Nightmares Relatively Common Among Military Personnel

Nightmares Relatively Common Among Military Personnel

New research reveals that a high percentage of military personnel with sleep disturbances met the criteria for nightmare disorder. However, few of them reported nightmares as a reason for sleep evaluation. The presence of a nightmare disorder increases the risk of other sleep and mental health disorders.

Investigators found that 31 percent of military participants with reported sleep issues had clinically significant nightmares, and trauma-related nightmares occurred in 60 percent of them.

Participants who met criteria for nightmare disorder were five times more likely to have post-traumatic stress disorder (PTSD), four times more likely to have depression, three times more likely to have anxiety, and two times more likely to have insomnia.

Despite their common presence, nightmares were reported as a sleep-related concern by only 3.9 percent of military personnel.

“This research provides a basis for furthering the study and knowledge of nightmares in survivors of traumatic experiences,” said principal investigator Dr. Jennifer Creamer, medical director of the Sleep Medicine Center at Martin Army Medical Center in Fort Benning, Georgia.

“Treatment of nightmares can lead to improvement in sleep, quality of life, and other disorders such as suicidality.”

The study results appear in the Journal of Clinical Sleep Medicine.

Nightmares are vivid, realistic, and disturbing dreams typically involving threats to survival or security, which often evoke emotions of anxiety, fear, or terror. A nightmare disorder may occur when repeated nightmares cause distress or impairment in social or occupational functioning.

According to the authors, this was the largest study to assess clinically significant nightmares in an active duty population referred for the evaluation of sleep disorders. The study involved 493 active duty U.S. military personnel. Participants had a mean age of 38 years, and 78.5 percent were men. Participants predominantly served in the Army (45.6 percent) and Air Force (45.2 percent); 9.2 percent served in the Navy/Marines. Approximately 74 percent of them had been deployed.

Researchers found that those with trauma-related nightmares were more likely to have traumatic brain injury, PTSD, anxiety, and depression.

Nightmares beginning within three months of a trauma are present in up to 80 percent of patients with PTSD, and these post-traumatic nightmares may persist throughout life. Post-traumatic nightmares may take the form of a realistic reliving of a traumatic event or may depict only some of its elements or emotional content.

“Nightmare disorder is highly prevalent but under-recognized in military personnel with sleep disturbances,” said Creamer.

A best practice guide from the American Academy of Sleep Medicine indicates that treatment options for nightmare disorder include medications, most prominently prazosin. Several behavioral therapies also can be effective, such as image rehearsal therapy and other nightmare-focused cognitive behavioral therapy variants.

“Military personnel and health care providers require education that nightmares are not normal and there are treatments available,” added Creamer.

Source: The American Academy of Sleep Medicine/EurekAlert

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ADHD Meds May Improve Mood in Healthy Humans

ADHD Meds May Improve Mood in Healthy Humans

New research finds that when healthy people take attention-deficit hyperactivity disorder (ADHD) drugs, the medication stimulates the release of a chemical in the brain associated with positive emotion.

ADHD medications cause a surge in the neurotransmitter glutamate in key parts of the brain. Subsequently, this increase is associated with changes in positive emotion.

The findings not only provide clues about how these drugs affect healthy brains, they also hint at a previously undiscovered link between glutamate and mood.

“This is the first time that an increase in brain glutamate in response to psychostimulant drugs has been demonstrated in humans,” said Dr. Tara White, an assistant professor in the Brown University School of Public Health and lead author of the new study.

“That’s important since glutamate is the major neurotransmitter responsible for excitation in the brain, and affects learning and memory.”

Even more interesting, White said, the rise in glutamate predicted the magnitude and the duration of positive emotional responses to the drug.

“Given the timing of these effects — the glutamate effect comes first, and the positive emotion comes later — this could indicate a causal link between glutamate and positive emotion,” White said. “I think what we’re seeing here is not just a drug effect, it’s how positive emotion works in humans.”

The research appears in the journal Neuropsychopharmacology.

