Posts Tagged ‘mental health’

Our thinking skills in childhood could offer a glimpse into how our minds might work at the age of 70, according to a study spanning decades.

The research started in 1946, when 502 8-year-olds, who were born in the U.K. in the same week, took tests to measure their thinking and memory skills. The participants took cognitive tests again between the ages of 69 and 71.

The participants also had scans, including a positron emission tomography (PET) scan that detects amyloid-beta plaques in the brain. These sticky collections of protein are linked to Alzheimer’s disease.

The study, published in the journal Neurology, shows those with the highest test scores in childhood were more likely to have high scores later in life. Kids in the top 25 percent had a greater chance of being in that same quartile at 70.

Educational attainment and socioeconomic status also appeared to make a difference. Those who were college-educated scored around 16 percent better in tests than those who left school before they hit 16. Participants who had a white-collar job were able to remember, on average, 12 details from a short story, versus 11 if they had a manual job. Overall, women did better than men when their memory and thinking speed were tested.

Participants who were found to have amyloid-beta plaques in their brains, meanwhile, scored lower on cognitive tests. In one assessment where participants had to find the missing pieces in five geometric shapes, those with the plaque got 23 out of 32 problems correct, versus 25 for those without the plaques.

Dr. Jonathan M. Schott of University College London commented: “Finding these predictors is important because if we can understand what influences an individual’s cognitive performance in later life, we can determine which aspects might be modifiable by education or lifestyle changes like exercise, diet or sleep, which may, in turn, slow the development of cognitive decline.

“Our study found that small differences in thinking and memory associated with amyloid plaques in the brain are detectable in older adults even at an age when those who are destined to develop dementia are still likely to be many years away from having symptoms.”

Earlier this year, Schott and his team published a separate study in the journal The Lancet Neurology that showed having high blood pressure in a person’s mid-30s was linked to higher levels of blood vessel damage in the brain, as well as shrinkage of the organ.

Professor Tara Spires-Jones from the UK Dementia Research Institute at the University of Edinburgh, who did not work on the new study, told Newsweek the findings add to other studies that suggest our genetics, as well as environmental factors, play a role in how we maintain our thinking skills as we age.

“However, this does not mean that all of your brain power during aging is determined during childhood,” she said. “There is good scientific evidence from this study and many others that keeping your brain and body active are likely to reduce your risk of developing Alzheimer’s disease, even as adults.”

Learning, socializing and exercise can all help, she said.

“One way this works is by building new connections between brain cells, called synapses. Synapses are the building blocks of memory, so building up a robust network of synapses, sometimes called ‘brain reserve’ is thought to be the biology behind the finding that more education is associated with a lower risk of dementia and age-related cognitive decline,” explained Spires-Jones.

Spires-Jones suggested amyloid-beta plaques might be linked with lower tests scores in the study because they build up and damage the connections between brain cells, called synapses, impairing brain function.

“Amyloid plaques are also widely thought to initiate a toxic cascade that leads to dementia in Alzheimer’s disease, including the build-up and spread of another pathology called ‘tangles,'” she said.

She said the study was “very strong” but limited because observational studies can’t explain the links that emerge, and the participants were all white so the results might not relate to other populations.

“It will be important in future work to try and understand the biological underpinnings for the associations between childhood intelligence and better cognitive ability during aging,” she said.

https://www.newsweek.com/dementia-aging-study-brains-tests-1468657

The 60 souls that signed on for Dr. Alain Brunet’s memory manipulation study were united by something they would rather not remember. The trauma of betrayal.

For some, it was infidelity and for others, a brutal, unanticipated abandonment. “It was like, ‘I’m leaving you. Goodbye,” the McGill University associate professor of psychiatry says.

In cold, clinical terms, his patients were suffering from an “adjustment disorder” due to the termination (not of their choosing) of a romantic relationship. The goal of Brunet and other researchers is to help people like this — the scorned, the betrayed, the traumatized — lose their total recall. To deliberately forget.

Over four to six sessions, volunteers read aloud from a typed script they had composed themselves — a first-person account of their breakup, with as many emotional details as possible — while under the influence of propranolol, a common and inexpensive blood pressure pill. The idea was to purposely reactivate the memory and bring the experience and the stinging emotions it aroused to life again. “How did you feel about that?” they were asked. How do you feel right now? And, most importantly: Has your memory changed since last week?

