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Efficacy of lifestyle medicine on sleep quality: A meta-analysis of randomized controlled trials. J Affect Disord 2023; 330:125-138. [PMID: 36863476 DOI: 10.1016/j.jad.2023.02.111] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 02/19/2023] [Accepted: 02/21/2023] [Indexed: 03/04/2023]
Abstract
OBJECTIVES Randomized controlled trials (RCTs) on the efficacy of multicomponent lifestyle medicine (LM) interventions for improving sleep quality have yielded inconsistent findings. This study marks the first meta-analysis to evaluate the efficacy of multicomponent LM interventions in improving sleep quality. METHODS We searched six online databases for RCTs that compared multicomponent LM interventions to an active or inactive control group in an adult population and assessed subjective sleep quality as a primary or secondary outcome using validated sleep measures at any post-intervention time-point. RESULTS A total of 23 RCTs with 26 comparisons involving 2534 participants were included in the meta-analysis. After excluding outliers, the analysis revealed that multicomponent LM interventions significantly improved sleep quality at immediate post-intervention (d = 0.45) and at short-term follow-up (i.e., <three months) (d = 0.50) relative to an inactive control group. Regarding the comparison with active control, no significant between-group difference was found at any time-point. No meta-analysis was conducted at the medium- and long-term follow-up due to insufficient data. Subgroup analyses supported that multicomponent LM interventions had a more clinically relevant effect on improving sleep quality in participants with clinical levels of sleep disturbance (d = 1.02) relative to an inactive control at immediate post-intervention assessment. There was no evidence of publication bias. CONCLUSION Our findings provided preliminary evidence that multicomponent LM interventions were efficacious in improving sleep quality relative to an inactive control at immediate post-intervention and at short-term follow-up. Additional high-quality RCTs targeting individuals with clinically significant sleep disturbance and long-term follow-up are warranted.
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Wilson C, Carpenter JS, Nichles A, Zmicerevska N, Song YJC, McHugh C, Hamilton B, Hockey S, Crouse J, Koethe D, Scott EM, Hickie IB. Double-blind, randomised placebo-controlled clinical trial of metformin as an adjunct to a sleep-wake, activity and metabolically focused behavioural intervention to improve cardiometabolic outcomes and mood symptoms in youth with major mood syndromes: study protocol. BMJ Open 2023; 13:e064682. [PMID: 36810174 PMCID: PMC9945047 DOI: 10.1136/bmjopen-2022-064682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
INTRODUCTION Metformin is a medication likely to improve measures of cardiometabolic disturbance in young people with mental illness. Evidence also suggests metformin may improve depressive symptoms. This 52-week double-blind randomised control trial (RCT) aims to investigate the efficacy of metformin pharmacotherapy as an adjunct to a healthy lifestyle behavioural intervention in improving cardiometabolic outcomes, and depressive, anxiety and psychotic symptoms in youth with clinically diagnosed major mood syndromes. METHODS AND ANALYSIS At least 266 young people aged 16-25 presenting for mental healthcare for major mood syndromes who are also at risk for poor cardiometabolic outcomes will be invited to participate in this study. All participants will engage in a 12-week sleep-wake, activity and metabolically focused behavioural intervention programme. As an adjunctive intervention, participants will receive either metformin (500-1000 mg) or placebo pharmacotherapy for 52 weeks.Participants will undergo a series of assessments including: (1) self-report and clinician-administered assessments; (2) blood tests; (3) anthropometric assessments (height, weight, waist circumference and blood pressure); and (4) actigraphy. Univariate and multivariate tests (generalised mixed-effects models) will be used to examine changes in primary and secondary outcomes (and associations with predetermined predictor variables). ETHICS AND DISSEMINATION This study has been approved by the Sydney Local Health District Research Ethics and Governance Office (X22-0017). The results of this double-blind RCT will be disseminated into the scientific and broader community through peer-reviewed journals, conference presentations, social media and university websites. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ANZCTR) Number: ACTRN12619001559101p, 12 November 2019.
