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Tag: mental health

  • Genetic link between PTSD and Alzheimer’s debunked in veterans study

    Genetic link between PTSD and Alzheimer’s debunked in veterans study

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    Previous studies have suggested that combat veterans who develop post-traumatic stress disorder (PTSD) are at three to four times the risk for future dementia, which may be attributed to genetic risk factors. In a recent study published in Nature Mental Health, researchers identify shared genetic loci among military veterans with late-onset Alzheimer’s disease and related dementias (ADRD).

    Study:  No replication of Alzheimer’s disease genetics as a moderator of the association between combat exposure and PTSD risk in 138,592 combat veterans. Image Credit: Prostock-studio / Shutterstock.com Study:  No replication of Alzheimer’s disease genetics as a moderator of the association between combat exposure and PTSD risk in 138,592 combat veterans. Image Credit: Prostock-studio / Shutterstock.com

    The APOE gene

    Specific variants of APOE, the gene that codes for apolipoprotein E (APOE), confer a substantial risk for Alzheimer’s disease (AD). For example, two copies of the E4 variant are associated with a 14-fold or more increased risk of AD among those of European ancestry and a three—to four-fold increased risk among those of African ancestry.

    The APOE4 ε4 variant adversely affects the clearance of abnormal amyloid beta (Aβ) in the brain, which is the pathognomonic feature of AD. Other pathways affected by this gene include neuroplasticity, neuroinflammation, neurogenesis in the hippocampus, and glucose metabolism. The APOE4 variant also increases the risk of cardiovascular and metabolic disease.

    Previous studies have reported an increased risk of dementia in APOE ε4 carriers who develop PTSD. These individuals also exhibit a more significant decline in cognitive performance with PTSD. PTSD may also be more common or more severe in APOE ε4 carriers after triggering exposures such as combat situations; however, evidence for this association is mixed and requires further research.

    About the study

    The current study examined the association between APOE variants and PTSD following combat exposure and head injury. The researchers also assessed the relationship between a polygenic risk score (PRS) for AD that did not include the APOE loci to identify possible non-APOE genetic risks common to both AD and PTSD.

    Study participants were part of the United States Department of Veterans Affairs’ Million Veteran Program (MVP). All study participants were combat-deployed and represented individuals of both European (EUR) and African ancestries (AA).

    The AA cohort was significantly lower in proportion to the EUR cohort. The subjects were further classified by age as young, middle-aged, and older. Each category had a relatively larger number of subjects than any earlier study.

    Study findings

    PTSD severity was strongly correlated with combat exposure. Middle-aged and older veterans were less likely to have PTSD; however, among younger veterans, the risk of PTSD increased with age.

    The presence of the APOE ε4 variant did not affect PTSD severity, irrespective of ethnicity or age.

    PTSD severity showed a rising trajectory in individuals with a history of head injury in all age groups. When combat exposure and head injury were considered, no correlation was observed with the APOE ε4 variant in moderating PTSD severity.

    The AD PRS did not significantly affect PTSD severity nor interact with a head injury to affect PTSD severity risk. None of these factors could predict current PTSD risk.

    Conclusions

    The largest AD genetic risk factor, APOE ε4, does not increase risk for PTSD, either alone or in interaction with combat stress or head injury.”

    Thus, earlier reports of interactions between the APOE ε4 variant and either PTSD diagnosis or severity may be attributed to non-generalizable sample-specific effects.

    The lack of an interaction between the APOE ε4 variant and PTSD reflects the findings from previous large-scale genome-wide association studies (GWAS) of PTSD. This dismisses earlier theories that the APOE ε4 variant increases the risk for PTSD and, in later life, dementia.

    The higher risk of ADRD in individuals with a history of PTSD cannot be attributed to genetic or biological factors that are shared between both conditions. Thus, although APOE variants that predict AD risk cannot be used to predict PTSD, the biological effects of chronic PTSD may be responsible for adverse effects on brain health.

    Alternatively, PTSD may result in chronic stress, inflammation, and damage to the cardiovascular system and metabolic pathways, which may lead to neuronal oxidative stress and damage. These effects could be exacerbated by combat exposure and head injury, which increase the risk of both PTSD and AD.

    A final hypothesis is that the correlation of PTSD is not with AD but with other dementias, which remains unobserved due to the rigor of current diagnostic processes. Thus, future studies are needed to explore these mechanisms to support the development of targeted interventions.

    Simultaneously, AD needs to be more accurately defined for diagnostic purposes. By improving AD diagnostic strategies, other types of dementias may be studied for possible relationships with PTSD.

    Journal reference:

    • Woll, E. J., Miller, M. W., Zhang, R., et al. (2024). No replication of Alzheimer’s disease genetics as a moderator of the association between combat exposure and PTSD risk in 138,592 combat veterans. Nature Mental Health. doi:10.1038/s44220-024-00225-1.

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  • UC San Diego researchers discover genetic connections to alcohol consumption

    UC San Diego researchers discover genetic connections to alcohol consumption

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    A research group centered at the University of California San Diego School of Medicine has drilled deep into a dataset of over 3 million individuals compiled by the direct-to-consumer genetics company 23andMe, Inc., and found intriguing connections between genetic factors influencing alcohol consumption and their relationship with other disorders.

    The study was recently published in the Lancet eBioMedicine.

    Sandra Sanchez-Roige, Ph.D., corresponding author and associate professor at UC San Diego School of Medicine Department of Psychiatry, explained that the study used genetic data to broadly classify individuals as being European, Latin American and African American. Such classifications “are needed to avoid a statistical genetics pitfall called population stratification,” noted co-author Abraham A. Palmer, Ph.D., professor and vice chair for basic research in the psychiatry department.