The investigators had hypothesized that four to six sessions of memory reactivation under propranolol would be sufficient to dramatically blunt the memories associated with their “attachment injury.” Decrease the strength of the memory, Brunet says, and you decrease the strength of the pain.

The study is now complete, and Brunet is hesitant to discuss the results, which have been submitted to a journal for peer review and publication. However, the participants “just couldn’t believe that we could do so much in such a small amount of time,” he confides.

“They were able to turn the page. That’s what they would tell us — ‘I feel like I’ve turned the page. I’m no longer obsessed by this person, or this relationship.’”

Brunet insists he isn’t interested in deleting or scrubbing painful memories out entirely. The idea of memory erasure, of finding the cellular imprint of a specific, discreet memory in the brain, of isolating and inactivating the brain cells behind that memory, unnerves him. ‘It’s not going to come from my lab,” he says, although others are certainly working on it. Memories are part of who we are, what forms our identity, what makes us authentic, “and as long as only one choice exists right now, and it’s toning down a memory, we feel on very solid and comfortable ground,” ethically speaking, Brunet says.

“However, if one day you had two options — I can tone down your memory, or I can remove it altogether, from your head, from your mind — what would you choose?”

The choice might soon be yours.

“If you could erase the memory of the worst day of your life, would you,” Elizabeth Phelps and Stefan Hofmann write in the journal, Nature. “How about your memory of a person who has caused you pain?”

What was once purely science fiction is moving ever closer to clinical reality. Researchers are working on techniques and drugs that might enable us to edit our memories or at least seriously dull their impact — to make the intolerable bearable — by, say, swallowing a pill to block the synaptic changes needed for a memory to solidify. A pill that could be taken hours, even months or years after the event.

Much of the work is based on the theory of memory reconsolidation – the belief that the mere conscious act of recalling or conjuring a memory makes it vulnerable to tinkering or meddling. When a memory is evoked, a reconsolidation window opens for a brief period of time (two to five hours, according to Brunet), during which time the memory returns to a state of “lability.” It becomes pliable, like Play-Doh. It also becomes susceptible to modification, before “reconsolidating” or re-storage. The thought is that propranolol interferes with proteins in the brain needed to lock down the memory again.

A similar line of thinking holds that a memory isn’t an exact impression of the original event, an Iphone video of the past, says Boston University neuroscientist Steve Ramirez. Rather it’s more like Plato’s wax tablet. Press a signet ring into the wax and it leaves an imprint, but the wax can melt when we recall the memory, form again and then melt all over again. “Memory is dynamic,” Ramirez says. It isn’t static. Memories can also be updated with new information when they’re recalled, like hitting “save as” every time you go into a Word file.

But the idea that memories can be edited, softened or dialled down, is more than a little discomfiting to some, and not just for what it means for eyewitness testimony. “We’re not reliable narrators when it comes to some details, and sometimes even entire scenarios,” Ramirez says. More profoundly, without good and bad memories it’s hard to imagine how we would know how to behave, says Dr. Judy Illes, professor of neurology and Canada Research Chair in neuroethics at the University of British Columbia.

Learning doesn’t occur without memory. How do we learn from a bad relationship, if we can’t remember it? “And so now, if we pre-select what memories stick and don’t stick, it almost starts to be like the eugenics of memory,” Illes says. “We ought to think carefully about that.”

She has absolutely no qualms about using memory manipulation for people suffering desperately from post-traumatic stress disorder, people whose burden of suffering from horrifying experiences exceeds any moral argument against using it.

“To me, a PTSD that is profound and debilitating is like a disease of any other and, to the extent that we can have an intervention that treats it, we should vigorously pursue it.”

Even the heartbroken recruited for Brunet’s study were experiencing symptoms congruent with PTSD. We’re geared to form attachments, he says, and not so much to detach.

