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Saraiva DDCA, Martucci RB, Monteiro GTR. Construction of a nutritional assessment tool for the pediatric cancer population (ANPEDCancer): content validation using the Delphi method. REVISTA PAULISTA DE PEDIATRIA 2023; 41:e2021126. [PMID: 36102395 PMCID: PMC9462402 DOI: 10.1590/1984-0462/2023/41/2021126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 09/19/2021] [Indexed: 11/21/2022]
Abstract
Objective: To develop and establish content validation of a nutritional assessment tool for pediatric cancer patients using the Delphi method. Methods: A literature review was performed and the nutritional assessment in pediatrics and cancer construct was discussed with experts. Forty-six nutrition experts from Brazil with experience in oncology participated in the panel. Rounds were held to discuss and judge the items that should be included in this tool. With the aid of an algorithm, it was possible to simultaneously consider the adequacy, relevance and measurement of the items. The consensus was reached with an agreement equal to or greater than 80% among the experts. Results: From the 7 domains suggested by the literature, the first round generated 81 items, which were assessed for adequacy, relevance and the possibility of being measured in the routine of nutritional assessment, by specialists in the following two rounds. The percentage of specialists who responded to each round was high (above 90%) and the dropout rate between the stages was relatively low. After applying the algorithm, the ANPEDCancer tool had 36 items considered appropriate by specialists from the five different geographical regions of Brazil. Conclusions: The Delphi method allowed the construction and content validation of the nutritional assessment tool for children and adolescents with cancer, providing the first stage for use in the Brazilian hospital setting.
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Wu H, Xu L, Zheng Y, Shi L, Zhai L, Xu F. Application of the Delphi Method in the Study of Depressive Disorder. Front Psychiatry 2022; 13:925610. [PMID: 35873226 PMCID: PMC9301200 DOI: 10.3389/fpsyt.2022.925610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/14/2022] [Indexed: 11/13/2022] Open
Abstract
Depressive disorder is a common mental disorder that has a high prevalence and low visiting rate, which caused patients years lived with disability. Due to the complexity of the depressive disorder, the Delphi method is a better choice compared with other commonly used methods, which provides a new perspective for the prevention and treatment of depression. This article will summarize the clinical studies of depressive disorders using the Delphi method from four perspectives, and summarize the advantages and disadvantages of the Delphi method in depressive disorders research, arguing that the Delphi method can cross the gap between clinical research and clinical practice, and is a highly practical part of the research process.
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Affiliation(s)
- Hengjin Wu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School of Beijing University of Traditional Chinese Medicine, Beijing, China
| | - Linjie Xu
- Graduate School of Beijing University of Traditional Chinese Medicine, Beijing, China.,Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yu Zheng
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lei Shi
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Liangfan Zhai
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - FengQuan Xu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Okereke OI, Vyas CM, Mischoulon D, Chang G, Cook NR, Weinberg A, Bubes V, Copeland T, Friedenberg G, Lee IM, Buring JE, Reynolds CF, Manson JE. Effect of Long-term Supplementation With Marine Omega-3 Fatty Acids vs Placebo on Risk of Depression or Clinically Relevant Depressive Symptoms and on Change in Mood Scores: A Randomized Clinical Trial. JAMA 2021; 326:2385-2394. [PMID: 34932079 PMCID: PMC8693224 DOI: 10.1001/jama.2021.21187] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
IMPORTANCE Marine omega-3 fatty acid (omega-3) supplements have been used to treat depression but their ability to prevent depression in the general adult population is unknown. OBJECTIVE To test effects of omega-3 supplementation on late-life depression risk and mood scores. DESIGN, SETTING, AND PARTICIPANTS A total of 18 353 adults participated in the VITAL-DEP (Vitamin D and Omega-3 Trial-Depression Endpoint Prevention) ancillary study to VITAL, a randomized trial of cardiovascular disease and cancer prevention among 25 871 US adults. There were 16 657 at risk of incident depression (no previous depression) and 1696 at risk of recurrent depression (previous depression, but not for the past 2 years). Randomization occurred from November 2011 through March 2014; randomized treatment ended on December 31, 2017. INTERVENTIONS Randomized 2 × 2 factorial assignment to vitamin D3 (2000 IU/d), marine omega-3 fatty acids (1 g/d of fish oil, including 465 mg of