Millions of kids nationwide take prescription medication to treat ADHD. But in addition to prescribed usage, there’s a thriving black market for these drugs, which young people use to improve attention, mood, and work and school performance. Yet little is known about what effects these drugs have on healthy brains, White said.

In this new study, subjects were first screened for mental and physical health and then underwent MRI spectroscopy scans designed to detect the concentration of neural compounds in specific regions of their brain.

From the medical literature on psychostimulants, White and her team wanted to look in the anterior cingulate cortex, which is a “hub” brain region that connects multiple brain networks involved in emotion, decision-making, and behavior.

They found that two ADHD medications, d-amphetamine and Desoxyn, significantly increased the overall amount of glutamate in the right dorsal anterior cingulate cortex, even after controlling for possible alternative contributing factors, such as volume of gray matter in the region.

The rise in brain glutamate predicted both the duration and the intensity of positive emotion, measured by participant ratings about whether they liked the drug or felt high after consuming it.

Researchers caution that while this was a placebo-controlled study, the findings only suggest an association between glutamate and positive mood, and not necessarily a causal relationship.

However, the fact that the mood changes consistently followed changes in glutamate is suggestive of a cause and effect relationship, though more research is necessary.

Glutamate is the most abundant neurotransmitter in the brain, White said, and its roles in learning and memory are well established. A potential link between glutamate and mood would be a novel finding.

“This is the first time we’ve seen a link between increases in brain glutamate and increases in positive emotion in healthy people, with both changes happening in real time,” said White. “I think it’s going to open up a whole new way of thinking about emotion in humans.”

The research also found evidence of gender differences in drug effects. Women in the sample showed a larger increase in glutamate compared to the men in the sample. Women also responded more strongly to Desoxyn, compared to d-amphetamine.

The gender difference is consistent with prior studies in animals, which show greater stimulant drug effects in females compared to males. The differences between the two drugs also indicate that ADHD medications can have different effects on glutamate and other compounds in the brain.

White and her colleagues believe the medications influence the development of more or new glutamate, rather than just improving the uptake of what is already available. With further research, new data could help scientists to better understand how individuals respond differently to drugs, and changes in positive emotion over time.

“[The] present findings provide the first evidence in humans that drug-induced changes in [glutamate] correlate with subjective experiences of drug liking and drug high following drug ingestion,” White and colleagues wrote.

Source: Brown University

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Study Finds No Link Between Teen Suicide Risk and Flu Drug

Study Finds No Link Between Teen Suicide Risk and Flu Drug

In a new study, researchers did not find an increased risk of suicide among adolescent patients taking the drug oseltamivir (Tamiflu), the only commercially available medication approved by the U.S. Food and Drug Administration (FDA) to treat the flu.

After the drug’s approval in 1999, case reports began to emerge of abnormal behavior in adolescents who had taken the drug. This led the FDA to require that the medication come with a warning label of potential neuropsychiatric side effects, such as hallucinations, delirium, self-harm, and suicide.

So far, clinical studies examining a link between Tamiflu and neuropsychiatric side effects in children, including suicide, have been inconclusive, however. They have also been limited by methodology and potential confounding factors, according to researchers.

In an effort to fill this gap, researchers from the University of Illinois at Chicago (UIC) College of Pharmacy retrospectively studied the association between the use of Tamiflu and the most consequential of those reported side effects: suicide.

“I think physicians will welcome a large, rigorous study on this topic and factor this information into their decision-making process,” said corresponding author Dr. James Antoon, assistant professor of clinical pediatrics in the UIC College of Medicine.

“While this study addresses suicide, there are still many other questions about other possible neuropsychiatric side effects of the drug, which we plan to study in the future. There are also other reasons to use caution when prescribing the drug, including resistance and efficacy in children.”

First, the researchers identified 21,047 children and teens between the ages of one and 18 who attempted suicide during five recent flu seasons (2009-2013) from a national administrative claims database. Of these, 251 had been exposed to Tamiflu, which was determined based on outpatient pharmacy dispensing data.