But memory manipulation has a slippery slope. Would it bleed into not-so-disabling disorders? If someone misbehaves at a cocktail party and would really sooner forget what happened, is that an appropriate use? Isn’t it good to be embarrassed by your past behaviour, to keep you from doing it again? What about war fighters, asks Illes. “If we had a drug that can mitigate a bad memory, could we possibly use it in advance of an act to actually prevent a memory from forming, and therefore enable people to fight less fearfully, and more fiercely, because there’s no consolidation of the acts of crime, or acts of war?”

The pull of moral responsibility — “one’s future ‘oughtness’” — is grounded in our life story, writes bioethicist Dr. Peter DePergola in the Journal of Cognition and Neuroethics. Using blood pressure pills or some other intervention like, say, transcranial direct current stimulation, to deaden or blast away memories of trauma “ultimately undermines one’s ability to seek, identify and act on the good,” DePergola argues.

And how do you manipulate a bad memory, without risking happy, shiny, positive ones? What does a memory even look like in the brain? Can we visualize it? Can we see what happens when positive and negative memories form? And where would all the bad memories go? Saved in glass bottles in the Ministry of Magic?

We can’t go into the brain and erase memories in an Eternal-Sunshine-of-the-Spotless-Mind kind of way, Ramirez says, at least not yet. We can’t touch or poke a memory. However, scientists are starting to get unprecedented glimpses into the physical structure of memory in the brain. The goal is to identify the brain cells a particular memory gloms onto, and artificially manipulate those cells.

The challenge is that human memories aren’t localized to one specific location in the brain. There’s no spot X you can point to, and say, Aha! There it is. Rather, they’re scattered throughout the organ. The sights and sounds and smells and emotions of a memory are going to recruit different corners of the brain that are involved in processing the sights and sounds and smells and emotions, Ramirez says.

“Right now, there are a lot of memories that are asleep in your brain. If I asked you, ‘what did you do last night?’, that memory just woke up. How did that happen? You just did that effortlessly in, like, 500 milliseconds. And yet we don’t know how that process works.”

However, we know that it does happen, and scientists have some pretty good indications of what happens physiologically when we recall a memory, and what it means for that memory to become awake again.

American-Canadian neurosurgeon Wilder Penfield was one of the first to hint at where to look. When Penfield stimulated cells in the hippocampus of people who were undergoing surgery for epilepsy in the 1940s with mild jolts of electricity, specific episodic memories — memories of actual experiences — suddenly popped into their minds. “It was like, ‘I have no idea why, but I’m randomly remembering my 16th birthday and I was walking my cat,’’” Ramirez said on a National Geographic podcast earlier this year.

In experiments that helped open the floodgates, Ramirez and other scientists at MIT reported that they could identify — in mice — the cells that make up part of an engram, the coding for a specific memory, and reactive those same cells using a technology called optogenetics.

Briefly, here’s what they did: Viruses were inserted into the brain cells of genetically modified mice that made the cells glow green in response to light. Next, the researchers isolated cells in the hippocampus of a mouse as the rodents were forming a specific memory — in this case, the memory of receiving a mild electric foot shock while exploring a box.

A day later, the mouse was placed in a different box — different smells, different floor, meaning there should be no reason for them to be fearful. But when those memory cells were activated with a laser, the mouse froze in fear.

More recently, in a paper published earlier this year, Ramirez and co-author Briana Chen mapped out which cells in the hippocampus were being activated when male mice made new memories of positive (meeting a female mouse) and negative (those mild electric foot zaps again) experiences. They were able to trigger the memories again later, using laser light to activate the memory cells. When memory cells in the bottom part of the hippocampus were stimulated, it seemed to dial up the negative memories. But stimulating memory cells in the top part of the hippocampus seemed to dial them down.

The goal, says Ramirez, is to artificially activate positive memories to overwrite the bad ones — in a sense, using the brain as a drug. “In depression, there is a bias toward negative thinking,” Ramirez says. We’ve been using drugs like Xanax and Prozac for decades, but we haven’t really advanced all that much since the 1970s, Ramirez says. “Maybe we need to tackle these kinds of disorders from all angles.”

Ten years ago, Sheena Josselyn’s lab was the first to offer fairly convincing evidence that we can erase a specific fear memory in mice, without erasing every one of the rodent’s fears. The University of Toronto neuroscientist used a toxin to destroy a handful of neurons housing the memory “It wasn’t like a huge legion. If you take out the entire brain, the mouse doesn’t remember a darn thing.”

