1. Positive father-child relationship can moderate negative effects of maternal depression

    May 24, 2017 by Ashley

    From the Bar-Ilan University press release:

    Maternal depression negatively impacts children’s emotional and cognitive development and family life. Studies have shown that a home in which the mother suffers from depression exhibits lower cohesion, warmth, and expressiveness and higher conflict, rigidity, and affectionless control. Since 15-18% of women in industrial societies and up to 30% in developing countries suffer from maternal depression, it is of clinical and public health concern to understand the effects of maternal depression on children’s development.

    A family affair

    A new study, published in Development and Psychopathology, by Prof. Ruth Feldman and colleagues at the Department of Psychology and Leslie and Susan Gonda (Goldschmied) Multidisciplinary Brain Research Center at Bar-Ilan University has, for the first time, examined whether fathering can moderate the negative effects of maternal depression on family-level functioning. The results of this study are the first to describe the family process by using direct observations of mothering, fathering, and family patterns in homes where mothers suffer clinical depression during the child’s first years of life.

    Feldman conducted a longitudinal study of a carefully selected sample of married or cohabiting chronically depressed women with no comorbid contextual risk, who were repeatedly assessed for maternal depression across the first year after childbirth and when the child reached age six. The families were home-visited when the child reached preschool age in order to observe and videotape mother-child, father-child, and both-parent-child interactions.

    Sense and sensitivity

    During the first years of life, sensitivity marks the most critical component of the parental style that affects the child’s emotional and social development. Sensitive parents are attuned to their child’s needs and attend to them in a responsive and nonintrusive manner. Parents who act intrusively tend to take over tasks that children are, or could be, performing independently, imposing their own agenda without regard for the child.

    In Feldman’s study depressed mothers exhibited low sensitivity and high intrusiveness, and children displayed lower social engagement during interactions with them. Partners of depressed mothers also showed low sensitivity, high intrusiveness, and provided little opportunities for child social engagement, so that the family unit was less cohesive, harmonious, warm, and collaborative. However, when fathers were sensitive, nonintrusive, and engaged children socially, maternal depression no longer predicted low family cohesion.

    Feldman: “When fathers rise to the challenge of co-parenting with a chronically depressed mother, become invested in the father-child relationship despite little modeling from their wives, and form a sensitive, nonintrusive, and reciprocal relationship with the child that fosters his/her social involvement and participation, fathering can buffer the spillover from maternal depression to the family atmosphere.”

    According to Feldman, because rates of maternal depression appear to increase each decade, and paternal involvement in child care is constantly increasing in industrial societies, it is critical to address the fathers’ potential contribution to family welfare by providing interventions for the development of a sensitive parenting style and other compensatory mechanisms, in order to enhance their role as buffers of the negative effects of maternal depression.

    This study was supported by the Israel Science Foundation, the Simms-Mann Foundation, and the Irving B. Harris Foundation.


  2. Study suggests exercise can help with boosting mood

    May 23, 2017 by Ashley

    From the University of Connecticut press release:

    You don’t have to spend hours at the gym or work up a dripping sweat to improve your mood and feel better about yourself, researchers at the University of Connecticut say in a new study.

    If you lead a sedentary lifestyle — spending large parts of your day sitting at home or at work — simply getting out of your chair and moving around can reduce depression and lift your spirits.

    “We hope this research helps people realize the important public health message that simply going from doing no physical activity to performing some physical activity can improve their subjective well-being,” says Gregory Panza, a graduate student in UConn’s Department of Kinesiology and the study’s lead author.

    “What is even more promising for the physically inactive person is that they do not need to exercise vigorously to see these improvements,” Panza continues. “Instead, our results indicate you will get the best ‘bang for your buck’ with light or moderate intensity physical activity.”

    For those keeping score, light physical activity is the equivalent of taking a leisurely walk around the mall with no noticeable increase in breathing, heart rate, or sweating, says Distinguished Kinesiology Professor Linda Pescatello, senior researcher on the project. Moderate intensity activity is equivalent to walking a 15-20-minute mile with an increase in breathing, heart rate, and sweating, yet still being able to carry on a conversation. Vigorous activity is equivalent to a very brisk walk or jogging a 13-minute mile with a very noticeable increase in breathing, heart rate, and sweating to the point of being unable to maintain a conversation.

