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Ward JH, McBride A, Price A, Delgado TN. Psychosocial interventions for improving the physical health of young people and adults with attention deficit hyperactivity disorder: a scoping review. BMC Psychiatry 2024; 24:569. [PMID: 39164688 PMCID: PMC11337789 DOI: 10.1186/s12888-024-06009-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 08/08/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND Young people and adults with ADHD are at risk of a range of physical health problems. There is limited guidance on how to approach health problems in ADHD, and especially around 16-25 year olds who will be transitioning from paediatric to adult care. The aim of this scoping review was to identify psychosocial interventions that target physical health in young people and adults with ADHD. METHODS We constructed searches in MEDLINE, PsycInfo, EMBASE of adolescents, young people and adults. Inclusion criteria were; studies of psychosocial interventions examining a component of physical health, applicable to people aged 16-25, with clinical or research diagnoses of ADHD. Data were extracted using a data extraction tool and tabulated, including study intervention framing/aims, population, intervention, and relevant outcomes (including specific statistics where relevant). RESULTS Our search identified 22 unique papers covering, psychosocial interventions targeting at least one of sleep (n=7), smoking (n=3), substance/alcohol use (n=4), physical health/exercise (n=6) and general health (n=3). Studies examined psychotherapy/behaviour interventions (n=12), psychoeducation (n=4), digital (n=2) and social interventions (n=4). There was significant heterogeneity in intervention framing, outcome measures and population. CONCLUSION Further work on the impact of targeted physical health interventions, with explicit reference to a conceptual framework of poor health in ADHD is required. Furthermore, future work standardising reporting of physical health outcomes in ADHD is crucial for the development of an evidence base in this field.
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Affiliation(s)
- John Headley Ward
- 2.05 South Cloisters, 2.05 South Cloisters, St Luke's Campus, University of Exeter Medical School, Heavitree Road, Exeter, EX2 4TH, UK.
- Royal Devon University NHS Foundation Trust, Exeter, UK.
- Department of Psychiatry, University of Oxford, Oxford, UK.
- Oxford Health NHS Foundation Trust, Oxford, UK.
| | - Audrey McBride
- 2.05 South Cloisters, 2.05 South Cloisters, St Luke's Campus, University of Exeter Medical School, Heavitree Road, Exeter, EX2 4TH, UK
| | - Anna Price
- 2.05 South Cloisters, 2.05 South Cloisters, St Luke's Campus, University of Exeter Medical School, Heavitree Road, Exeter, EX2 4TH, UK
| | - Tamsin Newlove Delgado
- 2.05 South Cloisters, 2.05 South Cloisters, St Luke's Campus, University of Exeter Medical School, Heavitree Road, Exeter, EX2 4TH, UK
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Chen R, Yan Y, Cheng X. Circadian light therapy and light dose for depressed young people: a systematic review and meta-analysis. Front Public Health 2024; 11:1257093. [PMID: 38259764 PMCID: PMC10800803 DOI: 10.3389/fpubh.2023.1257093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/06/2023] [Indexed: 01/24/2024] Open
Abstract
Background Empirical evidence has shown that light therapy (LT) can reduce depression symptoms by stimulating circadian rhythms. However, there is skepticism and inconclusive results, along with confusion regarding dosing. The purpose of this study is to quantify light as a stimulus for the circadian system and create a dose-response relationship that can help reduce maladies among adolescents and young adults (AYAs). This will provide a reference for light exposure and neural response, which are crucial in the neuropsychological mechanism of light intervention. The study also aims to provide guidance for clinical application. Methods The latest quantitative model of CLA (circadian light) and CSt,f (circadian stimulus) was adopted to quantify light dose for circadian phototransduction in youth depression-related light therapy. Articles published up to 2023 through Web of Science, Cochrane Library, Medline (OVID), CINAHL, APA PsycINFO, Embase, and Scholars were retrieved. A meta-analysis of 31 articles (1,031 subjects) was performed using Stata17.0, CMA3.0 (comprehensive meta-analysis version 3.0) software, and Python 3.9 platform for light therapy efficacy comparison and dose-response quantification. Results Under various circadian stimulus conditions (0.1 < CSt,f < 0.7) of light therapy (LT), malady reductions among AYAs were observed (pooled SMD = -1.59, 95%CI = -1.86 to -1.32; z = -11.654, p = 0.000; I2 = 92.8%), with temporal pattern (p = 0.044) and co-medication (p = 0.000) suggested as main heterogeneity sources. For the efficacy advantage of LT with a higher circadian stimulus that is assumed to be influenced by visualization, co-medication, disease severity, and time pattern, sets of meta-analysis among random-controlled trials (RCTs) found evidence for significant efficacy of circadian-active bright light therapy (BLT) over circadian-inactive dim red light (SMD = -0.65, 95% CI = -0.96 to -0.34; z = -4.101, p = 0.000; I2 = 84.9%) or circadian-active dimmer white light (SMD = -0.37, 95% CI = -0.68 to -0.06; z = -2.318, p = 0.02; I2 = 33.8%), whereas green-blue, circadian-active BLT showed no significant superiority over circadian-inactive red/amber light controls (SMD = -0.21, 95% CI = -0.45 to 0.04; z = -2.318, p = 0.099; I2 = 0%). Overall, circadian-active BLT showed a greater likelihood of clinical response than dim light controls, with increased superiority observed with co-medication. For pre-to-post-treatment amelioration and corresponding dose-response relationship, cumulative duration was found more influential than other categorical (co-medication, severity, study design) or continuous (CSt,f) variables. Dose-response fitting indicated that the therapeutic effect would reach saturation among co-medicated patients at 32-42 days (900-1,000 min) and 58-59 days (1,100-1,500 min) among non-medicated AYAs. When exerting high circadian stimulus of light therapy (0.6 < CSt,f < 0.7), there was a significantly greater effect size in 1,000-1,500 min of accumulative duration than <1,000 or >1,500 min of duration, indicating a threshold for practical guidance. Limitations The results have been based on limited samples and influenced by a small sample effect. The placebo effect could not be ignored. Conclusions Although the superiority of LT with higher circadian stimulus over dimmer light controls remains unproven, greater response potentials of circadian-active BLT have been noticed among AYAs, taking co-medication, disease severity, time pattern, and visual characteristics into consideration. The dose-response relationship with quantified circadian stimulus and temporal pattern had been elaborated under various conditions to support clinical depression treatment and LT device application in the post-pandemic era.
