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Tag: anxiety

  • Quality time with dogs increases the power of brain waves associated with relaxation

    Quality time with dogs increases the power of brain waves associated with relaxation

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    Spending quality time with dogs reduces stress and increases the power of brain waves associated with relaxation and concentration, according to a study published on March 13, 2024 in the open-access journal PLOS ONE by Onyoo Yoo from Konkuk University, South Korea, and colleagues.

    Animal-assisted interventions, like canine therapy, are widely used in hospitals, schools, and beyond to help reduce anxiety, relieve stress, and foster feelings of trust. Studies of the potential benefits of animal interactions often take a holistic approach, comparing people’s mood or hormone levels before and after spending time with a service animal. But this approach doesn’t differentiate between types of interactions, like grooming, feeding, or playing with an animal, limiting our understanding of how each specific interaction impacts a person’s health and well-being. To better understand how such animal-related activities affect mood, Yoo and colleagues recruited a small sample of 30 adult participants to each perform eight different activities with a well-trained dog, such as playing with a hand-held toy, giving her treats, and taking pictures with her. Participants wore electroencephalography (EEG) electrodes to record electrical activity from the brain while they interacted with the dog, and they recorded their subjective emotional state immediately following each activity.

    The relative strength of alpha-band oscillations in the brain increased while participants played with and walked the dog, reflecting a state of relaxed wakefulness. When grooming, gently massaging, or playing with the dog, relative beta-band oscillation strength increased, a boost typically linked to heightened concentration. Participants also reported feeling significantly less fatigued, depressed, and stressed after all dog-related activities.

    While not all participants had pets of their own, their fondness for animals likely motivated their willingness to participate in the experiment, potentially biasing the results. Nonetheless, the authors state that the unique relationships between specific activities and their physiological effects could serve as a reference for programming targeted animal-assisted interventions in the future.

    The authors add: “This study provides valuable information for elucidating the therapeutic effects and underlying mechanisms of animal-assisted interventions.”

    Source:

    Journal reference:

    Yoo, O., et al. (2024) Psychophysiological and emotional effects of human–Dog interactions by activity type: An electroencephalogram study. PLOS ONE. doi.org/10.1371/journal.pone.0298384

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  • What coping strategies are most effective?

    What coping strategies are most effective?

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    In a recent review article published in the Journal of Clinical Medicine, researchers summarized the results of a systematic review that explored the impact of different coping strategies for people living with inflammatory bowel disease (IBD).

    Study: Coping Strategies and Inflammatory Bowel Disease: A Narrative Review. Image Credit: PeopleImages.com - Yuri A/Shutterstock.comStudy: Coping Strategies and Inflammatory Bowel Disease: A Narrative Review. Image Credit: PeopleImages.com – Yuri A/Shutterstock.com

    Background

    Through keyword searches, they identified 57 articles published in English in medical databases such as the Cochrane Library, PubMed, EBSCOhost, and EMBASE, concluding that personalized interventions can help diverse populations with IBD rehabilitation and management.

    Challenges treating IBD

    The two forms of IBD, namely ulcerative colitis (UC) and Crohn’s disease (CD), are thought to occur as a result of mucosal barrier dysfunctions, gastrointestinal microbiome disturbances, immune response dysregulation, genetic background, and environmental risk factors including smoking, air pollution, diet, and stress.

    As many as four in 10 IBD patients show no response to biological therapy, though patient education regarding risk factors can improve the management of the disease.

    Since IBD can be chronic, it has significant psychosocial effects and can affect work and quality of life.

    Patients may cope with these stresses through adaptive strategies that could mitigate their psychological burden, while maladaptive strategies like denial or avoidance could lead to worsening symptoms.

    Effects of coping mechanisms

    Researchers identified active coping strategies in which individuals act directly to solve problems and address stressors, known as problem-focused coping.

    This could include actively monitoring the disease and its symptoms to identify triggers, changes, and patterns. However, becoming overly focused on monitoring can increase stress.

    Another form of emotion-focused coping involves reframing thoughts, regulating emotions, and seeking support systems. While these strategies can improve mental well-being, they can also reduce adherence to treatment and lead to individuals delaying seeking medical care.

    Disease severity, complications, and activity influence the health-related quality of life (HRQoL) of people living with IBD. However, effectively managing stress, seeking support, being physically active, and adhering to medicine can improve their symptomology and overall well-being.

    Adaptive coping mechanisms can lead to perceiving the illness more positively and reduce distress. People with IBD often show resilience by adapting to the side effects of treatments, psychosocial stressors, and symptom flares with problem-solving skills and psychological flexibility.

    Individuals may experience reduced psychological resilience after being diagnosed with IBD, but mindfulness can be an effective form of therapy.

    Maladaptive coping strategies that are negatively associated with HRQoL include negative religious coping, acceptance-resignation, catastrophizing, low acceptance, passive coping, decreased cognitive flexibility, emotion-focused coping, and perceived control.

    Some strategies are also correlated with higher levels of anxiety and depression and lower work productivity.

    Researchers have found differences in coping strategies between people with UC and CD. People with CD may experience higher levels of psychological distress and neuroticism while being more likely to adopt maladaptive coping strategies.

