Tri-County Services

In The News

Syndicate content
Psychology, psychiatry and mental health news and research findings, every weekday.
Updated: 2 hours 50 min ago

Antidepressants During Pregnancy Tied to Greater Risk of Gestational Diabetes

12 hours 56 min ago

Taking antidepressants during pregnancy is linked to a greater risk of developing gestational diabetes, according to a new Canadian study published in the online journal BMJ Open.

Gestational diabetes is a type of diabetes that develops during pregnancy. It affects one in 5 pregnant women worldwide. Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose).

These pregnancies are prone to complications, such as overweight babies and prolonged labor due to the baby getting stuck in the birth canal. The children of these pregnancies may also be more vulnerable to obesity and diabetes later on, while the moms are more likely to develop type 2 diabetes and cardiovascular disease.

The researchers found that risk was highest among women who were taking venlafaxine, a serotonin and norepinephrine reuptake inhibitor (SNRI) that goes by the brand name Effexor, and amitriptyline (Elavil), which belongs to an older class of antidepressant, known as tricyclics.

For the study, the researchers drew on information from the Quebec Pregnancy Cohort, which incorporates three Canadian databases, and includes all pregnancies and children born in Quebec between 1998 and 2015.

Each case of gestational diabetes (20,905), identified after 20 weeks of pregnancy, was randomly matched with 10 unaffected pregnancies (209,050) of the same age and calendar year of delivery.

Antidepressant use was assessed using information on prescriptions filled for these drugs between the start of pregnancy and the diagnosis of gestational diabetes. In all, 9,741 (just over 4%) of the moms took antidepressants, singly or combined.

These included citalopram, fluoxetine, fluvoxamine, paroxetine and sertraline, all of which are selective serotonin reuptake inhibitors, or SSRIs for short; venlafaxine; and amitriptyline.

After taking into account potentially influential factors, such as the mom’s age, welfare assistance, area of residence and other underlying conditions, the researchers found that taking antidepressants during pregnancy was linked to a heightened risk of developing gestational diabetes.

Taking any of these drugs was associated with a 19% heightened risk of being diagnosed with the condition compared with not taking antidepressants during pregnancy.

The risk was greatest for two antidepressant drugs, in particular: venlafaxine (27% heightened risk); and amitriptyline (52% heightened risk). What’s more, the risk increased, the longer certain types of antidepressants were taken, specifically SNRIs and tricyclics, singly or when combined.

Short term use was linked to a 15% greater risk; medium term use was associated with a 17% greater risk; and long term use with a 29% greater risk.

When further analysis was done on a smaller group of women (21,395) who had been diagnosed with depression/anxiety before they became pregnant, the findings were similar to those of the main analysis.

This is an observational study, and as such, doesn’t establish cause. But there are some possible explanations for what they found, say the researchers.

This includes that antidepressants directly affect glucose metabolism, especially as serotonin is involved in this process. And one of the side effects of antidepressants is weight gain, a risk factor for diabetes.

But the pros and cons of taking antidepressants during pregnancy need to be weighed carefully, warn the researchers, particularly for women whose depression is severe.

“The treatment of depression is a major concern and is challenging because depression is prevalent before and during pregnancy, and untreated depression can lead to relapse during pregnancy and in the [period immediately after birth],” they write.

Source: BMJ

 

Thrashing Sleep More Common Among Veterans With PTSD

Sun, 10/13/2019 - 8:16am

Military veterans with post-traumatic stress disorder (PTSD) or concussion are much more likely to develop REM sleep behavior disorder (RBD) — a thrashing form of sleep behavior — compared to the general population, according to a new study published in the journal SLEEP.

Next, the researchers from the VA Portland Health Care System and Oregon Health & Science University (OHSU) want to investigate whether RBD might provide an early signal of neurodegenerative conditions such as Parkinson’s disease.

Typically, during REM (rapid eye movement) sleep, a person’s muscles are effectively paralyzed. In cases of RBD, however, the brain’s control of muscle paralysis is impaired, resulting in people acting out their dreams, sometimes causing injuries to themselves or their partners.

RBD is estimated to affect less than 1% of the general population. However, the researchers found that 9% of the 394 veterans in this study had RBD, and this number increased to 21% among those with PTSD.

“This is important because, in the general population, RBD has been linked to Parkinson’s disease, and RBD often precedes classic symptoms of Parkinson’s by years,” said senior author Miranda Lim, M.D., Ph.D., a staff physician at the VA and assistant professor of neurology, medicine and behavioral neuroscience in the OHSU School of Medicine.

“We don’t know whether veterans who have PTSD and higher rates of RBD will go on to develop Parkinson’s, but it is an important question we need to answer.”

Researchers suspect chronic stress on the brain may play a role in causing the sleep disorder in veterans with PTSD, as many veterans have been exposed to concussion which potentially accelerates neurodegenerative processes.

Each participant underwent an overnight sleep study at the VA Portland Health Care System between 2015 and 2017 to determine the presence of dream enactment during episodes of REM sleep. Muscle activity was monitored constantly during the 8 hours of the study in order to diagnose RBD. The findings show that participants with PTSD had over 2-fold increased odds of RBD compared to veterans without PTSD.

“RBD seems to be highly prevalent in veterans with a history of trauma,” said lead author Jonathan Elliott, Ph.D., a research physiologist at the Portland VA and assistant professor of neurology in the OHSU School of Medicine.

Doctors involved in the study, including co-authors Kristianna Weymann, Ph.D., R.N., a clinical assistant professor in the OHSU School of Nursing, and Dennis Pleshakov, a student at the OHSU School of Medicine, will continue to track research participants with RBD, looking for early signs of Parkinson’s or other neurodegenerative conditions.

Although there are several approaches to ease certain Parkinson’s symptoms, including tremor and fatigue, there is no definitive therapy to prevent the condition.

Clinical trials for promising therapies are usually conducted well after patients have been diagnosed with Parkinson’s, at a stage which may be too late to reverse the symptoms. Lim said that identifying patients with RBD presents an opportunity to identify people earlier in the disease course, and potentially provides a more viable window to test promising interventions.

“By the time a patient shows classic symptoms of Parkinson’s, it may be too late,” Lim said. “If you could intervene when people first start to show RBD, maybe you could prevent later symptoms of Parkinson’s.”

Source: Oregon Health & Science University

 

Brain Scans May Predict Suicide Risk

Sun, 10/13/2019 - 6:00am

New research has identified brain circuitry differences that might be associated with suicidal behavior in individuals with mood disorders.

The study provides a promising lead toward tools that can predict which individuals are at the highest risk for suicide, according to researchers at the University of Utah Health and the University of Illinois at Chicago.

Suicide rates are rising steadily among young adults, especially those with mood disorders, such as depression. More than half of individuals who commit suicide saw a health professional within the past 30 days, but they did not necessarily seek care for mood problems, the researchers note.

“At present, we have very few tools to identify individuals who may be at high risk for suicide-related behavior,” said Dr. Scott Langenecker, a professor of psychiatry at the University of Utah Health and senior author on the study. “Right now, we go on self-report and clinician judgment. Those are good, but they’re not great.”

