Significant Improvement In Depression Scores Research Articles

Abstract 7462: Interventional dietary saffron drives antitumor immunity inInterventional dietary saffron drives antitumor immunity in high risk colorectal cancer IBD Patients, A Multisite Clinical Trial Study

Abstract Background: Inflammatory polyps in patients with Inflammatory Bowel Disease (IBD) pose a significant risk for colorectal cancer (CRC). Dietary interventions targeting anti-tumor immunity are crucial in mitigating this risk. Aim: We investigated saffron's anti-inflammatory effects in IBD patients due to the high prevalence of polyps, aiming to prevent CRC. Methods: The study retrospectively evaluated 485 colitis patients (70 IBD, 415 NIC) from Howard University Hospital, through colonoscopy, pathology, and clinical reports evaluations. At Howard University, three UC patients received 50mg of saffron twice daily for 8 weeks, with two cycles. Inflammatory markers, stool calprotectin, and cytokines were assessed. Similar saffron trials were conducted at Yazd University (30 UC patients) and Egypt University (11 UC patients). Results: Patients with inflammatory bowel disease (IBD) were found to have a 15.7% prevalence of polyps compared to 8.2% in Non-inflammatory colitis patients. Among IBD patients, those with ulcerative colitis had more polyps (27%) than those with Crohn's disease (5%). In a multisite clinical trial, Saffron treatment improved various health indicators, including Partial MayoScore and quality of life. In the study (HU site), pro-inflammatory cytokines decreased, anti-inflammatory markers increased, and fecal calprotectin levels dropped significantly after saffron treatment. Saffron also led to changes in gut bacteria composition. Importantly, no adverse events were reported in the study participants. In one group of patients (Yazd study), saffron treatment led to significant improvements in depression scores, disease severity, and inflammation markers. In another site (Egypt study), 50% of saffron-treated patients showed improvement in markers related to disease severity, inflammation, and quality of life. Conclusion: Saffron supplementation, alongside standard treatments, shows promise in reducing local and systemic inflammation in IBD patients and may reduce the risk of developing inflammatory polyps and hence CRC. This safe and feasible intervention warrants further exploration as an inflammation-driven CRC preventive strategy. Citation Format: Hassan Ashktorab, Roham Salmanroghani, Hassan Salmanroghani, Reza Oskrochi, Mudasir Rashid, Adeyinka Laiyemo, Suryanarayana Reddy Challa, Philip Oppong-Twene, Nasrin Farjana, Angesom Kibreab, Holden Maeker, Amr Amin, Amal Ahmed Mohamed, Amr Elsayed, Zaki Mohamed Zaki, Omima Mohamed, Alshymaa Hassnine, Salma Saed, Soha Hassanin, Farshad Aduli, Lakshmi Gayathri Chirumamilla, Hassan Brim. Interventional dietary saffron drives antitumor immunity inInterventional dietary saffron drives antitumor immunity in high risk colorectal cancer IBD Patients, A Multisite Clinical Trial Study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 7462.

Evaluating cognitive behavioral therapy as a solution for postnatal depression in economically disadvantaged regions.

Postnatal depression (PND) impacts numerous women after childbirth, leading to various impairments in their lives. Mental health interventions, such as cognitive behavioral therapy (CBT), need further evaluation in low- and middle-income countries (LMICs) where resources may be scarce. This study aimed to assess the effectiveness of CBT in treating PND in women from LMICs, comparing it to standard care. A systematic review and meta-analysis were conducted following the PRISMA Statement 2020 guidelines. Databases such as PubMed, CINAHL Plus, Cochrane Library, and PsycINFO were searched until September 2022. A modified Delphi process was employed to identify relevant studies. The primary outcome was mean depression scores, measured by the Edinburgh postnatal depression scale at baseline and post-intervention. Out of 487 studies identified, five trials were included, totaling 1056 participants (520 in the intervention group and 536 in the comparator group). At baseline, a minor, insignificant positive effect size was found (Cohen's d = 0.1, 95% CI = - 0.15, 0.35). Post-CBT, the intervention group showed significant improvements in depression scores (Cohen's d = - 1.9, 95% CI = - 3.8, 0). When accounting for the influence of one study, (Ngai et al., Psychother Psychosom 84:294-303, 2015), which held substantial weight in the initial analysis, the effect size was adjusted to d = 0.5, highlighting a lesser but still significant difference. CBT appears to be effective in improving PND symptoms among women in LMICs and may be considered a first-line treatment for at-risk mothers, including those who are displaced. However, the significant impact of one study on the results emphasizes the need for more rigorous research. The study also highlights the challenges and limitations of providing psychotherapies across LMICs, emphasizing the need for culturally adapted and contextually appropriate interventions to ensure successful implementation and sustainability of mental health care for postnatal women in these settings.

