Mental Health

Targeting Maternal Gut Microbiome to Improve Mental Health Outcomes-A Pilot Feasibility Trial

sana — Wed, 27 Mar 2024 16:36:00 +0000

Targeting Maternal Gut Microbiome to Improve Mental Health Outcomes-A Pilot Feasibility Trial sana Wed, 03/27/2024 - 12:36

Background

Perinatal Depression and anxiety (PDA) is prevalent in new and expectant mothers affecting millions of women worldwide. Those with a history of mood and anxiety disorders are at the greatest risk of experiencing PDA at a subsequent pregnancy. Current safety concerns with pharmacological treatments have led to a greater need for adjunctive treatment options for PDA. Changes in the composition of the microbiome have been associated with various diseases during pregnancy and these changes are thought to be at least partially at play in perinatal mood disorders. While the relation between PDA and the microbiome has not been explored, evidence suggests that nutritional interventions, with fiber, fish oils, and probiotics, may play a favorable role in neuropsychiatric outcomes during and after pregnancy. The primary objective of the present study is to assess the feasibility and acceptability of a combination of non-pharmacological interventions in currently stable and pregnant women with a history of anxiety and/or depression. This study will also aim to understand ease of recruitment, treatment compliance, and protocol adherence in this cohort.

Methods

This a single centered, partially randomized-placebo controlled-double blind feasibility trial. 100 pregnant women, with a history of depression and/or anxiety/PDA will be recruited and randomized into one of four arms which could include: receiving a daily dose of both investigational products and dietary counselling on increasing dietary fiber, receiving a daily dose of both investigational drugs only, receiving fish oil investigational product and placebo, and a control arm with no intervention. The study involves six study visits, all of which can be conducted virtually every 3 months from the time of enrollment. At all study visits, information on diet, mental health, physical activity, and sleep quality will be collected. Additionally, all participants will provide a stool sample at each visit.

Discussion

It is anticipated that pregnant women with a history of depression and anxiety will be particularly interested in partaking in this trial, resulting in favourable recruitment rates. Given the positive findings of O3FA and probiotic supplements on mental health symptoms in non-pregnant adults, we expect a similar trend in PDA symptoms, with a low likelihood of adverse events. This study will build the foundation for larger powered studied to further contribute evidence for the efficacy of this potential treatment option.

Trial Registration

This trial was registered at ClinicalTrials/gov on October 6, 2023; NCT06074250. Trial Sponsor: The Canadian College of Naturopathic Medicine, 1255 Sheppard Ave E, Toronto, ON M2K 1E2, 416-498-1255.

DOI link: https://doi.org/10.1101/2024.03.08.24303670

Author

Faith Gallant, Kieran Cooley, Sophie Grigoriadis, Neda Ebrahimi

Citedate

2024-03-10

Citation

Gallant, F, Cooley K, Grigoriadis S, Ebrahimi E. Targeting Maternal Gut Microbiome to Improve Mental Health Outcomes-A Pilot Feasibility Trial. medRxiv 2024.03.08.24303670; doi: https://doi.org/10.1101/2024.03.08.24303670

Publication

medRxiv

Taxonomy

Mental Health

Adjunctive Naturopathic Medicine in the Management of Depression and Anxiety Symptoms: A Retrospective Chart Review

sana — Wed, 27 Mar 2024 15:01:24 +0000

Adjunctive Naturopathic Medicine in the Management of Depression and Anxiety Symptoms: A Retrospective Chart Review sana Wed, 03/27/2024 - 11:01

Background

Naturopathic medicine uses natural and evidence-based treatments to promote health. The objective of this study was to characterize and evaluate the effectiveness of naturopathic medicine in reducing symptoms of anxiety and depression in patients seeking care from the Mental Health Shift at a Canadian naturopathic teaching clinic.

Methods

Charts of 192 consecutive patients who attended appointments between 1 January 2019 and 6 March 2020 were reviewed. Subjects were included if they screened positive on the General Anxiety Disorder 7 (GAD7) or the Patient Health Questionnaire 9 (PHQ9) and attended follow up at least 4 weeks after initial treatment.

