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1.
Immunological Disturbances and Neuroimaging Findings in Major Depressive Disorder (MDD) and Alcohol Use Disorder (AUD) Comorbid Patients.
Kakanakova, A, Popov, S, Maes, M
Current topics in medicinal chemistry. 2020;(9):759-769
Abstract
Mood disorders and Major Depressive Disorder, in particular, appear to be some of the most common psychiatric disorders with a high rate of comorbidity most frequently of anxiety or substance abuse disorders (alcohol use disorder). In both cases - MDD and AUD, a number of immunological disturbances are observed, such as chronic mild inflammation response, increased level of cytokines, hypercortisolaemia, which lead to specific changes in brain neurotransmitter functions. Some of the contemporary brain imaging techniques are functional magnetic resonance imaging (fMRI) and magnetic spectroscopy which are most commonly used to assess the brain metabolism and functional connectivity changes such as altered responses to emotional stimuli in MDD or overactivation of ventromedial prefrontal areas during delayed and underactivation of dorsolateral prefrontal regions during impulsive reward decisions in AUD and dysfunction of gamma-aminobutyric acid (GABA) and/or glutamate neurotransmitter systems, low NAA and myo-Inositol in both MDD and AUD.
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2.
Ketogenic Diet: A Dietary Modification as an Anxiolytic Approach?
Włodarczyk, A, Cubała, WJ, Wielewicka, A
Nutrients. 2020;(12)
Abstract
Anxiety disorders comprise persistent, disabling conditions that are distributed across the globe, and are associated with the high medical and socioeconomic burden of the disease. Within the array of biopsychosocial treatment modalities-including monoaminergic antidepressants, benzodiazepines, and CBT-there is an unmet need for the effective treatment of anxiety disorders resulting in full remission and recovery. Nutritional intervention may be hypothesized as a promising treatment strategy; in particular, it facilitates relapse prevention. Low-carbohydrate high-fat diets (LCHF) may provide a rewarding outcome for some anxiety disorders; more research is needed before this regimen can be recommended to patients on a daily basis, but the evidence mentioned in this paper should encourage researchers and clinicians to consider LCHF as a piece of advice somewhere between psychotherapy and pharmacology, or as an add-on to those two.
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3.
Low high-density lipoprotein and psychopathology: A review.
Douglas, J, Nasrallah, HA
Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists. 2019;(3):209-213
Abstract
BACKGROUND An association between the level of total cholesterol and psychopathology has been the focus of numerous studies. Low total cholesterol has been found to be related to depression, personality disorders, and dissociative disorder. High cholesterol has been associated with schizophrenia, obsessive-compulsive disorder (OCD), panic disorder, generalized anxiety disorder, and posttraumatic stress disorder. However, no reviews of the psychiatric correlates of high-density lipoprotein (HDL) have been published. We reviewed the literature for studies reporting a significant association between low or high levels of HDL and psychopathology. METHODS A search of major databases (PubMed and CINAHL) was conducted using the following keywords: HDL, depression, anxiety, schizophrenia, OCD, and psychiatric disorders. RESULTS Eight studies met our search criteria. Six of the 8 studies reported significantly higher rates of depression, anxiety, suicide attempts, and violent behaviors in participants with low HDL. CONCLUSIONS Overall, a low HDL may not only be associated with risk for cardiac disease, but also with increased risk for serious psychiatric disorders. Further controlled studies are warranted.
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4.
Silexan in anxiety disorders: Clinical data and pharmacological background.
Kasper, S, Müller, WE, Volz, HP, Möller, HJ, Koch, E, Dienel, A
The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry. 2018;(6):412-420
Abstract
OBJECTIVES Silexan is a lavender oil preparation available in 80-mg capsules. Here we review clinical trials investigating its anxiolytic efficacy, safety and tolerability in humans, as well as preclinical investigations supporting this therapeutic use. METHODS Besides three selected publications reporting preclinical investigations, seven clinical trials are included, of which five had a treatment duration of 6 or 10 weeks. Primary outcome measure was the HAM-A total score reduction, while single items were assessed with regard to effects on concomitant depressive symptoms and on quality of sleep. RESULTS In patients with subthreshold (subsyndromal) anxiety or generalised anxiety disorder (GAD), an anxiolytic effect of Silexan was evident after 2 weeks. HAM-A total score reductions between baseline and end of treatment were significantly superior to placebo in patients with subthreshold anxiety and comparable with those achieved under lorazepam or paroxetine in patients with GAD. In addition, Silexan had beneficial effects on typical concomitant symptoms of anxiety disorders, such as impaired sleep, somatic complaints, co-morbid depression or decreased quality of life. Except for mild gastrointestinal symptoms, Silexan did not induce any adverse effects and did not cause drug interactions, sedation or withdrawal symptoms at daily doses of 80 or 160 mg. CONCLUSIONS Silexan is a safe and effective treatment in anxiety disorders.
