Normal Mood Research Articles

How Much Better is Faster? Empirical Tests of QALY Assumptions in Health-Outcome Sequences.

This study was designed to test hypotheses regarding the path dependence of health-outcome values in the form of linear additivity of health-state utilities and diminishing marginal utility of health outcomes. We employed a discrete-choice experiment to quantify patient treatment preferences for major depressive disorder. In a series of choice questions, participants evaluated seven symptom-improvement sequences and out-of-pocket costs over 6-week durations. Money-equivalent values were derived from a deductive latent-class mixed-logit analysis. The discrete-choice experiment was completed by 751 respondents with self-reported major depressive disorder recruited from an online commercial panel. The class-membership probability was 0.83 for latent-class preferences consistent with supporting relative importance weights for all symptom-improvement sequences in the study design. First, we found strong support for diminishing marginal utility in symptom-improvement sequences. The money-equivalent value of an initial week of normal mood was $147 (95% confidence interval: $128, $166) and a second week of normal mood was $70 ($49, $91). Furthermore, for short treatment durations where conventional discounting was not a factor, equivalent changes in health status were valued more highly for an earlier onset of effect: holding subsequent symptom patterns constant, $338 (211, 454) versus $70 (49, 91) for improvements starting in week 2 versus week 3 and $147 ($128, $166) versus $29 (-$4, $64) for improvements starting in week 3 versus week 4. Our findings imply that conventional quality-adjusted life-year calculations in which health values are assumed to be path independent can understate the value of health improvements that appear earlier in a sequence.

Kavalactones support motivation to move during intensive training in males preparing for military special operations forces.

Military special operators, elite athletes, and others requiring uninterrupted optimal performance currently lack options for sleep and mood support without performance-inhibiting effects. Kavalactones, derived from the root of the kava plant (Piper methysticum Forst), have been shown to elevate mood and wellbeing by producing a feeling of relaxation without addiction or cognitive impairment. In this placebo-controlled, crossover study (NCT05381025), we investigated the effects of 2 weeks of kavalactones use on cortisol (diurnal salivary), sleep (RSQ-W; Restorative Sleep Questionnaire, Weekly), mood (DASS-21; Depression Anxiety Stress Scale-21), and motivation state to expend (Move) or conserve (Rest) energy (CRAVE; Cravings for Rest and Volitional Energy Expenditure, Right Now) in a cohort of 15 healthy, physically fit young males engaged in a rigorous, two-a-day preparation class for special operations forces qualification. Cortisol, sleep, and mood were within normal, healthy parameters in this cohort at baseline. This remained unchanged with kavalactones use with no significant findings of clinical interest. However, a statistically similar, positive slope for within-group Move scores was seen in both groups during kavalactones loading (first group Move slope 2.25, second group Move slope 3.29, p = 0.299). This trend was seen regardless of order and with no apparent effects on the Rest metric (all p ≥ 0.05). Moreover, a significant between-group difference appeared after 1 week of kavalactones use in the first phase (p = 0.044) and persisted through the end of the first loading period (p = 0.022). Following the 10-day washout, this between-groups divergence remained significant (p = 0.038) but was reversed by 1 week after the crossover (p = 0.072), with Move scores once again statistically similar between groups and compared to baseline at study end. Furthermore, the group taking kavalactones first never experienced a significant decrease in Move motivation state (lowest mean score 21.0, highest 28.6, all p ≥ 0.05), while the group receiving kavalactones in the last 2 weeks of the study had Move scores that were statistically lower than baseline (lowest mean score 8.6, highest 25.9, all p ≤ 0.05) at all time points but the last (p = 0.063) after 2 weeks of kavalactones exposure. We report a novel finding that kavalactones may support performance by maintaining or rescuing the desire to expend energy in the context of significant physical and mental strain in well-conditioned individuals, even in a context of already normal cortisol, sleep, and mood.

Mapping Thyroid Hormone Action in the Human Brain.

