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Roberts E, Watts M, Riley S, Hart K. Scoping survey of dietetic resourcing for eating disorders: why is the dietitian's role marginalised in community eating disorders? Gen Psychiatr 2024; 37:e101604. [PMID: 39687216 PMCID: PMC11647276 DOI: 10.1136/gpsych-2024-101604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 11/11/2024] [Indexed: 12/18/2024] Open
Affiliation(s)
- Elizabeth Roberts
- Child and Adolescent Mental Health Service - Community Eating Disorders Service, Somerset NHS Foundation Trust, Taunton, UK
| | - Mala Watts
- Community Eating Disorders Service/ARFID, Hywel Dda University Health Board, Carmarthen, Wales, UK
| | - Safiya Riley
- Department of Nutrition, Food & Exercise, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Kathryn Hart
- Department of Nutrition, Food & Exercise, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
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Hotzy F, Seifritz E, Vetter S, Mötteli S. Persisting unhealthy eating behaviors and the role of dieting in outpatients treated for severe mental illness: Findings from a longitudinal study. Int J Soc Psychiatry 2024:207640241303033. [PMID: 39644203 DOI: 10.1177/00207640241303033] [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] [Indexed: 12/09/2024]
Abstract
BACKGROUND Individuals living with severe mental illness (SMI) are at higher risk of being overweight and obese. In addition to medication side effects, poor dietary habits are considered as modifiable factors. However, individuals with SMI face a variety of barriers to healthy eating, and it is still unclear which dietary strategies are best. AIMS The current study aimed to examine the course of dietary habits in dieting and non-dieting patients treated at a psychiatric day clinic. METHOD In this longitudinal observational study, symptom severity, dietary habits, and other health-risk behaviors of n = 53 psychiatric outpatients with a primary ICD-10 diagnosis (85% F3 and 15% F2) were assessed at the start of treatment in a psychiatric day clinic and after 3 months using semi-structured interview data and anthropometric measurements. RESULTS Patients' mental health improved after 3 months of treatment (e.g. lower scores on a modified Global Assessment of Functioning Scale (m-GAF) and on the 9-item Patient Health Questionnaire (PHQ-D)). However, BMI and lifestyle behaviors (e.g. diet quality, physical activity, and smoking) remained unchanged. Fewer depressive symptoms and dieting were even associated with weight gain over the 3 months (+1.7 kg). Compared with non-dieters, dieters had higher levels of neuroticism and ambivalence about eating, were more likely to overeat and were more dissatisfied with their body weight. CONCLUSIONS The group of dieters may benefit from professional support to achieve a healthier lifestyle.
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Affiliation(s)
- Florian Hotzy
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Switzerland
| | - Stefan Vetter
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Switzerland
| | - Sonja Mötteli
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Switzerland
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
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Mörkl S, Varnagy A, Wagner-Skacel J, Lahousen T, Brodtrager D, Sallmutter K, Bengesser SA, Painold A, Narrath M, Pieter L, Butler MI, Mueller-Stierlin A, Reininghaus EZ, Lackner S, Holasek S. Culinary Medicine Cooking Workshops as Add-On Therapy for Inpatients with Depression and Eating Disorders. Nutrients 2024; 16:3973. [PMID: 39599759 PMCID: PMC11597544 DOI: 10.3390/nu16223973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2024] [Revised: 11/14/2024] [Accepted: 11/14/2024] [Indexed: 11/29/2024] Open
Abstract
BACKGROUND Culinary medicine integrates healthy eating with positive food experiences, offering a holistic approach to treating mental health disorders, such as depression and eating disorders, where disruptions in eating habits and mood are common. While traditional psychiatric treatments focus on medication and psychotherapy, culinary workshops provide a novel intervention for inpatient care. This study evaluated the effectiveness of culinary medicine cooking workshops as a supplementary treatment for psychiatric inpatients with depression and eating disorders. METHODS We assessed the feasibility of five cooking workshops led by a professional chef and nutritional therapist in 39 psychiatric inpatients (depression, n = 29; eating disorders, n = 10). Participants completed questionnaires on dietary habits, mood, and workshop feedback before and after the intervention. RESULTS The workshops were highly accepted, with 90% of participants reporting they would recommend them for recovery. Significant improvements were observed in mood (p < 0.001), sadness (p < 0.001), hopelessness (p = 0.002), and tiredness (p = 0.003) across the overall group. Patients with depression showed improvements in nearly all mood subscales, while those with eating disorders improved in sadness (p = 0.029). CONCLUSIONS Culinary medicine workshops are a promising tool for enhancing mood and reducing hopelessness and tiredness in inpatients with depression. They also promote sustainable lifestyle changes that may benefit long-term physical and mental health. Future studies should explore the long-term impact of these interventions on psychiatric disorders.
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Affiliation(s)
- Sabrina Mörkl
- Division of Medical Psychology, Psychosomatics and Psychotherapy, Medical University of Graz, 8036 Graz, Austria; (S.M.); (A.V.); (J.W.-S.)
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria; (T.L.); (D.B.); (K.S.); (S.A.B.); (A.P.); (M.N.); (L.P.); (E.Z.R.)
| | - Attila Varnagy
- Division of Medical Psychology, Psychosomatics and Psychotherapy, Medical University of Graz, 8036 Graz, Austria; (S.M.); (A.V.); (J.W.-S.)
