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Updated: 1 hour 51 min ago

Study: One-Third of Australian Coeds Save Calories for Binge Drinking

Sat, 05/16/2020 - 6:30am

A new study finds that a staggering 87.2 percent of female Australian university students have engaged in “Drunkorexia,” a dangerous behavior where disordered patterns of eating are used to offset negative effects of drinking too much alcohol, such as gaining weight.

Researchers at the University of South Australia found that 28 percent of the students were regularly and purposely skipping meals, consuming low-calorie or sugar-free alcoholic beverages, purging, or exercising after drinking to help reduce ingested calories from alcohol, at least 25 percent of the time.

 Clinical psychologist and lead researcher Alycia Powell-Jones said the prevalence of Drunkorexic behaviors among Australian female university students is concerning.

“Due to their age and stage of development, young adults are more likely to engage in risk-taking behaviors, which can include drinking excess alcohol,” Powell-Jones said. “Excess alcohol consumption combined with restrictive and disordered eating patterns is extremely dangerous and can dramatically increase the risk of developing serious physical and psychological consequences, including hypoglycemia, liver cirrhosis, nutritional deficits, brain and heart damage, memory lapses, blackouts, depression, and cognitive deficits.”

“Certainly, many of us have drunk too much alcohol at some point in time, and we know just by how we feel the next day, that this is not good for us, but when nearly a third of young female uni students are intentionally cutting back on food purely to offset alcohol calories, it’s a serious health concern,” she continued.

In Australia, one in six people consume alcohol at dangerous levels, placing them at lifetime risk of an alcohol-related disease or injury, she noted. The combination of excessive alcohol intake with restrictive eating behaviors to offset calories can result in a highly toxic cocktail for this population, she added.

For the study researchers examined the drinking patterns of 479 female Australian university students between the ages of 18 and 24.

The study was undertaken in two stages. The first measured the prevalence of self-reported, compensative and restrictive activities in relation to alcohol consumption.

The second stage identified participants’ Early Maladaptive Schemes (EMS) — or thought patterns — finding that the subset EMS most predictive of Drunkorexia were insufficient self-control, emotional deprivation, and social isolation.

According to Powell-Jones, identifying the early maladaptive schemas linked to Drunkorexia is key to understanding the harmful condition.

These are deeply held and pervasive themes that can develop in childhood and influence all areas of life, often in dysfunctional ways, she said. Early maladaptive schemas can also be influenced by cultural and social norms.

Drunkorexic behavior appears to be motivated by two key social norms for young adults — drinking alcohol and thinness.

“This study has provided preliminary insight into better understanding why young female adults make these decisions to engage in Drunkorexic behaviors,” Powell-Jones said. “Not only may it be a coping strategy to manage social anxieties through becoming accepted and fitting in with peer group or cultural expectations, but it also shows a reliance on avoidant coping strategies.

“It is important that clinicians, educators, parents and friends are aware of the factors that motivate young women to engage in this harmful and dangerous behavior, including cultural norms, beliefs that drive self-worth, a sense of belonging, and interpersonal connectedness,” she concluded. “By being connected, researchers and clinicians can develop appropriate clinical interventions and support for vulnerable young people within the youth mental health sector.”

Source: University of South Australia

What Fuels Burnout in Health Care Workers During Pandemic?

Sat, 05/16/2020 - 6:00am

In an article, published in the journal Anesthesia & Analgesia, a team of experts from Texas A&M University and Houston Methodist Hospital outline the effects of fatigue and burnout on intensive care unit (ICU) workers, and the steps that can be taken to reduce these symptoms.

“The COVID-19 pandemic exacerbated an already existing problem within our health care systems and is exposing the pernicious implications of provider burnout,” said Dr. Farzan Sasangohar, assistant professor in the Department of Industrial and Systems Engineering at Texas A&M.

The findings show that health care workers are experiencing stress from multiple areas. Not only are they working longer shifts and experiencing more loss of life, but the lack of personal protective equipment (PPE) and training on how to use new equipment causes many to question if they have been exposed to the virus. This leads to fear that they could infect their family and loved ones.

In addition to those fears, there is anxiety surrounding job security. For example, to reduce the spread of infection, many states have stopped elective procedures and consequently, many health care professionals have been laid off or had their hours reduced.

Overall, the paper highlights four major areas of stress with the goal of identifying mitigation strategies to reduce burnout: occupational hazards, national vs. locally scaled responses, process inefficiencies and financial instability.

“Minimizing occupational hazard is the most important criteria to assure that our health care workforce is fully equipped and assured to be safe in order to face the battle against this virus,” said Dr. Bita Kash, professor of health policy and management in the Texas A&M School of Public Health and director of the Joint Center for Outcomes Research at Houston Methodist Hospital.

Health care workers need effective PPE readily accessible and available to ensure their safety and that of their patients. Getting the necessary equipment has been challenging due to the low numbers of PPE and ventilators in the U.S. Strategic National Stockpile and delays getting equipment into local areas.

This slow response, which has caused some providers to reuse PPE past the point of safety and warranty protections, can contribute to anxiety in health care workers.

Process inefficiencies have also contributed to fatigue and burnout due to misinformation or conflicting information given between different specialties. While one subspecialty’s professional organization recommends a certain guideline, another specialty could recommend something else, which leads to confusion.

Finally, anxiety about future career prospects and the overall economy can also lead to burnout. Elective surgeries have been canceled or delayed, causing financial stress on some physicians. Others not directly affected by financial hardship may be worried about loved ones or their own family and how they will weather a coming economic recession.

The researchers’ recommendations to reduce provider burnout and fatigue in pandemics include:

  • pandemic plans should include guidance for relevant industries to quickly transition into producing needed medical supplies;
  • national and regional disaster mitigation plans to help shorten the time needed to provide necessary equipment and testing;
  • provision of adequate numbers of test kits and PPE;
  • training on disaster management and response for medical professionals;
  • relaxing licensing restrictions for individuals licensed outside their state of residence;
  • creating a medical reserve corps of these licensed individuals;
  • using wearable sensors to monitor health care workers’ mental health and provide simple ways to mitigate anxiety and stress.

“There is much to learn from the response to COVID-19,” said Sasangohar. “In our approach, we used a multi-disciplinary systems approach to learn not just from failures and shortcomings, but also from successful adaptations and improvised interventions at the individual, team and system levels to improve our resilience.”

Source: Texas A&M University

Gardening May Bring as Much Happiness as Dining Out or Biking

Fri, 05/15/2020 - 7:00am

A new Princeton study suggests that levels of well-being, or happiness, reported by city residents who engage in home gardening are similar to happiness levels linked to other popular activities, such as eating out, biking or walking.

The paper, titled “Is gardening associated with greater happiness of urban residents? A multi-activity, dynamic assessment in the Twin-Cities region, USA,” is published in the journal Landscape and Urban Planning.

As civic leaders and urban planners work to make cities more sustainable and livable by investing in outdoor spaces and recreational activities such as biking and walking, Princeton researchers have discovered the benefits of an activity largely overlooked by policymakers: home gardening.

Importantly, the affects of gardening on happiness were similar across racial boundaries and between urban and suburban areas, said first author Graham Ambrose, a research specialist in Princeton’s Department of Civil and Environmental Engineering.

In fact, home gardening was the only activity out of the 15 studied for which women and people with low incomes reported higher emotional well-being than men and medium- and high-income participants, respectively.

“This has implications for equity in food action planning considering that people with lower incomes tend to have less access to healthy food options,” said corresponding author Anu Ramaswami, Princeton’s Sanjay Swani ’87 Professor of India Studies, professor of civil and environmental engineering and the Princeton Environmental Institute (PEI).

“Gardening could provide the health benefits of fresh fruits and vegetables, promote physical activity, and support emotional well-being, which can reinforce this healthy behavior.”

In addition, whether people gardened alone or with others made no difference, and those who kept vegetable gardens reported a higher level of average emotional well-being than people who worked in ornamental gardens.

The study involved 370 people in the Minneapolis-St. Paul metropolitan area. Participants used a cell phone app called Daynamica to report their emotional well-being while engaged in any of 15 daily activities.

The app was developed by study co-author Yingling Fan, a professor of urban and regional planning at the University of Minnesota, who led a larger emotional well-being study as a part of the National Science Foundation-funded Sustainable Healthy Cities Network led by Ramaswami.