Background: Normal brain development, mood, and cognitive functions depend on thyroid hormone (TH) action. However, little is known about how TH mediates its actions in the human brain. This is due to limited access to human brains deprived of TH during fetal and early postnatal life, as well as from adults with altered thyroid status. One way to partially bypass these limitations is by using magnetic resonance imaging and spectroscopy, two neuroimaging techniques that provide detailed, noninvasive information on human brain structure and function. Another way is using human-induced pluripotent stem cell (hiPSCs)-derived three-dimensional in vitro systems, known as brain organoids, which allow for the study of fundamental aspects of the early stages of human brain development. Summary: This narrative review focuses on neuroimaging and brain organoid studies. Neuroimaging of human brains performed in individuals with different thyroid conditions provides information on the volume, myelination, blood flow, neural activity, and connectivity of different areas. Such studies show that suboptimal thyroid status can impact human brain development and its normal function throughout life. This is true not only for patients with sporadic congenital hypothyroidism, during pregnancy or early after birth, but also for adult patients with hypo- or hyperthyroidism, patients carrying mutations that manifest as impaired sensitivity to TH, and even for normal individuals during aging. Studies using brain organoids generated from hiPSCs of healthy individuals or patients with thyroid genetic conditions provide insights into how TH can impact the early development of the human cerebral cortex. Conclusions: The developmental alterations in children born to mothers with different degrees of gestational hypothyroidism or who developed hypothyroidism early in life are remarkable, affecting multiple brain regions and pathways, including the cerebral cortex, hippocampus, cerebellum, interhemispheric and corticospinal tracts, and associative nuclei. The data connecting such changes to poor neurological outcomes in adult patients with hypothyroidism represent an objective link between thyroid-specific functional brain alterations and behavior. Growing brain organoids require TH, which is critical for human neurogenesis and oligodendrogenesis. These models have proven useful in screening drugs with potential therapeutic effects for patients with genetic thyroid diseases.

The benefits of physical activity for depression

Depression is an affective disorder present throughout human history, characterized by feelings of sadness, pessimism and low self-esteem. Medical care is essential for proper diagnosis and treatment. Estimates suggest that more than 300 million people worldwide suffer from depression, which differs from normal mood fluctuations. When chronic and intense, it can cause great suffering and dysfunction, and can even lead to suicide. With around 800,000 deaths by suicide every year, depression is one of the leading causes of death among young people. Regular physical activity is considered by some scientists to be one of the best antidepressants, bringing a range of benefits for mental and emotional health.

Challenges faced by the family members of bipolar patients: a case study

Support systems can change lives. However, their own lives are filled with burdens and responsibilities. When people go through normal mood swings, it not only affects them but also the ones surrounding them. To help those who are living with someone who is already living with bipolar disorder, it is important to conduct an in-depth analysis of the lives and suffering of family members. Family members or caregivers face numerous uncertainties that could be explored through a qualitative study and how family members deal with such challenges. Family members of four patients were thoroughly interviewed, and their challenges were analyzed under six dimensions—financial burden of the caregivers, disruption of routine family activities, disruption of family leisure, disruption of family interaction, physical health of the caregivers and mental health of the caregivers—by considering the Family Burden Interview Scale developed by Pai and Kapur in 1981. Instances of disruption in family leisure, activities, and interactions were greater than the physical health and financial burdens. Financial burden was more evident in nuclear families living in rural areas. While considering the mental health of the caregivers, most of them mentioned stress due to increased responsibilities.

Gut microbiota: a perspective for bipolar disorders

Psychiatric disorders, notably major depressive disorder and bipolar disorder, stand out as some of the most incapacitating conditions worldwide. Approximately 4.4% of the global population grapples with depression, making it a significant health concern. Bipolar disorder is distinguished by alternating episodes of depression and mania, interspersed with periods of normal mood. The beginning and progression of mental illnesses are becoming more influenced by the gut microbiome. Probiotics stand out as highly promising agents for modulating microbiota and have been studied for their potential to treat a broad range of illnesses, including obesity, type 2 diabetes, cancer, arthritis and mental health issues. This review delves into the connection between bipolar disorders and gut microbiota, elucidates the mechanisms through which probiotic bacteria alleviate bipolar symptoms and examines the potential of incorporating probiotic bacteria as an efficacious element in the therapy of bipolar disorder.

