Tag Archives: mental health

More daytime sleepiness, more Alzheimer’s disease?

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Aging adults who report being very sleepy during the day were nearly three times more likely than those who didn’t to have brain deposits of beta amyloid, a protein that’s a hallmark for Alzheimer’s disease, years later.

The finding, published on Sept. 5 in the journal SLEEP, adds to a growing body of evidence that poor quality sleep could encourage this form of dementia to develop, suggesting that getting adequate nighttime sleep could be a way to help prevent Alzheimer’s disease.

“Factors like diet, exercise and cognitive activity have been widely recognized as important potential targets for Alzheimer’s disease prevention, but sleep hasn’t quite risen to that status–although that may well be changing,” says Adam Spira, associate professor at the Johns Hopkins Bloomberg School of Public Health.

“If disturbed sleep contributes to Alzheimer’s disease,” he said. “We may be able to treat patients with sleep issues to avoid these negative outcomes.”

The study used data from the Baltimore Longitudinal Study of Aging (BLSA) that was started way back in  1958 to follow the health of thousands of volunteers as they age. Volunteers filled a questionnaire between 1991 and 2000 that asked a simple yes/no question: “Do you often become drowsy or fall asleep during the daytime when you wish to be awake?” They were also asked, “Do you nap?” with response options of “daily,” “1-2 times/week,” “3-5 times/week,” and “rarely or never.”

A subgroup of BLSA volunteers also began receiving neuroimaging assessments in 1994. Starting in 2005, some of these participants received positron emission tomography (PET) scans using Pittsburgh compound B (PiB), a radioactive compound that can help identify beta-amyloid plaques in neuronal tissue, which are a hallmark of Alzheimer’s disease.

The researchers identified 123 volunteers who both answered the earlier questions and had a PET scan with PiB an average of nearly 16 years later and then analyzed it to see if there was a correlation between participants who reported daytime sleepiness and whether they scored positive for beta-amyloid deposition in the brain.

The results showed that those who reported daytime sleepiness were about three times more likely to have beta-amyloid deposition than those who didn’t report daytime fatigue. After adjusting for other health factors, the risk was still 2.75 times higher among them.

The unadjusted risk for amyloid-beta deposition was about twice as high in volunteers who reported napping, but this did not reach statistical significance.

It’s currently unclear why daytime sleepiness would be correlated with the deposition of beta-amyloid protein, Spira says. One possibility is that daytime sleepiness itself might somehow cause this protein to form in the brain.

Based on previous research, a more likely explanation is that disturbed sleep or insufficient sleep due to other factors, causes beta-amyloid plaques to form through a currently unknown mechanism, and that these sleep disturbances also cause excessive daytime sleepiness.

“However, we cannot rule out that amyloid plaques that were present at the time of sleep assessment caused the sleepiness,” he added.

This new study adds to growing evidence that poor sleep might actually contribute to Alzheimer’s disease development. Spira suggests that sleep quality could be a risk factor that’s modifiable by targeting disorders that affect sleep, such as obstructive sleep apnea and insomnia, as well as social- and individual-level factors, such as sleep loss due to work or binge-watching TV shows.

“There is no cure yet for Alzheimer’s disease, so we have to do our best to prevent it. Even if a cure is developed, prevention strategies should be emphasized,” Spira says.

One hour of exercise a week can prevent depression

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A landmark study led by the Black Dog Institute has revealed that regular exercise of any intensity can prevent future depression – and just one hour can help.

Published today in the American Journal of Psychiatry, the results show even small amounts of exercise can protect against depression, with mental health benefits seen regardless of age or gender.

In the largest and most extensive study of its kind, the analysis involved 33,908 Norwegian adults who had their levels of exercise and symptoms of depression and anxiety monitored over 11 years.

The international research team found that 12 percent of cases of depression could have been prevented if participants undertook just one hour of physical activity each week.