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Affiliation(s)
- Ranpeng Chen
- School of Architecture and Urban Planning, Chongqing University, Chongqing, China
| | - Yonghong Yan
- School of Architecture and Urban Planning, Chongqing University, Chongqing, China
- Key Laboratory of New Technology for Construction of Cities in Mountain Area, Chongqing University, Chongqing, China
| | - Xiang Cheng
- School of Architecture and Urban Planning, Chongqing University, Chongqing, China
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Ruf A, Neubauer AB, Koch ED, Ebner-Priemer U, Reif A, Matura S. Microtemporal Dynamics of Dietary Intake, Physical Activity, and Impulsivity in Adult Attention-Deficit/Hyperactivity Disorder: Ecological Momentary Assessment Study Within Nutritional Psychiatry. JMIR Ment Health 2023; 10:e46550. [PMID: 37590053 PMCID: PMC10472180 DOI: 10.2196/46550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/24/2023] [Accepted: 06/17/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Increasing attention is being paid to lifestyle factors, such as nutrition and physical activity (PA), as potential complementary treatment options in attention-deficit/hyperactivity disorder (ADHD). Previous research indicates that sugar and saturated fat intake may be linked to increased impulsivity, a core symptom of ADHD, whereas protein intake and PA may be related to reduced impulsivity. However, most studies rely on cross-sectional data that lack microtemporal resolution and ecological validity, wherefore questions of microtemporal dynamics (eg, is the consumption of foods high in sugar associated with increased impulsivity within minutes or hours?) remain largely unanswered. Ecological momentary assessment (EMA) has the potential to bridge this gap. OBJECTIVE This study is the first to apply EMA to assess microtemporal associations among macronutrient intake, PA, and state impulsivity in the daily life of adults with and without ADHD. METHODS Over a 3-day period, participants reported state impulsivity 8 times per day (signal-contingent), recorded food and drink intake (event-contingent), and wore an accelerometer. Multilevel 2-part models were used to study the association among macronutrient intake, PA, and the probability to be impulsive as well as the intensity of impulsivity (ADHD: n=36; control: n=137). RESULTS No association between macronutrient intake and state impulsivity was found. PA was not related to the intensity of impulsivity but to a higher probability to be impulsive (ADHD: β=-.09, 95% CI -0.14 to -0.04; control: β=-.03, 95% CI -0.05 to -0.01). No evidence was found that the combined intake of saturated fat and sugar amplified the increase in state impulsivity and that PA alleviated the positive association between sugar or fat intake and state impulsivity. CONCLUSIONS Important methodological considerations are discussed that can contribute to the optimization of future EMA protocols. EMA research in the emerging field of nutritional psychiatry is still in its infancy; however, EMA is a highly promising and innovative approach as it offers insights into the microtemporal dynamics of psychiatric symptomology, dietary intake, and PA in daily life.
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Affiliation(s)
- Alea Ruf
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Andreas B Neubauer
- DIPF | Leibniz Institute for Research and Information in Education, Frankfurt, Germany
- Center for Research on Individual Development and Adaptive Education of Children at Risk (IDeA), Frankfurt, Germany
| | - Elena D Koch
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Ulrich Ebner-Priemer
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Silke Matura
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
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Li K, Chen L, Wang K, Jiang X, Ji Y, Fang S, Wei H. Emotional problems mediate the association between attention deficit/hyperactivity disorder and obesity in adolescents. BMC Psychiatry 2023; 23:381. [PMID: 37259044 DOI: 10.1186/s12888-023-04882-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/17/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Attention deficit/hyperactivity disorder (ADHD) has been identified as a risk factor for obesity in both children and adolescents. However, the mechanisms underlying the relationship between ADHD and obesity are still unclear. This study aimed to test a theoretical model of whether anxiety/depression is an intermediary factor in the ADHD-obesity relationship. METHODS Data were derived from the National Health Interview Survey (NHIS), a principal source of information on the health of the civilian noninstitutionalized population of the United States. A total of 35,108 adolescents aged 12-17 years old from 2010-2015 NHIS and 2016-2018 NHIS representing 46,550,729 individuals in the weighted population, had a parent-reported previous ADHD diagnosis, emotional problems, and height and weight data. Mediation analyses were used to explore whether anxiety/depression is an intermediary factor in the relationship between ever having ADHD and obesity. Mediation analyses were performed using multiple logistic regressions. RESULTS The findings showed that ADHD was a predictor of obesity. This relationship was partially mediated by depression(2010-2015: β=0.28, 95%CI:0.13-0.43; 2016-2018: β=0.26, 95%CI:0.03-0.49), as well as anxiety (2010-2015: β=0.28, 95%CI:0.18-0.38). CONCLUSIONS Our study suggests the hypothetical role of depression and anxiety as underlying mechanisms in the association between ever having ADHD and obesity in adolescents. When treating children with ADHD, clinicians need to be particularly attentive to whether they show emotional problems and use interventions to eliminate anxiety/depression to protect against obesity.
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Affiliation(s)
- Ke Li
- Department of Child Health Care, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Liangliang Chen
- Department of Developmental and Behavioral Pediatrics, (Fujian Branch of Shanghai Children's Medical Center), Fujian Children's Hospital, Fuzhou, China
| | - Kai Wang
- Department of Pediatrics, 1st Affiliated Hospital to Zhengzhou University, Zhengzhou, China
| | - Xiaodong Jiang
- Rehabilitation Medicine Department, Wuhan Children's Hospital(Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Yiting Ji
- Department of Child and Adolescent Healthcare, Children's Hospital of Soochow University, Suzhou, China
| | - Shuanfeng Fang
- Department of Child Health Care, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China.
| | - Haiyan Wei
- Department of Endocrinology and Genetic Metabolism, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China.
