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Tag: mental health

  • The vital role of therapeutic alliances in psychedelic treatment

    The vital role of therapeutic alliances in psychedelic treatment

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    Drug effects have dominated the national conversation about psychedelics for medical treatment, but a new study suggests that when it comes to reducing depression with psychedelic-assisted therapy, what matters most is a strong relationship between the therapist and study participant.

    Researchers analyzed data from a 2021 clinical trial that found psilocybin (magic mushrooms) combined with psychotherapy in adults was effective at treating major depressive disorder.

    Data included depression outcomes and participant reports about their experiences with the drugs and their connection with therapists. Results showed that the stronger the relationship between a participant and clinician – called a therapeutic alliance – the lower the depression scores were one year later.

    What persisted the most was the connection between the therapeutic alliance and long-term outcomes, which indicates the importance of a strong relationship.”

    Adam Levin, Study Lead Author and Psychiatry and Behavioral Health Resident, College of Medicine, The Ohio State University

    Past research has consistently found that as mental health treatments changed, a trusting relationship between clients and clinicians has remained key to better outcomes, said senior author Alan Davis, associate professor and director of the Center for Psychedelic Drug Research and Education in The Ohio State University College of Social Work.

    “This concept is not novel. What is novel is that very few people have explored this concept as part of psychedelic-assisted therapy,” Davis said. “This data suggests that psychedelic-assisted therapy relies heavily on the therapeutic alliance, just like any other treatment.”

    The study was published recently in the journal PLOS ONE.

    Twenty-four adults who participated in the trial received two doses of psilocybin and 11 hours of psychotherapy. Participants completed the therapeutic alliance questionnaire, assessing the strength of the therapist-participant relationship, three times: after eight hours of preparation therapy and one week after each psilocybin treatment.

    Participants also completed questionnaires about any mystical and psychologically insightful experiences they had during the drug treatment sessions. Their depression symptoms were assessed one week, four weeks, and up to one year after the trial’s end.

    The analysis showed that the overall alliance score increased over time and revealed a correlation between a higher alliance score and more acute mystical and/or psychologically insightful experiences from the drug treatment. Acute effects were linked to lower depression at the four-week point after treatment, but were not associated with better depression outcomes a year after the trial.

    “The mystical experience, which is something that is most often reported as related to outcome, was not related to the depression scores at 12 months,” Davis said. “We’re not saying this means acute effects aren’t important – psychological insight was still predictive of improvement in the long term. But this does start to situate the importance and meaning of the therapeutic alliance alongside these more well-established effects that people talk about.”

    That said, the analysis showed that a stronger relationship during the final therapy preparation session predicted a more mystical and psychologically insightful experience – which in turn was linked to further strengthening the therapeutic alliance.

    “That’s why I think the relationship has been shown to be impactful in this analysis – because, really, the whole intervention is designed for us to establish the trust and rapport that’s needed for someone to go into an alternative consciousness safely,” Davis said.

    Considering that psychedelics carry a stigma as Schedule I drugs under the Controlled Substances Act, efforts to minimize negative experiences in future studies of their therapeutic potential should be paramount – and therapy is critical to creating a supportive environment for patients, the authors said.

    This study ideally will help clearly position psychedelics treatment as a psychotherapeutic intervention moving forward – rather than its primary purpose being administration of a drug, Levin said.

    “This isn’t a case where we should try to fit psychedelics into the existing psychiatric paradigm – I think the paradigm should expand to include what we’re learning from psychedelics,” Levin said. “Our concern is that any effort to minimize therapeutic support could lead to safety concerns or adverse events. And what we showed in this study is evidence for the importance of the alliance in not just preventing those types of events, but also in optimizing therapeutic outcomes.”

    This work was supported by the Center for Psychedelic and Consciousness Research, funded by the Steven & Alexandra Cohen Foundation, the RiverStyx Foundation and private donors. It was also supported by the Center for Psychedelic Drug Research and Education (CPDRE), funded by anonymous donors.

    Additional co-authors are Rafaelle Lancelotta, Nathan Sepeda and Theodore Wagener of Ohio State, and Natalie Gukasyan, Sandeep Nayak, Frederick Barrett and Roland Griffiths of the Center for Psychedelic and Consciousness Research at Johns Hopkins University, where Davis is an affiliate.

    Source:

    Journal reference:

    Levin, A. W., et al. (2024) The therapeutic alliance between study participants and intervention facilitators is associated with acute effects and clinical outcomes in a psilocybin-assisted therapy trial for major depressive disorder. PLOS ONE. doi.org/10.1371/journal.pone.0300501.

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  • Delving into burning issues about heart disease and much more

    Delving into burning issues about heart disease and much more

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    The hottest science in the prevention of heart disease awaits at ESC Preventive Cardiology 2024, a scientific congress of the European Society of Cardiology (ESC). The annual congress of the European Association of Preventive Cardiology (EAPC), a branch of the ESC, takes place 25 to 27 April at the Megaron – Athens International Conference Centre, Greece. Explore the scientific programme.

