Middle-aged women with no obvious signs of cardiac trouble may be prone to depression and the eventual development of
heart disease if their heart rate varies less than expected in response to fluctuations in the body's hormone levels,
according to findings from a substudy of the Women's Health Initiative published today in the Archives of Internal Medicine.
The study results are the first to note an association between lower heart rate variability - a measure of how the heart
responds to changing levels of hormones produced by the sympathetic nervous system - and symptoms of depression in a large
population of otherwise healthy postmenopausal women. They also support the notion that increased hormone levels not only
affect mood but also can lead to heart disease by promoting higher blood pressure, heart rhythm problems and blood platelet
stickiness, which in turn can cause blood clots to lodge in arteries and trigger a heart attack.
"These are patients without obvious heart disease," said David S. Sheps, M.D., associate chief of cardiovascular medicine at
UF's College of Medicine and the Malcom Randall Veterans Affairs Medical Center. "We're finding the same kinds of things that
are found in cardiac patients with depression are also found in the normal population. This supports the hypothesis that
depression is related to or may actually be associated with increases in abnormalities in the autonomic nervous system, the
main regulator of heart rate, which may actually put people who have no obvious disease more at risk for developing disease
in the future."
UF researchers joined with investigators at nine other medical centers to evaluate 2,699 postmenopausal women between the
ages of 50 and 83 years who were enrolled in the Myocardial Ischemia and Migraine Study, an ancillary study to the Women's
Health Initiative. Participants wore a small electrocardiographic monitoring device that measured heart rate and rhythm as
they went about their daily activities. They also completed standardized questionnaires that screen for signs of depression.
About one in 10 of the study participants had depressive symptoms. Those women tended to have lower heart rate variability
and a higher average heart rate.
Past studies conducted elsewhere have linked decreased heart rate variability with increased death from cardiac
complications, both in healthy patients and those with heart disease. Recent research also has shown decreased heart rate
variability accelerates the development of atherosclerosis and increases the likelihood of dying after a heart attack. In
addition, it is associated with heart rhythm abnormalities and sudden death.
"Decreased heart rate variability may not only contribute to increased cardiac morbidity and mortality in (coronary artery
disease) patients, but also may be the link that places depressed subjects with no known history of CAD at risk for
cardiovascular disease," the authors wrote in the journal. The paper's lead author was Chin K. Kim, M.D., a postdoctoral
fellow at UF's College of Medicine who collaborated with researchers from the Albert Einstein College of Medicine at Yeshiva
University, the University of Alabama at Birmingham, George Washington Medical Center, the University of California, and
others.
The relationship between depression and heart disease has garnered much interest among medical professionals in recent
months. Sheps is editor of the journal Psychosomatic Medicine, which published a supplement devoted to depression and heart
disease May 23. Depression raises the chance of suffering a heart attack or dying two to three times above normal, making it
a risk factor on par with smoking or having high blood pressure.
Depression is twice as common in women as in men. Women who have an underlying cardiac condition also frequently develop
symptoms that differ from those commonly found in men with the same problem, making it easy for some practitioners to
overlook a diagnosis of heart disease, Sheps said.
"For example, women are much more likely to present with chest pain which is not typical for angina. Typical angina is chest
pain that occurs with exertion and that is relieved by rest," he said. "Women may not present with that or they may present
with other types of atypical symptoms more frequently than men do. That can sometimes be difficult for the physician to
interpret or throw them off the diagnosis of heart disease."
Robert N. Golden, M.D., professor and chairman of psychiatry at the University of North Carolina at Chapel Hill, said the
study findings are important because of the higher prevalence of clinical depression among women.
"We have known for some time that depression is a potentially deadly disease, not only because of the associated risk for
suicide, but also because of increased mortality from other medical conditions," Golden said. "This research report helps
explain one potential mechanism for increased mortality, namely the abnormal heart rate variability in older women with
depression."
UF researchers said they will continue to track the study participants in a search for other markers of heart disease-related
complications, and to see whether heart rate variability could be used to assess long-term outcome in these patients.
"We will be able to see whether, for example, these changes predict development of adverse events in the future," Sheps said.
Researchers don't yet fully understand the connection between depression and heart disease, but Golden said chemical
communication systems could be the culprit. Levels of the hormone norepinephrine often are altered in depression and are
known to affect blood pressure and heart function, he said, and other chemicals, such as serotonin, are involved in
depression and can affect the formation of blood vessel disease in the heart and throughout the body.
"These findings reinforce the importance and urgency of long-term depression treatment studies which examine medical as well
as psychiatric aspects," Golden added. "Can we prevent the development of heart disease through more vigorous efforts to
identify and thoroughly treat depression early in its course? This might not only improve the quality of life, but also
prevent the potentially deadly consequences of depression-associated 'silent' heart disease."
University of Florida Health Science Center
1600 S.W. Archer Rd., Rm. C3-025
Gainesville, FL 32610
United States
news.health.ufl
среда, 29 июня 2011 г.
воскресенье, 26 июня 2011 г.
Treating Depression With Heart Rate Variability Feedback
Described as a novel, alternative approach to the treatment of major depression, heart rate variability is the subject of a special issue published in the latest Biofeedback.
Autonomic nervous system dysfunction is thought to play a significant role in depression. Prior research shows that individuals suffering from depression often show decreased vagal tone, increased heart rate, fatigue, sleep disturbance, and sympathetic arousal.
Heart rate variability biofeedback has been shown to increase vagus nerve activity and improve homeostatic control over blood pressure. The treatment involves training subjects to adjust their breathing rate to a frequency that is usually slower than normal breathing and that maximizes smooth orderly variations in heart rate.