Co-author Kirti Das, a postdoctoral research associate in civil and environmental engineering at Princeton, was instrumental in recruiting participants from a range of communities and in carrying out the survey.

While the social and environmental benefits of community gardens are hot topics in urban research, available data seem to fall short when it comes to gardening in individual households, Ambrose said.

“People know where community gardeners garden, but it is hard to know who is gardening at home, which our group uniquely identified,” Ambrose said.

For example, the study found that 31% of participants engaged in home gardening for about 90 minutes per week on average, compared to 19% who engaged in biking (an average of 30 minutes each week) and 85% who walked (an average of one hour and 40 minutes each week).

“Many more people garden than we think and it appears that it associates with higher levels of happiness similar to walking and biking,” Ramaswami said. “In the movement to make cities more livable, gardening might be a big part of improving quality-of-life.”

The research team found that home gardening was among the top five activities in terms of how meaningful an activity felt to people while engaging in it.

“The high levels of meaningfulness that respondents reported while gardening might be associated with producing one’s own food,” Ambrose said.

“The boost to emotional well-being is comparable to other leisure activities that currently get the lion’s share of infrastructure investment. These findings suggest that, when choosing future well-being projects to fund, we should pay just as much attention to household gardening.”

Source: Princeton University

Emergency Room Visits for Drug Overdose Linked to Increased Risk for Suicide Later

Fri, 05/15/2020 - 6:30am

New research finds that patients who visited the emergency room for an opioid overdose are 100 times more likely to die by drug overdose in the year after being discharged and 18 times more likely to die by suicide.

The data analysis, funded by the National Institutes of Health, also found that in the year after emergency room discharge patients who visited for a sedative/hypnotic overdose had overdose death rates 24 times higher and suicide rates nine times higher than the general population.

The findings, published in the American Journal of Preventive Medicine, highlight the need for interventions that reduce suicide and overdose risk that can be implemented when patients come to the emergency room, according to researchers.

“We knew that nonfatal opioid and sedative/hypnotic drug overdoses were a major cause of disease. What these new findings show is that overdose patients also face an exceptionally high risk of subsequent death — not just from an unintentional overdose, but also from suicide, non-suicide accidents, and natural causes,” said Sidra Goldman-Mellor, Ph.D., lead study author and an assistant professor of public health at the University of California, Merced.

Deaths by drug overdose increased 225% between 1999 and 2015, with prescription drugs and heroin overdose accounting for the majority of these deaths, researchers reported. Although previous studies have detailed trends in emergency room visits related to opioid and sedative/hypnotic drug overdose, less is known about the risk of death in the year following emergency care for a drug overdose, the researchers said.

“We have tracked and reported patient survival for health concerns, such as cancers and heart surgery, for decades,” said study co-author Michael Schoenbaum, Ph.D., a senior advisor for mental health services, epidemiology, and economics at the National Institute of Mental Health (NIMH), part of the NIH. “We improve what we measure and should be doing the same type of tracking for people with overdose or suicide risk to inform our prevention and treatment programs.”

To learn more about the risks for death that follow a nonfatal opioid overdose, a research team led by Goldman-Mellor examined discharge data for all visits to emergency rooms in California between 2009 and 2011. These data were matched with death records from the California Department of Public Health, which provided information about the date and cause of death for all individuals who died between 2009-2012, the researchers explained.

The researchers focused on patients who visited the emergency room for an opioid overdose (for example, heroin or methadone) or for a sedative/hypnotic drug overdose (such as barbiturate or benzodiazepine) at least once during the 2009-2011 study period.

The data showed that for those who had visited for sedative/hypnotic drug overdose, the death rate in the following year was 18,080 per 100,000. For those who had visited for an opioid overdose, the death rate in the following year was 10,620 per 100,00 patients. The death rates for these groups were significantly higher than the death rate observed in a demographically matched group of Californians (3,236 per 100,000 people), according to the study’s findings.

The researchers discovered that 88% of the unintentional deaths among patients who had visited for opioid overdose were caused by an unintentional overdose (1,863 per 100,000) — a rate 100 times higher than that of the general population. The suicide rate for this group (319 per 100,000 patients), which included some deaths by intentional drug overdose, was 18 times higher than that of the general population, according to the study’s findings.

The researchers also discovered that 60% of unintentional deaths among patients who had visited for sedative/hypnotic overdose were caused by an unintentional drug overdose (342 per 100,00 patients), a rate 24 times higher than that of the general population.

Among those who had previously experienced a sedative/hypnotic drug overdose, the rate of death by suicide (174 per 100,000 patients) was almost nine times higher than the general population, the study found.

“There are already promising emergency department-based interventions that could reduce overdose and other mortality risks, such as suicide, among these patients, but such interventions need to be much more widely implemented,” said Goldman-Mellor. “Moreover, those interventions should target not just patients overdosing on opioids, but also those overdosing on sedative/hypnotic drugs, since blocking RasGRP1 with drugs, or even with gene therapy, may have very little or no major side effects

While the study provides important information about the outcomes of individuals presenting to emergency departments after an overdose, Goldman-Mellor notes that the findings should be replicated in other parts of the U.S. using more recent data, as patterns of opioid and sedative/hypnotic use — and related mortality — have changed substantially over time.

Source: National Institutes of Health

Mouse Study Unveils Mechanism Behind Med-Induced Dyskinesia in Parkinson’s

Fri, 05/15/2020 - 6:00am

A new mouse study led by Scripps Research Institute may have discovered a key cause of dyskinesia — a debilitating movement disorder often caused by the dopamine-replacement drugs used to treat Parkinson’s disease.

Dopamine replacement therapy makes Parkinson’s symptoms much better at first, but eventually treatment gives way to uncontrollable, jerky body movements. Until now, the mechanism behind this condition has largely remained a mystery.

The study shows that underlying this condition is the medication’s unintended boost of a protein called RasGRP1 (Ras-guanine nucleotide-releasing factor 1). This boost in RasGRP1 produces a cascade of effects which lead to abnormal, involuntary movements known as LID, or L-DOPA-induced dyskinesia, says co-lead author Srinivasa Subramaniam, PhD, associate professor of neuroscience at Scripps Research, Florida.

Encouragingly, the team found that in dopamine-depleted mice and other animal models, inhibiting production of RasGRP1 in the brain during dopamine replacement reduced the involuntary movements without negating the useful effects of the dopamine therapy.

The findings, published in the journal Science Advances, offer a new path to easing Parkinson’s dyskinesia while allowing maintenance of dopamine replacement therapy.

Subramaniam’s research team has long been interested in cellular signaling in the brain underlying motor movements, and how it is affected by brain diseases, including Huntington’s and Parkinson’s.

“Parkinson’s patients describe treatment-induced dyskinesia as one of the most debilitating features of their illness,” Subramaniam says. “These studies show that if we can down-regulate RasGRP1 signaling before dopamine replacement, we have an opportunity to greatly improve their quality of life.”

In addition to Subramaniam, the co-lead author is Alessandro Usiello, PhD, of the University of Campania Luigi Vanvitelli, Caserta, Italy, and the Behavioural Neuroscience Laboratory at Ceinge Biotecnologie Avanzate, Naples, Italy.

Dopamine is a neurotransmitter and hormone that plays a key role in movement, learning, memory, motivation, and emotion. Parkinson’s develops when dopamine-producing neurons in a region of the brain called the substantia nigra stop working or die.

This brain region is associated with both movement initiation and reward, so its impairment causes a wide variety of symptoms, including stiffness, balance problems, walking difficulty, tremor, depression and memory issues.

Doctors treat Parkinson’s with a dopamine replacement drug, such as levodopa. The brain converts levodopa into dopamine, and at proper doses, this leads to resolution of symptoms. But as dose and duration grow, a side effect called dyskinesia can develop. After a decade, about 95% of Parkinson’s patients will experience some degree of involuntary dyskinesia, Subramaniam says.

The reason for its development has eluded scientists. Subramaniam’s team had studied the problem for the past decade, leading them eventually to the discovery that RasGRP1 signaling was a main culprit.