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The dynamical association between physical activity and affect in the daily life of individuals with ADHD. Eur Neuropsychopharmacol 2022; 57:69-74. [PMID: 35151951 DOI: 10.1016/j.euroneuro.2022.01.110] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 11/20/2022]
Abstract
Exercise interventions in mental disorders have evidenced a mood-enhancing effect. However, the association between physical activity and affect in everyday life has not been investigated in adult individuals with ADHD, despite being important features of this disorder. As physical activity and affect are dynamic processes in nature, assessing those in everyday life with e-diaries and wearables, has become the gold standard. Thus, we used an mHealth approach to prospectively assess physical activity and affect processes in individuals with ADHD and controls aged 14-45 years. Participants wore accelerometers across a four-day period and reported their affect via e-diaries twelve times daily. We used multilevel models to identify the within-subject effects of physical activity on positive and negative affect. We split our sample into three groups: 1. individuals with ADHD who were predominantly inattentive (n = 48), 2. individuals with ADHD having a combined presentation (i.e., being inattentive and hyperactive; n = 95), and 3. controls (n = 42). Our analyses revealed a significant cross-level interaction (F(2, 135.072)=5.733, p = 0.004) of physical activity and group on positive affect. In details, all groups showed a positive association between physical activity and positive affect. Individuals with a combined presentation significantly showed the steepest slope of physical activity on positive affect (slope_inattentive=0.005, p<0.001; slope_combined=0.009, p<0.001; slope_controls=0.004, p = 0.008). Our analyses on negative affect revealed a negative association only in the individuals with a combined presentation (slope=-0.003; p = 0.001). Whether this specifically pronounced association in individuals being more hyperactive might be a mechanism reinforcing hyperactivity needs to be empirically clarified in future studies.
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Physical Activity and Depression in Adolescents: Evidence from China Family Panel Studies. Behav Sci (Basel) 2022; 12:bs12030071. [PMID: 35323390 PMCID: PMC8945286 DOI: 10.3390/bs12030071] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 02/21/2022] [Accepted: 03/03/2022] [Indexed: 02/06/2023] Open
Abstract
Depression in adolescents is a major public health disorder. The relationship between physical activity and risk of depression in adolescents was examined using three waves of data from the China Family Panel Studies in 2020. The risk of depression was significantly higher among adolescents who reported lower frequency and shorter duration of physical exercise than those who reported physical exercise more frequently and for a longer duration. The risk of depression was significantly higher among adolescents who reported intense physical exercise than those who reported little or no intense physical exercise. The amount of time spent on housework by adolescents is inversely associated with depression. These results provide somewhat stronger evidence for an activity−depression link than previous studies and suggest a differential role for different types of physical activity, such as exercise and housework. The overall model predicting depression in adolescents (LR chi-squared = 95.974, p < 0.001, Nagelkerke R-square = 0.183) was statistically significant. To effectively control depression in adolescents, the government, schools and parents need to act together to guide adolescents towards participation in appropriate physical activities. The appropriate level of physical activity is for adolescents to experience breathing, rapid heartbeat, and slight perspiration.
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Wang X, Cai ZD, Jiang WT, Fang YY, Sun WX, Wang X. Systematic review and meta-analysis of the effects of exercise on depression in adolescents. Child Adolesc Psychiatry Ment Health 2022; 16:16. [PMID: 35227300 PMCID: PMC8886903 DOI: 10.1186/s13034-022-00453-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 02/18/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Depression is widespread among adolescents and seriously endangers their quality of life and academic performance. Developing strategies for adolescent depression has important public health implications. No systematic review on the effectiveness of physical exercise for adolescents aged 12-18 years with depression or depressive symptoms has previously been conducted. This study aims to systematically evaluate the effect of physical exercise on adolescent depression in the hope of developing optimum physical exercise programs. METHODS Nine major databases at home and abroad were searched to retrieve randomized controlled trials (RCTs) on exercise interventions among adolescents with depression or depressive symptoms. The retrieval period started from the founding date of each database to May 1, 2021. The methodological quality of the included articles was evaluated using the modified PEDro scale. A meta-analysis, subgroup analysis, sensitivity analysis, and publication bias tests were then conducted. RESULTS Fifteen articles, involving 19 comparisons, with a sample size of 1331, were included. Physical exercise significantly reduced adolescent depression (standardized mean difference [SMD] = - 0.64, 95% CI - 0.89, - 0.39, p < 0.01), with a moderate effect size, in both adolescents with depression (SMD = -0.57, 95% CI - 0.90, - 0.23, p < 0.01) and adolescents with depressive symptoms (SMD = - 0.67, 95% CI - 1.00, - 0.33, p < 0.01). In subgroups of different depression categories (depression or depressive symptoms), aerobic exercise was the main form of exercise for the treatment of adolescents with depression. For adolescents with depression, interventions lasting 6 weeks, 30 min/time, and 4 times/week had optimum results. The effects of aerobic exercise and resistance + aerobic exercise in the subgroup of adolescents with depressive symptoms were significant, while the effect of physical and mental exercise (yoga) was not significant. For adolescents with depressive symptoms, aerobic exercise lasting 8 weeks, 75-120 min/time, and 3 times/week had optimum results. Physical exercise with moderate intensity is a better choice for adolescents with depression and depressive symptoms. CONCLUSIONS Physical exercise has a positive effect on the improvement of depression in adolescents. The protocol for this study was registered with INPLASY (202170013). DOI number is 10.37766/inplasy2021.7.0013. Registration Date:2021.7.06.