It is critical to offer a variety of treatments for depression so that individuals can be presented with a variety of treatment options if the treatment currently being used is not effective, says the study author Maria Karavidas. A treatment focusing on the physiological process potentially removes some of the stigma associated with depression and enables patients to become active participants, thereby returning some level of control to patients.
Heart Rate Variability Biofeedback for Major Depression
Maria Karavidas
Biofeedback, 2008; Vol. 36(1):18-21
To read the entire study, click here .
Biofeedback is a quarterly journal of the Association for Applied Psychophysiology and Biofeedback (AAPB).
Association for Applied Psychophysiology and Biofeedback .
Autonomic nervous system dysfunction is thought to play a significant role in depression. Prior research shows that individuals suffering from depression often show decreased vagal tone, increased heart rate, fatigue, sleep disturbance, and sympathetic arousal.
Heart rate variability biofeedback has been shown to increase vagus nerve activity and improve homeostatic control over blood pressure. The treatment involves training subjects to adjust their breathing rate to a frequency that is usually slower than normal breathing and that maximizes smooth orderly variations in heart rate.
It is critical to offer a variety of treatments for depression so that individuals can be presented with a variety of treatment options if the treatment currently being used is not effective, says the study author Maria Karavidas. A treatment focusing on the physiological process potentially removes some of the stigma associated with depression and enables patients to become active participants, thereby returning some level of control to patients.
Heart Rate Variability Biofeedback for Major Depression
Maria Karavidas
Biofeedback, 2008; Vol. 36(1):18-21
To read the entire study, click here .
Biofeedback is a quarterly journal of the Association for Applied Psychophysiology and Biofeedback (AAPB).
Association for Applied Psychophysiology and Biofeedback .
четверг, 23 июня 2011 г.
Benefits Of Antidepressants Out-Weigh Risks In Treating Pediatric Depression, Anxiety Disorders
According to a new study, conducted by the Center for Innovation in Pediatric Practice (CIPP) at Columbus Children's Hospital and published in the April 18 issue of The Journal of the American Medical Association (JAMA), there is more information for parents about the risks and benefits of antidepressant treatment for children with depression and anxiety disorders.
The Children's Hospital study found the overall benefits of antidepressants in treating pediatric major depressive disorder (MDD), obsessive-compulsive disorder (OCD) and non-OCD anxiety disorders (ANX) in children 19-years-old and younger appear to out-weigh the risks of suicidal thoughts and attempts associated with these medications.
"Although our findings regarding suicidal thoughts and attempts are in the same direction as the Food and Drug Administration (FDA) meta-analysis, we found a much lower overall risk and we added analyses of the potential benefit of these medications," said lead author Jeff Bridge, PhD, CIPP principal investigator and assistant professor of pediatrics at The Ohio State University College of Medicine. "This is good news for parents because it gives them more information for discussions with their family's physician about their child's treatment options."
The study found that for every 100 children and adolescents younger than 19 years who were treated with antidepressants for MDD, OCD and ANX, about one child would have thoughts of suicide or attempt suicide beyond the risk associated with the condition itself. The FDA study, which included seven fewer trials, found that for every 100 patients, approximately two would be expected to have suicidal thoughts or attempt suicide beyond the anticipated risks due to short-term treatment with antidepressants.
"Our findings mean that antidepressants should be considered as a first-line treatment option for pediatric depression and anxiety disorders, with the recognition that these medications are more effective for anxiety disorders, including OCD and modestly effective for MDD," said Bridge.
Bridge said the study also looked at whether the effectiveness of antidepressants was influenced by age. The only antidepressant effective in treating depression in children younger than 12 years was fluoxetine (PROZAC). In children 12 years or older, several antidepressants were effective in treating depression.
Data for the study were collected from a meta-analysis of published and unpublished randomized, controlled and clinical trial reports looking at both the benefits and risks of antidepressants in treating children and adolescents younger than 19 years for MDD, OCD and ANX.
"We recognize that there are other therapies, aside from antidepressants, to treat pediatric depression and anxiety disorders including psychotherapies," said Bridge. "While there is a small overall increased risk of suicidal thoughts and attempts with antidepressants, the risk-benefit ratio appears favorable."
Bridge's study collaborators are currently with the University of Pittsburgh, Columbia University, the RAND Corporation and the University Hospital of Geneva, Switzerland.
Columbus Children's Hospital
Columbus, OH
United States
childrenscolumbus
View drug information on Prozac Weekly.
The Children's Hospital study found the overall benefits of antidepressants in treating pediatric major depressive disorder (MDD), obsessive-compulsive disorder (OCD) and non-OCD anxiety disorders (ANX) in children 19-years-old and younger appear to out-weigh the risks of suicidal thoughts and attempts associated with these medications.
"Although our findings regarding suicidal thoughts and attempts are in the same direction as the Food and Drug Administration (FDA) meta-analysis, we found a much lower overall risk and we added analyses of the potential benefit of these medications," said lead author Jeff Bridge, PhD, CIPP principal investigator and assistant professor of pediatrics at The Ohio State University College of Medicine. "This is good news for parents because it gives them more information for discussions with their family's physician about their child's treatment options."
The study found that for every 100 children and adolescents younger than 19 years who were treated with antidepressants for MDD, OCD and ANX, about one child would have thoughts of suicide or attempt suicide beyond the risk associated with the condition itself. The FDA study, which included seven fewer trials, found that for every 100 patients, approximately two would be expected to have suicidal thoughts or attempt suicide beyond the anticipated risks due to short-term treatment with antidepressants.