    Don’t miss the late breaking science sessions for cutting-edge research in preventive cardiology, including unhealthy food and beverage trends in adolescents and the links between physical activity and smoking in children. Novel research will be presented in hundreds of scientific abstracts including data on stair climbing, insomnia, dairy products, and the potential connections between air pollution, mental health, and cardiovascular disease. Plus scientific sessions delving into burning issues about heart disease, sex, and much more…

    Patients often have insecurities after a heart event and we will discuss important questions such as when sexual activity can be resumed after a heart attack. We know that exercise helps prevent cardiovascular disease, so is sexual activity enough ‘exercise’?”

    Dr. Nicolle Kränkel, Congress Programme Committee Chair

    Hear experts examine the links between the heart and brain in a session exploring common pathways between depression and heart disease, and how patients with cardiac conditions can stop worrying.

    Dr. Kränkel said: “After a heart attack, patients are often scared and depressed. Depression and anxiety can also impact heart health. Additionally, awareness and cognition of one’s heart health play a large role in adhering to a healthy lifestyle. There is also crosstalk between the heart and other organs. That’s why this year’s congress theme is ‘Cardiovascular risk: The heart and beyond’ – exploring how we can harness these interactions to improve heart health and overall wellbeing.”

    Other important questions that you should attend to hear the answers to:

    Heart health and the young:

    • How do energy drinks affect the hearts of adolescents?
    • Is doping dangerous for the heart? Find out in a session dedicated to stimulants and their effects on the heart.
    • What is the impact of e-cigarettes on young hearts?

    Lifestyle issues:

    • Weight loss update: different approaches to weight loss are needed from childhood to old age – hear how one size does not fit all. And it’s not only about losing fat: learn about personalising exercise in obese patients.
    • What’s new in smoking cessation, including digital tools?
    • Can heart healthy diets be affordable? And the latest evidence on demographic and socio-economic disparities in nutrition. Check out nutrition for a better heart.

    And finally, could a vaccine prevent heart disease? Get up-to-the-minute scientific evidence on immunity and cardiovascular risk and what’s on the horizon.

    Source:

    European Society of Cardiology (ESC)

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  • Study shows yoga’s positive impact on emotional health in forensic psychiatry

    Study shows yoga’s positive impact on emotional health in forensic psychiatry

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    Previous studies in correctional facilities have shown positive effects of yoga on inmates. They experience increased impulse control and improved mental health. Are the same positive results seen in detained individuals with severe psychiatric disorders? Now, the first results from a large national and globally unique research study in forensic psychiatry from the University West are presented.

    It is the first scientific study of its kind to describe the effect and feasibility of trauma-adapted yoga in forensic psychiatry.

    It is a breakthrough that we can now demonstrate the possibility of using yoga as a complementary care intervention in psychiatry and the positive effects it brings.”


    Nóra Kerekes, Professor in Medical Sciences (Psychiatry) at the University West, and research leader of the study

    The results of the study are now published in the prestigious scientific journal, Psychiatry Research.

    “We wanted to explore whether previous positive results with the use of yoga in correctional facilities could be transferred to detained individuals suffering from severe psychiatric disorders. Therefore, we evaluated trauma-adapted yoga as a support within forensic psychiatry,” says Nóra Kerekes.

    Forensic psychiatry deals with the complex challenges that arise at the intersection of psychiatric illness, legal issues, and security concerns.

    “There are few high-quality clinical studies on individuals who have committed crimes and who have a serious mental disorder. What exists are either studies on inmates separately or studies of individuals suffering from various psychiatric disorders. For both of these groups, yoga has shown positive effects,” says Nóra Kerekes.

    Yoga class for 10 weeks

    Self-choice was a central component in the study design, where 56 patients at various forensic psychiatric clinics chose to participate. Over 10 weeks, they either participated in specially developed yoga classes or chose to engage in other forms of physical activity. Throughout the study, changes in their mental health, emotional states, antisocial and aggressive behaviors, pain perception, substance cravings, and ability to control their behavior and emotional reactions were observed.

    Positive effects measured

    In the current study, the yoga group showed remarkable reductions in negative emotional states, anxiety, paranoid ideation, hostility, and overall psychological distress. These reductions were not observed in the group performing other forms of physical activities. Additionally, the yoga group exhibited a significant reduction in pain frequency, and showed strengthened self-control and accountability.

    “We can conclude that trauma-iadapted yoga implemented in a forensic psychiatric setting demonstrates feasibility and results in several positive changes in patients’ mental health, emotional states, pain, and self-control,” says Nóra Kerekes.

    She continues:

    “A structured program of trauma-adapted yoga for patients and training for healthcare personnel has been developed and has now been confirmed to be feasible and beneficial within forensic psychiatry.”

     

    Source:

    Journal reference:

    Kerekes, N. (2024). Exploring the Impact of Trauma-Adapted Yoga in Forensic Psychiatry: Midterm Findings and Insights. Psychiatry Research. doi.org/10.1016/j.psychres.2024.115879.

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  • Rural jails turn to community health workers to help the newly released succeed

    Rural jails turn to community health workers to help the newly released succeed

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    Garrett Clark estimates he has spent about six years in the Sanpete County Jail, a plain concrete building perched on a dusty hill just outside this small, rural town where he grew up.