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Affiliation(s)
- Xiang Wang
- School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438 China
| | - Zhi-dong Cai
- School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438 China
| | - Wan-ting Jiang
- School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438 China
| | - Yan-yan Fang
- School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438 China
| | - Wen-xin Sun
- School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438 China
| | - Xing Wang
- School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438 China
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Pawley A, Mostert JC, Bilbow A, Reif A, Vasquez AA, Kuntsi J, Franke B. NBR Special Issue: Life-span comorbidity of ADHD and related phenotypes - from biology to epidemiology and back. Neurosci Biobehav Rev 2022; 135:104586. [PMID: 35182539 DOI: 10.1016/j.neubiorev.2022.104586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/14/2022] [Accepted: 02/14/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Adam Pawley
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK
| | - Jeanette C Mostert
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Departments of Psychiatry and Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Andrea Bilbow
- ADDISS ADHD Information Services, PO Box 340, Edgware, Middlesex HA8 9HL, United Kingdom
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Heinrich-Hoffmann-Str. 10, D-60528 Frankfurt am Main, Germany
| | - Alejandro Arias Vasquez
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Departments of Psychiatry and Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jonna Kuntsi
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK
| | - Barbara Franke
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Departments of Psychiatry and Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
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Mayer JS, Brandt GA, Medda J, Basten U, Grimm O, Reif A, Freitag CM. Depressive symptoms in youth with ADHD: the role of impairments in cognitive emotion regulation. Eur Arch Psychiatry Clin Neurosci 2022; 272:793-806. [PMID: 35107603 PMCID: PMC9279209 DOI: 10.1007/s00406-022-01382-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 01/14/2022] [Indexed: 12/21/2022]
Abstract
Youth with attention-deficit/hyperactivity disorder (ADHD) are at increased risk to develop co-morbid depression. Identifying factors that contribute to depression risk may allow early intervention and prevention. Poor emotion regulation, which is common in adolescents, is a candidate risk factor. Impaired cognitive emotion regulation is a fundamental characteristic of depression and depression risk in the general population. However, little is known about cognitive emotion regulation in youth with ADHD and its link to depression and depression risk. Using explicit and implicit measures, this study assessed cognitive emotion regulation in youth with ADHD (N = 40) compared to demographically matched healthy controls (N = 40) and determined the association with depressive symptomatology. As explicit measure, we assessed the use of cognitive emotion regulation strategies via self-report. As implicit measure, performance in an ambiguous cue-conditioning task was assessed as indicator of affective bias in the processing of information. Compared to controls, patients reported more frequent use of maladaptive (i.e., self-blame, catastrophizing, and rumination) and less frequent use of adaptive (i.e., positive reappraisal) emotion regulation strategies. This pattern was associated with the severity of current depressive symptoms in patients. In the implicit measure of cognitive bias, there was no significant difference in response of patients and controls and no association with depression. Our findings point to depression-related alterations in the use of cognitive emotion regulation strategies in youth with ADHD. The study suggests those alterations as a candidate risk factor for ADHD-depression comorbidity that may be used for risk assessment and prevention strategies.
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Affiliation(s)
- Jutta S Mayer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, 60528, Frankfurt am Main, Germany.
| | - Geva A Brandt
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J 5, 68159, Mannheim, Germany
| | - Juliane Medda
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, 60528, Frankfurt am Main, Germany
| | - Ulrike Basten
- Department of Psychology, University of Koblenz-Landau, Fortstraße 7, 76829, Landau in der Pfalz, Germany
| | - Oliver Grimm
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt am Main, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt am Main, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, 60528, Frankfurt am Main, Germany
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Ruf A, Koch ED, Ebner-Priemer U, Knopf M, Reif A, Matura S. Studying Microtemporal, Within-Person Processes of Diet, Physical Activity, and Related Factors Using the APPetite-Mobile-App: Feasibility, Usability, and Validation Study. J Med Internet Res 2021; 23:e25850. [PMID: 34342268 PMCID: PMC8406112 DOI: 10.2196/25850] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 01/12/2021] [Accepted: 05/04/2021] [Indexed: 12/16/2022] Open
Abstract
Background Diet and physical activity (PA) have a major impact on physical and mental health. However, there is a lack of effective strategies for sustaining these health-protective behaviors. A shift to a microtemporal, within-person approach is needed to capture dynamic processes underlying eating behavior and PA, as they change rapidly across minutes or hours and differ among individuals. However, a tool that captures these microtemporal, within-person processes in daily life is currently not present. Objective The APPetite-mobile-app is developed for the ecological momentary assessment of microtemporal, within-person processes of complex dietary intake, objectively recorded PA, and related factors. This study aims to evaluate the feasibility and usability of the APPetite-mobile-app and the validity of the incorporated APPetite-food record. Methods The APPetite-mobile-app captures dietary intake event-contingently through a food record, captures PA continuously through accelerometers, and captures related factors (eg, stress) signal-contingently through 8 prompts per day. Empirical data on feasibility (n=157), usability (n=84), and validity (n=44) were collected within the Eat2beNICE-APPetite-study. Feasibility and usability were examined in healthy participants and psychiatric patients. The relative validity of the APPetite-food record was assessed with a subgroup of healthy participants by using a counterbalanced crossover design. The reference method was a 24-hour recall. In addition, the energy intake was compared with the total energy expenditure estimated from accelerometry. Results Good feasibility, with compliance rates above 80% for prompts and the accelerometer, as well as reasonable average response and recording durations (prompt: 2.04 min; food record per day: 17.66 min) and latencies (prompts: 3.16 min; food record: 58.35 min) were found. Usability was rated as moderate, with a score of 61.9 of 100 on the System Usability Scale. The evaluation of validity identified large differences in energy and macronutrient intake between the two methods at the group and individual levels. The APPetite-food record captured higher dietary intakes, indicating a lower level of underreporting, compared with the 24-hour recall. Energy intake was assessed fairly accurately by the APPetite-food record at the group level on 2 of 3 days when compared with total energy expenditure. The comparison with mean total energy expenditure (2417.8 kcal, SD 410) showed that the 24-hour recall (1909.2 kcal, SD 478.8) underestimated habitual energy intake to a larger degree than the APPetite-food record (2146.4 kcal, SD 574.5). Conclusions The APPetite-mobile-app is a promising tool for capturing microtemporal, within-person processes of diet, PA, and related factors in real time or near real time and is, to the best of our knowledge, the first of its kind. First evidence supports the good feasibility and moderate usability of the APPetite-mobile-app and the validity of the APPetite-food record. Future findings in this context will build the foundation for the development of personalized lifestyle modification interventions, such as just-in-time adaptive interventions.