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5.
Kava for Generalized Anxiety Disorder: A Review of Current Evidence.
Ooi, SL, Henderson, P, Pak, SC
Journal of alternative and complementary medicine (New York, N.Y.). 2018;(8):770-780
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is a chronic and debilitating condition characterized by persistent and overpowering anxiety. Treatment of GAD with antidepressants and benzodiazepines is only moderately effective and not free from side effects. Kava (Piper methysticum) has been explored as a potential phytotherapeutic option for GAD. OBJECTIVES To perform a systematic review and meta-analysis of the available evidence on Kava as a treatment for GAD. METHODS Systematic search of English-language publications from major databases for clinical trials reporting the effects of Kava for the treatment of GAD. RESULTS Twelve articles were included in this review. Evidence supporting Kava as an effective treatment for GAD was found in two placebo-controlled trials and a reference-controlled trial. One negative trial demonstrated that Kava was not more effective than placebo. Meta-analyses of the results of three placebo-controlled trials (n = 130) favored Kava for GAD treatment with effect sizes between 0.59 and 0.99 (standard mean difference) without reaching statistical significance. Kava is an appealing treatment option to GAD patients who are more attune to natural remedies or lifestyle approaches to reduce stress. Positive patient experiences and improvement of vagal cardiac control due to Kava treatment were also reported in the literature. Kava is safe and well tolerated for short-term (4-8 weeks) therapeutic use at a dosage of 120-280 mg per day of Kavalactones, regardless of dosage schedule. CONCLUSIONS Current evidence, although promising, is insufficient to confirm the effect of Kava for GAD treatment beyond placebo. New evidence is expected from a large, multisite ongoing trial.
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6.
Emerging literature in the Microbiota-Brain Axis and Perinatal Mood and Anxiety Disorders.
Rackers, HS, Thomas, S, Williamson, K, Posey, R, Kimmel, MC
Psychoneuroendocrinology. 2018;:86-96
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Abstract
Perinatal Mood and Anxiety Disorders (PMAD) are common and can cause significant morbidity and mortality for mother and child. A healthy perinatal period requires significant adaptations; however, systems can become imbalanced resulting in depressive and anxiety symptoms. The interface between the microbiome, the immune system, and the stress system may be a model for understanding mechanisms underlying PMAD. Emerging literature from general populations regarding immune, hormone, and HPA axis changes in relation to the microbiome combined with literature on immune, gonadotropin, and stress systems in the perinatal period provides a background. We systematically investigated literature in the developing field of the microbiome in relation to PMAD. Our inclusion criteria were 1) reporting measure of maternal mood, stress, or anxious or depressed behavior; 2) in the perinatal period, defined as pregnancy through one year postpartum; and 3) reporting measure of maternal microbiome including manipulations of the microbiome through prebiotics, probiotics, or interventions with microbial byproducts. The review identified research studying associations between stress and maternal microbiome; dietary impacts on microbial composition, mood, and stress; and the relationship between the microbiome and the immune system through immunoregulatory mechanisms. Important themes identified include: the importance of studying the maternal microbiome and measures of stress, anxiety, and depression and that multi-hit models will be needed as research strives to determine the effects of multiple mechanisms working in concert.
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7.
Novel biotherapies are needed in youth mental health.
Amminger, GP, Berger, M, Rice, SM, Davey, CG, Schäfer, MR, McGorry, PD
Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists. 2017;(2):117-120
Abstract
Adverse effects and lack of efficacy in a significant number of patients limit pharmaceutical interventions in youth psychiatry. This is exemplified by the fact that no medication is currently approved for the treatment of non-OCD anxiety disorders or major depressive disorder in young people younger than 18 years of age in Australia. Here, emerging biological therapies for youth with mental health problems are discussed. There is an urgent need for more research into biological interventions with acceptable risk-benefit balances. Omega-3 fatty acids, cannabidiol and N-acetylcysteine are currently being evaluated. If initial findings are confirmed, they may offer alternatives with more benign side-effect profiles than existing treatments.