That’s obviously not technically, or ethically ideal in humans. No one is talking about ablating neurons in people, or injecting viruses into human brain cells to make them glow green. “But it does tell us that in order to manipulate a memory in people we don’t have to give an entire, systemic thing,” Josselyn says. Rather, we could go in and just hit the target neurons using some kind of smart bomb.

Mice aren’t humans, and efforts to translate the results from animal experiments to healthy humans have been mixed, Phelps and Hoffman note in their Nature article. Still, whether it’s beta-blockers like propranolol, or ecstasy or ketamine or other drugs being tested that might block the synthesis of proteins required to lock down a memory after it’s been retrieved, Ramirez and others believe we could tackle the emotional “oomph,” the psychological sting, of a traumatic memory, while leaving the autobiographic experience — the actual, conscious recollection of the event — intact. No, you may not be able to erase the memory of the “venomous, evil snake that is my ex,” as one Redditor asked Ramirez. There isn’t a memory anti-venom. With memory manipulation, people would still remember the breakup, and the person, but the toxic, gut-twisting emotions associated with it would melt, like ice cream in the sun. And, just as doctors shouldn’t hand out anti-depressants to the entire population of Boston, Ramirez says memory manipulation should be reserved for those suffering crippling anxiety, depression or other symptoms.

Betrayal and abandonment themselves are “no small stuff,” adds Brunet. “This is the material Greek tragedies are made of.” People can become hyper vigilant, he says. They have intrusive thoughts. Everything around them reminds them of the former relationship. “It affects negatively your world views, your self esteem and the trust you can place in other people,” Brunet says.

However, a memory buster is challenging, Illes, of UBC says, because it interferes with our experience as humans.

Our brains are hardwired to remember emotionally charged events. “Do you remember where you were on 9/11? Do you remember five supermarkets ago?” Illes asks.

Our memories are so closely interrelated and interconnected, she adds, that you can’t just pull one brick out without the integrity of the entire wall being affected.

“Go back to your dating question,” Illes says as a thought experiment. “We have a bad relationship. Unless two people are on an isolated island and don’t interact with other humans, your bad relationship has other people in there. And, so, how do you remove all the memories associated with all the complexities that we have on a daily basis?”

Memories give us a sense of consciousness, she says, of who we are and what we know to be right and wrong and moral and immoral.

A prescient 2003 report from the U.S. President’s Council on Bioethics asked whether the then-emerging field of memory-alteration would mean abandoning our own truthful identities.

“Armed with new powers to ease the suffering of bad memories, we might come to see all psychic pain as unnecessary and in the process come to pursue a happiness that is less than human,” the authors wrote, “an unmindful happiness, unchanged by time and events, unmoved by life’s vicissitudes.”

Steve Ramirez was running in the Boston marathon in 2013 when two crude pressure cooker bombs detonated 12 seconds apart near the finish line, killing three and injuring several hundred more. The sights, the sounds, the smells — “they helped carve a very deep corner into my personality,” he says.

“It exposed a darker aspect of humanity, but I wouldn’t really find any personal gain in not knowing that corner, either.”

If you could erase the worst memory of your life, would you? Scientists are working on a pill for that

Thanks to Kebmodee for bringing this to the It’s Interesting community.

· Children who were bullied by siblings and peers are more likely to develop clinical depression, self-harm and think about suicide in their early twenties

· Children bullied at home and school had no safe place to escape bullying

· Education of parents and mental health professionals is needed to reduce sibling bullying, as in turn it could reduce peer bullying and lead to a decrease in issues later on in life

Depression, self-harm and suicidal ideation are more prominent in adults in their early twenties if they were bullied at home and at school, a study by researchers at the University of Warwick have found. Researchers stress that intervention is needed to educate people in bullying to reduce it.

Previous studies have identified that sibling bullying has an effect on mental health in adolescence, however researchers Professor Dieter Wolke and Dr. Slava Dantchev have now found children who were bullied by siblings and friends are more likely to harm themselves.