    In another study, people with UC were more likely to cope by modifying meal content, sleeping more, and seeking medical care.

    People with CD, however, adopted strategies like skipping meals or switching to elemental diets as they perceived these as more useful.

    Interventions for IBD patients

    Educational programs can reduce disease-related anxiety and depression while improving knowledge and the use of adaptive coping strategies. Notably, these improvements have been observed despite disease activity remaining similar.

    This suggests that uncertainty around IBD can lead to worse outcomes and that individuals who know more about their condition benefit from this understanding.

    Cognitive behavioral therapy (CBT) has also been shown to improve symptoms of depression and anxiety, while interventions focusing on mind-body relaxation additionally improved symptoms and reduced expression of genes directly linked to inflammatory processes.

    Another study found that transcranial direct current stimulation reduced pain in the short term, but the effects faded after one week.

    People with inactive IBD show a higher inclination to participate in treatment; they also experience lower depression and a higher quality of life.

    Some patients with IBD may also experience joint and back pain; they show greater adaptability and flexibility but are less likely to perceive medical interventions as effective.

    Conclusions

    Individuals living with IBD experience severe challenges to their health and quality of life. As the prevalence of this condition increases, effective coping strategies must be identified to improve the treatment and management of this disease.

    The review indicates that patients adopt a multitude of coping mechanisms, some adaptive and some maladaptive.

    Their experience of the disease in terms of duration and severity modifies their coping strategies, and these strategies may also affect their condition.

    Understanding these complex interplays can help health professionals tailor interventions to groups of people who have specific needs, providing the necessary level of social support and promoting resilience and treatment adherence.

    Journal reference:

    • Popa, S.L., Stanculete, M.F., Grad, S., Brata, V.D., Duse, T., Badulescu, A., Dragan, R., Bottalico, P., Pop, C., Ismaiel, A., Turtoi, D., Dumitrascu, D.I., Pojoga, C., Gherman, C., David, L. (2024) Coping strategies and inflammatory bowel disease: a narrative review. Journal of Clinical Medicine. doi: https://doi.org/10.3390/jcm13061630. https://www.mdpi.com/2077-0383/13/6/1630

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  • Short-term, self-regulating therapies may help alleviate long COVID symptoms

    Short-term, self-regulating therapies may help alleviate long COVID symptoms

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    A new UCLA-led study suggests that some people living with long COVID may be able to alleviate certain symptoms by using short-term, self-regulating therapies.

    The small-scale study, published in the Journal of Psychosomatic Research, recruited a group of 20 long COVID patients, many of whom had been experiencing symptoms for more than a year. Each participant underwent six sessions of biofeedback therapy, which involves the practice of breathwork and relaxation techniques paired with visual feedback to teach self-regulation of autonomic functions such as heart rate and temperature.

    Clinical psychologist Dr. Natacha Emerson, the study’s lead author and assistant clinical professor in the UCLA Department of Psychiatry and Biobehavioral Sciences, said her study sought to test whether biofeedback would improve both the physical symptoms associated with long COVID and the psychological distress that often accompanies untreated chronic symptoms. While biofeedback has been established for chronic somatic symptoms, this is the first study to explore its effects in long COVID.

    Immediately following the six-weeks of treatment, participants self-reported significant improvements in physical, depression and anxiety symptoms as well as in sleep and quality of life. The benefits were also sustained three months later without further intervention.

    Study participants also reported fewer visits to their medical providers and reduced use of prescribed medications at this three-month time point.

    Our biggest hope is that we’ve identified a way to alleviate chronic physical symptoms that are not successfully treated by standard biomedical approaches, and that we did so with a short-term, non-pharmacological model that is easily scalable.”


    Dr. Natacha Emerson, study’s lead author and assistant clinical professor in the UCLA Department of Psychiatry and Biobehavioral Sciences

    An estimated 65 million people worldwide are reported to have long COVID, which causes a constellation of physical and mental health symptoms including brain fog, dizziness, heart palpitations, depression, anxiety and sleep issues. A patient is considered to have long COVID if they have persistent symptoms for at least three months, though many patients report ongoing symptoms lasting more than a year.

    “It is important to underscore that while this behavioral intervention may help symptoms, patients with long COVID are not in control of their symptoms and are not faking or exaggerating what they report to their doctors,” Emerson said. “Whether it is a racing heart rate, chronic cough, or fatigue, these are real symptoms, just not rooted in a disease process. Instead, we think the autonomic nervous system is off balance and signaling fight or flight mechanisms, similarly to what we see in panic attacks.”

    Emerson adds: “What is exciting is that we are restoring hope in people who feared they would be disabled long-term. And if this tool works, it is one they can practice long term and might apply to future periods of stress.”

    The authors said the study has several limitations including a small sample size and lack of a control group for comparison. Additionally, some patients were co-enrolled in other treatments such as acupuncture or psychotherapy, which may have contributed to overall improvements.

