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Diet And Weight May Affect Response To Bipolar Disorder Treatment

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Data from a clinical trial has shown that how people respond to treatment for Bipolar Disorder may be influenced by their weight and the overall quality of their diet, including whether they are eating a diet high in foods thought to contribute to general inflammation. These are early results, but if replicated may mean that treatment of some mental health problems could benefit from the inclusion of dietary advice. This is presented at the ECNP Conference in Barcelona.

Bipolar Disorder (which used to be called ‘manic depression’) is characterised by episodes of mood swings, between being very up or very down with periods in between the two extremes. The fact that there are two opposite sets of symptoms means that finding an effective treatment is difficult. While current medications are useful, they are better at targeting mania symptoms (the ‘up’ phase), leaving a lack of effective treatment for people experiencing depressive episodes. Now a group of Australian, German and American scientists have shown those who have a high quality diet, a less inflammatory diet, and/or a low BMI (Body Mass Index) may respond better to an add-on nutraceutical treatment provided as part of a clinical trial.

“If we can confirm these results, then it’s good news for people with Bipolar Disorder, as there is a great need for better treatments for the depressive phase of Bipolar Disorder” said lead researcher Melanie Ashton of Deakin University in Australia.

A total of 133 participants were randomly assigned to take a combination of nutraceuticals (compounds derived from foods such as vitamins or minerals that treat or prevent a disease or disorder) including the anti-inflammatory amino acid n-acetylcysteine (NAC), or NAC alone, or a placebo (a dummy pill) for 16 weeks. Participants received the study medication in addition to any stable treatments they were already receiving. Researchers measured BMI at the beginning of the study, and then measured depression and how a person is able to function in their day to day life. Researchers also rated whether a participant was improving and, if so, how much, over the next 20 weeks. Participants filled in a questionnaire about what they usually eat over the year and researchers calculated a diet quality score, where good diets included a healthy diet with lots of fruit and vegetables, whereas poorer-quality diets had more saturated fat, refined carbohydrates and alcohol. These types of diets were then categorised as either anti-inflammatory or pro-inflammatory based on foods that affect inflammation.

Melanie Ashton continued, “We found that people who had a better-quality diet, a diet with anti-inflammatory properties, or a lower BMI, showed better response to add-on nutraceutical treatment than did those who reported a low-quality diet, or a diet including foods that promote inflammation, or who were overweight.

What this means, if these results can be repeated in a larger trial, is that treatment for Bipolar Disorder would need to take into account what a person eats and their weight.

There are some points we need to note about this study. This is a randomised, controlled trial, but what we found were exploratory outcomes; in other words, it wasn’t the main result that we were testing. Our result is statistically significant, but because the study wasn’t specifically designed to test the effect of diet quality,

inflammatory diets and BMI on drug response in general, it is necessary to see the work replicated in a larger study before any firm conclusions can be formed.”

Commenting, Professor Eduard Vieta (Barcelona) said:

“This is interesting work, which holds out the possibility that patients with Bipolar Disorder may benefit from a balanced diet. However, it is an early study, and we need more research before we can think whether this might affect clinical practice.”

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Parents, Kids Spend More Time Discussing How To Use Mobile Technology Than Talking About Content

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ANN ARBOR—Most parents would agree that one of the of the biggest modern parenting challenges is monitoring a child’s online activity.

A new study appearing in the Journal of Child and Family Studies found that parents spend more time talking with kids about the mechanics of using their mobile devices than they do about what their kids watch and download on those devices.

The findings came from a small, recent study of 75 children and their families, led by researcher Sarah Domoff, then a postdoctoral fellow at University of Michigan Center for Human Growth and Development. The children wore recording devices at home, which recorded talking, conversations or other sounds nearby, as well as audible screen media use.

Domoff, now an assistant professor at Central Michigan University, said the findings revealed some concerning trends in how families and children communicate about media today. Specifically, the researchers observed minimal conversation about the content of programming that children were watching.

Additionally, they learned that other family members appear to play an important role when content is discussed. Children––not parents––initiated most conversations about content, and older siblings played a much bigger role than parents in content mediation for younger siblings. Also, the study found that children as young as toddlers were exposed to multiple media sources at one time, or media multitasking.

Other findings include:

  • Negotiations and conflict are common among parents and children.
  • Parallel family media use is common, meaning different family members use their own devices at the same time.

“One of the most challenging aspects of parenting today is being aware of what children are exposed to online, particularly content delivered via mobile devices,” Domoff said.

“Thus, it is critical that parents utilize privacy settings and restrictions to protect children from certain content. Ideally, this would occur before the child received their own mobile device.”

Domoff recommends developing a family media plan. In 2016, The American Academy of Pediatrics released a tool that helps families set different goals and media use rules based on individual needs, she said.