Previous studies identified brain circuits associated with mood disorders: The cognitive control network (CCN), which is involved in executive function, problem-solving and impulsivity; the salience and emotional network (SEN), which is involved in emotion processing and regulation; and the default mode network (DMN), which is active when individuals are engaged in self-focused thought.

However, these studies focused primarily on depression, according to the researchers.

“This is one of the first studies to try to understand brain mechanisms that may be relevant to suicide risk,” said Dr. Jonathan Stange, an assistant professor of psychiatry at the University of Illinois at Chicago and first author on the study.

The study used resting-state functional MRI (fMRI), which captured brain images while participants were rested and calm, to assess the connectivity of these circuits in 212 young adults at the University of Illinois at Chicago and the University of Michigan.

“For risk factors involved in suicide, the tasks we have to measure are pretty nonspecific and inexact,” Langenecker said. “If we go to the level of the resting-state networks, we’re actually asking the brain to tell us which brain networks and connections are most relevant.”

The study included individuals with mood disorders and a history of suicide attempts, those with mood disorders and a history of suicidal thoughts, those with mood disorders and no history of suicidal behavior or thoughts, and healthy controls. All study participants with mood disorders were in remission, the researchers noted.

Compared with other study participants — even those with mood disorders and a history of suicidal thoughts — people with a history of suicide attempts showed less connectivity in the CCN and between the CCN and DMN, neural circuitry associated with cognitive control and impulsivity, according to the study’s findings.

These differences could present a target for treatment, according to the researchers.

“If we could figure out how to improve connectivity within this brain circuit, we might be able to reduce suicide risk in the future,” Stange said.

Stange and Langenecker emphasize the research is still in its early stages. This was a small study, with only 18 participants with mood disorders and a history of suicide attempts. It will have to be replicated in a larger number of participants, they said.

In addition, the researchers note it is not yet clear whether individuals with mood disorders and at risk for suicide have a different disease from those without such risk, or whether all individuals with mood disorders are at varying degrees of risk for suicide.

The study was published in Psychological Medicine.

Source: The University of Illinois at Chicago

From ‘Inside Out,’ Regulating Emotions to Enhance Self-Control

Sun, 10/13/2019 - 5:00am

Impulsive shopping can be costly for people who are eager to escape emotional pain, which led researchers to seek out a strategy to increase self-control in spite of negative feelings.

They were inspired by the Pixar movie “Inside Out” to research how anthropomorphic thinking — thinking of emotions as people — influenced the experience of emotions and subsequent shopping behaviors.

The researchers said they suspected that people who anthropomorphized sadness would psychologically detach from this negative emotion and feel less sad, which would increase the chances of making wiser buying decisions.

To test this hypothesis, they asked participants to write about a time when they felt very sad, such as after the loss of someone close to them.

One group wrote about who sadness would be if it came to life as a person, while a second group wrote about what sadness would be like in terms of the emotional and affective impacts.

Both groups then rated their levels of sadness on a scale of one to seven.

The results showed that participants reported lower levels of sadness after they had written about the emotion as a person, according to the researchers.

People who had anthropomorphized sadness described the emotion in ways like “a little girl walking slowly with her head down,” “a pale person with no smile,” or “someone with grey hair and sunken eyes,” according to study author Dr. Li Yang of the University of Texas at Austin.

By doing this, “people start to think of an emotion as a person who is separate from themselves, which makes them feel more detached from the sadness,” she said.

The researchers also tested whether the results were the same when participants anthropomorphized the emotion of happiness. They discovered that levels of happiness were also lower for the group that described the emotion as a person.

“It’s probably not wise to apply this strategy for positive emotions because we do not want to minimize these good feelings,” Yang said.

The researchers then explored whether decreased sadness led to better self-control when making decisions about what to buy.

Like the first experiment, participants wrote about sad experiences, then one group anthropomorphized sadness by writing about it as a person. Next, the researchers asked people in both groups to select a side dish to accompany a lunch entrée, and the choices were cheesecake or a salad. The participants who had anthropomorphized sadness were more likely to choose the salad — the healthier option that required more self-control.

Then they repeated the experiment with a different consumption choice: A computer optimized for productivity versus a computer optimized for entertainment. This time, the participants thought about sadness as a person before encountering a specific sad event: Throwing away an old laptop.

Again, the participants who anthropomorphized sadness were more likely to select the practical computer option rather than the indulgent one.

“Our study suggests that anthropomorphizing sadness may be a new way to regulate this emotion,” Yang said. “Activating this mindset is a way to help people feel better and resist temptations that may not benefit them in the long-term.”

The study was published  in the Journal of Consumer Psychology.

Source: Society for Consumer Psychology

Large Study Shows PTSD Has Strong Genetic Component

Sat, 10/12/2019 - 5:00am

In the largest and most diverse genetic study to date of post-traumatic stress disorder (PTSD), scientists reveal that PTSD has a strong genetic component similar to other psychiatric disorders.

The findings are published in the journal Nature Communications.

Despite much research, it has remained unclear why some people go on to develop PTSD after a traumatic event while others do not. Some researchers suggest that the disorder is only a social construct, but other studies point to the fact that genetics may be involved.

In the new study, researchers from the University of California (UC) San Diego School of Medicine and more than 130 additional institutions participating in the Psychiatric Genomics Consortium suggest that genetics may account for between five and 20 percent of the variability in PTSD risk following exposure to a traumatic event.

“Our long-term goal is to develop tools that might help clinicians predict who is at greatest risk for PTSD and personalize their treatment approaches,” said the study’s first and corresponding author Caroline Nievergelt, Ph.D., associate professor of psychiatry at UC San Diego School of Medicine and associate director of neuroscience in the Center of Excellence for Stress and Mental Health at the Veterans Affairs San Diego Healthcare System.

“We can’t always protect people from trauma. But we can treat them in the best ways possible, at the best time.”

The findings show that, like other psychiatric disorders and many other human traits, PTSD is highly polygenic, meaning it is associated with thousands of genetic variants throughout the genome, each making a small contribution to the disorder.

According to the findings, six genomic regions called “loci” contain variants strongly associated with disease risk, providing some clues about the biological pathways involved in PTSD.

“Based on these findings, we can say with certainty that there is just as much of a genetic component to PTSD risk as major depression and other mental illnesses,” said senior author Dr. Karestan Koenen, associate member of the Stanley Center for Psychiatric Research at the Broad Institute of MIT and Harvard.

“Our limited ability to study the living human brain and uncover the biological roots of PTSD has contributed to the lack of treatments and the stigma around this debilitating condition. Genetics helps us make new discoveries, find opportunities for new therapies, and counter that stigma,” she said.

Since many behavioral traits and psychiatric disorders have some shared genetic factors, the researchers also looked for genetic correlations between PTSD and 235 other disorders, behaviors and physical traits. They discovered significant overlap with 21, including depression, schizophrenia, neuroticism, insomnia, asthma and coronary artery disease.

“Similar to other mental disorders, the genetic contribution to PTSD correlates with that for many other traits,” said Koenen, who is also professor of psychiatric epidemiology in the Harvard T.H. Chan School of Public Health. “Further research is needed to determine what this means — whether some of the same genes that influence risk for PTSD also influence risk for other diseases like, for example, depression.”

