivility, but self-affirmation techniques could help alleviate fears about being replaced by these machines, according to research published online in the Journal of Applied Psychology [PDF].

Researchers found that workers in the United States and parts of Asia feel job insecurity from robots, even in industries where robots aren’t being used, and those fears may not be justified, said lead researcher Kai Chi Yam, PhD, an associate professor of management at the National University of Singapore.

“Some economists theorise that robots are more likely to take over blue-collar jobs faster than white-collar jobs,” Dr Yam said. “However, it doesn’t look like robots are taking over that many jobs yet, at least not in the United States, so a lot of these fears are rather subjective.”

Researchers conducted experiments and analysed data from participants in the US, Singapore, India and Taiwan.

Working with industrial robots was linked to greater reports of burnout and workplace incivility in an experiment with 118 engineers employed by an Indian auto manufacturing company.

An online experiment with 400 participants found that self-affirmation exercises, where people are encouraged to think positively about themselves and their uniquely human characteristics, may help lessen workplace robot fears. Participants wrote about characteristics or values that were important to them, such as friends and family, a sense of humour or athletics.

“Most people are overestimating the capabilities of robots and underestimating their own capabilities,” Dr Yam said.

Fears about job insecurity from robots are common. The researchers analysed data about the prevalence of robots in 185 U.S. metropolitan areas along with the overall use of popular job recruiting sites in those areas (LinkedIn, Indeed, etc). Areas with the highest robot use also had the highest rates of job recruiting site searches, even though unemployment rates weren’t higher in those areas. The researchers theorised that people in these areas may have felt more job insecurity because of robots, but that there could be other reasons, such as people seeking new careers or feeling dissatisfied with their current jobs.

Another experiment comprised 343 parents of students at the National University of Singapore who were randomly assigned to three groups. One group read an article about the use of robots in businesses, the second group read a general article about robots, and the third read an unrelated article. Then the participants were surveyed about their job insecurity concerns, with the first group reporting significantly higher levels of job insecurity than the two other groups.

While some people may have legitimate concerns about losing their jobs to robots, some media coverage may be unnecessarily heightening fears among the general public, Dr Yam said.

“Media reports on new technologies like robots and algorithms tend to be apocalyptic in nature, so people may develop an irrational fear about them,” he said.

Source: American Psychological Association

Categories : Mental Health Obstetrics & GynaecologyTags :

Biological Changes in Mothers Experiencing Postpartum Depression

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Newly discovered biological changes in mothers who suffer postpartum depression may help explain the condition, yield long-sought treatments and let doctors identify those at risk even before their babies are born. The findings were published in Molecular Psychiatry.

Postpartum depression strikes up to 20% of new mothers, and roughly 20% of maternal deaths after childbirth are from suicide. Postpartum depression can cause anxiety and irritability, feelings of self-doubt and difficulty bonding with the baby, cognitive impairment, and interfering with sleeping and eating. For the child, maternal postpartum depression can lead to cognitive, emotional and social development problems.

Risk factors for postpartum depression are thought to include the mother’s age at childbirth, diabetes and prior history of mental health issues. But the new discovery suggests a previously unknown biological contributor: an impairment of the body’s ability to clean up old genetic material and other cellular debris.

“The finding that cells aren’t cleaning out old proteins and cellular debris, called autophagy, occurs before women develop depression symptoms, indicating that it could be part of the disease process,” explained Jennifer L. Payne, MD, director of the Reproductive Psychiatry Research Program at the University of Virginia School of Medicine. “There are several medications that promote autophagy in cells, so this finding might open the door to new treatments and to identification of women at risk of postpartum depression before they become ill.”

Understanding Postpartum Depression

Dr Payne and colleagues wanted to determine if ‘extracellular RNA communication’, a newly discovered form of communication among cells, might contribute to postpartum depression. Extracellular RNA communication is heightened during pregnancy and is critical in embryo implantation and in the body’s inflammatory response afterward.