It’s also troubling that some apps downloaded by children include advertising or request in-app purchases, she said. Parents can identify these apps by using Common Sense Media’s app review.

Parents can also recruit older children to help younger siblings make good content choices.

The study aimed to identify themes of parental mediation and family communication around mobile media devices. There’s a dearth of scientific data in this area compared to television and video games, but studies show that parental mediation leads to better outcomes for children.

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Internet Therapy Apps Reduce Depression Symptoms

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BLOOMINGTON, Ind. — In a sweeping new study, Indiana University psychologists have found that a series of self-guided, internet-based therapy platforms effectively reduce depression.

The work, which reviewed 21 pre-existing studies with a total of 4,781 participants, was published in the November issue of the Journal of Medical Internet Research. The study was led by Lorenzo Lorenzo-Luaces, an assistant professor of clinical psychology in the IU Bloomington College of Arts and Sciences’ Department of Psychological and Brain Sciences.

In the past several years, many internet-based apps and websites have made claims to treat depression. The subjects of the IU study were specifically those applications that provide treatment with cognitive behavioral therapy, a form of psychotherapy that focuses on changing thought patterns and behavior to alleviate symptoms of depression and other mental disorders.

Previous studies had examined the effectiveness of individual internet-based cognitive behavioral therapy apps, or iCBT, using a range of methods. Until this study, however, no review had examined whether the effects of these treatments were inflated by excluding patients with more severe depression or additional conditions such as anxiety or alcohol abuse.

“Before this study, I thought past studies were probably focused on people with very mild depression, those who did not have other mental health problems, and were at low risk for suicide,” Lorenzo-Luaces said.

“To my surprise, that was not the case. The science suggests that these apps and platforms can help a large number of people.”

For Lorenzo-Luaces, internet-based cognitive behavioral therapy apps are an important new tool for addressing a major public health issue: that individuals with mental health disorders like depression far outnumber the mental health providers available to treat them.

“Close to one in four people meet the criteria for major depressive disorder,” he said.

“If you include people with minor depression or who have been depressed for a week or a month with a few symptoms, the number grows, exceeding the number of psychologists who can serve them.”

People with depression are also expensive for the health care system, he added.

“They tend to visit primary-care physicians more often than others,” Lorenzo-Luaces said.

“They have more medical problems, and their depression sometimes gets in the way of their taking their medication for other medical problems.”

By conducting a “meta-regression analysis” of 21 studies, Lorenzo-Luaces and collaborators decisively determined that internet-based therapy platforms effectively alleviate depression. A central question was determining whether previous studies distorted the strength of these systems’ effects by excluding people with severe depression.

The conclusion was that the apps worked in cases of mild, moderate and severe depression.

Many of the studies in the analysis compared use of internet-based cognitive behavioral therapy apps to placement on a wait list for therapy or the use of a “fake app” that made weak recommendations to the user. In these cases, the iCBT apps worked significantly better.

“This is not to say that you should stop taking your medication and go to the nearest app store,” added Lorenzo-Luaces, who said both face-to-face therapy and antidepressants may still prove to be more effective than the iCBT apps alone.

“People tend to do better when they have a little bit of guidance,” he said. But he added that a 10- to 15-minute check-in may be sufficient for many people, freeing health care providers to see more patients.

App-based therapy also has an advantage in situations where access to face-to-face therapy is limited due to logistical barriers, such as long distances in rural areas or inflexible work schedules.

“ICBT apps take the methods we have learned and make them available to the many people who could benefit from them,” Lorenzo-Luaces said.

“It’s an exciting development.”

 

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New Study Finds Employee Incentives Can Lead To Unethical Behavior In The Workplace

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Considering end-of-year bonuses for your employees? Supervisors be forewarned, a new study finds that while incentive rewards can help motivate and increase employee performance it can also lead to unethical behavior in the workplace.

“Goal fixation can have a profound impact on employee behavior, and the damaging effects appear to be growing stronger in today’s competitive business landscape,” says Bill Becker, co-author of the study and associate professor of management in the Pamplin College of Business at Virginia Tech.

The study, “The effects of goals and pay structure on managerial reporting dishonesty,” provides valuable insight into the relationship between pay structures and motivation.

Findings suggest that setting compensation goals can increase dishonesty when managers are also paid a bonus for hitting certain targets.

“These unintended negative consequences can lead to dishonesty, unethical behavior, increased risk-taking, escalation of commitment, and depletion of self-control,” says Becker.

The study points to observations of unethical behaviors in the workplace that include employees falsifying or manipulating financial reporting information as well as time and expense reports.

For example, service professionals such as auditors, contractors, lawyers, and consultants who report hours billed against a target budget is often based on a fixed contract price.

“This causes potential for both under-reporting and over-reporting costs, which can undermine organizational objectives and negatively impact the interest of the firm,” says Becker.

“Using purely monetary incentives is almost always a double edged sword.”

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