"Our findings mean that antidepressants should be considered as a first-line treatment option for pediatric depression and anxiety disorders, with the recognition that these medications are more effective for anxiety disorders, including OCD and modestly effective for MDD," said Bridge.
Bridge said the study also looked at whether the effectiveness of antidepressants was influenced by age. The only antidepressant effective in treating depression in children younger than 12 years was fluoxetine (PROZAC). In children 12 years or older, several antidepressants were effective in treating depression.
Data for the study were collected from a meta-analysis of published and unpublished randomized, controlled and clinical trial reports looking at both the benefits and risks of antidepressants in treating children and adolescents younger than 19 years for MDD, OCD and ANX.
"We recognize that there are other therapies, aside from antidepressants, to treat pediatric depression and anxiety disorders including psychotherapies," said Bridge. "While there is a small overall increased risk of suicidal thoughts and attempts with antidepressants, the risk-benefit ratio appears favorable."
Bridge's study collaborators are currently with the University of Pittsburgh, Columbia University, the RAND Corporation and the University Hospital of Geneva, Switzerland.
Columbus Children's Hospital
Columbus, OH
United States
childrenscolumbus
View drug information on Prozac Weekly.
понедельник, 20 июня 2011 г.
Downward mobility hits men far harder than women, depression risk four times higher for men
Downward mobility hits men far harder than women, quadrupling their risk of depression, finds research in the Journal of Epidemiology and Community Health.
The findings are based on survey responses from 503 men and women taking part in the Newcastle Thousand Families Study, all of whom were born in May and June 1947 to mothers living in Newcastle upon Tyne, north east England.
Information on their family's social class was gathered at their birth. And at the age of 50 participants were asked to describe their own social class at the time and when they were 25, in a bid to track social mobility over the life course.
They also completed a general health questionnaire, which included questions about their mental health.
Living standards have generally improved in Britain since 1947, boosting average life expectancy at birth by 8.5 years in both men and women between 1950 and 1998, say the authors.
More women than men were clinically depressed at the age of 50, according to the health questionnaire. And around twice as many women as men reported downward mobility between birth and 50 years of age.
But while a woman's risk of depression in mid life was strongly linked to social class at birth, this was not the case for men.
By the age of 50, downwardly mobile men were over three and a half times as likely to be depressed as their downwardly mobile female peers. And they were around four times as likely to be depressed as men whose social class remained the same.
The results suggest that women may be more sensitive to the impact of poor socioeconomic status in very early childhood, say the authors.
And they point out that since the late 1970s, Britain's manufacturing base has gradually given way to service industries, which tend to employ more women than men. This may have taken a toll on men's role identity and self esteem, which could explain the findings, they say.
Social mobility over the life course and self reported mental health at age 50: prospective cohort study J Epidemiol Community Health 2005; 59: 870-2
Emma Dickinson
edickinsonbmj
44-207-383-6529
BMJ Specialty Journals
bmj
The findings are based on survey responses from 503 men and women taking part in the Newcastle Thousand Families Study, all of whom were born in May and June 1947 to mothers living in Newcastle upon Tyne, north east England.
Information on their family's social class was gathered at their birth. And at the age of 50 participants were asked to describe their own social class at the time and when they were 25, in a bid to track social mobility over the life course.
They also completed a general health questionnaire, which included questions about their mental health.
Living standards have generally improved in Britain since 1947, boosting average life expectancy at birth by 8.5 years in both men and women between 1950 and 1998, say the authors.
More women than men were clinically depressed at the age of 50, according to the health questionnaire. And around twice as many women as men reported downward mobility between birth and 50 years of age.
But while a woman's risk of depression in mid life was strongly linked to social class at birth, this was not the case for men.
By the age of 50, downwardly mobile men were over three and a half times as likely to be depressed as their downwardly mobile female peers. And they were around four times as likely to be depressed as men whose social class remained the same.
The results suggest that women may be more sensitive to the impact of poor socioeconomic status in very early childhood, say the authors.
And they point out that since the late 1970s, Britain's manufacturing base has gradually given way to service industries, which tend to employ more women than men. This may have taken a toll on men's role identity and self esteem, which could explain the findings, they say.
Social mobility over the life course and self reported mental health at age 50: prospective cohort study J Epidemiol Community Health 2005; 59: 870-2
Emma Dickinson
edickinsonbmj
44-207-383-6529
BMJ Specialty Journals
bmj
пятница, 17 июня 2011 г.
Delayed hospice care can increase depression among survivors after death of loved one
Delayed enrollment in hospice can result in increased depression among family members after the death of their loved one,
according to a study by Yale researchers published in the American Journal of Psychiatry.
The study followed over 200 family caregivers from the patient's first enrollment with hospice, through their death, and then
for six months after the death. The team studied the impact of hospice use on family well-being after the patient's death.
"We found that shorter hospice enrollment was linked to elevated depression among family caregivers, who are often the spouse
or daughter of the deceased," said lead author Elizabeth Bradley, associate professor of public health at Yale School of
Medicine. "The finding is particularly troublesome because nationally the length of hospice enrollment has been declining,
with more patients enrolling only in the last week or days of life. This is the first study to examine the impact of that
trend on families' well being, and it looks like the impact is significant."
"It is often difficult to discuss, plan for, and then enroll with hospice, especially if the family is not fully aware of and
accepting the patient's prognosis," said Emily Cherlin, co-author and research associate at Yale. "But the study reveals the
importance of thinking about hospice earlier in the course of an illness.
The inadequate preparation for the death, including delays in seeking and receiving appropriate hospice care can measurably
compromise post-loss adjustment, according to the study.