    The researchers analyzed genetic data from the 3 million 23andMe research participants, focusing on three specific little snippets of DNA known as single-nucleotide polymorphisms, or SNPs. Sanchez-Roige explained that variants, or alleles, of these particular SNPs are “protective” against a variety of alcohol behaviors, from excessive alcohol drinking to alcohol use disorder.

    One of the alcohol-protective variants they considered is very rare: the most prevalent among the three alleles found in the study showed up in 232 individuals of the 2,619,939 European cohort, 29 of the 446,646 Latin American cohort and in 7 of the 146,776 African American cohort; others are much more common. These variants affect how the body metabolizes ethanol -; the intoxicating chemical in alcoholic beverages.

    The people who have the minor allele variant of the SNP convert ethanol to acetaldehyde very rapidly. And that causes a lot of negative effects.”


    Sandra Sanchez-Roige, Ph.D., corresponding author and associate professor at UC San Diego School of Medicine Department of Psychiatry

    She went on to say that the resulting nausea eclipses any pleasurable effects of alcohol -; think of a bad hangover that sets in almost immediately.

    “These variants are primarily associated with how much someone may consume alcohol,” she said. “And they also tend to prevent alcohol use disorder, because these variants are primarily associated with the quantity of alcohol someone may drink.”

    Sanchez-Roige explained that the SNP variants’ influence on alcohol consumption are well researched, but her group took a “hypothesis-free” approach to the 23andMe dataset, which contains survey data on thousands of traits and behaviors. The researchers wanted to find out if the three SNP variants might have any other effects beyond alcohol consumption.

    Sanchez-Roige and Palmer noted that their group has developed a 10-year partnership with 23andMe that has focused on numerous traits, especially those with relevance for addiction. This work is the basis of an academic collaboration through the 23andMe Research Program. 

    They data-mined the analyses of DNA from saliva samples submitted by consenting 23andMe research participants, as well as the responses to the surveys of health and behavior available from the 23andMe database, and found a constellation of associations, not necessarily connected with alcohol. Individuals with the alcohol-protecting alleles had generally better health, including less chronic fatigue and needing less daily assistance with daily tasks.

    But the paper notes individuals with the alcohol-protective alleles also had worse health outcomes in certain areas: more lifetime tobacco use, more emotional eating, more Graves’ disease and hyperthyroidism. Individuals with the alcohol-protective alleles also reported totally unexpected differences, such as more malaria, more myopia and several cancers, particularly more skin cancer and lung cancer, and more migraine with aura. 

    Sanchez-Roige acknowledged that there is a chicken-and-egg aspect to their findings. For example: Cardiovascular disease is just one of a number of maladies known to be associated with alcohol consumption. “So is alcohol consumption leading to these conditions?” she asks. Palmer finishes the thought: “Or do these genetic differences influence traits like malaria and skin cancer in a manner that is independent of alcohol consumption?”

    Sanchez-Roige said that such broad, hypothesis-free studies are only possible if researchers have access to very large sets of data. Many datasets, including the one used in the study, rely heavily on individuals with European ancestry.

    “It is important to include individuals from different ancestral backgrounds in genetic studies because it provides a more complete understanding of the genetic basis of alcohol behaviors and other conditions, all of which contributes to a more inclusive and accurate understanding of human health,” she said. “The study of only one group of genetically similar individuals (for example, individuals of shared European ancestry) could worsen health disparities by aiding discoveries that will disproportionately benefit only that population.”

    She said their study opens numerous doors for future research, chasing down possible connections between the alcohol-protective alleles and conditions that have no apparent connection with alcohol consumption.

    “Understanding the underlying mechanisms of these effects could have implications for treatments and preventative medicine,” Sanchez-Roige noted. 

    Co-authors on the paper from the University of California San Diego School of Medicine Department of Psychiatry are Mariela V. Jennings, Natasia S. Courchesne-Krak, Renata B. Cupertino and Sevim B. Bianchi. Sandra Sanchez-Roige is also associated with the Department of Medicine, Division of Genetic Medicine, Vanderbilt University.

    Other co-authors are: José Jaime Martínez-Magaña, Department of Psychiatry, Division of Human Genetics, Yale University School of Medicine; Laura Vilar-Ribó, Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d’Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain; Alexander S. Hatoum, Department of Psychology & Brain Sciences, Washington University in St. Louis; Elizabeth G. Atkinson, Department of Molecular and Human Genetics, Baylor College of Medicine; Paola Giusti-Rodriguez, Department of Psychiatry, University of Florida College of Medicine; Janitza L. Montalvo-Ortiz, Department of Psychiatry, Division of Human Genetics, Yale University School of Medicine, National Center of Posttraumatic Stress Disorder, VA CT Healthcare Center; Joel Gelernter, VA CT Healthcare Center, Department of Psychiatry, West Haven CT; and Departments of Psychiatry, Genetics & Neuroscience, Yale Univ. School of Medicine; María Soler Artigas, Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d’Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Mental Health, Hospital Universitari Vall d’Hebron, Barcelona; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid; and Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona; Howard J. Edenberg, Department of Biochemistry and Molecular Biology, Indiana University School of Medicine; and the 23andMe Inc. Research Team, including Sarah L. Elson and Pierre Fontanillas.

    The study was funded, in part, by Tobacco-Related Disease Research Program grants T32IR5226 and 28IR-0070, National Institute of Health (NIH) National Institute of Drug Abuse (NIDA) DP1DA054394, and NIH National Institute of Mental Health (NIMH) R25MH081482. 