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Affiliation(s)
- Chloe Wilson
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | | | - Alissa Nichles
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Natalia Zmicerevska
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Yun Ju Christine Song
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Catherine McHugh
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Blake Hamilton
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Samuel Hockey
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Jacob Crouse
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Dagmar Koethe
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Elizabeth M Scott
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
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Improving physical activity and diet in patients with severe mental disorders: Results from the LIFESTYLE multicentric, real-world randomized controlled trial. Psychiatry Res 2022; 317:114818. [PMID: 36088834 DOI: 10.1016/j.psychres.2022.114818] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/27/2022] [Accepted: 08/30/2022] [Indexed: 11/23/2022]
Abstract
Aims of the present study are to test the efficacy of a lifestyle group intervention, compared to a brief psychoeducational intervention, on levels of physical activity and dietary habits in a real-world sample of patients with severe mental disorders. The study, funded by the Italian Ministry of Education, has been carried out in six Italian University psychiatric outpatient units. All patients were randomly assigned to the experimental or control group and were assessed through standardized assessment instruments at baseline and six months after randomization. Of the 401 recruited patients, 43.3% had a diagnosis of bipolar disorder, 29.9% of psychosis and 26.9% of major depression. Patients were mainly female (57%), with a mean age of 45.6±11.8 years. Treated patients have almost 8 times the likelihood to show an increase of the total MET (OR: 8.02; p < .001) and of the walking MET (OR: 7.68; p < .001) and are more likely to increase the weekly consumption of vegetables (OR= 1.98, p < .05) and to reduce that of junk food (OR:0.23; p < .05). The present study support the notion that patients with severe mental disorders can improve their lifestyle behaviours and that, with appropriate support, they can achieve a healthy living.
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Bradley T, Campbell E, Dray J, Bartlem K, Wye P, Hanly G, Gibson L, Fehily C, Bailey J, Wynne O, Colyvas K, Bowman J. Systematic review of lifestyle interventions to improve weight, physical activity and diet among people with a mental health condition. Syst Rev 2022; 11:198. [PMID: 36085250 PMCID: PMC9462072 DOI: 10.1186/s13643-022-02067-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 09/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with a mental health condition experience an elevated risk of chronic disease and greater prevalence of health and behaviours. Lifestyle interventions aim to reduce this risk by modifying health behaviours such as physical activity and diet. Previous reviews exploring the efficacy of such interventions for this group have typically limited inclusion to individuals with severe mental illness (SMI), with a focus of impact on weight. This review assessed the efficacy of lifestyle interventions delivered in community or outpatient settings to people with any mental health condition, on weight, physical activity and diet. METHODS Eligible studies were randomised or cluster-randomised controlled trials published between January 1999 and February 2019 aiming to improve weight, physical activity or diet, for people with any mental health condition. Two reviewers independently completed study screening, data extraction and assessment of methodological quality. Primary outcome measures were weight, physical activity and diet. Secondary outcome measures were body mass index (BMI), waist circumference, sedentary behaviour and mental health. Where possible, meta-analyses were conducted. Narrative synthesis using vote counting based on direction of effect was used where studies were not amenable to meta-analysis. RESULTS Fifty-seven studies were included (49 SMI only), with 46 contributing to meta-analyses. Meta-analyses revealed significant (< 0.05) effect of interventions on mean weight loss (-1.42 kg), achieving 5% weight loss (OR 2.48), weight maintenance (-2.05 kg), physical activity (IPAQ MET minutes: 226.82) and daily vegetable serves (0.51), but not on fruit serves (0.01). Significant effects were also seen for secondary outcomes of BMI (-0.48 units) and waist circumference (-0.87cm), but not mental health (depression: SMD -0.03; anxiety: SMD -0.49; severity of psychological symptoms: SMD 0.72). Studies reporting sedentary behaviour were not able to be meta-analysed. Most trials had high risk of bias, quality of evidence for weight and physical activity were moderate, while quality of evidence for diet was low. CONCLUSION Lifestyle interventions delivered to people with a mental health condition made statistically significant improvements to weight, BMI, waist circumference, vegetable serves and physical activity. Further high-quality trials with greater consistency in measurement and reporting of outcomes are needed to better understand the impact of lifestyle interventions on physical activity, diet, sedentary behaviour and mental health and to understand impact on subgroups. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019137197.