To conduct the study, the team collaborated with the Psychiatric Genomics Consortium’s PTSD working group and Cohen Veterans Bioscience, a non-profit organization dedicated to accelerating PTSD and traumatic brain injury research.

The team built an international network of more than 200 researchers, assembling data and DNA samples from more than 60 groups of people with PTSD and control subjects, including the UK Biobank.

The data included more than 200,000 people, which is 10 times larger than the first Psychiatric Genomics Consortium PTSD study, published in 2017. The study group is also the most ancestrally diverse for any psychiatric genetics study to date, with more than 23,000 people with PTSD of European ancestry and more than 4,000 of African ancestry. It also included both civilians and members of the military.

“Our study is distinguished by the fact that it’s international and is highly diverse,” Nievergelt said. “There’s greater representation here than in most studies to date.”

The team used the data to conduct a genome-wide association study (GWAS), using statistical tests to measure the effect of common genetic variants at millions of points across the genome on someone’s likelihood of developing PTSD.

The study uncovered DNA variants at six loci that were significantly tied to PTSD risk. Three of the six loci were specific to certain ancestral backgrounds — two European and one African — and three were only detected in men.

The six loci hint that inflammatory and immune mechanisms may be at play in the disorder, which is consistent with findings from previous research.

Overall, the researchers conclude that PTSD’s heritability — the level of influence genetics has on the variability of PTSD risk in the population — is between five and 20 percent, with some variability by gender. These findings were similar across different ancestral groups.

The research team also developed a polygenic score that could potentially predict one’s risk of developing PTSD following a traumatic event. Polygenic scores take into account the effects of millions of genetic variations and create a measure that can predict a person’s risk of developing a certain trait or disorder.

The team tested their scores on data from men in the UK Biobank dataset, finding that those with the highest scores had 0.4-fold greater odds of developing than those with the lowest scores.

Similarly, when applied to data from the Million Veterans Program — a study of how genes, lifestyle and military exposures impact health and illness — individuals with the highest scores had a significant increase in re-experiencing traumatic memories — a key PTSD symptom.

The researchers assert that polygenic scores are not ready for clinical use. Even larger studies with more diverse datasets are needed to improve the accuracy of PTSD prediction and confirm the genetic findings.

Source: University of California- San Diego

 

Severe Morning Sickness May Be Risk Factor for Autism

Sat, 10/12/2019 - 12:25am

A new study discovers children whose mothers had a severe form of a morning sickness during pregnancy were 53 percent more likely to be diagnosed with autism spectrum disorder. Kaiser Permanente researchers said the condition, known as hyperemesis gravidarum, is rare and occurs in less that 5 percent of all pregnancies.

Nevertheless, researchers believe the findings are important because the research suggests that children born to women with hyperemesis may be at an increased risk of autism. “Awareness of this association may create the opportunity for earlier diagnosis and intervention in children at risk of autism,” explains lead study author Darios Getahun, M.D., Ph.D., of Kaiser Permanente Southern California Department of Research and Evaluation.

The study appears in the American Journal of Perinatology.

Experts explain that women with the severe form of morning sickness experience intense nausea and are unable to keep down food and fluids. This can lead to dangerous dehydration and inadequate nutrition during pregnancy.

To determine the extent of the association between hyperemesis gravidarum and autism spectrum disorder, researchers reviewed electronic health records of nearly 500,000 pregnant women and their children born between 1991 and 2014 at Kaiser Permanente in Southern California. They compared children whose mothers had a diagnosis of hyperemesis gravidarum during pregnancy to those whose mothers did not.

Other findings from the research included:

• Exposure to hyperemesis gravidarum was associated with increased risk of autism when hyperemesis gravidarum was diagnosed during the first and second trimesters of pregnancy, but not when it was diagnosed only in the third trimester;
• Exposure to hyperemesis gravidarum was associated with risk of autism regardless of the severity of the mother’s hyperemesis gravidarum;
• The association between hyperemesis gravidarum and autism spectrum disorder was stronger in girls than boys and among whites and Hispanics than among blacks and Pacific Islanders;
• The medications used to treat hyperemesis gravidarum did not appear to be related to autism risk.

Investigators explain that the results are consistent with the hypothesis that women experiencing hyperemesis gravidarum have poor nutritional intake. This may, in turn lead to potential long-term neurodevelopment impairment in their children.

The study cannot, however, rule out other possible explanations, such as perinatal exposures to some medications and maternal smoking.

Source: Kaiser Permanente/EurekAlert

Air Pollution Tied to Higher Rates of Violent Crime

Fri, 10/11/2019 - 11:25pm

A new series of studies from Colorado State University (CSU) reveal a strong association between short-term exposure to air pollution and aggressive behavior, in the form of aggravated assaults and other violent crimes across the continental United States.

The findings, published in the Journal of Environmental Economics and Management, were derived from daily Federal Bureau of Investigation crime statistics and an eight-year, detailed map of daily U.S. air pollution.

The paper’s lead author is Dr. Jesse Burkhardt, assistant professor in the Department of Agricultural and Resource Economics, who teamed up with fellow economist Dr. Jude Bayham in the same department; Dr. Ander Wilson in the Department of Statistics; and several air pollution experts in civil engineering and atmospheric science.

Air pollution scientists typically measure rates of pollution through concentrations of ozone, as well as of “PM2.5,” or breathable particulate matter 2.5 microns in diameter or smaller, which research has linked to health effects.

Eighty-three percent of crimes considered “violent” by the FBI are categorized as assaults in crime databases. The findings show that a 10 microgram-per-cubic-meter increase in same-day exposure to PM2.5 is linked to a 1.4% increase in violent crimes, nearly all of which is driven by crimes categorized as assaults.

Researchers also found that a 0.01 parts-per-million increase in same-day exposure to ozone is associated with a 0.97% increase in violent crime, or a 1.15% increase in assaults. Changes in these air pollution measures had no statistically significant effect on any other category of crime.

The team also discovered that 56 percent of violent crimes and 60 percent of assaults occurred within the home, which is an indication that many such crimes are tied to domestic violence.

“We’re talking about crimes that might not even be physical — you can assault someone verbally,” co-author Bayham said. “The story is, when you’re exposed to more pollution, you become marginally more aggressive, so those altercations – some things that may not have escalated – do escalate.”

The researchers were careful to correct for other possible explanations, including weather, heat waves, precipitation, or more general, county-specific confounding factors.

They also made no claims on how exposure to pollution can lead someone to become more aggressive; their results only show a strong link between such crimes and levels of air pollution.

The team published a companion paper in the Journal of Environmental Economics and Policy with similar results that used monthly crime statistics. A third paper in Epidemiology, with lead author Jesse Berman from the University of Minnesota and co-authors from CSU, used EPA pollution monitor databases and different statistical techniques and came to similar conclusions.

“The results are fascinating, and also scary,” said co-author Jeff Pierce, associate professor in the Department of Atmospheric Science and a Monfort Professor. “When you have more air pollution, this specific type of crime, domestic violent crime in particular, increases quite significantly.”