    Emerson and colleagues hope to replicate findings through a randomized control trial, including comparing biofeedback to other treatments such as psychotherapy or pulmonary rehabilitation. Other areas of study could include the addition of brain imaging techniques or inflammation-based biomarkers such as cortisol.

    Source:

    University of California – Los Angeles Health Sciences

    Journal reference:

    Emerson, N. D., et al. (2024). An open trial of biofeedback for long COVID. Journal of Psychosomatic Research. doi.org/10.1016/j.jpsychores.2024.111625.

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  • AI tool can convert doctors’ notes into accurate lay language

    AI tool can convert doctors’ notes into accurate lay language

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    An artificial intelligence (AI) tool can convert the text of doctors’ notes summarizing patients’ hospital visits into accurate lay language, a new study found.

    The research focuses on discharge notes used to capture patient’s health status in the medical record as they are discharged from the hospital. Effective summaries are essential for patient safety during these transitions in care, but most are filled with technical language and abbreviations that are hard to understand and increase patient anxiety, say the study authors.

    To address the problem, NYU Langone Health has been testing the capabilities of generative AI, which develops likely options for the next word in any sentence based on how billions of people use words in context on the internet. A result of this next-word prediction is that such generative AI chatbots have become good at replying to questions in realistic, simple language and at producing clear summaries of complex texts. However, AI programs, which work based on probabilities instead of actually thinking, may produce inaccurate summaries, and so are therefore meant to assist, not replace, human providers.

    To explore generative AI, NYU Langone in March 2023 received access to GPT-4, the latest tool from OpenAI, the company that created the famous ChatGPT chatbot. NYU Langone licensed one of the first “private instances” of the tool, which allowed hundreds of its frontline clinicians to experiment with AI-based solutions to clinical problems using real patient data, while still adhering to federal standards that protect patient privacy.

    One of the first studies by researchers using GPT-4, published online March 11 in JAMA Network Open, looked at how well the tool could convert the text in 50 patient discharge notes into patient-friendly language. Specifically, running discharge notes through generative AI dropped the reports from an 11th-grade reading level on average to a 6th-grade level, the gold standard for patient education materials.

    The team also ranked the AI discharge report translations using the Patient Education Materials Assessment Tool (PEMAT), which generates a percentage score based on 19 factors that represent the ability of patients to understand any piece of reading material. GPT-4 translation raised PEMAT understandability scores to 81 percent, up from the 13 percent score achieved by the original doctor-written discharge reports from the medical record.

    The research team designed the study to look at AI performance by itself as a scientific question: How far could it go independently when translating discharge reports?

    GPT-4 worked well alone, with some gaps in accuracy and completeness, but did more than well enough to be highly effective when combined with physician oversight, the way it would be used in the real world. One focus of the study was on how much work physicians must do to oversee the tool, and the answer is very little. Such tools could reduce patient anxiety even as they save each provider hours each week in medical paperwork, a major source of burnout.”


    Jonah Feldman, MD, senior study author, medical director of clinical transformation and informatics within NYU Langone’s Medical Center Information Technology (MCIT) Department of Health Informatics

    To measure the accuracy of the AI tool’s translations, the authors also asked two physicians to review the AI discharge summary for accuracy based on a six-point scale. The reviewing physicians awarded 54 percent of the AI-generated discharge notes the best-possible accuracy rating. They also found that 56 percent of notes created by AI were entirely complete. These results must be considered in context, say the authors. For instance, they say, the results signify that even at the current performance level, providers would not have to make a single change in more than half of the AI summaries reviewed.

    Dr. Feldman notes that generative AI tools are sensitive, and asking a question of the tool in two subtly different ways may yield divergent answers. The skill required to frame the questions asked of chatbots in a way that elicits the desired response, called prompt engineering, combines intuition and experimentation. Physicians and nurses, with their deep understanding of individual cases and nuanced medical contexts, are best positioned to engineer prompts, say the authors, and they can do this without learning to write computer code.

    Within weeks, the research team intends to launch a program asking patients waiting to be discharged whether AI-generated reports are clear and helpful after physician review. By the summer, the team expects to launch a pilot program to provide lay language discharge summaries that have been generated by GPT-4 and reviewed by physicians to patients on a larger scale.

    “Having more than half of the AI reports generated being accurate and complete is an amazing start,” said first study author Jonah Zaretsky, MD, associate chief of medicine at NYU Langone Hospital—Brooklyn. “Even at the current level of performance, which we expect to improve shortly, the scores achieved by the AI tool suggest that it can be taught to recognize subtleties.”

    Along with Dr. Feldman and Dr. Zaretsky, NYU Langone study authors were Jonathan S. Austrian, MD, and Yindalon Aphinyanaphongs, MD, PhD, from the MCIT Department of Health Informatics; Saul B. Blecker, MD, from the Departments of Medicine and Population Health; Yunan Zhao, from the Department of Population Health; Jeong Min Kim, MD, and Samuel Baskharoun, MD, from the Department of Medicine at NYU Grossman Long Island School of Medicine; and Ravi Gupta, MD, from Long Island Community Hospital, which is affiliated with NYU Langone.