“There is an immediate need for new therapeutic targets to stop LID, or L-DOPA-induced dyskinesia in Parkinson’s disease,” Subramaniam says. “The treatments now available work poorly and have many additional unwanted side effects. We believe this represents an important step toward better options for people with Parkinson’s.”

Next, the researchers hope to discover the best route to selectively reduce expression of RasGRP1 in the striatum while not affecting its expression in other areas of the body.

“The good news is that in mice, a total lack of RasGRP1 is not lethal, so we think that blocking RasGRP1 with drugs, or even with gene therapy, may have very little or no major side effects,” Subramaniam says.

Source: Scripps Research Institute

Clusters of Depressive Symptoms Respond to Different TMS Targets

Fri, 05/15/2020 - 5:30am

For the first time, researchers from Beth Israel Deaconess Medical Center (BIDMC) have identified two clusters of depressive symptoms that respond to two distinct treatment targets in patients undergoing transcranial magnetic brain stimulation (TMS).

TMS is a non-invasive procedure that affects brain activity with powerful magnetic fields.

The findings, published in the American Journal of Psychiatry, shed new light on the brain circuitry behind specific symptoms of depression and may pave the way for personalized TMS therapy for depression and other psychiatric or neurological disorders.

Specifically, the analysis identified two distinct clusters of depressive symptoms, with each responding better to a different TMS target.

One cluster included symptoms such as sadness, decreased interest, and suicidality, while a smaller cluster included symptoms such as irritability, sexual disinterest and insomnia. The researchers referred to these symptom clusters as “dysphoric” and “anxiosomatic,” respectively.

Depression is the leading cause of disability worldwide, affecting as many as one in four women and one in eight men in their lifetime. According to the most recent government statistics, more than 17 million adults in the United States struggled with depression in 2017.

Clinicians have long recognized that depression manifests in different ways across individuals; official diagnostic criteria include weight loss or weight gain, excessive sleeping or insomnia, inability to concentrate or obsessive rumination.

However, the field of psychiatry has yet to reach a consensus classification of depression subtypes based on distinct symptoms, and any previously proposed classification schemes have failed to improve treatment outcomes.

“We’ve known for over a century that different brain regions have different functions, and now we can finally translate this into symptom-specific treatment targets,” said Shan H. Siddiqi, MD, a neuropsychiatrist in the Division of Cognitive Neurology at BIDMC and an Instructor in Psychiatry at Harvard Medical School. “We hope this discovery will help to usher in a new era of personalized medicine in psychiatry.”

TMS was approved in 2008 for the treatment of depression in adults who were non-responsive to antidepressant drugs. Currently, TMS practitioners use head measurements to position the machine’s magnetic coil outside the patient’s scalp. This can result in the stimulation of other brain circuits. Despite the imprecision, the well-tolerated therapy has a 50% to 60% success rate, higher than most antidepressant drugs.

Taking advantage of that variation, the research team, including senior author Michael D. Fox, MD, PhD, Director of the Laboratory for Brain Network Imaging and Modulation at BIDMC and an Associate Professor of Neurology at Harvard Medical School, analyzed outcomes for two independent groups of patients who were undergoing TMS for treatment-resistant depression.

Patients’ symptoms were self-reported with a validated questionnaire as well as assessed by clinicians.

The team mapped each patient’s TMS site to underlying brain circuits — a technique pioneered by Fox at BIDMC — and compared these maps to the total change in depression symptoms across participants.

The analysis identified two distinct clusters of depressive symptoms, with each responding better to a different TMS target. One cluster, called “dysphoric,” included symptoms such as sadness, decreased interest, and suicidality, while a smaller cluster, called “anxiosomatic,” included symptoms such as irritability, sexual disinterest and insomnia.

Next, to validate the findings, the scientists used these cluster maps to accurately predict clinical improvement in a separate set of patients. The results are consistent with recent studies identifying different symptom clusters — or biotypes — in people with depression. However, Siddiqi and Fox’s study takes the reverse approach.

“Rather than identify biotypes and then searching for ways to treat them, we started with therapeutic response to an anatomically targeted treatment,” said Siddiqi. “Our novel approach harnesses TMS to causally link neuro-anatomy and behavior. We started with depression and anxiety, but this approach could also be used to find a treatment target for any cluster of psychiatric symptoms.”

Source: Beth Israel Deaconess Medical Center

How COVID-19 May Affect People at Risk for Psychosis

Thu, 05/14/2020 - 6:30am

In a new review, published in the journal Schizophrenia Research, a team of researchers describes how the current COVID-19 pandemic may affect people with psychosis or those at risk for psychosis. The authors also emphasize the potential difficulties of helping patients with psychosis manage social distancing and other necessary precautions.

Psychosis is a condition that affects how a person perceives reality; it may lead to seeing, hearing or sensing things that are not there. Psychosis can be triggered by a mental or physical illness, medication or extreme stress or trauma.

“COVID-19 is a very stressful experience for everyone, particularly those with complex mental health needs,” said Dr. Ellie Brown, co-lead author on the study. “We know that psychosis, and first episodes of psychosis, are commonly triggered by substantial psychosocial stresses. In the context of COVID-19, this could include stress relating to isolation and having to potentially remain within challenging family situations.”

“People with psychosis are a population that are particularly vulnerable in the current COVID-19 pandemic and their needs are often overlooked. This research shows that their thoughts around contamination, and their understanding around concepts such as physical distancing may be different from the wider population,” said Brown, a research fellow at Orygen, a not-for-profit organization focused on research, advocacy and education to benefit young people’s mental health.

For the study, a research team from Orygen and La Trobe University in Melbourne, Australia conducted a rapid review of contemporary epidemic and pandemic research to help determine the potential impact of COVID-19 on people with psychosis. They discovered that an increase in the prevalence of psychosis as a result of COVID-19 would likely be linked to viral exposure, pre-existing vulnerability and psychosocial stress.

The findings also suggest that individuals with psychosis may present a major challenge and potential infection control risk to clinical teams working with them.

For the review, Brown looked at previously published studies on viruses such as MERS (Middle East respiratory syndrome), SARS (severe acute respiratory syndrome), swine influenza (a human respiratory infection caused by an influenza strain that began in pigs) and other influenzas that have occurred in the past two decades.

Her goal was to see if any of these studies could offer information on how these influenza viruses might impact people with psychosis.

Co-lead author of the research, Professor Richard Gray of La Trobe University said another important finding from the research was that psychotic symptoms, such as hearing voices, may occur in a small number of people with COVID-19.

“Maintaining infection control procedures when people are psychotic is challenging,” Gray said. “In order for them not to become potential transmitters of the virus, clinicians and service providers may benefit from specific infection control advice to mitigate any transmission risk.”

Brown said that although mental health disorders such as depression and anxiety were important to focus on during the COVID-19 pandemic, the community needed to be aware that the smaller but more severe spectrum of mental health conditions could be impacted as well.

Gray agreed. “This is a group that’s probably going to need more support, with isolation, physical distancing, hand washing etc, and clinicians may be the ones who need to be thinking and working on this to assist this vulnerable population,” he said.

Source: Orygen

Study: Online CBT Equally Effective for Health Anxiety

Thu, 05/14/2020 - 6:00am

A new study by Swedish researchers compared online delivery of cognitive-behavioral therapy to that of face-to-face CBT for the treatment of health anxiety. Researchers found that Internet-delivered treatment had comparable effects, and could serve as an alternative to physical meetings in helping people who are worried about their health.

Researchers at Karolinska Institutet evaluated around 200 study participants with half receiving CBT over the Internet and half conventional face-to-face CBT.

“The study is unique in that it is the first direct comparison of face-to-face CBT and Internet-delivered CBT for health anxiety,” said Dr. Erik Hedman-Lagerlöf, professor of psychology and researcher at the Department of Clinical Neuroscience, Karolinska Institutet.

“The results show that a treatment delivered exclusively online is sufficient to achieve tough and required behavioral changes. This is especially relevant now when the coronavirus pandemic limits our opportunities for physical meetings, while the fear of being affected by a severe health condition is discussed more frequently.”

Health anxiety, also referred to as hypochondriasis, is characterized by an excessive and persistent fear or worry about serious illness. It often leads to significant suffering and functional impairment. , About 3.5 percent of the general population and up to 20 percent of patients in medical clinics are estimated to suffer from the condition, which causes great strain on the health care system.