    “That’s all I’ve known my whole life,” said Clark, 31, in December.

    Clark was at the jail to pick up his sister, who had just been released. The siblings think this time will be different. They are both sober. Shantel Clark, 33, finished earning her high school diploma during her four-month stay at the jail. They have a place to live where no one is using drugs.

    And they have Cheryl Swapp, the county sheriff’s new community health worker, on their side.

    “She saved my life probably, for sure,” Garrett Clark said.

    Swapp meets with every person booked into the county jail soon after they arrive and helps them create a plan for the day they get out.

    She makes sure everyone has a state ID card, a birth certificate, and a Social Security card so they can qualify for government benefits, apply to jobs, and get to treatment and probation appointments. She helps nearly everyone enroll in Medicaid and apply for housing benefits and food stamps. If they need medication to stay off drugs, she lines that up. If they need a place to stay, she finds them a bed.

    Then Swapp coordinates with the jail captain to have people released directly to the treatment facility. Nobody leaves the jail without a ride and a drawstring backpack filled with items like toothpaste, a blanket, and a personalized list of job openings.

    “A missing puzzle piece,” Sgt. Gretchen Nunley, who runs educational and addiction recovery programming for the jail, called Swapp.

    Swapp also assesses the addiction history of everyone held by the county. More than half arrive at the jail addicted to something.

    Nationally, 63% of people booked into local jails struggle with a substance use disorder — at least six times the rate of the general population, according to the federal Substance Abuse and Mental Health Services Administration. The incidence of mental illness in jails is more than twice the rate in the general population, federal data shows. At least 4.9 million people are arrested and jailed every year, according to an analysis of 2017 data by the Prison Policy Initiative, a nonprofit organization that documents the harm of mass incarceration. Of those incarcerated, 25% are booked two or more times, the analysis found. And among those arrested twice, more than half had a substance use disorder and a quarter had a mental illness.

    “We don’t lock people up for being diabetic or epileptic,” said David Mahoney, a retired sheriff in Dane County, Wisconsin, who served as president of the National Sheriffs’ Association in 2020-21. “The question every community needs to ask is: ‘Are we doing our responsibility to each other for locking people up for a diagnosed medical condition?’”

    The idea that county sheriffs might owe it to society to offer medical and mental health treatment to people in their jails is part of a broader shift in thinking among law enforcement officials that Mahoney said he has observed during the past decade.

    “Don’t we have a moral and ethical responsibility as community members to address the reasons people are coming into the criminal justice system?” asked Mahoney, who has 41 years of experience in law enforcement.

    Swapp previously worked as a teacher’s aide for those she calls the “behavior kids” — children who had trouble self-regulating in class. She feels her work at the jail is a way to change things for the parents of those kids. And it appears to be working.

    Since the Sanpete County Sheriff’s Office hired Swapp last year, recidivism has dropped sharply. In the 18 months before she began her work, 599 of the people booked into Sanpete County Jail had been there before. In the 18 months after she started, that number dropped to 237.

    In most places, people are released from county jails with no health care coverage, no job, nowhere to live, and no plan to stay off drugs or treat their mental illness. Research shows that people newly released from incarceration face a risk of overdose that is 10 times as high as that of the general public.

    Sanpete wasn’t any different.

    “For seven to eight years of me being here, we’d just release people and cross our fingers,” said Jared Hill, the clinical director for Sanpete County and a counselor at the jail.

    Nunley, the programming sergeant, remembers watching people released from jail walk the mile to town with nothing but the clothes they’d worn on the day they were arrested — it was known as the “walk of shame.” Swapp hates that phrase. She said no one has made the trip on foot since she started in July 2022.

    Swapp’s work was initially funded by a grant from the U.S. Health Resources and Services Administration, but it has proved so popular that commissioners in Sanpete County voted to use a portion of its opioid settlement money to cover the position in the future.

    Swapp doesn’t have formal medical or social work training. She is certified by the state of Utah as a community health worker, a job that has become more common nationwide. There were about 67,000 people working as community health workers in 2022, according to the U.S. Bureau of Labor Statistics.

    Evidence is mounting that the model of training people to help their neighbors connect to government and health care services is sound, said Aditi Vasan, a senior fellow at the Leonard Davis Institute of Health Economics at the University of Pennsylvania who has reviewed the research on the relatively new role.

    The day before Swapp coordinated Shantel Clark’s release, she sat with Robert Draper, a man in his 50s with long white hair and bright-blue eyes. Draper has been in and out of jail for decades. He was sober for a year and had been taking care of his ill mother. She kept getting worse. Then his daughter and her child came to help. It was all a little too much.

    “I thought, if I can just go and get high, I can deal with this shit,” said Draper. “But after you’ve been using for 40 years, it’s kinda easy to slip back in.”

    He didn’t blame his probation officer for throwing him back in jail when he tested positive for drugs, he said. But he thinks jail time is an overreaction to a relapse. Draper sent a note to Swapp through the jail staff asking to see her. He was hoping she could help him get out so he could be with his mom, who had just been sent to hospice. He had missed his father’s death years ago because he was in jail at the time.