In the paper ‘The Independent and Cumulative Effects of Sibling and Peer Bullying in Childhood on Depression, Anxiety, Suicidal Ideation, and Self-Harm in Adulthood’ published in the journal Frontiers in Psychiatry, researchers show there is a long shadow thrown by sibling bullying on self-harm, suicide attempts and depression at 24 years of age.

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

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

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

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

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

Professor Dieter Wolke of the Department of Psychology at the University of Warwick comments: “As sibling bullying often starts when children are young it will be important to educate and help parents to deal and reduce bullying between siblings in early childhood. This is an area which has been completely overlooked in mental health provision and parent support”

https://warwick.ac.uk/newsandevents/pressreleases/children_bullied_by

he most commonly prescribed antidepressant barely relieves symptoms of modern depression, a major study reveals.

The largest independent investigation ever undertaken found patients taking sertraline experienced negligible improvements in mood.

Published in the Lancet Psychiatry, the study comes amid mounting controversy over increased use of antidepressants by GPs in recent decades, with roughly 7.3 million people in England issued a prescription each year.

Its authors said they were “shocked and surprised” by the results, and called for the development of new classes of medication.

However, in the absence of better drugs, they do not want current prescribing practice to be changed because the trial also showed sertraline is effective in reducing anxiety, which often accompanies depression.

The new trial is by far the largest to be conducted without the involvement of the pharmaceutical industry.

It is also the most in-depth examination of sertraline – a type of selective serotonin reuptake inhibitor (SSRI) – in patients with a range of depression severities, rather than just in severely depressed patients in specialist mental health units.

The study included 654 people aged 18 to 74 who were given either the antidepressant for 12 weeks or a placebo.

The results showed depressive symptoms were five per cent lower after six weeks in the sertraline group, which was “no convincing evidence” of an effect.

After 12 weeks, there was a 13 per cent reduction, a finding the experts described as “weak”.

But the drug did offer clear benefits in reducing anxiety, with a 21 per cent reduction in symptoms at six weeks and 23 per cent at 12 weeks.

This is likely to explain why patients taking sertraline were twice as likely to say they felt generally better compared to the placebo group, even once questioned on specific symptoms of depression the benefit was far weaker.

Symptoms of depression include poor concentration, low mood, trouble with sleep, lack of enjoyment, whereas anxiety is presents as worry, nervousness, irritability and restlessness.

Professor Glyn Lewis, who led the research at University College London, said: “We were shocked and surprised when we did our analysis.

“There is absolutely no doubt this is an unexpected result.’

“Our primary hypothesis was that it would affect those depressive symptoms at six weeks and we didn’t find that.

“We definitely need better treatments for depression, and we need more research in this area.”

He suggested that new, more effective classes of antidepressants could be based on ketamine, psilocybin, the psychedelic in magic mushrooms, and anti-inflammatories.

It is thought that roughly four million people in England are long-term users of antidepressants.

Prescribing data shows that SSRI’s such as sertraline make up 54 per cent of antidepressant prescriptions.

Scientists have responded to the new study by pointing out that some of the patients had very mild symptoms of depression to start with, making it less likely that sertraline would cause an improvement.

However, others have pointed out that this is exactly the basis upon which GPs tend to hand out the drugs in practice.

Dr Gemma Lewis, who co-authored the new research, said: “I think it’s really important to understand that anxiety symptoms are very, very common among people with depression.”

She added: “It appears that people taking the drug are feeling less anxious, so they feel better overall, even if their depressive symptoms were less affected.

“We hope that we have cast new light on how antidepressants work, as they may be primarily affecting anxiety symptoms such as nervousness, worry and tension, and taking longer to affect depressive symptoms.”

Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said: “It is well-established that it often takes a while for patients to feel the full benefits of modern antidepressants and that they work best when taken for significant periods of time, which is one reason why doctors will often review patients after several weeks of use and then prescribe a fairly long course of the drugs, if they appear to be beneficial.”

https://www.telegraph.co.uk/science/2019/09/19/common-antidepressant-barely-helps-improve-depression-symptoms/

Thanks to Kebmodee for bringing this to the It’s Interesting community.

by David N. Osser, MD

Current estimates are that 4% to 5% of the population is at risk for a disorder on the bipolar spectrum. Among the patients in the so-called soft portion of that spectrum are those with a disturbance of temperament in the direction of hypomania.