The study was sponsored by the Nathan Cummings Foundation, The John D. Thompson Hospice Institute for Education, Training and
Research and the Donaghue Medical Research Foundation.
Other co-authors include Holly Prigerson, Stanislav Kasl and Melissa Carlson of Yale; and Rosemary Johnson-Huzerler of the
Connecticut Hospice.
Citation: The American Journal of Psychiatry, Vol. 161, issue 12, December 2004.
Contact: Karen N. Peart
karen.peartyale
203-432-1326
Yale University
according to a study by Yale researchers published in the American Journal of Psychiatry.
The study followed over 200 family caregivers from the patient's first enrollment with hospice, through their death, and then
for six months after the death. The team studied the impact of hospice use on family well-being after the patient's death.
"We found that shorter hospice enrollment was linked to elevated depression among family caregivers, who are often the spouse
or daughter of the deceased," said lead author Elizabeth Bradley, associate professor of public health at Yale School of
Medicine. "The finding is particularly troublesome because nationally the length of hospice enrollment has been declining,
with more patients enrolling only in the last week or days of life. This is the first study to examine the impact of that
trend on families' well being, and it looks like the impact is significant."
"It is often difficult to discuss, plan for, and then enroll with hospice, especially if the family is not fully aware of and
accepting the patient's prognosis," said Emily Cherlin, co-author and research associate at Yale. "But the study reveals the
importance of thinking about hospice earlier in the course of an illness.
The inadequate preparation for the death, including delays in seeking and receiving appropriate hospice care can measurably
compromise post-loss adjustment, according to the study.
The study was sponsored by the Nathan Cummings Foundation, The John D. Thompson Hospice Institute for Education, Training and
Research and the Donaghue Medical Research Foundation.
Other co-authors include Holly Prigerson, Stanislav Kasl and Melissa Carlson of Yale; and Rosemary Johnson-Huzerler of the
Connecticut Hospice.
Citation: The American Journal of Psychiatry, Vol. 161, issue 12, December 2004.
Contact: Karen N. Peart
karen.peartyale
203-432-1326
Yale University
вторник, 14 июня 2011 г.
If Your Antidepressant Does Not Work Switch To Another
If your treatment for depression has not worked during the first six to eight weeks your chances of recovery are greatly enhanced if you either add another medication or switch drugs completely, according to a new study.
Just one third of patients who are treated for depression recover within twelve weeks. If the unfortunate ones who do not get better within six to eight weeks, add another medication to their treatment, or change to a new antidepressant, their chances of a full recovery increase to 50%.
You can read about this study in the New England Journal of Medicine (NEJM). The study was commissioned by the National Institute of Mental Health.
Lead researcher, Dr. A J Rush, from the University of Texas Southwestern Medical Center, said "Fifty percent is extraordinarily good given the nature of these illnesses. Most people should expect two treatment attempts."
In this study, 2,976 patients were enrolled into a programme. The study, called STAR-D, spanned 2001 - 2004. The majority of patients had severe depression. 14 centres throughout the USA took part in STAR-D.
The researchers found that one third of patients recovered after a 12-week treatment period. The other two thirds were given either an additional drug or switched to a completely different antidepressant. This brought the total number of patients who got better to 50%.
The researchers said that with depression, as with many illnesses, one type of treatment does not suit all patients.
Just one third of patients who are treated for depression recover within twelve weeks. If the unfortunate ones who do not get better within six to eight weeks, add another medication to their treatment, or change to a new antidepressant, their chances of a full recovery increase to 50%.
You can read about this study in the New England Journal of Medicine (NEJM). The study was commissioned by the National Institute of Mental Health.
Lead researcher, Dr. A J Rush, from the University of Texas Southwestern Medical Center, said "Fifty percent is extraordinarily good given the nature of these illnesses. Most people should expect two treatment attempts."
In this study, 2,976 patients were enrolled into a programme. The study, called STAR-D, spanned 2001 - 2004. The majority of patients had severe depression. 14 centres throughout the USA took part in STAR-D.
The researchers found that one third of patients recovered after a 12-week treatment period. The other two thirds were given either an additional drug or switched to a completely different antidepressant. This brought the total number of patients who got better to 50%.
The researchers said that with depression, as with many illnesses, one type of treatment does not suit all patients.
суббота, 11 июня 2011 г.
Falls Among Elderly And Sedatives, Mood-Altering Drugs Linked: UBC Study
Falls among elderly people are significantly associated with several classes of drugs, including sedatives often prescribed as sleep aids and medications used to treat mood disorders, according to a study led by a University of British Columbia expert in pharmaceutical outcomes research.
The study, published Nov. 23 in the Archives of Internal Medicine, provides the latest quantitative evidence of the impact of certain classes of medication on falling among seniors. Falling and fall-related complications such as hip fractures are the fifth leading cause of death in the developed world, the study noted.
Antidepressants showed the strongest statistical association with falling, possibly because older drugs in this class have significant sedative properties. Anti-psychotics/neuroleptics often used to treat schizophrenia and other psychoses and benzodiazepines such as valium were also significantly associated with falls.
"These findings reinforce the need for judicious use of medications in elderly people at risk of falling," says principal investigator Carlo Marra, a UBC associate professor of Pharmaceutical Sciences. "Safer alternatives, such as counseling, shorter-term or less-sedating therapies, may be more appropriate for certain conditions."
The UBC study examined the effects of nine classes of drugs. It updated, expanded and analyzed 22 international observational studies from 1996-2007 investigating falls among people aged 60 years or older. The analysis included data on more than 79,000 participants and both prescription and over-the-counter medications.
