Tag: mental health

Categories : Gender Mental HealthTags :

Menstrual Cycles May Impact PTSD Symptoms in Women

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New research has found that post-traumatic stress disorder symptoms in women may vary over the course of the menstrual cycle, with more symptoms during the cycle’s first few days when the hormone oestradiol is low and fewer symptoms close to ovulation, when oestradiol is high.

The results could have implications for PTSD diagnosis and treatment, said lead author Jenna Rieder, PhD, an assistant professor of psychology at Thomas Jefferson University in Philadelphia. “When in the cycle you assess women might actually affect whether they meet diagnostic criteria for PTSD, especially for people who are right on the border. And that can have real practical implications, say, for someone who is a veteran and entitled to benefits or for health insurance purposes.”

The research was published in the journal Psychological Trauma: Theory, Research, Practice and Policy.

Oestradiol is a form of oestrogen that regulates the menstrual cycle. During the follicular phase, rising oestradiol levels trigger a cascade of events that result in ovulation. Studies have linked low-oestradiol portions of the cycle to greater activation in the limbic areas of the brain, which are related to emotion, and to lower activation in the prefrontal cortex when viewing emotional content. Low oestradiol has also been linked to greater stress and anxiety as well as increased fear responses.

To find out whether those links were related to traua response, researchers studied 40 women, aged 18 to 33, all of whom had experienced or witnessed a traumatic event, such as a serious injury or sexual violence. In the lab, researchers measured the participants’ level of oestradiol in their saliva, then asked them to describe the trauma that had happened to them and the PTSD symptoms they’d experienced in the past month. They found that lower oestradiol was associated with greater self-reported symptom severity in the participants.

The researchers also measured two stress biomarkers in participants’ saliva, the hormone cortisol and the enzyme salivary alpha-amylase, before and after the participants described their trauma. Salivary alpha-amylase is related to the “fight-or-flight” stress response, and cortisol is related to the body’s slower, more sustained stress response.

“In a healthy system we want a moderate, coordinated response of both of these biomarkers,” Prof Rieder said. In the women in the low-oestradiol portions of their menstrual cycles, the researchers instead found low cortisol and high salivary alpha-amylase levels resulting from recounting their trauma stories – a pattern that’s been linked in previous studies with maladaptive stress responses.

The researchers then asked the participants to answer five daily questionnaires for 10 days spanning the high- and low-oestradiol portions of their menstrual cycles. The questionnaires measured how participants were feeling at each time (from “extremely unpleasant” to “extremely pleasant” and “extremely nonstimulated or activated” to “extremely stimulated or activated”). Participants also completed a PTSD symptom checklist each evening.

Participants were found to have greater variability in their daily moods during the low-oestradiol days of their cycle and reported more severe PTSD symptoms on those days.

This could have implications for diagnosis and treatment of PTSD in women, who have long been underrepresented in PTSD research. “PTSD for a long time was mostly studied in men, in part because it was mainly studied in veterans, who were mostly men,” Prof Rieder said.

As well as its relevance to diagnosis, knowing how the menstrual cycle affects PTSD symptoms could be useful for both clinicians and patients, according to Prof Rieder. “I think this is something that clinicians would want to know, so they can impart this knowledge as part of psychoeducation,” she said. “For women who are naturally cycling, it may be useful to understand how the menstrual cycle affects their symptoms. When you can explain what’s happening biologically, it often becomes less threatening.”

Source: American Psychological Association

Categories : Ethics and Law HospitalsTags :

Violence in the ED: A Critical Issue in Healthcare

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A study by the Mayo Clinic found that most healthcare workers experience violence in emergency departments (EDs), but they seldomly report it to anyone.

Over six months prior to being surveyed, 72% of healthcare workers and other ED staff said they had personally experienced violence (71% verbal abuse and 31% physical assault), Sarayna McGuire, MD, chief resident of Mayo Emergency Medicine in Rochester, Minnesota, reported in a series of three studies at the American College of Emergency Physicians annual meeting.

Nurses and clinicians, along with security personnel, bore the brunt of the attacks: 94% of nurses and 90% of clinicians reported experiencing verbal abuse, and 54% of nurses and 36% of clinicians reported instances of physical assault.

“The whole team is impacted by workplace violence,” Dr McGuire said to MedPage Today. “Even people coming in to draw blood are being assaulted physically and verbally abused.”