    Source:

    Journal reference:

    Zaretsky, J., et al. (2024). Generative Artificial Intelligence to Transform Inpatient Discharge Summaries to Patient-Friendly Language and Format. JAMA Network Open. doi.org/10.1001/jamanetworkopen.2024.0357

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  • Parental touch can relieve acute procedural pain in neonates and parents’ anxiety

    Parental touch can relieve acute procedural pain in neonates and parents’ anxiety

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    The Neuroimaging Group, at the Department of Pediatrics, in collaboration with Bliss, the charity for babies born premature or sick, has launched a new suite of information resources for parents of neonates, designed to make them feel more confident about being involved in the care of their babies.

    While evidence demonstrates that parents can play a positive role in comforting their baby during painful procedures, practice in the UK lags far behind. However new research by the Neuroimaging Group, published in the Lancet Child & Adolescent Health and Pain has brought further proof of the positive impact that being involved in their baby’s care has on parents.

    The Parental touch trial (Petal) aimed to assess whether parental touch at a speed of approximately 3 cm/s to optimally activate C-tactile nerve fibres, provides effective pain relief during a heel-prick procedure. While there was no difference in the babies’ brain, behavioural or heart rate response to pain regardless of whether the parent touched their baby before or after the painful procedure, the findings did demonstrate that the majority of parents had positive emotions when involved in their child’s care – such as feeling useful and reassured – and an overall decrease in parental anxiety after their participation.

    These new resources, a combination of beautifully curated and informative videos, FAQs and online information content, have been developed in light of the collaboration with parents and healthcare professionals. They are free to access online and set out in detail the many ways that parents can touch and comfort babies of all gestations during painful procedures on the neonatal unit, including skin-to-skin care.

    Commenting on the research in an accompanying Lancet Child and Adolescent Health editorial, Ruth Guinsburg, said: “This study is an example of excellence in research. The trial was carefully designed with a clear question, strict inclusion and exclusion criteria, a well-designed and reproducible intervention based on biological plausibility, and defined outcomes, with the strength of using an objective rather than a subjective measure of pain. Only with trials like this might we transform faith in science and test the efficacy of traditional aspects of parental care in order to incorporate them, or not, in bundles to alleviate the pain in neonates.”

    Dr. Rebeccah Slater, Professor of Pediatric Neuroscience and Senior Wellcome Fellow at the Neuroimaging Group, said: “Working with parents, babies and healthcare professionals to better understand how we can support premature and sick babies during painful procedures has been a highlight of my career.

    “Developing these resources with Bliss has placed families at the heart of all the research we do, and has directly improved our engagement with families and the quality of our research. We will continue to find new ways to support parents and their babies when painful procedures form an essential component of neonatal care.”

    The Petal trial has highlighted the importance of involving parents in the provision of care and comfort for relieving their child’s pain. Future studies can build upon the insights gained from this trial including the positive parental experiences observed in this study. Prospective research might, for example, exercise a more spontaneous approach to delivering the gentle touch, such as allowing parents to stroke their child at their own pace, for as long as they need to calm and comfort their child, rather than a more mechanical and precise application.”


    Dr. Roshni Mansfield, a Pediatrics trainee and NIHR Academic Clinical Fellow in the Pediatric Neuroimaging Group

    Dr. Maria Cobo, a postdoctoral researcher who managed the trial, added: “Another positive aspect of the study was the high degree of involvement by both fathers (35%) and mothers (65%) in delivering the parental touch to their babies. This contrasts with many studies, where only mothers’ opinions and involvement have been sought.”

    Caroline Lee-Davey, Chief Executive of Bliss, said: “We are thrilled to have worked alongside the amazing team of researchers at the University of Oxford to further our understanding on the importance of parental involvement in their babies’ neonatal care. We know that babies have the best chance of survival and quality of life when their parents are empowered to be partners in their care but, sadly, we hear all too often that parents are not informed about their babies’ procedures or the role that they can have in comforting their baby. The outcomes of this research have directly shaped a new suite of Bliss information for parents and healthcare professionals which will help to validate what families often instinctively know to be true – that no matter how unexpected or strange the neonatal environment can feel, they are still their baby’s parent and they have a vital role to play in their comfort and care.”

    Additional funding from the Wellcome Trust enabled Bliss to develop these valuable resources for families, including new information, video content filmed at John Radcliffe Hospital’s neonatal unit giving precious insight into neonatal care, as well as translated flyers for neonatal units and a webinar for healthcare professionals on how to support parents to be involved in their babies’ procedures. These resources were created in collaboration with parents and healthcare professionals, and included a listening event with the Raham Project, a CIC supporting ethnic minority families, where four mothers shared their neonatal stories.

    Source:

    Journal reference:

    Hauck, A. G. V., et al. (2024). Effect of parental touch on relieving acute procedural pain in neonates and parental anxiety (Petal): a multicentre, randomised controlled trial in the UK. The Lancet Child & Adolescent Health. doi.org/10.1016/s2352-4642(23)00340-1.

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  • 11 Best Weighted Blankets (2024): Cooling, Throws, and Eye Masks

    11 Best Weighted Blankets (2024): Cooling, Throws, and Eye Masks

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    Most of the weighted blankets we’ve tested are worth recommending—and there are a lot of them. However, these didn’t stand out as much as the picks above.