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Affiliation(s)
- Tegan Bradley
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305 Australia
| | - Elizabeth Campbell
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW 2287 Australia
| | - Julia Dray
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305 Australia
| | - Kate Bartlem
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305 Australia
| | - Paula Wye
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
| | - Grace Hanly
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305 Australia
| | - Lauren Gibson
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305 Australia
| | - Caitlin Fehily
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305 Australia
| | - Jacqueline Bailey
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
| | - Olivia Wynne
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
| | - Kim Colyvas
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
| | - Jenny Bowman
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305 Australia
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Rookes TA, Barat A, Turner R, Taylor S. Reporting dose in complex self-management support interventions for long-term conditions: is it defined by researchers and received by participants? A systematic review. BMJ Open 2022; 12:e056532. [PMID: 35977763 PMCID: PMC9389087 DOI: 10.1136/bmjopen-2021-056532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 07/22/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The minimum clinically effective dose, and whether this is received in randomised controlled trials (RCTs) of complex self-management interventions in long-term conditions (LTCs), can be unclear. The Template for Intervention Description and Replication (TIDieR) checklist states that dose should be clearly reported to ensure validity and reliable implementation. OBJECTIVES To identify whether the expected minimum clinically effective dose, and the dose participants received is reported within research articles and if reporting has improved since the TIDieR checklist was published. METHODS Four databases were systematically searched (MEDLINE, PsycINFO, AMED and CINAHL) to identify published reports between 2008 and 2022 for RCTs investigating complex self-management interventions in LTCs. Data on reporting of dose were extracted and synthesised from the eligible articles. RESULTS 94 articles covering various LTCs including diabetes, stroke and arthritis were included. Most complex interventions involved behaviour change combined with education and/or exercise. The maximum dose was usually reported (n=90; 97.8%), but the expected minimum clinically effective dose and the dose received were reported in only 28 (30.4%) and 62 (67.4%) articles, respectively. Reporting of the expected minimum clinically effective dose and the dose participants received did not improve following the publication of the TIDieR checklist in 2014. CONCLUSIONS Interpreting results and implementing effective complex self-management interventions is difficult when researchers' reporting of dose is not in line with guidelines. If trial findings indicate benefit from the intervention, clear reporting of dose ensures reliable implementation to standard care. If the results are non-significant, detailed reporting enables better interpretation of results, that is, differentiating between poor implementation and lack of effectiveness. This ensures quality of interventions and validity and generalisability of trial findings. Therefore, wider adoption of reporting the TIDieR checklist dose aspects is strongly recommended. Alternatively, customised guidelines for reporting dose in complex self-management interventions could be developed. PROSPERO REGISTRATION NUMBER CRD42020180988.
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Affiliation(s)
| | - Atena Barat
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Rebecca Turner
- Institute of Clinical Trials and Methodology, UCL, London, UK
| | - Stephanie Taylor
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
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Pape LM, Adriaanse MC, Kol J, van Straten A, van Meijel B. Patient-reported outcomes of lifestyle interventions in patients with severe mental illness: a systematic review and meta-analysis. BMC Psychiatry 2022; 22:261. [PMID: 35418082 PMCID: PMC9006587 DOI: 10.1186/s12888-022-03854-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 03/11/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Lifestyle interventions for severe mental illness (SMI) are known to have small to modest effect on physical health outcomes. Little attention has been given to patient-reported outcomes (PROs). AIM To systematically review the use of PROs and their measures, and quantify the effects of lifestyle interventions in patients with SMI on these PROs. METHODS Five electronic databases were searched (PubMed/Medline, Embase, PsycINFO, CINAHL, and Web of Science) from inception until 12 November 2020 (PROSPERO: CRD42020212135). Randomised controlled trials (RCTs) evaluating the efficacy of lifestyle interventions focusing on healthy diet, physical activity, or both for patients with SMI were included. Outcomes of interest were PROs. RESULTS A total of 11.267 unique records were identified from the database search, 66 full-text articles were assessed, and 36 RCTs were included, of which 21 were suitable for meta-analyses. In total, 5.907 participants were included across studies. Lifestyle interventions had no significant effect on quality of life (g = 0.13; 95% CI = - 0.02 to 0.27), with high heterogeneity (I2 = 68.7%). We found a small effect on depression severity (g = 0.30, 95% CI = 0.00 to 0.58, I2 = 65.2%) and a moderate effect on anxiety severity (g = 0.56, 95% CI = 0.16 to 0.95, I2 = 0%). DISCUSSION This meta-analysis quantifies the effects of lifestyle interventions on PROs. Lifestyle interventions have no significant effect on quality of life, yet they could improve mental health outcomes such as depression and anxiety symptoms. Further use of patient-reported outcome measures in lifestyle research is recommended to fully capture the impact of lifestyle interventions.