In face-to-face CBT, which typically involves weekly sessions with a mental health clinician, about two thirds of patients respond to treatment. However, given the prevalence of health anxiety and scarcity of mental health professionals, the need for treatment far exceeds the availability of evidence-based face-to-face therapy.

Therefore, in the new study researchers wanted to examine the effect of an Internet-based treatment where the patient has access to information online and communicates regularly with a therapist through an email-like system. The patient also engages in behavioral changes in their day-to-day life, just as in the case of face-to-face CBT.

In the study, 204 adults with health anxiety were randomized to receive either face-to-face or Internet CBT for a period of 12 weeks. The participants were asked to rate their level of health anxiety each week using a standardized questionnaire commonly referred to as the Health Anxiety Inventory.

According to the researchers, Internet CBT had effects largely on par with the face-to-face treatment. This was despite the fact that the average Internet-therapist spent only 10 minutes per patient per week compared with about 45 minutes in the other group.

“One significant advantage is that the therapist can help more patients in the same time, but also that the treatment can be delivered regardless of the patient’s geographical location, including to people living in rural areas,” said Dr. Erland Axelsson, psychologist and researcher at the Department of Clinical Neuroscience, Karolinska Institutet.

“The fact that you can access the content and communicate with your therapist at any time of the day also means that people who struggle to take time off from work can take part in treatment.”

Another positive aspect of online CBT is that patients who are reluctant to seek psychological treatment due to perceived stigma may be more inclined to seek help, Erland Axelsson adds.

The study was conducted from 2014 to 2020 as a collaboration between Gustavsberg’s primary care clinic and Karolinska Institutet.

The study appears in JAMA Psychiatry.

Source: Karolinska Institutet

Young Refugees Face Risk of Mental Illness Even After Arriving to ‘Safety’

Tue, 05/12/2020 - 7:00am

Many refugees have experienced severe trauma, such as war, torture, human trafficking and extreme poverty, all of which place them at much greater risk for mental illness, even years later.

Now a new German study finds that, even after arriving in Germany, refugees are often forced to live in conditions which further worsen their mental stress.

A research team from the Max Planck Institute for Experimental Medicine show that each additional risk factor puts further strain on the mental health of young refugees. This can lead to functional deficits and behavioral problems, which may be expressed as aggressive and criminal behavior later in life.

It is therefore even more imperative to provide care and support for refugees, and to offer them the opportunity to break out of the spiral of negative experiences.

Previous studies have shown that traumatic experiences, physical and sexual abuse, drug and alcohol use and living in a city are all factors linked to an increase in the risk of mental illness. If a person is subjected to several of these risk factors before the age of 20, he or she is more likely to exhibit aggressive and criminal behavior later in life.

This led a group of Göttingen researchers to take a closer look at a specific risk group: young refugees, as they often experience traumatic events not only in their home country and during their flight, but also face mentally stressful conditions after their arrival in Germany.

Further, the effect of these risk factors is more pronounced among young people, because their brains are still developing, and they react more sensitively to adverse experiences.

To better understand the effects of harmful environmental stress on young refugees, and the consequences for their mental health, the team conducted detailed interviews with 133 relatively healthy refugees (average age 22). Many had traveled to Germany as unaccompanied minors.

In addition to the history-taking, the researchers also looked at the participants’ physical health and used structured interviews to assess any emerging signs of behavioral problems.

“Many refugees are exposed to a shocking number of risk factors,” said Martin Begemann, first author on the publication. In addition to the actual migration experience, more than 95 percent of the refugees are affected by other stressful life events, habits or living conditions that make them more susceptible to mental illness.

In the vast majority of cases, the researchers identified two, three or even more than four additional risk factors. Around half the participants had experienced traumatic experiences before and during their journey; a quarter had suffered physical and sexual abuse.

Around 40 percent of participants had scars or wounds from stabbing or shooting injuries, explosions or the resultant burns. Four young men displayed clear psychotic symptoms, two of these also had suicidal thoughts.

Overall, the more risk factors that were present in a person, the greater the reduction in their ability to function, and the more likely they were to show indications of mental health problems. Precisely which risk factors were present was less significant.

Surprisingly, close and stable personal relationships offered the refugees no protection from these negative effects: Having fled with family or friends, or having a good social network at the time of the study, had no influence on a person’s current mental state. The authors suspect that social support has only a weak protective effect.

It would be several years before the researchers could determine which refugees will go on to exhibit psychological problems or even criminal behavior. However, they expect they will only be able to contact about half of the participants again due to numerous transfers between refugee centers and deportations to the country of origin.

So what can be done right now to improve the poor prognosis for refugees under extreme stress?

“Given that each additional risk factor increases the probability of subsequent aggressive behaviour, criminal activity and mental disorders, we have to prevent the accumulation of further stress factors,” said study leader Hannelore Ehrenreich.

For example, providing refugees with close medical and psychological care and giving them their first simple work activities and language courses even before a final decision on their residence status could help significantly. This could help them to escape from cramped housing conditions where they are confronted with boredom, violence and drugs.

Source: Max-Planck-Gesellschaft


Study Finds Steep Rise in Mental Health Emergency Visits Among Youth

Tue, 05/12/2020 - 6:30am

A new study published in the journal Pediatrics shows that pediatric emergency department (ED) visits for mental health disorders have increased by 60% and visits for deliberate self-harm have increased 329%.

For the study, a research team from Nationwide Children’s Hospital evaluated the number and reason for mental health-related ED visits. They also looked at the geographic location of EDs and the overall number of children coming to each ED.

Prior research has shown that low pediatric volume EDs and EDs in rural settings are less prepared for all pediatric emergencies, and only one third of rural facilities have pediatric mental health policies or mental health transfer agreements.

“We would like children to go to their primary care provider or a psychiatrist, but EDs are the safety net for children with mental health disorders, and we need to be able to take care of them,” said Rachel Stanley, M.D., division chief of Emergency Medicine at Nationwide Children’s and the study’s senior author.

“Knowing why children are going to the ED is essential to making sure the EDs are prepared to treat them appropriately.”

Over the 10-year study period ending in 2016, most visits occurred at non-children’s EDs in both metropolitan and non-urban settings. The study evaluated children 5 to 17 years old, and data is representative of all U.S. emergency departments.

Overall, the biggest increase in ED visits was among 15- to 17-year-olds (68% increase), and while the rate grew among both males and females, it was more pronounced in girls (74% increase).

In addition, ED visits for substance use disorders increased by 75%, with alcohol-related disorders decreasing by nearly 40% and substance use disorders significantly increasing (over 150%). The rate of visits for deliberate self-harm increased 329%.

“Examining the characteristics of EDs that children present to was important because outcomes have been shown to be directly linked to the volume and geographic location of the EDs,” said Charmaine Lo, PhD, MPH, the study’s lead author and senior research scientist in Emergency Medicine at Nationwide Children’s.

More research is needed to identify solutions that will better equip all EDs with the tools, personnel and resources to better manage pediatric cases, especially those associated with mental health.

Universal screenings for suicidal ideation, a recent requirement of the Joint Commission, is one step to improving the quality of care for those being treated for behavioral health conditions.

The authors say telehealth services can offer greater access to behavioral health specialists who can provide screening, help with acute interventions, and support connections to continued care within the community, thereby avoiding long distance transfers, transportation costs and delays in care.

“The overall goal of our work is to improve preparedness of EDs for children,” said Stanley. “Large children’s hospitals with psychiatric providers can offer outreach services to these smaller EDs in the form of telehealth. Another solution is more training for emergency physicians and nurses so they know how to treat and triage children.”

Recently, a team of experts collaborated to develop and open a Psychiatric Crisis Department dedicated solely for youth and adolescents in a behavioral or mental health crisis. The Psychiatric Crisis Department opened in March 2020 at the Big Lots Behavioral Health Pavilion at Nationwide Children’s in Columbus, Ohio, the largest center of its kind on a pediatric medical campus.

The need for the Pavilion and others like it around the country are vital as one in five children is living with a significantly impairing mental illness that interferes with everyday life. Half of all lifetime mental health issues start by age 14.