Despite this prevalent violence and 58% reporting at least moderate awareness of reporting policies, 77% of all respondents said they never or rarely report violence, while only 10% said they often or always do.

A possible explanation could be that only 7% of non-security staff said they were “extremely familiar” with the procedures. And when participants were asked why ED abuse is not usually reported, the top four reasons given were:

  • No physical injury was sustained (53% of respondents)
  • “It comes with the job” (47%)
  • Staff are too busy (47%)
  • Reporting is inconvenient (41%)

The violence is not without consequences; 18% of respondents said they are considering leaving their position due to the violence, and 48% said violence has changed the way they view or interact with patients.

Men and more experienced staff reported feeling significantly better prepared compared with women. When asked which factors staff thought were most responsible for the violence, the following feature in at least 70% of responses: alcohol, illicit drugs, and significant mental illness.

A total of 86% of respondents said they felt at least moderately prepared to handle verbal abuse, while 68% said they felt prepared to handle physical assault.

“Everyone’s feeling right now that violence has increased in healthcare [during the pandemic], and our data have showed that,” Dr McGuire said. “How is this sustainable? …There is a critical issue in healthcare.”

She added that since reporting of violence is so low, true exposure to violence is probably much higher than the study found.

Study co-author Casey M. Clements, MD, PhD, also of Mayo Emergency Medicine, added that “we know this isn’t isolated to emergency departments.”

He explained that while the study encompassed the pandemic era, violence “has been a problem for some time in healthcare” – violence is a major threat to the healthcare workforce, Dr Clements said. He added that another problem is that physicians typically do not receive any training in de-escalation — “we learn this on the job.”

For the study, the researchers sent an anonymous survey to ED staff at 20 EDs. Also included were social workers, management, and security staff. Women made up 73% of the 833 respondents. Nursing staff (31%) made up the largest medical discipline, and 16% were clinicians.

Dr McGuire suggested that a centralised reporting system would help augment reporting of violence.

“We need to change the mindset that it’s anybody’s job to be assaulted at work,” Dr Clements said. “We cannot go on having our emergency department workers being abused and assaulted on a daily basis.”

Source: MedPage Today

Categories : Gastrointestinal Mental HealthTags :

Gut Inflammation and Mental Health Link

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Using mouse models, scientists have discovered a link between gut inflammation and mental comorbidities. In response to gut inflammation like that caused by inflammatory bowel disease (IBD), they observed that the vascular barrier in the brain choroid plexus closes, clamping down access to the brain. The findings were published in Science.

Though this gut-brain vascular axis deregulation is likely a protective mechanism for the brain against inflammation, the findings suggest it may also result in the various cognitive and psychiatric symptoms that are occasionally associated with IBD.

Usually associated with intestinal inflammation, IBD can also cause a wide variety of symptoms in other organs. There is a robust link between anxiety and IBD; up to 40% of patients with IBD also present with psychiatric symptoms such as anxiety or depression. While the gut-brain axis is thought to be involved in driving these symptoms, no other related mechanisms are currently known.

Using a mouse model of intestinal inflammation, Sara Carloni and colleagues identified a potential pathogenic link between IBD and its associated mental comorbidities. According to the findings, the gut vascular barrier becomes more permeable due to the inflammatory process, which allows inflammation to spread beyond the intestines.

In response to this spread, the vascular barrier in the choroid plexus of the brain shuts down, which helps to protect the brain from inflammation. However, in doing so, the process also potentially impairs communications between organs and may hinder brain function.

In a mouse model of genetically driven closure of choroid plexus endothelial cells, Carloni and colleagues observed a deficit in short-term memory and anxiety-like behaviour. Thus, the mental deficits observed alongside IBD may result from deregulation of the gut-brain vascular axis, the authors said. This finding could be used for the development of therapeutic targets in treating some behavioural disorders.

Source: News-Medical.Net

Categories : Mental HealthTags :

Simple Talking Therapy Relieves Loneliness in Elderly

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A simple form of talking therapy, delivered telephonically by trained support workers, successfully reduced loneliness in older people left isolated during the pandemic, according to initial results from a new study.

The intervention lasted for eight weeks and was designed in partnership with older people. People were contacted weekly and were encouraged to maintain their social contacts and to stick to a daily schedule, which included both routine and enjoyable activities.