    Swapp listened to Draper’s story without interruptions or questions. Then she asked if she could run through her list with him so she would know what he needed.

    “Do you have your Social Security card?”

    “My card?” Draper shrugged. “I know my number.”

    “Your birth certificate, you have it?”

    “Yeah, I don’t know where it is.”

    “Driver’s license?”

    “No.”

    “Was it revoked?”

    “A long, long time ago,” Draper said. “DUI from 22 years ago. Paid for and everything.”

    “Are you interested in getting it back?”

    “Yeah!”

    Swapp has some version of this conversation with every person she meets in the jail. She also runs through their history of addiction and asks them what they most need to get back on their feet.

    She told Draper she would try to get him into intensive outpatient therapy. That would involve four to five classes a week and a lot of driving. He’d need his license back. She didn’t make promises but said she would talk to his probation officer and the judge. He sighed and thanked her.

    “I’m your biggest fan here,” Swapp said. “I want you to succeed. I want you to be with your mom, too.”

    The federal grant that funded the launch of Sanpete’s community health worker program is held by the regional health care services organization Intermountain Health. Intermountain took the idea to the county and has provided Swapp with support and training. Intermountain staff also administer the $1 million, three-year grant, which includes efforts to increase addiction recovery services in the area.

    A similarly funded program in Kentucky called First Day Forward took the community health worker model a step further, using “peer support specialists” — people who have experienced the issues they are trying to help others navigate. Spokespeople from HRSA pointed to four programs, including the ones in Utah and Kentucky, that are using their grant money for people facing or serving time in local jails.

    Back in Utah, Sanpete’s new jail captain, Jeff Nielsen, said people in small-town law enforcement weren’t so far removed from those serving time.

    “We know these people,” Nielsen said. He has known Robert Draper since middle school. “They are friends, neighbors, sometimes family. We’d rather help than lock them up and throw away the key. We’d rather help give them a good life.”




    Kaiser Health NewsThis article was reprinted from khn.org, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF – the independent source for health policy research, polling, and journalism.

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  • Childhood trauma linked to higher rates of somatic symptoms, study finds

    Childhood trauma linked to higher rates of somatic symptoms, study finds

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    In a recent study published in the JAMA Network Open, a group of researchers investigated the prevalence and severity of somatic symptoms among children and adolescents who have experienced traumatic events in France.

    Study: Somatic and Posttraumatic Stress Symptoms in Children and Adolescents in France. Image Credit: Jan H Andersen / ShutterstockStudy: Somatic and Posttraumatic Stress Symptoms in Children and Adolescents in France. Image Credit: Jan H Andersen / Shutterstock

    Background 

    Somatic symptoms include a variety of physical complaints, such as gastrointestinal issues, body pain, cardiopulmonary disturbances, and fatigue, leading to significant functional impairment and emotional distress, often without a precise medical diagnosis. These symptoms are prevalent in 10% to 25% of adults, with higher occurrences in specialized medical settings and among at-risk groups like Latinx immigrants. There is a strong link between adverse childhood experiences (ACEs) and the development of somatic symptoms, which are associated with chronic physical and mental health problems, including posttraumatic stress disorder (PTSD). These symptoms show gender differences that intensify in adolescence. Further research is needed to better understand the mechanisms linking traumatic experiences to somatic symptoms in youth, enabling more targeted interventions and improved outcomes.

    About the study 

    The present cross-sectional study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE)  guidelines. It was conducted at the Nice Pediatric Psychotrauma Center (NPPC) in southern France. With ethical clearance from the National Ethics Committee NORTHWEST III and registration with ClinicalTrials.gov, this study forms part of a broader research program investigating the multifaceted associations of psychological trauma in children. Recruitment occurred throughout 2021, drawing participants from NPPC’s outpatient service. The center, known for its specialized, multidisciplinary approach to pediatric psycho-trauma, integrates expertise from a range of fields, including child psychiatry and psychology, neuropsychology, and pediatric nursing.

    Participants in the study were children and adolescents aged 7 to 17 who had experienced at least one Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 defined traumatic event, with assessments carried out by qualified child psychologists or psychiatrists specializing in trauma. The children, alongside their parents, provided informed consent before participation. The assessment tools used included the Child PTSD Checklist (CPC) for evaluating exposure to traumatic events and the Patient Health Questionnaire (PHQ)-13 questionnaire, which measures the severity of 13 different somatic symptoms ranging from stomach and back pain to fatigue and dizziness. The PHQ-13 assesses symptom severity over the previous week using a Likert scale and has been adapted from the adult version, excluding items irrelevant to children.

    Through comprehensive assessments, the research team sought to identify patterns of single versus multiple traumatic exposures and their impacts on somatic and PTSD symptoms. Statistical analyses were performed to explore these relationships, considering variables such as the number and intensity of somatic symptoms and PTSD symptom severity. 

    Study results 

    The study comprised 363 youths, with a nearly even gender distribution: 174 females (47.9%) and 189 males (52.1%). Participants ranged in age from 7 to 17 years, averaging 13.58 years. They were assessed for their exposure to potentially traumatic events, with 288 (79.3%) directly exposed, 36 (9.9%) indirectly exposed through a close relation, and 39 (10.7%) witnessing such events. The CPC identified 144 youths (39.7%) who met the criteria for PTSD.