Access for Cancer Caregivers to Education and Support for Shared Decision Making (ACCESS) intervention: a cluster cross-over randomised clinical trial

ObjectivesThe purpose of this study was to test an intervention named ACCESS (Access for Cancer Caregivers to Education and Support for Shared Decision Making). The intervention uses private Facebook support...

Impact of Treating Depression on Associated Comorbidities: A Systematic Literature Review.

Objective: To identify and summarize data that describe the impact of effectively treating major depressive disorder (MDD) on the severity or risk of serious comorbidities.Data Sources: MEDLINE, Embase, PsycINFO, Cochrane Database of Systematic Reviews, and several congresses were searched. Searches included terms related to MDD, randomized controlled trials (RCTs), and physical comorbidities and were restricted to English-language publications. Searches were conducted in November 2019 for the previous 2 years for conference proceedings; no date restriction was applied to the database searches.Study Selection: Included studies were RCTs or meta-analyses that assessed depression therapies. Studies were required to report a statistically significant improvement in depression scores as well as the concurrent impact on comorbidities. A total of 1,997 articles were initially identified for screening.Data Extraction: Two investigators extracted data and assessed study quality.Results: A total of 30 studies, including 24 RCTs (N = 6,333) and 6 meta/pooled analyses of RCTs, were included. Findings in several comorbidity categories were mixed; for example, in half (4 of 8) of the identified studies in people with cardiovascular disease and depression, individuals who received treatment leading to reduced depressive symptoms compared with a control arm also had a significantly decreased incidence of cardiovascular events or significantly improved cardiac disease symptom/severity scores compared with controls. Significant improvements in comorbid disease severity observed alongside improvements in depressive symptoms were also noted in studies of comorbid Parkinson's disease, multiple sclerosis, chronic pain and fibromyalgia, and chronic obstructive pulmonary disease.Conclusions: Effective treatment of MDD may lead to a reduction in the severity of certain serious comorbidities. These results highlight the importance of appropriate and timely treatment of MDD.

Isolating together during COVID-19: Results from the Telehealth Intervention Program for older adults.

BackgroundA pressing challenge during the COVID-19 pandemic and beyond is to provide accessible and scalable mental health support to isolated older adults in the community. The Telehealth Intervention Program for Older Adults (TIP-OA) is a large-scale, volunteer-based, friendly telephone support program designed to address this unmet need.MethodsA prospective cohort study of 112 TIP-OA participants aged ≥60 years old was conducted in Quebec, Canada (October 2020–June 2021). The intervention consisted of weekly friendly phone calls from trained volunteers. The primary outcome measures included changes in scores of stress, depression, anxiety, and fear surrounding COVID-19, assessed at baseline, 4 and 8-weeks. Additional subgroup analyses were performed with participants with higher baseline scores.ResultsThe subgroup of participants with higher baseline depression scores (PHQ9 ≥10) had significant improvements in depression scores over the 8-week period measured [mean change score = −2.27 (±4.76), 95%CI (−3.719, −0.827), p = 0.003]. Similarly, participants with higher baseline anxiety scores (GAD7 ≥10) had an improvement over the same period, which, approached significance (p = 0.06). Moreover, despite peaks in the pandemic and related stressors, our study found no significant (p ≥ 0.09) increase in stress, depression, anxiety or fear of COVID-19 scores.DiscussionThis scalable, volunteer-based, friendly telephone intervention program was associated with decreased scores of depression and anxiety in older adults who reported higher scores at baseline (PHQ 9 ≥10 and GAD7 ≥10).