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Affiliation(s)
- Laura M. Pape
- grid.12380.380000 0004 1754 9227Department of Health Sciences, Faculty of Science & Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Marcel C. Adriaanse
- grid.12380.380000 0004 1754 9227Department of Health Sciences, Faculty of Science & Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Jelle Kol
- grid.12380.380000 0004 1754 9227Department of Health Sciences, Faculty of Science & Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Annemieke van Straten
- grid.12380.380000 0004 1754 9227Department of Clinical, Neuro- and Developmental Psychology & Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Berno van Meijel
- grid.448984.d0000 0003 9872 5642Department of Health, Sports & Welfare, Research Group Mental Health Nursing, Inholland University of Applied Sciences, Amsterdam, The Netherlands ,grid.16872.3a0000 0004 0435 165XAmsterdam UMC (VUmc). Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,grid.476585.d0000 0004 0447 7260Parnassia Psychiatric Institute, Parnassia Academy, The Hague, The Netherlands
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Luciano M, Pompili M, Sartorius N, Fiorillo A. Editorial: Mortality of people with severe mental illness: Causes and ways of its reduction. Front Psychiatry 2022; 13:1009772. [PMID: 36061294 PMCID: PMC9434340 DOI: 10.3389/fpsyt.2022.1009772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mario Luciano
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes (AMH), Geneva, Switzerland
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
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Wilson C, Nichles A, Zmicerevska N, Carpenter JS, Song YJC, McHugh C, Hamilton B, Hockey S, Scott EM, Hickie IB. Effect of an online healthy lifestyle psychoeducation programme to improve cardiometabolic outcomes and affective symptoms in youth receiving mental health care: study protocol for a pilot clinical trial. BMJ Open 2021; 11:e044977. [PMID: 34187819 PMCID: PMC8245471 DOI: 10.1136/bmjopen-2020-044977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Worsened cardiometabolic profiles in youth with mental ill health have been associated with a number of modifiable lifestyle risk factors. It is becoming increasingly evident that clinical interventions need to be multimodal in focus to improve mental health symptoms and the physical health symptoms in this already at-risk cohort. METHODS AND ANALYSIS This 12-week pilot clinical trial examines the efficacy, feasibility and acceptability of an adjunctive online psychoeducation programme for improving cardiometabolic risk parameters and affective symptoms in a transdiagnostic sample of at least 44 young people aged 16-25 years presenting for mental healthcare for mood and/or psychotic syndromes (including anxiety, depression, bipolar disorder and psychosis). Individuals will be invited to participate in a pilot clinical trial for a structured online psychoeducation programme incorporating nutritional, physical activity, sleep-wake and healthy lifestyle information, delivered fortnightly over six online modules. Participants will undergo a series of assessments including: (1) self-report and clinician administered assessments determining mental health symptomatology; (2) fasting blood tests to assess cardiometabolic markers (fasting insulin, fasting glucose and blood lipids); (3) anthropometric assessments (height, weight, waist circumference and blood pressure); and (4) sleep-wake behaviours and circadian rhythm assessments. Changes in scores for all cardiometabolic and affective measures will be assessed via paired samples t-tests, and correlations between change scores will be assessed via Pearson's or Spearman's correlations. Feasibility will be assessed via completion rates, and the acceptability of the programme will be assessed via programme satisfaction measures. ETHICS AND DISSEMINATION This pilot clinical trial has been approved by the Sydney Local Health District Research Ethics and Governance Office (X20-0228 & 2020/ETH01201). The results of this pilot clinical trial will be disseminated into the scientific and broader community through peer-reviewed journals, conference presentations, social media and university websites. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ANZCTR) Number: ACTRN12620000772943, Date 28 August 2020.