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Affiliation(s)
- Alea Ruf
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Elena Doris Koch
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Ulrich Ebner-Priemer
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany.,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Monika Knopf
- Department of Developmental Psychology, Goethe University, Frankfurt, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Silke Matura
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
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11
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Reichert M, Gan G, Renz M, Braun U, Brüßler S, Timm I, Ma R, Berhe O, Benedyk A, Moldavski A, Schweiger JI, Hennig O, Zidda F, Heim C, Banaschewski T, Tost H, Ebner-Priemer UW, Meyer-Lindenberg A. Ambulatory assessment for precision psychiatry: Foundations, current developments and future avenues. Exp Neurol 2021; 345:113807. [PMID: 34228998 DOI: 10.1016/j.expneurol.2021.113807] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 06/18/2021] [Accepted: 07/02/2021] [Indexed: 11/30/2022]
Abstract
Precision psychiatry stands to benefit from the latest digital technologies for assessment and analyses to tailor treatment towards individuals. Insights into dynamic psychological processes as they unfold in humans' everyday life can critically add value in understanding symptomatology and environmental stressors to provide individualized treatment where and when needed. Towards this goal, ambulatory assessment encompasses methodological approaches to investigate behavioral, physiological, and biological processes in humans' everyday life. It combines repeated assessments of symptomatology over time, e.g., via Ecological Momentary Assessment (e.g., smartphone-diaries), with monitoring of physical behavior, environmental characteristics (such as geolocations, social interactions) and physiological function via sensors, e.g., mobile accelerometers, global-positioning-systems, and electrocardiography. In this review, we expand on promises of ambulatory assessment in the investigation of mental states (e.g., real-life, dynamical and contextual perspective), on chances for precision psychiatry such as the prediction of courses of psychiatric disorders, detection of tipping points and critical windows of relapse, and treatment effects as exemplified by ongoing projects, and on future avenues of how ambulatory interventions can benefit personalized care for psychiatric patients (e.g., through real-time feedback in everyday life). Ambulatory assessment is a key contributor to precision psychiatry, opening up promising avenues in research, diagnoses, prevention and treatment.
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Affiliation(s)
- Markus Reichert
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany; mental mHealth Lab, Department of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), 76131 Karlsruhe, Baden-Wuerttemberg, Germany; Department of eHealth and Sports Analytics, Faculty of Sports Science, Ruhr-University Bochum (RUB), 44801 Bochum, North Rhine-Westphalia, Germany.
| | - Gabriela Gan
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Malika Renz
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Urs Braun
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Sarah Brüßler
- mental mHealth Lab, Department of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), 76131 Karlsruhe, Baden-Wuerttemberg, Germany
| | - Irina Timm
- mental mHealth Lab, Department of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), 76131 Karlsruhe, Baden-Wuerttemberg, Germany
| | - Ren Ma
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Oksana Berhe
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Anastasia Benedyk
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Alexander Moldavski
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Janina I Schweiger
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Oliver Hennig
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Francesca Zidda
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Christine Heim
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Institute of Medical Psychology, Berlin, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Heike Tost
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Ulrich W Ebner-Priemer
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany; mental mHealth Lab, Department of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), 76131 Karlsruhe, Baden-Wuerttemberg, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany.
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Using e-diaries to investigate ADHD - State-of-the-art and the promising feature of just-in-time-adaptive interventions. Neurosci Biobehav Rev 2021; 127:884-898. [PMID: 34090919 DOI: 10.1016/j.neubiorev.2021.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 04/19/2021] [Accepted: 06/01/2021] [Indexed: 11/23/2022]
Abstract
Attention-deficit/hyperactive disorder (ADHD) is characterized by symptoms which are dynamic in nature: states of hyperactivity, inattention and impulsivity as core symptoms, and emotion dysregulation as associated feature. Although tremendous work has been done to investigate between-subject differences (how patients with ADHD differ from healthy controls or patients with other disorders), little is known about the relationship between symptoms with triggers and contexts, that may allow us to better understand their causes and consequences. Understanding the temporal associations between symptoms and environmental triggers in an ecologically valid manner may be the basis to developing just-in-time adaptive interventions. Fortunately, recent years have seen advances in methodology, hardware and innovative statistical approaches to study dynamic processes in daily life. In this narrative review, we provide a description of the methodology (ambulatory assessment), summarize the existing literature in ADHD, and discuss future prospects for these methods, namely mobile sensing to assess contextual information, real-time analyses and just-in-time adaptive interventions.
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13
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Biere S, Kranz TM, Matura S, Petrova K, Streit F, Chiocchetti AG, Grimm O, Brum M, Brunkhorst-Kanaan N, Oertel V, Malyshau A, Pfennig A, Bauer M, Schulze TG, Kittel-Schneider S, Reif A. Risk Stratification for Bipolar Disorder Using Polygenic Risk Scores Among Young High-Risk Adults. Front Psychiatry 2020; 11:552532. [PMID: 33192665 PMCID: PMC7653940 DOI: 10.3389/fpsyt.2020.552532] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 09/10/2020] [Indexed: 11/30/2022] Open
Abstract
Objective: Identifying high-risk groups with an increased genetic liability for bipolar disorder (BD) will provide insights into the etiology of BD and contribute to early detection of BD. We used the BD polygenic risk score (PRS) derived from BD genome-wide association studies (GWAS) to explore how such genetic risk manifests in young, high-risk adults. We postulated that BD-PRS would be associated with risk factors for BD. Methods: A final sample of 185 young, high-risk German adults (aged 18-35 years) were grouped into three risk groups and compared to a healthy control group (n = 1,100). The risk groups comprised 117 cases with attention deficit hyperactivity disorder (ADHD), 45 with major depressive disorder (MDD), and 23 help-seeking adults with early recognition symptoms [ER: positive family history for BD, (sub)threshold affective symptomatology and/or mood swings, sleeping disorder]. BD-PRS was computed for each participant. Logistic regression models (controlling for sex, age, and the first five ancestry principal components) were used to assess associations of BD-PRS and the high-risk phenotypes. Results: We observed an association between BD-PRS and combined risk group status (OR = 1.48, p < 0.001), ADHD diagnosis (OR = 1.32, p = 0.009), MDD diagnosis (OR = 1.96, p < 0.001), and ER group status (OR = 1.7, p = 0.025; not significant after correction for multiple testing) compared to healthy controls. Conclusions: In the present study, increased genetic risk for BD was a significant predictor for MDD and ADHD status, but not for ER. These findings support an underlying shared risk for both MDD and BD as well as ADHD and BD. Improving our understanding of the underlying genetic architecture of these phenotypes may aid in early identification and risk stratification.