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Nutritional supplements in Anxiety Disorder.
Fernández-Rodríguez, M, Rodríguez-Legorburu, I, López-Ibor Alcocer, MI
Actas espanolas de psiquiatria. 2017;(Supplement):1-7
Abstract
In recent years, a direct relation between the occurrence of anxiety disorders, sleep disturbances, and mood disorders has been observed as a consequence of poor or inadequate diet. Eating habits in Western societies have greatly changed in recent decades, with an increase in the consumption of foods low in vitamin and mineral content, high in caloric value, and rapidly prepared and easily consumed. It may be that the new lifestyles that directly affect family organization and planning interfere with following a proper diet. However, with increasing frequency, especially among young adults, there is interest in healthy and balanced nutrition, as well as learning culinary techniques. We reviewed the literature for this study, and describe the concept of anxiety and its existence in relation to dietary disorders, as well as alternatives for the treatment of these symptoms. The characteristics of these disorders and their impact on patients are analyzed. The information used in this work was obtained mainly from PubMed, PsycARTICLES, PsycCRITIQUES, and PsycINFO. It was retrieved using the keywords “mental health”, “nutrition”, “diet”, “phytotherapy”, “natural alternatives”, “anxiety”, “mood”, and “sleep disturbance”.
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9.
Personality traits and emotional patterns in irritable bowel syndrome.
Muscatello, MR, Bruno, A, Mento, C, Pandolfo, G, Zoccali, RA
World journal of gastroenterology. 2016;(28):6402-15
Abstract
The review focuses on those personality traits (neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness), constructs (alexithymia and distressed - Type D personality) and emotional patterns (negative and positive) that are of particular concern in health psychology, with the aim to highlight their potential role on the pathogenesis, onset, symptom clusters, clinical course, and outcome of irritable bowel syndrome (IBS). Personality traits and emotional patterns play key roles in affecting autonomic, immune, inflammatory, and endocrine functions, thus contributing not only to IBS clinical expression and symptomatic burden, but also to disease physiopathology. In this sense, psychological treatments should address those personality traits and emotional features that are constitutive of, and integral to IBS. The biopsychosocial model of illness applied to IBS acknowledges the interaction between biological, psychological, environmental, and social factors in relation to pain and functional disability. A holistic approach to IBS should take into account the heterogeneous nature of the disorder, and differentiate treatments for different types of IBS, also considering the marked individual differences in prevalent personality traits and emotional patterns. Beyond medications, and lifestyle/dietary interventions, psychological and educational treatments may provide the optimal chance of addressing clinical symptoms, comorbid conditions, and quality of life in IBS patients.
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10.
[Hypnosis for anxiety and phobic disorders: A review of clinical studies].
Pelissolo, A
Presse medicale (Paris, France : 1983). 2016;(3):284-90
Abstract
OBJECTIVE Hypnosis is classically presented as a useful psychotherapy for various psychiatric conditions, especially in the field of stress and anxiety. However, its place in therapeutic of chronic anxiety disorders remains unclear and questioned. Thus, the goal of this systematic review was to analyse the papers reporting clinical data on the efficacy of hypnosis in anxiety disorders. METHODS A literature search was conducted on Pubmed to retrieve all original papers, published between 1980 and 2015, reporting clinical information on the efficacy of hypnosis in six categories of anxiety disorders. Each paper has been assessed from a methodological point of view, and the results have been analysed. RESULTS Only three controlled studies have been identified, one in panic disorder and two in post-traumatic stress disorder (PTSD). The other papers related open-design studies (4 articles), or single case reports (20 articles). The controlled study conducted in panic disorder suggested that the combination of hypnosis with cognitive-behavior therapy was not an effective strategy, and this negative result was also obtained in one of the studies conducted in PTSD. The third study, including 48 Indonesian children with PTSD, showed a significant improvement with a specific hypnosis technique adapted to the local culture. Other papers related also positive results but in non-controlled studies or in case reports, their conclusions cannot be generalized. CONCLUSION To date, evidence is negative or insufficient to support the efficacy of hypnosis in chronic anxiety disorders, in any categories whatsoever - including phobia or PTSD. Specific further studies are needed to identify some potential profiles predictive of response to hypnosis in these conditions.