The mean age of this group was 15 years, 61 percent were female, and 65 percent had an underlying mental health diagnosis.

“For each of the 251 patients, we assigned the 10-day period immediately before the suicide attempt as the case period and we identified up to four earlier control periods of the same length, in the same flu season,” Antoon said. “This helped us to account for within-person confounders, like depression, mental health, trauma and abuse, and other factors, like race or ethnicity.”

The research team repeated the analysis with flu diagnosis alone (without the use of Tamiflu) to determine whether the infection itself could have been a confounding factor associated with suicide risk.

“The potential link between a drug and suicide is a particularly difficult topic to study,” Antoon said. “Many events, which can happen simultaneously or over time, can influence a person to attempt suicide, as can an illness itself, so it can be difficult to study scientifically.

“That’s why we used a novel method called a case-crossover design,” Antoon said. “This analysis is different because it allowed us to use each individual subject as his or her own comparison — we retrospectively studied how patients behaved when on Tamiflu and compared it to their behavior when they were not taking the drug.”

“We did not find any association between exposure to Tamiflu and suicide in pediatric patients,” Antoon said.

While Antoon believes the study may alleviate some fears health care providers have about prescribing the medication in healthy children, he says doctors will likely continue to prescribe Tamiflu with caution.

The findings are published in the Annals of Family Medicine.

Source: University of Illinois at Chicago

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Men and Women With Depression Show Opposite Molecular Changes

Men and Women With Depression Show Opposite Molecular Changes

New research finds that men and women with major depressive disorder (MDD) have opposite changes in the expression of the same genes. If true, the discovery suggests that men and women may need different types of treatment for depression.

Researchers at the University of Pittsburgh and Centre for Addiction and Mental Health (CAMH), Toronto, Canada, base their conclusion on a new postmortem brain study.

The findings, published in Biological Psychiatry, indicate distinct pathology for men and women.

“This important paper highlights the divergent molecular mechanisms contributing to depression in men and women. It challenges the assumption that a similar diagnosis across people has the same biology,” said John Krystal, M.D., editor of Biological Psychiatry.

This is the first time this unique opposing pathology has been reported.

“While researchers have been examining the brains of depressed subjects for decades, many of these studies included only men,” said lead author Marianne Seney, Ph.D., of University of Pittsburgh. This is despite the differences in MDD between men and women: Women are twice as likely to be diagnosed with MDD, and report greater illness severity and different types of symptoms than men.

The study combined eight published datasets (four in men and four in women) in a meta-analysis. Senior author Etienne Sibille, Ph.D., of CAMH, and colleagues analyzed gene expression levels, which indicate how much protein a gene is producing, in postmortem brain tissue of 50 people with MDD (26 men and 24 women) and the same number of unaffected men and women for comparison.

Most of the genes that had altered expression were changed in only men or only women. However, genes that were altered in both men and women were changed in opposite directions.

Women had increased expression of genes affecting synapse function, whereas men had decreased expression of the same genes. Women had decreases in genes affecting immune function, whereas men had increased expression of these genes.

Additionally, the researchers applied their methods to data from a different set of subjects and replicated the opposing changes.

The analysis focused on three different brain regions that regulate mood — the anterior cingulate cortex, dorsolateral prefrontal cortex, and amygdala — and that are dysfunctional in MDD.

Investigators discovered opposite changes in gene expression were specific to the different brain regions. So if women had increased expression of a particular gene in one region and decreased in another, men showed just the opposite.

Because the study used postmortem brain tissue, the effect of the opposite molecular signatures on how MDD affects men and women differently could not be studied. But the findings support sex-specific pathology in the disorder.

“These results have significant implications for development of potential novel treatments and suggest that these treatments should be developed separately for men and women,” said Seney.

For example, in the paper the authors suggest that new treatments targeting the sex-specific pathology in MDD might suppress immune function in men, or boost its function in women.

Source: Elsevier

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Gender Differences Found in Brains of Sleep Apnea Patients

Gender Differences Found in Brains of Sleep Apnea Patients

A new brain imaging study reveals structural brain changes in patients with sleep apnea as well as distinct differences between males and females with the condition.

