Getting dirty may help depression

Depression treatment with soil dirt

Treatment of mice with a 'friendly' bacteria, normally found in the soil, altered their behavior in a way similar to that produced by antidepressant drugs, reports research published in the latest issue of Neuroscience.
These findings, identified by researchers at the University of Bristol and colleagues at University College London, aid the understanding of why an imbalance in the immune system leaves some individuals vulnerable to mood disorders like depression.
Dr Chris Lowry, lead author on the paper from Bristol University, said: "These studies help us understand how the body communicates with the brain and why a healthy immune system is important for maintaining mental health. They also leave us wondering if we shouldn t all be spending more time playing in the dirt."
Interest in the project arose after human cancer patients being treated with the bacteria Mycobacterium vaccae unexpectedly reported increases in their quality of life. Lowry and his colleagues reasoned that this effect could be caused by activation of neurons in the brain that contained serotonin.
When the team looked closely at the brains of mice, they found that treatment with M. vaccae activated a group of neurons that produce the brain chemical serotonin. The lack of serotonin in the brain is thought to cause depression in people, thus M. vaccae s effects on the behavior of mice may be due to increasing the release of serotonin in parts of the brain that regulate mood.
The new research supports this hypothesis, but future studies will be designed to determine if M. vaccae, other bacteria, or pharmaceutical compounds have antidepressant properties through activation of this group of serotonin neurons.

Genes Help Identifying The Causes of Schizophrenia

Scientists from the University have identified a risk gene associated with the mental health disorder schizophrenia.
An international group of researchers, led by Professors Michael O’Donovan, Nick Craddock, and Michael Owen from the School of Medicine examined DNA samples from over 7,000 individuals with schizophrenia, and almost 13,000 people without the disorder.
Their findings, which are reported in the journal Nature Genetics, show that DNA variants that are common in the population at large also contribute to some individuals developing schizophrenia.
The researchers believe the risk genes may offer advantages in the brain function of unaffected people, which is why they can be found in the population at large.
Among the genes reported one appears to act by switching other genes on and off.
Professor O’Donovan said: “We looked for common changes in the genetic code that were more frequent in people with schizophrenia than people without it. Among the genes we found, the evidence for the gene called ZNF804A was particularly strong. We now need to determine the identity of the genes that it can switch on and off. Finding out which ones are regulated should tell us a lot about what biochemical disturbances result in disease, and provide further vital clues into the origins of schizophrenia and hopefully, new ways of treating it.”
Schizophrenia is a common brain disorder characterized by delusions, hallucinations, and changes in motivation and behaviour. It affects approximately one person in 100 at some point in their lives, usually in late adolescence or early adulthood.
The group also found that the same gene also influences risk of the major mood disorder known as bipolar disorder or manic-depression.
The study involved researchers from Ireland, Germany, Japan, China, Israel, America and Australia, and in the UK was funded by the Medical Research Council and the Wellcome Trust.
The group’s results are one of three breakthrough findings in schizophrenia research being published today in the journals Nature, and Nature Genetics, two of which involve the Cardiff team.
In the other paper, published in Nature, Cardiff scientists involved in The International Schizophrenia Consortium found that people with schizophrenia are more likely to have an excess of rare deletions and duplications of large segments of genetic material across their entire genome.