The concept of temperament is a product of German nosological research from a century ago starting with Kraepelin. In the US, the concept has been championed by Hagop Akiskal, MD and his colleagues. Akiskal is now the editor emeritus of the Journal of Affective Disorders. The notion of depressive temperament has been incorporated into DSM-5 nosology in the form of “persistent depressive disorder” (previously called dysthymia). The other pole was called hyperthymia by the Germans. DSM committees have considered adding hyperthymia but have not done so. The research base on it is still, to many, unconvincing. However, it seems that in clinical practice one encounters individuals who have chronic low-grade hypomanic symptoms—high energy, need for less sleep than others, chronic optimism, chronic risk taking. These individuals can be prone to major depressions and can become severely suicidal.

Akiskal and colleagues have been describing these patients for almost 40 years. Their research criteria for hyperthymic temperament include onset before age 21, habitual sleep of less than 6 hours even on weekends, excessive use of denial, and traits (described originally by Schneider et al) that include being overoptimistic, self-assured, grandiose, overtalkative, warm and people-seeking, uninhibited, promiscuous, and meddlesome (1). Neurobiological studies have suggested the individuals have dopaminergic dysregulation (2),

Treatment issues have focused on what medications to use when hyperthymic individuals become depressed. The studies have all been uncontrolled. However, it seems that antidepressants are ineffective for these depressions and often trigger a mixed state or frank mania at times. Mood stabilizers and medications effective for bipolar depression may be more appropriate for the depressions in these patients.Usually their sunny temperament itself doesn’t require treatment and may, in fact, foster excellent productivity and creativity during much of their lifespan.

Disclosures:
Dr Osser is a Consulting Psychiatrist, US Department of Veterans Affairs, National Telemental Health Center, Bipolar Disorders Telehealth Program, Brockton, MA.

References:
1. Akiskal HS, Mallya G. Criteria for the “soft” bipolar spectrum: treatment implications. Psychopharmacol Bull. 1987;23:68-73.

2. Rihmer Z, Akiskal KK, Rihmer A, Akiskal HS. Current research on affective temperaments. Curr Opin Psychiatry. 2010;23:12-18.

by Bruce Jancin

The tantalizing prospect that statins could be repurposed as adjunctive antidepressant drugs in a defined subgroup of patients with major depression is finally about to undergo rigorous testing.

Several lines of preliminary evidence, including large observational cohort studies as well as three small, short-duration randomized trials, suggest that this might indeed be the case. It’s an extremely attractive possibility, since patients and physicians wish that antidepressant therapy were more effective, statins are among the most widely prescribed drugs worldwide, and their safety profile is thoroughly established. The expectation is that a definitive answer as to whether repurposing of statins as antidepressants is worthwhile will be provided by the SIMCODE trial, recently approved for funding by the German Federal Ministry of Education and Research, Christian Otte, MD, announced at the annual congress of the European College of Neuropsychopharmacology.

SIMCODE is a multicenter, double-blind, placebo-controlled randomized trial to be conducted at eight German academic medical centers. Participants, all of whom must have major depressive disorder and comorbid obesity, will be randomized to simvastatin or placebo on top of standard antidepressant therapy with escitalopram, an SSRI which, like simvastatin, is available as a relatively inexpensive generic, explained Dr. Otte, professor and vice director of the department of psychiatry and psychotherapy at Charite University in Berlin.

For Dr. Otte, SIMCODE will close a circle he helped open with his 2012 report from the Heart and Soul Study, a prospective longitudinal study of nearly 1,000 San Francisco Bay Area patients with coronary heart disease who were assessed annually for depressive symptoms for 6 years. The 65% of patients who were on statin therapy, albeit in nonrandomized fashion, had an adjusted 38% lower risk of developing depression (J Clin Psychiatry. 2012 May;73[5]:610-5).

His was one of seven observational studies involving more than 9,000 patients included in a subsequent meta-analysis showing that statin users were 37% less likely to develop depression than were nonusers (J Affect Disord. 2014 May;160:62-7).