    The study looked at 419 generally healthy middle-aged adults who wore accelerometers on their hips to track physical activity over four days. Participants also completed a series of questionnaires asking them to describe their daily exercise habits, psychological well-being, depression level, pain severity, and extent to which pain interfered with their daily activities.

    Here’s what the researchers learned:

    • People who reported higher levels of sedentary behavior also reported lower levels of subjective well-being, meaning those who sat around a lot were the least happiest. Subjective well-being is defined as the positive and negative evaluations that people make of their own lives. These results confirmed previous studies.
    • In general, physical activity improved people’s sense of well-being. Yet, different intensities of physical activity were more beneficial to some people than others. For instance, people who participated in light-intensity physical activity reported higher levels of psychological well-being and lower levels of depression. People who participated in moderate-intensity physical activity reported higher levels of psychological well-being and lower levels of pain severity.
    • People who led sedentary lives and engaged in light or moderate physical activity showed the greatest improvement in overall sense of well-being. “The ‘more is better’ mindset may not be true when it comes to physical activity intensity and subjective well-being,” says Panza. “In fact, an ‘anything is better’ attitude may be more appropriate if your goal is a higher level of subjective well-being.”
    • While light and moderate physical activity clearly made some people feel better about themselves, when it came to vigorous activity, the results were neutral. There was no positive or negative association found between high intensity physical activity and subjective well-being.

    The last finding is actually good news for folks who enjoy hard, calorie-burning workouts, as it doesn’t support a widely reported recent study that found high intensity workouts significantly lowered some people’s sense of well-being.

    “Recent studies had suggested a slightly unsettling link between vigorous activity and subjective well-being,” says Beth Taylor, associate professor of kinesiology and another member of the research team. “We did not find this in the current study, which is reassuring to individuals who enjoy vigorous activity and may be worried about negative effects.”

    Many previous studies have attempted to identify the best exercise regimen to improve people’s sense of well-being. Yet no clear consensus has emerged. Some studies say moderate or vigorous activity is best. Others say low intensity exercise is better. The differences, the UConn researchers say, may be due to the way the studies were designed and possible limitations in how people’s well-being and levels of physical activity were measured.

    The UConn study is believed to be the first of its kind to use both objective (accelerometers) and subjective (questionnaires) measurements within a single group to examine the relationship between physical activity intensity and well-being.

    Yet the UConn research also has its limits, Panza says.

    All of the individuals who participated in the UConn study had a generally positive sense of well-being going into the project and were generally physically active. So their answers in the questionnaires need to be framed in that context. Whether the same results would hold true for people with lower subjective well-being or lower levels of physical activity is unknown, Panza says.

    Also, the conclusions formed in the UConn study are based on information gathered at a single point in time. A longitudinal study that tracks people’s feelings and physical activity over time would go a long way toward helping determine what exercise regimen might be best for different populations, Panza said.

    “If it doesn’t make us feel good, we don’t want to do it,” says Taylor. “Establishing the link between different types, doses, and intensities of physical activity on well-being is a very important step in encouraging more people to exercise.”

    The study was published in the Journal of Health Psychology in February.


  3. Severe mental illness linked to much higher risk for cardiovascular disease

    by Ashley

    From the King’s College London press release:

    An international study of more than 3.2 million people with severe mental illness reveals a substantially increased risk for developing cardiovascular disease compared to the general population.

    Led by King’s College London, the research shows that people with severe mental illness (SMI), including schizophrenia, bipolar disorder and major depression, have a 53 per cent higher risk for having cardiovascular disease than healthy controls, with a 78 per cent higher risk of developing cardiovascular disease over the longer term. Their risk of dying from the disease was also 85 per cent higher than people of a similar age in the general population.

    Published online in World Psychiatry, these findings highlight the importance of regularly screening SMI patients for cardiovascular risk and also point towards a number of potentially modifiable risk factors.

    It is well documented that people with SMI die 10 to 15 years earlier than the general population, largely due to cardiovascular disease, including heart disease, heart attack and stroke.