Obstructive sleep apnea, a disorder which involves disruption of the upper airway, affects about 10 percent of adults. Men are twice as likely to have the condition as women, and symptoms and brain function appear to vary between sexes. When left untreated, the effects of sleep apnea on brain damage increases over time. Its cause is still unknown.

For the study, researchers from the University of California, Los Angeles (UCLA) School of Nursing looked at the brain scans and clinical records of patients who recently had been diagnosed with sleep apnea.

Using high-resolution magnetic resonance imaging (MRI) scans, the researchers analyzed the cortex thickness of 12 women and 36 men who had diagnoses of mild to severe obstructive sleep apnea (who were not being treated for their condition), and compared those findings to 40 male and 22 female healthy controls. The researchers then compared clinical findings of each patient with evidence of cortex thinning.

Not only did they discover several connections between apnea symptoms and thinning of the brain’s cerebral cortex, but they also found distinct differences between men and women when it came to brain structure and concurrent symptoms.

For example, more regions of the superior frontal lobe were thinner in women with apnea than in men with apnea or control groups, which might explain the greater cognitive deficits often found among women with the condition.

In addition, overall cortical thinning could potentially result in poor regulation of the autonomic nervous system and the associated upper-airway breathing dysfunction typically seen in these patients. No sleep apnea patients showed any thickening of the cerebral cortex.

Although previous research has shown a link between brain structure changes and general clinical signs, no studies have definitively linked gender differences in brain structure with apnea symptoms.

The current study is one of the first to reveal significant clinical differences between men and women with sleep apnea, and points to the need for different treatment approaches in addressing these varied symptoms.

Overall, the greater cortex injury in the cognitive centers of women’s brains may help explain why female apnea patients tend to have more severe cognitive problems than men with the condition. In addition, the thinning associated with both men and women who have sleep apnea may be behind the disordered breathing seen in both sexes.

It is still unclear, however, whether these physical brain changes precede the sleep apnea disorder, or worsen sleep apnea’s symptoms as the disorder progresses.

Source: University of California, Los Angeles Health Sciences

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Therapy Dogs May Ease Stress of College Students

Therapy Dogs May Ease Stress of College Students

A new study from the University of British Columbia (UBC) shows that some one-on-one time with a therapy dog can do the trick of boosting student wellness.

Some believe college students are more stressed than ever before. As such, academic centers are taking proactive strategies to provide healthy avenues for students.

“Therapy dog sessions are becoming more popular on university campuses, but there has been surprisingly little research on how much attending a single drop-in therapy dog session actually helps students,” said Emma Ward-Griffin, the study’s lead author and research assistant in the UBC department of psychology.

“Our findings suggest that therapy dog sessions have a measurable, positive effect on the wellbeing of university students, particularly on stress reduction and feelings of negativity.”

In the study, researchers surveyed 246 students before and after they spent time in a drop-in therapy dog session. Students were free to pet, cuddle, and chat with seven to 12 canine companions during the sessions. They also filled out questionnaires immediately before and after the session, and again about 10 hours later.

The researchers found that participants reported significant reductions in stress as well as increased happiness and energy immediately following the session, compared to a control group of students who did not spend time at a therapy dog session. While feelings of happiness and life satisfaction did not appear to last, some effects did.

The study appears in Stress and Health.

“The results were remarkable,” said Dr. Stanley Coren, study co-author and professor emeritus of psychology at UBC.

“We found that, even 10 hours later, students still reported slightly less negative emotion, feeling more supported, and feeling less stressed, compared to students who did not take part in the therapy dog session.”

While previous research suggested that female students benefit from therapy dog sessions more than male students, the researchers found the benefits were equally distributed across both genders in this study.

Since the strong positive effects of the therapy dog session were short-lived, the researchers concluded that universities should be encouraged to offer them at periods of increased stress.