    Source:

    University of California San Diego

    Journal reference:

    Jennings, M. V., et al. (2024) A phenome-wide association and Mendelian randomisation study of alcohol use variants in a diverse cohort comprising over 3 million individuals. Lancet eBioMedicine. doi.org/10.1016/j.ebiom.2024.105086.

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  • Feeling lonely? It may affect how your brain reacts to food, new research suggests

    Feeling lonely? It may affect how your brain reacts to food, new research suggests

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    In a recent study published in JAMA Network Open, researchers investigated the associations between individuals’ perceived levels of social isolation and brain patterns related to food cues, psychological outcomes, and obesity.

    Their results indicate that loneliness can lead to challenges in control and motivation when responding to foods and have important implications for the development of effective treatments for obesity.

    ​​​​​​​Study: Social Isolation, Brain Food Cue Processing, Eating Behaviors, and Mental Health Symptoms. Image Credit: Mansoreh/Shutterstock.com​​​​​​​Study: Social Isolation, Brain Food Cue Processing, Eating Behaviors, and Mental Health Symptoms. Image Credit: Mansoreh/Shutterstock.com

    Background

    Perceived social isolation, or loneliness, is known to have significant impacts on health, including mental health disorders, cardiovascular disease, and obesity. The negative health consequences of social isolation were widely documented during the coronavirus disease 2019 (COVID-19) pandemic.

    The biological mechanisms that underlie loneliness include alterations in brain networks like the default mode network, executive control network, visual attention network, and reward network, which could lead to hypervigilance to perceived social threats, heightened self-rumination, and increased sensitivity to negative social cues.

    They may also contribute to maladaptive behaviors like overeating and substance cravings.

    Investigating the neural mechanisms that link loneliness to alterations in responses to food cues may yield important insights into what scientists have termed the ‘lonely brain’ phenomenon.

    About the study

    In this study, researchers hypothesized that loneliness is associated with increased activation in certain brain regions when viewing food cues, which correlates with worsened mental health, changed eating behaviors, and obesity measures.

    Another key hypothesis was that sweet food-related neural alterations would show stronger associations with maladaptive eating behaviors and mental health outcomes due to the well-documented rewarding nature of sugar-rich foods.

    Healthy, premenopausal female participants were recruited in Los Angeles and asked to report perceived social isolation using the Perceived Isolation Scale.

    They went through functional magnetic resonance imaging (fMRI) while being exposed to various food cues to evaluate neural responses to different food types.

    Various clinical and behavioral measures were examined, including body composition, eating behaviors, and mental health variables.

    Statistical analyses were conducted to compare demographic and clinical characteristics between high and low-perceived isolation groups. Whole-brain analyses were performed to assess perceived isolation-related differences in neural responses to the cues.

    Regions of interest (ROIs) were identified, and brain signal changes were extracted for further analysis. Multiple linear regression analyses examined associations between loneliness-related brain food cue reactivity and individual clinical and behavioral measures.

    Mediation analyses were conducted to assess the mediating effect of brain food cue reactivity on the association between perceived isolation and various outcomes of interest, such as body measurements, eating behaviors, and mental health. All analyses were adjusted for age.

    Findings

    Overall, 93 female participants aged 18 to 50 years, with a mean age of 25.38 years, were included, with 41% self-identifying as Filipino and 59% as Mexican.

    The high perceived isolation group (n=39) exhibited poorer diet quality, greater fat mass percentage, poorer mental health, and increased maladaptive eating behaviors compared to the low perceived isolation group (n=54).

    The findings from whole-brain comparisons showed that the group perceiving higher levels of social isolation reacted significantly more strongly to cues when viewing foods compared to non-foods, particularly in the region of the inferior parietal lobule (IPL).

    Specifically, when they viewed sweet foods compared to non-foods, increased reactivity was observed in multiple brain regions, including the lateral occipital cortex, inferior frontal gyrus, and IPL.

    Conversely, when they were shown savory foods compared to non-foods, the group perceiving higher levels of isolation exhibited less reactivity to cues in the dorsolateral prefrontal cortex (dlPFC) and central praecuneus.

    Brain reactivity to sweet groups only and all food groups was correlated with mental health indicators and maladaptive food consumption behaviors. However, no associations were found for the subsample of savory foods.

    When participants were shown food compared to non-food, brain reactivity was observed to mediate the correlations with reward-based eating, food cravings, and generally maladaptive eating behaviors.

    Similarly, when participants viewed sweet food compared to non-food, brain reactivity was seen to mediate associations with body fat percentage, reward-based eating, food cravings, and generally maladaptive eating behaviors.

    The association between viewing savory food and positive affect was also mediated by brain reactivity.

    Conclusions

    This study reveals that loneliness is linked to obesity, mental health symptoms, and maladaptive eating behaviors.

    Being lonely was associated with increased body fat; lonely individuals were also more likely to report maladaptive eating behaviors and increased vulnerability to psychological symptoms.

    Brain imaging showed heightened reactivity to cues in brain regions associated with social cognition and executive control, suggesting an imbalance in sensitivity to internal states and external cues.

    Sweet foods particularly influenced neural responses, potentially due to their rewarding nature and analgesic effect.

    These findings underscore the role of altered brain processing in mediating the association between social isolation and adverse health outcomes, highlighting the importance of holistic interventions targeting both body and mind.

    Journal reference:

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  • Study highlights COVID-19 challenges for perinatal women in Latino communities

    Study highlights COVID-19 challenges for perinatal women in Latino communities

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    Public policies blocked many families of Mexican descent living in the U.S. from accessing vital services such as food and mental health care during the COVID-19 pandemic, even though these communities experienced some of the highest infection and mortality rates.

