Metabolic syndrome improvement in depression six months after prescribing simple hygienic-dietary recommendations

BACKGROUND: Changes in diet and exercise have been separately demonstrated to improve Depression, although scientific evidence available is scarce. In a previously published controlled study, just recommending these and other lifestyle measures (sleep restriction and sunlight exposure) in combination once, patients experienced improvements in their depressive symptoms six months later. In this sample, one in three depressive patients had metabolic syndrome (MetS) at baseline. First line treatment of MetS condition is hygienic-dietetic, being Mediterranean diet and exercise especially important. Therefore we analyzed if lifestyle recommendations also improved their metabolic profile. FINDINGS: During the sixth month evaluation, a smaller number of patients from the group receiving hygienic-dietary recommendations met MetS criteria comparing with the control group. CONCLUSIONS: This study suggests that costless lifestyle recommendations, such as exercise and Mediterranean diet, have the capacity to promote both mental and physical health in a significant proportion of depressive patients. Further research is needed to confirm or discard these preliminary findings

Estil de vida i salut mental

L’augment de l’esperança de vida ha generat un creixent interès per l’estudi de la qualitat de vida de les persones grans. La depressió i l’ansietat són els dos problemes de salut mental més freqüents en aquest grup de pacients i amb més repercussió en la seva qualitat de vida. La depressió comporta habitualment una sèrie de conductes (mala alimentació, aïllament, sedentarisme, desinterès per la cura d’un mateix, etc.) que poden precipitar o agreujar altres malalties físiques. D’altra banda, el risc d’aparició de depressió en edats avançades pot augmentar davant la freqüent restricció d’activitats i l’aïllament social, els impediments en la mobilitat, així com per l’impacte creixent de malalties mèdiques, sobretot d’origen cardiovascular, vascular cerebrals i neurodegeneratives. Hi ha, per tant, una relació de causalitat bidireccional entre la salut física i la mental. Sembla que la ciència està demostrant el que va proposar fa molts segles Juvenal en la famosa expressió «Mens sana in corpore sano». És lògic, d’acord amb el que s’ha exposat més amunt, que intervencions basades en l’estil de vida estiguin demostrant utilitat en la prevenció i el tractament dels trastorns mentals. Per exemple, la pràctica regular d’exercici físic, una dieta sana i equilibrada com la que ofereix el patró mediterrani, una correcta higiene de son i l’exposició moderada a la llum solar poden ser eines importants per a l’abordatge dels símptomes depressius en la població gran, a més de millorar la seva salut física.El aumento de la esperanza de vida ha generado un creciente interés por el estudio de la calidad de vida de las personas mayores. La depresión y la ansiedad son los dos problemas de salud mental más frecuentes en este grupo de pacientes y con mayor repercusión en su calidad de vida. La depresión comporta habitualmente una serie de conductas (mala alimentación, aislamiento, sedentarismo, desinterés por la higiene y atención de un mismo, etc.) que pueden precipitar o agravar otras enfermedades físicas. Por otro lado, el riesgo de aparición de depresión en edades avanzadas puede aumentar ante la frecuente restricción de actividades y el aislamiento social, los impedimentos en la movilidad, así como por el impacto creciente de enfermedades médicas, sobre todo de origen cardiovascular, vascular-cerebrales y neurodegenerativas. Existe, por lo tanto, una relación de causalidad bidireccional entre la salud física y la mental. Parece que la ciencia está demostrando lo que propuso hace muchos siglos Juvenal en la famosa expresión «Mens sana in corpore sano». Es lógico, de acuerdo con lo expuesto anteriormente, que intervenciones basadas en el estilo de vida estén demostrando utilidad en la prevención y el tratamiento de los trastornos mentales. Por ejemplo, la práctica regular de ejercicio físico, una dieta sana y equilibrada como la que ofrece el patrón mediterráneo, una correcta higiene de sueño y la exposición moderada a la luz solar pueden ser herramientas importantes en el abordaje de los síntomas depresivos en la población mayor, además de mejorar su salud física

Effects of mindfulness-based interventions on biomarkers in healthy and cancer populations: a systematic review

