Objective The placebo response in depression studies is the change in symptoms amongst those who receive an inactive treatment.Many well-designed randomized controlled trials(RCTs)of depression have a high proportion ...Objective The placebo response in depression studies is the change in symptoms amongst those who receive an inactive treatment.Many well-designed randomized controlled trials(RCTs)of depression have a high proportion of placebo responders,with little understanding as to why.The present study assesses characteristics associated with the placebo response in a nutraceutical trial with a large proportion of placebo responders.Methods This is a secondary analysis of a nutraceutical depression RCT which identified no overall treatment benefit relative to placebo(n=69 in placebo group).We investigated participant characteristics such as socio-demographics,clinical features,and recruitment methods,and their association with the placebo response.Monoaminergic genetic polymorphisms were also assessed.Placebo response was measured based on change in Montgomery-Asberg Depression Rating Scale score.The association of these hypothesis-driven variables of interest and the placebo response was examined using linear mixed effects models.Results Greater levels of education,particularly pursuing post-high school education,better self-reported general health,marriage/de facto,greater improvement in the first trial week,and more failed antidepressant therapies in the current depressive episode were associated with greater placebo response.An increased placebo response was not found in those recruited via social media nor in those with concomitant antidepressant therapy.Single nucleotide polymorphisms from the tryptophan hydroxylase 1(TPH1)gene(A779C and A218C)were weakly associated with greater placebo response,although the evidence was attenuated after accounting for multiple comparisons.Conclusion This is,to our knowledge,the first study within nutraceutical research for depression to assess the association between participant characteristics and variation in the placebo response.Several variables appeared to predict the placebo response.Such findings may encourage future trial designs which could dampen placebo response,improve assay sensitivity,and allow for treatment effects to be potentially more detectable.展开更多
Little is known about the role of active school travel(AST)on mental health among adolescents.Thus,this study aimed to explore the AST-depression association among adolescents aged 12–15 years from 26 low-and middle-...Little is known about the role of active school travel(AST)on mental health among adolescents.Thus,this study aimed to explore the AST-depression association among adolescents aged 12–15 years from 26 low-and middle-income countries(LMICs).Data from the Global School-based Student Health Survey were analyzed in 51,702 adolescents[mean(SD)age 13.8(1.0)years;49.3%boys).Both depressive symptoms and AST were assessed by a single question self-reported measure,respectively.Participants who reported having 5 days or above were considered as AST.Multivariable logistic regression analysis(accounting for sampling weights)was performed while controlling for gender,age,physical activity,sedentary behavior,and food insecurity,and a countrywide meta-analysis was undertaken.The prevalence of depressive symptoms and AST were 30.1%and 37.0%,respectively.Compared with those not having AST,adolescents with AST were less likely to have self-reported depressive symptoms(OR=0.88,95%CI:0.85-0.93)regardless of gender.Countrywide meta-analysis demonstrated that having AST versus not having AST was associated with 12%lower odds for depressive symptoms(OR=0.88;95%CI:0.82-0.94)but with a moderate between-country heterogeneity(I^(2)=59.0%).Based on large samples of adolescents from LMICs,it would be expected that AST may play a critical role in preventing adolescent depression worldwide.However,it is necessary to consider more country-specific factors when implementing AST-related mental health interventions.Future studies should adopt the solid study design to confirm or negate our researchfindings.展开更多
The internet is a major source for health information. An increasing number of people, including patients with insomnia, search for remedies online; however, little is known about the quality of such information. This...The internet is a major source for health information. An increasing number of people, including patients with insomnia, search for remedies online; however, little is known about the quality of such information. This study aimed to evaluate the quality and readability of insomnia-related online information. Google was used as the search engine, and the top websites on insomnia that met the inclusion criteria were evaluated for quality and readability. The analyzed websites belonged to nonprofit, commercial, or academic organizations and institutions such as hospitals and universities. Insomnia-related websites typically included definitions （85%）, causes and risk factors （100%）, symptoms （95%）, and treatment options （90%）. Cognitive behavioral therapy for insomnia （CBT-I） was the most commonly recommended approach for insomnia treatment, and sleep drugs are frequently mentioned. The overall quality of the websites on insomnia is moderate, but all the content exceeded the recommended reading ease levels. Concerns that must be addressed to increase the quality and trustworthiness of online health information include sharing metadata, such as authorship, time of creation and last update, and conflicts of interest; providing evidence for reliability; and increasing the readability for a layman audience.展开更多
Defining pathophenotype, a systems level consequence of a disease genotype, together with environmental and stochastic influences, is an arduous task in psychiatry. It is also an appealing goal, given growing need for...Defining pathophenotype, a systems level consequence of a disease genotype, together with environmental and stochastic influences, is an arduous task in psychiatry. It is also an appealing goal, given growing need for appreciation of brain disorders biological complexity, aspiration for diagnostic tests development and ambition to identify novel drug targets. Here, we focus on the Schizophrenia and Major Depressive Disorder and highlight recent advances in metabolomics research. As a systems biologytool, metabolomics holds a promise to take part in elucidating interactions between genes and environment, in complex behavioral traits and psychopathology risk translational research.展开更多
