-
1.
Intolerance of uncertainty and eating disorder behaviour: Piloting a consumption task in a non-clinical sample.
Kesby, A, Maguire, S, Vartanian, LR, Grisham, JR
Journal of behavior therapy and experimental psychiatry. 2019;:101492
Abstract
BACKGROUND AND OBJECTIVES Intolerance of uncertainty (IU) is a transdiagnostic process contributing to the maintenance of anxiety disorders, and is a potential target for treatment. Recent literature has investigated IU as a cognitive process underpinning pathological fear and anxiety in Anorexia Nervosa (AN). The current study was designed to examine trait and state IU, and their relationship to restrictive eating disorder symptoms, anxiety, worry, cognitive rigidity and eating behaviour. METHODS A sample of undergraduate women (N = 85) completed measures of eating disorder symptoms, IU, cognitive rigidity and worry. Participants were randomised to complete an eating task under one of two conditions: the "certain" condition received a high-calorie meal and nutritional information, while the "uncertain" condition received the meal alone. During the meal, state IU and state anxiety were examined at three time-points (baseline, pre-eating, post-eating). RESULTS Trait IU was correlated with cognitive rigidity, worry, global eating disorder symptoms, and, in particular, dietary restraint. No differences emerged between conditions with respect to eating-related anxiety, or amount of food eaten. Controlling for condition and eating disorder symptoms, state IU predicted pre-eating anxiety. Beyond the contribution of condition, BMI and eating disorder symptoms, state IU predicted consumption, specifically greater dietary restriction. LIMITATIONS The study employed a non-clinical sample. CONCLUSIONS IU may be implicated in a rigid cognitive style, the anxiety response to energy-dense food, and restrictive eating behaviour. Should these findings be replicated in a clinical sample, then IU might emerge as an adjunctive treatment target for AN.
-
2.
Herbal medicine for post-stroke anxiety: A systematic review and meta-analysis of randomized controlled trials.
Kwon, CY, Lee, B, Chung, SY, Kim, JW
Complementary therapies in clinical practice. 2019;:237-252
Abstract
The study was conducted to investigate the efficacy and safety of herbal medicine (HM) for post-stroke anxiety (PSA). Through comprehensive searches, twenty randomized controlled trials were included. Meta-analysis showed that compared to the HM group, the conventional pharmacotherapy group showed significantly lower Hamilton anxiety rating scale (HAMA) score after 1 week of treatment, but not after 2, 4, and 6 weeks of treatment, and higher HAMA score after 8 weeks and 3 months of treatment. Meanwhile, compared to the conventional pharmacotherapy alone group, the HM plus conventional pharmacotherapy group showed significantly better results in HAMA score after 2, 4, 6, and 8 weeks of treatment. HM group was associated with lower incidence of adverse events. Current evidence suggests that HM or HM plus conventional pharmacotherapy may be safe and effective in PSA patients within a certain time period. However, due to limited strength of evidence, definite conclusions are not possible.
-
3.
The effects of melatonin supplementation on mental health, metabolic and genetic profiles in patients under methadone maintenance treatment.
Ghaderi, A, Banafshe, HR, Mirhosseini, N, Motmaen, M, Mehrzad, F, Bahmani, F, Aghadavod, E, Mansournia, MA, Reiter, RJ, Karimi, MA, et al
Addiction biology. 2019;(4):754-764
Abstract
This investigation was designed to determine the effect of melatonin supplementation on mental health parameters, metabolic and genetic profiles in patients under methadone maintenance treatment (MMT). This randomized, double-blind, placebo-controlled, clinical trial was conducted among 54 patients under MMT. Participants were randomly allocated to receive either 10 mg melatonin (2 melatonin capsules, 5 mg each) (n = 26) or placebo (n = 28) once a day, 1 hour before bedtime for 12 weeks. Melatonin supplementation significantly decreased Pittsburgh Sleep Quality Index (β -4.08; 95 percent CI, -5.51, -2.65; P < 0.001), Beck Depression Inventory index (β -5.46; 95% CI, -8.92, -2.00; P = 0.003) and Beck Anxiety Inventory index (β -3.87; 95% CI, -5.96, -1.77; P = 0.001) and significantly increased International Index of Erectile Functions (β 5.59; 95% CI, 1.76, 9.42; P = 0.005) compared with the placebo. Subjects who received melatonin supplements had significantly lower serum insulin levels (β -2.53; 95% CI, -4.48, -0.59; P = 0.01), homeostasis model of assessment-insulin resistance (β -0.56; 95% CI, -1.03, -0.09; P = 0.01) and higher quantitative insulin sensitivity check index (β 0.01; 95% CI, 0.004, 0.02; P = 0.009) and HDL-cholesterol levels (β 3.71; 95% CI, 1.77, 5.64; P = 0.002) compared to placebo. Additionally, melatonin intake resulted in a significant reduction in serum high sensitivity C-reactive protein (β -0.15; 95% CI, -0.27, -0.02; P = 0.02), malondialdehyde (β -0.31; 95% CI, -0.57, -0.05; P = 0.02) and protein carbonyl (β -0.06; 95% CI, -0.09, -0.04; P < 0.001). This trial indicated that taking melatonin supplements for 12 weeks by patients under MMT had beneficial effects on their mental health metabolic profiles.