Paeoniflorin exerts anti-PTSD effects in adult rats by modulating hippocampus and amygdala histone acetylation modifications in response to early life stress

Early life stress (ELS) can cause long-term changes by epigenetic factors, especially histone acetylation modification, playing a crucial role, affect normal cognition, mood, and behavior, and increase susceptibility to post-traumatic stress disorder (PTSD) in adulthood. It has been found that paeoniflorin (PF) can cross the blood-brain barrier to exert anti-PTSD effects on adult PTSD rats. However, whether PF can alleviate the harmful effects caused by ELS in adulthood has not yet been reported. Therefore, to explore the relationship between ELS and PTSD susceptibility in adulthood and its mechanism, in this study, SPS was used as a stressor of ELS, and the mathematical tool Z-normalization was employed as an evaluation criterion of behavioral resilience susceptibility. To investigate the regulatory mechanism of PF on histone acetylation in the hippocampus and amygdala of ELS rats in adulthood, using changes in HATs/HDACs as the entry point, meanwhile, the epigenetic marks (H3K9 and H4K12) in the key brain regions of ELS (hippocampus and amygdala) were evaluated, and the effects of PF on behavioral representation and PTSD susceptibility were observed. This study found that ELS lead to a series of PTSD-like behaviors in adulthood and caused imbalance of HATs/HDACs ratio in the hippocampus and amygdala, which confirms that ELS is an important risk factor for the development of PTSD in adulthood. In addition, paeoniflorin may improve ELS-induced PTSD-like behaviors and reduce the susceptibility of ELS rats to develop PTSD in adulthood by modulating the HATs/HDACs ratio in the hippocampus and amygdala.

A randomized, double-blinded, placebo-controlled clinical trial on Lactobacillus-containing cultured milk drink as adjuvant therapy for depression in irritable bowel syndrome

Irritable bowel syndrome (IBS) is frequently linked with coexisting mental illnesses. Our previous study discovered that 32.1% of IBS patients had subthreshold depression (SD), placing them at higher risk of developing major depression. Gut microbiota modulation through psychobiotics was found to influence depression via the gut-brain axis. However, the efficacy of lessening depression among IBS patients remains ambiguous. The study’s aim was to investigate the roles of cultured milk drinks containing 109 cfu Lactobacillus acidophilus LA-5 and Lactobacillus paracasei L. CASEI-01 on depression and related variables among IBS participants with SD. A total of 110 IBS participants with normal mood (NM) and SD, were randomly assigned to one of four intervention groups: IBS-NM with placebo, IBS-NM with probiotic, IBS-SD with placebo, and IBS-SD with probiotic. Each participant was required to consume two bottles of cultured milk every day for a duration of 12 weeks. The following outcomes were assessed: depression risk, quality of life, the severity of IBS, and hormonal changes. The depression scores were significantly reduced in IBS-SD with probiotic and placebo from baseline (p < 0.001). Only IBS-SD with probiotic showed a significant rise in serotonin serum levels (p < 0.05). A significantly higher life quality measures were seen in IBS-SD with probiotic, IBS-SD with placebo, and IBS-NM with placebo (p < 0.05). All groups, both placebo and probiotic, reported significant improvement in IBS severity post-intervention with a higher prevalence of remission and mild IBS (p < 0.05). Dual strains lactobacillus-containing cultured milk drink via its regulation of relevant biomarkers, is a potential anti-depressive prophylactic agent for IBS patients at risk.

Strain in the Midbrain: Impact of Traumatic Brain Injury on the Central Serotonin System.