- Department of Agriculture, Ecotrophology and Landscape Development, Hochschule Anhalt, University of Applied Sciences, 06406 Bernburg, Germany
| | - Jolana Wagner-Skacel
- Division of Medical Psychology, Psychosomatics and Psychotherapy, Medical University of Graz, 8036 Graz, Austria; (S.M.); (A.V.); (J.W.-S.)
| | - Theresa Lahousen
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria; (T.L.); (D.B.); (K.S.); (S.A.B.); (A.P.); (M.N.); (L.P.); (E.Z.R.)
| | - Daniel Brodtrager
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria; (T.L.); (D.B.); (K.S.); (S.A.B.); (A.P.); (M.N.); (L.P.); (E.Z.R.)
| | - Karl Sallmutter
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria; (T.L.); (D.B.); (K.S.); (S.A.B.); (A.P.); (M.N.); (L.P.); (E.Z.R.)
| | - Susanne A. Bengesser
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria; (T.L.); (D.B.); (K.S.); (S.A.B.); (A.P.); (M.N.); (L.P.); (E.Z.R.)
| | - Annamaria Painold
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria; (T.L.); (D.B.); (K.S.); (S.A.B.); (A.P.); (M.N.); (L.P.); (E.Z.R.)
| | - Martin Narrath
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria; (T.L.); (D.B.); (K.S.); (S.A.B.); (A.P.); (M.N.); (L.P.); (E.Z.R.)
| | - Lisa Pieter
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria; (T.L.); (D.B.); (K.S.); (S.A.B.); (A.P.); (M.N.); (L.P.); (E.Z.R.)
| | - Mary I. Butler
- Department of Psychiatry and Neurobehavioural Science, University College Cork, T12 K8AF Cork, Ireland;
| | | | - Eva Z. Reininghaus
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria; (T.L.); (D.B.); (K.S.); (S.A.B.); (A.P.); (M.N.); (L.P.); (E.Z.R.)
| | - Sonja Lackner
- Division of Immunology, Otto Loewi Research Center, Medical University of Graz, 8010 Graz, Austria;
| | - Sandra Holasek
- Division of Immunology, Otto Loewi Research Center, Medical University of Graz, 8010 Graz, Austria;
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4
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Moetteli S, Mueller-Stierlin AS. [Dietary Interventions In Psychiatry - A Neglected Opportunity to Promote Healthy Lifestyles]. PSYCHIATRISCHE PRAXIS 2024; 51:235-237. [PMID: 38991523 DOI: 10.1055/a-2315-2739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Affiliation(s)
- Sonja Moetteli
- Zentrum Psychiatrische Rehabilitation, Universitäre Psychiatrische Dienste Bern (UPD), Köniz, Schweiz
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5
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Sánchez-Ortí JV, Balanzá-Martínez V, Correa-Ghisays P, Selva-Vera G, Vila-Francés J, Magdalena-Benedito R, San-Martin C, Victor VM, Escribano-Lopez I, Hernandez-Mijares A, Vivas-Lalinde J, Crespo-Facorro B, Tabarés-Seisdedos R. Inflammation and weight change related to neurocognitive and functional impairment in diabetes and psychiatric disorders. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2024:S2950-2853(24)00030-9. [PMID: 38740330 DOI: 10.1016/j.sjpmh.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 04/24/2024] [Accepted: 05/05/2024] [Indexed: 05/16/2024]
Abstract
INTRODUCTION Obesity is a global pandemic associated with various cardio-metabolic and psychiatric disorders. Neurocognitive and functional deficits have been associated with several somatic and psychiatric disorders. Adiposity-related inflammation has recently emerged as a key risk factor for neurocognitive and functional impairments. This prospective transdiagnostic study aimed to investigate the role of adiposity-related inflammatory markers in neurocognitive and functional outcomes associated with weight changes. METHODS Peripheral blood inflammatory and oxidative stress biomarkers and neurocognitive and functional performance were assessed twice over 1 year in 165 individuals, including 30 with schizophrenia, 42 with bipolar disorder, 35 with major depressive disorder, 30 with type 2 diabetes mellitus (T2DM), and 28 healthy controls. Participants were stratified by body mass index into categories of type 2 obesity (T2OB; n=30), type 1 obesity (T1OB; n=42), overweight (OW; n=53), and average weight (NW; n=40). Mixed one-way analysis of covariance and linear and binary logistic regression analyses were performed. RESULTS Compared with NW, T2OB and T1OB were significantly associated with impaired neurocognitive and functional performance (p<0.01; η2p=0.06-0.12) and higher levels of C-reactive protein and platelets (PLT) (p<0.01; η2p=0.08-0.16), with small-to-moderate effect sizes. IL-6, IL-10, and PLT were key factors for detecting significant weight changes in T1OB and T2OB over time. Regression models revealed that inflammatory and oxidative stress biomarkers and cellular adhesion molecules were significantly associated with neurocognitive and functional performance (p<0.05). DISCUSSION Obesity is characterized by neurocognitive and functional impairments alongside low-grade systemic inflammation. Adiposity-related inflammatory biomarkers may contribute to neurocognitive and functional decline in individuals with T2DM and psychiatric disorders. Our data suggest that these biomarkers facilitate the identification of specific subgroups of individuals at higher risk of developing obesity.
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Affiliation(s)
- Joan Vicent Sánchez-Ortí
- INCLIVA - Health Research Institute, Valencia, Spain; Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain; TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain; Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Vicent Balanzá-Martínez
- INCLIVA - Health Research Institute, Valencia, Spain; Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain; TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain; Mental Health Unit of Catarroja, Valencia, Spain
| | - Patricia Correa-Ghisays
- INCLIVA - Health Research Institute, Valencia, Spain; Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain; TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain; Faculty of Psychology, University of Valencia, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | - Gabriel Selva-Vera
- INCLIVA - Health Research Institute, Valencia, Spain; Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain; TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | - Joan Vila-Francés
- IDAL - Intelligent Data Analysis Laboratory, University of Valencia, Valencia, Spain
| | | | - Constanza San-Martin
- TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain; Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Víctor M Victor
- INCLIVA - Health Research Institute, Valencia, Spain; Service of Endocrinology and Nutrition, University Hospital Dr. Peset, Spain; Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain; Department of Physiology, University of Valencia, Valencia, Spain
| | | | | | | | - Benedicto Crespo-Facorro
- Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain; Department of Psychiatry, Faculty of Medicine, University of Sevilla, HU Virgen del Rocío IBIS, Spain
| | - Rafael Tabarés-Seisdedos
- INCLIVA - Health Research Institute, Valencia, Spain; Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain; TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain.
