Working During Treatment For Depression Can Increase Work Productivity

A new study from the Centre for Addiction and Mental Health (CAMH) has found that employees with depression who receive treatment while still working are significantly more likely to be highly productive than those who do not. This is the first study of its kind to look into a possible correlation between treatment and productivity.

The study is particularly significant at a time when the Canadian economy continues to face uncertainty. Mental illness costs the Canadian economy an estimated $51 billion annually, with a third of that attributed to productivity losses.

Published in the current issue of the Canadian Journal of Psychiatry, the study examined data from a large-scale community survey of employed and recently employed people in Alberta.

People who experienced a depressive episode were significantly less likely to be highly productive, the study showed. "We expected this, as past research has found that depression has adverse effects on comprehension, social participation, and day-to-day-functioning," said Dr. Carolyn Dewa, head of CAMH's Centre for Research on Employment and Workplace Health and lead author.

"What's exciting is we found that treatment for depression improves work productivity. People who had experienced a moderate depressive episode and received treatment were 2.5 times more likely to be highly productive compared with those who had no treatment," she said. "Likewise, people who experienced severe depression were seven times more likely to be high-performing than those who had no treatment."

Of the 3,000 workers in the in the sample, 8.5 per cent experienced a depressive episode, representing 255 workers.

Though the results showed the effectiveness of treatment on work and performance, the data also showed a troubling trend. "We found that among all study participants who had been diagnosed with a severe depressive episode, 57 per cent did not receive treatment; 40 per cent of those who experienced a moderate depressive episode did not receive treatment," said Dr. Dewa. "When we look at the success of workers in the sample who received treatment while still in the workplace, it really speaks to the importance of prevention and the need for employers to facilitate treatment and support. If people are able to receive treatment early, disability leave, which costs companies $18,000 per leave, may be avoided."

"Stigma and discrimination have often affected people's willingness to access to services, as has the lack of knowledge around supports available in the workplace," added Dr. Dewa. "It is crucial that employers offer mental health interventions to their employees and support them in engaging in treatment, as well as continuing to support them as they transition back into the workplace."

Genes Behind Anxiety Identified

Overexpression of Crh and Oprm 1 genes is responsible for anxiety and behavioral problems, say scientists.

The genes (Crh [corticotropin-releasing hormone] and Oprm 1 [mu-opioid receptor MOR 1]) may point the way to treating these problems in patients with too much of the protein, said scientists at the Baylor College of Medicine.

MeCP2 is a "Goldilocks" in the protein world. When the protein is lacking or defective, girls develop the neurological disorder Rett syndrome early in life.

Too much protein results in the more recently identified MeCP2 duplication syndrome, which usually affects boys, who may inherit the gene duplications either from their mothers or, in rare cases, develop it sporadically.

In both cases, anxiety and social behavioural deficits are typical of those with the disease, along with other motor problems and cognitive defects.

"This is a nice example of a translational story," said Dr. Rodney Samaco, assistant professor of molecular and human genetics at BCM and first author of the study.

"We first identified the mouse model for MeCP2 duplication syndrome and then found people with the disorder in the clinic. We went back to the lab and found out that MeCP2 was indeed the major contributor to this phenotype in patients.

"We have now identified two genes involved in two major symptoms of the syndrome. Eventually, we may take the information back to the clinic to develop a treatment for patients," Samaco stated.

Patients with MeCP2 duplication disorder have a duplication in chromosomes that span both the MECP2 gene and another called IRAK1. But with this new study, it is now clear that excess MeCP2 accounts for the neuropsychiatric symptoms.

This finding is important because it shows that tweaking the expression of genes that the protein affects, rather than trying to adjust the levels of the finicky MeCP2 protein itself, can modify symptoms of MeCP2 disorders.

The finding appeared online in the journal Nature Genetics.

