Association between gastrointestinal symptoms and depression among older adults in Taiwan: A cross-sectional study

The relationship between gastrointestinal symptoms in FGID patients and D-type personality and emotion regulation strategies

This study examines the relationship between gastrointestinal symptoms in patients with functional gastrointestinal disorders (FGIDs) and type D personality traits, as well as emotion regulation strategies. Analyzing a diverse group of FGID patients, we uncover significant effects of gender and age on gastrointestinal symptoms. Negative Affectivity emerges as a key predictor, positively associated with symptom severity, whereas Social Inhibition correlates negatively with Abdominal Pain. Additionally, our findings suggest that the expressive suppression strategy predicts heightened gastrointestinal symptoms, whereas cognitive reappraisal predicts lower levels of certain symptoms. These findings provide valuable insights for precise diagnosis and tailored treatments of FGIDs. Further research is warranted to explore underlying mechanisms and inform evidence-based interventions.

Assessing Gastrointestinal Tolerance in Healthy Adults: Reliability and Validity of a Weekly Questionnaire

When examining gastrointestinal tolerance to nondigestible carbohydrates, a weekly vs. daily symptoms questionnaire may lessen participant burden. This secondary analysis examined the reliability and validity of the Gastrointestinal Symptom Rating Scale (GSRS) in healthy adults. The internal consistency reliability of the GSRS syndromes and a daily questionnaire (DQ) comparator were determined. The GSRS syndromes prediction of slow transit stool form was assessed by ROC analysis. The DQ (α = 0.76) and GSRS syndromes of constipation (α = 0.73; ω = 0.74), and diarrhea (α = 0.76; ω = 0.77) exhibited acceptable reliability, as did the GSRS overall (α = 0.76; ω = 0.87) but not the syndromes of abdominal pain (α = 0.54; ω = 0.54), reflux (α = 0.69; ω = 0.67), or indigestion (α = 0.64; ω = 0.67). The GSRS syndromes predicted slow transit stools (AUC = 0.855), and the GSRS items of stomach pain, nausea, flatus, constipation, and diarrhea were moderately correlated (ρ = 0.55-0.64; P < 0.001) with the corresponding DQ items. The GSRS may be useful to assess gastrointestinal tolerance and efficacy of nondigestible carbohydrates given its performance at predicting slow transit stools, suggestive of constipation.

Number of Chronic Medical Conditions and Quality of Life of Ethnic Minority Older Adults

Background: The Blacks’ mental health paradox is defined as disproportionately better mental health among Black individuals compared to White individuals, despite their higher exposure to a wide range of adversities. However, the existing literature on this phenomenon is mainly limited to studies that have compared Black and White individuals. There has been little research on this phenomenon among ethnic groups other than Whites. Objectives: This study tested the Blacks’ mental health paradox with consideration of Latinx individuals as the control group. Methods: This cross-sectional study collected demographic data, socioeconomic status, chronic medical conditions, and mental and physical quality of life of 724 older Black and Latinx adults residing in low socioeconomic areas of south Los Angeles. Linear regressions were used for data analysis with mental and physical health-related quality of life (HRQoL) as dependent variables and the number of chronic medical conditions as the independent variable. Results: Overall, a higher number of chronic medical conditions was associated with lower mental and physical quality of life. A statistically significant interaction was found between race/ethnicity and the effect of the number of chronic medical conditions on mental HRQoL, which was indicative of Blacks’ mental health paradox. Conclusion: Older Black adults with a higher number of chronic medical conditions report better mental health compared to their Latinx peers with the same number of chronic medical conditions. Thus, Blacks’ mental health paradox can be seen when Black and Latinx populations are compared. Replication of such a paradox provides additional support for the relative mental health advantage of Black people compared to other ethnic groups.

Vagus nerve stimulation increases stomach-brain coupling via a vagal afferent pathway

BACKGROUND

Maintaining energy homeostasis is vital and supported by vagal signaling between digestive organs and the brain. Previous research has established a gastric network in the brain that is phase synchronized with the rhythm of the stomach, but tools to perturb its function were lacking.

OBJECTIVE

To evaluate whether stomach-brain coupling can be acutely increased by non-invasively stimulating vagal afferent projections to the brain.

METHODS

Using a single-blind randomized crossover design, we investigated the effect of acute right-sided transcutaneous auricular vagus nerve stimulation (taVNS) versus sham stimulation on stomach-brain coupling.