Traumatic brain injury (TBI) is a pervasive public health crisis that severely impacts the quality of life of affected individuals. Like peripheral forms of trauma, TBI results from extraordinarily heterogeneous environmental forces being imparted on the cranial space, resulting in heterogeneous disease pathologies. This has made therapies for TBI notoriously difficult to develop, and currently, there are no FDA-approved pharmacotherapies specifically for the acute or chronic treatment of TBI. TBI is associated with changes in cognition and can precipitate the onset of debilitating psychiatric disorders like major depressive disorder (MDD), generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD). Complicating these effects of TBI, FDA-approved pharmacotherapies utilized to treat these disorders often fail to reach the desired level of efficacy in the context of neurotrauma. Although a complicated association, decades of work have linked central serotonin (5-HT) neurotransmission as being involved in the etiology of a myriad of neuropsychiatric disorders, including MDD and GAD. 5-HT is a biogenic monoamine neurotransmitter that is highly conserved across scales of biology. Though the majority of 5-HT is isolated to peripheral sites such as the gastrointestinal (GI) tract, 5-HT neurotransmission within the CNS exerts exquisite control over diverse biological functions, including sleep, appetite and respiration, while simultaneously establishing normal mood, perception, and attention. Although several key studies have begun to elucidate how various forms of neurotrauma impact central 5-HT neurotransmission, a full determination of precisely how TBI disrupts the highly regulated dynamics of 5-HT neuron function and/or 5-HT neurotransmission has yet to be conceptually or experimentally resolved. The purpose of the current review is, therefore, to integrate the disparate bodies of 5-HT and TBI research and synthesize insight into how new combinatorial research regarding 5-HT neurotransmission and TBI may offer an informed perspective into the nature of TBI-induced neuropsychiatric complications.

Study of the long-term results of effectiveness of children’s recreation and health improvement in recreation and health improvement organizations

The main form of organized recreation for children, which, according to many authors, has probably the greatest health-improving effect, is considered to be stationary out-of-town organizations. There is great interest in the effect of spending time in recreational organizations on children’s health and evaluation of its possible effects. However, if the assessment of the effects of recreation has been implemented in practice for a long time, there is relatively little information about the long-term effects of recreation in the literature. The purpose of the study is to study the possible long-term effects of recuperation in children who stayed in recreation and health improvement organizations. The data from a survey of 392 schoolchildren from 10 to 17 years old conducted in March 2021 were analyzed. In comparison with children who spent the summer in the city or went to the countryside, the proportion of children who stayed in the camp and did not get colds was higher, while the proportion of those who got sick twice a year or more was lower. Children who stayed in recreation and health improvement organizations indicated themselves to be in a good or normal mood and well-being and to have average or good stress tolerance more often than children who spent their summers in urban areas. According to the results obtained after processing the results by methods of statistical analysis, we can assume that spending time in recreation and health improvement organizations has a positive effect on the immunity, mood and well-being of children not only during their stay, but also several months after it. Due to the high actuality of applying the assessment of the effectiveness of children’s recuperation, the evaluation of the long-term effects of recuperation requires further in-depth research.

Ayurvedic management of Bipolar affective disorder: A case report

Abstract: Bipolar Affective Disorder (BPAD) is a recurrent and chronic disorder that is characterized by episodes of depression and elevated mood with intervening periods of normal mood. This disorder is associated with severely debilitating symptoms that hamper the quality of life of both patients and their caregivers as well. Bipolar disorder typically begins in adolescence or early adulthood and can have life-long adverse effects on the patient’s mental and physical health, educational and occupational functioning, and also on interpersonal relationships. A 25-year-old female presented with primary concerns of frequent speech which was occasionally incoherent, elevated mood, wandering nature, increased social mingling, increased thoughts, increased anger, irritable nature and feeling that her mother is the “devil,” and thoughts of killing her repeatedly coming to her mind for six months. A detailed interview with her parents revealed the presence of similar symptoms and irritable nature most of the time. The observations were made in the level of affective and behavioral domains of BPAD I. In Ayurveda, the condition was diagnosed as Vatikonmada (~Vata predominant insanity) with Pittanubandha (~association of Pitta) based on the clinical symptoms. Shodhana (~purificatory therapies)-based treatment protocols including Virechana (~therapeutic purgation), Snehapana (~internal oleation), Vamana (~therapeutic emesis), Basti (~enema), and Nasya (~medication through nose) followed by Shamana (~palliative procedure) were planned and administered. Psychological supportive measures such as Satvavajaya (~psychotherapy) and Yoga therapy were also sought under the supervision of Manasa roga (~psychiatric disorder) experts and qualified yoga therapists, and the mental status of the patient was assessed using the Young Mania Rating Scale. The case showed considerable relief after the treatment with Shodhana and Shamana based therapies and the psychological supportive measures.