    Somatic symptoms were notably more frequent and intense among the PTSD group compared to their peers without PTSD. The most common traumatic events were man-made disasters, including the terrorist attack on July 14, 2016, affecting 200 youths (55.1%); witnessing an assault noted by 109 participants (30.0%); and hospitalization, experienced by 94 youths (25.9%).

    The intensity of PTSS and associated functional impairments were quantitatively higher in the PTSD group, with average scores reflecting significant distress and disruption to daily functioning. In contrast, those in the non-PTSD group reported markedly lower levels of symptomatology and impairment.

    A closer look at the somatic symptomatology revealed that the PTSD group experienced a higher mean intensity and a greater number of somatic complaints. The most significant correlations were between PTSS intensity and symptoms such as stomach pain and headaches, suggesting a direct linkage between trauma exposure and physical manifestations of stress.

    Further analyses explored the impact of experiencing multiple traumatic events. Among participants with cumulative trauma exposures, those with multiple events reported higher levels of both somatic symptoms and overall symptom intensity. This group demonstrated a clear gradient, with increases in the number and severity of symptoms correlating with the number of traumatic events experienced. Lastly, the study’s multiple regression analysis, focusing on somatic symptoms significantly associated with PTSD, revealed that these symptoms could account for 6.5% of the variance in PTSS severity. 

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  • New study sheds light on the relationship between race and mental health stigma in college students

    New study sheds light on the relationship between race and mental health stigma in college students

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    A new study by a counseling researcher at New York Institute of Technology sheds light on the relationship between race and mental health stigma. The findings could help college counseling and wellness professionals better understand students’ cultural experiences and the barriers they may face in seeking mental health treatment. 

    Data shows that mental health challenges continue to be a growing concern among college students, with students of color remaining an underserved and understudied group. In addition, while mental health worsened among all student groups during the COVID-19 pandemic, students of color were particularly vulnerable. 

    Now, as seen in the Journal of College Student Mental Health, a new study led by Nayoung Kim, Ph.D., assistant professor of psychology and counseling at New York Institute of Technology, investigates how college students across different races perceive mental health treatment.

    Kim, a faculty member in the university’s Mental Health Counseling, M.S. program, and a researcher from Palo Alto University analyzed survey responses from 747 college students across the United States. Some responses were collected before the COVID-19 pandemic, as part of an earlier study, while others were collected after the pandemic’s onset.

    In both evaluations, students were asked to self-identify their race as Caucasian/White, African American/Black, Hispanic/Latinx, Asian/Asian American, American Indian/Native American, or Multiracial. The students then self-assessed statements regarding their perceptions on various mental health topics, with each statement having an individual scale (one to five, for example) correlating with whether they agreed or disagreed. Topics included:

    • Self-stigma: an individual’s negative attitudes toward themselves, and shame about mental health issues. Students reacted to statements like “I would feel inadequate if I went to a therapist for psychological help,” and “It would make me feel inferior to ask a therapist for help.”

    • Public stigma: the perceived negative attitudes of others about mental health issues. Students responded to statements regarding whether others would “think of you in a less favorable way,” and “think bad things of you” if they learned that the student was seeking mental health treatment.

    • Social support: having other people, including friends and family, to turn to in times of need or crisis. Sample statements included “I get the emotional help and support I need from my family,” and “I can count on my friends when things go wrong.”

    • Perceived discrimination: may take the form of microaggressions or environmental displays of prejudice and systemic racism. Students were presented with statements like “People act like you are not as smart,” and “You are treated with less respect than others.”

    The findings revealed that Asian/Asian American students had higher levels of self-stigma and public stigma compared to other groups, suggesting they may delay seeking help for mental health challenges. Given this, the researchers suggest that counselors offer these students a focused intervention to help address mental health issues promptly.

    On a positive note, college students who were enrolled during the pandemic, across all races, showed decreased levels of self-stigma. This suggests that increased mental health awareness resulting from the pandemic reduced shame associated with seeking mental health treatment.

    Given this, the researchers note that, at the administrative level, it is essential to educate the campus community about stigma and potential psychological distress that can impact students’ well-being. Doing so could significantly impact whether students feel empowered to seek help.

    “Our findings are particularly helpful for college counseling centers, which could benefit by tailoring counseling services to provide support for racial and ethnic minority students,” says Kim, whose clinical and supervision experiences include school, college, and community counseling settings. “With a deeper understanding of students’ cultural experiences, college counselors can also facilitate group counseling sessions that delve into the complexities of mental health stigma and create a safe and inclusive space where students can express their perspectives, acquire effective coping strategies, and gain insights into the impact of that stigma.”

    Source:

    New York Institute of Technology

    Journal reference:

    Kim, N., & Chen, S.-Y. (2024). Relationship Between Mental Health Stigma, Perceived Discrimination, and Social Support: Focusing on Racial Groups and COVID-19. Journal of College Student Mental Health. doi.org/10.1080/28367138.2024.2333371.