Source: Nationwide Children’s Hospital


High Fat Meal May Impair Concentration

Tue, 05/12/2020 - 6:00am

A new study finds eating just one meal high in saturated fat can hinder our ability to concentrate.

The Ohio State University study compared how 51 women performed on a test of their attention after they ate either a meal high in saturated fat or the same meal made with sunflower oil, which is high in unsaturated fat. Interestingly, the meal was a breakfast offering, designed to mimic breakfast choices found at fast food restaurants.

Researchers found participants’ attention span was worse after eating the high-saturated-fat meal than after they ate the meal containing a healthier fat, signaling a link between that fatty food and the brain.

As a background, researchers were also looking at whether a condition called leaky gut, which allows intestinal bacteria to enter the bloodstream, had any effect on concentration. Participants with leakier guts performed worse on the attention assessment no matter which meal they had eaten.

The loss of focus after a single meal was eye-opening for the researchers.

“Most prior work looking at the causative effect of the diet has looked over a period of time. And this was just one meal — it’s pretty remarkable that we saw a difference,” said Annelise Madison, lead author of the study and a graduate student in clinical psychology at The Ohio State University.

Madison also noted that the meal made with sunflower oil, while low in saturated fat, still contained a lot of dietary fat.

“Because both meals were high-fat and potentially problematic, the high-saturated-fat meal’s cognitive effect could be even greater if it were compared to a lower-fat meal,” she said.

The study appears in the American Journal of Clinical Nutrition.

Madison works in the lab of Janice Kiecolt-Glaser, professor of psychiatry and psychology and director of the Institute for Behavioral Medicine Research at Ohio State. For this work, Madison conducted a secondary analysis of data from Kiecolt-Glaser’s study assessing whether high-fat meals increased fatigue and inflammation among cancer survivors.

Women in the study completed a baseline assessment of their attention during a morning visit to the lab. The tool, called a continuous performance test, is a measure of sustained attention, concentration and reaction time based on 10 minutes of computer-based activities.

The high-fat meal followed: eggs, biscuits, turkey sausage and gravy containing 60 grams of fat, either a palmitic acid-based oil high in saturated fat or the lower-saturated-fat sunflower oil. Both meals totaled 930 calories and were designed to mimic the contents of various fast-food meals such as a Burger King double whopper with cheese or a McDonald’s Big Mac and medium fries.

Five hours later, the women took the continuous performance test again. Between one and four weeks later, they repeated these steps, eating the opposite meal of what they had eaten on the first visit.

Researchers also analyzed participants’ fasting baseline blood samples to determine whether they contained an inflammatory molecule that signals the presence of endotoxemia, the toxin that escapes from the intestines and enters the bloodstream when the gut barrier is compromised.

After eating the meal high in saturated fat, all of the participating women were, on average, 11 percent less able to detect target stimuli in the attention assessment. Concentration lapses were also apparent in the women with signs of leaky gut: Their response times were more erratic and they were less able to sustain their attention during the 10-minute test.

“If the women had high levels of endotoxemia, it also wiped out the between-meal differences. They were performing poorly no matter what type of fat they ate,” Madison said.

Though the study didn’t determine what was going on in the brain, Madison said previous research has suggested that food high in saturated fat can drive up inflammation throughout the body, and possibly the brain. Fatty acids also can cross the blood-brain barrier.

“It could be that fatty acids are interacting with the brain directly. What it does show is the power of gut-related dysregulation,” she said.

The statistical analysis accounted for other potential influences on cognition, including depressive symptoms and the participants’ average dietary saturated fat consumption. The women in the study ate three standardized meals and fasted for 12 hours before each lab visit to reduce diet variations that could affect their physiological response to the high-fat meals.

The findings suggest concentration could be even more impaired in people stressed by the pandemic who are turning to fatty foods for comfort, Kiecolt-Glaser said.

“What we know is that when people are more anxious, a good subset of us will find high-saturated-fat food more enticing than broccoli,” she said. “We know from other research that depression and anxiety can interfere with concentration and attention as well. When we add that on top of the high-fat meal, we could expect the real-world effects to be even larger.”

Source: Ohio State University Ohio State University

Even Before COVID-19, Many Older Adults Lacked Stable Food Supply

Tue, 05/12/2020 - 6:00am

Even before the COVID-19 pandemic negatively impacted the U.S. food supply and economy, a new poll shows that one in seven adults, ages 50 to 80, already had difficulties getting enough food because of cost or other issues.

The findings come from the National Poll on Healthy Aging, conducted by the University of Michigan (U-M) Institute for Healthcare Policy and Innovation (IHPI) with support from AARP and Michigan Medicine, U-M’s academic medical center.

The poll involved a national sample of more than 2,000 adults, ages 50 to 80, who answered a range of questions about their food security in December 2019.

According to the results, the number of respondents who said they’d experienced food insecurity in the past year was higher among those in their pre-Medicare years, as well as those who are African-American or Latino. Older adults with lower incomes and lower levels of education were also more likely to report that they’d had trouble getting food.

However, only a third of respondents with food affordability issues were receiving government food aid for people with low incomes, called SNAP benefits or “food stamps.” And less than 2% of those over 60 had received free meals served at senior centers or delivered to their home by programs like Meals on Wheels.

“This research reaffirms that many older adults struggle to afford the food they need, and are not using available food and nutrition assistance programs,” says Alison Bryant, Ph.D., senior vice president of research for AARP. “The current crisis makes it even more urgent to ensure that our most vulnerable populations can access the nutrition they need.”

Disruptions to food supply chains, employment and social services from COVID-19 may have worsened disparities, say the experts who designed the poll.

“These data suggest an important opportunity, which is likely even more urgent now, to connect older adults with resources they may not know about, and to explore public policies that could improve access,” says Cindy Leung, Sc.D., M.P.H., a member of IHPI and assistant professor of nutritional sciences at the U-M School of Public Health who worked on the poll.

Julia Wolfson, Ph.D., M.P.P., an assistant professor of health management and policy at the School of Public Health, notes the striking differences the poll reveals between those who said they hadn’t experienced food insecurity in the past year, and those who had.

“Food-insecure older adults were three times more likely to say they were in fair or poor physical health, and nearly five times as likely to say they were in fair or poor mental health,” Wolfson says.

Older adults with recent experiences of food insecurity were also twice as likely to say their diet was fair or poor. This could have further implications for their long-term health.

“Access to nutritious food and health status are closely linked, yet this poll reveals major disparities in that access,” says Preeti Malani, M.D., the poll’s director and a professor of internal medicine at Michigan Medicine.

“Even as we focus on preventing the spread of coronavirus, we must also ensure that older adults can get food that aligns with any health conditions they have, so we don’t exacerbate diabetes, hypertension, digestive disorders and other conditions further.”

Malani notes that because of COVID-19 and temporary closures of senior centers and other places that served meals, the federal program that supports Meals on Wheels and community food services for older adults now has more available money to put toward more home-delivered meals. And new programs to feed older adults have started at the federal and state levels.

For example, the state of Michigan has established an expanded program for meal delivery thanks to the newly flexible funds. An online form, available through the state COVID-19 website, acts as the central intake site.

In addition, the U.S. Department of Agriculture, which oversees the Supplemental Nutrition Assistance Program or SNAP, has allowed states to apply for emergency waivers to make it easier for people to qualify for the program, or to stay on it.

AARP Foundation has provided grants to multiple programs that aim to reduce food insecurity, including Food on the Move, The Campus Kitchens Project and funding for states to help seniors apply for nutrition assistance. In light of the coronavirus crisis, AARP recently called for Congress and USDA to provide a temporary increase in the maximum benefit and minimum monthly benefit for SNAP.

The National Poll on Healthy Aging results are based on responses from a nationally representative sample of 2,048 adults ages 50 to 80 who answered a wide range of questions online. Questions were written, and data interpreted and put together by the IHPI team.

Source: Michigan Medicine- University of Michigan



Cognition, Walking Speed Often Decline Together in Older Adults

Mon, 05/11/2020 - 6:56am

Cognition and walking speed often parallel each other when it comes to determining the health trajectory of older adults, according to a new study by researchers at the University of Texas (UT) Health San Antonio.

“For most of the population we studied, changes in cognition and gait speed were parallel, which suggests shared mechanisms,” said Mitzi M. Gonzales, Ph.D., lead author of the study and a neuropsychologist with the Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, part of UT Health San Antonio.