Natural language processing identification of documented mental health symptoms associated with risk of mental health disorders in patients with cancer.

1561 Background: Delayed diagnosis and care of mental health disorders (MHD) is a significant challenge in the care for patients with cancer. The objective of this study was to use natural language processing (NLP) to identify words related to mental health documented in clinical notes surrounding the time of cancer diagnosis and assess their predictive ability of future, new MHD. Methods: This single institution cohort study consisted of patients diagnosed with cancer between January 2012 and November 2022. Cancer and MHD were identified based on ICD-10 codes obtained from deidentified electronic health record data. MHD included psychotic disorders (F20-29), mood disorders (F30-39), and anxiety disorders (F40-48). The clinical Text Analysis Knowledge Extraction System was applied to deidentified clinical notes, and symptoms mapped to SNOMED concepts relevant to mental health were identified. These mental health symptoms were aggregated in the 15 days preceding and 15 days following a first cancer diagnosis and analyzed across MHD status. Patient characteristics including sex, age, race, cancer, and insurance were also analyzed. Results: This cohort consisted of 64,010 patients with cancer who had no documented MHD prior to cancer diagnosis, with a majority being 40-64 years old (45.8%) or 65+ (43.7%) and identifying as male (53.0%) or white (60.2%). Most patients had prostate (12.5%), hematologic (10.8%), or breast (10.3%) cancer and private insurance (46.2%). 9,825 (15.3%) patients developed a newly documented MHD, with a median time of 139 days (IQR: 40-466) from cancer diagnosis. The top five most common mental health documented symptoms for all patients were normal mood (23.3%), mental state finding (17.9%), worried (10.2%), feeling content (9.9%), and cognitive function finding (6.6%). Those who had a future MHD had higher documented rates across all mental health symptoms. Multivariate cox proportional hazards model identified 18-39 years old, female, white, and Medicaid or Medicare insurance as independent factors associated with an increased risk of a future, new MHD. Prostate cancer was associated with lower risk of a future MHD. Panic (OR 2.1 [95% CI 1.8-2.4]), feeling nervous (1.9 [1.5-2.4]), feeling guilt (1.9 [1.4-2.5]), mild anxiety (1.8 [1.4-2.4]), and feeling frustrated (1.4 [1.2-1.6]) were identified as the symptoms most strongly associated with an increased risk of a future MHD. Conclusions: NLP extracted mental health symptoms documented in clinical notes correlated with an increased risk of documented MHD. Computational approaches may be tools for improving the timely diagnosis of MHD and referral to specialty services. Further work is needed to investigate potential disparities in documentation and management of care for patients with cancer who develop MHD, including delays between documentation and eventual diagnosis.

Efficacy of Kinematic Therapy on Mood Disorders, Functional Independence Recovery and Quality of Life of Stroke Survivors

Background and Aims: Mood disorders impact negatively on rehabilitation process and outcomes in stroke survivors (SSv). This study determined efficacy of Kinematic Therapy (KT) on depression, anxiety, functional independence (FI) and QoL of SSv. Methodology: Study involved 940 ambulant SSv recruited from eight health institutions in Lagos, Nigeria and were assessed for depression, anxiety, QoL and FI using Becks Depression Inventory, Becks Anxiety Inventory, Stroke-Specific-QoL questionnaire and FI Measure respectively. They were randomised into KT and Common Physiotherapy (CP) groups. The KT received 25minutes of kinematic therapy while the CP received usual physiotherapy, twice weekly for 6weeks. Results: Six hundred and seventy-four (343males) of the 940 SSv were diagnosed of depression and/or anxiety and participated in this study; 341(50.59%) were in KT while 333 were in SP. More (81.23%) of KT had mild mood disturbance before intervention while 92.36% of them had normal mood after. More (83.18%) of SP had borderline mood disorder before intervention while 84.69% had normal mood after. There was significant (p&lt;0.05) improvement in depression, anxiety, QoL and FI except in language, personality, family role, self care, social role, thinking and upper-limb function in SP. The KT had significantly better improvement all the outcomes than SP. There was negative significant relationship (p&lt;0.05) between depression and anxiety, and FI and QoL. There was positive significant relationship (p&lt;0.05) between FI and QoL except in vision domain. Conclusion: Mood disorders is common in stroke survivors. Kinematic Therapy is more effective in managing depression and anxiety symptoms and improving functional independent recovery and quality of life than conventional physiotherapy in stroke survivors.