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Affiliation(s)
- Silvia Biere
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Thorsten M. Kranz
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Silke Matura
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Kristiyana Petrova
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim/University of Heidelberg, Mannheim, Germany
| | - Andreas G. Chiocchetti
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Center of Excellence Frankfurt, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Oliver Grimm
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Murielle Brum
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Natalie Brunkhorst-Kanaan
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Viola Oertel
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Aliaksandr Malyshau
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Dresden University of Technology, Dresden, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Dresden University of Technology, Dresden, Germany
| | - Thomas G. Schulze
- Institute of Psychiatric Phenomics and Genomics, University Hospital Munich, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital of Würzburg, University of Würzburg, Würzburg, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
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Silva LAD, Doyenart R, Henrique Salvan P, Rodrigues W, Felipe Lopes J, Gomes K, Thirupathi A, Pinho RAD, Silveira PC. Swimming training improves mental health parameters, cognition and motor coordination in children with Attention Deficit Hyperactivity Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2020; 30:584-592. [PMID: 31081373 DOI: 10.1080/09603123.2019.1612041] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 04/22/2019] [Indexed: 06/09/2023]
Abstract
The aim of this study was to verify the effects of swimming-learning program of mental health parameters, cognition and motor coordination in students with Attention Deficit Hyperactivity Disorder (ADHD). Thirty-three children of both sexes between 11 and 14 years were randomized into trained group (n = 18) and untrained group (n = 15). The training was performed for 8 weeks. Then, before and after 48 h of training period of both groups were submitted to find the mental health, cognition, motor coordination test, and physical fitness. Our results demonstrate that the aquatic exercise program significantly improved the depression parameters (p = 0.048), stress (p = 0.039), cognitive flexibility (p = 0.042) and selective attention (p = 0.047). In relation to motor coordination and physical fitness, the results showed significant improvements in the coordination of lower limbs laterality (p = 0.05), flexibility (p = 0.049), and abdominal resistance (p = 0.037). Taken together, the results suggest that swimming-learning program significantly improved the mental health, cognition, and motor coordination in children with ADHD.
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Affiliation(s)
- Luciano Acordi Da Silva
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, Universidade do Extremo Sul Catarinense , Criciúma, Brazil
| | - Ramiro Doyenart
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, Universidade do Extremo Sul Catarinense , Criciúma, Brazil
| | - Paulo Henrique Salvan
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, Universidade do Extremo Sul Catarinense , Criciúma, Brazil
| | - Welber Rodrigues
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, Universidade do Extremo Sul Catarinense , Criciúma, Brazil
| | - João Felipe Lopes
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, Universidade do Extremo Sul Catarinense , Criciúma, Brazil
| | - Karen Gomes
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, Universidade do Extremo Sul Catarinense , Criciúma, Brazil
| | - Anand Thirupathi
- Laboratory of Molecular Iron Metabolism, College of Life Science, Hebei Normal University , Shijiazhuang, Hebei, China
| | - Ricardo Aurino De Pinho
- Laboratory of Exercise Biochemistry in Health, Graduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná , Curitiba, Brazil
| | - Paulo Cesar Silveira
- Laboratory of Experimental Physiopathology, Graduate Program in Health Sciences, Universidade do Extremo Sul Catarinense , Criciúma, Brazil
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15
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Reichert M, Giurgiu M, Koch E, Wieland LM, Lautenbach S, Neubauer AB, von Haaren-Mack B, Schilling R, Timm I, Notthoff N, Marzi I, Hill H, Brüβler S, Eckert T, Fiedler J, Burchartz A, Anedda B, Wunsch K, Gerber M, Jekauc D, Woll A, Dunton GF, Kanning M, Nigg CR, Ebner-Priemer U, Liao Y. Ambulatory Assessment for Physical Activity Research: State of the Science, Best Practices and Future Directions. PSYCHOLOGY OF SPORT AND EXERCISE 2020; 50:101742. [PMID: 32831643 PMCID: PMC7430559 DOI: 10.1016/j.psychsport.2020.101742] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Technological and digital progress benefits physical activity (PA) research. Here we compiled expert knowledge on how Ambulatory Assessment (AA) is utilized to advance PA research, i.e., we present results of the 2nd International CAPA Workshop 2019 "Physical Activity Assessment - State of the Science, Best Practices, Future Directions" where invited researchers with experience in PA assessment, evaluation, technology and application participated. First, we provide readers with the state of the AA science, then we give best practice recommendations on how to measure PA via AA and shed light on methodological frontiers, and we furthermore discuss future directions. AA encompasses a class of methods that allows the study of PA and its behavioral, biological and physiological correlates as they unfold in everyday life. AA includes monitoring of movement (e.g., via accelerometry), physiological function (e.g., via mobile electrocardiogram), contextual information (e.g., via geolocation-tracking), and ecological momentary assessment (EMA; e.g., electronic diaries) to capture self-reported information. The strengths of AA are data assessment that near realtime, which minimizes retrospective biases in real-world settings, consequentially enabling ecological valid findings. Importantly, AA enables multiple assessments across time within subjects resulting in intensive longitudinal data (ILD), which allows unraveling within-person determinants of PA in everyday life. In this paper, we show how AA methods such as triggered e-diaries and geolocation-tracking can be used to measure PA and its correlates, and furthermore how these findings may translate into real-life interventions. In sum, AA provides numerous possibilities for PA research, especially the opportunity to tackle within- subject antecedents, concomitants, and consequences of PA as they unfold in everyday life. In-depth insights on determinants of PA could help us design and deliver impactful interventions in real-world contexts, thus enabling us to solve critical health issues in the 21st century such as insufficient PA and high levels of sedentary behavior.