Cognition and gait speed may be altered by blood vessel disease, brain tissue insults, hormone regulation, and abnormal deposits of amyloid beta and tau proteins in the brain, Gonzales said. Amyloid beta and tau deposits are well-known indicators of Alzheimer’s disease but may affect gait, too.

“Abnormal protein deposition promotes neurodegeneration and synaptic loss, which may induce dysfunction in brain regions governing cognition and gait,” said study co-author Sudha Seshadri, M.D., professor of neurology in UT Health’s Long School of Medicine and director of the Biggs Institute. “Another possibility is damage to white matter in regions integral to both cognition and gait coordination.”

For the study, researchers looked at data from 370 participants in the San Antonio Longitudinal Study of Aging (SALSA). Of all the participants, 182 were Mexican-American and 188 were European-American.

Cognition was measured using the Folstein Mini-Mental State Examination, a 30-item tool that assesses orientation to time and place, attention, recall, language and other aspects. Gait speed was measured with a timed 10-foot walk.

The subjects were grouped into three distinct trajectories based on the participants’ changes on a cognitive measure and a gait speed task over an average of 9½ years: Stable cognition and gait class (65.4% of the participants); cognitive and physical vulnerability class (22.2%); and physical vulnerability class (12.4%).

“In our community-based sample of Mexican-American and European-American older adults aged 65 to 74 years old at baseline, the majority of individuals began the study with higher scores in both domains, cognition and gait speed,” said study senior author Helen Hazuda, Ph.D., professor at Long School of Medicine and the principal investigator of SALSA.

“During follow-up, this group demonstrated resilience to age-related declines and continued to be functionally independent. In contrast, one-fifth of individuals began the study with lower scores in cognition and gait speed. They experienced deterioration in each domain during the follow-up period,” Hazuda said.

The third group of individuals, termed the physical vulnerability class, demonstrated stable cognition throughout the study, but their gait speed slowed over time.

The Mexican-American participants were almost four times more likely than European-Americans to be in the cognitive and physical vulnerability class, even after statistical adjustment for educational attainment, income and chronic medical conditions, Gonzales said.

Prevalence of a key risk factor in this group, diabetes, was significantly higher in Mexican-Americans (23%) than in European-Americans (7%). Diabetes was associated with a 4½ times higher likelihood of being part of the cognitive and physical vulnerability class.

Individuals who entered the study with poorer cognition and slower gait speed went on to decline in both domains at an accelerated pace through the years of follow-up, Hazuda said.

“In this at-risk group, we observed steeper rates of decline over and above the low starting point,” Hazuda said. “This suggests that preventive efforts should ideally target young and middle-aged adults in which there is still time to intervene to alter the trajectories.”

Overall, individuals in the cognitive and physical vulnerability class and the physical vulnerability class had a five- to sevenfold increased risk of mortality in comparison to the stable cognition and gait class.

Source: University of Texas Health Science Center at San Antonio


Regular Religious Service Attendance Tied to Fewer ‘Deaths of Despair’

Sun, 05/10/2020 - 9:58pm

A new study finds that people who attend religious services at least once a week are significantly less likely to die from “deaths of despair,” including those related to suicide, drug overdose, and alcohol poisoning.

The research team led by Harvard T.H. Chan School of Public Health also showed that the link between service attendance and lower risk of deaths from despair was somewhat stronger for women in the study than for men.

“Despair is something that can confront anyone dealing with severe difficulties or loss,” said Dr. Tyler VanderWeele, the John L. Loeb and Frances Lehman Loeb Professor of Epidemiology at the Chan school. 

“While the term ‘deaths of despair’ was originally coined in the context of working-class Americans struggling with unemployment, it is a phenomenon that is relevant more broadly, such as to the health care professionals in our study who may be struggling with excessive demands and burnout, or to anyone facing loss. As such, we need to look for important community resources that can protect against it.”

VanderWeele is also director of the Human Flourishing Program and co-director of the Initiative on Health, Religion and Spirituality at Harvard University.

Religion has been considered a social determinant of health, and previous research has shown that attending religious services may be linked to a reduced risk of various factors associated with despair, including heavy drinking, substance misuse and suicidality.

For the study, the research team looked at data from the Nurses’ Health Study II involving 66,492 women as well as data from the Health Professionals Follow-Up Study on 43,141 men. 

Among the women, there were 75 deaths from despair: 43 suicides, 20 deaths from poisoning, and 12 deaths from liver disease and cirrhosis. Among the men there were 306 deaths from despair: 197 suicides, 6 deaths from poisoning, and 103 deaths from liver diseases and cirrhosis.

After adjusting for a number of variables, the researchers found that women who attended services at least once per week had a 68% lower risk of death from despair compared to those never attending services. Men who attended services at least once per week had 33% lower risk of death from despair.

The study authors noted that religious participation may serve as an important antidote to despair and a positive practice for keeping a sense of hope and meaning. They also say that religion may be linked to strengthened psychosocial resilience by fostering a sense of peace and positive outlook, and promoting social connectedness.

“These results are perhaps especially striking amidst the present COVID-19 pandemic,” said Dr. Ying Chen, research associate and data scientist at the Human Flourishing Program at Harvard’s Institute for Quantitative Social Science, and first author of the paper. 

“They are striking in part because clinicians are facing such extreme work demands and difficult conditions, and in part because many religious services have been suspended. We need to think what might be done to extend help to those at risk for despair.”

Other authors from Harvard Chan School include Drs. Howard Koh and Ichiro Kawachi. Dr. Michael Botticelli of the Grayken Center for Addiction at Boston Medical Center was also a co-author.

The findings are published online in the journal JAMA Psychiatry.

Source: Harvard T.H. Chan School of Public Health


Many Kids With Autism Had Sleep Problems as Infants

Sun, 05/10/2020 - 6:30am

In a new study of more than 400 young children, those who were diagnosed with autism were more likely to have had difficulty falling asleep as infants. This sleep difficulty was associated with altered growth trajectories in the hippocampus.

The findings are published in the American Journal of Psychiatry.

Infants spend most of their first year of life sleeping, and these hours are vital for brain development, as neural connections are formed and sensory memories are encoded. But when sleep is disrupted, as occurs more often among children with autism, brain development may be affected.

In the new study, researchers at the University of Washington (UW) found that sleep problems in a baby’s first 12 months may not only precede an autism diagnosis, but also may be linked to an altered growth trajectory in a key part of the brain: the hippocampus.

“The hippocampus is critical for learning and memory, and changes in the size of the hippocampus have been associated with poor sleep in adults and older children,” said lead author Dr. Kate MacDuffie, a postdoctoral researcher at the UW Autism Center. “However, this is the first study we are aware of to find an association in infants as young as 6 months of age.”

As many as 80% of children with autism spectrum disorder (ASD) have sleep problems, said Dr. Annette Estes, director of the UW Autism Center and senior author on the study. But much of the existing research focus on behavior and cognition.

With sleep such a critical need for children and their parents, the researchers involved in the multicenter Infant Brain Imaging Study Network, or IBIS Network, believed there was more to be examined.

“In our clinical experience, parents have a lot of concerns about their children’s sleep, and in our work on early autism intervention, we observed that sleep problems were holding children and families back,” said Estes, who is also a UW professor of speech and hearing sciences.

The study was conducted because researchers had questions about how sleep and autism were related, Estes said. For example, do sleep problems exacerbate the symptoms of autism? Or is it the other way around, that autism symptoms lead to sleep problems? Or something different altogether?

“It could be that altered sleep is part-and-parcel of autism for some children. One clue is that behavioral interventions to improve sleep don’t work for all children with autism, even when their parents are doing everything just right. This suggests that there may be a biological component to sleep problems for some children with autism,” Estes said.

To investigate any associations among sleep, brain development and autism, researchers at the IBIS Network evaluated the MRI scans of 432 infants, surveyed parents about sleep patterns, and measured cognitive functioning using a standardized assessment.

Researchers at four institutions — UW, University of North Carolina at Chapel Hill, Washington University in St. Louis and the Children’s Hospital of Philadelphia — evaluated the children at 6, 12 and 24 months of age and surveyed parents about their child’s sleep, all as part of a longer questionnaire covering infant behavior. Sleep-specific questions addressed how long it took for the child to fall asleep or to fall back asleep if awakened in the middle of the night, for example.