DepressionEfficacy Of Vagus Nerve Stimulation For Treatment-Resistant Depression

Treatment-Resistant Depression
Medical University of South Carolina announced the results of a functional MRI (fMRI) study examining the effects of VNS (Vagus Nerve Stimulation) Therapy for patients with treatment-resistant depression (TRD).
The study, led by Ziad Nahas, M.D., associate professor, MUSC Department of Psychiatry, appears in the August 2007 issue of peer-reviewed Neuropsychopharmacology. The results show that VNS Therapy modulates areas of the brain that control mood. The researchers also identified variables, such as length of use, strength of stimulation and level of depression, to better understand the impact of VNS Therapy.
"These data provide further insight into VNS therapy's distinct mechanism of action and support its previously demonstrated long-term, sustained efficacy," Nahas said. "We are encouraged to see the unique benefit VNS therapy may bring to patients with one of the most difficult-to-treat forms of depression and are excited to continue neurostimulation research at MUSC."
The study illustrates that VNS Therapy modifies activity of the medial prefrontal cortex, the same area of the brain targeted by many antidepressant medications and electroconvulsive therapy (ECT). A critical time for such effective modulation occurs approximately at 30 weeks of treatment. Such modulation could support VNS Therapy's unique mechanism of action as a long- term treatment for chronic or recurrent depression and directly corresponds with the timeframe in which patients typically experience a decrease in symptoms. Further analysis of the data demonstrates that modulation of the brain is a dynamic process that over time leads to indirectly related improved response with continued use. These findings corroborate an earlier MUSC-led study that revealed approximately two-thirds of patients who respond to VNS Therapy continue to experience significant clinical benefit at 24 months, making VNS Therapy the only treatment for TRD to demonstrate such long-term improvements.
The FDA approved VNS therapy in 2005 as an adjunctive long-term treatment of chronic or recurrent depression for patients (18 years of age or older) who are experiencing a major depressive episode and have not had an adequate response to four or more antidepressant treatments. It is the only device ever studied and approved for treatment-resistant depression. VNS therapy is delivered from a small pacemaker-like device implanted in the chest area that sends mild pulses to the brain via the vagus nerve in the neck.
Nahas' esteemed colleague Mark S. George, M.D., MUSC Departments of Psychiatry, Neurology and Radiology, shares this vision and supports the need for additional research to maximize the potential of neurostimulation as a diagnostic and therapeutic agent. George has launched a new international, peer-reviewed journal that is dedicated to exploring the field of neuromodulation. Published by Elsevier, Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation strives to provide the most comprehensive collection of research being conducted in this emerging field. As editor-in-chief, George's extensive experience researching neurostimulation applications will aide him in facilitating and shaping the field's promising future.

Iraq Veterans Experience Delayed Mental Stress

Soldiers who served in Iraqare experiencing much greater mental distress three to six months after leavingthe war zone than when they first returned to the U.S., according to a Walter Reed Army Institute of Research/U.S. Army Center for Health Promotion andPreventive Medicinestudy published in the Journal of the American Medical Association,the Washington Post reports. For the study, researchers analyzed questionnaires completedby 88,235 Iraq War soldiers. About 56,000 of the respondents remain on activeduty, while 32,000 are in the Army Reserve or National Guard. Ninety percent of the questionnaires werecompleted by men, 60% of whom were married (Scott Tyson, Washington Post,11/14).
Overall, almost one-third of the servicemembers had signs of depression,post-traumatic stress disorder, conflicts in relationships and other mentalhealth problems six months after leaving Iraq, the study found (Johnson, AP/Long Island Newsday, 11/13). According to the study,soldiers were far more likely to report problems such as PTSD and conflictswith family or friends during a screening performed three to six months afterreturning from Iraqcompared with an assessment taken immediately upon their return (WashingtonPost, 11/14).
Paul Reickhoff, executive director of Iraq and Afghanistan Veterans ofAmerica, said that in the initial screening, soldiers might have minimizedconcerns so they would not be delayed in returning home. In addition, there isa "honeymoon period" upon returning home that lasts until negativeexperiences begin to sink in, according to the LosAngeles Times(Maugh, Los Angeles Times, 11/13). Stephen Jones, an Armyassistant surgeon general, said, "When you come back, … you’re almosteuphoric, … you don’t have any problems in the world," but after sometime has passed, "the stress starts to resurface."
Problems Reported MoreAmong Reservists Than Active Duty
The study also foundNational Guard members and reservists reported mental health problems at higherrates than active-duty troops. Based on the two screenings — one occurringimmediately upon return and one occurring up to six months later — one in fiveactive-duty Army soldiers and more than 40% of Army reservists were identifiedas being in need of treatment for their mental distress. During the secondscreening, 24.5% of reservists reported concerns with PTSD, compared with 16.7%of active-duty soldiers; 13% of reservists reported depression concerns,compared with 10.3% of active servicemembers; and 35.5% of reservists wereconcerned about their risk of developing mental health problems, compared with27.1% of active-duty soldiers.
In addition, nearly 12% of active-duty soldiers and 15% of reservists reportedabusing alcohol, yet less than 1% were referred for substance-abuse treatment,possibly due to concerns about treatment records not being confidential,according to the study. According to the Post, reservists mightexperience more mental health problems because of the adjustment to civilianlife without the daily support of their "war-zone comrades" (WashingtonPost, 11/14). In addition, Reickhoff said, reservists and National Guardmembers might be more willing to admit to mental health problems thanactive-duty military members because of perceived stigma (Los AngelesTimes, 11/14).
Recommendations
Researchers recommendedthat the Army provide mental health care services to veterans and their familymembers "before symptoms become chronically entrenched" (WashingtonPost, 11/14). Treating mental illness early can help prevent long-termproblems, according to lead researcher Charles Milliken of Walter Reed (LosAngeles Times, 11/13).
However, the study also questions the effectiveness of PTSD treatment in the"overburdened" military medical system, finding "no directrelationship of referral or treatment with symptom improvement" (WashingtonPost, 11/14).