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  • Natural diversity boosts mental wellbeing, research shows

    Natural diversity boosts mental wellbeing, research shows

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    New research from King’s College London has found that spaces with a diverse range of natural features are associated with stronger improvements in our mental wellbeing compared to spaces with less natural diversity.

    Published in Scientific Reports and funded by the National Institute for Health and Care Research (NIHR) and Wellcome, this citizen science study used the smartphone application Urban Mind to collect real-time reports on mental wellbeing and natural diversity from nearly 2000 participants.

    Researchers found that environments with a larger number of natural features, such as trees, birds, plants and waterways, were associated with greater mental wellbeing than environments with fewer features, and that these benefits can last for up to eight hours.

    Further analysis found that nearly a quarter of the positive impact of nature on mental health could be explained by the diversity of features present. These findings highlight that policies and practices that support richness of nature and species are beneficial both for environment and for public mental health.

    Lead author Ryan Hammoud, Research Assistant at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, said:

    “To our knowledge, this is the first study examining the mental health impact of everyday encounters with different levels of natural diversity in real-life contexts. Our results highlight that by protecting and promoting natural diversity we can maximise the benefits of nature for mental wellbeing. In practice, this means moving away from heavily curated monocultural pockets and parks of mown grass, which are typically associated with low biodiversity, towards spaces which mirror the biodiversity of natural ecosystems. By showing how natural diversity boosts our mental wellbeing, we provide a compelling basis for how to create greener and healthier urban spaces.”

    The study took place between April 2018 and September 2023, with 1,998 participants completing over 41,000 assessments. Each participant was asked to complete three assessments per day over a period of 14 days, entering information about their environment and answering a series of questions about their mental health. Natural diversity was defined by how many out of four natural features –trees, plants, birds and water – were present within the participant’s surrounding environment.

    Data were collected using the Urban Mind app, developed by King’s College London, landscape architects J&L Gibbons and arts foundation Nomad Projects. The Urban Mind project is funded by a Wellcome Climate Impacts Award to Professor Andrea Mechelli, the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre and the NIHR Applied Research Collaboration South London.

    Senior author Andrea Mechelli, Professor of Early Intervention in Mental Health at the IoPPN, said:

    “In the context of climate change, we are witnessing a rapid decline in biodiversity in the UK as well as globally. Our results suggest that biodiversity is critical not only for the health of our natural environments but also for the mental wellbeing of the people who live in these environments. It is time to recognize that biodiversity brings co-benefits for planetary and human health and needs to be considered vital infrastructure within our cities”.

    Source:

    Journal reference:

    Hammoud, R., et al. (2024). Smartphone-based ecological momentary assessment reveals an incremental association between natural diversity and mental wellbeing. Scientific Reports. doi.org/10.1038/s41598-024-55940-7.

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  • Is spousal cardiovascular disease associated with an increased risk for depression?

    Is spousal cardiovascular disease associated with an increased risk for depression?

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    Cardiovascular disease (CVD) is among the leading causes of illness and death in the current age. While CVD has long been linked to the onset of depression, not much is known about whether the spouses of those affected are more likely to become depressed after such events.

    A study recently published in JAMA Network Open explored this topic, laying the foundation for future prospective studies in this field.

    Study: Depression Onset After a Spouse’s Cardiovascular Event. Image Credit: Chay_Tee/Shutterstock.comStudy: Depression Onset After a Spouse’s Cardiovascular Event. Image Credit: Chay_Tee/Shutterstock.com

    Depression and health

    Depression has become 65% more prevalent, and it stands as the predominant mental health disorder worldwide, not only diminishing quality of life but also adversely affecting overall health.

    Depression is associated with a higher risk of CVD, dementia, poor cognition, and death.

    How is CVD linked to depression?

    CVD and depression are both more common in people who are obese, and both share inflammation in the immune system. When someone suffers a CVD event such as a stroke or a heart attack, the family also suffers from mental stress, anxiety, and even depression.

    The current study was designed to explore the association between CVD and depression at the household level. The data came from a national database maintained by the Japan Health Insurance Association (JHIA).

    This included about 40% of the Japanese working-age population or 30 million individuals in this age group.

    What did the study show?

    The researchers found that among nearly 278,000 married couples matched for important characteristics, the vast majority (95%) reported a CVD-related event in the male partner. The mean age of the patients was 58 years.

    Those whose spouses had a CVD event were more likely to be diabetic, hypertensive, or depressed compared to the other group. The spousal group had an increased cumulative incidence of depression, between 4% to 5% for males and females, respectively.

    For spouses between 20 and 59 years, about 4% of spouses became depressed vs 3% of those aged 60 years or more.

    New-onset depression was observed in nearly 2% of individuals. Spousal risk for depression after a CVD was 13% higher than in the group without such an event.

    This did not show any change by age, sex, income, or a previous CVD history.

    However, depression risk was higher by 13% to 15% after spousal stroke or heart failure, but not after a heart attack.

    Other potentially confounding factors included smoking, drinking, exercise, or whether the index patient was using drugs to reduce blood pressure. None of these showed any impact on the risk of depression in the spouse, however.

    The researchers also checked for the possible interaction of these results with the spouse’s health status.