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Alhur A, Alhur AA, Alqahtani S, Al Obaid H, Mohammed R, Al-Humam I, Buhayr S, Altowairqi R, Al-Shahrani W, Alshadidi A, Alghamdi H, Adel Qasim S, Alqabail WA, Albanai WH, Alanezi FO. Measuring Vitamin Literacy and Information-Seeking Behavior. Cureus 2024; 16:e60704. [PMID: 38903291 PMCID: PMC11187477 DOI: 10.7759/cureus.60704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2024] [Indexed: 06/22/2024] Open
Abstract
Background The significance of vitamins in maintaining health necessitates a comprehensive understanding among the population, which is critical for making informed decisions pertaining to diet and vitamin supplementation. Nevertheless, there is a notable deficiency in research regarding the mechanisms through which individuals in the Kingdom of Saudi Arabia (KSA) acquire and utilize vitamin-related knowledge, marking a considerable void in public health and nutrition education. Methods This study proposes a quantitative, cross-sectional analysis to evaluate vitamin literacy and information-seeking behaviors within KSA's diverse demographic sectors. Survey instruments will be utilized to ascertain the primary sources from which individuals derive vitamin information and to analyze the factors that influence the integration of this knowledge into daily health practices. Results Analysis showed significant variance in vitamin literacy with age and education acting as key differentiators. Kruskal-Wallis tests indicated significant differences in self-rated vitamin knowledge across age groups (p < 0.001), and Chi-square tests confirmed the association between education level and supplement use (p = 0.0022). The majority of participants demonstrated moderate knowledge of vitamins, yet a discrepancy exists between this knowledge and dietary application. Trust in information sources emerged as a significant predictor of dietary change (Chi-square, p < 0.001), although a substantial portion of participants did not actively incorporate vitamin knowledge into their daily diet. Conclusion The enhancement of vitamin literacy is paramount for the formulation of effective public health strategies. Our findings suggest that targeted educational programs, especially for younger and less-educated populations, are crucial to bridge the gap between vitamin knowledge and its application in daily diet. In addition, efforts should focus on improving the credibility of information sources, as this significantly influences dietary changes. These initiatives can lead to more informed decision-making regarding diet and vitamin supplementation, ultimately fostering healthier living practices and reducing the occurrences of vitamin-related health issues within the KSA populace. This research contributes substantively to the development of tailored educational initiatives and informed policymaking, guiding future efforts to advance nutrition guidelines and public health in the region.
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Affiliation(s)
- Anas Alhur
- Health Informatics, University of Hail College of Public Health and Health Informatics, Ha'il, SAU
| | | | | | | | | | | | - Saeed Buhayr
- College of Pharmacy, King Khalid University, Abha, SAU
| | | | | | | | | | | | | | - Wala H Albanai
- Department of Nursing, Qatif Central Hospital, Dhahran, SAU
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Minhas J, Mcbride JC. Perceptions of Mental Health Professionals on Nutritional Psychiatry as an Adjunct Treatment in Mainstream Psychiatric Settings in New South Wales, Australia. Cureus 2024; 16:e56906. [PMID: 38665727 PMCID: PMC11045159 DOI: 10.7759/cureus.56906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
Background Nutritional psychiatry refers to the practice of using food, or nutrition, as alternative or complementary treatment for mental health disorders. It is a growing area of research that has shown links between the biological processes in the gut and how the food we consume can impact cognitive function, which then can impact our mood and behaviour. However, there is a lack of understanding on the knowledge and education of nutritional psychiatry in mental health clinicians, and further, how nutritional psychiatry, if at all, is practised in psychiatric clinical settings. Therefore, this study aims to investigate the perceptions, knowledge, and education of mental health professionals within the state of New South Wales, Australia regarding their clinical practice and knowledge of nutritional psychiatry. Methods In this cross-sectional study, a self-administered structured questionnaire created by the authors was successfully completed by 40 mental health professionals (mental health nurses, occupational therapists, psychologists, medical officers, and other allied health workers) who were working in New South Wales, Australia. 49 questionnaires were attempted with nine excluded due to these being predominantly incomplete, including demographic data only or empty, ensuring integrity of the remaining data and analysis. The questionnaire aimed to uncover their perceptions, knowledge, and education in nutritional psychiatry and its role in mental health settings. The questionnaire included 16 questions that covered various themes such as the frequency and importance of discussing nutrition with patients, nutrition referrals for issues regarding nutrition, the value of including nutritional psychiatry in their clinical practice, and clinician training and willingness to train or gain further education in nutritional psychiatry. Data was analysed through a series of frequency tables to categorise patterns and identify patterns through the use of descriptive statistics in our analysis of the distribution of attitudes and practices among mental health professionals regarding nutritional psychiatry. Results A total of 40 mental health clinicians successfully completed the survey and their results were analysed. The results suggest that most clinicians (85% to 93%) recognised the importance of nutrition in mental health, however, revealed various barriers which hindered their clinical practice such as a lack of time, knowledge, and access to nutritional services. Further, 54% of clinicians rated their knowledge of nutritional psychiatry as low, however, 92% revealed that they would attend nutritional psychiatry training if given the opportunity. Additionally, the clinicians reported varied levels of education in nutrition, with 43% reporting no education at all on nutrition in their preclinical studies. Conclusions Clinicians recognise the importance of nutrition in mental health settings, but revealed lack of time, knowledge, and nutritional services as barriers in clinical practice. Further, clinicians reported a lack of pre-clinical education on nutrition together with an overwhelming interest in engaging with nutritional psychiatry education if it were made available. These conclusions provide important insights for higher education and health policy.