Reprintedwith permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign upfor email delivery at kaisernetwork.org/email . The Kaiser Daily Health PolicyReport is published for kaisernetwork.org, a free service of The Henry J.Kaiser Family Foundation. 2007 Advisory Board Company and Kaiser FamilyFoundation. All rights reserved.

Personal Care, Food Service Employees Have Highest Rates Of Depression

Rates of depression among full-time workers are highest in personal care and service jobs and food preparation and serving occupations, according to a new report by the Substance Abuse and Mental Health Services Administration.
The report on workers ages 18-64, Depression among Adults Employed Full-Time, by Occupational Category, said that 10.8 percent of personal care and service workers and 10.3 percent of food preparation and serving workers experienced one or more major depressive episodes in the past year. In the National Survey on Drug Use and Health, the source for this report, a major depressive episode is defined as a period of two weeks or longer during which there is depressed mood or loss of interest or pleasure and at least four other symptoms that reflect a change in functioning, such as problems with sleep, eating, energy, concentration and self-image.
Overall, 7 percent of full-time workers faced depression in the past year, according to these combined 2004-2006 estimates. While rates of depression were higher among the unemployed and part-time workers, 52.4 percent of the adults who reported past year depression were employed full-time. Full-time workers make up more than half of the adult population.
"Depression exacts a high price from workers and from their employers, costing the U.S. workplace an estimated $36.6 billion per year in lost productivity," said SAMHSA Administrator Terry Cline, Ph.D. "Employers, workers and their family members need to know effective treatments for depression are available. Depression screening, outreach and enhanced treatment can improve productivity, lower employer costs, and improve the quality of life for individuals and their families."
Among full-time workers ages 18 to 64, women were more likely than men to have faced depression. Young adult workers ages 18 to 25 had the highest rates of depression among all adult age groups. Among those 18 to 25 years old, 8.9 percent reported facing depression in the past year, while depression was reported by 7.6 percent of those ages 26-34; 7.2 percent of those ages 35-49; and 5.1 percent of those ages 50-64.� Among young adult workers, those in health care and technical occupations had the highest rate of past year depression (11.9 percent).
The occupations with the lowest rates of past year depression among all full-time workers ages 18 to 64 were engineering, architecture and surveying (4.3 percent); life, physical and social science (4.4 percent); and installation, maintenance and repair (4.4 percent).