    Thirty-eight perinatal women and mothers of young children were interviewed about the challenges they faced during the pandemic and proposed solutions to better meet the needs of their communities during future large-scale crises in a study led by University of Illinois Urbana-Champaign kinesiology and community health professor Sandraluz Lara-Cinisomo.

    Co-authors of the study are molecular anthropologist Amy L. Non of the University of California-San Diego; Kimberly D-Anna-Hernandez, a professor of psychology at Marquette University; and U. of I. graduate student Mary Ellen Mendy and undergraduate students Jessica Avalos and Jacqueline Marquez.

    The women in the study discussed the stressors they encountered during the pandemic, including their difficulties accessing mental health treatment, child care and food. Their suggestions and insights were used to identify actionable policies and programs that could help meet the needs of Latino communities during future emergencies.

    The participants, who were interviewed between September 2021 and December 2022, were part of a longitudinal study that recruited them from a clinic in San Diego, one of the U.S. cities with large Latino populations of Mexican heritage.

    The women were about 36 years old on average. Although about 81% of them were born in Mexico, many had resided in the U.S. for 17 years or more. About 31% reported having an annual household income of less than $21,000, while a similar percentage earned $40,000 or more, according to the study.

    Lara-Cinisomo said participants faced complex stressors during the pandemic. Half of the women in the study said their families had challenges obtaining food due to loss of income and subsidies such as school lunches, as well as supply chain shortages and consumer stockpiling.

    While early in the pandemic various federal and state programs and policies were deployed to mitigate people’s risks for exposure and enhance families’ economic security, millions of tax-paying families of Mexican descent and other Latino backgrounds were excluded because of restrictions and exclusions set by those programs.”

    Sandraluz Lara-Cinisomo, University of Illinois Urbana-Champaign kinesiology and community health professor

    The researchers found that more than twice as many Spanish speakers reported food-related issues compared with their English-speaking counterparts.

    “Policymakers should consider how language barriers increase the risks of Spanish-speaking families losing out on benefits designed to meet their needs, such as CalFresh,” California’s iteration of the federal SNAP food assistance program for low-income people, Lara-Cinisomo said.

    “Communicating food and health and safety information in linguistically appropriate media, such as texts, videos or commercials, is vital to ensure accessibility to people with differing literacy and technological skills and should be carefully considered by policymakers.”

    Involving trusted sources in disseminating relevant and critical information was also recommended by the participants. For marginalized communities that have experienced historical discrimination and anti-immigrant propaganda, trust in these sources is vital, Lara-Cinisomo said.

    “Research has shown that community engagement is critical in emergency preparedness and increases the likelihood of meeting the needs of marginalized communities,” Lara-Cinisomo said. Accordingly, she and her team recommended developing a contingency plan to train culturally and linguistically competent community health workers to cultivate networks of trusted community members to assist in crisis communication efforts.

    Some women discussed feeling anxiety about the uncertainties associated with the pandemic, such as lockdowns and conflicting health information. These feelings were exacerbated by employment disruptions, pregnancy, and food access problems, and their concerns extended to family members residing in other households and those living in Mexico, participants told the researchers.

    The majority of those interviewed advocated broadening access to food subsidy programs such as WIC and SNAP to offset income losses and food shortages during large-scale crises, along with providing public awareness campaigns about local food banks and assistance programs.

    Even though California provides more services for undocumented immigrants -; including paid family leave and one year of emergency coverage with mental health services under Medi-Cal, the state’s Medicaid plan, for pregnant women -; caring for their mental health needs was a significant problem for many participants. Fifteen women reported needing mental health care, but twice as many of the English-speaking women mentioned these issues compared with their Spanish-speaking counterparts, the researchers found.

    The researchers hypothesized that this difference may have been associated with cultural beliefs, with Spanish-speaking women feeling less comfortable disclosing mental health problems because of stigmatization compared with those who spoke English. Or, it may have been that those who spoke Spanish were more resilient or more concerned about immediate needs such as food assistance, the team said.

    Participants recommended broadening access to mental health services for mothers and their families, promoting awareness with providers and patients, and disseminating mental health information and resources through videos and other media and via programs such as WIC.

    Many of the women -; largely those who spoke only Spanish -; reported difficulties obtaining personal protective equipment and sanitization supplies because of shortages, consumer stockpiling, and price gouging, in keeping with other studies that showed low-income and marginalized communities were disproportionately affected.

    Although the study sample was small, Lara-Cinisomo said it highlighted critical needs for responsive, culturally appropriate policies and programs to ensure the well-being of Mexican-descent perinatal women and mothers of young children during public health crises.

    Lara-Cinisomo discussed the team’s findings and study participants’ recommendations during a virtual Briefing on Perinatal Health and Well-being on April 3 hosted by the journal Health Affairs, which published the study.

    Source:

    University of Illinois at Urbana-Champaign

    Journal reference:

    Lara-Cinisomo, S., et al. (2024). Solutions From Mexican-Descent Perinatal Women To Pandemic-Related Food, Mental Health, And Health And Safety Stressors. Health Affairs. doi.org/10.1377/hlthaff.2023.01492.

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  • Study shows positive impact of medical marijuana laws on mental health

    Study shows positive impact of medical marijuana laws on mental health

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    The approval of marijuana for medical use has had little effect on the mental health of the general population in the US. But legalization for therapeutic purposes does benefit those for whom it is intended. This is the conclusion of a study by researchers at the University of Basel.

    In the US, access to marijuana has been facilitated in most states since the mid-1990s – whether through medical clearance or through decriminalization of recreational use. However, liberalization is still controversial, and the effects on the well-being of specific groups and the therapeutic value of marijuana remain debated.