    They examined the body mass index (BMI), blood pressure, cholesterol levels, blood sugar concentrations, and kidney function. They found that the same increased risk was manifested after controlling for these factors.

    The study corroborates the depressive effect of a spousal CVD event, which could involve a need to be a caregiver for the sick spouse.

    This could mean inevitable lifestyle alterations, lack of other social interactions, sleep disruptions, and lack of exercise. All these are associated with chronic mental stress, which increases with the level and duration of caregiving.

    Financial problems due to the forced loss of employment to manage the spouse’s needs, with additional caregiving-related costs, are another source of stress.

    Finally, grief at the loss of a spouse or distress related to the stay of the loved one in the intensive care unit may trigger depression.

    Conclusions

    “These findings highlight the importance of preventive care for mental health disorders in individuals whose spouses experience incident CVD.”

    By paying attention to possible confounders such as a history of other diseases, individual practice of healthy habits, and physical health parameters, the study fills a knowledge gap and provides stronger evidence.

    Community-level and multidisciplinary clinical support systems should be studied as a possible intervention to reduce this risk for spouses of CVD patients through a wide-spectrum preventive care approach.

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  • Breakthrough brain stimulator could revolutionize treatment for neurological disorders

    Breakthrough brain stimulator could revolutionize treatment for neurological disorders

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    Rice University engineers have developed the smallest implantable brain stimulator demonstrated in a human patient. Thanks to pioneering magnetoelectric power transfer technology, the pea-sized device developed in the Rice lab of Jacob Robinson in collaboration with Motif Neurotech and clinicians Dr. Sameer Sheth and Dr. Sunil Sheth can be powered wirelessly via an external transmitter and used to stimulate the brain through the dura ⎯ the protective membrane attached to the bottom of the skull.

    The device, known as the Digitally programmable Over-brain Therapeutic (DOT), could revolutionize treatment for drug-resistant depression and other psychiatric or neurological disorders by providing a therapeutic alternative that offers greater patient autonomy and accessibility than current neurostimulation-based therapies and is less invasive than other brain-computer interfaces (BCIs).

    In this paper we show that our device, the size of a pea, can activate the motor cortex, which results in the patient moving their hand. In the future, we can place the implant above other parts of the brain, like the prefrontal cortex, where we expect to improve executive functioning in people with depression or other disorders.”


    Jacob Robinson, professor of electrical and computer engineering and of bioengineering, Rice University

    Existing implantable technologies for brain stimulation are powered by relatively large batteries that need to be placed under the skin elsewhere in the body and connected to the stimulating device via long wires. Such design limitations require more surgery and subject the individual to a greater burden of hardware implantation, risks of wire breakage or failure and the need for future battery replacement surgeries.

    “We eliminated the need for a battery by wirelessly powering the device using an external transmitter,” explained Joshua Woods, an electrical engineering graduate student in the Robinson lab and lead author on the study published in Science Advances. Amanda Singer, a former graduate student in Rice’s applied physics program who is now at Motif Neurotech, is also a lead author.

    The technology relies on a material that converts magnetic fields into electrical pulses. This conversion process is very efficient at small scales and has good misalignment tolerance, meaning it does not require complex or minute maneuvering to activate and control. The device has a width of 9 millimeters and can deliver 14.5 volts of stimulation.

    “Our implant gets all of its energy through this magnetoelectric effect,” said Robinson, who is founder and CEO of Motif, a startup working to bring the device to market. “The physics of that power transfer makes this much more efficient than any other wireless power transfer technologies under these conditions.”

    Motif is one of several neurotech companies that are probing the potential of BCIs to revolutionize treatments for neurological disorders.

    “Neurostimulation is key to enabling therapies in the mental health space where drug side effects and a lack of efficacy leave many people without adequate treatment options,” Robinson said.

    The researchers tested the device temporarily in a human patient, using it to stimulate the motor cortex ⎯ the part of the brain responsible for movement ⎯ and generating a hand movement response. They next showed the device interfaces with the brain stably for a 30-day duration in pigs.

    “This has not been done before because the quality and strength of the signal needed to stimulate the brain through the dura were previously impossible with wireless power transfer for implants this small,” Woods said.

    Robinson envisions the technology being used from the comfort of one’s home. A physician would prescribe the treatment and provide guidelines for using the device, but patients would retain complete control over how the treatment is administered.

    “Back home, the patient would put on their hat or wearable to power and communicate with the implant, push ‘go’ on their iPhone or their smartwatch and then the electrical stimulation from that implant would activate a neuronal network inside the brain,” Robinson said.

    Implantation would require a minimally invasive 30-minute procedure that would place the device in the bone over the brain. Both the implant and the incision would be virtually invisible, and the patient would go home the same day.

    “When you think about a pacemaker, it’s a very routine part of cardiac care,” said Sheth, professor and vice-chair of research, McNair Scholar and Cullen Foundation Endowed Chair of Neurosurgery at the Baylor College of Medicine. “In neurological and psychiatric disorders, the equivalent is deep brain stimulation (DBS), which sounds scary and invasive. DBS is actually quite a safe procedure, but it’s still brain surgery, and its perceived risk will place a very low ceiling on the number of people who are willing to accept it and may benefit from it. Here’s where technologies like this come in. A 30-minute minor procedure that is little more than skin surgery, done in an outpatient surgery center, is much more likely to be tolerated than DBS. So if we can show that it is about as effective as more invasive alternatives, this therapy will likely make a much larger impact on mental health.”