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Affiliation(s)
- Chloe Wilson
- Youth Mental Health and Technology Team, The University of Sydney Brain and Mind Centre, Sydney, New South Wales, Australia
| | - Alissa Nichles
- Youth Mental Health and Technology Team, The University of Sydney Brain and Mind Centre, Sydney, New South Wales, Australia
| | - Natalia Zmicerevska
- Youth Mental Health and Technology Team, The University of Sydney Brain and Mind Centre, Sydney, New South Wales, Australia
| | - Joanne Sarah Carpenter
- Youth Mental Health and Technology Team, The University of Sydney Brain and Mind Centre, Sydney, New South Wales, Australia
| | - Yun Ju Christine Song
- Youth Mental Health and Technology Team, The University of Sydney Brain and Mind Centre, Sydney, New South Wales, Australia
| | - Catherine McHugh
- Youth Mental Health and Technology Team, The University of Sydney Brain and Mind Centre, Sydney, New South Wales, Australia
| | - Blake Hamilton
- Youth Mental Health and Technology Team, The University of Sydney Brain and Mind Centre, Sydney, New South Wales, Australia
| | - Samuel Hockey
- Youth Mental Health and Technology Team, The University of Sydney Brain and Mind Centre, Sydney, New South Wales, Australia
| | - Elizabeth M Scott
- Youth Mental Health and Technology Team, The University of Sydney Brain and Mind Centre, Sydney, New South Wales, Australia
| | - Ian B Hickie
- Youth Mental Health and Technology Team, The University of Sydney Brain and Mind Centre, Sydney, New South Wales, Australia
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Vicinanza R, Bersani FS, D'Ottavio E, Murphy M, Bernardini S, Crisciotti F, Frizza A, Mazza V, Biondi M, Troisi G, Cacciafesta M. Adherence to Mediterranean diet moderates the association between multimorbidity and depressive symptoms in older adults. Arch Gerontol Geriatr 2020; 88:104022. [PMID: 32109694 DOI: 10.1016/j.archger.2020.104022] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 01/11/2020] [Accepted: 02/01/2020] [Indexed: 01/18/2023]
Abstract
AIM Adherence to Mediterranean Diet (Med-Diet) has been associated with a lower incidence of chronic diseases and may be associated with lower risk for depression. The aim of the present study was to investigate (i) the association of adherence to Med-Diet with depressive symptoms and multimorbidity in a cohort of geriatric medical outpatients, and (ii) the role of Med-Diet in mediating the association between depressive symptoms and multimorbidity. METHODS A total of 143 geriatric patients (mean age: 73.1 ± 8.35) were included. Adherence to Med-Diet was evaluated using a validated 14-item questionnaire; depressive and cognitive symptoms were assessed through the 15-item Geriatric Depression Scale (GDS) and Mini Mental State Examination (MMSE) respectively; multimorbidity was evaluated using the Cumulative Illness Rating Scale for Geriatrics (CIRSG-SI). RESULTS Significant associations were found between MDQ score, GDS and CIRSG-SI (MDQ score and GDS: r= -0.206, p = 0.014; MDQ score and CIRSG-SI: r= -0.247, p = 0.003; GDS and CIRSG-SI: r = 0.251; p = 0.003). These associations remained significant after adjusting for potential confounding factors. A mediational model analysis showed that the direct effect of CIRSG-SI on GDS was significant (b = 1.330; se = 0.59; p = 0.028) with this effect being counterbalanced by higher MDQ scores (indirect effect of CIRS-G on GDS through MDQ: b = 0.382; se = 0.19; p = 0.048). CONCLUSION These findings (i) add to the accumulating evidence that Med-Diet may have a positive impact on mental health in the elderly, and (ii) suggest that Med-Diet may contribute, at least in part, to protect geriatric patients with multimorbidity from the development of depressive symptoms, ultimately promoting healthy aging.
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Affiliation(s)
- Roberto Vicinanza
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma RM, Italy; Leonard Davis School of Gerontology, University of Southern California, 3715 McClintock Ave, Los Angeles, CA 90089, USA.
| | - Francesco Saverio Bersani
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Roma RM, Italy.
| | - Elisa D'Ottavio
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma RM, Italy.
| | - Melanie Murphy
- Leonard Davis School of Gerontology, University of Southern California, 3715 McClintock Ave, Los Angeles, CA 90089, USA.
| | - Sciaila Bernardini
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma RM, Italy.
| | - Flaminia Crisciotti
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma RM, Italy.
| | - Alessandro Frizza
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma RM, Italy.
| | - Valentina Mazza
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma RM, Italy.
| | - Massimo Biondi
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Roma RM, Italy.
| | - Giovanni Troisi
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma RM, Italy.
| | - Mauro Cacciafesta
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma RM, Italy.