Results

Of the 22 included subjects, a clinically significant decrease of at least 5 points occurred in 76% of individuals with elevated baseline PHQ9 scores and 59% of individuals with elevated GAD7 scores. Mean PHQ9 and GAD7 scores decreased 7.5 (p

Conclusion

Naturopathic medicine as performed on the Mental Health Shift may be effective in reducing depression and anxiety symptoms as an adjunctive treatment. Further research incorporating comparison groups is warranted.

DOI link: https://doi.org/10.54434/candj.157

Author

Joy Dertinger, ND, Monique Aucoin, MSc, ND

Citedate

2024-03-21

Citation

Dertinger J, Aucoin M. Adjunctive naturopathic medicine in the management of depression and anxiety symptoms: A retrospective chart review. CAND Journal. 2024;31(1):29-36

Publication

CAND Journal

Taxonomy

Mental Health

Dietary counselling plus omega-3 supplementation in the treatment of generalized anxiety disorder: protocol for a randomized wait-list controlled pilot trial (the “EASe-GAD Trial”)

sana — Thu, 16 Nov 2023 17:43:28 +0000

Dietary counselling plus omega-3 supplementation in the treatment of generalized anxiety disorder: protocol for a randomized wait-list controlled pilot trial (the “EASe-GAD Trial”) sana Thu, 11/16/2023 - 12:43

Background

Anxiety disorders are prevalent and disabling conditions involving excessive worry and tension. Generalized anxiety disorder (GAD), the most common anxiety disorder, affects 5% of individuals from high-income countries and many individuals report that treatment options are not accessible, effective, or tolerable. Clinical evidence suggests that nutrition interventions, based on the Mediterranean diet and supplementation of omega-3 fatty acids, can significantly improve symptoms of depression; however, the effect of nutrition interventions on anxiety symptoms has not been studied in a clinical population. The primary objective of the present study is to assess the feasibility and acceptability of a dietary counselling and omega-3 fatty acid supplementation intervention delivered to adult women with GAD. The secondary objectives include assessing changes in anxiety symptom severity, assessing changes in quality of life, assessing changes in biomarkers, and evaluating the components of the program.

Methods

This study is a randomized, wait-list controlled pilot trial delivering a 12-week, dietary counselling intervention and omega-3 supplementation to 50 adult women with GAD. Participants will complete seven individual counselling sessions which include education, personalized recommendations, mindful eating techniques, motivational interviewing, and goal setting. They will be provided with recipes, instructional videos, and food items. The intervention is designed based on the Social Cognitive Theory and previous research that has been done by the author team to identify dietary constituents with the most evidence to support their use in the treatment of anxiety disorders. Questionnaires and blood work will be completed at baseline, after the waiting period (for those in the waitlist group), and after the intervention.

Discussion

Results from this study will lay the foundation for future large-scale studies in this area and may provide preliminary evidence of the role of diet counselling and omega-3 supplementation in the management of GAD. Research on the role of nutrition in psychiatric care has been identified as a priority by a number of international organizations. The present trial directly addresses the call for the research that is most needed to advance the field.

Trial registration

This protocol was registered at ClinicalTrials.gov on October 10, 2022; NCT05573672.
Trial sponsor: The Canadian College of Naturopathic Medicine, 1255 Sheppard Ave E, Toronto, ON M2K 1E2, 416–498-1255.
Steering committee: Composed of MA, LL, KC, IvdW, SM, UN, AJ. The committee meets monthly to oversee the trial.
Protocol identifier: ��̳_EASe-GADCT_2201v4.
Peer Review reports

DOI link: https://doi.org/10.1186/s40814-023-01414-y

Author

Aucoin, M., LaChance, L., van der Wurff, I. et al.