At the beginning of the study, infants were classified according to their risk for developing autism. Those who were at higher risk of developing autism had an older sibling who had already been diagnosed (about two-thirds of the study sample). Infant siblings of children with autism have a 20 percent chance of developing autism spectrum disorder, a much higher risk than children in the general population.

A 2017 study by the IBIS Network found that infants who had an autistic older sibling and who also showed expanded cortical surface area at 6 and 12 months of age were more likely to be diagnosed with autism compared with infants without those indicators.

In the new study, 127 of the 432 infants were identified as “low risk” at the time the MRI scans were taken because they had no family history of autism. They later evaluated all of the participants at 24 months of age to determine whether they had developed autism. Of the roughly 300 children originally considered “high familial risk,” 71 were diagnosed with ASD.

The findings allow researchers to re-examine previously collected longitudinal brain scans and behavioral data and identify some patterns. Difficulties with sleep were more common among the infants later diagnosed with ASD, as were larger hippocampi.

No other subcortical brain structures were affected, including the amygdala, which is responsible for certain emotions and aspects of memory, or the thalamus, a signal transmitter from the spinal cord to the cerebral cortex.

The UW-led sleep study is the first to show an association between hippocampal growth and sleep problems in infants who are later diagnosed with autism. It is still unclear if there is a causal relationship, however.

Source: University of Washington


Garden Time Linked to Better Health and Well-Being

Sun, 05/10/2020 - 6:00am

A new study shows a link between spending time in a garden and enhanced health and mental well-being.

For the study, researchers at the University of Exeter and the Royal Horticultural Society charity in the UK analyzed data from nearly 8,000 people collected by Natural England between 2009 and 2016.

The researchers found that people who spend time in a garden are significantly more likely to report general good health, higher psychological well-being, and greater physical activity levels than those who do not spend time in a garden.

The study found the benefits of gardening to health and well-being were similar to the difference in health between people living in the wealthiest parts of the country, compared to the poorest, the researchers added.

The benefits applied whether people spent their time gardening or simply relaxing, according to the study’s findings.

People who regularly spend time in their garden were also more likely to visit nature elsewhere once a week, the researchers noted.

The study also found that people with access to a private garden had higher psychological well-being. The researchers also discovered that people who have an outdoor space, such as a yard, were more likely to meet physical activity guidelines.

There is growing evidence that living in a greener neighborhood can be good for health and well-being, but most research has focused on public green spaces, such as parks and playing fields, the researchers noted. The current research used data collected by Natural England’s Monitor of Engagement with the Natural Environment Survey, the world’s largest survey collecting data on people’s weekly contact with the natural world.

“A growing body of evidence points to the health and well-being benefits of access to green or coastal spaces,” said Dr. Sian de Bel, of the University of Exeter Medical School and lead author of the study. “Our study is one of the largest to date to look at the benefits of gardens and gardening specifically. Our findings suggest that whilst being able to access an outdoor space such as a garden or yard is important, using that space is what really leads to benefits for health and well-being.”

“Gardens are a crucial way for people to access and experience the natural environment,” added project lead Dr. Becca Lovell of the University of Exeter Medical School. “Our new evidence highlights that gardens may have a role as a public health resource and that we need to ensure that their benefit is available equally.”

“This work adds to the increasing body of scientific evidence on the health benefits of gardens and gardening,” said Professor Alistair Griffiths, director of science and collections at the Royal Horticultural Society and co-author on the paper. “As the current COVID crisis has demonstrated, there’s an urgent need to include the provision of private gardens in the planning process to better support the UK’s preventative health agenda and the wellbeing of our nation.”

“In these unprecedented times, the government’s priority continues to be making sure people stay at home to help protect the NHS and save lives,” said Marian Spain, Interim Chief Executive of Natural England. “The benefits of spending time around nature during this time, be that in our back gardens or in local green spaces as part of our daily exercise, cannot be underestimated — and this research shines a light on the impact this has on people’s health and well-being.”

The study was published in Elsevier’s Landscape and Urban Planning.

Source: University of Exeter

Rural Environment Tied to Better Mental Health for Elderly

Sat, 05/09/2020 - 7:00am

A new study has found a link between the mental well-being of the elderly and where they live.

Specifically, researchers discovered that those who live in more rural areas enjoy better mental health.

The study by researchers at the University of Barcelona and Pompeu Fabra University in Spain focuses on a field that has been little studied to date: The association between the main variables related to the satisfactory mental well-being of the elderly and the rural or urban characteristics of the environment in which they live.

“The perception that older people living in rural areas have with regard to the limitations of health and aging is associated with less deterioration of mental well-being, while living in urban areas is related with an increased risk of suffering emotional problems attributable to economic difficulties or a low level of education,” the researchers said in the study, which was published in the International Journal of Environmental Research and Public Health.

The researchers say that encouraging older people to live in rural areas could lead to greater well-being in later life.

The researchers used cross-sectional microdata from 2015 and 2017 from the Health Survey of Catalonia (ESCA), an official survey administered to the entire population residing in Catalonia, which is conducted continuously throughout the year.

The sample, which is representative of the overall population, included 2,621 individuals (1,219 men and 1,402 women) aged 65 and over living in municipalities classified as rural, semi-urban, and urban.

Each person responded to a questionnaire, providing information on their health and lifestyles in relation to a wide range of socio-demographic factors, the researchers explained. The results were measured using the Short Warwick-Edinburgh scale of mental wellbeing (SWEMWBS), which allowed the researchers to extract indicators of mental wellbeing.

The study sought to identify factors that may influence the mental wellbeing of older people, including where they live, as well as socio-demographic, health, and lifestyle characteristics.

Some of the risk factors identified by the researchers included demographic factors, economic status, self-perceived health, physical health burden, functional limitations and dependence, social support, family burden, physical activity and sleep hours.

 “Variables related to health status, personal autonomy and social support appear to be strongly associated with mental well-being,” the researchers said in the study.

The study’s finding show that those who live in the most rural areas had a better level of mental wellbeing. For example, 21.4 percent of the people who lived in urban areas had deficient scores, compared to 17.4 percent for people who lived in semi-rural areas and 12.9 percent for rural residents.

According to the researchers, the study affirms that social policies should seek to address not only health problems but also well-being including mental health, in both urban and rural environments.

“Our results reinforce the belief that good social welfare policies are crucial,” the researchers concluded. “Policymakers must try to plan the specific provision of services to cover different geographic areas that present different demographic patterns.”

The study was conducted by Drs. Manuela Alcañiz and Maria-Carme Riera-Prunera, researchers at the Department of Econometrics, Statistics and Applied Economics at the University of Barcelona, and Dr. Aïda Solé-Auró, a researcher of the Sociodemography research group (DemoSoc) at the Department of Political and Social Sciences at Pompeu Fabra University in Barcelona.

Source: Pompeu Fabra University

Yoga May Help Ease Migraines

Sat, 05/09/2020 - 6:00am

Migraine patients who add yoga to their regularly prescribed treatment plan may experience greater relief from the debilitating condition than when they take medication alone, according to a new study published in the online issue of Neurology, the medical journal of the American Academy of Neurology.

The findings show that participants who added yoga to their regimen experienced significant benefits in all areas, including headache frequency, pain intensity, use of medications and how much migraine interfered with daily life.

“Migraine is one of the most common headache disorders, but only about half the people taking medication for it get real relief,” said study author Rohit Bhatia, M.D., D.M., D.N.B., of the All India Institute of Medical Sciences in New Delhi, India, and a member of the American Academy of Neurology.

“The good news is that practicing something as simple and accessible as yoga may help much more than medications alone. And all you need is a mat.”

For the study, the researchers observed 114 people between the ages of 18 and 50 who had episodic migraine. Participants had been experiencing four to 14 headaches per month and were randomly assigned to one of two groups: medication-only or yoga plus medication.

Individuals in the yoga group were taught a one-hour yoga practice that included breathing and relaxation exercises and postures. The participants were supervised by a yoga instructor three days a week for one month.