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Affiliation(s)
- Markus Reichert
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT); postal address: Engler-Bunte-Ring 15, 76131 Karlsruhe, Baden-Wuerttemberg, Germany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg University; postal address: Central Institute of Mental Health (CIMH), Square J5, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Marco Giurgiu
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT); postal address: Engler-Bunte-Ring 15, 76131 Karlsruhe, Baden-Wuerttemberg, Germany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg University; postal address: Central Institute of Mental Health (CIMH), Square J5, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Elena Koch
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT); postal address: Engler-Bunte-Ring 15, 76131 Karlsruhe, Baden-Wuerttemberg, Germany
| | - Lena M. Wieland
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT); postal address: Engler-Bunte-Ring 15, 76131 Karlsruhe, Baden-Wuerttemberg, Germany
| | - Sven Lautenbach
- Heidelberg Institute for Geoinformation Technology (HeiGIT) at Heidelberg University; postal address: Heidelberg Institute for Geoinformation Technology, Schloss-Wolfsbrunnenweg 33, 69118 Heidelberg, Baden-Wuerttemberg, Germany
| | - Andreas B. Neubauer
- Department of Education and Human Development, DIPF | Leibniz Institute for Research and Information in Education; postal address: Rostocker Straße 6, 60323 Frankfurt am Main, Hessen, Germany
- Center for Research on Individual Development and Adaptive Education of Children at Risk (IDeA); postal address: Rostocker Straße 6, 60323 Frankfurt am Main, Hessen, Germany
| | - Birte von Haaren-Mack
- Department of Health and Social Psychology, Institute of Psychology, German Sport University Cologne; postal address: Am Sportpark Muengersdorf 6, 50933 Cologne, North Rhine-Westphalia, Germany
| | - Renè Schilling
- Department of Sport, Exercise and Health, University of Basel, Postal address: Birsstrasse 320 B, 4052 Basel, Switzerland
| | - Irina Timm
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT); postal address: Engler-Bunte-Ring 15, 76131 Karlsruhe, Baden-Wuerttemberg, Germany
| | - Nanna Notthoff
- Institute of Sport and Exercise Psychology, Department of Sports Science, Leipzig University; postal address: Jahnallee 59, 04109 Leipzig, Saxony, Germany
| | - Isabel Marzi
- Department of Sports Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg (FAU); postal address: Gebbertstrasse 123b, 91058 Erlangen, Bavaria, Germany
| | - Holger Hill
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT); postal address: Engler-Bunte-Ring 15, 76131 Karlsruhe, Baden-Wuerttemberg, Germany
| | - Sarah Brüβler
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT); postal address: Engler-Bunte-Ring 15, 76131 Karlsruhe, Baden-Wuerttemberg, Germany
| | - Tobias Eckert
- Departments of Preventive Medicine and Psychology, University of Southern California; postal address: 2001 N. Soto St., Los Angeles, CA, 90032, USA
| | - Janis Fiedler
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT); postal address: Engler-Bunte-Ring 15, 76131 Karlsruhe, Baden-Wuerttemberg, Germany
| | - Alexander Burchartz
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT); postal address: Engler-Bunte-Ring 15, 76131 Karlsruhe, Baden-Wuerttemberg, Germany
| | - Bastian Anedda
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT); postal address: Engler-Bunte-Ring 15, 76131 Karlsruhe, Baden-Wuerttemberg, Germany
| | - Kathrin Wunsch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT); postal address: Engler-Bunte-Ring 15, 76131 Karlsruhe, Baden-Wuerttemberg, Germany
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Postal address: Birsstrasse 320 B, 4052 Basel, Switzerland
| | - Darko Jekauc
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT); postal address: Engler-Bunte-Ring 15, 76131 Karlsruhe, Baden-Wuerttemberg, Germany
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT); postal address: Engler-Bunte-Ring 15, 76131 Karlsruhe, Baden-Wuerttemberg, Germany
| | - Genevieve F. Dunton
- Departments of Preventive Medicine and Psychology, University of Southern California; postal address: 2001 N. Soto St., Los Angeles, CA, 90032, USA
| | - Martina Kanning
- Department of Sport Science, Social and Health Sciences, University of Konstanz; postal address: Universitätsstraße 10, 78464 Konstanz, Baden-Wuerttemberg, Germany
| | - Claudio R. Nigg
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT); postal address: Engler-Bunte-Ring 15, 76131 Karlsruhe, Baden-Wuerttemberg, Germany
| | - Ulrich Ebner-Priemer
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT); postal address: Engler-Bunte-Ring 15, 76131 Karlsruhe, Baden-Wuerttemberg, Germany
| | - Yue Liao
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, postal address: 1515 Holcombe Blvd., Houston, Texas 77030, USA
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Obesity and Circadian Cycle of Sleep and Wakefulness: Common Points and Prospects of Therapy. ACTA BIOMEDICA SCIENTIFICA 2020. [DOI: 10.29413/abs.2020-5.1.3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The prevalence of obesity in recent years has assumed the character of a non-communicable epidemic. Wherein, the standard approaches for its treatment are not always successful. Meanwhile, obesity remains one of the main causes of the formation of a number of some serious diseases, such as cardiovascular, diabetes, cancer, etc. and death from them. In search of alternative and more adequate methods of obesity treatment and preventing its complications, recent studies are aimed at further identifying new associations and revealing the pathophysiological mechanisms underlying excessive weight gain. It should be noted an increasing amount of chronobiological studies that raised awareness of the key role of the body’s circadian rhythms and its main regulator, melatonin, responsible for the temporary organization of the main physiological (including metabolism) processes throughout the 24-h day, in the development and progression of obesity. This review is devoted to the consideration of mutually directed interactions between the circadian system and metabolism; attempts have been made to explain the role of sleep-wake cycle disruptions in the excess accumulation of adipose tissue and the formation of obesity and its comorbidities, as well as detailed therapeutic principles based on normalizing disruption of body clocks using time-coordinated approaches to food intake, physical activity, the effects of non-drug methods and pharmacological substances (chronobiotics), which represents a novel and promising ways to prevent or treat obesity and associated diseases.
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Korman M, Palm D, Uzoni A, Faltraco F, Tucha O, Thome J, Coogan AN. ADHD 24/7: Circadian clock genes, chronotherapy and sleep/wake cycle insufficiencies in ADHD. World J Biol Psychiatry 2020; 21:156-171. [PMID: 30234417 DOI: 10.1080/15622975.2018.1523565] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objectives: The current paper addresses the evidence for circadian clock characteristics associated with attention-deficit hyperactivity disorder (ADHD), and possible therapeutic approaches based on chronomodulation through bright light (BL) therapy.Methods: We review the data reported in ADHD on genetic risk factors for phase-delayed circadian rhythms and on the role of photic input in circadian re-alignment.Results: Single nucleotide polymorphisms in circadian genes were recently associated with core ADHD symptoms, increased evening-orientation and frequent sleep problems. Additionally, alterations in exposure and response to photic input may underlie circadian problems in ADHD. BL therapy was shown to be effective for re-alignment of circadian physiology toward morningness, reducing sleep disturbances and bringing overall improvement in ADHD symptoms. The susceptibility of the circadian system to phase shift by timed BL exposure may have broad cost-effective potential implications for the treatment of ADHD.Conclusions: We conclude that further research of circadian function in ADHD should focus on detection of genetic markers (e.g., using human skin fibroblasts) and development of BL-based therapeutic interventions.