    While some fear negative consequences from addiction, others highlight the potential medical benefits for people suffering from chronic pain, nausea or convulsions.

    In a new study, researchers from Basel have now investigated whether medical cannabis legislation in the USA is improving the situation for sick people and whether it has a negative impact on the mental health of the overall population.

    Probability-based analysis

    For their analysis, the researchers combined two large datasets. They used data from almost eight million people who took part in telephone surveys between 1993 and 2018 as part of the Behavioral Risk Factor Surveillance System, which collects data about mental well-being, among other things. But they also used data from the National Survey on Drug Use and Health, which collects information on health-related issues such as drug use in the United States.

    The researchers formed different groups using statistical assignment. They include individuals who are highly likely to abstain from using marijuana, to use marijuana as a recreational drug or to use it for medical reasons. It was also possible to identify individuals with a high probability of chronic pain. Mental health was measured using self-assessment, in which respondents reported the number of days they had had mental health problems in the previous month.

    Positive effects of therapeutic use

    Using statistical methods, the researchers were able to estimate the impact of the legal approval of marijuana for medical use. The result: Easier access improves the mental health of individuals who use marijuana for medical reasons. The same applies to people who are very likely to suffer from pain. The study authors estimate that these two groups spend 0.3 days less per month in poor mental health due to the change in the law.

    At the same time, the researchers found no effect on the mental health of recreational users or on younger populations.

    Overall, our results show that medical cannabis legislation in the USA benefits the people it is intended for without harming other groups.”


    Prof. Alois Stutzer, study leader from the University of Basel

    Source:

    Journal reference:

    Kalbfuss, J., et al. (2024). Medical marijuana laws and mental health in the United States. Health Economics, Policy and Law. doi.org/10.1017/S1744133124000033.

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  • Exploring prebiotics and probiotics as dual fighters against depression and obesity

    Exploring prebiotics and probiotics as dual fighters against depression and obesity

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    Depression is among the most prevalent and potentially serious mental health disorders, accounting for up to 800,000 suicides a year. The risk factors for depression have, therefore, undergone much exploration.

    A recent study published online in Nutrients deals with the interactions between depression and nutrition, coupled with exercise.

    Study: The Role of Gut Microbiota, Nutrition, and Physical Activity in Depression and Obesity—Interdependent Mechanisms/Co-Occurrence. Image Credit: Bits And Splits/Shutterstock.comStudy: The Role of Gut Microbiota, Nutrition, and Physical Activity in Depression and Obesity—Interdependent Mechanisms/Co-Occurrence. Image Credit: Bits And Splits/Shutterstock.com

    About depression

    Depressive disorders include several categories, including persistent depressive disorder (dysthymia), premenstrual dysphoric disorder, as well as depression induced by addictive drugs or medications or by medical conditions.

    All are characterized by sadness and irritability, with bodily and mental changes. The effect is a lowered quality of life and impaired functioning.

    Moreover, depression is known to increase the risk for a number of metabolic diseases, such as diabetes, obesity, and ischemic heart disease.

    Conversely, dietary patterns are linked to mental health as well as malnutrition. For instance, excessive fat intake leads to chronic inflammation and obesity.

    Obesity

    Obesity is defined as the accumulation of body fat in excess, as measured by the body mass index (BMI) and the body fat percentage. It is associated with a higher risk of cardiovascular disease (CVD), insulin resistance, cancer, and nerve damage.

    Risk factors for obesity are well-known and include gender, age, smoking, apart from the consumption of excessive fat and of processed foods, which are typical of Western diets.

    Obesity and depression often affect the same individual, along with anxiety disorders. They have a common mechanism of action, as seen by their bidirectional association.

    People who are depressed often indulge in comfort eating, which may increase body weight, especially if the person is also inactive. The risk of obesity in people undergoing emotional stress is almost 40% higher.

    Similarly, obese people are almost 20% more likely to become anxious or depressed because of negative self-image as well as adverse social perceptions that they are too lazy or undisciplined to regulate their diet and their weight. The treatment of depression with antidepressants is effective but may cause weight increase.

    Unfortunately, both obesity and depression are among the most prevalent disorders globally and have a high death rate, leading to powerful scientific interest in their interrelationships.

    Gut microbiota

    The gut microbiota is essential to proper energy storage and metabolism, but shows marked variability in obese vs lean individuals. This includes lower diversity and fewer commensal bacteria but more pathogenic microbes in the obese. The resulting aberration in metabolism may contribute to obesity.

    The need for a rational diet along with therapies like psychotherapy and medication to treat patients with depression is stressed by some scientists.

    In addition, probiotics and prebiotics may be required, along with nutritional supplements, to correct dysbiosis and vitamin deficiencies.

    Probiotics and gut microbiota

    The researchers sought to understand how gut microbes may be useful in treating both obesity and depression and the role of probiotics and prebiotics in such therapy.

    The review suggests that about 57% of the composition of the gut microbiota responds to dietary patterns.

    Probiotics strengthen the gut barrier and modulate the immune system. Their use is associated with improving depressive symptoms, perhaps by supplying vitamin D and short-chain fatty acids (SCFAs), which combat inflammation.

    Some strains of probiotic bacteria directly affect neural pathways. They inhibit the depression-inducing hypothalamic–pituitary–adrenal axis (HPA axis), and promote the secretion of the anti-stress neurotransmitter GABA, also known as gamma-aminobutyric acid.

    Others produce gut neurotransmitters that also affect the brain, affecting the mood for the better.

    Some clinical trials in humans suggest a positive effect of probiotics on depressive disorders as well as on obesity and related metabolic conditions like insulin resistance, type 2 diabetes, and nonalcoholic fatty liver disease (NAFLD).