    Quince’s Knit Weighted Blanket for $150: This open-knit blanket costs less than Bearaby’s but is as high-quality and uses a recycled polyester fill. There’s just one 15-pound weight option, and it’s a bit more rigid than what Bearaby offers. I like both models, but if you want a drapey blanket, go with Bearaby. (Quince makes some of our favorite sheets.) Available in 15 pounds

    Luxome Weighted Blanket for $105 to $250: Luxome makes a pair of my favorite sheets, and now I also love its blanket. I tried the one-piece blanket with one side made of bamboo lyocell and the other a plush minky fabric, but there are a few options including those with a separate cover. Lying under the bamboo was extra cooling in the best way. It comes in an impressive amount of weight options. Available in 8, 15, 18, or 25 pounds

    Sleep Number True Temp Weighted Blanket for $200: This blanket comes with a cover that’s meant to stay cool throughout the night and this was pretty accurate in my experience. I found the polyester material to be just slightly scratchy, so I wouldn’t want to sleep directly under it, but I typically layer a weighted blanket over a sheet and comforter anyway. Available in 12 or 20 pounds

    Luna Sherpa Throw for $68: We love Luna’s many options linked above, and this sherpa throw is incredibly soft and just heavy enough for its size. It’s machine washable too. Available in 10 pounds

    Gravity Weighted Blanket for $250 to $300: The Basics by Gravity is our top pick because it’s a great blanket for a great price. This original blanket from the brand is also stellar and is available in more weights, sizes, and pretty colors, but you’ll have to shell out for it. Available in 15, 20, or 35 pounds

    Gravity’s Flex Travel Blanket for $50: Gravity also makes a small 10-pound blanket that folds into its included bag. It’s a bit noisy, like the material of a sleeping bag, but if you need something on the go it’s not a bad option. Available in 10 pounds

    Tranquility Cooling Weighted Blanket for $40 to $50: A lot of budget weighted blankets are disappointing. This one genuinely surprised me. It felt great to cuddle up under, and it’s sufficiently weighty with one soft side and a slinky cool side (that stayed pretty cool). Unfortunately, the one we tried is nearly always out of stock, but there are others available from the brand that might be worth a shot. Available in 15 or 20 pounds

    Thera Weighted Blanket for $79 to $129: This blanket might be the softest thing I’ve ever touched, like petting a furry animal. After my first few weeks with it, however, it ripped and let glass beads take over my bed like sand. I think kitty claws got the best of it, so keep that in mind and treat it carefully. Available in 10, 12, or 15 pounds

    Aricove Weighted Blanket for $170 to $200: This is a fantastic cooling blanket to sleep with solo. It’s nice and thin, so you won’t feel trapped or too hot underneath. Available in 10, 12, 15, 17 20, or 22 pounds

    Casper Weighted Blanket for $169 to $189: Casper is another popular bedding brand whose blanket is classic cool cotton rather than knit or plush, which can get hot. About the size of a throw blanket, it’s dense enough that even the lightest model gives you that comfortably squished feeling, while the heaviest is like a Thundershirt for humans. Casper has frequent sales too. Available in 10, 15, or 20 pounds

    Layla Weighted Blanket for $189 to $239: Our tester loved snuggling with a partner under Layla’s massive king-size blanket. It’s double-sided with one cotton and one plush side. Available in 15, 20, or 25 pounds

    Yogibo Calm Antimicrobial Weighted Blanket for $159: The actual blanket is cool cotton, but the real draw here is Yogibo’s famous cotton-and-spandex blend it uses for its covers. The company says it’s insanely soft, and it isn’t lying. It’s stretchy, smooth, and machine washable (the actual blanket is not). I found that pet hair clings to it though, which is common with softer fabrics. Available in 15 pounds

    Gravid Weighted Blanket for $189 to $199: This blanket comes with a plush or cooling cover (or both), and this is where it shines. There’s nothing worse than a blanket cover with only a few attachment points so that after a few minutes underneath it, everything is twisted and off to one side. Gravid’s cover attaches with a zipper that goes the entire length of the blanket. Why other brands don’t do this is beyond me. Available in 15 or 20 pounds

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  • Diabetes drug dulaglutide may reduce symptoms of depression

    Diabetes drug dulaglutide may reduce symptoms of depression

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    A recent Brain and Behavior study investigated the antidepressant effect of dulaglutide and the mechanism that underlies this effect.

    Study: Dulaglutide treatment reverses depression-like behavior and hippocampal metabolomic homeostasis in mice exposed to chronic mild stress. Image Credit: luchschenF/Shutterstock.com
    Study: Dulaglutide treatment reverses depression-like behavior and hippocampal metabolomic homeostasis in mice exposed to chronic mild stress. Image Credit: luchschenF/Shutterstock.com

    Background

    Depression is a chronic mood disorder that is associated with low mood, insomnia, weight loss, a state of unhappiness, aversion to activity, fatigue, and low self-esteem. According to the World Health Organization, depression has become one of the major health burdens across the world.