The intervention developed in the BASIL-C19 (Behavioural Activation in Social Isolation) study lasted for eight weeks and was designed in partnership with older people who had direct experience of social isolation, loneliness and depression during the pandemic.  

The importance of social connection was highlighted by the COVID pandemic and its restrictions. Pre-pandemic research identified 1.4 million older adults in England as experiencing significant loneliness with impacts on their mental health.  Research since the pandemic shows that rates of loneliness and depression have increased, particularly for those who were self-isolating.

A team of leading researchers and clinicians anticipated the impacts of the pandemic on mental health and re-focussed their research expertise to examine the psychological impact of enforced isolation, disruption to daily routines, loss of social contact and loneliness.

They designed a very brief telephone delivered intervention to combat depression and loneliness.  Older people appreciated the offer of telephone contact and they found the intervention to be helpful in maintaining daily routines and social contact.

In the preliminary results, published in PLOS Medicine, the research team found evidence of improved mental health, and a strong indication that loneliness rates were substantially reduced in the first three months. A much larger trial follow-on trial is now currently recruiting over 600 older people and is the largest study ever undertaken to tackle loneliness and depression in this way.  

Source: University of York

Categories : Mental HealthTags :

A Daily Dose of Sunshine Improves Mood and Sleep Quality

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Getting a daily dose of sunlight can improve a person’s mood and sleep quality, a new study has found.

A research team led by Monash University PhD student Angus Burns and Associate Professor Sean Cain conducted a study published in the upcoming December issue of the Journal of Affective Disorders.

The study examined 400 000 participants in the UK Biobank programme, and found that a lack of daytime light exposure was a risk factor for depressive symptoms, poor mood, and insomnia.

Burns said that most light and health-related messaging focusses on avoiding light at night, as it disrupts the circadian rhythm, but this study highlights the importance of getting enough daylight to ensure our bodies function optimally.

“In this study, we observed that the greater time spent in outdoor light during the day was associated with fewer depressive symptoms, lower odds of using antidepressant medication, better sleep and fewer symptoms of insomnia,” Burns said.

“These results may be explained by the impacts of light on the circadian system and the direct effects of light on mood centres in the brain.”

Associate Professor Cain said a few small changes to a person’s daily routine could help improve their mood, sleep, and energy levels.

“People now spend most waking hours in intermediate, artificial lighting conditions, due to reduced sunlight exposure and relatively bright night-time light exposure,” he said.

“In this study, we observed that greater time spent in outdoor light was associated with better mood outcomes, better quality sleep, and ease of wakening.

“Insufficient exposure to daytime light could be a key factor contributing to poor mood and sleep outcomes in depressive disorders. My general advice for everyone is simple: when the sun is out, get as much light as you can, but after it sets, keep it dark. Your body will thank you.”

Source: Monash University

Categories : Allergies Mental HealthTags :

A Link Between Mental Health and Allergies

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Researchers have reported finding a link between allergic diseases and mental health conditions, but one which was likely not causal.

The analysis of data from the UK Biobank was published in Clinical and Experimental Allergy. The researchers used a genetic instrument derived from associated variants for a broad allergic disease phenotype to test for causal relationships with various mental health outcomes. They also investigated whether these relationships were specific to atopic dermatitis (AD), asthma or hayfever.

The researchers found that people with asthma, atopic dermatitis, and hay fever also had a higher likelihood of having depression, anxiety, bipolar disorder, or neuroticism. However neither category appeared to play a role in causing the other. Nevertheless, future studies should investigate whether interventions that aim to improve allergic diseases might also have an effect on mental health (and vice versa).

“Our research does not rule out a potential causal effect upon the progression of disease, which is yet to be investigated and could help uncover novel treatment strategies for allergic disease or mental health traits,” said lead author Ashley Budu-Aggrey, PhD, of the University of Bristol.

Senior author Hannah Sallis, MSc, PhD, added that the research used a combination of approaches and data from several studies. “This helps to strengthen our confidence in the findings,” she said. “Establishing whether allergic disease causes mental health problems, or vice versa, is important to ensure that resources and treatment strategies are targeted appropriately.”

Source: Wiley

Categories : Mental HealthTags :

Ketamine Holds Promise as a Treatment for Depression

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New research with low doses of the anaesthetic ketamine, recently approved by the FDA for use as an antidepressant, shows the drug could provide longer-lasting relief.