    This new study is the largest ever meta-analysis of SMI and cardiovascular disease, including over 3.2 million patients and more than 113 million people from the general population. The researchers examined 92 studies across four continents and 16 different countries, including the US, UK, France, Australia and Sweden.10 per cent of people with SMI had cardiovascular disease, with rates slightly higher in schizophrenia (11.8 per cent) and depression (11.7 per cent) than bipolar disorder (8.4 per cent), with a substantially increased risk for developing cardiovascular disease over time.

    The researchers identified some important factors which increase risk for cardiovascular disease, including antipsychotic use and higher body mass index. Based on these results, it is crucial that clinicians where possible choose antipsychotics with lower side effects related to weight gain, high blood pressure and glucose abnormalities.

    Clinicians should also screen for emerging and existing cardiovascular diseases, as well as proactively managing risk factors such as weight and body mass index, according to the study authors.

    Dr Brendon Stubbs from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London, said: ‘These findings are a stark reminder that people with SMI are being left behind, at a time when the health of the general population as a whole appears to be benefitting from public health initiatives to reduce the burden of cardiovascular disease. We found that the prevalence of cardiovascular disease in people with severe mental illness (SMI) was higher in more recent studies, which suggests that our efforts so far have been unsuccessful in reducing the health gap between people with SMI and the general population.

    ‘People with SMI die much earlier than those without these disorders, yet the majority of these premature deaths may be preventable with care that prioritises lifestyle changes, such as exercise, better nutrition and stopping smoking, along with cautious prescribing of antipsychotics.’


  4. Research evaluates effectiveness of yoga in treating major depression

    May 14, 2017 by Ashley

    From the Care New England press release:

    When treating depression, the goal is to help individuals achieve full recovery and normal functioning. While traditional treatment such as medication or psychotherapy is effective for many patients, some may not fully recover even with these treatments. Researchers sought to determine if the addition of hatha yoga would improve treatment outcomes for these patients. They found that the benefits of yoga were less pronounced early in treatment, but may accumulate over time.

    The research, entitled “Adjunctive yoga v. health education for persistent major depression: a randomized controlled trial,” has been published in Psychological Medicine. The research was led by Lisa Uebelacker, PhD, a research psychologist in the Psychosocial Research Department at Butler Hospital, a Care New England hospital, and an associate professor of psychiatry and human behavior at The Warren Alpert Medical School of Brown University. The team also included Gary Epstein-Lubow, MD; Ana M. Abrantes, PhD; Audrey Tyrka, MD, PhD; Brandon A. Gaudiano, PhD; and Ivan W. Miller III, PhD, of Butler Hospital and the Warren Alpert Medical School; Geoffrey Tremont, PhD and Tanya Tran of Rhode Island Hospital and the Warren Alpert Medical School; Tom Gillette of Eyes of the World Yoga; and David Strong of the University of California, San Diego.

    “The purpose of this study was to examine whether hatha yoga is effective for treating depression when used in addition to antidepressant medication,” explained Dr. Uebelacker. “We did not see statistically significant differences between hatha yoga and a control group (health education) at 10 weeks, however, when we examined outcomes over a period of time including the three and six months after yoga classes ended, we found yoga was superior to health education in alleviating depression symptoms.”

    According to Dr. Uebelacker, this is the largest study of yoga for depression to date. The team enrolled individuals with current or recent major depression who were receiving antidepressant medication and continued to have clinically significant depression symptoms. Participants were randomized into two groups – those who participated in a hatha yoga class and a control group who took part in a health education class. The intervention phase lasted 10 weeks and participants were followed for six months afterward.

    “We hypothesized that yoga participants would show lower depression severity over time as assessed by the Quick Inventory of Depression Symptomatology (QIDS), as well as better social and role functioning, better general health perceptions and physical functioning, and less physical pain relative to the control group,” said Dr. Uebelacker. “We found that yoga did indeed have an impact on depression symptoms.”


  5. Exposure to racism harms children’s health

    by Ashley

    From the American Academy of Pediatrics press release:

    New research to be presented at the 2017 Pediatric Academic Societies 2017 Meeting illustrates the unhealthy effects racism can have on children, with reported exposure to discrimination tied to higher rates of Attention Deficit Hyperactivity Disorder (ADHD), anxiety and depression, as well as decreased general health.