    This mental health condition is commonly treated with an antidepressant that takes around a month to alleviate the symptoms. However, several side effects are associated with the use of antidepressant drugs and could be toxic at high doses.

    A combination of psychological, genetic, and neurological factors contributes to the manifestations of depression. Even though the exact etiology of this mental health issue is not fully understood, research has shown chronic stress to be an inducer of depression. 

    The hippocampus is a region of the brain that is associated with depression and modifies functionally and morphologically in response to stress. Animal model studies have shown that a decrease in neuronal and glial size, reduction in synaptic markers, loss of dendrites, and increase in apoptosis in the hippocampus leads to depression.

    Many studies have uncovered the metabolic aspects of depression. For instance, diabetes and obesity are two common metabolic disorders that increase the risk of depression. Considering its high prevalence, novel therapies with high efficacy and fewer side effects are required to combat depression. The chronic mild stress (CMS) model has been recognized as a reliable rodent model to study depression. 

    Glucagon-like peptide-1 (GLP-1) and its receptor agonists are involved with anti-inflammatory effects and neuroprotective activities and can improve mental disorders, particularly depression and cognition. GLP-1 is a peptide hormone that stimulates the secretion of insulin and restricts the synthesis of glucagon in the pancreas in a glucose-dependent manner. Liraglutide is a GLP-1 analog that exhibited a positive effect in reducing anxiety and depression symptoms.

    Dulaglutide is a novel long-acting GLP-1 receptor agonist that improves cognitive dysfunction and neuronal damage in rats with vascular dementia. Although many studies highlighted the efficacy of dulaglutide in preventing depression-like behavior triggered by chronic social defeat stress (CSDS), the underlying mechanism of this effect is not clearly understood.

    About the study

    The current study used a metabolomics strategy to evaluate the effect of dulaglutide in a CMS model. Furthermore, the underlying mechanism of this effect was also assessed. Adult male ICR mice, which is a strain of albino mice, were selected for this study. All test mice were around seven weeks old.

    After one week of acclimatization, 60 mice were randomly assigned in four groups, namely, control (CON), the CMS and Vehicle group (CMS+Veh), the CMS and 0.3 mg/kg dulaglutide group (Low Dula), and the CMS and 0.6 mg/kg dulaglutide group (High Dula). Except for the CON group, all other groups were exposed to stressors.

    To establish the CMS model of depression, selected mice were exposed to two or three different stressors for 28 days continuously. For stress induction, mice were deprived of water and food for 12 hours, kept in wet bedding for 24 hours, kept in a tilted cage for 24 hours, pintail for 1 minute, and cold water treatment for five minutes. The body weight of each test mouse was measured weekly, and behavioral tests, such as the tail suspension test (TST), open field test (OFT), and forced swimming test (FST), were performed.

    Study findings

    The mice subjected to CMS for four weeks exhibited depressive- and anxiety-like symptoms. An LC-MS/MS metabolomics study was performed to understand the potential pathophysiological mechanisms and investigate the efficacy of drugs to alleviate depression-like symptoms.

    A distinct difference between the CON group, CMS+Veh group, and High Dula group was observed in accordance with the metabolic disorders induced by chronic stress, which was altered through dulaglutide treatment. Many potential biomarkers were identified that are associated with purine metabolism, arginine and proline metabolism, glycerophospholipid metabolism, glutamate metabolism, sphingolipid metabolism, and bile secretion.

    Lipid metabolism pathways could be potential targets through which dulaglutide alleviates depression. Lysophosphatidylcholine (LPC), phosphatidylethanolamine (PE), lysophosphatidylethanolamine (LPE), phosphatidylinositol (PI), sphingolipids, and phosphatidylcholine (PC), are involved with the therapeutic effect of dulaglutide in alleviating depression. Consistent with previous studies findings, this study highlighted the association between lipid metabolism and the antidepressant effect of dulaglutide.

    The current study indicated the downregulation of N-acetyl-L-aspartic acid (NAA) in the CMS model group. NAA, which is one of the most important metabolites of the vertebrate nervous system, was found in decreased levels in rats with chronic, unpredictable, mild stress. However, the current study indicated that dulaglutide therapy increased the levels of NAA through its upregulation in the hippocampus.

    In the CMS model group, an upregulation in L-glutamic acid and L-arginine was observed. Dulaglutide treatment caused a decrease in arginine and proline, thereby indirectly exhibiting a neuroprotective effect.

    Conclusions

    The current study highlighted the antidepressant effects of dulaglutide using the CMS depression model. Notably, the potential metabolisms that underlie the antidepressant effect of dulaglutide have been elucidated in this study. 

    Journal reference:

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  • New psychological treatment for epileptic children lowers mental health problems

    New psychological treatment for epileptic children lowers mental health problems

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    A new psychological treatment for children with epilepsy, developed by a UCL-led team of scientists, has been shown to reduce mental health difficulties compared to standard care, a new study finds.

    Mental health problems such as worries, low mood and behaviour problems are more common in children and young people with brain conditions such as epilepsy, than in the general population – with up to 60% of those with epilepsy having associated mental health disorders and many having more than one mental health condition.