eicosapentaenoic acid and 375 mg of docosahexaenoic acid) or placebo; 9171 were randomized to omega-3 and 9182 were randomized to matching placebo. MAIN OUTCOMES AND MEASURES Prespecified coprimary outcomes were risk of depression or clinically relevant depressive symptoms (total of incident + recurrent cases); mean difference in mood score (8-item Patient Health Questionnaire [PHQ-8] depression scale). RESULTS Among 18 353 participants who were randomized (mean age, 67.5 [SD, 7.1] years; 49.2% women), 90.3% completed the trial (93.5% among those alive at the end of the trial); the median treatment duration was 5.3 years. The test for interaction between the omega-3 and the vitamin D agents was not significant (P for interaction = .14). Depression risk was significantly higher comparing omega-3 (651 events, 13.9 per 1000 person-years) with placebo (583 events, 12.3 per 1000 person-years; hazard ratio [HR], 1.13; 95% CI, 1.01-1.26; P = .03). No significant differences were observed comparing omega-3 with placebo groups in longitudinal mood scores: the mean difference in change in PHQ-8 score was 0.03 points (95% CI, -0.01 to 0.07; P = .19). Regarding serious and common adverse events, the respective prevalence values in omega-3 vs placebo groups were major cardiovascular events (2.7% vs 2.9%), all-cause mortality (3.3% vs 3.1%), suicide (0.02% vs 0.01%), gastrointestinal bleeding (2.6% vs 2.7%), easy bruising (24.8% vs 25.1%), and stomach upset or pain (35.2% vs 35.1%). CONCLUSIONS AND RELEVANCE Among adults aged 50 years or older without clinically relevant depressive symptoms at baseline, treatment with omega-3 supplements compared with placebo yielded mixed results, with a small but statistically significant increase in risk of depression or clinically relevant depressive symptoms but no difference in mood scores, over a median follow-up of 5.3 years. These findings do not support the use of omega-3 supplements in adults to prevent depression. TRIAL REGISTRATION ClinicalTrials.gov Identifiers: NCT01696435 and NCT01169259.
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Affiliation(s)
- Olivia I. Okereke
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Chirag M. Vyas
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
| | - David Mischoulon
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Grace Chang
- Department of Psychiatry, VA Boston Healthcare System, Brockton, Massachusetts
| | - Nancy R. Cook
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Alison Weinberg
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Vadim Bubes
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Trisha Copeland
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Georgina Friedenberg
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - I-Min Lee
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Julie E. Buring
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Charles F. Reynolds
- Department of Psychiatry, UPMC and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - JoAnn E. Manson
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
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Schroder JD, de Araújo JB, de Oliveira T, de Moura AB, Fries GR, Quevedo J, Réus GZ, Ignácio ZM. Telomeres: the role of shortening and senescence in major depressive disorder and its therapeutic implications. Rev Neurosci 2021; 33:227-255. [PMID: 34388328 DOI: 10.1515/revneuro-2021-0070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 07/17/2021] [Indexed: 11/15/2022]
Abstract
Major depressive disorder (MDD) is one of the most prevalent and debilitating psychiatric disorders, with a large number of patients not showing an effective therapeutic response to available treatments. Several biopsychosocial factors, such as stress in childhood and throughout life, and factors related to biological aging, may increase the susceptibility to MDD development. Included in critical biological processes related to aging and underlying biological mechanisms associated with MDD is the shortening of telomeres and changes in telomerase activity. This comprehensive review discusses studies that assessed the length of telomeres or telomerase activity and function in peripheral blood cells and brain tissues of MDD individuals. Also, results from in vitro protocols and animal models of stress and depressive-like behaviors were included. We also expand our discussion to include the role of telomere biology as it relates to other relevant biological mechanisms, such as the hypothalamic-pituitary-adrenal (HPA) axis, oxidative stress, inflammation, genetics, and epigenetic changes. In the text and the discussion, conflicting results in the literature were observed, especially considering the size of telomeres in the central nervous system, on which there are different protocols with divergent results in the literature. Finally, the context of this review is considering cell signaling, transcription factors, and neurotransmission, which are involved in MDD and can be underlying to senescence, telomere shortening, and telomerase functions.