Citedate

2023-11-10

Citation

Aucoin, M., LaChance, L., van der Wurff, I. et al. Dietary counselling plus omega-3 supplementation in the treatment of generalized anxiety disorder: protocol for a randomized wait-list controlled pilot trial (the “EASe-GAD Trial”). Pilot Feasibility Stud

Publication

Pilot and Feasibility Studies

Taxonomy

Mental Health

Perinatal diet and offspring anxiety: A scoping review

sana — Fri, 09 Sep 2022 14:15:09 +0000

Perinatal diet and offspring anxiety: A scoping review sana Fri, 09/09/2022 - 10:15

Abstract

Health behaviors during pregnancy have an impact on the developing offspring. Dietary factors play a role in the development of mental illness: however, less is known about the impact of diet factors during pre-conception, gestation, and lactation on anxiety levels in offspring. This scoping review sought to systematically map the available research involving human and animal subjects to identify nutritional interventions which may have a harmful or protective effect, as well as identify gaps. Studies investigating an association between any perinatal diet pattern or diet constituent and offspring anxiety were included. The number of studies reporting an association with increased or decreased levels of anxiety were counted and presented in figures. A total of 55,914 results were identified as part of a larger scoping review, and 120 articles met the criteria for inclusion. A greater intake of phytochemicals and vitamins were associated with decreased offspring anxiety whereas maternal caloric restriction, protein restriction, reduced omega-3 consumption, and exposure to a high fat diet were associated with higher levels of offspring anxiety. Results were limited by a very large proportion of animal studies. High quality intervention studies involving human subjects are warranted to elucidate the precise dietary factors or constituents that modulate the risk of anxiety in offspring.

DOI Link: https://doi.org/10.1515/tnsci-2022-0242

Author

Sasha Monteiro, Yousef Sadat Nejad and Monique Aucoin

Citedate

2022-09-06

Citation

Monteiro, S., Nejad, Y. & Aucoin, M. (2022). Perinatal diet and offspring anxiety: A scoping review. Translational Neuroscience, 13(1), 275-290. https://doi.org/10.1515/tnsci-2022-0242

Publication

Translational Neuroscience

Taxonomy

Mental Health

The Effect of Natural Therapies in Combination with Usual Care for Depression: A Narrative Review

sana — Mon, 07 Feb 2022 18:09:23 +0000

The Effect of Natural Therapies in Combination with Usual Care for Depression: A Narrative Review sana Mon, 02/07/2022 - 13:09

Introduction

Major depressive disorder (MDD) is the most common and debilitating form of depression with a 12-month prevalence of 4.7% and a lifetime prevalence of 11.2% in Canada. Various classes of antidepressants are commonly used treatments for MDD; however, high failure rates occur due to adverse events and discontinuation of use. Non-drug and alternative interventions are commonly sought by people when drug treatment fails. The purpose of this investigation was to analyze the evidence on the effect of natural therapies in combination with pharmaceutical standard of care for the management of MDD.

Methods

The following inclusion criteria were defined before conducting the literature search: 1) population of adults with major depressive disorder, 2) intervention of lavender, folic acid or acupuncture, combined with standard treatment, 3) comparison group of a placebo, standard treatment or natural therapy used alone, 4) changes to Hamilton Depression Rating Scale (HAM-D) as the primary outcome. PubMed, APA PsycARTICLES and Google scholar were used for the research. The articles were limited to randomized clinical trials (RCTs), and systematic reviews with meta-analyses. The different therapies were used as key words in the literature search.

Results

The literature search for ‘lavender’ yielded 214 studies, of which 3 RCTs met the criteria. ‘Folic acid’ yielded 680 studies of which 2 RCTs and 1 systematic review with meta-analysis met the criteria. ‘Acupuncture’ yielded 2240 studies of which 2 RCTs and 2 systematic reviews with meta-analyses met the criteria. Only the RCTs not summarized in the systematic reviews and meta-analyses were summarized in this review.

Discussion

All ten studies using natural interventions showed a statistically significant decrease in the mean score change versus comparison groups, however, the magnitude of the effect varied between the studies. Sample sizes were small and there was significant heterogeneity between studies.

Conclusions

Evidence suggests that natural therapies can be used adjunctively to the pharmaceutical care of MDD, however, the overall research quality is low and substantial heterogeneity exists between studies. Further, additional research using more rigorous methodologies and standardized interventions is needed.