The economists calculated that a 10 percent reduction in daily PM2.5 could save $1.1 million in crime costs per year, which they called a “previously overlooked cost associated with pollution.”

Source: Colorado State University

Performance Anxiety Reduces Pre-Performance Memory

Fri, 10/11/2019 - 7:00am

New research finds that performance anticipation at work or school may hinder your ability to remember what happened before your presentation or performance. Investigators also discovered that the presence of an audience may be an important factor in pre-performance memory deficit.

University of Waterloo researchers designed the study to explore what is called the next-in-line effect. “Performance anticipation could weaken memory because people tend to focus on the details of their upcoming presentation instead of paying attention to information that occurs before their performance,” says lead author Noah Forrin.

“People who experience performance anxiety may be particularly likely to experience this phenomenon.”

Forrin and his co-authors experimented with a variety of techniques that enhance memory, including the production effect — we can remember something best if we say it aloud.

One of the study’s co-authors, psychology professor Colin MacLeod, coined the term production effect from previous research. Prior studies have identified that reading aloud involves at least three distinct processes that help to encode memory: articulation, audition and self-reference.

Research by Forrin and MacLeod has demonstrated that reading aloud is better for memory than reading silently, writing, or hearing another person speak aloud. In the new study, however, the findings suggest that the production effect has a downside: When people anticipate reading aloud, they may have worse memory for information they encounter before reading aloud.

The researchers conducted four experiments with 400 undergraduate students and found that students have worse memory for words that they read silently when they anticipate having to read upcoming words aloud (compared to when they anticipate having to read upcoming words silently).

“Our results show that performance anticipation may be detrimental to effective memory encoding strategies,” said Forrin. “Students frequently have upcoming performances — whether for class presentations or the expectation of class participation.”

“We are currently examining whether the anticipation of those future performances reduces students’ learning and memory in the classroom.”

Forrin suggests that a strategy to avoid pre-performance memory deficits relates to scheduling.

“Try to get your performance over with by being the first student in class (or employee in a meeting) to present. After that, you can focus on others’ presentations without anticipating your own.”

The paper, “Wait for it… performance anticipation reduces recognition memory,” appears in the Journal of Memory and Language.

Source: University of Waterloo

Coastal Living Tied to Better Mental Health Among England’s Poor

Fri, 10/11/2019 - 6:30am

Living near the ocean is linked to better mental health among people living in England’s poorest urban communities, according to a new study published in the journal Health and Place.

The analysis, which involved survey data of nearly 26,000 respondents, is one of the most detailed investigations ever conducted into the mental health effects of living near the coast. The findings add to the growing evidence that access to blue spaces — particularly coastal environments — might improve health and wellbeing.

Approximately one in six adults in England struggles with a mental health disorder such as anxiety and/or depression, and these conditions are even more prevalent among people from poorer backgrounds. The findings suggest that access to the coast could help reduce these health inequalities in towns and cities close to the ocean.

“Our research suggests, for the first time, that people in poorer households living close to the coast experience fewer symptoms of mental health disorders,” said study leader Dr. Jo Garrett from the University of Exeter. “When it comes to mental health, this ‘protective’ zone could play a useful role in helping to level the playing field between those on high and low income.”

For the study, researchers from the University of Exeter looked at data from the Health Survey for England and compared people’s health to their proximity to the coast — from those living less than 1 kilometer (slightly more than half a mile) away to those more than 50 km (31 miles) away.

The study represents the first time the benefits of coastal living have been demonstrated at such a detailed level according to income and comes as Natural England prepares to open access to all of England’s Coast Path by 2020. With everywhere in England within 70 miles of the sea, more people could harness the mental health benefits of living near the coast thanks to improved access.

“This kind of research into blue health is vital to convincing governments to protect, create and encourage the use of coastal spaces,” said Dr. Mathew White, environmental psychologist at the University of Exeter.

“We need to help policy makers understand how to maximise the wellbeing benefits of ‘blue’ spaces in towns and cities and ensure that access is fair and inclusive for everyone, while not damaging our fragile coastal environments.”

This work is part of the BlueHealth project, funded by the European Union’s Horizon 2020 program.

Source: University of Exeter

 

Chair Yoga May Improve Quality of Life in Dementia Patients

Fri, 10/11/2019 - 6:00am

Chair yoga may help improve quality of life in older adults with moderate-to-severe dementia, according to a new study by Florida Atlantic University (FAU).

Chair yoga provides a safe environment for stretching, strengthening and flexibility while decreasing the risk of falls by using a chair. It also provides important breathing and relaxation techniques through stationary poses and guided relaxation of various muscle groups.

“We think that the physical poses we used in the chair yoga and chair-based exercise groups were an important factor in improving quality of life for the participants in our study,” said Juyoung Park, Ph.D., lead author and an associate professor in the Phyllis and Harvey Sandler School of Social Work within FAU’s College for Design and Social Inquiry.

“It is fascinating that, although some participants showed mild levels of agitation or wandering in the intervention room prior to the yoga session, they became calm and attentive when the yoga interventionist started demonstrating yoga poses.”

“Although they did not understand the interventionist’s verbal instructions due to their cognitive impairment associated with advanced dementia, they followed the instructor’s poses.”

For the study, published in the American Journal of Alzheimer’s Disease & Other Dementias, researchers from FAU compared chair yoga with two other types of non-pharmacological interventions: chair-based exercise and music intervention.

The study involved older adults (mean average age was 84 years old) with moderate-to-severe dementia, including Alzheimer’s disease (the largest diagnostic group), Lewy Body dementia and Parkinson disease dementia. The patients were unable to participate in regular exercise or standing yoga due to cognitive impairment, problems with balance, or fear of falling.

Participants in each of the three groups attended 45-minute sessions twice a week for 12 weeks. Researchers collected data at baseline, after six weeks and after completing the 12-week intervention.

Results showed that participants with moderate-to-severe dementia could safely adhere to non-pharmacological interventions, and more than 97% of the participants fully engaged in each session.

The findings show that those in the chair yoga group improved significantly in quality-of-life scores compared to the music intervention group. Both the chair yoga and chair-exercise groups showed improvement over time, while the music intervention group declined.

In addition, both the chair yoga and chair-based exercise groups showed lower depression across all three time points when compared to the music intervention group.

The team did not find any differences in the three intervention groups on physical function, with the exception of handgrip strength, which was higher in the chair yoga group compared to the music intervention group. None of the three groups declined significantly in any of the investigated physical functional measures.

Researchers also did not find any significant between-group differences in anxiety at any time point. There were no significant between-group differences in change in depression and anxiety. The researchers also did not find significant differences among the three intervention groups for sleep quality at any of the three time points.

“We did see an increase in agitation in the chair yoga group even though this group reported a higher quality of life score, including physical condition, mood, functional abilities, interpersonal relationships, ability to participate in meaningful activities, and final situations,” said Park.

“It’s important to note that quality of life is a more comprehensive approach to biopsychosocial and behavioral function than a mere measure of agitation. Meditation and the mind-body connection component of the chair yoga program may have increased quality of life for participants in this study. This finding is consistent with our earlier studies that showed a targeted approach was successful in increasing quality of life in patients with dementia.”