Background: Only a small number of articles have investigated the relationship between mindfulness-based interventions (MBIs) and biomarkers. The aim of this systematic review was to study the effect of MBIs on specific biomarkers (cytokines, neuropeptides and C-reactive protein (CRP)) in both healthy subjects and cancer patients. Methods: A search was conducted using PubMed, EMBASE, PsycINFO and the Cochrane library between 1980 and September 2016. Results: A total of 13 studies with 1110 participants were included. In the healthy population, MBIs had no effect on cytokines, but were found to increase the levels of the neuropeptide insulin-like growth factor 1 (IGF-1). With respect to neuropeptide Y, despite the absence of post-intervention differences, MBIs may enhance recovery from stress. With regard to CRP, MBIs could be effective in lower Body Mass Index (BMI) individuals. In cancer patients, MBIs seem to have some effect on cytokine levels, although it was not possible to determine which specific cytokines were affected. One possibility is that MBIs might aid recovery of the immune system, increasing the production of interleukin (IL)-4 and decreasing interferon gamma (IFN-gamma). Conclusions: MBIs may be involved in changes from a depressive/carcinogenic profile to a more normalized one. However, given the complexity and different contexts of the immune system, and the fact that this investigation is still in its preliminary stage, additional randomized controlled trials are needed to further establish the impact of MBI programmes on biomarkers in both clinical and non-clinical populations.Instituto de Salud Carlos III of the Spanish Ministry of Economy and CompetitivenessNetwork for Prevention and Health Promotion in primary Care from the Instituto de Salud Carlos III of the Ministry of Economy and Competitiveness (Spain)European Union ERDF fundsAragon Hlth Sci Inst IACS, Zaragoza, SpainShowa Univ, Dept Psychiat, Sch Med, Tokyo, JapanPrimary Care Prevent & Hlth Promot Res Network RE, Barcelona, SpainUniv Zaragoza, Miguel Servet Univ Hosp, Dept Psychiat, Zaragoza, SpainUniv Zaragoza, Fac Social & Human Sci, Dept Psychol & Sociol, Teruel, SpainFed Univ Sao Paulo UNIFESP, Dept Prevent Med, Mente Aberta Brazilian Ctr Mindfulness & Hlth Pro, Sao Paulo, BrazilHosp Israelita Albert Einstein, Sao Paulo, BrazilUniv Zaragoza, Fac Hlth Sci & Sports, Huesca, SpainUniv Balearic Isl, Res Inst Hlth Sci IUNICS, Palma De Mallorca, SpainFed Univ Sao Paulo UNIFESP, Dept Prevent Med, Mente Aberta Brazilian Ctr Mindfulness & Hlth Pro, Sao Paulo, BrazilInstituto de Salud Carlos III of the Spanish Ministry of Economy and Competitiveness: PI13/01637Network for Prevention and Health Promotion in primary Care from the Instituto de Salud Carlos III of the Ministry of Economy and Competitiveness (Spain): RD12/0005Web of Scienc

Prescripción de ejercicio físico en la depresión por parte de médicos de familia : factores involucrados