    Authors of the study abstract, “The Detrimental Influence of Racial Discrimination in the United States,” will present their findings on Sunday, May 7, in the Moscone Covention Center West in San Francisco. For the study, they looked at data from 95,677 participants in the 2011-12 National Survey on Children’s Health. In addition to providing physical and mental health data, caregivers of children in the survey were asked whether the child had experienced being “judged or treated unfairly” because of his or her race or ethnicity.

    After adjusting for socioeconomic status, family structure, primary language and other factors, the researchers found a significant link between exposure to racism and health. The average proportion of children reported by parents to be in “excellent health” decreased by 5.4 percent among those exposed to perceived discrimination, for example. Exposure to racism also appeared to boost the odds of ADHD by 3.2 percent.

    The biggest reduction in general health appeared among low-income, minority children, particularly Hispanic participants, said Ashaunta Anderson, MD, MPH, lead author of the study abstract and Assistant Professor of Pediatrics at the University of California, Riverside.

    Some children exposed to discrimination who were from high-income households, however, also experienced negative health effects.

    “White children with high income who experienced racial or ethnic discrimination had larger decreases in general health,” Dr. Anderson said, “while black children experiencing that combination of factors had increased rates of ADHD.”

    The study also found that children who experienced racial discrimination had twice the odds of anxiety and depression compared to children who did not experience discrimination. In turn, children with anxiety or depression had roughly half the odd of excellent general health, and four times the odds of ADHD.

    “Our findings suggest that racial discrimination contributes to race-based disparities in child health, independent of socioeconomic factors,” Dr. Anderson said, adding that coordinated efforts are needed to support children affected by discrimination with developmentally appropriate coping strategies and systems of care. In particular, she said, programs that provide positive parenting practices training and promote positive peer and role model relationships can help buffer children from the negative health effects of discrimination.


  6. Study links childhood abuse to higher incidence of self-injury in teens

    May 12, 2017 by Ashley

    From the University of Toronto press release:

    Adolescents who were physically abused or sexually abused were more likely to engage in non-suicidal self-injury than their non-abused counterparts, according to a new study from researchers at the University of Toronto and Western University. The study appears online in the journal Child Abuse & Neglect.

    “We found that about one in three adolescents with mental health problems in Ontario engaged in non-suicidal self-injury. We were surprised to find that only the experience of adversities directed towards the child (physical and sexual abuse) predicted non-suicidal self-injury and not adversities indicative of parental risk such as parental mental health issues or exposure to domestic violence” says lead author Philip Baiden, a PhD Candidate at the Factor-Inwentash Faculty of Social Work, University of Toronto. Controlling for other factors, the authors also found that adolescents who are females, had symptoms of depression, diagnosis of ADHD, and mood disorders were more likely to engage in non-suicidal self-injury. However, adolescents who have someone that they could turn to for emotional support when in crises were less likely to engage in non-suicidal self-injury.

    The researchers utilized data from a representative sample of 2,038 children and adolescents aged 8-18 years referred to community and inpatient mental health settings in Ontario. The data was collected using the interRAI Child and Youth Mental Health assessment instrument.

    “Depression is one indication that an individual is having difficulty coping with his/her life situation and being depressed can severely impact one’s ability to regulate emotions and focus almost exclusively on the negative aspect of life. Among survivors of sexual abuse, depression can also manifest itself as emotional pain, for which non-suicidal self-injury becomes an outlet” says co-author Shannon Stewart, an interRAI Fellow and Director of Clinical Training, School and Applied Child Psychology at Western University.

    Co-author Barbara Fallon, an associate professor at the Factor-Inwentash Faculty of Social Work at University of Toronto and Canada Research Chair in Child Welfare, also notes that “understanding the mechanism through which non-suicidal self-injury may occur can inform clinicians and social workers working with formerly abused children in preventing future non-suicidal self-injurious behaviours.”


  7. Study suggests depression in fathers may affect adolescents’ behaviour

    May 5, 2017 by Ashley

    From the Brigham Young University press release:

    New research from BYU social work professor Kevin Shafer shows that a dad’s depression can have a specific impact on his parenting.

    “Many studies look at moms who are depressed and how they impact children,” Shafer said. “Very few looked at how depressed fathers influence their children. As dads become more involved in their children’s lives, we thought this was an important question with significant implications for families.”