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Affiliation(s)
- Junaid Minhas
- Psychiatry and Behavioral Sciences, Oceania University of Medicine, Sydney, AUS
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Thomson-Casey C, McIntyre E, Rogers K, Adams J. Practice recommendations and referrals, perceptions of efficacy and risk, and self-rated knowledge regarding complementary medicine: a survey of Australian psychologists. BMC Complement Med Ther 2024; 24:13. [PMID: 38166841 PMCID: PMC10759583 DOI: 10.1186/s12906-023-04288-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 11/29/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Many people with mental health problems use a range of complementary medicine (CM), including over the counter products, practices, and utilise the services of CM practitioners. Psychologists are likely to consult with clients using CM, in some form, as part of their broader mental health care. The aim of this research was to determine the number of types of CM products, practices, and practitioners are recommended and/or referred by Australian psychologists as part of their clinical practice, as well as explore the relationship between psychologists' perspectives on the risk and relevance of engaging with CM in psychology. METHODS Survey data was collected from psychologists in clinical practice who self-selected to participate in the study via an online 79-item questionnaire exploring core aspects of CM engagement in psychology clinical practice. RESULTS Amongst the 201 psychologists, 5% reported not recommending any type of CM, with 63% recommending four or more types of CM. Further, 25% had not referred to a CM practitioner, while 33% had referred to four or more types of CM practitioner. Psychologists are recommending and referring to CM even when they perceive their knowledge of CM to be poor, and that engaging with CM was a risk. CONCLUSION This study provides insights into psychologist perceptions of CM within psychology practice and how these perceptions are associated with rates of recommending and referring to CM as part of their clinical practice. These findings may inform the development of CM relevant education and guidelines for psychologists.
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Affiliation(s)
- Carrie Thomson-Casey
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.
- Faculty of Health, Southern Cross University, Gold Coast, Australia.
| | - Erica McIntyre
- Institute for Sustainable Futures, University of Technology Sydney, Sydney, Australia
| | - Kris Rogers
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Jon Adams
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Peisser AM, Cornet S, Moerkl S, Müller-Stierlin A. ["But without Therapeutic Support, I wouldn't Succeed" - Exploration of Subjective Experiences of People with Mental Illness Regarding Support with Diet-Related Problems]. PSYCHIATRISCHE PRAXIS 2024; 51:16-23. [PMID: 37429315 DOI: 10.1055/a-2106-7234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
OBJECTIVE In this study we explored the subjective experiences and needs of people with severe mental illness regarding dietary and weight-related support within routine care. METHODS For this purpose, a total of 16 interviews with adults living with mental illness were conducted in Ulm (Germany) and Graz (Austria) using a semi-structured topic guide and were analysed in a qualitative approach. RESULTS Several participants criticized the limited support by professionals regarding diet- and weight-related problems and wished for greater awareness of these issues in mental health care. CONCLUSION The implementation of health-promoting services in mental health care is important to ensure needs-oriented care from the patients' point of view. Interdisciplinary care concepts could be used to share responsibilities among several professional groups.
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Affiliation(s)
- Anna Maria Peisser
- Universitätsklinik für Psychiatrie, Psychosomatik und Psychotherapie, Klinische Abteilung für Psychiatrie und Psychotherapeutische Medizin, Medizinische Universität Graz, Österreich
| | - Sebastian Cornet
- Klinik für Psychiatrie und Psychotherapie II, Ulm University Medical Faculty, Günzburg, Deutschland
| | - Sabrina Moerkl
- Klinische Abteilung für medizinische Psychologie, Psychosomatik und Psychotherapie, Medizinische Universität Graz, Österreich
| | - Annabel Müller-Stierlin
- Klinik für Psychiatrie und Psychotherapie II, Ulm University Medical Faculty, Günzburg, Deutschland
- Institut für Allgemeinmedizin, Universitätsklinikum Ulm, Deutschland
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Thomson-Casey C, Adams J, McIntyre E. The engagement of psychology with complementary medicine: A critical integrative review. Heliyon 2023; 9:e21201. [PMID: 37928398 PMCID: PMC10622697 DOI: 10.1016/j.heliyon.2023.e21201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 05/27/2023] [Accepted: 10/18/2023] [Indexed: 11/07/2023] Open
Abstract
Amidst the global rise in complementary medicine (CM) use for mental health, a substantial number of clients consulting a psychologist also utilise at least one form of CM. Yet, how psychologists should engage with CM in their clinical practice (e.g., how to respond to a client disclosing CM use or enquiries regarding CM products or services for mental health) remains contested and unclear. In response, a systematic integrative review was conducted to examine empirical literature reporting on one or more aspects of the relationship between psychology (incorporating clinical practice, professional associations and academia) and CM, and how that relationship may relate to or inform psychologists' engagement with CM in their clinical practice. Twenty-seven peer-reviewed articles met the specific inclusion criteria and quality appraisal was employed. Analysis shows a substantial number of psychologists are engaging with, or are interested in engaging with, CM in their clinical practice. Analysis identified a dissonance between psychologists' engagement with CM in clinical practice and the limited engagement of the broader discipline of psychology with CM. Further research is required to understand these differing types of engagement with a view to helping inform relevant policy and practice guidelines, and ultimately assist psychologists in navigating CM in their clinical practice.