The researchers analysed blood plasma samples from 14 research participants with and without postpartum depression, collected during and after their pregnancies. The researchers found that extracellular RNA communication in immune cells was altered extensively in women who suffered postpartum depression. Further, they determined that this “large and consistent” change significantly limited the women’s bodies’ ability to perform important cellular cleanup – suggesting a potential biological cause for their depression.

“Deficits in autophagy are thought to cause toxicity that may lead to the changes in the brain and body associated with depression,” Dr Payne said. “We have never fully understood the biological basis for postpartum depression, and this finding gets us closer to an understanding.”

Source: University of Virginia Health System

Categories : Mental HealthTags :

Depression Risk Increases with Greater Social Media Use

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A recent study published in the Journal of Affective Disorders Reports has found that young adults who use more social media are significantly more likely to develop depression within six months, regardless of personality type. 

“Previous research has linked the development of depression with numerous factors,” the authors noted. “However, the literature has been lacking in studies that focus on how various personality characteristics may interact with social media use and depression. This new study addressed these important research questions, finding strong and linear associations of depression across all personality traits.”

People with high agreeableness were found to be 49% less likely to become depressed than people with low agreeableness. Additionally, those with high neuroticism were twice as likely to develop depression than those with low neuroticism when using more than 300 minutes of social media per day. More importantly, for each personality trait, social media use was strongly associated with the development of depression.

A 2018 sample of 18–30 year old US adults was analysed with the Patient Health Questionnaire to measure depression. Social media was measured by asking participants how much daily time was spent using popular social media platforms, and personality was measured using the Big Five Inventory, which assessed openness, conscientiousness, extraversion, agreeableness and neuroticism. 

The authors suggest that problematic social comparison can enhance negative feelings of oneself and others, which could explain how risk of depression increases with increased social media use. Engaging primarily in negative content can also enhance these feelings. And lastly, engaging in more social media reduces opportunities for in-person interactions and activities outside of the home.

Depression has been noted as the leading cause of disability and mortality worldwide. This makes these findings even more pronounced for creating health interventions and prevention efforts.

“Findings from this study are important during a time of technology expansion and integration,” said author Renae Merrill said, a doctoral student when writing the paper. “Connecting to people virtually may increase the risk of miscommunication or misperception that leads to relationship difficulties and potential risk for developing mental health problems.” 

“People have innate emotional needs for social connection and understanding,” Merrill added. “For example, social media experiences can be improved by becoming more aware of our emotions and our connection with others in various life circumstances. This awareness helps improve relationship quality by simply reaching shared meaning and understanding through more effective communication and concern for others and ourselves. Despite our differences, we have the ability to create a culture of empathy and kindness.” 

Source: University of Arkansas

Categories : Mental Health Metabolic DisordersTags :

Genes and Environment Bridge Depression and Endocrine-metabolic Disorders

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While endocrine-metabolic disorders and depression are known to co-occur, genetic and environmental factors are known to underlie both. In a study examining the link, published in the American Journal of Psychiatry, analysis revealed the balance of genetic and environmental influences underlying the co-occurrence of depression for a range of endocrine-metabolic disorders.

It is known that there is elevated co-occurrence between endocrine-metabolic disorders and depression, but the relationship between them is still not well understood.

Familial aggregation

The authors identified 2.2 million individuals born in Sweden between 1973 and 1996, as well as their full and half siblings, and followed them up to age 40. A number of medical conditions were studied; depression and various endocrine-metabolic disorders, including three autoimmune diseases (autoimmune hypothyroidism, Graves’ disease, and type 1 diabetes) and three non-autoimmune disorders (type 2 diabetes, obesity, and polycystic ovary syndrome).

Individuals with endocrine-metabolic disorders had 1.4 to 3.5 times the risk of depression compared to people without these diagnoses. Full and half siblings of these individuals also showed some elevated risk for depression, suggesting that genetic and/or environmental risk factors shared between family members play a role in the co-occurrence of these mental and physical disorders.

Genetic and environmental contributions

By comparing pairs of full sibling (who share about half of their genes) to pairs of half siblings (who share about a quarter of their genes), it was possible to calculate the relative contribution of genetic and environmental factors to the co-occurrence of depression and various endocrine-metabolic disorders. 