Source: Florida Atlantic University

Early Prenatal Anemia May Increase Risk of Autism, ADHD

Fri, 10/11/2019 - 5:30am

A new Swedish study suggests anemia early in pregnancy may increase the risk of autism, ADHD and intellectual disability in children. Anemia is a common condition in late pregnancy and researchers discovered anemia toward the end of pregnancy did not have the same correlation.

The findings, published in JAMA Psychiatry, underscore the importance of early screening for iron status and nutrition counseling.

An estimated 15-20% of pregnant women worldwide suffer from iron deficiency anemia — lower blood oxygen levels due to a lack of iron. By the third trimester, pregnant women have nearly 50% more blood than they did pre-pregnancy in order to provide enough oxygen for both the woman and the fetus, and their iron requirements are nearly double that of nonpregnant women. Thus, the vast majority of anemia diagnoses are made toward the end of pregnancy, when blood levels are at their highest.

In the current study, the researchers examined what impact the timing of an anemia diagnosis had on the fetus’ neurodevelopment. Investigators specifically assessed if there was an association between an earlier diagnosis in the mother and the risk of intellectual disability (ID), autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) in the child.

Overall, very few women are diagnosed with anemia early in pregnancy. In this study of nearly 300,000 mothers and more than half a million children born in Sweden between 1987-2010, less than 1% of all mothers were diagnosed with anemia before the 31st week of pregnancy. Among the 5.8% of mothers who were diagnosed with anemia, only 5% received their diagnosis early on.

The researchers found that children born to mothers with anemia diagnosed before the 31st week of pregnancy had a somewhat higher risk of developing autism and ADHD and a significantly higher risk of intellectual disability compared to healthy mothers and mothers diagnosed with anemia later in pregnancy.

Among the early anemic mothers, 4.9% of the children were diagnosed with autism compared to 3.5% of children born to non-anemic mothers, 9.3% were diagnosed with ADHD compared to 7.1%, and 3.1% were diagnosed with intellectual disability compared to 1.3%.

After considering other factors such as income level and maternal age, the researchers concluded that the risk of autism in children born to mothers with early anemia was 44% higher compared to children with non-anemic mothers. The risk of ADHD was 37% higher and the risk of intellectual disability was 120% higher.

Even when compared to their siblings, children exposed to early maternal anemia were at higher risk of autism and intellectual disability. Importantly, anemia diagnosed after the 30th week of pregnancy was not associated with a higher risk for any of these conditions.

“A diagnosis of anemia earlier in pregnancy might represent a more severe and long-lasting nutrition deficiency for the fetus,” says Renee Gardner, project coordinator at the Department of Public Health Sciences at Karolinska Institutet and the study’s lead researcher.

“Different parts of the brain and nervous system develop at different times during pregnancy, so an earlier exposure to anemia might affect the brain differently compared to a later exposure.”

The researchers also noted that early anemia diagnoses were associated with infants being born small for gestational age while later anemia diagnoses were associated with infants being born large for gestational age.

Babies born to mothers with late-stage anemia are typically born with a good iron supply, unlike babies born to mothers with early anemia.

Although researchers could not specify whether iron deficiency anemia is more detrimental than anemia caused by other factors, iron deficiency is by far the most common cause of anemia. Investigators say the findings may thus support regular iron supplementation in maternity care.

Scientists emphasize the importance of early screening for iron status and nutrition counseling but note that more research is needed to find out if early maternal iron supplementation could help reduce the risk of neurodevelopmental disorders in children.

Adult women 19 to 50 years old typically need 18 mg of iron per day, though needs increase during pregnancy. Since excessive iron intake can be toxic, pregnant women should discuss their iron intake with their midwife or doctor.

Source: JAMA

Kids Bullied by Siblings May Have Mental Health Issues in Early 20s

Thu, 10/10/2019 - 6:00am

UK researchers have discovered that kids bullied at home and at school are more likely to have mental health issues in young adulthood. Investigators found that depression, self-harm and suicidal ideation are more prominent in young adults if they were bullied.

Notably, even sibling bullying can be harmful as it often leads to peer bullying and then issues later in life. Experts stress that education of parents and mental health professionals is necessary to mitigate what may have previously been viewed as harmless banter between siblings.

The new findings are not without precedent as previous studies have identified that sibling bullying has an effect on mental health in adolescence. However, University of Warwick researchers Professor Dieter Wolke and Dr. Slava Dantchev have now found that children who were bullied by siblings and friends are more likely to harm themselves.

The paper appears in the journal Frontiers in Psychiatry. The research shows that sibling bullying can lead to on self-harm, suicide attempts and depression at 24 years of age.

Using the Children of the 90s study, they were able to show that children who were bullied by siblings had more mental health issues in adulthood. If they were also bullied by peers this risk increased further.

The participants were asked to self-report bullying when they were 12 years old; depression, anxiety, suicidal ideation and self-harm were assessed at 24 years old.

Of 3,881 youths studied it was found that 31.2% experienced bullying by a sibling. Of those who both became victims and bullied siblings 15.1% were diagnosed with clinical depression, 35.7% experienced suicidal ideation and 16.1% self-harmed with a further 4.9% with the intent of suicide.

Those who experienced sibling bullying and peer bullying had double the odds of developing clinical depression and consider suicide.

Dantchev said this is the first study to show that being bullied by siblings has adverse effects on mental health into adulthood, when the siblings are not living together anymore. “Those bullied at home are also more likely to be bullied by peers and have no safe space at school or at home. This further increased their torment and affected their mental health.”

Wolke also commented, “As sibling bullying often starts when children are young it will be important to educate and help parents to deal and reduce bullying between siblings in early childhood. This is an area which has been completely overlooked in mental health provision and parent support.”

Source: University of Warwick

Jury Awards Victim $8 Billion in J&J Risperdal Case

Wed, 10/09/2019 - 3:57pm

A Philadelphia jury awarded a young man, Nicholas Murray, $8 billion in punitive damages after he claimed he was not warned of a significant side effect — breast growth — of an atypical antipsychotic medication called Risperdal (risperidone).

Risperdal is made by Janssen Pharmaceuticals, a Johnson & Johnson (J&J) company.

Murray was originally prescribed Risperdal in 2003 when he was 13 years old for treatment of autism spectrum disorder. Risperdal was not yet approved by the U.S. Food and Drug Administration (FDA) for the treatment of autism in 2003. But doctors can prescribe an FDA-approved medication for any condition they choose.

Murray, now 26, was previously awarded $1.75 million in the lawsuit in 2015, but the amount was reduced to $680,000 in a state appeals court. Murray claimed the company failed to warn that teenagers and young men using Risperdal could grow breasts.

Risperdal is typically prescribed (and FDA-approved) to treat bipolar disorder, schizophrenia, and other mental health disorders. Murray’s lawyers claimed the drug can create a hormonal imbalance, causing the formation of female breast tissue in men (a condition called gynecomastia).

The FDA approved Risperdal for children and teens (5 to 16 years old) diagnosed with autism in 2007.

This is not the first legal action taken against J&J due to its marketing of Risperdal.