DOI Link: https://doi.org/10.26685/urncst.321

Author

Prabhjot Kaur Chohan; Adam Gratton

Citedate

2022-02-07

Citation

https://doi.org/10.26685/urncst.321

Publication

URNCST Journal(2022): Volume 6, Issue 2

Taxonomy

Mental Health

Randomized controlled trials in long-term care residents with dementia: a systematic review.

Anonymous — Tue, 24 Aug 2021 15:42:03 +0000

Randomized controlled trials in long-term care residents with dementia: a systematic review. Anonymous (not verified) Tue, 08/24/2021 - 11:42

OBJECTIVE: To evaluate the quality of reporting of randomized controlled trials for pharmacologic interventions in long-term care residents with dementia. DATA SOURCES: We performed electronic searches of AMED, CINAHL, E-PSYCHE, Cochrane Controlled Trials Register, and MEDLINE. We also searched the reference lists of included studies and bibliographies of relevant review articles. STUDY SELECTION: All randomized controlled trials for pharmacologic interventions in patients with dementia residing in long-term care facilities. DATA ABSTRACTION: We abstracted data independently, in duplicate, using a data abstraction sheet and a quality checklist. DATA SYNTHESIS: Fifteen trials met inclusion criteria. Five trials lacked institutional ethical review, while two lacked informed consent. Eleven trials gave adequate description of withdrawals and 14 trials reported adverse events adequately. We found incomplete reporting of methods of randomization, allocation concealment, restriction, blinding, sample size estimation and intention-to-treat analysis. Sensitivity analysis indicated that reporting of allocation concealment was associated with increased quality of trial according to the quality scale (P = 0.007). CONCLUSIONS: Clinicians and the public do not have high-quality information to guide pharmacologic decision making for long-term care residents with dementia. The reporting quality is highly variable in the trials reviewed, and concerns exist surrounding the conduct of several trials. PMID: 14613596

Author

Mills EJ, Chow TW.

Citedate

2003-01-01

Citation

J Am Med Dir Assoc. 2003;4(6):302-7.

Affiliations

University of Oxford

Taxonomy

Mental Health

Pellagra may be a rare secondary complication of anorexia nervosa: a systematic review of the literature.

Anonymous — Tue, 24 Aug 2021 15:42:03 +0000

Pellagra may be a rare secondary complication of anorexia nervosa: a systematic review of the literature. Anonymous (not verified) Tue, 08/24/2021 - 11:42

Pellagra is a nutritional wasting disease attributable to a combined deficiency of tryptophan and niacin (nicotinic acid). It is characterized clinically by four classic symptoms often referred to as the four Ds: diarrhea, dermatitis, dementia, and death. Prior to the development of these symptoms, other nonspecific symptoms insidiously manifest and mostly affect the dermatological, neuropsychiatric, and gastrointestinal systems. A review of the literature reveals several case reports describing pellagra in patients with anorexia nervosa. The most common features of pellagra in patients with anorexia nervosa are cutaneous manifestations such as erythema on sun-exposed areas, glossitis, and stomatitis. Health care providers might consider a trial of 150-500 mg niacin if anorexic patients exhibit these cutaneous findings. Pellagra can be diagnosed if cutaneous symptoms resolve within 24-48 hours after oral niacin administration. To further corroborate a diagnosis of pellagra in anorexic patients, specific 24-hour urine tests for niacin metabolites and 5-hydroxy-indole-acetic acid could be run prior to treatment with niacin being instituted. Other factors, such as mycotoxins, excessive dietary leucine intake (although not in anorexia), estrogens and progestogens, carcinoid syndrome, and various medications, might also lead to the development of pellagra. Although pellagra appears to be a rare, yet possible secondary complication of anorexia nervosa, it should be considered in the work-up of patients who exhibit cutaneous manifestations subsequent to sunlight exposure. PMID: 12777163

Author

Prousky JE.

Citedate

2003-01-01

Citation

Altern Med Rev. 2003;8(2):180-5.

Affiliations

Canadian College of Naturopathic Medicine

Publication

http://www.altmedrev.com/publications/8/2/180.pdf

Taxonomy

Mental Health

Supplemental niacinamide mitigates anxiety symptoms: three case reports.