Depression is often treated with selective serotonin reuptake inhibitors, or SSRIs, but they can take six weeks before symptom relief begins, and in up to 30% of people they are ineffective.

For the past two decades, however, psychiatrists have been using low doses of ketamine, normally a veterinary anaesthetic, to treat patients whose depression has not responded to other treatments. It also has hallucinogenic effects and is sometimes abused as a street drug. Its use in psychiatry was long considered “off label,” but in 2019 the U.S. Food and Drug Administration approved a nasal spray version for use as an antidepressant, followed in 2020 by expanding the approval to include patients with depression who are having suicidal thoughts or have recently tried to take their own lives or otherwise harm themselves.

The approval opened up new possibilities as well as new lines of research that may change the way psychiatrists think about depression. Dr Benjamin Brody, an assistant professor of clinical psychiatry at Cornell University is heading a programme exploring ketamine to treat the condition. “What’s so exciting about ketamine is not only that it works for people whose symptoms are not responding to traditional treatments, but it also works much more rapidly — in days or even hours,” says Dr. Brody, who developed the protocol before the spray was approved, and still prefers infusions because they allow him to tailor each dose to a patient’s weight (while the spray only comes in two pre-set doses). “For some people, ketamine really does provide almost immediate relief. That’s wonderful and very gratifying to see.”

One problem with ketamine, however, is that its positive effects wear off within weeks or months. “Another major issue,” says Dr. Brody, “is that we have so little information on the long-term effects, or what type of treatment patients will need to remain well.”

Dr Conor Liston, associate professor of neuroscience in the Feil Family Brain and Mind Research Institute, is exploring the question of how ketamine works in the long term to create more synapses in a region of the brain called the medial prefrontal cortex. The new connections seem temporary, but if they could be augmented with another treatment, a person might be permanently cured of depression.

For a study published last year in Science, Dr. Liston and his team worked with mice that exhibited depression-like behavior, as determined by their reaction to a stressful situation. A mouse that freezes more than it attempts to wriggle free, known as “motivated escape behaviour”, displays an important feature of depression. “Mice are not people, and many symptoms that we think of as core to depression — sadness, hopelessness — are hard or probably even impossible to imagine modelling in a mouse,” said Dr Liston. “But there are some things we can measure.”

Dr Liston examined the mice’s brains before administering ketamine. As predicted, lacking motivated escape behaviour was correlated with lost synapses in the medial prefrontal cortex. Just hours after one dose, the mice no longer exhibited that ‘depressed’ behaviour and their brains showed that synapses had regrown. But just like humans, depressive symptoms returned days later and the new synapses had disappeared.

Interestingly, the reduction in depressive behaviour occurred before the new synapses appeared, meaning they could not have caused the immediate relief. However, the new synapses were apparently necessary for maintaining the antidepressant effects long after the ketamine dose. If those synapses were eliminated, the mice quickly became depressed again. “We think that some kind of intervention aimed at boosting the restoration of those synapses or enhancing their survival over time could be useful for augmenting ketamine’s antidepressant effects,” said Dr. Liston, adding that it could be another drug or an intervention as simple as exercise or improved sleep, two known factors in synapse survival.

Dr Liston noted that his team’s work is just a first step and more basic science needs to be done before work involving human subjects. 

Source: Weill Cornell Medical College

Categories : Mental HealthTags :

Cannabis Use Linked to Increased Mental Health Risk

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Individuals with a history of using cannabis have a much greater risk of developing mental health problems including anxiety and depression, as well as more severe mental illnesses, according to new research.

The findings indicate the need to emphasise the importance of general practitioners to continue enquiring about recreational drug use.

While there is extensive research linking cannabis use to severe mental illnesses such as schizophrenia and psychosis, associations are less clear between cannabis use as described in patient’s GP records and mental health problems such as anxiety.

In a new study, published in Psychological Medicine, researchers reported a strong link between general practice recorded cannabis use and mental ill health in one of the largest cohorts ever studied.

Senior author Dr Clara Humpston said: “Cannabis is often considered to be one of the ‘safer’ drugs and has also shown promise in medical therapies, leading to calls for it be legalised globally. Although we are unable to establish a direct causal relationship, our findings suggest we should continue to exercise caution since the notion of cannabis being a safe drug may well be mistaken.”