In 2013, the U.S. Justice Department settled a $2.2 billion claim against J&J for Risperdal allegations. In that settlement, the Justice Department alleged that despite repeated warnings from the FDA, J&J’s Janssen division continued misleading marketing messages to physicians.

From that 2013 article, it was also noted that Janssen apparently marketed Risperdal for use in children with behavior challenges, despite known health risks to children and adolescents. Until late in 2006, Risperdal was not approved for use in children for any purpose, and the FDA repeatedly advised the company that promoting its use in children was problematic and could violate the law.

According to additional legal filings, J&J apparently faces some 13,400 lawsuits tied to Risperdal and its potential side effect of breast growth in boys who take the drug. More than 7,000 of those lawsuits are pending in state court in Philadelphia.

According to ClassAction.com, J&J has settled more than 80 cases related to Risperdal for undisclosed amounts from 2012 to 2013. In 2016, a jury awarded $70 million to Andrew Yount, “ruling that the company not only failed to warn Yount about the issues surrounding Risperdal but had destroyed evidence related to the case,” according to Fox Business News.

They also noted that, “In August of 2012, J&J agreed to pay $181 million to 36 states and the District of Columbia to settle fraud charges related to its unlawful marketing of Risperdal.”

“This jury resoundingly told J&J that its actions were deliberate and malicious,” Tom Kline and Jason Itkin, two of Murray’s lawyers, said in an emailed statement to Bloomberg.

The $8 billion sum is likely to be reduced on grounds that it violates due process. J&J said that it will appeal the ruling, claiming the amount was “grossly disproportionate.”

J&J is also involved in lawsuits related to its marketing of opioid painkillers. It recently settled two Ohio opioid-related lawsuits for more than $20.4 million. J&J formerly marketed the painkillers Duragesic and Nucynta.

Opioids were involved in 400,000 overdose deaths in the United States from 1999 to 2017, according to the U.S. Centers for Disease Control and Prevention. The company claims the settlement includes no admission of liability.

Source: Wire reports

Young Adults’ Income Slump May Hike Risk of Middle-Aged Cognitive Issues

Wed, 10/09/2019 - 6:00am

A new study suggests that experiencing an annual income drop of 25 percent or more during young adulthood may increase the risk of developing thinking problems and reduced brain health in middle age.

“Income volatility is at a record level since the early 1980s and there is growing evidence that it may have pervasive effects on health,” said study senior author Adina Zeki Al Hazzouri, Ph.D., assistant professor of epidemiology at Columbia Mailman School of Public Health.

“Our study followed participants in the United States over 30 years, including the recession time in the late 2000s when many people experienced financial instability. Our results provide evidence that higher income volatility during peak earning years are associated with worse brain aging in middle age.”

The study, which appears online in Neurology®, involved 3,287 people who were 23 to 35 years old at the start of the study. Participants were enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study, which includes a racially diverse population.

Study members reported their annual pre-tax household income every three to five years for 20 years, from 1990 to 2010.

Researchers examined how often income dropped as well as the percentage of change in income between 1990 and 2010 for each participant. Based on the number of income drops, participants fell into three groups: 1,780 people who did not have an income drop; 1,108 who had one drop of 25 percent or more from the previous reported income; and 399 people who had two or more such drops.

Participants were given thinking and memory tests that measured how well they completed tasks and how much time it took to complete them. For one test, participants used a key that paired numbers 1 to 9 with symbols. They were then given a list of numbers and had to write down the corresponding symbols.

Researchers found that people with two or more income drops had worse performances in completing tasks than people with no income drops. On average, they scored worse by 3.74 points or 2.8 percent.

“For reference, this poor performance is greater than what is normally seen due to one year in aging, which is equivalent to scoring worse by only 0.71 points on average or 0.53 percent,” said first author Leslie Grasset, Ph.D., of the Inserm Research Center in Bordeaux, France.

Participants with more income drops also scored worse on how much time it took to complete some tasks.

The results were the same after researchers adjusted for other factors that could affect thinking skills, such as high blood pressure, education level, physical activity and smoking.

There was no difference between the groups on tests that measured verbal memory.

Of the study group, 707 participants also had brain scans with magnetic resonance imaging (MRI) at the beginning of the study and 20 years later to measure their total brain volume as well as the volumes of various areas of the brain.

Researchers found when compared to people with no income drops, people with two or more income drops had smaller total brain volume. People with one or more income drops also had reduced connectivity in the brain, meaning there were fewer connections between different areas of the brain.

According to the researchers, there may be several explanations as to why an unstable income may have an influence on brain health. Potential influences may include that people with a lower or unstable income could have reduced access to high quality health care. This could result in worse management of diseases like diabetes, or management of unhealthy behaviors such as smoking and drinking.

While the study does not prove that drops in income cause reduced brain health, it does reinforce the need for additional studies examining the role that social and financial factors play in brain aging.

Source: Columbia University Mailman School of Public Health/EurekAlert

Exposure to Violence Tied to Loneliness, Hypervigilance, Health Issues

Wed, 10/09/2019 - 6:00am

Exposure to community and police violence can negatively impact a person’s physical and psychosocial health, according to new research published in the journal Health Affairs.

The research involved two studies based on in-person surveys of more than 500 adults living in Chicago neighborhoods with high rates of violent crime, and mostly comprising racial and ethnic minority groups. Of the study participants, 77% were age 50 and up.

Elizabeth L. Tung, M.D., a social epidemiologist from the University of Chicago Medicine and coauthor of both studies, was inspired to conduct this research after she noticed that more of her patients from violent neighborhoods were struggling to follow their prescribed health regimens.

“They would be hesitant to join walking groups because they were afraid to walk in their neighborhoods. Or I’d ask, ‘Why didn’t you get your medications on time?’ And they’d say, ‘Well, I could only get a ride at night, and I don’t want to leave the house at night.’ That kind of thing was coming up a lot more,” Tung said.

In the first report, researchers found that social isolation and loneliness were linked to limited physical activity, not taking medication properly, poor nutrition, binge drinking and smoking.

The results reveal that the more violence people experienced in their own community, the lonelier they were likely to be. The greatest risk for loneliness was found among those who were exposed to community violence and screened positive for post-traumatic stress disorder (PTSD).

The findings are particularly troublesome for older adults who live in violent neighborhoods, who are more prone to loneliness and might already have chronic health issues like diabetes, obesity or heart disease. Loneliness is a growing health concern, and a key predictor of mortality in the U.S.

“The association between violence exposure and loneliness is a really interesting one, because there’s such a strong link,” said Tung. “The pervasiveness of violence seems to be more evident now than ever. What does that sense of violence in our culture do more broadly to loneliness?”

Social withdrawal might be a survival strategy in violent neighborhoods, but it’s not a good long-term option, said study coauthor Monica E. Peek, M.D., an associate professor at the University of Chicago and the associate director of the Chicago Center of Diabetes Translation Research.

“Someone who is socially isolated and lonely has a higher risk for cardiovascular disease, just like someone who has a history of smoking. Loneliness is a public health issue with real health implications,” Peek said.

“Violence impacts more than just the victims, but the whole community. Everyone’s health is potentially affected.”