Metformin's reversal of insulin resistance improves outcomes in bipolar disorder

Patients with treatment‐resistant bipolar depression and insulin resistance who received metformin over 26 weeks and experienced reversal of insulin resistance saw significant improvement in depressive symptoms compared with those not experiencing reversal, a placebo‐controlled trial has found. Significant improvement in depression scores in the group of metformin converters was apparent by week 6 of treatment.

Efficacy of Prenatal Yoga in the Treatment of Depression and Anxiety during Pregnancy: A Systematic Review and Meta-Analysis.

Women commonly suffer from depression during pregnancy. For reducing depression, yoga seems to be more suitable for pregnant women than other physical activities because of its low exercise intensity. The objective of this study was to assess the efficacy of prenatal yoga on the treatment of depression during pregnancy. Three electronic databases were searched for relevant articles from their inception to May 2021, including PubMed, Cochrane Library, and ScienceDirect. Pre- and post-test outcomes were adopted to estimate standardized mean difference with a 95% confidence interval for assessing the efficacy of yoga. Heterogeneity among articles was detected using I2 value. A total of 13 articles that contained 379 subjects were included for meta-analysis. No significant improvement in depression scores after practicing yoga was observed for women without depression (p = 0.09) but significant improvement was observed for women with depression (p = 0.001). Although significant improvement in anxiety scores after yoga was observed for women without depression (p = 0.02), the results of the sensitivity analysis were not consistent, while significant improvement in anxiety scores after yoga was also observed for women with depression (p < 0.00001). The current evidence has suggested that yoga had significant improvement in depression and anxiety scores in pregnant women with depression. However, the level of evidence of this study was not high. More articles with high levels of evidence should be conducted to confirm our conclusion in the future.

Meta-Analysis of Positive Psychology Interventions on the Treatment of Depression.

This meta-analysis examined the efficacy of positive psychology interventions (PPIs) in treating depression in 11 articles. PubMed, Web of Science, and Clinical Key were used to identify papers published from 2010 to 2020 that utilized PPIs. Key terms were “positive psychology” and “treatment of depression.” Studies on adults with (a) depressive symptoms or (b) diagnosed clinical depression were included. A random-effects model was used to compare PPIs and control groups on post- vs. pre-intervention differences in depression scores. Data analysis examined Beck Depression Inventory-II (BDI-II), Center for Epidemiologic Studies Depression Scale (CES-D), and Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR16) scores. Findings show PPIs are effective in treating depressive symptoms, with significant improvements in depression scores when compared to control groups in all but one study. This was true for both post- vs. pre-intervention (pooled Cohen’s d = −0.44 (−0.77, −0.11)) and follow-up- vs. pre-intervention analyses (pooled Cohen’s d = −0.46 (−1.02, 0.09)). PPIs can improve the accessibility and affordability of depression treatments.

Depression Is Transiently Increased in Patients Undergoing Two-Stage Revision Arthroplasty.