    Further research is essential to validate these results, especially as probiotics work well on gut health and overall disease control only as part of a holistic management strategy, including proper diet, exercise, stress regulation, and adequate sleep.

    Bacterial strains linked to improved neural pathways, sometimes called psychobiotics, include multiple Lactobacillus strains like Lactobacillus casei Shirota, Lactobacillus fermentum NS8 and NS9, and Lactobacillus rhamnosus JB-1, as well as Bifidobacterium strains like Bifidobacterium longum Rosell-175, Bifidobacterium longum 1714, and Bifidobacterium longum NCC3001.

    Diet and mental health

    The brain receives a good share of absorbed nutrients and utilizes them to keep itself healthy. For instance, regeneration, neuroplasticity, and an adequate antioxidant reserve depend on the proper supply of nutrients to the brain.

    Supplementation with fatty acids like eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), magnesium, folate, and vitamins E and D have been suggested to be beneficial in countering or mitigating severe depression and reducing neuroinflammation.

    Specific diets like the Mediterranean diet (MD), the DASH (Dietary Approaches to Stop Hypertension), or vegetarian diets have frequently been assessed for their relationship with physical and mental health.

    The authors of the current study found reduced depression and obesity risk with both the DASH and the MD, but contradictory data with vegetarian and vegan diets. However, high-quality vegetarian diets were protective against depression, underlining the pivotal role of diet quality in the type of diet chosen.

    Physical activity and obesity/mood disorders

    There is ample evidence that weight management is aided by increasing the overall energy expenditure and improving the mood, with reduced anxiety and depression. Aerobic exercise has been recommended for its ability to build fitness and help reduce weight.

    Physical exercise is linked with lengthening telomeres, a metabolic health biomarker. It is also associated with better brain health, sleep quality, and reduced depressive symptoms.

    Physical exercise is also linked to better gut microbiota composition, stronger commensals, and more anti-inflammatory bacteria.

    Early-life exercise may promote the development of bacteria that can help the host adapt to changing conditions and promote healthy brain development.

    The broader impact of obesity and depression

    Depression is associated with increased mortality and morbidity, absenteeism, severe decreases in the quality of life, and reduced productivity.

    Obesity, which is currently estimated to have a prevalence of 30% in the USA, also has profound impacts on personal and social health. It reduces female fertility, promotes loss of cognitive ability, reduces the lifespan, and may increase employment difficulty.

    Conclusions

    Obesity and depression have common origins and act to exacerbate each other. This interrelationship significantly impacts the quality of life. One possible explanation for their connections may be via gut dysbiosis.

    This has stimulated much study on the potential use of probiotics and prebiotics in depression and anxiety, as well as in obesity.

    “Encouraging findings from existing research underscore the need for robust clinical trials to evaluate the therapeutic potential of microbiota modulation.”

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  • WHO launches AI-powered empathetic digital health promoter

    WHO launches AI-powered empathetic digital health promoter

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    Ahead of World Health Day, focused on ‘My Health, My Right’, the World Health Organization (WHO) announces the launch of S.A.R.A.H., a digital health promoter prototype with enhanced empathetic response powered by generative artificial intelligence (AI).

    S.A.R.A.H. is a Smart AI Resource Assistant for Health that represents an evolution of AI-powered health information avatars, using new language models and cutting-edge technology. It can engage users 24 hours a day in 8 languages on multiple health topics, on any device.

    WHO’s digital health promoter is trained to provide information across major health topics, including healthy habits and mental health, to help people optimize their health and well-being journey. It aims to provide an additional tool for people to realize their rights to health, wherever they are.

    S.A.R.A.H., also known as Sarah, has the ability to support people in developing better understanding of risk factors for some of the leading causes of death in the world, including cancer, heart disease, lung disease, and diabetes. She can help people access up-to-date information on quitting tobacco, being active, eating a healthy diet, and de-stressing among other things. 

    The future of health is digital, and supporting countries to harness the power of digital technologies for health is a priority for WHO. S.A.R.A.H. gives us a glimpse of how artificial intelligence could be used in future to improve access to health information in a more interactive way. I call on the research community to help us continue to explore how this technology could narrow inequities and help people access up-to-date, reliable health information.”


    Dr. Tedros Adhanom Ghebreyesus, WHO Director-General 

    S.A.R.A.H. is now powered by generative AI rather than a pre-set algorithm or script helping her to provide more accurate responses in real-time; engage in dynamic personalized conversations at scale that more accurately mirror human interactions and provide nuanced, empathetic responses to users in a judgment-free environment. ​​The technology is supported by Soul Machines Biological AI. 

    WHO calls for continued research on this new technology to explore potential benefits to public health and to better understand the challenges. While AI has enormous potential to strengthen public health it also raises important ethical concerns, including equitable access, privacy, safety and accuracy, data protection, and bias.

    Continuous evaluation and refinement as part of this project emphasize WHO’s dedication to bringing health information closer to people while maintaining the highest standards of ethics and evidence-based content. Developers, policy makers and health care providers need to address these ethics and human rights issues when developing and deploying AI to ensure that all people can benefit from it.

    The S.A.R.A.H. project strives for continuous learning and development of a prototype that can inspire reliable, responsible and accessible information. 

    Previous iterations of S.A.R.A.H. were used to disseminate critical public health messages, under the name Florence, during the COVID-19 pandemic on the virus, vaccines, tobacco use, healthy eating and physical activity. 

    WHO continues to use many digitaltools and channels to disseminate and amplify health information including social media, chatbots, channels and text messaging.