Anonymous — Tue, 24 Aug 2021 15:42:02 +0000

Supplemental niacinamide mitigates anxiety symptoms: three case reports. Anonymous (not verified) Tue, 08/24/2021 - 11:42

The purpose of this report is to highlight the potential of niacinamide for the treatment of anxiety disorders. Three patients were prescribed large pharmacological doses of niacinamide (2,000-2,500 mg per day). Each of the patients had considerable relief from their anxiety when regularly using niacinamide. The possible biochemical reasons for niacinamide's effectiveness might be related to the correction of subclinical pellagra, the correction of an underlying vitamin B3 dependency disorder, its benzodiazepine-Uke effects, its ability to raise serotonin levels, or its ability to modify the metabolism of blood lactate (lactic acid). Adverse effects did not occur with these doses, but nausea and vomiting can occur when doses as high as 6,000 mg per day are used. These positive case reports suggest that niacinamide might be helpful for the treatment of anxiety disorders. However, definitive proof requires properly conducted randomized controlled trials to assess niacinamide's actual therapeutic effects and adverse effects profile.

Author

Prousky J.

Citedate

2005-01-01

Citation

Journal of Ortho Med, 2005; 20(3):167-178.

Affiliations

Canadian College of Naturopathic Medicine

Publication

http://orthomolecular.org/library/jom/2005/pdf/2005-v20n03-p167.pdf

Taxonomy

Mental Health

Orthomolecular Treatment of Anxiety Disorders

Anonymous — Tue, 24 Aug 2021 15:42:02 +0000

Orthomolecular Treatment of Anxiety Disorders Anonymous (not verified) Tue, 08/24/2021 - 11:42

Anxiety disorders are life altering psychiatric conditions that severely impair the quality of life of those suffering from them. They are the most common psychiatric disorders in the United States, and are characterized by numerous somatic symptoms, such as facial flushing, hyperhydrosis (excessive sweating), muscle tension, paresthesias (numbness and tingling), shallow breathing, syncope (fainting), and tachycardia (rapid heart rate). The emotional symptoms of anxiety disorders occur simultaneously with the somatic ones and include agitation, derealization (feelings of unreality), tearfulness, feelings of impending doom, irritability, nervousness, and shyness. Patients with anxiety disorders often report escape and avoidance behaviors that merely reinforce and perpetuate their ongoing anxiety. They also tend to engage in catastrophic thinking by over-predicting the negative consequences of events.

Author

Prousky, J.

Citedate

2005-01-01

Citation

Townsend Letter for Doctors and Patients, 2005;259/260:82-87.

Affiliations

Canadian College of Naturopathic Medicine

Taxonomy

Mental Health

Orthomolecular and Botanical Treatments to Help Alleviate the Side Effects of Atypical Antipsychotic Drugs.

Anonymous — Tue, 24 Aug 2021 15:42:00 +0000

Orthomolecular and Botanical Treatments to Help Alleviate the Side Effects of Atypical Antipsychotic Drugs. Anonymous (not verified) Tue, 08/24/2021 - 11:42

The current standard of care for schizophrenic patients, such as continual medication with atypical antipsychotic drugs, does more harm than good. A review of the literature revealed that in addition to causing the well known side effects of extrapyramidal symptoms and tardive dyskinesia, side effects such as hyperprolactinemia, sexual dysfunction, weight gain, diabetes, cardiac arrhythmias, and even a worsening of psychosis (when used long-term) are common occurrences. Specific orthomolecular and botanical treatments might help prevent and/or reduce some of these negative side effects. The most effective approach is to institute all the components of an ideal treatment program, as advocated by Dr. Abram Hoffer. This is the only approach that facilitates genuine recovery among chronic schizophrenic patients.

Author

Prousky J, Hayman R.

Citedate

2006-01-01

Citation

Journal of Ortho Med 2006;21(1):17-33.

Affiliations

Canadian College of Naturopathic Medicine

Publication

http://orthomolecular.org/library/jom/2006/pdf/2006-v21n01-p17.pdf

Taxonomy

Mental Health