“These sessions clearly provide benefits for students in the short-term, so we think universities should try to schedule them during particularly stressful times, such as around exam periods,” said Dr. Frances Chen, the study’s senior author and an assistant professor of psychology at UBC.

“Even having therapy dogs around while students are working on their out-of-class assignments could be helpful.”

The therapy dog sessions were organized in partnership with UBC’s Alma Mater Society and Vancouver ecoVillage, a non-profit organization that provides therapeutic services, including therapy dog sessions, and mental health wellness services.

Source: University of British Columbia

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Mix of Some Personality Traits May Up Risk of Compulsive Social Media Use

Mix of Some Personality Traits May Up Risk of Compulsive Social Media Use

In a new study, researchers explored how the interaction of specific personality traits can impact the likelihood of developing compulsive Internet use, in particular to social networking sites.

“There has been plenty of research on how the interaction of certain personality traits affects addiction to things like alcohol and drugs,” said Binghamton University School of Management assistant professor Dr. Isaac Vaghefi.

“We wanted to apply a similar framework to social networking addiction.”

Vaghefi, and co-researcher Dr. Hamed Qahri-Saremi of DePaul University in Chicago, collected self-reported data from nearly 300 college-aged students. They found that three personality traits in particular — neuroticism, conscientiousness, and agreeableness — were related to social network addiction.

These three personality traits are part of the five-factor personality model, a well-established framework for  understanding the human personality.

Researchers found that the two other traits in the model — extraversion and openness to experience — did not play much of a role in the likelihood of developing a social network addiction.

In addition to testing the effect the singular traits had, the investigators studied how the traits interact with one another as they relate to social network addiction.

“It’s a complex and complicated topic. You can’t have a simplistic approach,” said Vaghefi.

Study authors note that on their own, the personality traits of neuroticism and conscientiousness have direct negative and positive effects on the likelihood of developing a social network addiction.

Researchers found that neuroticism (the extent to which people experience negative emotions such as stress and anxiety) seemed to increase the likelihood of developing an addiction to social network sites.

On the other hand, higher amounts of conscientiousness (having impulse control and the drive to achieve specific goals) seemed to decrease the likelihood of developing a social network addiction.

But when tested together, they found that neuroticism seemed to moderate the effect of conscientiousness as it relates to social network addiction.

The finding is complex because someone can simultaneously be highly neurotic and conscientious. Researchers found that even if someone is able to practice self-discipline and regularly persists at achieving goals, the fact that they may also be a stressful and anxious person often overrides the perceived control they may have over social network use.

This moderation effect could cause a conscientious person to be more likely to develop an addiction to social networking sites.

Researchers found that agreeableness alone, the degree to which someone is friendly, empathetic, and helpful, didn’t have a significant effect on social network addiction — but this changes when combined with conscientiousness.

A combination of low levels of both agreeableness and conscientiousness (someone can be both generally unsympathetic and irresponsible) often are related to a higher likelihood of social network addiction. Paradoxically, the opposite combination of high levels of both agreeableness and conscientiousness also increase risk of social network addiction.

Vaghefi said this unexpected finding could be explained from a “rational addiction” perspective, meaning some users are intentionally using more of a social network to maximize the perceived benefits of it.

For example, he said an agreeable and friendly person may be making a very conscientious decision to use social networks more in order to interact with their friends, as they make it a deliberate goal to flourish those relationships through the use of social networks.

This is unique because this addiction would not be a result of irrationality or a lack of impulse control, as is often associated with addiction. Rather, a person would be developing an addiction through a rational and well-meaning process.

Vaghefi hopes that based on this research, people will look at the “whole picture” when it comes to how personality traits impact social networking addiction.

“It’s more of a holistic approach to discover what kind of people are more likely to develop an addiction,” said Vaghefi.

“Rather than just focusing on one personality trait, this allows you to look at an all-inclusive personality profile.”

Vaghefi’s paper was presented at the 51st Hawaii International Conference on Systems Science.