-
4.
Randomized Trial Comparing the Physiological and Psychological Effects of Different Relaxation Interventions in Chinese Women Breastfeeding Their Healthy Term Infant.
Yu, J, Wells, J, Wei, Z, Fewtrell, M
Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine. 2019;(1):33-38
Abstract
OBJECTIVE To compare the effects of different relaxation techniques on physiological outcomes and perceived relaxation in primiparous Chinese mothers breastfeeding their healthy term infant. DESIGN Twenty primiparous mothers who were breastfeeding were enrolled into a within-subject study, and attended six treatment sessions in randomized order (relaxation meditation tape [RM], music tape [M], relaxation lighting [L], combined RM+L, and combined M+L, and control session with no intervention), with a washout period of 1-3 days between sessions. Heart rate, systolic and diastolic blood pressure (SBP, DBP), fingertip temperature, and perceived relaxation were assessed before and after each session. RESULTS Compared with the pretest state, significant changes for all outcomes (p < 0.05) were observed for RM, RM+RL, M+RL treatments, whereas differences for all outcomes apart from SBP were observed for treatment M. Compared with the control, significant changes were found in all outcomes for RM treatment, and in fingertip temperature and perceived relaxation for all treatments. CONCLUSION Our findings suggest that simple relaxation techniques can reduce both perceived and physiological markers of stress in breastfeeding mothers. Overall, the RM was the most effective technique compared with the control state, considering the number of outcomes affected, effect sizes, and simplicity, suggesting this merits further research in this population.
-
5.
The effect of a very low calorie diet on subjective depressive symptoms and anxiety: meta-analysis and systematic review.
Ein, N, Armstrong, B, Vickers, K
International journal of obesity (2005). 2019;(7):1444-1455
Abstract
There are conflicting findings regarding the effect very low calorie diets (VLCDs) have on self-reported depressive symptoms and anxiety levels. Some studies have reported decreased subjective depressive symptoms and anxiety post-diet, whereas other studies have not. Further complicating matters, the protocol for VLCDs vary substantially across studies, which could account for the mixed findings. The primary goal of this meta-analysis and systematic review was to determine the effect VLCDs have on subjective depressive symptoms and anxiety pre- to post-diet. In addition, potential moderators (the presence/absence of behavioral therapy, duration of diet, inclusion/exclusion of low intensity exercise, and amount of weight lost) were examined to assess the effect of procedural deviations across VLCD studies on depressive symptoms and anxiety. A random-effects model was used for the meta-analysis and included nine studies with 16 independent samples. To further explain the results, study rigor was examined in the systematic review, which included 11 studies with 20 independent samples. Depressive symptoms significantly decreased pre- to post-diet when behavioral therapy was implemented during the diet, the duration of the diet was relatively long (8-16 weeks), low intensity exercise was included, and the dieters lost 14.1 kg or more post-diet. However, no difference in depressive symptoms were observed pre- to post-diet when behavioral therapy was not included, the diet was shorter (1-7 weeks), no exercise was implemented and dieters lost <14 kg of weight post-diet. There was no change in anxiety pre- to post-diet. Health care providers involved in supervising VLCDs should consider using a VLCD of at least 8 weeks that includes behavioral therapy and low intensity exercise in order to enhance the potential benefits of VLCDs on depressive symptoms. More research is required to examine the effect of VLCDs on anxiety.
-
6.
Celiac Disease Autoimmunity and Emotional and Behavioral Problems in Childhood.