Source-ANI

Drugs Causing Low Sodium Levels / Hyponatremia

The body maintains a careful balance of electrolytes like sodium, potassium and chloride within the cells as well as in fluid outside the cells like blood and body fluids. Sodium is necessary to carry out some important functions like maintaining blood pressure. It also helps to maintain the function of nerves and muscles. Sodium enters the body through food and fluid intake. The common salt or table salt contains sodium chloride and it is used not only for cooking but also in preservatives. The same sodium chloride also is the reason for the salinity of our oceans. Excess sodium is excreted by the kidneys via the urine. Sodium levels in the plasma are normally maintained at a level of between 135 to 145 mmol/L.

The condition in which plasma level of sodium falls to below 135 mmol/L is called hyponatremia. Hyponatremia causes movement of excess water in the cells, causing them to swell. The cells of the brain in particular are unable to cope up with this swelling since they are confined within the bones of the skull. Thus, many of the symptoms caused by hyponatremia, especially severe cases, are related to the brain.

When taking medication we must remember that some of the drugs cause hyponatremia as a side effect. Many among these bring about this effect by resulting in a condition called SIADH or Syndrome of Inappropriate Secretion of ADH. ADH (antidiuretic hormone) or vasopressin is a hormone secreted by a small gland near the brain called the pituitary. It plays an important role in water absorption from the kidneys and stimulates thirst. Thus, in conditions of dehydration, by increasing water absorption from the urine and stimulating thirst, it helps to maintain the water content of the body.

SIADH is a condition where the control of ADH secretion is lost and it is secreted independent of the need to conserve water. This results in water retention and subsequent dilution of sodium levels, leading to hyponatremia.

Symptoms of hyponatremia may be mild like:

Nausea, vomiting, headache, and muscle cramps, or Symptoms may be serious like alteration in mental status including confusion, seizures and coma.

If hyponatremia is diagnosed, a careful history should be taken from the patients or their caregivers to find out if the patients are taking any medications that could result in hyponatremia. Stopping the medication usually helps to solve the problem.

medindia.net

Research: Inflammation may Link Obesity and Adverse Pregnancy Outcomes

Many immunological mechanisms ensure the successful establishment and maintenance of pregnancy and imbalance in these mechanisms is associated with adverse pregnancy outcomes.

In a review published in Advances in Neuroimmune Biology, researchers from the Institute of Life Science, College of Medicine at Swansea University in the UK examine the impact of maternal obesity on the inflammatory responses in tissues of both the mother and the child.

"While great progress has been made in elucidating the immunological mechanisms that ensure reproductive success, we now need to understand the impact of a very modern epidemic on immune response at the materno-fetal interface, as well on the mother and the child," said lead investigator Catherine A. Thornton, PhD. "Inflammation may have a key role in many of the detrimental effects of obesity in non-pregnant individuals, and emerging data suggest that inflammation also links obesity and adverse pregnancy outcomes."

Evidence of altered inflammatory status with obesity in the circulation of both the mother and child in pregnancy is emerging. For example, obese pregnant women have elevated levels of interleukin-6 (IL-6). IL-6 is also increased in the cord plasma of offspring of obese mothers, and is associated with increased fetal adiposity and, in a rat model, to hypertension and increased hypothalamic-pituitary-adrenal axis activity in adulthood. Altered inflammatory status of the placenta in association with maternal obesity may have a critical role in the short term programming of health and disease in the offspring, the researchers commented. Maternal obesity is associated with an inflammatory response by the placenta including elevated pro-inflammatory cytokine gene expression.

The negative impact of maternal obesity on the immune function of mother and child includes an increased risk for preeclampsia, likely mediated via inflammation and triglycerides. Increased maternal body mass index is associated with an increased risk of neonatal early onset group B streptococcal disease, and an increased risk of respiratory tract infections. The inflammatory response and immune function of the newborn might relate to later health outcomes. Hyper-responsiveness of inflammatory function at birth is linked to the development of allergic disease in infancy.

