Do yoga and meditation moderate the relationship between negative life events and depressive symptoms? Analysis of a national cross-sectional survey of Australian women

ObjectivesThis study aims to examine the role of yoga/meditation in the relationship between negative life events, stress and depression.MethodsThe Australian Longitudinal Study on Women’s Health (ALSWH) surveyed 7,186 women aged 36–43 years (mean age 39.2 years; 57.2% university degree) in 2015. Mediation and moderation analyses were conducted to examine whether yoga/meditation practice moderated those relationships.ResultsYoga/meditation was practiced by 27.5% of participants, 33.2% reported negative life events in the past 12 months, and 24% had clinical depression. Perceived stress partially mediated the association between negative life events and depressive symptoms (B = 6.28; 95%CI 5.65; 6.92). Social support (B = −0.38; 95%CI −0.54; −0.23) and optimism (B = −0.25;95%CI −0.31; −0.18) moderated the association between stress and depressive symptoms. Yoga/meditation practice moderated the direct association between negative life events and depressive symptoms (B = −0.92; 95%CI −1.67; −0.18).ConclusionYoga/meditation use was a significant moderator of the relationship between negative life events and depression. Yoga/mediation use did not act via reducing perceived stress, but instead was found to dampen the influence of negative life events on depression directly. More research on how yoga has an impact on depression is warranted

Feasibility of combining tDCS with exercise for increasing physical activity in people with depression

IntroductionPhysical inactivity and depression are significant public health concerns, often co-occurring and exacerbating one another. Transcranial direct current stimulation (tDCS) has shown promise in enhancing cognitive and affective processes, potentially improving exercise adherence and outcomes in individuals with depressive symptoms. This study aimed to evaluate the feasibility and preliminary within group effects of combining tDCS with an aerobic exercise (AE) intervention to increase physical activity in individuals with elevated depressive symptoms.MethodA pilot randomized controlled trial (RCT) was conducted with 51 participants exhibiting low physical activity levels and elevated depressive symptoms. Participants were randomized to receive either active tDCS (n = 25) targeting the left dorsolateral prefrontal cortex (DLPFC) or sham tDCS (n = 26), followed by supervised AE sessions three times per week for eight weeks. Physical activity was measured using accelerometers, and secondary outcomes included cardiorespiratory fitness, depressive symptoms, and affect.ResultsFeasibility metrics indicated moderate adherence rates to sessions, good follow-up rates, and successful blinding as belief about receiving active stimulation was comparable across conditions. Within the active tDCS group, small-to-medium effect sizes were observed for increases in accelerometer-derived daily steps (d = 0.36) and MVPA (d = 0.34) at end of treatment. Both the active tDCS and sham groups demonstrated large within-group improvements in cardiorespiratory fitness (d = 0.99 for active, d = 1.18 for sham) and self-reported MVPA (active d = 0.78, sham d = 0.90). Similarly, large reductions in depressive symptoms (active d = −1.00, sham d = −0.88) were observed within both groups.DiscussionThe combination of tDCS and AE appears feasible and shows preliminary potential for positively influencing daily step counts in individuals with depressive symptoms. The results support further investigation into tDCS as an adjunctive treatment to enhance exercise outcomes in this population

Priorities for HIV and chronic pain research results from a survey of individuals with lived experience

The Global Task Force on Chronic Pain in HIV published seven research priorities in the field of HIV-associated chronic pain in 2019: (1) causes; (2) management; (3) treatment individualization and integration with addiction treatment; (4) mental and social health factors; (5) prevalence; (6) treatment cost effectiveness; and (7) prevention. The current study used a web-based survey to determine whether the research topics were aligned with the priorities of adults with lived experiences of HIV and chronic pain. We also collected information about respondents' own pain and treatment experiences. We received 311 survey responses from mostly US-based respondents. Most respondents reported longstanding, moderate to severe, multisite pain, commonly accompanied by symptoms of anxiety and/or depression. The median number of pain treatments tried was 10 (IQR = 8, 13), with medications and exercise being the most common modalities, and opioids being viewed as the most helpful. Over 80% of respondents considered all research topics either "extremely important" or "very important". Research topic #2, which focused on optimizing management of pain in people with HIV, was accorded the greatest importance by respondents. These findings suggest good alignment between the priorities of researchers and US-based people with lived experience of HIV-associated chronic pain.</p

Managing Medically Unexplained Symptoms in Primary Care

Medically unexplained symptoms (MUS) are persistent physical symptoms in the absence of identifiable disease. MUS present a major challenge for primary care providers (PCPs) because complex symptom presentations, strained patient-physician relationships, and treatment-resistant symptoms can challenge a PCP’s sense of competency. This review is intended to help PCPs understand the burden and theoretical context of MUS and to provide concise recommendations for managing MUS within primary care settings. Based on a narrative review of the literature, these recommendations emphasize in particular the importance of co-creating plausible explanations for MUS, understanding the pitfalls of consultations involving MUS, and developing multimodal treatment plans. </jats:p