    These conditions can have a big impact on patients’ quality of life and overall health.

    Currently, mental health problems in children and young people with epilepsy are often not identified because centres that treat epilepsy are usually separated from those that treat mental health difficulties. When mental health difficulties are identified, standard treatment for children who also have epilepsy is usually carried out by specialists, such as child and adolescent mental health services (CAMHS) or hospital-based paediatric psychology services. The treatment given usually involves treating each mental health condition (ie. anxiety, depression, behavioural issues) individually.

    The new treatment, named the Mental Health Intervention for Children with Epilepsy (MICE), is based on the treatments that the National Institute for Health and Care Excellence (NICE) recommends for the treatment of common mental health difficulties, like cognitive behavioural therapy for anxiety and depression. However, it uses a modular approach, that enables multiple mental health conditions to be treated at once, instead of having different treatments for different mental health difficulties.

    It was also modified specifically for children and young people with epilepsy, for example including sessions that explain about the relationship between epilepsy and mental health.

    Additionally, the treatment can be delivered over the phone or via video call so that people did not have to travel to the hospital and miss time from school or work. And rather than being outsourced to services such as CAMHS, it was integrated into epilepsy services – meaning that it could be delivered by non-mental health specialists.

    Lead author Dr Sophie Bennett, who carried out the research while working at UCL Great Ormond Street Institute of Child Health, said: “This treatment breakthrough means that we have a new way to help children and young people with epilepsy who also have mental health difficulties.

    “The treatment can be delivered from within epilepsy services to join up care. It doesn’t need to be delivered by specialist mental health clinicians like psychologists.

    “Integrating the care can help children with epilepsy and their families more effectively and efficiently. We were particularly pleased that benefits were sustained when treatment ended.”

    The new treatment, outlined in The Lancet, was created together with young people and their families and the professionals who care for them, including doctors, nurses and psychologists.

    Patients were given an initial assessment followed by weekly calls with the clinician – although face-to-face therapy was available if preferred. The sessions were delivered to either the young person directly, or via their caregiver, based on their individual circumstances.

    Researchers trialled the treatment with 334 children and young people aged three to 18. Of these, 166 received the new MICE treatment and 168 received the usual treatment for mental health problems in children with epilepsy.

    They assessed adolescents’ mental health and overall well-being from a parent-reported Strengths and Difficulties Questionnaire (SDQ) – covering areas such as emotional problems, conduct, hyperactivity and peer problems.

    The results showed that the children who had the MICE treatment had fewer mental difficulties than those who had the usual treatment, and the change is equivalent to a decrease of 40% in the likelihood of having a psychiatric disorder.

    These groundbreaking findings not only promise brighter futures for children with epilepsy but also pave the way for a revolutionary shift in mental healthcare practices.


    The collaborative efforts of scientists, patients, and healthcare professionals have brought forth a new era of treatment of mental health challenges associated with epilepsy, offering a beacon of hope for families in the face of mental health challenges associated with epilepsy.”


    Professor Roz Shafran, Co-Chief Investigator, UCL Great Ormond Street Institute of Child Health and GOSH

    Co-Chief Investigator, Professor Helen Cross (UCL Great Ormond Street Institute of Child Health and GOSH), said: “This study shows real progress for clinicians considering the high rate of mental health problems in children with epilepsy, as we demonstrate the benefit of a therapy that can be implemented within existing epilepsy services.”

    Co-author, Professor Isobel Heyman (UCL Great Ormond Street Institute of Child Health and Clinical Co-Lead for mental health at Cambridge Children’s Hospital), said: “These promising results show that staff working in paediatric settings can be trained to deliver effective mental health treatment to children with a physical health condition (epilepsy).

    “It clearly demonstrates that children’s healthcare needs can be met in a holistic way to treat the ‘whole child’, in the same place at the same time.”

    The work was conducted in collaboration with experts at Great Ormond Street Children’s Hospital (GOSH), King’s College London and UCLA, and with funding from the National Institute for Health and Care Research (NIHR).

    Source:

    University College London

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  • Research on fishing as PTSD treatment gets a $1.3 million funding boost

    Research on fishing as PTSD treatment gets a $1.3 million funding boost

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    A “game-changing” $1.3m cash injection has been awarded to researchers exploring if doctors can prescribe fishing to treat PTSD. 

    The vital funding will allow the University of Essex’s Dr Nick Cooper and collaborator Dr Mark Wheeler to expand their influential work which has helped hundreds of military veterans. 

    Now the Department of Psychology’s Dr Cooper will explore if casting a rod from the bankside can aid police officers, paramedics, firefighters, and the coast guard deal with trauma. 

    Taking place over the course of three and a half years the National Institute for Health and Care Research-funded project (NIHR) is one of only three being explored across the UK. 

    It is hoped Casting Away Trauma will develop innovative nature-based treatments for mental health conditions on the NHS. 

    Watch a YouTube documentary on the project’s life-changing work here.

    This is a game-changing funding for our research, which will help us show definitively if fishing can make a real difference to the people who have given so much to keep us all safe. 