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Iannone LF, Preda A, Blottière HM, Clarke G, Albani D, Belcastro V, Carotenuto M, Cattaneo A, Citraro R, Ferraris C, Ronchi F, Luongo G, Santocchi E, Guiducci L, Baldelli P, Iannetti P, Pedersen S, Petretto A, Provasi S, Selmer K, Spalice A, Tagliabue A, Verrotti A, Segata N, Zimmermann J, Minetti C, Mainardi P, Giordano C, Sisodiya S, Zara F, Russo E, Striano P. Microbiota-gut brain axis involvement in neuropsychiatric disorders. Expert Rev Neurother 2019; 19:1037-1050. [PMID: 31260640 DOI: 10.1080/14737175.2019.1638763] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Introduction: The microbiota-gut brain (MGB) axis is the bidirectional communication between the intestinal microbiota and the brain. An increasing body of preclinical and clinical evidence has revealed that the gut microbial ecosystem can affect neuropsychiatric health. However, there is still a need of further studies to elucidate the complex gene-environment interactions and the role of the MGB axis in neuropsychiatric diseases, with the aim of identifying biomarkers and new therapeutic targets, to allow early diagnosis and improving treatments. Areas covered: To review the role of MGB axis in neuropsychiatric disorders, prediction and prevention of disease through exploitation, integration, and combination of data from existing gut microbiome/microbiota projects and appropriate other International '-Omics' studies. The authors also evaluated the new technological advances to investigate and modulate, through nutritional and other interventions, the gut microbiota. Expert opinion: The clinical studies have documented an association between alterations in gut microbiota composition and/or function, whereas the preclinical studies support a role for the gut microbiota in impacting behaviors which are of relevance to psychiatry and other central nervous system (CNS) disorders. Targeting MGB axis could be an additional approach for treating CNS disorders and all conditions in which alterations of the gut microbiota are involved.
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Affiliation(s)
- Luigi Francesco Iannone
- Science of Health Department, School of Medicine, University of Catanzaro , Catanzaro , Italy
| | - Alberto Preda
- Paediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, "G. Gaslini" Institute , Genova , Italy
| | - Hervé M Blottière
- Micalis Institute, INRA, AgroParisTech, Université Paris-Saclay, JouyenJosas&MetaGenoPolis, INRA, Université Paris-Saclay , Jouyen Josas , France
| | - Gerard Clarke
- Department of Psychiatry and Neurobehavioural Science, School of Medicine, College of Medicine & Health, University College Cork, Cork, Ireland; APC Microbiome Ireland, University College Cork , Cork , Ireland
| | - Diego Albani
- Department of Neuroscience, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri , Milan , Italy
| | | | - Marco Carotenuto
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Università degli Studi della Campania 'Luigi Vanvitelli' , Napoli , Italy
| | - Annamaria Cattaneo
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli , Brescia , Italy.,Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry , King's College , London
| | - Rita Citraro
- Science of Health Department, School of Medicine, University of Catanzaro , Catanzaro , Italy
| | - Cinzia Ferraris
- Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine University of Pavia , Pavia , Italy
| | - Francesca Ronchi
- Department forBiomedical Research, University of Bern , Bern , Switzerland
| | - Gaia Luongo
- Ordine dei Tecnologi Alimentari Campania e Lazio , Napoli , Italy
| | | | - Letizia Guiducci
- National Research Council, Institute of Clinical Physiology , Pisa , Italy
| | - Pietro Baldelli
- Department of Experimental Medicine, Section of Physiology, University of Genova , Genova , Italy
| | - Paola Iannetti
- Department of Pediatrics`, "Sapienza" University of Rome , Rome , Italy
| | - Sigrid Pedersen
- Department of Refractory Epilepsy, Division of Clinical Neuroscience, Oslo University Hospital , Oslo , Norway
| | - Andrea Petretto
- Laboratory of Mass Spectrometry - Core Facilities, Istituto Giannina Gaslini , Genova , Italy
| | - Stefania Provasi
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli , Brescia , Italy
| | - Kaja Selmer
- Department of Research and Development, Division of Clinical Neuroscience, Oslo University Hospital, Osla, Norway and Department of Refractory Epilepsy, Division of Clinical Neuroscience, Oslo University Hospital , Osla , Norway