    The research, published last month, found that a father’s depression had a direct effect on both internalized and externalized behavioral problems in adolescents. Internalizing behaviors include high levels of withdrawal, anxiety and depressed mood. Externalizing behaviors are directed outward and are associated with heightened anger and aggression. In contrast, the study also showed that maternal depression impacts kids, but in more subtle ways, since most women internalize their depression.

    “Kids probably pick up on their dad’s depression in ways they don’t with mothers,” Shafer said. “Men are more likely to show anger and frustration. Children are going to notice, and it’s going to affect them.”

    Mental health awareness campaigns have been popping up across the country, especially on college campuses. Shafer says these are helpful in showing people, particular men, that it’s alright to talk about mental health openly and honestly.

    At BYU, star quarterback Tanner Mangum opened up about his own mental health battles during BYU’s recent #MentalHealthMatters campaign. His Instagram post was a revelation to many. It spread throughout social media and made local and national headlines.

    As more prominent male figures continue to share their experiences like this, Shafer says it can have a positive ripple effect with other men being more willing to share and seek help themselves. This would then benefit more than just themselves in the long run.

    “What Tanner showed is that it’s OK for men to be vulnerable and admit to mental health issues,” Shafer said. “Tanner is what many would call a man’s man. He plays football. He might be the most visible male student on this campus. We need men to understand that if they are depressed, its OK to get help. It will benefit them, their families and their communities.”

    Depression is the most common mental health issue in the United States, with approximately seven percent experiencing a major depressive episode each year and nearly 20 percent experiencing it in their lifetime.

    BYU graduate students Brandon Fielding and Doug Wendt were co-authors on the study with Shafer. Fielding recently graduated with his master’s of social work from BYU. Wendt is currently a second-year PhD student in marriage and family therapy at BYU.

    “In studying and researching men’s depression with Kevin, it has not only expanded my definitions of mental health for men, but I have become more forthcoming with friends and loved ones about my own challenges and shortcomings regarding mental health,” Field said.


  8. Neurons’ faulty wiring leads to serotonin imbalance, depression-like behavior in mice

    May 2, 2017 by Ashley

    From the Zuckerman Institute at Columbia University press release:

    Columbia scientists have identified a gene that allows neurons that release serotonin — a neurotransmitter that regulates mood and emotions — to evenly spread their branches throughout the brain. Without this gene, these neuronal branches become entangled, leading to haphazard distribution of serotonin, and signs of depression in mice. These observations shed light on how precise neuronal wiring is critical to overall brain health, while also revealing a promising new area of focus for studying psychiatric disorders associated with serotonin imbalance — such as depression, bipolar disorder, schizophrenia and autism.

    The findings were published in Science.

    “By pinpointing the genes that guide the organization of neurons, we can draw a line between changes to those genes, and the cellular, circuitry and behavioral deficiencies that can occur as a result,” said Tom Maniatis, PhD, a principal investigator at Columbia’s Mortimer B. Zuckerman Mind Brain Behavior Institute, the Isidore S. Edelman Professor and Chair of department of Biochemistry & Molecular Biophysics at Columbia University Medical Center and the studys’ senior author.

    Today’s research is the result of parallel efforts by Dr. Maniatis, his lab and collaborators across Columbia to understand how individual neurons in the brain ‘see’ each other — and how each of their hundreds, or even thousands, of branches wind through the brain without getting tangled up along the way.

    To investigate this problem, Dr. Maniatis and his team focused on a group of genes called clustered protocadherins, or Pcdhs. More than a decade ago, Dr. Maniatis’ lab discovered the human Pcdh gene cluster, and later studies by Maniatis and others revealed that these genes encode a cell surface “barcode” by which individual neurons can distinguish themselves from other neurons.

    Subsequently, collaborative studies with fellow Zuckerman Institute structural biologists Barry Honig, PhD, and Larry Shapiro, PhD, revealed the precise mechanism by which the Pcdh code is assembled at the cell surface, and how this code is “read” when neurons come in contact with each other. This allows neurons to prevent entanglements by recognizing — and steering clear of — their own branches, a process known as self-avoidance.

    In the two papers published in Science, Dr. Maniatis and his team examined the function of Pcdhs in the wiring of olfactory sensory neurons (which impart a sense of smell), and serotonergic neurons (which produce and release serotonin). The olfactory sensory neuron (OSN) study revealed that the diversity of Pcdhs, working together, produced the necessary combinations of cell-coating molecules to provide each neuron its unique identity. In the absence of diversity, OSNs fail to wire properly in the brain, and the mice fail to distinguish between different odors.