547: CEREBRAL EDEMA IN MOG ANTIBODY DISEASE TREATED WITH INVASIVE MULTIMODAL NEUROMONITORING

Introduction: Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a neuroinflammatory disorder with a range of clinical phenotypes. MOGAD is typically steroid-responsive, with more refractory cases receiving intravenous immunoglobulin (IVIG) or plasmapheresis. Invasive multimodal neuromonitoring provides real-time measurements of intracranial pressure (ICP) and brain tissue oxygenation (PbtO2) and may be accomplished via insertion of an intraparenchymal probe, also known as a “bolt”. It is becoming an important strategy in the management of patients with traumatic brain injury but is less well described in other acute neurological conditions associated with increased ICP. We describe a case of MOGAD in a child that presented as life-threatening cerebral edema, in which invasive multimodal neuromonitoring with ICP- and PbtO2-directed therapy was employed. This child ultimately survived with some persistent neurological deficits but with normal mood and affect and the ability to eat, drink, and ambulate independently. Description: A 7-year old boy presented with headaches, nausea and somnolence and was found to have increased ICP of unclear etiology. He then progressed to develop exam findings consistent with herniation. He received emergent medical therapies including hypertonic (3%) saline, hyperventilation, and sedation. A bolt was placed for invasive neuromonitoring, which guided treatment based on real-time measurements of ICP and PbtO2. Workup for the etiology of his severe cerebral edema revealed serum MOG antibodies. He received immunomodulatory therapies including steroids, plasmapheresis, and tocilizumab. He was discharged two months later with expressive and receptive aphasia and mild gait imbalance, but with recovered bowel and bladder continence, independent ambulation, and the ability to eat, drink, and interact socially with a normal mood and affect. Discussion: We describe a child who presented with cerebral edema and herniation due to MOGAD. He was managed with invasive multimodal neuromonitoring in addition to standard immunomodulatory treatments and had a favorable outcome. While further data is needed, invasive multimodal neuromonitoring may have utility as an adjunct to standard therapy in children with MOGAD and severe cerebral edema.

Investigation on Depression of College Students Majoring in Physical Education and Nonphysical Education: A StudyBased on the Age Region and Gender of 374 Students.

In the research on the relationship between depression and college students' major, there are some differences in the degree of depression between sports major and nonsports major students. Based on these results, we assume that there is the possibility of emotional differences between professional and nonprofessional sports. A total of 374 samples of students majoring in physical education and nonphysical education at the same university were analyzed by using the methods of literature review and data analysis. A total of 188 subjects, including 121 males and 253 females (186 majoring in sports and nonsports), were asked to fill in the SDS (Self-Rating Depression Scale). SDS is widely used in rough screening, emotional state evaluation, investigation, and scientific research of outpatients in clinical psychology departments. The research obtained the difference in depression degree in the whole sample and further compared the depression degree of students of different ages and native places. Statistical analysis was performed on all data using SPSS 23.0 software. Basic data description, paired chi-square analysis, and covariance analysis were used. The results show that in this sample, the maximum value (minimum/maximum value) of one item of the total depression score of nonphysical education students exceeds the average value by 3 standard deviations, and this shows that the general level of depression scores of non-PE majors is high; most non-PE majors are in mild depression, which is equal to the number of PE majors who are in a normal mood; and nonsports majors in cities are more likely to have mild depression.