| | - Alberto Spalice
- Department of Experimental Medicine, Section of Physiology, University of Genova , Genova , Italy
| | - Anna Tagliabue
- Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry , King's College , London
| | - Alberto Verrotti
- Department of Pediatrics, University of L'Aquila , L'Aquila , Italy
| | - Nicola Segata
- Centre for Integrative Biology, University of Trento , Trento , Italy
| | - Jakob Zimmermann
- Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine University of Pavia , Pavia , Italy
| | - Carlo Minetti
- Paediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, "G. Gaslini" Institute , Genova , Italy
| | | | - Carmen Giordano
- Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano , Milano , Italy
| | - Sanjay Sisodiya
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology , Queen Square, London , UK
| | - Federico Zara
- Laboratory of Neurogenetics, Istituto Giannina Gaslini , Genova , Italy
| | - Emilio Russo
- Science of Health Department, School of Medicine, University of Catanzaro , Catanzaro , Italy
| | - Pasquale Striano
- Paediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, "G. Gaslini" Institute , Genova , Italy
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Tengeler AC, Kozicz T, Kiliaan AJ. Relationship between diet, the gut microbiota, and brain function. Nutr Rev 2018; 76:603-617. [DOI: 10.1093/nutrit/nuy016] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Anouk C Tengeler
- Department of Anatomy, Radboud university medical center, Center for Medical Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Preclinical Imaging Center PRIME, Nijmegen, the Netherlands
| | - Tamas Kozicz
- Department of Anatomy, Radboud university medical center, Center for Medical Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Preclinical Imaging Center PRIME, Nijmegen, the Netherlands
- Department of Pedriatrics, Hayward Genetics Center, Tulane University School of Medicine, Tulane University, New Orleans, Louisiana, USA
| | - Amanda J Kiliaan
- Department of Anatomy, Radboud university medical center, Center for Medical Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Preclinical Imaging Center PRIME, Nijmegen, the Netherlands
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12
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Quintiliani MI, Imperatori C, Testani E, Losurdo A, Tamburello S, Contardi A, Della Marca G, Farina B. Usefulness of psychoeducational intervention in chronic insomnia: an actigraphic study. J Ment Health 2017; 29:20-26. [PMID: 29271275 DOI: 10.1080/09638237.2017.1417563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Background: Chronic Insomnia is a severe and disabling condition characterized by difficulty in initiating or maintaining sleep, waking up too early, despite adequate opportunity and circumstances for sleep. Maladaptive thoughts and dysfunctional beliefs about sleep are considered crucial factors in developing and perpetuating this disorder.Aims: The aim of the study was to explore the usefulness, in patients with chronic insomnia, of a one-session psychoeducational intervention on sleep-related maladaptive thoughts and beliefs, and on sleep perception.Methods: Thirty-eight patients with chronic insomnia were enrolled in the study and randomly assigned to receive psychoeducational intervention (PI+) or to act as controls (PI-). Patients wore an actigraph and compiled a sleep diary for 14 d. After the first 7 d, only PI+ patients received one session of psychoeducational intervention.Results: A significant reduction of sleep related preoccupations, a reduction of dysfunctional beliefs about sleep, and an improvement of subjective perception of sleep were observed in the PI+ group, but not in the PI- group. No significant modification was observed for objective total sleep time.Conclusions: Our results suggest that one-session psychoeducational intervention is associated with a decrease of sleep-related maladaptive thoughts and beliefs, and with an improvement on subjective sleep perception.
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Affiliation(s)
| | | | - Elisa Testani
- Institute of Neurology, Catholic University, Rome, Italy
| | - Anna Losurdo
- Institute of Neurology, Catholic University, Rome, Italy
| | | | - Anna Contardi
- Department of Human Sciences, European University, Rome, Italy and
| | | | - Benedetto Farina
- Department of Human Sciences, European University, Rome, Italy and
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