Narcotics (painkillers) were found not to be statistically associated with falling among the classes studied, a finding that requires further research, says Marra, a Canada Research Chair in Pharmaceutical Outcomes in the Collaboration for Outcomes Research and Evaluation based in the Faculty of Pharmaceutical Sciences and a member of the Centre for Hip Health and Mobility, part of Vancouver Coastal Health Research Institute.
Other medication classes studied include anti-hypertensives (used to reduce blood pressure); diuretics; beta-blockers used to treat heart conditions; and non-steroidal anti-inflammatory drugs such as aspirin and ibuprofen. "Elderly people may be more sensitive to drugs' effects and less efficient at metabolizing medications, leading to adverse events, which in turn lead to falls," adds Marra, who is also a research scientist at the Centre for Health Evaluation and Outcome Sciences at Providence Health.
Prescribing medications to seniors has increased substantially over the past decade, according to the study. For example, the BC Rx Atlas, recently published by UBC researchers, shows that more than one in seven people aged 80 or older filled at least one antidepressant prescription in 2006. In addition, determining which medication classes are associated with falls remains a challenge since seniors are often on multiple medications for multiple health conditions, with new drugs entering the market on a regular basis, says Marra.
In follow-up research, he aims to explore how pharmacists can identify patients at risk of falling and educate them about medication use to ensure their safety.
Co-authors include: Dr. Karim Khan; John Woolcott; Kathryn Richardson; Matthew Wiens; Bhavini Patel; and Judith Marin.
Research was supported (in part) by the Canadian Institutes of Health Research and the Michael Smith Foundation for Health Research.
The study, published Nov. 23 in the Archives of Internal Medicine, provides the latest quantitative evidence of the impact of certain classes of medication on falling among seniors. Falling and fall-related complications such as hip fractures are the fifth leading cause of death in the developed world, the study noted.
Antidepressants showed the strongest statistical association with falling, possibly because older drugs in this class have significant sedative properties. Anti-psychotics/neuroleptics often used to treat schizophrenia and other psychoses and benzodiazepines such as valium were also significantly associated with falls.
"These findings reinforce the need for judicious use of medications in elderly people at risk of falling," says principal investigator Carlo Marra, a UBC associate professor of Pharmaceutical Sciences. "Safer alternatives, such as counseling, shorter-term or less-sedating therapies, may be more appropriate for certain conditions."
The UBC study examined the effects of nine classes of drugs. It updated, expanded and analyzed 22 international observational studies from 1996-2007 investigating falls among people aged 60 years or older. The analysis included data on more than 79,000 participants and both prescription and over-the-counter medications.
Narcotics (painkillers) were found not to be statistically associated with falling among the classes studied, a finding that requires further research, says Marra, a Canada Research Chair in Pharmaceutical Outcomes in the Collaboration for Outcomes Research and Evaluation based in the Faculty of Pharmaceutical Sciences and a member of the Centre for Hip Health and Mobility, part of Vancouver Coastal Health Research Institute.
Other medication classes studied include anti-hypertensives (used to reduce blood pressure); diuretics; beta-blockers used to treat heart conditions; and non-steroidal anti-inflammatory drugs such as aspirin and ibuprofen. "Elderly people may be more sensitive to drugs' effects and less efficient at metabolizing medications, leading to adverse events, which in turn lead to falls," adds Marra, who is also a research scientist at the Centre for Health Evaluation and Outcome Sciences at Providence Health.
Prescribing medications to seniors has increased substantially over the past decade, according to the study. For example, the BC Rx Atlas, recently published by UBC researchers, shows that more than one in seven people aged 80 or older filled at least one antidepressant prescription in 2006. In addition, determining which medication classes are associated with falls remains a challenge since seniors are often on multiple medications for multiple health conditions, with new drugs entering the market on a regular basis, says Marra.
In follow-up research, he aims to explore how pharmacists can identify patients at risk of falling and educate them about medication use to ensure their safety.
Co-authors include: Dr. Karim Khan; John Woolcott; Kathryn Richardson; Matthew Wiens; Bhavini Patel; and Judith Marin.
Research was supported (in part) by the Canadian Institutes of Health Research and the Michael Smith Foundation for Health Research.
среда, 8 июня 2011 г.
Hunger Hormone May Protect Against Stress Induced Depression And Anxiety
By doing tests on mice fed on a calorie restricted diet, US researchers have discovered that ghrelin, a hormone that increases when people
don't eat, may defend against symptoms of depression or anxiety brought on by stress.
The research is the work of scientists led by senior author Dr Jeffrey Zigman, assistant professor of internal medicine and psychiatry at the University of Texas (UT) Southwestern Medical Center in Dallas. It was published online on 15th June
2008 in the journal Nature Neuroscience.
"Our findings in mice suggest that chronic stress causes ghrelin levels to go up and that behaviors associated with depression and anxiety decrease
when ghrelin levels rise," said Zigman, adding that:
"An unfortunate side effect, however, is increased food intake and body weight."
Lead author and instructor of psychiatry at UT Southwestern, Dr Michael Lutter, said:
"Our findings support the idea that these hunger hormones don't do just one thing; rather, they coordinate an entire behavioral response to stress and
probably affect mood, stress and energy levels."
Scientists like Zigman and colleagues already knew that fasting causes the gut to produce ghrelin, which is involved in sending hunger signals to the
brain, and this has led them to suggest blocking ghrelin as an approach to weight control.
But this new study shows that if you do that, it could interfere with the body's natural way of dealing with anxiety and depression.
For the study, Zigman and his team put "wild type" (ie not genetically altered in any way) mice on a calorie restricted diet for 10 days, which led to a
four-fold increase in their ghrelin levels. Stress tests involving mazes and forced swims showed that the calorie restricted mice had reduced
symptoms of anxiety and depression compared to control couterparts that had been allowed unrestricted access to food.
