Efficacy of a Multimodal Online Lifestyle Intervention for Depressive Symptoms and Quality of Life in Individuals With a History of Major Depressive Disorder

Validation of Wistar-Kyoto rats kept in solitary housing as an animal model for depression using voxel-based morphometry

Major depressive disorder is a common psychiatric condition often resistant to medication. The Wistar-Kyoto (WKY) rat has been suggested as an animal model of depression; however, it is still challenging to translate results from animal models into humans. Solitary housing is a mild stress paradigm that can simulate the environment of depressive patients with limited social activity due to symptoms. We used voxel-based morphometry to associate the solitary-housed WKY (sWKY) rat model with data from previous human studies and validated our results with behavioural studies. As a result, atrophy in sWKY rats was detected in the ventral hippocampus, caudate putamen, lateral septum, cerebellar vermis, and cerebellar nuclei (p < 0.05, corrected for family-wise error rate). Locomotor behaviour was negatively correlated with habenula volume and positively correlated with atrophy of the cerebellar vermis. In addition, sWKY rats showed depletion of sucrose consumption not after reward habituation but without reward habituation. Although the application of sWKY rats in a study of anhedonia might be limited, we observed some similarities between the regions of brain atrophy in sWKY rats and humans with depression, supporting the translation of sWKY rat studies to humans.

Smartphone-delivered multicomponent lifestyle medicine intervention for improving mental health in a nonclinical population: a randomized controlled trial

Objective

To prevent the exacerbation of mental health burdens, a growing body of research has recommended a balanced approach that emphasizes both the delivery of mental health treatments to individuals with common mental disorders (CMDs) and the strengthening of protective factors for CMDs among nonclinical populations. This randomized controlled trial (RCT) evaluated the efficacy of a smartphone-delivered multicomponent lifestyle medicine (LM) intervention, Lifestyle Hub, for improving mental health among a nonclinical population of Chinese adults.

Methods

A total of 106 participants with Patient Health Questionnaire-9 total score < 10 and Generalized Anxiety Disorder 7-Item Scale <8 were randomly assigned to either the Lifestyle Hub intervention group (LH, n = 53) or the waitlist control group (WL, n = 53). Lifestyle Hub is an 8-week smartphone-delivered multicomponent LM intervention developed based on the transtheoretical model. The intervention components included lifestyle psychoeducation, physical activity, diet and nutrition, stress management, sleep management, and motivation and goal-setting techniques. Assessments were conducted at baseline, immediate post-intervention, and 1-month follow-up (LH only).

Results

The linear mixed effect model based on the intention-to-treat principle indicated that Lifestyle Hub significantly improved overall mental health, depressive symptoms, anxiety symptoms, stress, insomnia severity, overall health-promoting behaviors, dietary quality, and stress management compared to the WL group at immediate post-intervention (d = 0.13-0.56). No significant between-group differences were observed in terms of functional impairment, health-related quality of life, health responsibility, physical activity level, spiritual growth, and interpersonal relations. The intervention gains in the LH group were maintained at 1-month follow-up. The LH participants indicated that Lifestyle Hub was an acceptable intervention for improving mental health, although a significantly higher level of study attrition was observed in the LH group (20.8%) relative to the WL group (5.7%).

Conclusion

Lifestyle Hub may serve as an efficacious and acceptable intervention for improving mental health in nonclinical adult populations. To extend the benefits of LM interventions at the population level, future studies are warranted to examine a stepped-care approach to delivering LM interventions.Trial registration: This randomized controlled trial was pre-registered with ClinicalTrials.gov (NCT04295369).

Nutritional counseling needs of patients with mental disorders in psychiatric care: A cross-sectional survey

BACKGROUND

The exploration of diet and nutrition as they relate to mental health and psychiatric disorders is a developing field. Anxiety, depression, and pharmacological treatments used to treat these disorders are likely to have side effects that induce decreases in activity and irregular eating habits, resulting in persistent nutritional imbalance. Unhealthy dietary patterns are associated with an increased risk of developing physical and mental health conditions. Despite this, nutritional support to patients in psychiatric care is not adequate.

AIMS

This study aimed to determine the factors underlying the need for nutritional counseling among patients with a mental disorder in psychiatry. The factors explored are eating-related symptoms, eating behavior, interest in food, seeking nutritional counseling, and impact on quality of life (QOL).

METHODS

We utilized a cross-sectional study design. Eligible patients were asked to complete a questionnaire regarding physical measurements and nutritional counseling. In addition, patients' diagnoses and blood test data were referenced from their medical records. The analysis focused on two groups: those who desired to consult a nutritionist and those who did not.

RESULTS

Ninety-three patients completed the study. The nutritional status and need for nutritional counseling in psychiatry patients indicates that patients with dietary problems requested nutritional counseling (p < .001). Patients who were more likely to need nutritional counseling had lower QOL in daily life (p = .011), pain/discomfort (p = .024), and anxiety/depression (p = .010) on the EuroQol 5-Dimension 5-level (EQ-5D-5L).

CONCLUSIONS

Patients with mental disorders who need nutritional counseling tend to have food-related problems and low QOL. It is necessary to establish an interdisciplinary system for nutritional counseling.

The Effect of Healthy Lifestyle Changes on Work Ability and Mental Health Symptoms: A Randomized Controlled Trial

OBJECTIVE

The effects of lifestyle interventions on the prevention of a decline in work ability and mental health are not well known. The aim of this randomized controlled trial was to examine the effects of healthy lifestyle changes on work ability, sleep, and mental health.

METHODS

Workers aged 18-65 years, who were free from cardiovascular diseases, diabetes, and malignant diseases, and did not use medication for obesity or lipids were included (N = 319). Based on their cholesterol balance, participants were classified into medium-risk and high-risk groups and were randomized into four arms: group lifestyle coaching (N = 107), individual lifestyle coaching (N = 53), the control group for group coaching (N = 106), and the control group for individual coaching (N = 53). The intervention groups received eight sessions of mostly remote coaching for 8 weeks about healthy diet, physical activity, other lifestyle habits, and sources/management of stress and sleep problems, and the control groups received no intervention. In individual coaching, the coach focused more on individual problem solving and the possibilities for motivation and change. The intention-to-treat principle was applied, and missing data on the outcomes were imputed using multiple imputation.

RESULTS

After the completion of the intervention, the risk of depressive symptoms was lower by 53% (95% CI 1-77%) in participants who received individual lifestyle coaching compared with the control group. The intervention had no beneficial effects on anxiety, work ability, sleep duration, or daily stress. In subgroup analyses, group lifestyle coaching had beneficial effects on depressive symptoms and work ability in participants with less tight schedules or less stretching work, whereas individual lifestyle coaching lowered the risk of depressive symptoms in those with fewer overlapping jobs, less tight schedules, or less stretching work.

CONCLUSION

Short but intensive remote lifestyle coaching can reduce depressive symptoms and improve work ability, and time-related resources at work may improve mental health in the context of individual lifestyle intervention. However, further randomized controlled trials are needed to confirm the findings.