“We’ve known for some time that exercise has a role to play in treating symptoms of depression, but this is the first time we have been able to quantify the preventative potential of physical activity in terms of reducing future levels of depression,” said lead author Associate Professor Samuel Harvey from Black Dog Institute and UNSW.

“These findings are exciting because they show that even relatively small amounts of exercise – from one hour per week – can deliver significant protection against depression.

“We are still trying to determine exactly why exercise can have this protective effect, but we believe it is from the combined impact of the various physical and social benefits of physical activity.

“These results highlight the great potential to integrate exercise into individual mental health plans and broader public health campaigns. If we can find ways to increase the population’s level of physical activity even by a small amount, then this is likely to bring substantial physical and mental health benefits.”

The findings follow the Black Dog Institute’s recent Exercise Your Mood campaign, which ran throughout September and encouraged Australians to improve their physical and mental wellbeing through exercise.

Researchers used data from the Health Study of Nord-Trøndelag County (HUNT study) – one of the largest and most comprehensive population-based health surveys ever undertaken – which was conducted between January 1984 and June 1997.

A healthy cohort of participants was asked at baseline to report the frequency of exercise they participated in and at what intensity: without becoming breathless or sweating, becoming breathless and sweating, or exhausting themselves. At follow-up stage, they completed a self-report questionnaire (the Hospital Anxiety and Depression Scale) to indicate any emerging anxiety or depression.

The research team also accounted for variables which might impact the association between exercise and common mental illness. These include socio-economic and demographic factors, substance use, body mass index, new onset physical illness and perceived social support.

Results showed that people who reported doing no exercise at all at baseline had a 44% increased chance of developing depression compared to those who were exercising one to two hours a week.

However, these benefits did not carry through to protecting against anxiety, with no association identified between level and intensity of exercise and the chances of developing the disorder.

According to the Australian Health Survey, 20 percent of Australian adults do not undertake any regular physical activity, and more than a third spend less than 1.5 hours per week being physically active. At the same time, around 1 million Australians have depression, with one in five Australians aged 16-85 experiencing a mental illness in any year.

“Most of the mental health benefits of exercise are realised within the first hour undertaken each week,” said Associate Professor Harvey.

“With sedentary lifestyles becoming the norm worldwide, and rates of depression growing, these results are particularly pertinent as they highlight that even small lifestyle changes can reap significant mental health benefits.”

Smartphone apps reduce depression

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New Australian-led research has confirmed that smartphone apps are an effective treatment option for depression, paving the way for safe and accessible interventions for the millions of people around the world diagnosed with this condition.

Depression is the most prevalent mental disorder and a leading cause of global disability, with mental health services worldwide struggling to meet the demand for treatment.

In an effort to tackle this rising challenge, researchers from Australia’s National Institute of Complementary Medicine (NICM), Harvard Medical School, The University of Manchester, and the Black Dog Institute in Australia examined the efficacy of smartphone-based treatments for depression.

The researchers systematically reviewed 18 randomised controlled trials which examined a total of 22 different smartphone-delivered mental health interventions.

The studies involved more than 3400 male and female participants between the ages of 18-59 with a range of mental health symptoms and conditions including major depression, mild to moderate depression, bipolar disorder, anxiety and insomnia.

The first of its kind research, published today in World Psychiatry found that overall smartphone apps significantly reduced people’s depressive symptoms, suggesting these new digital therapies can be useful for managing the condition.

Lead author of the paper, NICM postdoctoral research fellow Joseph Firth says this was an important finding which presented a new opportunity for providing accessible and affordable care for patients who might not otherwise have access to treatment.

“The majority of people in developed countries own smartphones, including younger people who are increasingly affected by depression,” said Mr Firth.

“Combined with the rapid technological advances in this area, these devices may ultimately be capable of providing instantly accessible and highly effective treatments for depression, reducing the societal and economic burden of this condition worldwide.”

Co-author, NICM deputy director, Professor Jerome Sarris highlighted the importance of the findings for opening up non-stigmatising and self-managing avenues of care.