The researchers then bred genetically altered mice whose bodies did not respond to ghrelin and fed them a calorie restricted diet as well, but under
stress tests their depression and anxiety symptoms stayed high; there was no anti-depression or anti-anxiety effect as there had been in the wild type
mice on the low calorie diet.
Finally, Zigman and colleagues did a third test, this time to explore social stress where normal wild type and genetically altered mice were exposed to aggressive "bully" mice every day (an approach often used to study parallels of depression in humans).
Under stress conditions both types of mice had raised ghrelin that lasted for up to four weeks after being bullied for the last time, but the mice that had been genetically altered not to respond to gherlin showed more social avoidance behaviour and ate less than the non-altered mice, suggesting they had more depression symptoms.
A possible explanation could be the survival advantage that is gained from such an effect over countless generations of evolution where the main
priority is getting enough food to avoid starving to death. Zigman suggested that hunter gatherers needed to remain calm in order to hunt
successfully (or they could end being someone else's meal). Perhaps ghrelin induced by hunger leading to anti-anxiety gave them the edge over
their competitors.
These findings might also explain what happens in conditions like anorexia nervosa said Lutter:
"We're very interested to see whether ghrelin treatment could help people with anorexia nervosa, with the idea being that in a certain population,
calorie restriction and weight loss could have an antidepressant effect and could be reinforcing for this illness."
Zigman, Lutter and colleagues hope to continue with their research and look at the areas of the brain where ghrelin could be causing these
antidepressant-like effects.
"The orexigenic hormone ghrelin defends against depressive symptoms of chronic stress."
Michael Lutter, Ichiro Sakata, Sherri Osborne-Lawrence, Sherry A Rovinsky, Jason G Anderson, Saendy Jung, Shari Birnbaum, Masashi Yanagisawa,
Joel K Elmquist, Eric J Nestler & Jeffrey M Zigman
Nature Neuroscience Published online 15 June 2008.
DOI: 10.1038/nn.2139
Click here for
Abstract.
Sources: Nature Neuroscience press release and abstract.
, PhD
don't eat, may defend against symptoms of depression or anxiety brought on by stress.
The research is the work of scientists led by senior author Dr Jeffrey Zigman, assistant professor of internal medicine and psychiatry at the University of Texas (UT) Southwestern Medical Center in Dallas. It was published online on 15th June
2008 in the journal Nature Neuroscience.
"Our findings in mice suggest that chronic stress causes ghrelin levels to go up and that behaviors associated with depression and anxiety decrease
when ghrelin levels rise," said Zigman, adding that:
"An unfortunate side effect, however, is increased food intake and body weight."
Lead author and instructor of psychiatry at UT Southwestern, Dr Michael Lutter, said:
"Our findings support the idea that these hunger hormones don't do just one thing; rather, they coordinate an entire behavioral response to stress and
probably affect mood, stress and energy levels."
Scientists like Zigman and colleagues already knew that fasting causes the gut to produce ghrelin, which is involved in sending hunger signals to the
brain, and this has led them to suggest blocking ghrelin as an approach to weight control.
But this new study shows that if you do that, it could interfere with the body's natural way of dealing with anxiety and depression.
For the study, Zigman and his team put "wild type" (ie not genetically altered in any way) mice on a calorie restricted diet for 10 days, which led to a
four-fold increase in their ghrelin levels. Stress tests involving mazes and forced swims showed that the calorie restricted mice had reduced
symptoms of anxiety and depression compared to control couterparts that had been allowed unrestricted access to food.
The researchers then bred genetically altered mice whose bodies did not respond to ghrelin and fed them a calorie restricted diet as well, but under
stress tests their depression and anxiety symptoms stayed high; there was no anti-depression or anti-anxiety effect as there had been in the wild type
mice on the low calorie diet.
Finally, Zigman and colleagues did a third test, this time to explore social stress where normal wild type and genetically altered mice were exposed to aggressive "bully" mice every day (an approach often used to study parallels of depression in humans).
Under stress conditions both types of mice had raised ghrelin that lasted for up to four weeks after being bullied for the last time, but the mice that had been genetically altered not to respond to gherlin showed more social avoidance behaviour and ate less than the non-altered mice, suggesting they had more depression symptoms.
A possible explanation could be the survival advantage that is gained from such an effect over countless generations of evolution where the main
priority is getting enough food to avoid starving to death. Zigman suggested that hunter gatherers needed to remain calm in order to hunt
successfully (or they could end being someone else's meal). Perhaps ghrelin induced by hunger leading to anti-anxiety gave them the edge over
their competitors.
These findings might also explain what happens in conditions like anorexia nervosa said Lutter:
"We're very interested to see whether ghrelin treatment could help people with anorexia nervosa, with the idea being that in a certain population,
calorie restriction and weight loss could have an antidepressant effect and could be reinforcing for this illness."
Zigman, Lutter and colleagues hope to continue with their research and look at the areas of the brain where ghrelin could be causing these
antidepressant-like effects.
"The orexigenic hormone ghrelin defends against depressive symptoms of chronic stress."
Michael Lutter, Ichiro Sakata, Sherri Osborne-Lawrence, Sherry A Rovinsky, Jason G Anderson, Saendy Jung, Shari Birnbaum, Masashi Yanagisawa,
Joel K Elmquist, Eric J Nestler & Jeffrey M Zigman
Nature Neuroscience Published online 15 June 2008.
DOI: 10.1038/nn.2139
Click here for
Abstract.