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Affiliation(s)
- Jessica Daniela Schroder
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Rodovia SC 484 - Km 02, Fronteira Sul, Postal Code: 89815-899Chapecó, SC, Brazil
| | - Julia Beatrice de Araújo
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Rodovia SC 484 - Km 02, Fronteira Sul, Postal Code: 89815-899Chapecó, SC, Brazil
| | - Tacio de Oliveira
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Rodovia SC 484 - Km 02, Fronteira Sul, Postal Code: 89815-899Chapecó, SC, Brazil
| | - Airam Barbosa de Moura
- Laboratory of Translational Psychiatry, Graduate Program in Health Sciences, University of Southern Santa Catarina, Av. Universitária, 1105 - Bairro Universitário Postal Code: 88806-000Criciúma, SC, Brazil
| | - Gabriel Rodrigo Fries
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, Translational Psychiatry Program, The University of Texas Health Science Center at Houston (UTHealth), 1941 East Road BBSB 3142, Houston77054, TX, USA.,Neuroscience Graduate Program, Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston (UTHealth), 1941 East Road, BBSB 3142, Houston77054, TX, USA.,Center for Precision Health, School of Biomedical Informatics, The University of Texas Health Science Center at Houston, 1941 East Road, BBSB 3142, Houston77054, TX, USA
| | - João Quevedo
- Laboratory of Translational Psychiatry, Graduate Program in Health Sciences, University of Southern Santa Catarina, Av. Universitária, 1105 - Bairro Universitário Postal Code: 88806-000Criciúma, SC, Brazil.,Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, Translational Psychiatry Program, The University of Texas Health Science Center at Houston (UTHealth), 1941 East Road BBSB 3142, Houston77054, TX, USA.,Neuroscience Graduate Program, Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston (UTHealth), 1941 East Road, BBSB 3142, Houston77054, TX, USA.,Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, Center of Excellence on Mood Disorders, The University of Texas Health Science Center at Houston (UTHealth), 1941 East Road, BBSB 3142, Houston77054, TX, USA
| | - Gislaine Zilli Réus
- Laboratory of Translational Psychiatry, Graduate Program in Health Sciences, University of Southern Santa Catarina, Av. Universitária, 1105 - Bairro Universitário Postal Code: 88806-000Criciúma, SC, Brazil
| | - Zuleide Maria Ignácio
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of the Southern Frontier, Rodovia SC 484 - Km 02, Fronteira Sul, Postal Code: 89815-899Chapecó, SC, Brazil.,Laboratory of Translational Psychiatry, Graduate Program in Health Sciences, University of Southern Santa Catarina, Av. Universitária, 1105 - Bairro Universitário Postal Code: 88806-000Criciúma, SC, Brazil
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5
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Nutrition, Exercise, and Stress Management for Treatment and Prevention of Psychiatric Disorders. A Narrative Review Psychoneuroendocrineimmunology-Based. ENDOCRINES 2021. [DOI: 10.3390/endocrines2030022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Psychoneuroendocrineimmunology (PNEI) brings together knowledge acquired since the 1930s from endocrinology, immunology, neuroscience, and psychology. With PNEI, a model of research and interpretation of health and disease is emerging, which sees the human body as a structured and interconnected unit, where the psychological and biological systems are mutually coordinated. In the PNEI view, many factors could influence mental health, with the endocrine system involved in mediating the effects of environmental stress on mental health and inflammation in the onset and course of psychiatric disorders as a result of individual and collective conditions and behaviors. Among these, nutrition is one way by which the environment impacts physiology: indeed, many pieces of research showed that several elements (e.g., probiotics, fish oil, zinc) have a positive effect on mental disorders thus being potentially augmentation agents in treatment. Still, physical activity can moderate depressive symptoms, while prolonged stress increases the risk of psychopathology. Taken together, the PNEI-based approach may inform prevention and treatment strategies, also in the field of mental health care.
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Komysheva NP, Shishkina GT. [Prospects for the use of drugs with anti-inflammatory properties for the treatment of depression]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:124-131. [PMID: 34283542 DOI: 10.17116/jnevro2021121061124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The review briefly summarizes experimental and preclinical data of the role of pro-inflammatory cytokines in triggering pathophysiological changes associated with depression, primarily major depressive disorder (MDD), as well as the possibility of using anti-inflammatory drugs as antidepressants.