Then the participants in the yoga group practiced on their own at home for five days a week over the next two months. Both groups were given the appropriate medications and counseling about lifestyle changes that may help with migraine, such as getting plenty of sleep, eating regular meals and exercising. Participants kept a log about how long their headaches lasted, how severe they were and medications they took.

The study showed participants improved in both the medication-only group as well as the yoga group; however, the benefit was greater in the yoga group in all areas, including headache frequency, pain intensity, use of medications as well as how much migraine interfered with daily life.

For headache frequency, the yoga group started with an average of 9.1 headaches per month, and ended the study reporting just 4.7 headaches per month, a 48% reduction. The medication-only group reported an average of 7.7 headaches per month at the start of the study and 6.8 at the end of the three months, a 12% decrease.

The average number of pills participants in the yoga group used decreased by 47% after three months. Meanwhile, the average number of pills the medication-only group used decreased by about 12%.

“Our results show that yoga can reduce not just the pain, but also the treatment cost of migraines,” said Bhatia. “That can be a real game changer, especially for people who struggle to afford their medication. Medications are usually prescribed first, and some can be expensive.”

One limitation of the study was that people reported information about their headaches themselves, so the results may not be consistent.

Bhatia also noted that the research lasted only three months and that more evidence is needed to determine whether the benefits of yoga would last for a longer period.

Source: American Academy of Neurology


Study IDs Potential New Drug Target for Schizophrenia

Fri, 05/08/2020 - 7:30am

Japanese researchers have discovered a deficiency in the brains of people with schizophrenia. The findings could lead to the development of new drug therapies.

For the study, researchers at the RIKEN Center for Brain Science (CBS) in Japan conducted post-mortem exams (autopsies) and discovered that schizophrenia was linked to lower-than-normal levels of S1P, a type of fatty molecule found in the white matter of the brain.

In recent years, drug therapy for schizophrenia has come to a halt. Most schizophrenia drugs currently available are based on dopamine, but they are ineffective in about one out of every three patients. The researchers believe that preventing S1P degradation might be a new target for drug development.

“Because we don’t have another angle on what causes schizophrenia, many pharmaceutical companies are pulling out of schizophrenia-related drug development,” says Takeo Yoshikawa, team leader at RIKEN CBS. “Hopefully, our findings can provide the new angle with a new target for drug development.”

Although schizophrenia is a well-researched mental disorder, the mechanisms behind it remain a mystery. Scientists have known for some time that the brains of people with schizophrenia have less white matter than normal brains.

White matter is produced by oligodendrocytes, special cells that wrap around the parts of neurons that carry outgoing signals, which help them communicate with each other. The psychotic symptoms of schizophrenia include hallucinations and delusions — the inability to distinguish reality from fantasy — which might originate in white matter abnormalities that cause irregular communication between neurons.

Led by Takeo Yoshikawa, the team at RIKEN CBS investigated sphingolipids, a group of lipids known to have many functions, some related to white matter. In cadavers of schizophrenia patients, the researchers conducted an analysis of the large white matter tract that connects the left and right sides of the brain. In doing so, they found a severe deficiency in S1P, a sphingolipid necessary for oligodendrocyte production.

Further research showed that although normal amounts of S1P had been produced, it was metabolized and broken down when it should not have been.

“Drugs that prevent S1P degradation could be particularly effective in treating schizophrenia,” says Kayoko Esaki, first author and postdoctoral research scientist.

Although the experiment sounds simple, measuring S1P levels in the brains of cadavers was a big challenge and required interdisciplinary expertise in chemistry — specifically mass spectrometry — that was brought to the team by Esaki.

“This was the first psychiatric study of the postmortem brain to use mass spectroscopic analysis, and our discovery would not have been possible without our newly established comprehensive technique for screening sphingolipids,” says Yoshikawa.

After discovering S1P sphingolipid deficiency in schizophrenia brains, the researchers then examined postmortem brains of people with bipolar disorder or major depressive disorder. They found that S1P levels did not differ from what they found in normal brains, indicating that the problem is specific for schizophrenia, and not a common feature of mental disorders.

Before schizophrenia-specific clinical trials can begin, studies in animals will be necessary. “The next important step,” says Yoshikawa, “is to determine precisely which S1P receptor-acting drugs are effective in experimental animals. Although the new blockbuster drug fingolimod works at the S1P receptor and is effective at treating multiple sclerosis, we do not yet know how effective it would be for schizophrenia.”

The findings are published in the journal Schizophrenia Bulletin.

Source: RIKEN

With Engaged, Flexible Parenting, Happy Babies Can Become Happy Toddlers

Fri, 05/08/2020 - 7:00am

In a new U.K. study of children under the age of two, researchers found that parents who take a more flexible approach to their infant’s learning can minimize behavioral problems during the toddler years — but only if they were easy babies.

This flexible method of parenting, known as ‘autonomy support,’ puts emphasis on the child taking the lead while learning new things. For example, as the child engages in tasks, parents should watch and adjust how they respond according to how the child is managing, say the researchers. They acknowledge that this method of helping the child to be in control is not necessarily easy.

The findings are published in the journal Developmental Science.

Specifically, the study shows a link between parental autonomy support in 14-month-old children, and reduced behavioral problems ten months later. However, this link only applied to children who had been rated as ‘easy babies’ — those in a generally happy mood, who adapted easily to new experiences and quickly established routines.

Further, children who showed high levels of self-control at 14 months were less likely to exhibit behavior problems at 24 months, compared to babies with less self-control.

“It’s not about doing everything for your child, or directing their actions. It’s more of a to-and-fro between parent and child. Parents who do best at this can sit back and watch when they see their child succeeding with something, but increase support or adapt the task when they see the child struggling,” said Professor Claire Hughes, Deputy Director of the Centre for Family Research at the University of Cambridge, and joint first author of the study.

“If you’re blessed with a happy baby, then you can get them through the ‘terrible twos’ without things getting too bad or lasting too long, by being flexible about the way you play with your child between the age of 14 and 24 months. A puzzle game, for example, can turn into quite a different game if you allow your child to take the lead,” said Hughes.

Many toddlers have temper tantrums and exhibit frustration and defiant behavior, in what is commonly known as the ‘terrible twos’. Unfortunately, the autonomy support strategy isn’t equally effective for all children: those born with a more irritable temperament are still more likely to be difficult toddlers.

Parenting needs to be tailored according to the child, say the researchers. Parents who don’t remember their baby having an easy temperament should let go of the idea of achieving specific goals during play, and allow their children to develop at their own pace. This is particularly true during the current COVID-19 quarantine.

“As we cope with the upheavals of being in lockdown, we’re having to be patient with ourselves in so many ways. Parents particularly need to be more patient with the toddlers who found life a bit more challenging, even in ordinary times,” said Hughes.

The study involved more than 400 expectant couples from the East of England, New York State and the Netherlands. Each couple was visited when their new baby was 4 months, 14 months and 24 months old, and filmed interacting as their young children engaged in a range of specific tasks. The researchers rated the level of parental support for each interaction. In addition, parents rated their child’s temperament as a baby, and reported any behavioral problems at 14 and 24 months.

Simple tasks were used to assess the level of autonomy support parents gave to their child. In one, each child was given farm animal pieces that fit into cut-out shapes on a board. Some of the parents appeared quite anxious for their child to put the pieces in the right places, and gave them a lot of help. Others realized that the task was too difficult for their child, and let the game evolve by following the child’s lead.

“We had some children who took two animal pieces from a wooden farm puzzle and started clapping them together, and making a game out of the fact that they made a clapping noise. Here, parents might respond by encouraging the child to make animal noises that match the animals being clapped together,” said Devine. “Autonomy supportive parenting is about being flexible, following a child’s lead, and providing just the right amount of challenge.”

During the COVID-19 lockdown, many parents are having to look after young children at home rather than leaving them in nursery care during working hours. Trying to keep children motivated and engaged all day can be a daunting task. Yet having more time to spend with young children can also be seen as a rare opportunity to explore new ways of engaging with them, say the researchers.

“Rather than trying to make a child achieve a rigidly defined task, autonomy support is more of a playful interaction. It promotes the child’s problem solving and their ability to learn, by letting games or tasks evolve into experiences that engage them,” said Hughes.

Hughes conducted the study with Dr. Rory Devine from the University of Birmingham’s School of Psychology.

Source: University of Cambridge