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Affiliation(s)
- Maria Korman
- The Edmond J. Safra Brain Research Center for the Study of Learning Disabilities, University of Haifa, Haifa, Israel
| | - Denise Palm
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Adriana Uzoni
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Frank Faltraco
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Johannes Thome
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Andrew N Coogan
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth, Ireland
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18
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Ebner-Priemer UW, Reichert M, Tost H, Meyer-Lindenberg A. [Wearables for context-triggered assessment in psychiatry]. DER NERVENARZT 2019; 90:1207-1214. [PMID: 31641793 DOI: 10.1007/s00115-019-00815-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The breathtaking technological progress in the field of mobile computing, smartphones and wearables offers new opportunities for psychiatric research and therapy. Wearables enable not only the objective assessment of psychiatric symptoms in real time and everyday life but using continuous monitoring and analysis of relevant parameters can also define important situations, contexts and timing during which extended assessment strategies and real-life interventions can be implemented. The momentary effect of inner city green space exposure on well-being, motivational behavior feedback and geofencing for the detection of drinking episodes are used as examples to illustrate the core benefits of real-time analyses and feedback from wearables for psychiatric research and therapy.
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Affiliation(s)
- U W Ebner-Priemer
- Mental mHealth Lab, Lehrstuhl für Angewandte Psychologie, Institut für Sport und Sportwissenschaft, Karlsruher Institut für Technologie, Engler-Bunte-Ring 15, Geb. 40.40, 76131, Karlsruhe, Deutschland.
| | - M Reichert
- Mental mHealth Lab, Lehrstuhl für Angewandte Psychologie, Institut für Sport und Sportwissenschaft, Karlsruher Institut für Technologie, Engler-Bunte-Ring 15, Geb. 40.40, 76131, Karlsruhe, Deutschland.,Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, J5, Mannheim, 76131, Deutschland
| | - H Tost
- Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, J5, Mannheim, 76131, Deutschland
| | - A Meyer-Lindenberg
- Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, J5, Mannheim, 76131, Deutschland
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19
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Geoffroy PA, Micoulaud Franchi JA, Lopez R, Schroder CM. The use of melatonin in adult psychiatric disorders: Expert recommendations by the French institute of medical research on sleep (SFRMS). L'ENCEPHALE 2019; 45:413-423. [PMID: 31248601 DOI: 10.1016/j.encep.2019.04.068] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 04/08/2019] [Indexed: 12/11/2022]
Abstract
Melatonin is a hormone secreted by the pineal gland at night. This hormone has many physiological functions, the main one being to synchronise individuals' biological rhythms. Exogenous melatonin has the same chronobiotic action, even at small doses (0.125mg). In addition, a sleep-inducing (soporific) action appears to occur in a dose-effect relationship, i.e. as the dose increases. In psychiatric disorders, these two effects could have interesting applications in clinical practice. The French institute of medical research on sleep (SFRMS) appointed a group of experts to conduct a consensus conference to study the indications of melatonin and the conditions of its prescription. An account of the conclusions on adult psychiatric disorders (presented orally at the Congress on Sleep in Marseille, 23 November 2017) is given here. Exogenous melatonin proves to be useful among patients with a stabilized psychiatric disorder or in remission, to prevent relapse in case of associated complaints of insomnia, poor quality sleep or delayed sleep phase syndrome. During acute phases, melatonin could be used as an adjuvant treatment when there are insomnia symptoms, in mood disorders (bipolar disorder, major depressive disorder, seasonal affective disorder), in attention deficit hyperactivity disorder (ADHD), in peri-surgical anxiety and in schizophrenia. In somatoform disorders, melatonin is a possible treatment for painful symptoms in fibromyalgia, irritable bowel syndrome, functional dyspeptic syndrome and temporomandibular joint dysfunction.
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Affiliation(s)
- P A Geoffroy
- Sleep Disorders Center & CIRCSom (International Research Center for ChronoSomnology), University Hospital, 1, place de l'hôpital, 67000 Strasbourg, France; CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 5, rue Blaise-Pascal, 67000 Strasbourg, France; Paris Diderot University - Paris VII, 5, rue Thomas-Mann, 75013 Paris, France.
| | - J-A Micoulaud Franchi
- Services d'explorations fonctionnelles du système nerveux, clinique du sommeil, CHU de Bordeaux, 33076 Bordeaux, France; USR CNRS 3413 SANPSY, université de Bordeaux, CHU de Pellegrin, 33076 Bordeaux, France
| | - R Lopez
- Unité des troubles du sommeil, département de neurologie, centre national de référence narcolepsie, hypersomnies rares, hôpital Gui de Chauliac, 34000 Montpellier, France; Inserm U1061, 34000 Montpellier, France
| | - C M Schroder
- Sleep Disorders Center & CIRCSom (International Research Center for ChronoSomnology), University Hospital, 1, place de l'hôpital, 67000 Strasbourg, France; CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 5, rue Blaise-Pascal, 67000 Strasbourg, France; Department of Child and Adolescent Psychiatry, Strasbourg University Hospital, 1, place de l'hôpital, 67091 Strasbourg cedex, France
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The Association between ADHD and Obesity: Intriguing, Progressively More Investigated, but Still Puzzling. Brain Sci 2019; 9:brainsci9100256. [PMID: 31569608 PMCID: PMC6826981 DOI: 10.3390/brainsci9100256] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 09/21/2019] [Accepted: 09/26/2019] [Indexed: 12/14/2022] Open
Abstract
This narrative review is aimed at presenting the most recent evidence on the association between attention-deficit/hyperactivity disorder (ADHD) and obesity. The review is informed by previous relevant systematic reviews and a search in Pubmed and PsycINFO up to 1 August 2019. Although the association between ADHD and obesity would seem, at first, paradoxical, in the past two decades there has been an increasing number of studies on this topic. The present review shows that there is meta-analytic evidence supporting a significant association between these two conditions, at least in adults. Growing evidence is also being published on the genetic and environmental factors underlying the association. However, the cause–effects paths, as well as the exact mechanisms explaining the association, remain unclear. Additionally, empirical evidence guiding the management/treatment of patients with the two conditions is still limited. Therefore, after almost 20 years from the first report of a link between ADHD and obesity, this association continues to be puzzling.
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