Introducción: El problema del sedentarismo es acuciante en sociedades desarrolladas y sus consecuencias para la salud de la población constituyen uno de los principales problemas de salud pública actuales. La depresión es un motivo de consulta muy habitual en las consultas de atención primaria de países occidentales. Se ha planteado la prescripción de ejercicio físico como una estrategia antidepresiva útil en depresiones leves-moderadas, con frecuencia de forma complementaria a los tratamientos de primera elección: psicoterapia y/o farmacoterapia. Sin embargo, los médicos de atención primaria no siempre lo prescriben y se desconoce de qué depende que lo hagan. Contribuir a aclarar esta cuestión es el objetivo del presente trabajo. Nuestra hipótesis era que el grado de prescripción depende de sus opiniones y experiencia sobre el tratamiento de la depresión.Método: Estudio descriptivo transversal en el que participaron 13 centros de salud. Utilizamos el cuestionario Depression Questionaire Attitude para valorar la actitud de los médicos hacia la depresión, y recogimos otras variables relacionadas con la importancia que otorgaban al ejercicio físico y a otros aspectos del estilo de vida en la salud física y mental.RESULTADOS: Se confirma que las opiniones y actitudes de los médicos frente a la depresión influyen en su disposición a recomendar ejercicio físico. Además, los médicos de atención primaria con menos años de práctica profesional valoran más el papel del ejercicio físico en la salud, tanto en la depresión como en otras patologías médicas. También se observa una correlación entre la importancia que se da al ejercicio físico en la salud y la que se da a otros factores ligados al estilo de vida, especialmente la dieta.Discusión: Aunque la utilidad de recomendar ejercicio físico en la depresión va acercándose al mismo nivel de importancia que en otros problemas de salud su empleo por parte de los médicos de atención primaria es muy mejorable. Por ello, es importante insistir en la necesidad de ofrecer apoyo y programas de formación continuada a los médicos de atención primaria para ayudarles en este propósito.A sedentary lifestyle is an urgent problem in developed societies and its consequences are one of the main current problems in public health. Depression is a common reason to attend primary care in Western countries. In many cases of low and mild depression, exercise is recommended as a complement to the main therapy: Psychotherapy and/or pharmacotherapy. Nevertheless, general practitioners do not always recommend exercise to depressive patients and it is unknown why they do not. The main aim of our study was to clarify how the degree of prescribing exercise relies on a general practitioner's opinion and experience in depression treatment. A cross-sectional design was undertaken in 13 public health centers. The Depression Attitude Questionnaire (DAQ) was used to evaluate general practitioners' attitude towards depression; other variables related to the importance accorded to physical exercise; and other lifestyle aspects of physical and mental health. Our results show that general practitioners' attitude towards depression influence their willingness to recommend exercise. Moreover, less experienced general practitioners (in years) tend to appreciate the importance of exercise in health, not only in depression. A positive relationship was found between importance of exercise and importance accorded to other factors linked to lifestyle, especially diet. Although recommendation of exercise in depression is similar to other medical conditions, its prescription may be improved. Hence, it is important to point out the need for education programs for general practitioners, in order to improve their capacity to deal with their task.O problema do sedentarismo é premente nas sociedades desenvolvidas e as suas consequências para a saúde da população constituem um dos principais problemas de saúde pública actuais. A depressão é um motivo muito habitual nas consultas de cuidados primários nos países ocidentais. Foi delineada a prescrição de exercício físico como uma estratégia antidepressiva útil em depressões leves-moderadas, de forma complementar aos tratamentos de primeira escolha. Contudo, os médicos de cuidados primários nem sempre o prescrevem e desconhece-se o porquê de o fazerem. Contribuir para clarificar esta questão é o objectivo d presente trabalho. A nossa hipótese era que o grau de prescrição depende das suas opiniões e experiências no tratamento da depressão. Trata-se de um estudo descritivo transversal no qual participaram 13 centros de saúde. Utilizámos o questionário Depression Questionaire Attitude para avaliar a atitude dos médicos face à depressão e medimos outras variáveis relacionadas com a importância que atribuíam ao exercício físico e a outros aspectos do estilo de vida na saúde física e mental. Os resultados confirmam que a atitude dos médicos face à depressão influí na sua disposição para recomendar exercício físico. Adicionalmente, os médicos de cuidados primários com menos anos de prática profissional valorizam mais o papel do exercício físico na saúde, tanto na depressão como noutras patologias médicas. Também se observa uma correlação entre a importância que se dá ao exercício físico na saúde e à que se dá a outros factores ligados ao estilo de vida, especialmente à dieta. Conclui-se que apesar da utilidade de recomendar exercício físico na depressão se ir aproximando do nível de importância atribuído a outros problemas de saúde, a sua utilização por parte dos médicos de cuidados primários pode ser substancialmente melhorada. Para tal, é importante insistir na necessidade de oferecer apoio e programas de formação continuada aos médicos de cuidados primários para ajudá-los neste propósito

Mindfulness skills and experiential avoidance as therapeutic mechanisms for treatment-resistant depression through mindfulness-based cognitive therapy and lifestyle modification