Wahab, RJ, Beth, SA, Derks, IPM, Jansen, PW, Moll, HA, Kiefte-de Jong, JC
Pediatrics. 2019;(4)
Abstract
BACKGROUND AND OBJECTIVES Celiac disease (CeD) is associated with psychopathology in children. It is unknown whether this association is present in children with celiac disease autoimmunity (CDA) identified by screening. We examined the associations between subclinical CDA and emotional and behavioral problems in children without previous CeD diagnosis. METHODS In a population-based cohort study of 3715 children (median age: 6 years), blood titers of tissue transglutaminase autoantibodies were analyzed. CDA was defined as a measurement of tissue transglutaminase autoantibodies ≥7 U/mL (n = 51). Children with previous CeD diagnosis or children on a gluten-free diet, were excluded. The Child Behavior Checklist (CBCL) was filled in by parents and was used to assess behavioral and emotional problems of children at a median age of 5.9 years. Multiple linear regression models were applied to evaluate the cross-sectional associations between CDA and CBCL scores. Sensitivity analyses were done in a subgroup of children who were seropositive carrying the HLA antigen risk alleles for CeD. RESULTS In basic models, CDA was not associated with emotional and behavioral problems on the CBCL scales. After adjustment for confounders, CDA was significantly associated with anxiety problems (β = .29; 95% confidence interval 0.02 to 0.55; P = .02). After exclusion of children who did not carry the HLA-DQ2 and/or HLA-DQ8 risk alleles (n = 4), CDA was additionally associated with oppositional defiant problems (β = .35; 95% confidence interval 0.02 to 0.69). Associations were not explained by gastrointestinal complaints. CONCLUSIONS Our results reveal that CDA, especially combined with the HLA-DQ2 and HLA-DQ8 risk alleles, is associated with anxiety problems and oppositional defiant problems. Further research should be used to establish whether behavioral problems are a reflection of subclinical CeD.
-
7.
Probiotic Lactobacillus plantarum P8 alleviated stress and anxiety while enhancing memory and cognition in stressed adults: A randomised, double-blind, placebo-controlled study.
Lew, LC, Hor, YY, Yusoff, NAA, Choi, SB, Yusoff, MSB, Roslan, NS, Ahmad, A, Mohammad, JAM, Abdullah, MFIL, Zakaria, N, et al
Clinical nutrition (Edinburgh, Scotland). 2019;(5):2053-2064
Abstract
BACKGROUND & AIMS To investigate the effects of probiotic in alleviation of stress in stressed adults, along our focus to identify and justify strain specificity on selected health benefits with a precisely targeted population. METHODS This 12-weeks randomized, double-blind and placebo-controlled study investigated the effects of a probiotic (Lactobacillus plantarum P8; 10 log CFU daily) on psychological, memory and cognition parameters in one hundred and three (P8 n = 52, placebo n = 51) stressed adults with mean age of 31.7 ± 11.1 years old. All subjects fulfilled the criteria of moderate stress upon diagnosis using the PSS-10 questionnaire. RESULTS At the end of study, subjects on P8 showed reduced scores of stress (mean difference 2.94; 95% CI 0.08 to 5.73; P = 0.048), anxiety (mean difference 2.82; 95% CI 0.35 to 5.30; P = 0.031) and total score (mean difference 8.04; 95% CI 0.73 to 15.30; P = 0.041) as compared to placebo after 4-weeks, as assessed by the DASS-42 questionnaire. Although plasma cortisol levels were only marginally different between placebo and P8 (mean difference 3.28 ug/dl; 95% CI -7.09 to 0.52; P = 0.090), pro-inflammatory cytokines such as IFN-γ (mean difference 8.07 pg/ml; 95% CI -11.2 to -4.93; P < 0.001) and TNF-α (mean difference 1.52 pg/ml; 95% CI -2.14 to -0.89; P < 0.001) showed higher reduction as compared to placebo over 12-weeks. These were accompanied by enhanced memory and cognitive traits such as social emotional cognition and verbal learning and memory upon administration of P8 as compared to the placebo, with different effects in women as compared to men. CONCLUSIONS The present data illustrated that L. plantarum P8 is a feasible and natural intervention for the alleviation of selected stress, anxiety, memory and cognitive symptoms in stressed adults. TRIAL REGISTRATION Approved by the JEPeM-USM Review Panel on Clinical Studies (Approval number USM/JEPeM/16050195) and was registered at ClinicalTrials.gov (identifier number NCT03268447).