At a symposium on repurposing statins as antidepressants held at ECNP 2019, Dr. Otte was joined by other researchers who have made key contributions in this area. All agreed that the verdict isn’t in yet as to statins’ effectiveness as adjunctive antidepressants, and that the subgroup of patients with major depression who are most likely to gain added antidepressive effect from a statin are those with what the speakers variously described as comorbid cardiometabolic disease, immunometabolic disease, or simply, as in SIMCODE, obesity. These are patients with a high degree of systemic inflammation, which often makes their depression less responsive to standard antidepressant therapies. The working hypothesis is that the pleiotropic anti-inflammatory effects of statins will result in a greater response to conventional antidepressants.

Animal studies point to multiple potential mechanisms by which statins might have antidepressant efficacy in clinical practice, according to Dr. Otte. Beyond their anti-inflammatory effects, these include the drugs’ documented effects on glutamatergic N-methyl-D-aspartate (NMDA) receptors, dopamine receptors, brain-derived neurotrophic factor, glucocorticoid receptors, and hippocampal serotonin 2A receptors.

https://www.the-hospitalist.org/hospitalist/article/207875/depression/statins-may-do-double-duty-antidepressants?channel=51329

by Lisa Rapaport

Kids who have more supportive experiences with family, friends, and people in their school and community may be less likely to have psychological or relationship troubles in adulthood, a new study suggests.

Adverse childhood experiences (ACEs) like abuse, neglect, violence, and parental absence have long been linked to lasting negative effects on physical and mental health, researchers note in JAMA Pediatrics. But less is known about whether positive experiences make it easier for kids to cope, or what happens with children whose lives have mix of negative and positive experiences

For the current study, researchers surveyed 6,118 adults about how often in childhood they felt able to talk to family and friends about feelings; felt their family stood by them during difficult times; enjoyed participating in community traditions; felt a sense of belonging in high school; felt supported by friends; had at least two nonparent adults who took an interest in them; and felt safe and protected by an adult in their home.

Overall, adults who reported six to seven of these positive childhood experiences were 72% less likely to have depression or at least 14 poor mental health days each month than adults who reported no more than two positive childhood experiences. Even three to five positive experiences were tied to a 50% lower likelihood of depression or poor mental health than two or fewer.

These associations held true even when respondents reported multiple adverse childhood experiences.

“The absence of the types of positive childhood experiences we assessed in our study is very stressful for a child,” said lead study author Christina Bethell of the Bloomberg School of Public Health at Johns Hopkins University in Baltimore.

“Without positive nurturance, children’s stress hormones can get stuck on high and this impacts how their brain develops in ways that can make it hard for them to experience safety, relaxation and to become open, curious and learn to have positive relationships with others,” Bethell said by email.

The association between positive life experiences and better adult mental health and relationships persisted even among people who experienced ACEs during childhood.

Compared to participants who reported no more than two positive childhood experiences, people who experienced six to seven positive childhood experiences were also more than three times more likely to report that as adults, they “always” got the social and emotional support they needed.

When people had no more than two positive childhood experiences, only about one-third reported always getting the social and emotional support they needed – even when they didn’t have a history of ACEs.

The study doesn’t prove that positive childhood experiences impact adult mental health or relationships.

“In fact, people with poor mental health might be less likely to view their childhood experiences as positive,” said Dr. Rebecca Dudovitz, a researcher at the David Geffen School of Medicine at the University of California Los Angeles.

“It might actually be that adults with depression remember their childhood differently than adults without depression,” Dudovitz, who wasn’t involved in the study, said by email.

Parents may not be able to prevent adverse childhood experiences, but they can help kids become resilient, said Dr. Angelica Robles, a developmental-behavioral pediatrician at Novant Health in Charlotte, North Carolina, who wasn’t involved in the study.

“Parents can accomplish this by simply talking about feelings with their children, standing by their children during difficult times, and showing interest in their daily lives,” Robles said by email. “The child will then feel safe, and it is in this sense of security in the face of stress that the child learns to flourish.”

https://www.reuters.com/article/us-health-childhood/positive-childhood-experiences-tied-to-better-adult-mental-health-idUSKCN1VU2CP