Source: Binghamton University/EurekAlert

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Mice Study Shows How Others’ Stress Can Alter Brain Just Like Real Thing

Mice Study Shows How Others’ Stress Can Alter Brain Just Like Real Thing

New Canadian research using mice shows that stress transmitted from others can change the brain in the same way as real stress does. The study also shows that the effects of stress on the brain are reversed in female mice — but not males — following a social interaction.

Jaideep Bains, Ph.D., and his team at the University of Calgary studied the effects of stress in pairs of male or female mice. They removed one mouse from each pair and exposed it to a mild stress before returning it to its partner.

They then examined the responses of a specific population of cells, specifically CRH neurons which control the brain’s response to stress, in each mouse. Networks in the brains of both the stressed mouse and naïve partner were altered in the same way.

“Brain changes associated with stress underpin many mental illnesses including PTSD, anxiety disorders, and depression,” said Bains, professor in the Department of Physiology and Pharmacology and member of the Cumming School of Medicine’s Hotchkiss Brain Institute (HBI).

“Recent studies indicate that stress and emotions can be ‘contagious’. Whether this has lasting consequences for the brain is not known.”

Toni-Lee Sterley, Ph.D., a postdoctoral associate in Bains’ lab and the study’s lead author comments, “What was remarkable was that CRH neurons from the partners, who were not themselves exposed to an actual stress, showed changes that were identical to those we measured in the stressed mice.”

The team then used optogenetic approaches to engineer these neurons so that they could either turn them on or off with light. When the team silenced these neurons during stress, they prevented changes in the brain that would normally take place after stress.

When they silenced the neurons in the partner during its interaction with a stressed individual, the stress did not transfer to the partner. Remarkably, when they activated these neurons using light in one mouse, even in the absence of stress, the brain of the mouse receiving light and that of the partner were changed just as they would be after a real stress.

The team discovered that the activation of these CRH neurons causes the release of a chemical signal, an “alarm pheromone,” from the mouse that alerts the partner.

The partner who detects the signal can in turn alert additional members of the group. This propagation of stress signals reveals a key mechanism for transmission of information that may be critical in the formation of social networks in various species.

Another advantage of social networks is their ability to buffer the effects of adverse events. The Bains team also found evidence for buffering of stress, but this was selective.

They noticed that in females the residual effects of stress on CRH neurons were cut almost in half following time with unstressed partners. The same was not true for males.

Bains suggested these findings may also be present in humans. “We readily communicate our stress to others, sometimes without even knowing it. There is even evidence that some symptoms of stress can persist in family and loved ones of individuals who suffer from PTSD. On the flip side, the ability to sense another’s emotional state is a key part of creating and building social bonds.”

The study, which appears in the journal Nature Neuroscience, indicates that stress and social interactions are intricately linked. The consequences of these interactions can be long-lasting and may influence behaviors at a later time.

Source: University of Calgary/EurekAlert

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Is Suicide Linked to Living at High Altitude?

Is Suicide Linked to Living at High Altitude?

A research review discovers high-altitude areas have increased rates of suicide and depression. In the United States, intermountain states were found to have the highest suicide rate with investigators positing that blood oxygen levels due to low atmospheric pressure may play a factor.

The research appears in the Harvard Review of Psychiatry.

Brent Michael Kious, M.D., Ph.D., from the University of Utah, and colleagues explain that additional research may reveal interventions to reduce the effects of low blood oxygen on mood and suicidal thoughts.

In the current study, the researchers reviewed and analyzed previous evidence linking higher altitude of residence to increased risk of suicide and depression. The scientists then considered possible explanations for these associations.

“There are significant regional variations in the rates of major depressive disorder and suicide in the United States, suggesting that sociodemographic and environmental conditions contribute,” Kious and coauthors write.

Twelve studies were analyzed with most performed in the United States. The investigations included population-based data on the relationship between suicide or depression and altitude.

While the studies used varying methods, most reported that higher-altitude areas had increased rates of depression and suicide. In general, the correlation was stronger for suicide than for depression.

The highest suicide rates were clustered in the intermountain states: Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, and Wyoming. (Alaska and Virginia also had high suicide rates.)