The new findings tie into a bigger conversation happening nationwide about how issues like loneliness, food insecurity and housing impact a person’s physical and psychological health, Peek added.

“Our health care system is changing and evolving, and we’re starting to think not just about medical care but the social needs of our patients, and trying to use the medical system as a way to integrate those needs. Having a more holistic approach will better help our health outcomes,” she said.

The second report, led by Nichole A. Smith, a medical student at the University of Chicago Pritzker School of Medicine, quantified a connection between exposure to community and police violence and hypervigilance.

Hypervigilance — defined as a heightened emotional state of always feeling “on guard” — can prevent people from making healthy lifestyle choices. Chronic hypervigilance can lead to hypertension, cardiovascular disease, memory impairment, anxiety disorders and difficulty regulating emotions.

“It’s a very well-studied phenomenon, mostly in veterans. But it’s so poorly studied in community-based settings where you have this chronic exposure to violence,” Tung said.

The study found a surprisingly strong link between hypervigilance and exposure to police violence more than community violence.

Exposure to community violence was linked to a 5.5% increase in the hypervigilance score, while exposure to police violence was associated with a 9.8% increase. Respondents who experienced a traumatic event during a police stop had a 20% increase in hypervigilance scores.

The findings suggest a complex association between police violence and the mental and physical health of community members. It raises the question of whether hypervigilance, both among residents and police officers, could possibly lead to harmful escalations during police stops.

The study suggests that more trauma-informed policing and opportunities for community-building activities between police and community members, such as the CAPS police baseball league with community members, could help reduce hypervigilance on both sides and prevent situations from escalating into harmful ones.

Source: University of Chicago Medical Center

European Study: Changing Roles & Family-Friendly Policies Make For Happier Parents

Wed, 10/09/2019 - 5:00am

New research from the University of Zurich (UZH) finds that mothers and fathers today are happier with their lives than parents were 20 or 30 years ago, thanks mainly to evolving roles.

Greater freedom of choice and the increased equality of mothers and fathers have been supported as well by government and employer policies for families.

According to researchers, motherhood is no longer seen as an obligatory part of female identity and fulfillment. It is no longer automatically expected that mothers will give up paid work, and it is becoming increasingly normal for fathers to have a more active role in raising and caring for children.

Researchers from the UZH along with sociologists from Germany investigated how these new societal expectations altered the life satisfaction of mothers and fathers. For their empirical work, investigators evaluated information garnered from a long-term study of individuals living in Germany.

The database provides information on more than 18,000 women and almost 12,000 men who were surveyed between 1984 and 2015. “While in the last few years the prevailing message in the media is that modern parents are under great stress or even regret having become parents, our analysis shows the opposite,” said first author Dr. Klaus Preisner from the UZH Institute of Sociology.

In surveys in the 1980s, most mothers were less satisfied with their lives than women without children. The idea of having a “little bundle of joy” that would bring great happiness — which stemmed in part from the taboo against speaking negatively of motherhood in any way — did not translate to reality for many women.

“With the increasing freedom to choose whether or not to have a child and to shape parenthood more individually, the ‘maternal happiness gap’ has closed. Today we no longer find a difference in the life satisfaction of mothers and of women without children,” Preisner said.

Researchers discovered the picture is different for men: In the past, in contrast to women, men were not expected to take an active role in childcare, to take parental leave or to reduce their working hours after having children.

Although that situation is different today, the life satisfaction of men has barely changed as a result. What’s more, there is no difference in life satisfaction between fathers and men without children.

“Fathers who step up to meet the new expectations placed on them are increasingly rewarded with public praise for their commitment,” said Preisner.

Alongside changed normative expectations in Germany, new political measures have been introduced, such as support for parental leave after the birth of a child and childcare for small children outside the family.

On the one hand, such changes mean mothers and fathers can choose more freely how they want to arrange their family lives with regard to childcare. On the other, the roles and responsibilities are more equally distributed between mothers and fathers nowadays. Both these aspects have a positive effect on parents’ life satisfaction.

Researchers report that the greater freedom of choice and the increased equality of mothers’ and fathers’ roles has been encouraged — and in some cases even made possible at all — by modern policies for families.

Parental leave enables mothers and fathers to share childcare responsibilities and to be involved in their children’s upbringing. In addition, subsidized childcare outside the home, such as that in Germany, also makes it easier for families to combine parenthood and employment.

Preisner also sees another advantage: “These family-friendly political measures are not only significant for equality between the sexes. They are just as important for their role in improving life satisfaction of parents, and thus ultimately of children.”

Source: University of Zurich

Common Household Drugs Often Used By Youth in Suicide Attempts

Tue, 10/08/2019 - 6:00am

A new study finds that adolescent suicide attempts by self-poisoning often involve common household medications, such as ibuprofen or antidepressants.

The findings, published online in the journal Clinical Toxicology, also reveal that self-poisoning suicide attempts are more common in rural communities, particularly during the academic school year.

The study expands on previous research that looked at the incidence and outcomes from intentional suspected-suicide self-poisoning in children and young adults ages 10 to 24 years old from 2000-2018.

In that 19-year time frame, there were more than 1.6 million intentional suspected-suicide self-poisoning cases in youth and young adults reported to U.S. poison centers. The majority of cases were female (71%), and involved a pharmaceutical (92%).

“While most of these cases involved medications, with adolescents, any available medication can be a potential hazard,” said Henry Spiller, M.S., D.ABAT, director of the Central Ohio Poison Center at Nationwide Children’s Hospital, and co-author of the study.

“It’s not so much a matter of substance type, but rather a matter of access to the substance. Any type of medication can be misused and abused in ways that can unfortunately lead to very severe outcomes, including death.”

The two most common substance groups in all age groups were over-the-counter (OTC) painkillers such as acetaminophen, ibuprofen and aspirin, followed by antidepressants. In youth (ages 10-12) and adolescents (ages 13-15), ADHD medications were common, and had the highest risk of serious medical outcomes. Opiates only accounted for 7% of cases with serious medical outcomes.

“Because medications are so readily available in homes, many families do not take precautions to store them safely. Our findings suggest this is a big problem,” said John Ackerman, Ph.D., clinical psychologist and suicide prevention coordinator for the Center for Suicide Prevention and Research at Nationwide Children’s, and co-author of the study.

“Medications can be part of effective treatment, but they require an extra layer of care. The answer is not to stop prescribing medications to those who stand to benefit, but rather to emphasize the practice of safe storage and vigilance when administering any kind of medicine, especially when children and teens live in the home.”

The findings also show that states with a lower population per square mile (rural areas) had a greater number of reported cases with all outcomes and serious medical outcomes.

Results also revealed there was a significant decrease in the number of cases in school-aged individuals during non-school months of June through August (27.5% decrease in 10-12-year-olds; 27.3% decrease in 13-15-year-olds; and 18.3% decrease in 16-18-year-olds), compared with school months September through May.

Nationwide Children’s Big Lots Behavioral Health experts recommend that parents check in with their children regularly, and ask them directly how they are doing and if they have ever had thoughts about ending their life. These direct questions are even more critical if warning signs of suicide are observed.