    We are incredibly proud to receive NIHR funding to expand our project, which we have proved has a real impact on servicemen and women. 


    We have shown that a weekend of angling has demonstrable and real impact on vulnerable veterans and can help them back into society. 


    We are incredibly excited and honoured to receive the funding to expand our research.” 


    Dr Nick Cooper, Department of Psychology, University of Essex

    PTSD -Post Traumatic Stress Disorder – sees sufferers relive traumatic and can lead to debilitating depression, anxiety and even suicide. 

    The Casting Away Trauma project has found a way to break barriers stopping veterans and other sufferers from engaging with traditional therapy. 

    By emphasising learning a new recreational skill rather than traditional therapy they use peer support and sessions led by a qualified recreation coach to ease the symptoms. 

    Dr Wheeler added: “This is a tremendous piece of news for all concerned. 

    “As joint CEO of iCARP CIC, alongside Dr Cooper, I can state that, as an organisation, we are immensely proud to have played our part in this ground-breaking research project. 

    “From our first research design and trip, 10 years ago now, we have worked tirelessly to reach this point and could not be more pleased for all our supporters, collaborators and volunteers who have all played an integral part in the programme. 

    “We look forward to the next part of the journey with excitement and anticipation. 

    Dr Cooper and Dr Wheeler will conduct the research through their community interest company iCARP CIC, which runs picturesque lakes nestled near Harwich, Essex.” 

    Their previous research took servicemen with PTSD, who had an average of 12 years military experience on a weekend fishing retreat – focussing on relaxation, socialisation and learning new skills. 

    The innovative intervention sparked significant clinical change in 60% of participants that also reduced depression and anxiety for a month after the trip – with wellbeing scores soaring. 

    It also confirmed the 30-hour, 2-day peer-support intervention can now be expanded to deliver a large-scale trial using the same methods. 

    The project has been praised by the Ministry of Defence (receiving a gold award in 2022), recognised by The Angling Trust and recently received a contract to deliver community mental health treatment for the NHS Essex Partnership University Trust via local volunteering bodies. 

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  • Housing affordability for new mothers may help stave off postpartum depression

    Housing affordability for new mothers may help stave off postpartum depression

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    Becoming a parent comes with lots of bills. For new mothers, being able to afford the rent may help stave off postpartum depression.

    “Housing unaffordability has serious implications for mental health,” said Katherine Marcal, an assistant professor at the Rutgers School of Social Work and author of a study published in the journal Psychiatry Research. “For mothers who rent their homes, the ability to make monthly payments appears to have a correlation to well-being.”

    Housing hardship – missing rent or mortgage payments, moving in with others, being evicted or experiencing homelessness – has been associated with increased risk for depression. Yet little is understood about unique manifestations of housing hardship among postpartum mothers in renter households, said Marcal.

    To address this gap, Marcal used data from the Future of Families and Child Wellbeing Study, a multiyear study of nearly 5,000 children born in the United States between 1998 and 2000. As part of the research, mothers were interviewed in hospitals shortly after giving birth, and five times over the next 15 years.

    Marcal drew on data for 2,329 mothers who reported being renters at year one of the survey. Participants were asked a series of questions related to housing hardship. For instance, had they ever missed a rent or utility payment, moved in with friends or family or spent at least one night homeless during the postpartum year?

    Using latent class analysis, a modeling approach that allows clustering of data and statistical inference, Marcal used Future of Families and Child Wellbeing Study responses to investigate manifestations of housing hardship.

    Four groups emerged from the data: a “stable” group with very little housing hardship; “rent-assisted” mothers with government housing assistance; “cost-burdened” mothers who skip periodic rent and utility payments but manage to avoid most severe housing outcomes; and a “housing insecure” group or mothers who experience elevated rates of displacement.

    Finally, these clustered data were analyzed with responses from year three of the Future of Families and Child Wellbeing Study, when participants were asked if they had experienced major depressive and anxiety disorders.

    What emerged was a clear connection between housing hardship and depression. Mothers in the housing insecure group were far more likely to be depressed than those in the stable group. For anxiety risk, the best determinant was whether rent was paid each month. In total, the prevalence of maternal depression was 21 percent, while the prevalence of anxiety was 5 percent.

    Marcal also identified a racial component to the findings: Black renters were less likely than whites to be cost-burdened.

    The reason is counterintuitive, Marcal said.

    Black families are more likely to receive rental assistance, but Blacks are also more likely to be evicted faster than whites.”


    Katherine Marcal, Assistant Professor, Rutgers School of Social Work 

    In other words, Black tenants don’t remain cost-burdened for long. “They’re either making their rent payments or they’re getting evicted or moving out,” Marcal said.

    Taken together, the findings highlight the importance of government housing support for low-income families.

    “Rental assistance is very effective in keeping people housed and in reducing risk for depression and anxiety,” Marcal said. “But what this research shows is that we need to do a much better job at promoting equity in assistance programs.”

    Source:

    Journal reference:

    Marçal, K. (2024). Housing hardship and maternal mental health among renter households with young children. Psychiatry Research. doi.org/10.1016/j.psychres.2023.115677.

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