BackgroundThe implications of two-stage revision on mental health are poorly understood. The purpose of this study is to determine (1) whether patients undergoing two-stage revision total hip and knee arthroplasty for prosthetic joint infection were more likely to get Patient-Reported Outcomes Measurement Information System (PROMIS) Depression scores consistent with major depressive disorder (MDD) than those undergoing aseptic revision and (2) whether these symptoms resolved after the procedure.MethodsRecords of all 366 patients that underwent revision total hip or knee arthroplasty from January 1, 2015, – June 20, 2019, were reviewed. Forty-two patients were excluded for missing PROMIS Depression scores or incomplete treatment. Preoperative (<3 months), early postoperative (2-8 weeks), and final postoperative (6-18 months) Depression scores were collected. Patients crossing the PROMIS Depression threshold equivalent to a Patient Health Questionnaire-9 score ≥10, indicative of MDD, were evaluated.ResultsMore two-stage revision patients developed Depression scores indicative of MDD perioperatively than the aseptic cohort (20.0% vs 6.5%, P = .01). Two-stage revision patients had higher (worse) median Depression scores preoperatively (54.8 vs 51.3, P = .04) and at early follow-up (54.3 vs 49.9, P = .01), but not at final follow-up (50.4 vs 49.1, P = .39). Across all patients, Depression scores improved by 2.4 points at early follow-up (95% confidence interval:1.1–3.7; P < .001) and 3 points at final follow-up (95% confidence interval:1.5-4.5; P < .001; minimal clinically important difference 3.0).ConclusionsTwenty percent of two-stage revision arthroplasty patients, compared to <7% of aseptic revision patients, developed PROMIS Depression scores consistent with MDD during treatment. At final follow-up, a clinically significant improvement in Depression scores from baseline was evident in both cohorts.

A Systematic Review and Meta-Analysis of Randomized Sham-Controlled Trials of Repetitive Transcranial Magnetic Stimulation for Bipolar Disorder.

Repetitive transcranial magnetic stimulation (rTMS) is effective in treating unipolar depression. However, the efficacy of rTMS in bipolar disorder (BD) is unclear. This meta-analysis aimed to examine the efficacy and tolerability of rTMS for both depressive and manic phases in BD. MEDLINE, EMBASE, PsycINFO, CENTRAL databases were searched for controlled trials on treatment of BD with rTMS. Primary outcomes included changes in depression or mania scores, response and remission rates. Secondary outcomes included quality of life and functioning assessment. We used random-effects model, Hedge's g, risk differences (RDs) and the number needed to treat (NNT). Eleven randomized sham-controlled studies were included, with a total of 345 patients with BD (bipolar depression = 257, mania = 86, mixed affective = 2). Trials of rTMS in bipolar depression (N= 8) demonstrated small but significant improvement in depression scores [standardized mean difference = 0.302, p< 0.05], compared to control group. Furthermore, rTMS brought a higher remission rate than sham-controls [RD = 0.104 ± 0.044, p< 0.05, NNT = 10; and a trend of greater response rate [RD = 0.074 ± 0.039, p= 0.06]. Results were inconclusive for effect of rTMS in mania. In both depressive and manic groups, no serious adverse events were reported. Risk of treatment-emergent mania appeared low. There was limited number of eligible primary studies, with variable randomization procedures. rTMS appears safe and effective in treating bipolar depression. More stringent RCTs are necessary for concrete conclusion about efficacy in mania.

P185 MULTI-MODAL PREHABILITATION DURING NEOADJUVANT THERAPY PRIOR TO RESECTION FOR OESOPHAGOGASTRIC CANCER: A PILOT RANDOMISED CONTROLLED TRIAL