-
8.
The efficacy of herbal medicines on anxiety and depression in peri- and postmenopausal women: A systematic review and meta-analysis.
Shahmohammadi, A, Ramezanpour, N, Mahdavi Siuki, M, Dizavandi, F, Ghazanfarpour, M, Rahmani, Y, Tahajjodi, R, Babakhanian, M
Post reproductive health. 2019;(3):131-141
-
9.
An Observational Preliminary Study on the Safety of Long-Term Consumption of Micronutrients for the Treatment of Psychiatric Symptoms.
Rucklidge, JJ, Eggleston, MJF, Ealam, B, Beaglehole, B, Mulder, RT
Journal of alternative and complementary medicine (New York, N.Y.). 2019;(6):613-622
Abstract
Objectives: There is an increasing body of literature documenting the efficacy of micronutrients (vitamins and minerals) interventions for the treatment of psychiatric problems in the short term; however, long-term safety is largely unexplored. The goal of this observational study was to investigate the safety of two commercially available broad-spectrum micronutrient formulas (EMPowerplus and Daily Essential Nutrients) given at doses above the Recommended Dietary Allowances for the long-term treatment of individuals with psychiatric symptoms. Design: Participants on long-term treatment with micronutrients (medication-free) for psychiatric problems (attention-deficit hyperactivity disorder [ADHD, n = 21], anxiety/depression [n = 13]) were identified from ongoing research studies and the community through purchasing records. Seventeen children and 17 adults had blood tests to assess their full blood count, coagulation profile, liver and kidney function, fasting glucose, iron studies, key nutrients, and prolactin. Questionnaires assessed psychological/psychiatric functioning. Seventeen of the participants had completed the same measures pretreatment. Results: The average length of consuming micronutrients was 2.66 years (standard deviation = 2.86). Excluding B12 (which was elevated for almost all participants), 94.6% of all blood test results were within the test reference ranges. One participant was diagnosed with hemochromatosis based on iron studies. No other clinically relevant adverse changes in blood results were identified pre- and post-treatment. No clinically significant adverse effects were reported. Post-treatment psychometrics identified that 85% of the participants were in nonclinical ranges for measures of ADHD, depression, anxiety, and stress. Conclusions: We report preliminary evidence for the safety of long-term commercially available micronutrients, although questions remain. Overall, the substantial psychiatric benefits observed appear to outweigh the minimal observed risks in these participants. Screening for potential medical problems is recommended before initiating treatment. Long-term pharmacovigilance monitoring is required to ascertain any rare but significant adverse events.
-
10.
Effects of a Web-Based Self-Management Program on the Behavior and Blood Glucose Levels of Women with Gestational Diabetes Mellitus.
Kim, YS, Kim, HS, Kim, YL
Telemedicine journal and e-health : the official journal of the American Telemedicine Association. 2019;(5):407-414
Abstract
Background:Women diagnosed with gestational diabetes mellitus suffer from anxiety and depression, which make controlling blood glucose levels difficult.Introduction:This quasi-experimental study uses a nonequivalent control group pretest-posttest design to investigate the effects of a web-based self-care program on self-care behaviors, anxiety, depression, and blood glucose in patients with gestational diabetes mellitus.Methods:The subjects of the study were outpatients being treated in the Department of Endocrinology at Hospital G, located in Seoul near University C, from July 15, 2015, to December 31, 2016. The experimental and control groups contained 22 participants each. The experimental group received a 12-week web-based program and one session of nutrition education; the control group received nutrition education. Using the SPSS program, pre-post changes in blood glucose, anxiety, depression, and self-care behaviors were examined between the two groups by a repeated-measures ANOVA.Results:After the 12 weeks intervention, self-care behaviors increased in both groups, and blood glucose monitoring increased in the experimental group (p = 0.001). Anxiety in the experimental group decreased by 5.1 points but increased by 1.0 point in the control group (p = 0.048). Depression increased in both groups. Glycated hemoglobin (HbA1C) levels decreased in the experimental group but increased in the control group (p = 0.001).Discussion:In addition to reducing HbA1C and anxiety, the web-based self-care program was effective in increasing the frequency of daily blood glucose monitoring in patients with gestational diabetes mellitus.Conclusions:This study will be helpful in informing an anxiety intervention program, blood glucose control, and healthy self-care behaviors in women with gestational diabetes mellitus.