    The serotonergic neuron study revealed another important function of Pcdhs.

    “The main job of these neurons is to distribute serotonin uniformly throughout the brain, which is responsible for maintaining mood balance,” said Dr. Maniatis, who is also director of Columbia’s Precision Medicine Initiative. “To do this, the neurons lay their branches out in a precise, evenly-spaced pattern — a process called axonal tiling. However, the exact mechanism that allows them to do this remained elusive.”

    In a series of experiments in mice, Dr. Maniatis’ team pinpointed a single gene within the Pcdh cluster, called Pcdh-alpha-c2, that was responsible for the ability of serotonergic neurons to assemble into a tiled pattern throughout the brain, and thus evenly distribute serotonin.

    “We were surprised to find that, unlike other neurons that displays distinct barcodes of diverse Pcdhs, all serotonergic neurons display a single functional recognition protein,” said Dr. Maniatis. “Thus, serotonergic axonal branches can recognize and repel one another, leading to their even spacing.”

    “We found that deleting the Pcdh-alpha-c2 caused serotonergic neuron branches to become tangled and clumped together,” Dr. Maniatis continued. “Serotonin was released, but it wasn’t distributed evenly throughout the brain.”

    Silencing Pcdh-alpha-c2 also resulted in striking behavioral changes. Compared to normal, healthy mice, Pcdh-alpha-c2-deficient mice showed behavioral despair (reduced desire to escape) and enhanced fear memory (increased freezing when frightened) — both classic signs indicative of depression.

    “Serotonin imbalance has long been linked to a variety of psychiatric disorders, including depression, bipolar disorder and schizophrenia, but most studies focus on problems with the production or uptake of serotonin, not on problems with the brain’s wiring itself,” said Dr. Maniatis. “Wiring anomalies are clearly a new place to look.”

    Today’s results may also inform studies of autism. After an exhaustive genetic analysis of autistic individuals and their families by an international consortium of investigators, several hundred genes have been identified that are associated with the disorder, as documented by the Simons Foundation Autism Research Initiative (SFARI) human gene module. Among these genes is the Pcdh gene cluster — including Pcdh-alpha-c2.

    “For this pair of studies published today, we focused on two types of neurons that are well understood and have been deeply explored, but this is only the starting point,” said Dr. Maniatis. “If we are to truly understand how the brain is wired both in health and in disease, then the rest of the brain is where we have to go next.”


  9. Study looks at factors that may help in antidepressant selection

    by Ashley

    From the Elsevier Health Sciences press release:

    Selecting the antidepressant that will be most effective for a specific patient suffering from depression can be a “try and try again” process. Examining new personalized and precision psychiatry approaches, a new study in Personalized Medicine in Psychiatry shows that body mass index (BMI), sex of the patient, and symptom profile can be used to determine a personalized treatment that guides antidepressant choice and significantly improves patient outcome.

    “We are in the midst of a paradigm shift in the field of psychiatry, to find specific clinical and biological signals that help clinicians and patients decide what is the best treatment,” explained lead investigator Leanne Williams, PhD, VA Palo Alto Health Care System and the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine. “This is the shift to incorporate precision medicine approaches to improve outcomes for patients. Our study adds new knowledge to this effort, and does so for two commonly associated chronic conditions, clinical depression and obesity, that need new treatment approaches. Our results have the potential for a significant impact on the majority of patients suffering from depression who are seen in primary care and community settlings.”

    Researchers analyzed data from 659 adults (ages 18-65) with clinical depression who completed the International Study to Predict Optimized Treatment in Depression (iSPOT-D). They were randomly assigned one of three antidepressants (venlafaxine-XR, sertraline, or escitalopram) and followed for eight weeks of treatment. Height and weight were recorded and each participant completed the 17-item Hamilton Rating Scale (a self-reported depression inventory) before and after treatment to measure change in depression severity. Patients who improved so substantially that they were no longer experiencing clinical symptoms were defined as “remitters.”