The results were a mix of these possibilities; the overlap between depression and non-autoimmune conditions was mainly explained by shared genetic influences, while environmental factors were predominantly involved in the association between depression and autoimmune disorders, particularly type 1 diabetes.

This indicates that the link between depression and different endocrine-metabolic disorders may be driven by different mechanisms. For example, shared biological mechanisms, such as immuno-inflammatory and metabolic dysregulations, may underlie the co-occurrence of depression and type 2 diabetes, obesity, and polycystic ovarian syndrome. In contrast, the absence of shared genetics in the association between type 1 diabetes and depression may reflect the existence of environmental factors influencing the risk of both conditions and/or a direct link between these conditions through mediating factors – eg, biological and psychosocial mechanisms connected to type 1 diabetes, including inflammation, cerebral damage, as well as stress of this lifelong condition that is often diagnosed early in life and that requires a complex management regime for both patients and their families.

“Our results underscore that clinicians should be aware of increased risks of depression in individuals with endocrine-metabolic disorders, and vice versa, and be vigilant for shared symptoms. This study also provides a useful foundation for future research aimed at identifying and targeting the biological mechanisms and modifiable risk factors underlying the co-presentation of endocrine-metabolic disorders and depression”, said Marica Leone, first author for the study.

Source: Karolinska Institutet

Categories : Mental Health NeurologyTags :

Unlocking the Complex Neurological Puzzle of Depression

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By studying the brains of fruit flies, which share similar mechanisms to human ones, scientists at Johannes Gutenberg University Mainz (JGU) are attempting to gain a better understanding of depression-like states and thus improve means of treating them. Their findings include the effect of Asian traditional medicine and its mode of preparation, and the effect of timing, such as getting a reward in the evening as opposed to other times of the day. The results were published recently in the journal Current Biology.

One aspect of their research “We have been looking at the effects of natural substances used in traditional Asian medicine, such as in Ayurveda, in our Drosophila fly model,” explained Professor Roland Strauss at JGU. “Some of these could have an anti-depressive potential or prophylactically strengthen resilience to chronic stress, so that a depression-like state might not even develop.”

The researchers intend to demonstrate efficacy, find optimal formulations, and isolate the active substances from the plant, which could lead to new drugs.

“In the Drosophila model we can pinpoint exactly where these substances are active because we are able to analyse the entire signalling chain,” Strauss pointed out. “Furthermore, every stage in the signalling pathway can also be proven.” The researchers subject the flies to a mild form of recurrent stress, such as irregular phases of vibration of the substrate. This treatment results in the development of a depression-like state (DLS) in the flies, ie, they move more slowly, do not stop to examine unexpectedly encountered sugar, and, unlike their more relaxed counterparts, are less willing to climb wide gaps. Whether or not the natural substances have an effect depends on the preparation of each natural substance, eg, whether it has been extracted with water or alcohol.

The research team has also discovered that if they reward the flies for 30 minutes on the evening of a stressful day, by offering them food with a higher sugar content than usual, or by activating the reward signalling pathway, this can prevent DLS developing. Flies have sugar receptors on their tarsi (the lower part of their legs) and their proboscis, while the end of the signalling pathway at which serotonin is released onto the mushroom body (equivalent to the human hippocampus) have also been located.

The researchers’ investigations showed that the pathway was considerably more complex than anticipated. Three different neurotransmitter systems have to be activated until the serotonin deficiency at the mushroom body, which is present in flies in a DLS, is compensated for by reward. One of these three systems is the dopaminergic system, which also signals reward in humans. Humans might obtain a reward through something other than sugar.

Boosting resilience by preventing depression

In addition, the researchers decided to look for resilience factors in the fly genome. The team intends to find out whether and how the genomes of flies that are able to better cope with stress differ from those that develop a DLS in response to exposure to recurrent mild stress. The hope is that in the future it will be possible to diagnose genetic susceptibility to depression in humans – and then treat this with the natural substances that are also being investigated during the project.

Source: Johannes Gutenberg Universitaet Mainz