The feasibility and effectiveness of virtual reality meditation on reducing chronic pain for older adults with knee osteoarthritis.

There is an urgent need for safe and effective nonpharmacologic approaches to treat chronic knee pain in older adults. Although virtual reality (VR) has shown some effectiveness for acute pain, there is limited evidence on the effects of VR on chronic pain particularly with older adult populations. This single application, within-subject pilot study evaluated the feasibility and effectiveness of VR as a clinical treatment for older adults with chronic osteoarthritis knee pain. Nineteen participants aged 60+ years old participated in a 10-min VR meditation program. Data on pain and affect were collected immediately prior to, post, and 24-48 h after the VR. Results suggest that VR meditation had significant moderate to large analgesic effects on knee pain intensity, primarily during VR (d=1.10) and post VR (d=0.99), with some lasting effects into next day (d=0.58). The findings also suggest VR meditation intervention had a positive effect on affect, with a significant large decrease in negative affect scores pre- to post-VR (d=1.14). The significant moderate to large decreases in pain interference for normal work (d=0.71), mood (d=0.53), sleep (d=0.67), and enjoyment of life (d=0.72) suggest that older adults may have a higher ability to participate in meaningful daily activities up to 24-48 h after VR meditation. VR appears to be a feasible and effective nonpharmacological tool for older adults to treat chronic overall and knee-specific pain.

Coaction of Exercise and Eating Improvements Within a Behavioral Obesity Treatment: Directionality and Psychological Mechanisms

ABSTRACT Purpose: Because coaction (a favorable change in one behavior increasing the probability of a similarly favorable change in another behavior) associated with health behaviors has been identified, directionalities of such relationships within weight-loss behaviors (e.g., exercise, healthy eating) and their theory-based psychological mechanisms requires more investigation. Method: Women with obesity and either disturbed mood (n = 61) or normal mood (n = 58) participated in a cogntive-behavioral weight-management treatment within a community setting. Analyses of both group differences, and mediation models using aggregate data of behavioral and psychological variables, were conducted. Results: Improvements in measures of self-regulation, self-efficacy, mood, exercise, and fruit/vegetable intake were significant overall; with fruit/vegetable increase greater in the disturbed mood group. The prediction of increase in fruits/vegetables from baseline-Month 6 by increase in exercise from bascline-Month 3 (β = .24) was stronger than effects of change in fruit/vegetabe intake on exercise (β = .16). Overall mediation models were significant where changes in self-regulation and self-efficacy were entered as serial mediators of predictions of fruit/vegetable change by change in exercise (R 2= .35 and .32), and vice versa (R 2= .24 and .23). Paths demonstrating effects through self-regulation change and self-efficacy change were significant in the prediction of eating and exercise changes, respectively. Conclusion: Contributions to advancements in behavioral theory and treatment curricula targeting self-regulation and self-efficacy to improve exercse-eating change relationships were suggested.

Depression is associated with worse outcome after percutaneous endoscopic lumbar discectomy: a 5-year follow-up study

ABSTRACT This study aimed to investigate the relationship between depression and outcome of percutaneous endoscopic lumbar discectomy (PELD) in patients with lumbar disc herniation. We examined 268 patients who underwent PELD for lumbar disc herniation and were followed for five years. Patients were grouped according to mood: normal mood (159 patients) and continuous depression (109 patients). Depressive symptoms were assessed using the 21-item Beck Depression Inventory. Back and leg pain were assessed using the visual analogue scale. Subjective disability was measured using the Oswestry Disability Index. Neurological function and physical disability were assessed using the Japanese Orthopaedic Association score. Disc-height ratio and intervertebral instability were measured to assess lumbar stability. Clinical and radiological data were recorded before surgery and at the 3-month, 6-month, 1-year, 2-year, and 5-year follow-ups. Although the Japanese Orthopaedic Association, visual analogue scale, and Oswestry Disability Index scores did not significantly differ between groups before surgery, all three scores significantly differed between groups at all follow-up time points after PELD (p < 0.05). Measurements of disc-height ratio and intervertebral instability did not significantly differ between the groups before surgery nor at any point after surgery (P > 0.05). Patients with continuous depression exhibited less improvement in symptom severity and disability score after PELD at all time points in the five years after surgery. Depression had little effect on lumbar vertebral stability after PELD. Interventions to detect and treat depression should be performed before and after surgery.