    The study found that for both men and women, having a larger BMI than patients of “normal” weight predicted remission for venlafaxine-XR specifically, due to a reduction in physical symptoms, including sleep disturbance, somatic anxiety, and appetite. Females with higher BMI were likely to remit regardless of medication type and this effect was related to a change in cognitive symptoms, including thoughts of suicide and guilt.

    These findings are very well suited for immediate translation into the primary care and community settings in which most patients are treated. Primary care doctors have access to information regarding patient sex, BMI (weight relevant to height), along with symptoms of depression.

    According to lead author Erin Green, PhD, VA Palo Alto Health Care System and the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, “Although these findings require replication, they are ready for ‘prime time’ translation into clinical practice where there are currently no indicators and algorithms available for guiding treatment choice for patients with both depression and obesity.”

    “The future of psychiatry is in a precision, personalized medicine approach to refining diagnosis and tailoring treatments accordingly. This study demonstrates that currently available markers are poised to improve patient outcomes without introducing new costs. Markers such as BMI are likely to complement others being developed out of neuroimaging and genomics,” added Dr. Williams.


  10. Study suggests food insecurity can affect mental health

    May 1, 2017 by Ashley

    From the Elsevier Health Sciences press release:

    Food insecurity (FI) affects nearly 795 million people worldwide. Although a complex phenomenon encompassing food availability, affordability, utilization, and even the social norms that define acceptable ways to acquire food, FI can affect people’s health beyond its impact on nutrition. A new study published in the American Journal of Preventive Medicine determined that FI was associated with poorer mental health and specific psychosocial stressors across global regions (149 countries), independent of individuals’ socioeconomic status.

    Nearly one in three individuals (29.2%) globally experience a common mental disorder during their lifetime, such as depression, anxiety, and somatic symptom disorders. FI may be a key contributor to common mental disorders through several different mechanisms. First, by generating uncertainty over the ability to maintain food supplies or to acquire sufficient food in the future, FI can provoke a stress response that may contribute to anxiety and depression. Furthermore, acquiring foods in socially unacceptable ways can induce feelings of alienation, powerlessness, shame, and guilt that are associated with depression. FI may also magnify socioeconomic disparities within households and communities that could increase cultural sensitivities and influence overall mental well-being.

    Andrew D. Jones, PhD, of the Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA, conducted this research using data from the 2014 Gallup World Poll (GWP). The GWP is a series of nationally representative surveys of individuals 15 years and older that uses probability sampling covering both urban and rural areas. FI data were available for 147,826 individuals across 11 world regions encompassing 149 countries. The extent of FI ranged from 18.3% in East Asia to 76.1% in Sub-Saharan Africa.

    Mental health status was determined using the Negative Experience Index (NEI) and the Positive Experience Index (PEI), two five-question surveys that examine topics such as pain, sadness, enjoyment, feelings of respect, and other factors. Data for the mental health indices were available for 152,696 individuals. The PEI was highest in Latin America and the Caribbean region (79.4) and lowest in Russia and the Caucasus (59.2), while the NEI was lowest in Central Asia (17.4) and highest in the Middle East and North Africa region (34.9).

    Dr. Jones found that FI was associated with poorer mental health status in a dose-response fashion, comparing NEI vs. FI for multiple age ranges. An inverse effect was found for PEI vs. FI data.

    The consistent dose-response trend suggests a causal association between FI and mental health status. According to Dr. Jones, “This trend suggests that the psychosocial stressors that underlie the mental health indices examined may be amplified with increasing FI. For example, anxiety related to one’s ability to acquire sufficient food in the future may be provoked even under conditions of mild FI, and is likely to increase with moderate and severe FI. Alternatively, multiple pathways from FI to poorer mental health may be invoked with increasing severity of FI. Under conditions of more severe FI, for example, individuals may resort to acquiring food in socially unacceptable ways as a coping strategy. The feelings of shame and guilt associated with this behavior could compound pre-existing anxiety precipitated by mild FI to yield even poorer mental health conditions.”

    Dr. Jones acknowledges the possibility that the direction of the association between FI and mental health status could be the reverse — that poor mental health could drive FI. However, this is the first study to carry out a global analysis of this association and it should inspire further research. Dr. Jones explained, “Developing robust monitoring systems and strengthening the measurement of both FI and mental health to more comprehensively understand their relation across contexts may help to inform interventions that can effectively address the mental health consequences of FI.”