基金funded by an Australian National Health and Medical Research Council project grant (No. APP1048222) and was co-sponsored by FITBio Ceuticals (who provided the trial product and placebo)supported by an NHMRC Fellowship (No. APP1125000)supported by a NHMRC Senior Principal Research Fellowship (No. 1059660 and 1156072)
文摘Objective The placebo response in depression studies is the change in symptoms amongst those who receive an inactive treatment.Many well-designed randomized controlled trials(RCTs)of depression have a high proportion of placebo responders,with little understanding as to why.The present study assesses characteristics associated with the placebo response in a nutraceutical trial with a large proportion of placebo responders.Methods This is a secondary analysis of a nutraceutical depression RCT which identified no overall treatment benefit relative to placebo(n=69 in placebo group).We investigated participant characteristics such as socio-demographics,clinical features,and recruitment methods,and their association with the placebo response.Monoaminergic genetic polymorphisms were also assessed.Placebo response was measured based on change in Montgomery-Asberg Depression Rating Scale score.The association of these hypothesis-driven variables of interest and the placebo response was examined using linear mixed effects models.Results Greater levels of education,particularly pursuing post-high school education,better self-reported general health,marriage/de facto,greater improvement in the first trial week,and more failed antidepressant therapies in the current depressive episode were associated with greater placebo response.An increased placebo response was not found in those recruited via social media nor in those with concomitant antidepressant therapy.Single nucleotide polymorphisms from the tryptophan hydroxylase 1(TPH1)gene(A779C and A218C)were weakly associated with greater placebo response,although the evidence was attenuated after accounting for multiple comparisons.Conclusion This is,to our knowledge,the first study within nutraceutical research for depression to assess the association between participant characteristics and variation in the placebo response.Several variables appeared to predict the placebo response.Such findings may encourage future trial designs which could dampen placebo response,improve assay sensitivity,and allow for treatment effects to be potentially more detectable.
基金supported by the National Social Science Foundation(18BTY011)Brendon Stubbs is supported by a Clinical Lectureship(ICA-CL-2017-03-001)jointly funded by Health Education England(HEE)and the National Institute for Health Research(NIHR)+1 种基金Brendon Stubbs is part funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust.Brendon Stubbs also holds active grants with the Medical Research Council(GCRF and multimorbidity calls)and Guys and St Thomas Charity(GSTT).Brendon Stubbs has received consultancy fees from ASICS Europe BV.The views expressed are those of the author(s)and not necessarily those of the(partner organization),the NHS,the NIHR,the Department of Health and Social Care,the MRC or GSTTZD’s contribution was supported by the Hungarian National Research,Development and Innovation Office(KKP126835,ELTE Thematic Excellence Programme 2020,KP2020-IKA-05).
文摘Little is known about the role of active school travel(AST)on mental health among adolescents.Thus,this study aimed to explore the AST-depression association among adolescents aged 12–15 years from 26 low-and middle-income countries(LMICs).Data from the Global School-based Student Health Survey were analyzed in 51,702 adolescents[mean(SD)age 13.8(1.0)years;49.3%boys).Both depressive symptoms and AST were assessed by a single question self-reported measure,respectively.Participants who reported having 5 days or above were considered as AST.Multivariable logistic regression analysis(accounting for sampling weights)was performed while controlling for gender,age,physical activity,sedentary behavior,and food insecurity,and a countrywide meta-analysis was undertaken.The prevalence of depressive symptoms and AST were 30.1%and 37.0%,respectively.Compared with those not having AST,adolescents with AST were less likely to have self-reported depressive symptoms(OR=0.88,95%CI:0.85-0.93)regardless of gender.Countrywide meta-analysis demonstrated that having AST versus not having AST was associated with 12%lower odds for depressive symptoms(OR=0.88;95%CI:0.82-0.94)but with a moderate between-country heterogeneity(I^(2)=59.0%).Based on large samples of adolescents from LMICs,it would be expected that AST may play a critical role in preventing adolescent depression worldwide.However,it is necessary to consider more country-specific factors when implementing AST-related mental health interventions.Future studies should adopt the solid study design to confirm or negate our researchfindings.
文摘The internet is a major source for health information. An increasing number of people, including patients with insomnia, search for remedies online; however, little is known about the quality of such information. This study aimed to evaluate the quality and readability of insomnia-related online information. Google was used as the search engine, and the top websites on insomnia that met the inclusion criteria were evaluated for quality and readability. The analyzed websites belonged to nonprofit, commercial, or academic organizations and institutions such as hospitals and universities. Insomnia-related websites typically included definitions （85%）, causes and risk factors （100%）, symptoms （95%）, and treatment options （90%）. Cognitive behavioral therapy for insomnia （CBT-I） was the most commonly recommended approach for insomnia treatment, and sleep drugs are frequently mentioned. The overall quality of the websites on insomnia is moderate, but all the content exceeded the recommended reading ease levels. Concerns that must be addressed to increase the quality and trustworthiness of online health information include sharing metadata, such as authorship, time of creation and last update, and conflicts of interest; providing evidence for reliability; and increasing the readability for a layman audience.
文摘Defining pathophenotype, a systems level consequence of a disease genotype, together with environmental and stochastic influences, is an arduous task in psychiatry. It is also an appealing goal, given growing need for appreciation of brain disorders biological complexity, aspiration for diagnostic tests development and ambition to identify novel drug targets. Here, we focus on the Schizophrenia and Major Depressive Disorder and highlight recent advances in metabolomics research. As a systems biologytool, metabolomics holds a promise to take part in elucidating interactions between genes and environment, in complex behavioral traits and psychopathology risk translational research.