Sources: Nature Neuroscience press release and abstract.
, PhD
воскресенье, 5 июня 2011 г.
Notable Impact On Autism Research In Opening Year Shown By First National Autism Registry
On April 2, the Kennedy Krieger Institute will commemorate World Autism Awareness Day and National Autism Awareness Month with the one-year anniversary of the Interactive Autism Network (IAN), the first national autism registry.
Launched in April 2007 by the Kennedy Krieger Institute, the IAN Project (IANProject) facilitates the exploration of causes, treatments, and the search for a possible cure to autism. As an online network that links parents to researchers, the IAN Project is accelerating the pace of autism research in two important ways. First, parents - the people who know the most about their child - provide valuable data to researchers without having to leave their home or office. Second, children with autism are matched with local and national research studies for which they qualify.
To date, more than 22,000 individuals have joined the IAN Project, making it the largest collection of autism data in the world. Represented in the registry are families from all 50 states, as well as the District of Columbia, American Samoa, Northern Mariana Islands, Guam, Marshall Islands and Palau.
"By facilitating opportunities for parents of children with autism and researchers to connect, the IAN Project has taken a lead role in fostering dialogue and mutual understanding amongst the many stakeholders in the autism community," said Dr. Paul Law, Director of the Interactive Autism Network at Kennedy Krieger Institute in Baltimore, Maryland. "It has ultimately created an invaluable opportunity to change the face of research as we know it."
From data collected thus far, the IAN Project has revealed significant insights, including:
* Maternal Depression: Of those enrolled in the IAN Project, 46 percent of mothers with children with autism reported a diagnosis of depression, versus the general population where approximately 20 percent of women are faced with clinical depression in their lifetime.
* Autism Treatments: Most children with autism are on 5 or more different treatments at any given time, 67 percent of which are not covered by insurance. Parents have reported they spend an average of $500/month on treatments.
These insights emphasize the tremendous financial and emotional support that must be provided to families of children with autism, and opens the door for researchers to further investigate treatments that are viable for scientific study, as well as pursue new lines of study, as in the case of parental depression.
According to Dr. Law, the IAN Project is well positioned to facilitate many of these studies going forward. To date, more than 60 researchers from respected institutions across the country have applied to utilize IAN data, including: National Institute of Mental Health, Harvard Medical School, Yale Medical School and Mt. Sinai School of Medicine.
"We are just now beginning to scratch the surface of the complex issues associated with autism. Although we have made some strides, much more work remains to be done. By informing and educating even more families and researchers across the country about the IAN Project, we can continue to organize and mobilize the autism community's research efforts," said Dr. Gary Goldstein, President and CEO of Kennedy Krieger Institute.
The IAN Project is run by the Kennedy Krieger Institute and funded by Autism Speaks. Parents and researchers may participate in IAN and learn more about the initiative by visiting IANProjectIANProject.
About Autism
Autism spectrum disorders (ASD) is the nation's fastest growing developmental disorder, with current incidence rates estimated at 1 in 150 children. This year more children will be diagnosed with autism than AIDS, diabetes and cancer combined, yet profound gaps remain in our understanding of both the causes and cures of the disorder. Continued research and education about developmental disruptions in individuals with ASD is crucial, as early detection and intervention can lead to improved outcomes in individuals with ASD.
About the Kennedy Krieger Institute
Internationally recognized for improving the lives of children and adolescents with disorders and injuries of the brain and spinal cord, the Kennedy Krieger Institute in Baltimore, MD serves more than 13,000 individuals each year through inpatient and outpatient clinics, home and community services and school-based programs. Kennedy Krieger provides a wide range of services for children with developmental concerns mild to severe, and is home to a team of investigators who are contributing to the understanding of how disorders develop while pioneering new interventions and earlier diagnosis. For more information on Kennedy Krieger Institute, visit kennedykrieger/.
About Autism Speaks
Autism Speaks is dedicated to increasing awareness of autism spectrum disorders, to funding research into the causes, prevention and treatments for autism, and to advocating for the needs of individuals with autism and their families. It was founded in February 2005 by Suzanne and Bob Wright, the grandparents of a child with autism. Bob Wright is Vice Chairman, General Electric, and served as chief executive officer of NBC for more than twenty years. To learn more about Autism Speaks, please visit autismspeaks/.
Launched in April 2007 by the Kennedy Krieger Institute, the IAN Project (IANProject) facilitates the exploration of causes, treatments, and the search for a possible cure to autism. As an online network that links parents to researchers, the IAN Project is accelerating the pace of autism research in two important ways. First, parents - the people who know the most about their child - provide valuable data to researchers without having to leave their home or office. Second, children with autism are matched with local and national research studies for which they qualify.
To date, more than 22,000 individuals have joined the IAN Project, making it the largest collection of autism data in the world. Represented in the registry are families from all 50 states, as well as the District of Columbia, American Samoa, Northern Mariana Islands, Guam, Marshall Islands and Palau.
"By facilitating opportunities for parents of children with autism and researchers to connect, the IAN Project has taken a lead role in fostering dialogue and mutual understanding amongst the many stakeholders in the autism community," said Dr. Paul Law, Director of the Interactive Autism Network at Kennedy Krieger Institute in Baltimore, Maryland. "It has ultimately created an invaluable opportunity to change the face of research as we know it."
From data collected thus far, the IAN Project has revealed significant insights, including:
* Maternal Depression: Of those enrolled in the IAN Project, 46 percent of mothers with children with autism reported a diagnosis of depression, versus the general population where approximately 20 percent of women are faced with clinical depression in their lifetime.