In a 2014 study, the percentage of adults with “serious thoughts of suicide” ranged from 3.3 percent in Connecticut (average altitude 490 feet) to 4.9 percent in Utah (average altitude 6,100 feet).

Other key findings from previous research on altitude and suicide included:

  • Populations living at higher altitudes had increased suicide rates despite having decreased rates of death from all causes. Rather than a steady increase, the studies suggested a “threshold effect”: suicide rates increased dramatically at altitudes between about 2,000 and 3,000 feet;
  • Suicide rates were more strongly associated with altitude than with firearm ownership. Other factors linked to suicide rate included increased poverty rate, lower income, and smaller population ratios of white and divorced women. However, the studies could not account for all factors potentially affecting variations in suicide, such as substance abuse rates and cultural differences;
  • While more than 80 percent of U.S. suicides occur in low-altitude areas, that’s because most of the population lives near sea level. Adjusted for population distribution, suicide rates per 100,000 population were 17.7 at high altitude, 11.9 at middle altitude, and 4.8 at low altitude. Studies from some other countries, but not all, also reported increased suicide rates at higher altitudes.

Why would altitude affect suicide rates? Kious and coauthors suggest the answer might be “chronic hypobaric hypoxia”: low blood oxygen related to low atmospheric pressure.

That theory is supported by studies in animals and short-term studies in humans BJR. The authors suggest two pathways by which hypobaric hypoxia might increase the risks of suicide and depression: by altering the metabolism of the neurotransmitter serotonin and/or; through its effects on brain bioenergetics.

If borne out by future studies, these mechanisms suggest some possible treatments to mitigate the effects of altitude on depression and suicide risk: supplemental 5-hydroxytryptophan (a serotonin precursor) to increase serotonin levels, or creatinine to influence brain bioenergetics.

Indeed, the review identifies several areas in need of further research, including the effects of prolonged exposure to altitude on both serotonin metabolism and brain bioenergetics.

Source: Wolters Kluwer Health/EurekAlert

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Older Adults with Fewer Social Ties Less Likely to Get Cataract Surgery

Older Adults with Fewer Social Ties Less Likely to Get Cataract Surgery

A new study adds to the growing body of research examining the effects of social isolation on health. The findings, published in the journal JAMA Ophthalmology, show that older people with very few family members or friends are less likely to get cataract surgery, a procedure with broad implications for health.

A cataract is a medical condition in which the lens of the eye becomes progressively opaque, resulting in blurry vision. It is one of the most common and treatable causes of vision impairment in the United States. Cataract surgery can improve one’s quality of life, reduce the risk of falls and cut cognitive decline among older adults.

The researchers from the University of Michigan Kellogg Eye Center believe that strong social networks may play a significant role in the likelihood of older adults opting for cataract surgery. Not only can family members motivate older adults to take care of their fading vision, but they can also can help them get the care they need.

“It may get to a point that it takes people around them to speak up about their changing vision,” said study author Brian Stagg, M.D., a Kellogg ophthalmologist and health services researcher at the University of Michigan.

For the study, the researchers looked at 9,760 adults over the age of 65 with Medicare benefits. They found that those with none, one or two family members had 40-percent lower odds of receiving cataract surgery than adults with three or more family members. Data came from the National Health and Aging Trends Study.

The new study by Kellogg Eye Center is consistent with a trend in health research that examines the harmful impact of social isolation on health.

“A nuanced understanding of the impact of social support networks is important to develop as we implement strategies to improve access to cataract surgery for a rapidly growing older population,” Stagg said.

There are several ways to help older patients who may not have a sufficient social network. For example, primary care doctors and ophthalmologists may need to ask their older patients if transportation and support is available after the procedure. A social worker could help navigate care, too, say the authors of the study.

According to the findings, friends, spouses or partners did not influence an older person’s decision to have cataract surgery as much as their adult children. This suggests that an adult child who regularly visits an older parent might detect vision changes that others have not noticed.

Source: Michigan Medicine- University of Michigan

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