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Affiliation(s)
- Carrie Thomson-Casey
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Jon Adams
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Erica McIntyre
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
- Institute for Sustainable Futures, University of Technology Sydney, Sydney, Australia
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Marx W, Manger SH, Blencowe M, Murray G, Ho FYY, Lawn S, Blumenthal JA, Schuch F, Stubbs B, Ruusunen A, Desyibelew HD, Dinan TG, Jacka F, Ravindran A, Berk M, O'Neil A. Clinical guidelines for the use of lifestyle-based mental health care in major depressive disorder: World Federation of Societies for Biological Psychiatry (WFSBP) and Australasian Society of Lifestyle Medicine (ASLM) taskforce. World J Biol Psychiatry 2023; 24:333-386. [PMID: 36202135 PMCID: PMC10972571 DOI: 10.1080/15622975.2022.2112074] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/24/2022] [Accepted: 08/07/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The primary objectives of these international guidelines were to provide a global audience of clinicians with (a) a series of evidence-based recommendations for the provision of lifestyle-based mental health care in clinical practice for adults with Major Depressive Disorder (MDD) and (b) a series of implementation considerations that may be applicable across a range of settings. METHODS Recommendations and associated evidence-based gradings were based on a series of systematic literature searches of published research as well as the clinical expertise of taskforce members. The focus of the guidelines was eight lifestyle domains: physical activity and exercise, smoking cessation, work-directed interventions, mindfulness-based and stress management therapies, diet, sleep, loneliness and social support, and green space interaction. The following electronic bibliographic databases were searched for articles published prior to June 2020: PubMed, EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register), CINAHL, PsycINFO. Evidence grading was based on the level of evidence specific to MDD and risk of bias, in accordance with the World Federation of Societies for Biological Psychiatry criteria. RESULTS Nine recommendations were formed. The recommendations with the highest ratings to improve MDD were the use of physical activity and exercise, relaxation techniques, work-directed interventions, sleep, and mindfulness-based therapies (Grade 2). Interventions related to diet and green space were recommended, but with a lower strength of evidence (Grade 3). Recommendations regarding smoking cessation and loneliness and social support were based on expert opinion. Key implementation considerations included the need for input from allied health professionals and support networks to implement this type of approach, the importance of partnering such recommendations with behaviour change support, and the need to deliver interventions using a biopsychosocial-cultural framework. CONCLUSIONS Lifestyle-based interventions are recommended as a foundational component of mental health care in clinical practice for adults with Major Depressive Disorder, where other evidence-based therapies can be added or used in combination. The findings and recommendations of these guidelines support the need for further research to address existing gaps in efficacy and implementation research, especially for emerging lifestyle-based approaches (e.g. green space, loneliness and social support interventions) where data are limited. Further work is also needed to develop innovative approaches for delivery and models of care, and to support the training of health professionals regarding lifestyle-based mental health care.
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Affiliation(s)
- Wolfgang Marx
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Sam H Manger
- College of Medicine and Dentistry, James Cook University, Queensland, Australia
- Australasian Society of Lifestyle Medicine, Melbourne, Australia
| | - Mark Blencowe
- Australasian Society of Lifestyle Medicine, Melbourne, Australia
| | - Greg Murray
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Sharon Lawn
- Lived Experience Australia Ltd, Adelaide, Australia
- Flinders University, College of Medicine and Public Health, Adelaide, Australia
| | - James A. Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham NC 27710
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Anu Ruusunen
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Hanna Demelash Desyibelew
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Felice Jacka
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Arun Ravindran
- Department of Psychiatry & Institute of Medical Sciences, University of Toronto. Centre for Addiction and Mental Health, Toronto, Canada
| | - Michael Berk
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Adrienne O'Neil
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
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12
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Thomson-Casey C, McIntyre E, Rogers K, Adams J. The relationship between psychology practice and complementary medicine in Australia: Psychologists' demographics and practice characteristics regarding type of engagement across a range of complementary medicine modalities. PLoS One 2023; 18:e0285050. [PMID: 37141280 PMCID: PMC10159172 DOI: 10.1371/journal.pone.0285050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/14/2023] [Indexed: 05/05/2023] Open
Abstract
INTRODUCTION Many people with mental health problems utilise a range of complementary medicine (CM) practitioners, products, and practices. Psychologists are likely to consult with clients who are seeking and using CM, in some form, as part of their wider mental health treatment. The aim of this research is to determine how much, and in what ways, Australian psychologists recommend CM products and/or practices, and/or initiate referrals to CM practitioners as part of their clinical practice and to explore if these behaviours have any association with the characteristics of the psychologist or their wider practice. METHODS Survey data was collected from psychologists in clinical practice who self-selected to participate between February and April 2021. Participation in the study was via an online 79-item questionnaire exploring core aspects of CM engagement in psychology clinical practice. RESULTS Amongst the 202 psychologists who completed the survey, mind/body approaches (90.5%) were the most recommended CM and cultural/spiritual approaches the least recommended CM (7.5%). Participants also reported referring to CM practitioners with naturopaths the most common focus of their referrals (57.9%) and cultural and spiritual practitioners the least common focus of their referrals (6.69%). Our analysis shows the demographic and practice characteristics of a psychologist are generally not predictors of a psychologist's engagement with CM in their clinical practice. CONCLUSIONS Substantial numbers of psychologists recommend CM products and practices and/or refer clients to CM practitioners. Alongside subjecting CM interventions for mental health to an evidence-base assessment, the broader discipline of psychology needs to also consider psychologist engagement with CM in clinical practice in order to help ensure cultural-sensitivity, client safety and client choice.