* Autism Treatments: Most children with autism are on 5 or more different treatments at any given time, 67 percent of which are not covered by insurance. Parents have reported they spend an average of $500/month on treatments.
These insights emphasize the tremendous financial and emotional support that must be provided to families of children with autism, and opens the door for researchers to further investigate treatments that are viable for scientific study, as well as pursue new lines of study, as in the case of parental depression.
According to Dr. Law, the IAN Project is well positioned to facilitate many of these studies going forward. To date, more than 60 researchers from respected institutions across the country have applied to utilize IAN data, including: National Institute of Mental Health, Harvard Medical School, Yale Medical School and Mt. Sinai School of Medicine.
"We are just now beginning to scratch the surface of the complex issues associated with autism. Although we have made some strides, much more work remains to be done. By informing and educating even more families and researchers across the country about the IAN Project, we can continue to organize and mobilize the autism community's research efforts," said Dr. Gary Goldstein, President and CEO of Kennedy Krieger Institute.
The IAN Project is run by the Kennedy Krieger Institute and funded by Autism Speaks. Parents and researchers may participate in IAN and learn more about the initiative by visiting IANProjectIANProject.
About Autism
Autism spectrum disorders (ASD) is the nation's fastest growing developmental disorder, with current incidence rates estimated at 1 in 150 children. This year more children will be diagnosed with autism than AIDS, diabetes and cancer combined, yet profound gaps remain in our understanding of both the causes and cures of the disorder. Continued research and education about developmental disruptions in individuals with ASD is crucial, as early detection and intervention can lead to improved outcomes in individuals with ASD.
About the Kennedy Krieger Institute
Internationally recognized for improving the lives of children and adolescents with disorders and injuries of the brain and spinal cord, the Kennedy Krieger Institute in Baltimore, MD serves more than 13,000 individuals each year through inpatient and outpatient clinics, home and community services and school-based programs. Kennedy Krieger provides a wide range of services for children with developmental concerns mild to severe, and is home to a team of investigators who are contributing to the understanding of how disorders develop while pioneering new interventions and earlier diagnosis. For more information on Kennedy Krieger Institute, visit kennedykrieger/.
About Autism Speaks
Autism Speaks is dedicated to increasing awareness of autism spectrum disorders, to funding research into the causes, prevention and treatments for autism, and to advocating for the needs of individuals with autism and their families. It was founded in February 2005 by Suzanne and Bob Wright, the grandparents of a child with autism. Bob Wright is Vice Chairman, General Electric, and served as chief executive officer of NBC for more than twenty years. To learn more about Autism Speaks, please visit autismspeaks/.
четверг, 2 июня 2011 г.
African Red Tea Imports Announces Availability Of Organic Anti-Depressant And Immune Support Remedies From South Africa
African Red Tea Imports (ART) is pleased to announce the addition of two major new products to their outstanding line of Rooibos based organic and kosher products. Sutherlandia Frutescens, known in South Africa as Cancer Bush, and Sceletium Tortuosum, a plant with recorded usage dating back to the 1600s, are now available through the Los Angeles based importer.
Sutherlandia Frutescens has long been regarded as the most profound and multi-purpose medicinal plant in South Africa and is proven to powerfully assist the body-mind-energy system. Used as a treatment for cancer, Sutherlandia has also been highly effective in treating HIV as well as wasting from AIDS and TB. Sceletium Tortuosum, a rare plant successfully cultivated on a limited basis, is being used by medical professionals with excellent results to relieve anxiety and depression in patients with little or no adverse side effects. Sceletium also helps relieve symptoms from menopause and works as a support mechanism for smoking cessation.
For more information or to purchase these and a wide range of healthy-living organically grown products, please visit their website at africanredtea or contact them in Los Angeles at 323-658-7832. ART products are available in major markets across the United States through UNFI and Select Nutrition. They can also be found at Whole Foods, Bristol Farms, and Wild Oats stores.
The owner and co-founder of ART, Ms. Nira Levy Maslin will be available at the following events: (Select Nutrition Distributors) 2008 West Coast Table Top Show on February 7; Natural Products Expo West 2008 at the Fresh Ideas Organic Market Place, Booth #9 on March 13; The CA Dietetic Association 2008 on April 11 and 12; and also the World Tea Expo in Las Vegas, Booth 843, May 30 - June 1. Complimentary samples for media available upon request to ART.
africanredtea
Sutherlandia Frutescens has long been regarded as the most profound and multi-purpose medicinal plant in South Africa and is proven to powerfully assist the body-mind-energy system. Used as a treatment for cancer, Sutherlandia has also been highly effective in treating HIV as well as wasting from AIDS and TB. Sceletium Tortuosum, a rare plant successfully cultivated on a limited basis, is being used by medical professionals with excellent results to relieve anxiety and depression in patients with little or no adverse side effects. Sceletium also helps relieve symptoms from menopause and works as a support mechanism for smoking cessation.
For more information or to purchase these and a wide range of healthy-living organically grown products, please visit their website at africanredtea or contact them in Los Angeles at 323-658-7832. ART products are available in major markets across the United States through UNFI and Select Nutrition. They can also be found at Whole Foods, Bristol Farms, and Wild Oats stores.
The owner and co-founder of ART, Ms. Nira Levy Maslin will be available at the following events: (Select Nutrition Distributors) 2008 West Coast Table Top Show on February 7; Natural Products Expo West 2008 at the Fresh Ideas Organic Market Place, Booth #9 on March 13; The CA Dietetic Association 2008 on April 11 and 12; and also the World Tea Expo in Las Vegas, Booth 843, May 30 - June 1. Complimentary samples for media available upon request to ART.
africanredtea
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