Abstract Aim We aimed to assess the effect of prehabilitation on cardiopulmonary exercise test (CPET) performance in patients undergoing neoadjuvant chemotherapy (NAC) for oesophagogastric (OG) cancer. Background &amp; Methods NAC reduces fitness as assessed by CPET1 and induces skeletal muscle loss (sarcopenia)2,3. Both are associated with poorer post-operative outcomes. A parallel-arm RCT was conducted (December 2016 to November 2018), with randomisation to receive a 15-week multi-modal prehabilitation programme (Prehab) or standard-care (Control). Prehab comprised twice-weekly supervised and thrice-weekly home exercise sessions, Medical Coaching, and tailored dietetic input. CPET was performed before and after NAC, and 1 week pre-operatively. On staging and re-staging CT, skeletal muscle cross-sectional area at L3 was analysed by a blinded investigator. Becks’ Depression Inventory questionnaires were completed pre- and post-surgery. Results Groups (Prehab n=25, Control n=28) were matched at baseline. Supervised and home exercise programme compliance was 76%, and 65% respectively, with no adverse events. Prehab resulted in an improvement in peak VO2 following NAC (Prehab +31.50ml/min/m2 vs Control -89.57 ml/min/m2; p=0.004) with a trend towards lesser reduction in anaerobic threshold (Prehab -0.87ml/kg/min vs Control -1.44ml/kg/min; p=0.342). A higher proportion of controls required NAC deferral or dose reduction (Prehab 16% (4/25) vs Control 43% (12/28); p=0.041), with 72% (Prehab) and 46% (Control) completing all cycles at full dose (p=0.076). There was no difference in chemotherapy-related toxicity. The Prehab group demonstrated less skeletal muscle loss following NAC (Prehab -11.62 vs Control -15.61; p=0.049). Controls showed a trend towards more sarcopenia development after NAC (Prehab: Pre-NAC 37% (9/24) and post-NAC 54% (13/24) vs Control: Pre-NAC 32% (9/28) and post-NAC 64% 18/28) (p=0.404). Prehab subjects had a significant improvement in depression scores following NAC (Prehab -2.71 vs Control +0.57; p=0.003). There was a trend towards shorter median length of stay in the Prehab group (Prehab 11 vs Control 16 days; p=0.155) and lower complication rates (Prehab 50% (11/22) vs Control 74% (17/23); p=0.89). Conclusion Multi-modal prehabilitation is safe and feasible in OG patients receiving NAC. Despite the effects of NAC, prehabilitation produced a significant improvement in peak VO2, depression scores and less skeletal muscle loss, with a trend towards improved clinical outcomes. This warrants further investigation.

Controlled trial of the impact of a BC adult mental health practice support program (AMHPSP) on primary health care professionals\u2019 management of depression

BackgroundDepression affects over 400 million people globally. The majority are seen in primary care. Barriers in providing adequate care are not solely related to physicians’ knowledge/skills deficits, but also time constraints, lack of confidence/avoidance, which need to be addressed in mental health-care redesign. We hypothesized that family physician (FP) training in the Adult Mental Health Practice Support Program (AMHPSP) would lead to greater improvements in patient depressive symptom ratings (a priori primary outcome) compared to treatment as usual.MethodsFrom October 2013 to May 2015, in a controlled trial 77 FP practices were stratified on the total number of physicians/practice as well as urban/rural setting, and randomized to the British Columbia AMHPSP⎯a multi-component contact-based training to enhance FPs’ comfort/skills in treating mild-moderate depression (intervention), or no training (control) by an investigator not operationally involved in the trial. FPs with a valid license to practice in NS were eligible. FPs from both groups were asked to identify 3–4 consecutive patients > 18 years old, diagnosis of depression, Patient Health Questionnaire (PHQ-9) score ≥ 10, able to read English, intact cognitive functioning. Exclusion criteria: antidepressants within 5 weeks and psychotherapy within 3 months of enrollment, and clinically judged urgent/emergent medical/psychiatric condition. Patients were assigned to the same arm as their physician. Thirty-six practices recruited patients (intervention n = 23; control n = 13). The study was prematurely terminated at 6 months of enrollment start-date due to concomitant primary health-care transformation by health-system leaders which resulted in increased in-office demands, and recruitment failure. We used the PHQ-9 to assess between-group differences at baseline, 1, 2, 3, and 6 months follow-up. Outcome collectors and assessors were blind to group assignment.ResultsOne hundred-and-twenty-nine patients (intervention n = 72; control n = 57) were analysed. A significant improvement in depression scores among intervention group patients emerged between 3 and 6 months, time by treatment interaction, likelihood ratio test (LR) chi2(3) = 7.96, p = .047.ConclusionsThis novel skill-based program shows promise in translating increased FP comfort and skills managing depressed patients into improved patient clinical outcomes⎯even in absence of mental health specialists availability.Trial registration#NCT01975948.