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Affiliation(s)
- Carrie Thomson-Casey
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
- Faculty of Health, Southern Cross University, Gold Coast, Australia
| | - Erica McIntyre
- Institute for Sustainable Futures, University of Technology Sydney, Sydney, Australia
| | - Kris Rogers
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Jon Adams
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
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13
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Logan AC, D'Adamo CR, Prescott SL. The Founder: Dispositional Greed, Showbiz, and the Commercial Determinants of Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095616. [PMID: 37174136 PMCID: PMC10178243 DOI: 10.3390/ijerph20095616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/04/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023]
Abstract
Marketing unhealthy products by multinational corporations has caused considerable harm to individual health, collective wellbeing, and environmental sustainability. This is a growing threat to all societies and a significant contributor to the rising global burden of non-communicable diseases and early mortality. While there is growing consideration of the commercial determinants of health, this is largely focused on the methods by which unhealthy products are marketed and disseminated, including efforts to manipulate policy. Little attention has been paid to the underlying psychological traits and worldviews that are driving corporate greed. Here, we consider the role of "dispositional greed" in the commercial determinants of health with a focus on the historical attitudes and culture in the ultra-processed food industry-exemplified by "The Founder" of the McDonald's franchise. We argue that greed and associated psychological constructs, such as social dominance orientation and collective narcissism, permeate the commercial determinants of health at a collective level. This includes how a culture of greed within organizations, and individual dispositional greed, can magnify and cluster at scale, perpetuated by social dominance orientation. We also consider the ways in which "showbiz" marketing specifically targets marginalized populations and vulnerable groups, including children-in ways that are justified, or even celebrated despite clear links to non-communicable diseases and increased mortality. Finally, we consider how greed and exploitative mindsets mirror cultural values and priorities, with trends for increasing collective narcissism at scale, recognizing that many of these attitudes are cultivated in early life. A healthier future will depend on navigating a path that balances material prosperity with physical and spiritual wellbeing. This will require cultural change that places higher value on kindness, reciprocity, and mutualistic values especially in early life, for more equitable flourishing.
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Affiliation(s)
- Alan C Logan
- Nova Institute for Health, Baltimore, MD 21231, USA
| | - Christopher R D'Adamo
- Nova Institute for Health, Baltimore, MD 21231, USA
- Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Susan L Prescott
- Nova Institute for Health, Baltimore, MD 21231, USA
- Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Medical School, University of Western Australia, Nedlands, WA 6009, Australia
- The ORIGINS Project, Telethon Kids Institute, Nedlands, WA 6009, Australia
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14
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Mueller-Stierlin AS, Peisser A, Cornet S, Jaeckle S, Lehle J, Moerkl S, Teasdale SB. Exploration of Perceived Determinants of Disordered Eating Behaviors in People with Mental Illness-A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:442. [PMID: 36612764 PMCID: PMC9819820 DOI: 10.3390/ijerph20010442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
Disordered eating behaviors are common in people with a serious mental illness (SMI) such as schizophrenia, bipolar disorder and major depressive disorder. This study employed qualitative exploration to understand the perceived determinants of eating behaviors, in particular those connected to disordered eating patterns, in people with SMI. In total, 28 semi-structured interviews were conducted in a consecutive sample of people with SMI under treatment in local mental health services in Australia (n = 12), Germany (n = 8) and Austria (n = 8) (mean age: 43.3 years, proportion of female participants: 61%, proportion of participants with ICD-10 F2 diagnosis: 57%, proportion of participants with ICD-10 F3 diagnosis: 64%). A thematic analysis approach, the framework method, was applied using MAXQDA 2020. Three main themes of determinants were derived: (i) impacts to daily functioning, (ii) disrupted physical hunger cues and (iii) emotional hunger. For impacts to daily functioning, the following themes emerged: lack of daily structure, time and drive, and difficulty planning ahead. For physical hunger, themes emerged for disrupted hunger and satiety cues, and mindless eating. All motives listed in the Palatable Eating Motives Scale (PEMS), i.e., coping, reward, social and conformity, have been reported by participants to be drivers for their emotional eating behavior. Subsequent reported behaviors were eating too much or too little, binge eating, night eating and food cravings. We conclude that interprofessional approaches should target daily functioning, disrupted physical hunger cues and emotional eating to reduce disordered eating behaviors in people with SMI.
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Affiliation(s)
- Annabel S. Mueller-Stierlin
- Department of General Practice and Primary Care, Ulm University Hospital, 89070 Ulm, Germany
- Department of Psychiatry and Psychotherapy II, Ulm University, 89070 Ulm, Germany
| | - Anna Peisser
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Sebastian Cornet
- Department of Psychiatry and Psychotherapy II, Ulm University, 89070 Ulm, Germany
| | - Selina Jaeckle
- Department of Psychiatry and Psychotherapy II, Ulm University, 89070 Ulm, Germany
| | - Jutta Lehle
- Department of Psychiatry and Psychotherapy II, Ulm University, 89070 Ulm, Germany
| | - Sabrina Moerkl
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Scott B. Teasdale
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW 2052, Australia
- Mindgardens Neuroscience Network, Sydney, NSW 2052, Australia
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15
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Thomson-Casey C, Adams J, McIntyre E. Complementary medicine in psychology practice: an analysis of Australian psychology guidelines and a comparison with other psychology associations from English speaking countries. BMC Complement Med Ther 2022; 22:171. [PMID: 35752820 PMCID: PMC9233840 DOI: 10.1186/s12906-022-03620-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Psychologists, and their clients, are engaging with complementary medicine (CM). Increasing evidence for CM approaches, such as improved nutrition and St John's wort, has led to their inclusion in the Royal Australian New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. This research aims to determine in what ways, and to what extent, Australian psychology regulatory bodies and associations consider CM relevant to psychology practice. Specifically, how these regulatory bodies and professional association's ethical and practice guidelines engage with CM. METHODS Documents from Australian regulatory bodies and professional associations, that relate to the governance or guidance of psychologists' clinical practice, were systematically searched for key terms relating to CM. RESULTS There were no direct references to CM in the 58 ethical and practice guidelines reviewed. There was also no reference to the relevance of CM to ethnocultural groups, such as Aboriginal and Torres Strait Islander traditional healing practices. CONCLUSION While other mental health care disciplines are working toward integrating CM, the discipline of psychology in Australia is not currently engaged in such developments. Given the exponential rise of CM use amongst those with mental health problems, psychology associations should consider developing resources and guidelines to assist psychologists in navigating CM in relation to clinical practice to help minimise risks, such as patient safety associated with concurrent CM use.