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Affiliation(s)
- N P Komysheva
- Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - G T Shishkina
- Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
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Forbes MP, O'Neil A, Lane M, Agustini B, Myles N, Berk M. Major Depressive Disorder in Older Patients as an Inflammatory Disorder: Implications for the Pharmacological Management of Geriatric Depression. Drugs Aging 2021; 38:451-467. [PMID: 33913114 DOI: 10.1007/s40266-021-00858-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2021] [Indexed: 12/14/2022]
Abstract
Depression is a common and highly disabling condition in older adults. It is a heterogenous disorder and there is emerging evidence of a link between inflammation and depression in older patients, with a possible inflammatory subtype of depression. Persistent low-level inflammation, from several sources including psychological distress and chronic disease, can disrupt monoaminergic and glutaminergic systems to create dysfunctional brain networks. Despite the evidence for the role of inflammation in depression, there is insufficient evidence to recommend use of any putative anti-inflammatory agent in the treatment of depression in older adults at this stage. Further characterisation of markers of inflammation and stratification of participants with elevated rates of inflammatory markers in treatment trials is needed.
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Affiliation(s)
- Malcolm P Forbes
- Mental Health, Drugs and Alcohol Services, Barwon Health, Geelong, VIC, 3216, Australia.
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, 3216, Australia.
- Department of Psychiatry, University of Melbourne, Parkville, VIC, 3050, Australia.
| | - Adrienne O'Neil
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, 3216, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Melissa Lane
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, 3216, Australia
| | - Bruno Agustini
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, 3216, Australia
| | - Nick Myles
- Faculty of Medicine, University of Queensland, St Lucia, QLD, 4072, Australia
| | - Michael Berk
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, 3216, Australia
- Department of Psychiatry, University of Melbourne, Parkville, VIC, 3050, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
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Chae M, Park K. Association between dietary omega-3 fatty acid intake and depression in postmenopausal women. Nutr Res Pract 2021; 15:468-478. [PMID: 34349880 PMCID: PMC8313386 DOI: 10.4162/nrp.2021.15.4.468] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/14/2021] [Accepted: 02/16/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND/OBJECTIVES This study aimed to analyze the association between dietary omega-3 fatty acid intake and depression in postmenopausal women using data from the Korea National Health and Nutrition Examination Survey (KNHANES) VI. SUBJECTS/METHODS The KNHANES is a cross-sectional nationwide health and nutrition survey. Dietary data, including omega-3 fatty acids, were assessed using the 24-h recall method. Depression was evaluated using a survey questionnaire. The association between dietary omega-3 fatty acids and depression was evaluated using multivariate logistic regression analysis. Depression, according to the dietary omega-3 fatty acid intake, was expressed as the odds ratio (OR) with a 95% confidence interval (CI). A total of 4,150 postmenopausal women were included in the analysis. RESULTS In the fully-adjusted model, the group with the highest dietary omega-3 fatty acid intake significantly showed lower prevalence of depression than the group with the lowest intake (OR, 0.52; 95% CI, 0.33-0.83); a significant linear trend was detected (P for trend = 0.04). According to the dose-response analysis using cubic restricted spline regression, this association was linear and monotonic (P for non-linearity = 0.32). CONCLUSIONS In this study, the dietary omega-3 fatty acid intake in postmenopausal women was inversely proportional to depression in a dose-response manner. Large cohort studies are needed to verify the causality between omega-3 fatty acids and depression in Korean postmenopausal women.