Tibolone improves depression in women through the menopause transition: A double-blind randomized controlled trial of adjunctive tibolone

BackgroundMany women with no past psychiatric history experience severe mood symptoms for the first time in their life during the menopausal transition, with debilitating long-term consequences. Women with a history of depression can experience a relapse or worsening of symptoms during the menopause transition. Traditional antidepressants, SSRIs or SNRIs, are commonly prescribed as the first line response. However, such treatment has shown only small improvements with side effects. Hormone therapies directly targeting the perimenopausal fluctuations in reproductive hormonal systems such as tibolone, have significant potential to treat perimenopausal depression. Our study investigated the use of adjunctive tibolone, selective tissue estrogenic activity regulator, to treat de-novo or relapsing depression occurring during the menopause transition period. MethodsWomen who were going through the menopause transition with depressive symptoms were invited to participate in a double-blind, 12 week randomized control trial with two arms: tibolone (2.5 mg oral/day) or oral placebo (NCT01470092). Forty-four women met inclusion/exclusion criteria; 22 were randomized to tibolone and 22 were randomized to oral placebo. Symptoms were measured with the ‘Montgomery- Asberg depression rating scale’ (MADRS) as the primary outcome measure. Latent growth curve analysis was used to assess the MADRS scores change over time. ResultsParticipants in the tibolone group demonstrated a significant improvement in depression scores, as compared to the placebo group, without any significant side effects. LimitationsThis trial only monitored tibolone's effects over 12 weeks. Future research should be conducted over an extended timeframe and explore whether the benefits of tibolone extend to other symptoms of perimenopausal depression. ConclusionsThe use of hormone therapies such as tibolone provide exciting innovations for the treatment of depression during the menopause transition.

Systematic meta-analysis of pharmacological and psychological interventions for the treatment of anxiety in patients with chronic obstructive pulmonary disease

Rates of anxiety symptoms in patients with COPD range from 13% to 51%, which is higher than rates for patients with other chronic diseases, yet evidence underpinning the effectiveness of the various treatment options is lacking. The aim of this review was to assess the efficacy and safety of both pharmacological and psychological interventions for the management of anxiety in COPD. We searched two Cochrane Specialised Registers of Cochrane Airways group and Cochrane Col-laboration of Depression, Anxiety and Neurosis with complementary screening of Medline, PsycINFO and CENTRAL. Reference lists of included studies and online clinical trial registries were also explored. Randomised controlled trials (RCTs) and cross-over studies of pharmacological or psychological interventions for patients (age >40 years) with diagnosed COPD and co-existing anxi-ety (confirmed by recognised diagnostic criteria or validated measurement scale) were identified for inclusion. Data was extracted by two independent review authors with meta-analyses of outcomes performed using the random-effect model using Review Manager Version 5.3. A total of 1,792 citations resulted in nine included studies (five pharmacological and four psycho-logical). Meta-analysis of these studies revealed significant reductions in anxiety symptoms, both with and without adjusting for heterogeneity, in the treatment arm (mean difference -2.84; 95%CI - 4.42 to -1.26; p=0.0004, standardised mean difference -0.44; 95% CI -0.74 to -0.14; p=0.004) with the psychological studies producing greater treatment efficacy (p=0.005 for MD and p=0.02 for SMD) over pharmacological (p=0.10 for MD and p=0.20 for SMD) within sub-group analysis. Sig-nificant improvement in depression scores was noted (p=0.03), mainly driven by psychological in-terventions. A trend in favour of the intervention was found for the physical composite of quality of life measured by St George’s Respiratory Questionnaire (standardised mean difference -0.36; 95%CI -0.74 to 0.02; p=0.06; 3 studies), but not for other measures of quality of life. No evidence of any effect was found for exercise capacity or FEV1. Psychological therapies appear to be more effective than pharmacological interventions, which have little or no effect to reduce anxiety in COPD pa-tients. However, poor methodological quality and small sample size of studies investigating pharma-cotherapy may be contributing to this discrepancy.

Mindfulness and its efficacy for psychological and biological responses in women with breast cancer.