    Source:

    The World Health Organization

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  • How cognitive-behavioral therapy components impact mental health

    How cognitive-behavioral therapy components impact mental health

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    In a recent study published in Science Advances, researchers tested the effects of cognitive-behavioral therapy components on cognitive mechanisms.

    Study: Different components of cognitive-behavioral therapy affect specific cognitive mechanisms. Image Credit: Microgen/Shutterstock.comStudy: Different components of cognitive-behavioral therapy affect specific cognitive mechanisms. Image Credit: Microgen/Shutterstock.com

    Background

    Psychotherapy programs are complex, multicomponent interventions that can effectively treat common mental health problems. However, there is a lack of understanding about how the different components of these programs work.

    Gaining insights into these programs is vital as delineating mechanisms can help achieve mental health research goals, such as improved efficacy, engagement, and treatment personalization.

    The study and findings

    In the present study, researchers investigated the mechanisms by which specific components of cognitive and behavioral therapies work. First, each set of measures and tasks underwent analytic and design optimizations.

    Next, various studies were performed to test whether interventions derived from distinct components of cognitive restructuring and behavioral activation therapies impact their proposed mechanisms.

    Participants completed task-based assessments twice, with their assignment to an active or a matched control intervention in between (the two).

    After these initial discovery experiments, replication tests were performed to examine the reliability of the results. After each study, participants provided clinical and demographic information.

    The team developed a short, gamified task to investigate how a goal-setting intervention affects reward-effort decision-making.

    This intervention was based on exercises from a behavioral activation therapy for low mood and comprised texts describing the significance of setting realistic goals. Participants had to select between two options that varied in effort and reward.

    The option with a higher reward required more effort. Subjects had to exert the required efforts to gain the reward within a limited time. Participants rated their sense of achievement, pleasure, and boredom after each block of trials.

    During the second time (i.e., post-intervention), the goal-setting group had to set a goal (e.g., the number of coins to be earned) before each block.

    Linear mixed-effect modeling indicated significant interactions between the intervention condition and time point (pre- and post-intervention) when choosing higher-effort and reward options.

    Moreover, there was a greater choice of higher-effort options the second time in the goal-setting group due to a reduction in effort sensitivity.

    Further, participants in the goal-setting intervention had a greater sense of achievement upon successful efforts, greater pleasure in gaining rewards, and lower boredom during the second time.

    Next, the team developed and used a causal attribution task to investigate the effects of cognitive restructuring. This intervention was based on materials from cognitive therapy for low mood.

    Subjects were presented with brief descriptions of events and instructed to select which of the four listed causal explanations they thought most likely.

    The four explanations varied in terms of describing global and internal causes. Consistently, linear mixed-effects modeling showed significant interactions between intervention and time point, i.e., pre- and post-intervention, on the choice of internal attributions for negative events.

    There was a lower choice of internal attributions for negative events during the second time in the intervention group, and this was due to a declined tendency to attribute negative events to internal (or self-related) causes.

    Further, a crossover design study was performed to test whether intervention effects were specific to their proposed mechanisms.

    To this end, individuals were randomized to intervention and task conditions to examine the effects of 1) goal setting on reward-effort decision-making relative to cognitive restructuring and 2) cognitive restructuring on causal attribution relative to goal setting.

    The team found that goal setting decreased effort sensitivity and not cognitive restructuring for participants randomized to the reward-effort decision-making task.

    Likewise, cognitive restructuring reduced internal attribution for negative events and not goal setting for those randomized to the causal attribution task. Besides, cognitive restructuring was associated with higher internal attribution for positive events.

    Finally, the researchers performed an exploratory analysis to examine whether individual (psychological) symptom profile differences might moderate intervention effects.

    As such, they merged the discovery and replication samples for each task and tested whether the effects in this combined sample were replicated in the crossover data.

    There was evidence of moderate variation in change in the mean effort sensitivity (after goal-setting) and a tendency to attribute positive events to internal causes (after cognitive restructuring).

    Conclusions

    In sum, the researchers found that a goal-setting intervention reliably increased the choice of higher-effort and -reward actions due to a selective decrease in sensitivity to required efforts when deciding how to act.

    Moreover, this was accompanied by a higher sense of achievement for efforts and pleasure for rewards. In addition, a cognitive restructuring intervention reliably reduced the tendency to attribute negative events to internal causes.

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  • Bridging the gap in mental health services for pregnant women with serious mental illness

    Bridging the gap in mental health services for pregnant women with serious mental illness

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    Women with serious mental illness (SMI) who are pregnant or planning a pregnancy face gaps in information, support and resources in mental health services, new research suggests.

    The findings, published April 1 in the peer-reviewed journal Health Affairs, highlight the need to integrate pregnancy and parenting interventions, education, and other resources for women with SMI into mental health services.

    Policies that increase mental health provider and clinic capacity to address pregnancy and parenting can dramatically improve care for women living with mental illness, which would ultimately advance maternal and child outcomes, said Dr. Nichole Goodsmith, psychiatrist and health services researcher at Veterans Affairs Greater Los Angeles Healthcare System, and assistant clinical professor of psychiatry at the David Geffen School of Medicine at UCLA.

    Our study suggests that the topic of pregnancy may be under-discussed in mental health care, leading to a missed opportunity to understand patients’ pregnancy goals and desires and offer appropriate support and services. The women we spoke to wanted more information on the potential impact of their psychiatric medications on fertility, pregnancy, fetal development, and breastfeeding. The mothers we interviewed expressed needing more parenting support and resources-;things like parenting classes, on-site childcare during mental health visits, and referrals for resources like baby supplies.”