RESULTS

In line with preclinical research, taVNS increased stomach-brain coupling in the nucleus of the solitary tract (NTS) and the midbrain while boosting coupling across the brain. Crucially, in the cortex, taVNS-induced changes in coupling occurred primarily in transmodal regions and were associated with changes in hunger ratings as indicators of the subjective metabolic state.

CONCLUSIONS

taVNS increases stomach-brain coupling via an NTS-midbrain pathway that signals gut-induced reward, indicating that communication between the brain and the body is effectively modulated by vago-vagal signaling. Such insights may help us better understand the role of vagal afferents in orchestrating the recruitment of the gastric network which could pave the way for novel neuromodulatory treatments.

Relationship between diet quality and depression among Iranian older adults in Tehran

Background

Depression is one of the prevalent mental disorders that is common in older ages. Evidence suggests that dietary intake status may potentially be associated with depression. However, this association has not been well studied in older adults, and the nature of the association remains unclear. This study aimed to investigate the association between diet quality and depression in free-living older adults living in Tehran city.

Methods

This cross-sectional study was conducted on 583 older adults (279 men and 304 women) aged 60 to 80 years living in Tehran city, selected by the systematic cluster sampling method. Individuals' dietary intake was determined by two non-consecutive 24-h dietary recalls, and diet quality was assessed calculating score of Healthy Eating Index-2015 (HEI-2015). The validated short form of the Geriatric Depression Scale (GDS-11) was used to assess depression status. A logistic regression model was used to assess the chance of depression across tertiles of HEI-2015 score.

Results

The point prevalence of depression was 22.5%, which was significantly higher in women (91 (69.5%) women vs. 40 (30.5%) men). A higher percentage of seniors at the higher tertile of HEI score were women, belonged to Fars ethnicity and had a higher score of activity of daily living (ADL). After adjustment for all potential confounders, the trend of depression chance was significantly decreased in those with higher HEI-2015 scores (p-for trend < 0.05).

Conclusion

Higher quality of diet was associated with a lower possibility of depression in the studied participants. Further studies are required to investigate the possible causal relationship.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-03380-1.

Predictors of Depression Level among Community-Dwelling Elderly Persons

Elderly people in the community have difficulty taking care of themselves because of their inability to care for themselves in daily life as well as their poor social support system, which leads to loneliness, resulting in depression. The primary objective was to investigate the level of depression and related factors among community-dwelling elderly persons (CDEP). This was a cross-sectional study, and 150 participants were interviewed. The questionnaires included demographics, the Functional Independence Measure, the Interpersonal Support Evaluation List, the UCLA Loneliness Scale, and the Geriatric Depression Scale Short Form. It was found that participants with different levels of depression accounted for 26%, and education level, living status, chronic disease, daily life function, social support, and loneliness were all significant factors influencing the depression level among the CDEP that could significantly predict 63.4% of the variation in depression level. Nursing staff must understand the level of depression and its influencing factors, encourage the elderly in the community to increase social networks, and integrate leisure into their lives, thereby enhancing the sense of value and meaning of life and reducing feelings of loneliness and depression.

Factors associated with the mental health status of isolated COVID-19 patients in Korea

Background

The COVID-19 pandemic has a substantial impact on the physical and mental health status of patients with COVID-19. This study's objective was to evaluate the factors associated with mental health in patients isolated with COVID-19.

Methods

It is a retrospective, cross-sectional study. One hundred and two patients discharged from COVID-19 hospitalization in Korea were analyzed. The primary outcome was the correlation between psychological problems such as anxiety, depression, and fear of stigma and physical symptoms such as respiratory symptoms, gastrointestinal symptoms, headache, and fever. Mental and physical symptoms were ascertained using closed and multiple-choice questions. The secondary outcome was the correlation between mental issues, demographic factors, and disease severity. Hypoxia and the need for oxygen therapy, a need for remdesivir antiviral treatment, and indications of pneumonia progression on chest x-ray were confirmed through a review of medical records and used to measure disease severity.

Results

Patients with COVID-19 indicated feelings of depression (48.1%), anxiety (49.1%), and fear of stigma (60.45%), and some continued to experience physical symptoms even after discharge. Logistic regression revealed that gastrointestinal symptoms positively correlated with depression (p < .05) and headache positively correlated with fear of stigma (p < .05), while the other factors were not statistically significant (p > .05).