Many breast cancer survivors have to deal with a variety of psychological and physiological sequelae including impaired immune responses. The primary purpose of this randomized controlled trial was to determine the efficacy of a mindfulness‐based stress reduction (MBSR) intervention for mood disorders in women with breast cancer. Secondary outcomes were symptom experience, health status, coping capacity, mindfulness, posttraumatic growth, and immune status. This RTC assigned 166 women with breast cancer to one of three groups: MBSR (8 weekly group sessions of MBSR), active controls (self‐instructing MBSR) and non‐MBSR. The primary outcome measure was the Hospital Anxiety and Depression Scale. Secondary outcome measures were: Memorial Symptom Assessment Scale, SF‐36, Sense of Coherence, Five Facets of Mindfulness Questionnaire, and Posttraumatic Growth Index. Blood samples were analyzed using flow cytometry for NK‐cell activity (FANKIA) and lymphocyte phenotyping; concentrations of cytokines were determined in sera using commercial high sensitivity IL‐6 and IL‐8 ELISA (enzyme‐linked immunosorbent assay) kits. Results provide evidence for beneficial effects of MBSR on psychological and biological responses. Women in the MBSR group experienced significant improvements in depression scores, with a mean pre‐MBSR HAD‐score of 4.3 and post‐MBSR score of 3.3 (P = 0.001), and compared to non‐MBSR (P = 0.015). Significant improvements on scores for distress, symptom burden, and mental health were also observed. Furthermore, MBSR facilitated coping capacity as well as mindfulness and posttraumatic growth. Significant benefits in immune response within the MBSR group and between groups were observed. MBSR have potential for alleviating depression, symptom experience, and for enhancing coping capacity, mindfulness and posttraumatic growth, which may improve breast cancer survivorship. MBSR also led to beneficial effect on immune function; the clinical implications of this finding merit further research.

Outcomes of an integrated community-based nurse-led cardiovascular disease prevention programme

BackgroundNational guidance for England recommends that cardiovascular disease (CVD) should be managed as a family of diseases in the community. Here, we describe the results of such an approach.MethodsPatients with...

Serum cortisol and BDNF in patients with major depression—effect of yoga

Depression is associated with low serum Brain Derived Neurotrophic Factor (BDNF) and elevated levels of serum cortisol. Yoga practices have been associated with antidepressant effects, increase in serum BDNF, and reduction in serum cortisol. This study examined the association between serum BDNF and cortisol levels in drug-naïve patients with depression treated with antidepressants, yoga therapy, and both. Fifty-four drug-naïve consenting adult outpatients with Major Depression (32 males) received antidepressants only (n = 16), yoga therapy only (n = 19), or yoga with antidepressants (n = 19). Serum BDNF andcortisol levels were obtained before and after 3 months using a sandwich ELISA method. One-way ANOVA, Chi-square test, and Pearson’s correlation tests were used for analysis. The groups were comparable at baseline on most parameters. Significant improvement in depression scores and serum BDNF levels, and reduction in serum cortisol in the yoga groups, have been described in previous reports. A significant negative correlation was observed between change in BDNF (pre–post) and cortisol (pre–post) levels in the yoga-only group (r = −0.59, p = 0.008). In conclusion, yoga may facilitate neuroplasticity through stress reduction in depressed patients. Further studies are needed to confirm the findings and delineate the pathways for these effects.

Abstract P2-12-07: The association between exercise behavior and patient-reported outcomes in women with early breast cancer receiving locoregional radiation therapy