    Dr. Nichole Goodsmith, study’s senior author 

    Goodsmith conducted the research while in the National Clinician Scholars Program at UCLA.

    The researchers conducted telephone interviews with 22 reproductive-age women being served at four Los Angeles County Department of Mental Health outpatient clinics in 2020 and 2021. Most participants were Black or Latina and had children.

    Among the findings, few women recalled discussions of pregnancy with their mental health providers, and those who did described them as “quick conversations.” In addition, many were dissatisfied with the information they received about potential safety concerns of taking their psychiatric medications in pregnancy.

    As for parenting, most described their mental health providers as helpful and supportive, though some were concerned that even talking about their mental health symptoms could lead to losing custody of their children.

    The study has some limitations, the researchers write. It was conducted in a large, urban safety-net mental health system, so the findings may not apply to other locations or populations, it surveyed only English-speaking women did not include other languages or gender identities.

    But the findings shed light on the need to build mental health providers’ capacity to discuss and address their patients’ pregnancy- and parenting-related needs.

    “Overall, results underscore the need for greater integration of pregnancy and parenting interventions, education, support, and resources into mental health services for women living with SMI,” the researchers write. “Incorporating educational content related to pregnancy and parenting into academic, professional, and continuing education curriculums can help close this knowledge gap.”

    Additional authors are Karissa Fenwick, Kristina Cordasco, and Alison Hamilton of Veterans Affairs (VA) Greater Los Angeles Healthcare System; Emily Dossett of the University of Southern California, and Rebecca Gitlin of the Los Angeles County Department of Mental Health.

    The project was funded by the National Clinician Scholars Program at UCLA, the Veterans Affairs (VA) Office of Academic Affiliations through the Health Services Research Fellowship Program (TPH 65-000-15), the VA Research Career Scientist (VA Health Services Research and Development Grant No. RCS 21-135), the VA Office of Academic Affiliations, and a K12 (K12HS26407) career development award from the Agency for Healthcare Research and Quality and the Patient-Centered Outcomes Research Institute.

    Source:

    University of California – Los Angeles Health Sciences

    Journal reference:

    Fenwick, K., et al. (2024) Addressing Pregnancy And Parenting In Mental Health Care: Perspectives Of Women With Serious Mental Illness. Health Affairs. doi.org/10.1377/hlthaff.2023.01450.

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  • Study highlights need for exercise habits among youth for long-term health

    Study highlights need for exercise habits among youth for long-term health

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    Forming a long-term recreational exercise habit as a young person has a beneficial impact on physical and mental health later in life, but some groups, such as females and academic high-achievers, miss out on these benefits disproportionately.

    A University of Adelaide study found females, people with low self-efficacy, reluctant exercisers, higher academic achievers, and those experiencing socioeconomic disadvantage are all most at risk of failing to establish regular exercise patterns during the transition from adolescence to young adulthood.

    The finding was made by examining data collected as part of the Longitudinal Survey of Australian Youth (LSAY), which also showed young Australians on average exercise less regularly every year after transitioning from high school to university and work.

    It is well known that sustained regular exercise in young people improves fitness, physical health, self-esteem, reduces distress and sets up long-term patterns that reduce disease risk in adulthood. There seems to be a critical period in people’s teens, around the age of 15, to establish these behaviors.”


    Oliver Schubert, Associate Professor from the University of Adelaide’s Adelaide Medical School and the Northern Adelaide Local Health Network

    While women’s sport is increasing in prominence, the researchers say multiple factors contribute to the gender disparity.

    “The disadvantage experienced by females is influenced by reduced opportunity, lower access, and lack of sports diversity, but also divergent parental and cultural expectations, stereotypes, and role models,” says Dr Julie Morgan, Clinical Associate Lecturer at the University of Adelaide’s Discipline of Psychiatry and lead author of the study.

    “Psychological factors, such as perceived sports competency and self-efficacy, may play an additional role. Our study highlights that more needs to be done to promote long-term regular of exercise to female adolescents.”

    Females were not the only at-risk group that came as a surprise to the researchers.

    “The risk for academic high achievers was unexpected and highlights the need to promote a balance between study and self-care to this group,” said Associate Professor Scott Clark, Head of the University of Adelaide’s Discipline of Psychiatry.

    Prior research has shown similar findings regarding the benefits of forming exercise habits, but the LSAY data provides a clearer understanding than previously possible.

    “The large size and high follow-up rate of LSAY, which follows Australian youth as they transition from school to study or work, makes it an extremely valuable resource for analyzing the impact of changes in society and policy that can influence educational, occupational and physical- and mental-health outcomes,” says Jana Bednarz, a senior statistician from the University of Adelaide who conducted the longitudinal modeling analyses.

    “Our trajectory-based analysis of repeated measurements provides more robust data than previous cross-sectional studies, where data are collected only once, and therefore provides good evidence for youth exercise policy development in Australia.”

    The researchers say outreach is required at an early stage to encourage the at-risk groups they’ve identified to develop long-term exercise habits.

    “Given the predictors of these patterns are identifiable at age 15, there is a key role for secondary school, especially in the last years, when academic achievements become more central for young people,” said Associate Professor Schubert.

    “Equally, universities and vocational training institutions could run programs to support and encourage physical activity and sport.

    “State governments and local councils need to ask whether the current leisure infrastructure supports the needs of young people. Funding and support for grass-roots community sport across gender and socioeconomic groups is critical.”

    Source:

    Journal reference:

    Morgan, J. A., et al. (2024). Long-term recreational exercise patterns in adolescents and young adults: Trajectory predictors and associations with health, mental-health, and educational outcomes. PLOS ONE. doi.org/10.1371/journal.pone.0284660.

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