Background/objective: The COVID-19 pandemic and consequent physical distancing has made it difficult to provide care for those with Treatment-Resistant Depression (TRD). As a secondary analysis of a clinical trial, the aim of this study was to explore potential mechanisms through which three online-delivered approaches, added to treatment as usual, improve depressive symptoms in TRD patients. Methods: The three approaches included (a) Minimal Lifestyle Intervention (MLI), (b) Mindfulness-Based Cognitive Therapy (MBCT), and (c) Lifestyle Modification Program (LMP). Sixty-six participants with TRD completed assessments pre-post intervention (mindfulness skills [FFMQ]; self-compassion [SCS]; and experiential avoidance [AAQ-II]) and pre-intervention to follow-up (depressive symptoms [BDI-II]). Data were analyzed using within-subjects regression models to test mediation. Results: Mindfulness skills mediated the effect of MBCT on depressive symptoms (ab = −4.69, 95% CI = −12.93 to−0.32), whereas the lack of experiential avoidance mediated the effect of LMP on depressive symptoms (ab = −3.22, 95% CI = −7.03 to−0.14). Conclusion: Strengthening mindfulness skills and decreasing experiential avoidance may promote recovery in patients with TRD, MBCT, and LMP have demonstrated that they may help increase mindfulness skills and decrease experiential avoidance, respectively. Future work will need to unpick the components of these interventions to help isolate active ingredients and increase optimization

Relación entre actividad física, gravedad clínica y perfil sociodemográfico en pacientes con Depresión Mayor

El ejercicio físico está demostrando en los últimos años ser una buena estrategia antidepresiva complementaria para muchos pacientes. La asociación entre el grado de actividad física y las características clínicas y sociodemográficas en la Depresión aún no se ha estudiado suficientemente en muestras amplias y representativas de pacientes. Hacerlo es importante para obtener información que posibilite mejorar el diseño de programas destinados a promover el ejercicio físico en estos pacientes. Se reclutaron 3374 pacientes con Depresión Mayor en tratamiento, que acudieron a consulta psiquiátrica por primera vez en Centros de Salud Mental distribuidos por toda España. Fueron clasificados en tres grupos de acuerdo con el nivel de actividad física semanal que declararon. En este estudio comparamos el grupo que comunicó mayor actividad física (n = 1033; 30.6%) con el que menos (n = 858; 25.4%). Los pacientes más activos tenían menor gravedad clínica de acuerdo con la puntuación en la escala Montgomery-Asberg Depression Rating Scale (MADRS). Además eran más jóvenes, con mejor nivel educativo y de empleo, menor aislamiento social y menor consumo de tabaco. Sin embargo, cuando todas estas variables fueron controladas, la diferencia en la puntuación en la MADRS seguía siendo estadísticamente significativa. De lo anterior deducimos que los pacientes depresivos con más edad o dificultades socioeconómicas tienden a hacer menos ejercicio espontáneamente, por lo que probablemente necesiten un apoyo especial al recomendárselo.Physical activity is showing in recent years to be a good antidepressant complementary strategy for many patients. The association between the degree of physical activity and clinical and sociodemographic characteristics in depression has still not been studied sufficiently in large and representative patient samples. Doing so is important to improve the design of programs that promote physical activity in depressive patients. 3374 patients with Major Depression who first came to psychiatric consultation in mental health centres in Spain were recruited. They were classified into three groups according to the level of weekly physical activity declared. In this study we compared the most physical activity declared group (n = 1033; 30.6%) with less physical activity declared group (n = 858; 25.4%). Most physically active patients had lower clinical depression severity according to the Montgomery-Asberg Depression Rating Scale (MADRS) scale. They were also younger, with higher education level and employment status; do not tend to live alone and less tobacco use. However, when all these variables were controlled, differences in MADRS Scores between groups remain statistically significant. Older and with socioeconomic difficulties depressive patients tend to do less physical activity, for this reason, it is probably that they need a particular support to recommend do exercise.A atividade física mostra nos últimos anos uma boa estratégia de antidepressivos complementares para muitos pacientes. A associação entre o grau de atividade física e as características clínicas e sociodemográcas na Depressão ainda não foi sucientemente estudada em amostras grandes e representativas de pacientes. Fazer isso é importante para obter informa- ções que permitam melhorar o design de programas destinados a promover a atividade física nesses pacientes. Registramos 3374 pacientes com maior depressão no tratamento, que participaram de consultas psiquiátricas pela primeira vez em centros de saúde mental distribuídos em toda a Espanha. Eles foram classicados em três grupos de acordo com o nível de atividade física semanal que relataram. Neste estudo, comparamos o grupo que relatou a maior atividade física (n = 1033, 30,6%) com o mínimo (n = 858, 25,4%). Os pacientes mais ativos tiveram menor gravidade clínica de acordo com a pontuação na Escala de Avaliação de Depressão de Montgomery-Asberg (MADRS). Eles também eram mais jovens, com melhores níveis educacionais e de emprego, menos isolamento social e menor consumo de tabaco. No entanto, quando todas essas variáveis foram controladas, a diferença no índice MADRS permaneceu estatisticamente signicante. A partir do acima, deduzimos que os pacientes deprimidos mais velhos ou as diculdades socioeconômicas tendem a uma atividade física espontaneamente menor, então eles provavelmente precisam de apoio especial ao recomendá-lo