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Affiliation(s)
- Carrie Thomson-Casey
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.
| | - Jon Adams
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Erica McIntyre
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
- Institute for Sustainable Futures, University of Technology Sydney, Sydney, Australia
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16
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Mueller-Stierlin AS, Cornet S, Peisser A, Jaeckle S, Lehle J, Moerkl S, Teasdale SB. Implications of Dietary Intake and Eating Behaviors for People with Serious Mental Illness: A Qualitative Study. Nutrients 2022; 14:nu14132616. [PMID: 35807799 PMCID: PMC9268504 DOI: 10.3390/nu14132616] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022] Open
Abstract
The impact of poor diet quality and nutritional inadequacies on mental health and mental illness has recently gained considerable attention in science. As the opinions and experiences of people living with serious mental illness on dietary issues are unknown, we aimed to understand the role of nutrition in a biopsychosocial approach. In total, 28 semi-structured interviews were conducted with people living with serious mental illness (SMI) in Australia, Germany and Austria, and a generic thematic analysis approach was applied. Four positive (positive effects on the body and mind, therapeutic effects in treating somatic illnesses, pleasure and opportunity for self-efficacy) and three negative (impairment related to mental illness and its treatment, perceived stigma and negative effects on the body and mind) implications of diet were identified. A key issue for most of the participants was the mental burden arising from their body weight. This might indicate that negative implications, such as guilt and stigma, were of primary importance for people with SMI when talking about their dietary behavior. In conclusion, diet-related support is urgently needed for people with SMI. However, especially participants from Germany and Austria reported that this is not yet widely available in mental health settings, leading to hopelessness and resignation.
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Affiliation(s)
- Annabel S. Mueller-Stierlin
- Department of Psychiatry and Psychotherapy II, Ulm University, 89070 Ulm, Germany; (A.S.M.-S.); (S.C.); (S.J.); (J.L.)
| | - Sebastian Cornet
- Department of Psychiatry and Psychotherapy II, Ulm University, 89070 Ulm, Germany; (A.S.M.-S.); (S.C.); (S.J.); (J.L.)
| | - Anna Peisser
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria;
| | - Selina Jaeckle
- Department of Psychiatry and Psychotherapy II, Ulm University, 89070 Ulm, Germany; (A.S.M.-S.); (S.C.); (S.J.); (J.L.)
| | - Jutta Lehle
- Department of Psychiatry and Psychotherapy II, Ulm University, 89070 Ulm, Germany; (A.S.M.-S.); (S.C.); (S.J.); (J.L.)
| | - Sabrina Moerkl
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria;
- Correspondence:
| | - Scott B. Teasdale
- Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW) Sydney, Sydney, NSW 2052, Australia;
- Mindgardens Neuroscience Network, Sydney, NSW 2052, Australia
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17
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Robbins JP, Solito E. Does Neuroinflammation Underlie the Cognitive Changes Observed With Dietary Interventions? Front Neurosci 2022; 16:854050. [PMID: 35620671 PMCID: PMC9127342 DOI: 10.3389/fnins.2022.854050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/24/2022] [Indexed: 11/13/2022] Open
Abstract
Dietary interventions, such as calorie restriction and ketogenic diet, have been extensively studied in ageing research, including in cognitive decline. Epidemiological studies indicate beneficial effects of certain dietary regimes on mental health, including mood disorders and dementia. However, randomised-controlled trials (the gold-standard of evidence-based medicine) on calorie restriction diets and the ketogenic diet have yet to show clinically convincing effects in neuropsychiatric disorders. This review will examine the quality of studies and evidence base for the ketogenic and calorie restriction diets in common neuropsychiatric conditions, collating findings from preclinical experiments, case reports or small clinical studies, and randomised controlled clinical trials. The major cellular mechanisms that mediate the effects of these dietary interventions on brain health include neuroinflammation, neuroprotection, and neuromodulation. We will discuss the studies that have investigated the roles of these pathways and their interactions. Popularity of the ketogenic and calorie restriction diets has grown both in the public domain and in psychiatry research, allowing for informed review of the efficacy, the limitations, and the side effects of these diets in specific patient populations. In this review we will summarise the clinical evidence for these diets in neuropsychiatry and make suggestions to improve clinical translation of future research studies.