Психические состояния и креативность субъекта в дидактической VR-среде различной иммерсивности

This article examines the changes in mental states and personality creativity when working with short-term virtual reality. This is part of comprehensive research on personality (and mental in general) changes in didactic and training VR programs. The first part of the work was aimed at examining the influence of modern didactic programs in virtual reality (VR) on mental states in adolescence. The materials of empirical research obtained on a sample of 1—2-year students of the Moscow State University of Psychology and Education and SmolSU are presented. In study 1 (N = 73) (with a highly immersive VR program) and 2 (N = 46) (using a didactic VR environment of low immersion), respondents aged 19 to 26 took part. We used the «Actual state» methodology by L.V. Kulikova, «Assessment of Mood», didactic VR programs are used as instructive independent variables. The results obtained indicate that the didactic VR environment of the highest level may has a significant effect on mental states, increasing indicators on the scales of activation, excitement, tone, euphoria, and reducing asthenia indicators. Conditions such as well-being, normal mood, calmness remain stable in immersive didactic VR. In the control sample, in a less immersive VR-environment, statistically significant changes in indicators — tone, excitement, well-being were not revealed. The second part of the research, which examines the effect of higher-level VR programs on creativity, was carried out using a similar mixed factorial design with one independent variable. Johnson’s questionnaire, Torrance and Rorschach tests were used to diagnose creativity. In the experimental group (with vive helmets), in the parameters of all three tests, significant differences were diagnosed according to the Wilcoxon criterion of no less than 95%. In the control group, where the subjects worked with the same program («Surfaces of the second order») on ordinary monitors, the significance of the changes was confirmed by the method of Johnson and Torrance by the Wilcoxon test, by the G test «in Torrance», the changes were not reliable, by «Rorschach», by the two criteria, the changes were not reliable. In general, the results showed that the higher immersiveness of even short didactic VR programs promotes greater changes in creativity. The effectiveness of VR programs in influencing mental states and creativity is determined by the successful modeling of 3D objects, high animation, interactivity, originally incorporated into the content of higher level VR. Changes in creativity in VR, along with changes in cognitive processes, personal parameters (motivation, abilities, focus, consciousness), mental states are considered as an indicator of the presence and specificity of VR ontology.

Abstract- Poster

Background:Neuroendocrine tumors (NETs) were rare tumors, however due to the wide spread use of endoscopy they are being identified more. Carcinoid syndrome (CS) is the clinical expression for serotonin-producing NETs. Caution is exercised on SSRI use as adverse effects of SSRIs could overlap and exacerbate symptoms of CS.Case Report:A 52 year old lady, with family history of suicide and dementia was referred to Psychiatry for anxiety and sleep disturbances. She was premorbidly well-adjusted and had been having multiple stressors over 2 years. She had 9 months history of dyspeptic symptoms, aches and pains, palpitations, hot flushes, abdominal discomfort, headache, insomnia, anxiety and low mood. She was diagnosed to have Gastric Neuroendocrine tumour Type 1 with DOTATE PET showing the tumour to be dormant, with no other synchronous tumours or metastases. No active intervention was required. The Urine spot 5HIAA was negative. She was referred to psychiatry for the management of anxiety. Her HAM-A score was 39 and BDI score was 26. She was treated with Tab. Propranolol 10 mg BD for 2 weeks after which her HAM- A score reduced to 23 but the depressive symptoms persisted. Tab. Mirtazapine was initiated and after a month she reported normal mood (BDI -3) and no anxiety (HAM – A -1).Discussion:Neuroendocrine Tumor can be functioning or non-functioning tumors. NETs have potential to synthesize multiple metabolically active substances including Serotonin. This case highlights the need for evaluating the functional status of the Neuroendocrine Tumor before treating with SSRIs.