Effectiveness of hygienic-dietary recommendations as enhancers of antidepressant treatment in patients with Depression: Study protocol of a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>In recent years some studies have been published supporting the efficacy of light exposure, physical activity, sleep control and a Mediterranean diet pattern on the improvement or prevention of Depression. However, to our knowledge, there have been no studies using all these measures together as an adjuvant antidepressant strategy.</p> <p>Methods</p> <p>Multicenter, randomized, controlled, two arm-parallel, clinical trial. Eighty depressed patients undergoing standard antidepressant treatment will be advised to follow four additional hygienic-dietary recommendations about exercise, diet, sunlight exposure and sleep. Outcome measures will be assessed before and after the 6 month intervention period.</p> <p>Discussion</p> <p>We expect the patients in the active recommendations group to experience a greater improvement in their depressive symptoms. If so, this would be a great support for doctors who might systematically recommend these simple and costless measures, especially in primary care.</p> <p>Trial Registration</p> <p>ISRCTN59506583</p

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

Muon reconstruction performance of the ATLAS detector in proton–proton collision data at √s = 13 TeV

This article documents the performance of the ATLAS muon identification and reconstruction using the LHC dataset recorded at √s = 13 TeV in 2015. Using a large sample of J/ψ→μμ and Z→μμ decays from 3.2 fb−1 of pp collision data, measurements of the reconstruction efficiency, as well as of the momentum scale and resolution, are presented and compared to Monte Carlo simulations. The reconstruction efficiency is measured to be close to 99% over most of the covered phase space (|η| 2.2, the pT resolution for muons from Z→μμ decays is 2.9 % while the precision of the momentum scale for low-pT muons from J/ψ→μμ decays is about 0.2%

Measurements of the charge asymmetry in top-quark pair production in the dilepton final state at s √ =8 TeV with the ATLAS detector

Measurements of the top-antitop quark pair production charge asymmetry in the dilepton channel, characterized by two high-pT leptons (electrons or muons), are presented using data corresponding to an integrated luminosity of 20.3  fb−1 from pp collisions at a center-of-mass energy s√=8  TeV collected with the ATLAS detector at the Large Hadron Collider at CERN. Inclusive and differential measurements as a function of the invariant mass, transverse momentum, and longitudinal boost of the tt¯ system are performed both in the full phase space and in a fiducial phase space closely matching the detector acceptance. Two observables are studied: AℓℓC based on the selected leptons and Att¯C based on the reconstructed tt¯ final state. The inclusive asymmetries are measured in the full phase space to be AℓℓC=0.008±0.006 and Att¯C=0.021±0.016, which are in agreement with the Standard Model predictions of AℓℓC=0.0064±0.0003 and Att¯C=0.0111±0.0004