Conclusions

This study showed that psychological symptoms persisted even after discharge. Gastrointestinal symptoms and headache were influential factors in predicting depression and fear of stigma. Based on this, dedicated COVID-19 hospitals should provide mental health support and preventive management.

Altered Brain Functional Asymmetry in Patients With Major Depressive Disorder Related to Gastrointestinal Symptoms

Objective

Disrupted brain functional asymmetry has been reported in major depressive disorder (MDD). The comorbidity may be a crucial factor to this functional asymmetry. It is quite common that gastrointestinal (GI) symptoms are comorbid with MDD, but limited evidence focuses on the effect of GI comorbidity on the neuropathology of MDD from a functional lateralization perspective.

Methods

Resting-state functional magnetic resonance imaging was obtained in 28 healthy controls (HCs), 35 MDD patients with GI symptoms (GI-MDD patients), and 17 patients with MDD without GI symptoms (nGI-MDD patients). The parameter of asymmetry (PAS) was used to analyze the imaging data and evaluate the changes of functional asymmetry.

Results

The GI-MDD patients showed increased PAS scores in the left inferior frontal gyrus (IFG) and superior medial prefrontal cortex (MPFC) and decreased PAS scores in the right postcentral gyrus in comparison with nGI-MDD patients. The PAS scores of the left IFG and left superior MPFC were correlated with the severity of GI problems and could be applied to distinguish GI-MDD patients from nGI-MDD patients with an accuracy, a sensitivity, and a specificity of 92.31, 100, and 76.47%, respectively. Furthermore, GI-MDD and nGI-MDD patients both displayed increased PAS scores in the PCC/precuneus.

Conclusions

This study revealed the influence of concomitant GI symptoms on functional asymmetry in MDD patients. Increased PAS scores of the left IFG and superior MPFC might represent an unbalanced regulation of brain over GI function and had the potential to be regarded as distinctive features related to functional GI symptoms in MDD.

Shared and Distinct Fractional Amplitude of Low-Frequency Fluctuation Patterns in Major Depressive Disorders With and Without Gastrointestinal Symptoms

Objective: Gastrointestinal (GI) symptoms are fairly common somatic symptoms in depressed patients. The purpose of this study was to explore the influence of concomitant GI symptoms on the fractional amplitude of low-frequency fluctuation (fALFF) patterns in patients with major depressive disorder (MDD) and investigate the connection between aberrant fALFF and clinical characteristics. Methods: This study included 35 MDD patients with GI symptoms (GI-MDD patients), 17 MDD patients without GI symptoms (nGI-MDD patients), and 28 healthy controls (HCs). The fALFF method was used to analyze the resting-state functional magnetic resonance imaging data. Correlation analysis and pattern classification were employed to investigate the relationship of the fALFF patterns with the clinical characteristics of patients. Results: GI-MDD patients exhibited higher scores in the HRSD-17 and suffered more severe insomnia, anxiety/somatization, and weight loss than nGI-MDD patients. GI-MDD patients showed higher fALFF in the right superior frontal gyrus (SFG)/middle frontal gyrus (MFG) and lower fALFF in the left superior medial prefrontal cortex (MPFC) compared with nGI-MDD patients. A combination of the fALFF values of these two clusters could be applied to discriminate GI-MDD patients from nGI-MDD patients, with accuracy, sensitivity, and specificity of 86.54, 94.29, and 70.59%, respectively. Conclusion: GI-MDD patients showed more severe depressive symptoms. Increased fALFF in the right SFG/MFG and decreased fALFF in the left superior MPFC might be distinctive neurobiological features of MDD patients with GI symptoms.

Current treatment of COVID-19 in renal patients: hope or hype?

To date the severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2), known as COVID-19, is for clinicians the most difficult global therapeutic problem. In this landscape, the management of patients with chronic kidney disease, acute kidney injury or patients undergoing immunosuppressant therapies for kidney transplant or glomerular diseases, represent a clinical challenge for nephrologists, especially in patients with severe acute lung involvement. Therefore in this setting, due to the lack of anti-COVID treatment schedules, tailored management is mandatory to reduce the side effects, as consequence of impaired renal function and drugs interactions. We report the main treatment actually used against SARS-CoV-2, underlining its possible use in the nephropatic patients and the central role of nephrologists to improve the clinical outcome.