Dr Joht Singh Chandan said: “The research reaffirms the need to ensure a public health approach to recreational drug use continues to be adopted across the UK. We must continue to progress measures to improve the prevention and detection of drug use as well as implement the appropriate supportive measures in an equitable manner to prevent the secondary negative health consequences.”

Drawing on primary care data from the IQVIA Medical Research Database (IMRD-UK), analysis showed that following the first recorded use of cannabis, patients were three times more likely to develop common mental health problems such as depression and anxiety. In addition, they were almost 7 times more likely to develop severe mental illnesses such as psychosis or schizophrenia.

The dataset included records from 787 GP practices gathered between 1995 and 2018. The researchers were able to include data from 28 218 patients with a recorded exposure to cannabis. These were matched to 56 208 patients who had not been using cannabis and controlled for factors such as sex and age.

The cannabis users also had much higher rates of having a recorded history of using other drugs such as heroin, cocaine and amphetamines. The next steps will be to investigate levels of cannabis use or the potency of ingredients.

Source: University of Birmingham

Categories : Diet and Nutrition Mental HealthTags :

Fruit and Vegetable Consumption Directly Increases Happiness

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Fruit and vegetable consumption and exercise can directly increase levels of self-reported happiness, according to findings from a new study.

Public health campaigns encourage healthier diets and exercise by virtue of the well-studied link between lifestyle and wellbeing, and will benefit from new findings published by the Journal of Happiness Studies showing that there is also a positive causation from lifestyle to life satisfaction.

This research is the first to identify the causation of happiness, the consumption of fruit and vegetables and exercising are related, rather than generalising a correlation. The researchers, Dr Adelina Gschwandtner (Kent’s School of Economics), Dr Sarah Jewell and Professor Uma Kambhampati (both from the University of Reading’s School of Economics), used an instrumental variable approach to filter out any effect from happiness to lifestyle. This approach revealed that it is the effect of fruit and vegetables and exercising that makes people happy and not the other way round.

The findings show individuals’ ability to delay gratification and apply self-control plays a major role in influencing lifestyle decisions, which in turn has a positive impact on wellbeing. The research also shows that men appear to exercise more, and women eat more fruit and vegetables.

Dr Gschwandtner said: ‘Behavioural nudges that help the planning self to reinforce long-term objectives are likely to be especially helpful in maintaining a healthy lifestyle. If a better lifestyle not only makes us healthier but also happier, then it is a clear win-win situation.’

Professor Kambhampati said: ‘There has been a bigger shift in recent years for healthier lifestyle choices. To establish that eating more fruit and vegetables and exercising can increase happiness as well as offer health benefits is a major development. This may also prove useful for policy campaigns around environment and sustainability.’

Source: University of Kent

Categories : Mental HealthTags :

Impacts of Sleep Deprivation Linger a Week Later

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A Polish study found that, after a week-long recovery from sleep deprivation, only reaction speed is restored to baseline levels while other functions are still lacking.

The negative impacts of sleep deficiency are well known, and include deficits in attention and memory, increased risk of car accidents, heart problems, and other medical issues. However, while some research has addressed recovery after chronic sleep deprivation, it has been unclear how much time is needed to fully recover from prolonged periods of deficient sleep.

To shed more light on this topic, Jeremi Ochab of the Jagiellonian University in Kraków and colleagues conducted a small study, published in PLOS ONE, with several healthy adults who underwent 10 days of purposeful sleep restriction followed by seven recovery days with unrestricted sleep. Participants completed the study in their normal day-to-day environments, wearing wrist sensors to track sleep and activity. Daily electroencephalography (EEG) monitored their brain activity, and they answered daily questions (Stroop tasks) to measure reaction times and accuracy.

After 7 days of recovery, the participants had not yet returned to their baseline performance on most measures of functioning. These included several EEG measures of brain activity, rest-versus-activity patterns captured by wrist sensors, and accuracy on Stroop tasks. Only their reaction times had recovered to baseline levels.

While the researchers note that it is difficult to compare these results with other studies that employed different methods, the findings contribute new insights into recovery from chronic sleep loss. Future research could include more participants, investigate longer recovery periods, and determine in what order different functions return to normal.

The authors added: “The investigation of the recovery process following an extended period of sleep restriction reveal that the differences in behavioural, motor, and neurophysiological responses to both sleep loss and recovery.”

Source: SciTech Daily