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Affiliation(s)
- Minjeong Chae
- Department of Food and Nutrition, Yeungnam University, Gyeongsan 38541, Korea
| | - Kyong Park
- Department of Food and Nutrition, Yeungnam University, Gyeongsan 38541, Korea
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'An Apple a Day'?: Psychiatrists, Psychologists and Psychotherapists Report Poor Literacy for Nutritional Medicine: International Survey Spanning 52 Countries. Nutrients 2021; 13:nu13030822. [PMID: 33801454 PMCID: PMC8000813 DOI: 10.3390/nu13030822] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/16/2021] [Accepted: 02/25/2021] [Indexed: 02/01/2023] Open
Abstract
Nutritional interventions have beneficial effects on certain psychiatric disorder symptomatology and common physical health comorbidities. However, studies evaluating nutritional literacy in mental health professionals (MHP) are scarce. This study aimed to assess the across 52 countries. Surveys were distributed via colleagues and professional societies. Data were collected regarding self-reported general nutrition knowledge, nutrition education, learning opportunities, and the tendency to recommend food supplements or prescribe specific diets in clinical practice. In total, 1056 subjects participated in the study: 354 psychiatrists, 511 psychologists, 44 psychotherapists, and 147 MHPs in-training. All participants believed the diet quality of individuals with mental disorders was poorer compared to the general population (p < 0.001). The majority of the psychiatrists (74.2%) and psychologists (66.3%) reported having no training in nutrition. Nevertheless, many of them used nutrition approaches, with 58.6% recommending supplements and 43.8% recommending specific diet strategies to their patients. Only 0.8% of participants rated their education regarding nutrition as 'very good.' Almost all (92.9%) stated they would like to expand their knowledge regarding 'Nutritional Psychiatry.' There is an urgent need to integrate nutrition education into MHP training, ideally in collaboration with nutrition experts to achieve best practice care.
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Botturi A, Ciappolino V, Delvecchio G, Boscutti A, Viscardi B, Brambilla P. The Role and the Effect of Magnesium in Mental Disorders: A Systematic Review. Nutrients 2020; 12:nu12061661. [PMID: 32503201 PMCID: PMC7352515 DOI: 10.3390/nu12061661] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 05/13/2020] [Accepted: 05/25/2020] [Indexed: 12/25/2022] Open
Abstract
Introduction: Magnesium is an essential cation involved in many functions within the central nervous system, including transmission and intracellular signal transduction. Several studies have shown its usefulness in neurological and psychiatric diseases. Furthermore, it seems that magnesium levels are lowered in the course of several mental disorders, especially depression. Objectives: In this study, we wish to evaluate the presence of a relationship between the levels of magnesium and the presence of psychiatric pathology as well as the effectiveness of magnesium as a therapeutic supplementation. Methods: A systematic search of scientific records concerning magnesium in psychiatric disorders published from 2010 up to March 2020 was performed. We collected a total of 32 articles: 18 on Depressive Disorders (DD), four on Anxiety Disorders (AD), four on Attention Deficit Hyperactivity Disorder (ADHD), three on Autism Spectrum Disorder (ASD), one on Obsessive–Compulsive Disorder (OCD), one on Schizophrenia (SCZ) and one on Eating Disorders (ED). Results: Twelve studies highlighted mainly positive results in depressive symptoms. Seven showed a significant correlation between reduced plasma magnesium values and depression measured with psychometric scales. Two papers reported improved depressive symptoms after magnesium intake, two in association with antidepressants, compared to controls. No significant association between magnesium serum levels and panic or Generalized Anxiety Disorder (GAD) patients, in two distinct papers, was found. In two other papers, a reduced Hamilton Anxiety Rating Scale (HAM-A) score in depressed patients correlated with higher levels of magnesium and beneficial levels of magnesium in stressed patients was found. Two papers reported low levels of magnesium in association with ADHD. Only one of three papers showed lower levels of magnesium in ASD. ED and SCZ reported a variation in magnesium levels in some aspects of the disease. Conclusion: The results are not univocal, both in terms of the plasma levels and of therapeutic effects. However, from the available evidence, it emerged that supplementation with magnesium could be beneficial. Therefore, it is necessary to design ad hoc clinical trials to evaluate the efficacy of magnesium alone or together with other drugs (antidepressants) in order to establish the correct use of this cation with potential therapeutic effects.
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Affiliation(s)
- Andrea Botturi
- Neurologic Clinic, Fondazione IRCCS Istituto neurologico Carlo Besta, 20133 Milan, Italy
- Correspondence:
| | - Valentina Ciappolino
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; (V.C.); (A.B.); (B.V.); (P.B.)
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
| | - Andrea Boscutti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; (V.C.); (A.B.); (B.V.); (P.B.)
| | - Bianca Viscardi
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; (V.C.); (A.B.); (B.V.); (P.B.)
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; (V.C.); (A.B.); (B.V.); (P.B.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
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