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Affiliation(s)
- Jacqueline P. Robbins
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Egle Solito
- William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
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18
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Horn J, Mayer DE, Chen S, Mayer EA. Role of diet and its effects on the gut microbiome in the pathophysiology of mental disorders. Transl Psychiatry 2022; 12:164. [PMID: 35443740 PMCID: PMC9021202 DOI: 10.1038/s41398-022-01922-0] [Citation(s) in RCA: 77] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 03/22/2022] [Accepted: 03/29/2022] [Indexed: 12/12/2022] Open
Abstract
There is emerging evidence that diet has a major modulatory influence on brain-gut-microbiome (BGM) interactions with important implications for brain health, and for several brain disorders. The BGM system is made up of neuroendocrine, neural, and immune communication channels which establish a network of bidirectional interactions between the brain, the gut and its microbiome. Diet not only plays a crucial role in shaping the gut microbiome, but it can modulate structure and function of the brain through these communication channels. In this review, we summarize the evidence available from preclinical and clinical studies on the influence of dietary habits and interventions on a selected group of psychiatric and neurologic disorders including depression, cognitive decline, Parkinson's disease, autism spectrum disorder and epilepsy. We will particularly address the role of diet-induced microbiome changes which have been implicated in these effects, and some of which are shared between different brain disorders. While the majority of these findings have been demonstrated in preclinical and in cross-sectional, epidemiological studies, to date there is insufficient evidence from mechanistic human studies to make conclusions about causality between a specific diet and microbially mediated brain function. Many of the dietary benefits on microbiome and brain health have been attributed to anti-inflammatory effects mediated by the microbial metabolites of dietary fiber and polyphenols. The new attention given to dietary factors in brain disorders has the potential to improve treatment outcomes with currently available pharmacological and non-pharmacological therapies.
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Affiliation(s)
- J Horn
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - D E Mayer
- MayerInterconnected, LLC, Los Angeles, CA, USA
| | - S Chen
- University of California, San Francisco, CA, USA
| | - E A Mayer
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
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19
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Young CL, Rocks T, Opie RS, Berk M, O'Neil A. Supporting Dietary Change for the Treatment of Mood Disorders in Adults: How Can We Harness Digital Platforms? Psychiatr Ann 2022. [DOI: 10.3928/00485713-20220126-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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20
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LaChance L, Aucoin M, Cooley K. Design and pilot evaluation of an evidence-based worksheet and clinician guide to facilitate nutrition counselling for patients with severe mental illness. BMC Psychiatry 2021; 21:556. [PMID: 34758760 PMCID: PMC8579166 DOI: 10.1186/s12888-021-03575-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 11/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schizophrenia spectrum disorders (SSD) are severe, persistent mental illnesses resulting in considerable disability and premature mortality. Emerging evidence suggests that diet may be a modifiable risk factor in mental illness; however, use of nutritional counselling as a component of psychiatric clinical practice is limited. The objective of this project is the design and evaluate a worksheet and clinician guide for use in facilitating nutritional counseling in the context of existing mental health care. METHODS The worksheet and clinician guide were developed based on the results of a recent scoping review on the relationship between diet and mental health symptoms among individuals with SSD. A feedback process involved a focus group with psychiatrists and interviews with individuals with lived experience with psychosis. Participants were asked a series of structured and open-ended questions. Interviews were transcribed and data units were allocated to categories from an existing framework. The comments were used to guide modifications to the worksheet and clinician guide. A brief interview with all participants was completed to gather feedback on the final version. RESULTS Five psychiatrist participants and six participants with lived experience completed interviews. Participants provided positive comments related to the worksheet design, complexity and inclusion of interactive components. A novel theme emerged relating to the lack of nutritional counselling in psychiatric training and clinical practice. Many constructive comments were provided which resulted in meaningful revisions and improvements to the worksheet and clinician guide design and content. All participants were satisfied with the final versions. CONCLUSIONS A worksheet and clinician guide designed to facilitate nutritional counselling with individuals with SSD was found to be acceptable to all participants following a process of feedback and revision. Further research and dissemination efforts aimed at increasing the use of nutritional counselling in psychiatric practice are warranted.
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Affiliation(s)
- Laura LaChance
- McGill University, Department of Psychiatry, Ludmer Research & Training Building, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada. .,St. Mary's Hospital Centre, 3830 Lacombe Avenue, Montreal, QC, H3T 1M5, Canada.
| | - Monique Aucoin
- grid.418588.80000 0000 8523 7680Canadian College of Naturopathic Medicine, 1255 Sheppard Ave E, North York, ON M2K 1E2 Canada
| | - Kieran Cooley
- grid.418588.80000 0000 8523 7680Canadian College of Naturopathic Medicine, 1255 Sheppard Ave E, North York, ON M2K 1E2 Canada ,grid.117476.20000 0004 1936 7611University of Technology Sydney, Ultimo, Australia ,Pacific College of Health Sciences, San Diego, USA ,grid.1031.30000000121532610National Centre for Naturopathic Medicine, Southern Cross University, Lismore, Australia
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21
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The Development of a Nutrition Screening Tool for Mental Health Settings Prone to Obesity and Cardiometabolic Complications: Study Protocol for the NutriMental Screener. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111269. [PMID: 34769787 PMCID: PMC8583622 DOI: 10.3390/ijerph182111269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/26/2021] [Accepted: 10/26/2021] [Indexed: 11/17/2022]
Abstract
People living with serious mental illness (SMI) experience physical health complications at disproportionate rates to people without an SMI. Unhealthy dietary intake and disordered eating behaviors are key driving factors. There is a lack of valid nutrition-risk screening tools targeted to mental health services, and typically used nutrition-risk screening tools are not suitable for mental health services. This paper details the rationale and study protocol for development and validation of the NutriMental screener, a tool for use in clinical practice to identify service users who are at risk for common nutrition issues experienced by this population group and trigger referral to a specialist clinician. The development process includes five phases. Phase I is the development of nutrition-related domains of interest from screening tools used in mental health services. Phase II involves a literature review and service-user interviews to identify additional domains. Phase III consists of international workshops with relevant clinicians and persons with SMI to gain a consensus on questions to be included in the draft tool. Phase IV involves conducting multinational feasibility and preliminary validation studies. Phase V consists of performing formal validation studies. The development of a nutrition-risk screening tool for mental health services is a necessary step to help rectify the physical-health disparities and life-expectancy gap for people with SMI.
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