Abstract Purpose/Objectives: RT is associated with acute treatment-related complications that can lead to poor quality of life (QOL) and fatigue. Exercise has been shown in other cancer treatment settings to improve negative outcomes. We conducted a prospective pilot study to explore the association between exercise, patient-reported outcomes (PROs), and radiation therapy (RT) toxicities. Materials/Methods: Patients with surgically excised ductal carcinoma in situ or invasive breast carcinoma receiving curative radiation were enrolled. Each patient completed an exercise behavior/QOL survey at two time points: before the patient’s 5th fraction of radiation and during the last week of treatment. Limb girth measurements to evaluate lymphedema and assessment of shoulder range of motion (ROM) were completed on all patients at the same two time points. Skin toxicity was assessed weekly throughout radiotherapy. Exercise behavior was quantified with the Godin Leisure Time Exercise Questionnaire (metabolic equivalent [MET] hours per week). Patients with &amp;gt;7 METs/week were designated the exercise cohort (n=10) and those with &amp;lt;7METs/week the non-exercise cohort (n=10). PROs were measured using standardized questionnaires. Continuous variables were compared using the Wilcoxon rank sum test and percentages were compared using Fisher’s exact test. Results: Median patient age was 56 (range 28-70) years. Median MET in the exercise cohort was 12.9/week (range 7.5-35.0, n=10); 0.0/week in the non-exercise cohort (range 0-5.8, n=10). Women in the exercise cohort experienced significant improvement in depression scores over the course of treatment as compared to those who did not exercise (p=0.013). Those in the exercise cohort also reported less fatigue on the FACT-Fatigue subscale at treatment completion (exercise: 133.0; non-exercise: 121.0) (p=0.6). In addition, only 30% of exercisers suffered from grade 2 dermatitis compared to 70% of non-exercisers (p=0.2), despite a similar body mass index (26.4 exercise cohort versus 28.1 non-exercise). Exercisers also had greater ROM in the affected (91.7 vs. 85.2%, p=0.1) and contralateral shoulder (95 vs. 90%, p=0.048) at treatment completion. No differences in pain or sleep scores were noted and lymphedema was mild (&amp;lt;3cm) in the entire patient cohort. Conclusion: The vast majority of current exercise oncology literature indicates that physical activity is an independent predictor of quality of life metrics in cancer patients. Our study notes a trend towards improved outcomes with increased exercise during radiation therapy, suggesting that accrual of additional patients to our pilot study is worthwhile. Ultimately, a concurrent exercise intervention may improve quality of life and reduce acute toxicity in patients undergoing breast radiation treatment. Citation Format: Ritu Arya, Lee W Jones, Rachel C Blitzblau, Manisha Palta, Lisa Massa, Gloria Broadwater, Janet K Horton. The association between exercise behavior and patient-reported outcomes in women with early breast cancer receiving locoregional radiation therapy [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-12-07.

Effects of music aerobic exercise on depression and brain-derived neurotrophic factor levels in community dwelling women.

A randomized clinical trial was utilized to compare the improvement of depression and brain-derived neurotrophic factor (BDNF) levels between community women with and without music aerobic exercise (MAE) for 12 weeks. The MAE group involved 47 eligible participants, whereas the comparison group had 59 participants. No significant differences were recorded in the demographic characteristics between the participants in the MAE group and the comparison group. Forty-one participants in the MAE group and 26 in the comparison group completed a pre- and posttest. The MAE group displayed significant improvement in depression scores (p = 0.016), decreased depression symptoms in crying (p = 0.03), appetite (p = 0.006), and fatigue (p = 0.011). The BDNF levels of the participants significantly increased after the 12-week MAE (p = 0.042). The parallel comparison group revealed no significant changes in depression scores or BDNF levels. In summary, the 12-week MAE had a significant impact on the enhancement of BDNF levels and improvement of depression symptoms. Middle-aged community women are encouraged to exercise moderately to improve their depression symptoms and BDNF levels.

Cognitive impairment in chronic kidney disease: keep vascular disease in mind

Cognitive impairment is a major cause of morbidity in people with chronic kidney disease (CKD) and is associated with lower quality of life, more difficulty adhering to medications, and worse survival. Prior data suggest a relationship between vascular disease and cognitive impairment in individuals with CKD, although overall risk factors remain poorly understood. Critically, clinicians should be aware of the high rates of cognitive impairment that occur in all stages of CKD, which, although sometimes subtle, may impact comprehension and decision making in these individuals and may herald future, more debilitating impairment.