“The data shows us that smartphones can help people monitor, understand and manage their own mental health. Using apps as part of an ‘integrative medicine’ approach for depression has been demonstrated to be particularly useful for improving mood and tackling symptoms in these patients,” said Professor Sarris.

When it comes to the question of “Which app is best?” and “For who?”, the results suggested these interventions so far may be most applicable to those with mild to moderate depression, as the benefits in major depression have not been widely studied as of yet.

The researchers found no difference in apps which apply principles of mindfulness compared to cognitive behavioural therapy or mood monitoring programs.

However, interventions that used entirely ‘self-contained’ apps – meaning the app did not reply on other aspects such as clinician and computer feedback – were found to be significantly more effective than ‘non-self-contained’ apps.

The authors suggested this might be due to the comprehensiveness of these particular stand-alone apps rather than the combination of therapies.

Despite the promising early results, there is currently no evidence to suggest that using apps alone can outperform standard psychological therapies, or reduce the need for antidepressant medications.

According to co-author and co-director of the digital psychiatry program at Beth Israel Deaconess Medical Center and a clinical fellow in the department of psychiatry at Harvard Medical School, Dr John Torous, the research is a timely and promising step forward in the use of smartphones in mental health.

“Patients and doctors are faced with a vast array of mental health apps these days, and knowing which ones are actually helpful is imperative,” said Dr Torous.

“This research provides much needed information on the effectiveness of apps for depression, and offers important clues into the types of apps which can help patients manage their condition.”

Jennifer Nicholas, a PhD Candidate at Black Dog Institute and co-author of the paper says with the knowledge that apps can be effective for managing depression, future research must now investigate which features produce these beneficial effects.

“Given the multitude of apps available – many of them unregulated – it’s critical that we now unlock which specific app attributes reap the greatest benefits, to help ensure that all apps available to people with depression are effective.”

DREAMers at greater risk for mental health distress

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Immigrants who came to the United States illegally as small children and who meet the requirements of the Development Relief and Education for Alien Minors Act, more commonly known as DREAMers, are at risk for mental health distress, according to a new study from researchers at Rice University.

Picture of U.S. and Mexico”DREAMers Living in the United States: A Contextual Perspective and Clinical Implications” will appear in an upcoming edition of the American Journal of Psychiatry. This article presents a clinical perspective that emphasizes how living in the country without proper documentation affects mental health as a result of facing constant institutional and societal exclusion.

To study the prevalence of mental health distress among Mexican immigrants living illegally in high-risk areas (places that have strong opposition and punitive actions against immigrants living here illegally), the researchers surveyed nearly 260 people. To be eligible for the survey, the participants had to confirm that they were residing in the U.S. without proper documentation.

Among participants, respondents aged 18-25 were the most likely to exhibit psychological distress (63 percent). Also, more than 90 percent of all respondents cited the loss of their home, social status, family and symbolic self as reasons for mental health distress.

Luz Garcini, a postdoctoral research fellow in the Department of Psychology at Rice and the study’s lead author, said that DREAMers in particular are at risk for psychological distress and diminished quality of life as a result of the many complex stressors they face. They often experience these stressors over an extended period, under harsh living conditions and without access to adequate mental health services.

“DREAMers are often marginalized and discriminated against, and as a result they may become isolated from the larger educational and work communities,” Garcini said. “Many also experience separation from deported family members, and they do not have the option of traveling internationally to visit them. Finally, they live in constant fear of deportation and experience a sense of voicelessness, invisibility and limited opportunities, due to their conflicting undocumented status.”

Garicini hopes that the study will inform the development of interventions and advocacy efforts for this at-risk immigrant subgroup.

“Debates on programs and policies pertaining to DREAMers are complex and multifaceted, and differences of opinion and divisions on policy options are long-standing,” she said. “However, as clinicians, we may contribute by devising solutions grounded in evidence and developing alternatives designed to facilitate access to culturally and contextually sensitive mental health services for these at-risk youths, which is critical to protecting their mental health and their basic human rights.”