Medications should be stored up, away and out of sight, preferably in a locked cabinet. Administration of medicine should always be supervised.

“It should concern us that youth in rural areas are about twice as likely as those living in urban areas to die by suicide. Although we are in dire need of more research to help us understand what places some people at more risk than others, available evidence indicates that include increased social isolation, stigma, access to lethal means and lack of appropriate mental health resources may play a role in this disparity,” said Ackerman.

His suicide prevention team provides comprehensive training to more than 140 central and southeast Ohio schools with the SOS Signs of Suicide program.

“It is vital that parents, teachers and other trusted adults start conversations about mental health early, and pay even closer attention during the school year, as rates of anxiety and depression are shown to increase during that time. Warning signs can often be detected and support is available for young people in crisis.”

Source: Nationwide Children’s Hospital

Antidepressant Use By Those Over 65 In UK Doubled Over 20 Years

Tue, 10/08/2019 - 5:30am

New research from the United Kingdom finds that antidepressant use among those  over 65 more than doubled over two decades. But despite the rise in antidepressant use, there was little change in the number of older people actually diagnosed with depression.

The research effort, led by University of East Anglia investigators, evaluated data from the Cognitive Function and Aging Studies, conducted at two time points: between 1991 and 1993, and between 2008 and 2011. Researchers interviewed more than 15,000 over 65s in England and Wales to see whether the prevalence of depression and antidepressant use is changing.

“Between two comparable samples interviewed 20 years apart, we found little change in the prevalence of depression, but the proportion of participants taking antidepressants rose from 4 percent to almost 11 percent,” said lead author Prof. Antony Arthur, from UEA’s School of Health Sciences. “This could be due to improved recognition and treatment of depression, overprescribing, or use of antidepressants for other conditions.”

Arthur added, “Depression is a leading cause of poor quality of life worldwide, and we know that older people may be less likely than other age groups to go to their physician with symptoms of depression.

“Until now, little was known about how the relationship between the prevalence of depression and antidepressant use among older people has changed over time.”

Arthur noted that the Cognitive Function and Aging Studies led by the University of Cambridge can examine changes in the health needs of older people across generations. The studies are based on random sampling and diagnostic methods held constant over time.

“We asked participants about their health, daily activities, use of health and social care services, and the medications they were taking,” he said.

Arthur said a standardized interview process allowed the investigators to ascertain the presence or absence of symptoms of depression. They were then able to apply diagnostic criteria to see whether the participant was considered to have “case level” depression; a level of depression more severe than that characterized by minor mood symptoms, such as loss of energy, interest or enjoyment.

The study’s lead investigator, Prof. Carol Brayne, director of the Cambridge Institute of Public Health, said, “Our research has previously shown a dramatic age-for-age drop in dementia occurrence across generations. This new work reveals that depression has not shown the same reduction even in the presence of dramatically increased prescribing, itself not without concern given potential adverse effects we have also shown that are associated with polypharmacy.”

Among the key findings:

  • the proportion of older people receiving antidepressant medication more than doubled over two decades, from 4.2 per cent in the early ’90s to 10.7 percent 20 years later;
  • the estimated prevalence of depression among over 65s in the early 1990s was 7.9 per cent, compared to 6.8 percent 20 years later;
  • depression and antidepressant use was more common in women than men at both time points;
  • depression was associated with living in a more deprived area;
  • the proportion of over 65s living in care homes declined, but prevalence of depression in care homes remained unchanged; affecting around one in ten residents;
  • across both time periods, most people with case-level depression were not on antidepressants, while most of those on antidepressants did not have depression.

Arthur said the research shows that “depression affects one in 15 people aged over 65, and its impact is felt by the individual, their families and friends.”

“Substantial increases in prescribing have not reduced the prevalence of depression in the over-65 population. The causes of depression in older people, the factors that perpetuate it, and the best ways to manage it remain poorly understood and merit more attention.”

The research was led by the University of East Anglia in collaboration with the University of Cambridge, the University of Newcastle and the University of Nottingham.

The study appears in the British Journal of Psychiatry.

Source: University of East Anglia

When Abuse Involves Controlling a Partner’s Education

Mon, 10/07/2019 - 5:00am

A new study offers a closer look at a lesser-known form of psychological abuse: educational sabotage. This type of abuse involves behaviors aimed at hindering or stopping another person’s educational efforts.

“This form of violence is used by one of the partners as a means for furthering their own power and control over the other partner,” said Dr. Rachel Voth Schrag, a domestic violence expert and assistant professor in the School of Social Work at The University of Texas at Arlington. “Pursuing higher education can be perceived as a threat by the abusing party.”

Educational sabotage is a form of coercive control that directly affects a survivor’s efforts to obtain educational credentials, said Voth Schrag. Tactics may include disruption of financial aid or academic efforts, physical violence and/or inducing guilt related to academic efforts.

These strategies are a serious hindrance to the successful completion of educational programs and, ultimately, the economic independence and safety of survivors, she said.

For the study, the researchers conducted 20 interviews with community college students who reported current or recent intimate partner violence  (IPV). The participants identified several ways in which educational sabotage had impacted their lives. Impacts included reduced academic achievement, emotional or mental health challenges, but on a more positive note, an increased desire to overcome such obstacles.

Educational sabotage is considered a form of IPV, which is a factor in 16.5% of all homicides in the U.S., according to The Centers for Disease Control and Prevention. The agency estimates one in four women and nearly one in 10 men have experienced intimate partner violence during their lifetime.

Pursuing higher education can be a catalyst for breaking out of the isolation and cycles of dependency that often accompany IPV. According to Voth Schrag’s study, “by understanding, addressing, and preventing school sabotage, scholars, institutions of higher education, and their community partners have an opportunity to make an important contribution to the well-being and safety of students.”

The study is published in the journal Violence Against Women.

Source: University of Texas at Arlington

 

Self-Silencing Women May See Increased Risk of Stroke

Sun, 10/06/2019 - 8:04pm

A new study shows that women who do not speak up for themselves — called self-silencing — have increased carotid plaque buildup, which could lead to a stroke or other cardiovascular problems.

People engage in a range of behaviors to maintain close relationships, some of which may be costly to their own health, researchers note. One of those damaging behaviors is self-silencing, which is sometimes used to avoid conflict or relationship loss. Although self-silencing has been linked to worse mental and self-reported physical health in women, it has not been previously examined in relation to women’s cardiovascular health, researchers note.

In this new study of 304 nonsmoking women, researchers tested whether self-silencing was associated with carotid atherosclerosis. They found that greater self-silencing was related to increased odds of plaque, independent of socio-demographics, cardiovascular disease risk factors, and depression.

The results were based on women’s self-reporting on a range of factors, such as how often they expressed anger or put someone else’s needs before their own, the researchers reported. Ultrasound imaging was used to quantify carotid plaque.

“Given increased public health interest in women’s experiences in intimate relationships, our results suggest that women’s socio-emotional expression may be relevant to their cardiovascular health,” said lead author Karen Jakubowski from the Department of Psychiatry at the University of Pittsburgh.

The study was presented at the 2019 North American Menopause Society (NAMS) annual meeting.

Source: The North American Menopause Society