Maternal metabolic status during pregnancy and weaning is particularly relevant to healthy development of hypothalamic neurones that regulate weight and feeding in offspring, the researchers report. One study demonstrated that a high-fat diet during pregnancy can induce the expression of hypothalamic peptides involved in the regulation of food intake and body composition in weanling rats. More recently, female offspring of fathers fed a chronic high fat diet had impaired glucose tolerance and insulin secretion. "These findings lead to the suggestion that such programmed expression has a role to play in adult physiology, including increased food intake, preference for a fat-rich diet, weight gain, and metabolic dysfunction," says Dr. Thornton.

"Diseases once found only in adults are increasing in the paediatric population. The focus has been on diseases with a clear metabolic component and it remains relatively unknown what risk maternal obesity during pregnancy imposes for the development of autoimmune diseases, allergy and asthma, and neurodevelopment and cognitive behavior," stated Dr. Thornton. "Animal models indicate that the provision of a normal diet to the offspring once weaned does not overcome the effects of maternal overnutrition, so simple dietary changes may prove ineffective. Targeted maternal immunomodulation might be needed to curtail this potential pandemic."



Source-Eurekalert

Combination Therapy Benefits Children With ADHD

While pharmacologic agents have a proved effective in children with Attention-deficit/hyperactivity disorder (ADHD), some children have suboptimal response to a single pharmacologic agent.

A recent study by Dr. Timothy E. Wilens and colleagues, published in the January 2012 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), is the first randomized placebo-controlled trial designed to assess efficacy and safety of guanfacine extended release (GXR) as an adjunct to psychostimulants in children and adolescents diagnosed with ADHD who had a suboptimal response to a psychostimulant alone.

As reported in the article "A Controlled Trial of Extended-release Guanfacine and Psychostimulants for Attention-deficit/hyperactivity disorder," Wilens and colleagues conducted a nine week multicenter, double-blind, placebo-controlled, dose-optimization study, with participants in 59 study sites who continued their stable dose of psychostimulant given in the morning and were randomized to receive GXR in the morning, GXR in the evening, or placebo.

For both morning and evening administration of GXR, subjects receiving GXR plus a psychostimulant showed significantly greater improvement from baseline to endpoint, as measured by the ADHD-Rating Scale IV total score, compared with subjects receiving placebo plus a psychostimulant. In particular, the inattention subscale rating and the hyperactivity/ impulsivity subscales of the ADHD-RS-IV showed significantly greater improvements from baseline in subjects receiving GXR with a psychostimulant compared with subjects receiving placebo plus psychostimulant. Significant benefits of adjunctive administration were observed whether GXR was administered in the morning or evening. No new safety signals emerged after adjunctive administration of GXR with psychostimulants compared with psychostimulants alone.

Reflecting on their research findings, Wilens and colleagues stated, "The results of this study support the hypothesis that adjunctive administration of the selective alpha2A-adrenoceptoragonist, GXR, to a psychostimulant in subjects with suboptimal response to psychostimulants reduces ADHD symptoms over placebo with a psychostimulant."
 

Source-Eurekalert

 

 

Do Race and Gender also Play a Role in Obesity and Cancer Screening ? Read more: Do Race and Gender also Play a Role in Obesity and Cancer Screening ?

 

A study on the role of obesity in cancer screening rates for prostate, cervical as well as breast and colorectal cancers across race/ethnicity and gender is examined in the current issue of the Journal of Obesity.

Researchers in Family and Community Medicine at Thomas Jefferson University recently found that obesity was linked to higher rates of prostate cancer screening across all races/ethnic differences and lower rates of cervical cancer screening, most notably in white women.

"Numerous studies have suggested that obesity constitutes an obstacle to cancer screening, but a deeper examination also considering the role of race/ethnicity and gender in the equation has not been done before," said Heather Bittner Fagan, MD, FAAFP MPH, lead author and associate professor, Thomas Jefferson University and director of Health Services Research, department of Family and Community Medicine, Christiana Care Health System. "A greater understanding of the relationship between cancer screening and obesity, race/ethnicity and gender can also help explain the association between obesity and increased cancer mortality."

Obesity is second only to tobacco use as a risk factor for cancer and is associated with increased mortality for all cancer combined as well as for cancer of specific sites, including cancer of the colon/rectum, prostate, breast, and cervix. 

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