    For some conditions, epilepsy for example, the device may need to be on permanently or most of the time, but for disorders such as depression and OCD, a regimen of just a few minutes of stimulation per day could suffice to bring about the desired changes in the functioning of the targeted neuronal network.

    In terms of next steps, Robinson said that on the research side he is “really interested in the idea of creating networks of implants and creating implants that can stimulate and record, so that they can provide adaptive personalized therapies based on your own brain signatures.” From the therapeutic development standpoint, Motif Neurotech is in the process of seeking FDA approval for a long-term clinical trial in humans. Patients and caregivers can sign up on the Motif Neurotech website to learn when and where these trials will begin.

    The work was supported in part by The Robert and Janice McNair Foundation, the McNair Medical Institute, DARPA and the National Science Foundation.

    Source:

    Journal reference:

    Woods, J. E., et al. (2024) Miniature battery-free epidural cortical stimulators. Science Advances. doi.org/10.1126/sciadv.adn0858.

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  • Netherlands and WHO forge stronger partnership in global health agenda

    Netherlands and WHO forge stronger partnership in global health agenda

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    The WHO and the Netherlands convened in The Hague on 10 April 2024, to discuss joint priorities and alignment between the Dutch Global Health Strategy and WHO’s key strategic goals, marking a new milestone in their longstanding partnership.

    Rooted in the Netherlands’ unwavering commitment to global health, human rights, and universal access to comprehensive health services, the collaboration between the WHO and the Netherlands is instrumental in addressing global health challenges and fostering health and well-being, worldwide and in the country.

    Against the backdrop of ongoing conflicts, disasters, and the escalating impact of climate change, and the interconnectedness of the Dutch public health landscape in the Netherlands with global health challenges, this year’s Strategic Dialogue emerged as a critical platform for reflecting on this partnership’s long-term vision.

    In this Strategic Dialogue, throughout all sessions, WHO and the Netherlands showed a commitment to cooperation and to deepening their partnership based on the strong alignment between their respective priorities and objectives.”


    Ms. Marjolijn Sonnema, Director General for Public Health at the Netherlands’ Ministry of Health, Welfare and Sport

    A key outcome of the Strategic Dialogue was the recognition of the alignment between the Dutch Global Health Strategy and the WHO’s forthcoming 14th General Programme of Work, paving the way for synergies in areas such as health system strengthening, pandemic preparedness, climate change and health, anti-microbial resistance (AMR) and mental health support.

    “At a time when inequity in health and in access to essential health services and financial protection is increasing, disproportionately impacting the poor and most vulnerable, the Netherlands stands as a global health leader and trusted WHO partner. With shared priorities and commitment to sexual and reproductive rights, gender equity, health systems, security, climate resilience, and mental health, we look forward to strengthening our partnership to enhance the health and well-being of all, globally and in the Netherlands”, said Dr Bruce Aylward, WHO Assistant Director-General, Universal Health Coverage, Life Course.

    WHO acknowledged the Netherlands’ global leadership as a flexible donor, with an agreement around the imperative to ensure WHO’s financing is more sustainable, through the inaugural WHO Investment Round. This WHO initiative aims to mobilize predictable, sustainable and flexible resources essential for the WHO to respond swiftly and effectively to global health challenges and improve health outcomes, particularly for vulnerable populations.

    Addressing contemporary challenges such as geopolitical tensions while seizing opportunities for advancing global health objectives were also on the table during the dialogue. Both parties stressed the importance of sustained collaboration to address pressing health issues comprehensively.

    Taking stock of the joint achievements since the previous strategic dialogue in 2022

    In 2022, the Strategic Dialogue between the Netherlands and WHO called on both partners to enhance synergies between WHO priorities and the new Dutch Global Health Strategy. Implementing this approach, the Netherlands and WHO:

    • Expanded their cooperation to new areas of joint interest, e.g., climate change and health;

    • Renewed their longstanding cooperation on Water, Sanitation and Hygiene and Mental Health and Psychosocial Support in health emergencies and humanitarian settings;

    • Improved the flexibility and predictability of the Netherlands’ financial support through renewed General Arrangements with the Ministry of Foreign Affairs (2022-2025) and the Ministry of Health, Welfare and Sport (2024–2028) demonstrating the Netherlands’ commitment to WHO’s sustainable financing; 

    • Hosted together the 2nd World Local Production Forum in the Netherlands;

    • Continued and deepened their technical cooperation through secondments, Junior Professional Officers and the Collaborative Centres.

    The outcomes of the 2024 dialogue will inform future collaboration between the Netherlands and the WHO, so that efforts are aligned, and the optimal use of resources is helps achieve improved health outcomes worldwide. The enduring partnership between the Netherlands and the WHO stands as a cornerstone in the global health landscape, reflecting a shared commitment to advancing health and well-being globally.

    Source:

    The World Health Organization

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