Tag: Mental health

Posted on

GLP-1s May Benefit Mental Health Through Gut–Brain Axis

GLP-1 drugs could act on depression by improving the balance of microorganisms in the intestinal tract, preclinical research suggests.

The findings, in Cell Host & Microbe, suggest extra benefits from this new class of drugs, beyond their metabolic effects on diabetes and obesity.

The GLP-1 receptor agonist liraglutide appeared have mental health benefits on mice, influencing brain function and behavior and reducing symptoms of depression.

This related to an increase in the abundance in the microbe Lactobacillus delbrueckii, which is known to act positively on neurons relating to stress.

Researcher Yonggui Yuan, PhD, from Southeast University in Jiangsu, China, noted mixed results from previous studies into the antidepressant effects from GLP-1 agonists.

“The prevailing model held that these drugs act directly on GLP-1 receptors in the brain, while our study provides evidence for an alternative pathway,” he said.

Emerging evidence suggests this drug class may exert biological effects beyond GLP receptors, such as reducing neuroinflammation after stroke or protecting against cisplatin-induced kidney injury.

The researchers therefore examined the neuropsychiatric effects of liraglutide and found that it had antidepressant effects that remained in mice deficient in the GLP-1 receptor.

The team identified a pathway independent of the GLP-1 receptor through which liraglutide could alleviate depressive-like behaviors in the animals.

Liraglutide encouraged the growth of L. delbrueckii by improving bacterial biosynthesis of serine and phosphoenolpyruvate (PEP), two metabolites that occupy pivotal roles in bacterial central metabolism.

PEP serves as a precursor for biosynthesis of amino acids, nucleotides, and cell wall components while the amino acid serine is a key node in one-carbon metabolism and a precursor for glycine, cysteine, and phospholipid synthesis, all essential for rapid bacterial proliferation.

Increasing levels of L. delbrueckii aided the production of diacylglycerol via triacylglycerol lipase.

This provided a precursor by which the animals could synthesize 2-arachidonoylglycerol (2-AG) levels, to normalize neuronal activity in emotional brain regions.

Gut-derived 2-AG inhibited stress-induced neuronal hyperactivity in the basolateral amygdala and dorsomedial hypothalamus, revealing a microbiota-endocannabinoid axis for potential use in depression therapy.

“Given the growing clinical use of GLP-1R agonists for metabolic disorders and the high comorbidity between metabolic and psychiatric conditions, understanding these pleiotropic, microbiota-mediated effects has important translational implications,” the authors noted.

“More broadly, the demonstration that a clinically approved metabolic drug can exert neuropsychiatric effects through microbiota-dependent mechanisms opens new avenues for drug repurposing and suggests that the therapeutic potential of existing pharmacological agents may extend far beyond their originally intended targets,” the authors concluded.

The post GLP-1s May Benefit Mental Health Through Gut–Brain Axis appeared first on Inside Precision Medicine.

Posted on

Tracking the longitudinal course of physiologic and mental health functioning among individuals in substance use disorder treatment

IntroductionMental health monitoring is crucial to long-term recovery in substance use disorder (SUD) treatment; however, little is known about how changes in physiological indicators align with changes in self-reported mental health over time.MethodsWe examined longitudinal associations of resting heart rate (RHR) and heart rate variability (HRV) collected via a WHOOP® photoplethysmography device with self-reported stress, anxiety, and depressive symptoms among individuals in SUD treatment. Participants (N = 59) continuously wore the device and completed at least two mental health and stress assessments during the first month of residential treatment. ResultsLinear regression results indicated favorable changes in mental health and/or physiologic metrics, with notable heterogeneity in concurrent subject-level trends. Among participants with decreased RHR (better physiological functioning), 39% (N=23) also endorsed decreased stress, 42% (N=25) decreased anxiety, and 39% (N=23) improved depressive symptoms. Of those with increased HRV (greater stress adaptability), 39% (N=23) endorsed decreased stress, 39% (N=23) improved anxiety, and 41% (N=24) reduced depressive symptoms.DiscussionConcurrent changes in physiologic and mental health metrics during the first month of treatment varied across participants. These findings highlight the importance of integrating subjective mental health measures with physiological indicators to capture clinically relevant change during early SUD treatment.
Posted on

Association between plasma proBDNF levels and cognitive impairment in patients with alcohol dependence: a case–control and longitudinal study

BackgroundAlcohol dependence is frequently accompanied by cognitive impairment. Brain-derived neurotrophic factor (BDNF) signaling plays a critical role in synaptic plasticity, while the precursor form, proBDNF, has been increasingly implicated in neurodegenerative and psychiatric disorders. However, the association between plasma proBDNF levels and cognitive impairment in alcohol dependence remains unclear.MethodsEighty male patients with alcohol dependence and forty-two matched healthy controls were enrolled. Plasma proBDNF levels were measured via enzyme-linked immunosorbent assay (ELISA). Cognitive function was assessed using the Mini-Mental State Examination (MMSE), the Modified Wisconsin Card Sorting Test (M-WCST), and the Verbal Fluency Test (VFT). Forty-one patients were reassessed after four weeks of abstinence. Group comparisons and correlation analyses were performed.ResultsPatients with alcohol dependence exhibited significantly elevated plasma proBDNF levels and impaired cognitive performance compared with controls. Plasma proBDNF levels were positively correlated with alcohol consumption severity, and linked to global cognitive deficits alongside nuanced executive performance variations. After four weeks of abstinence, plasma proBDNF levels decreased and cognitive performance improved; however, changes in proBDNF were weakly associated with cognitive recovery.ConclusionsElevated plasma proBDNF levels are associated with alcohol dependence severity and cognitive impairment, suggesting that proBDNF may serve as a peripheral biomarker reflecting the dynamic neurocognitive status in alcohol dependence.
Posted on

SleepPathfinder: A Socratic Questioning and Self-Decision–Based Chatbot to Support User Engagement in Digital CBT-I: Usability and Feasibility Study

Background: Chronic insomnia is a highly prevalent sleep disorder that adversely affects quality of life and mental health. Cognitive behavioral therapy for insomnia (CBT-I) is internationally recommended as the first-line treatment, and digital CBT-I (dCBT-I) has been developed to improve accessibility and scalability. While existing dCBT-I systems effectively support structured behavioral training through standardized protocols, they provide relatively limited support for users’ cognitive exploration and meaning-making processes, particularly in helping users reflect on and internalize the rationale behind CBT-I practices in daily life. These limitations may contribute to challenges in sustained engagement and long-term adherence. Objective: This study aimed to examine the usability and feasibility of SleepPathfinder, a conversational CBT-I support chatbot that integrates Socratic questioning and a self-decision mechanism to support users’ understanding of and engagement with CBT-I practices. Methods: SleepPathfinder was designed around a 4-stage conversational flow: education on CBT-I techniques, Socratic cognitive exploration, self-decision, and advice provision. We conducted (1) a single-session pilot usability study (n=45) to assess system stability and user experience and (2) a 5-day condition-based comparative experiment (n=30) consisting of daily sessions, comparing an exploratory dialogue condition with a directive, protocol-guided dialogue condition. Quantitative measures assessed usability, cognitive appraisals related to sleep problems, autonomy-related experiences, and behavioral readiness, while qualitative feedback and conversational log analyses were used to examine interaction patterns and engagement characteristics. Results: In the comparative experiment, the exploratory dialogue condition showed a tendency toward reduced perceived threat and severity appraisal of sleep problems compared with the directive condition, accompanied by moderate effect sizes in cognitive perception measures. Autonomy-related experiences, including perceived choice and engagement, demonstrated suggestive upward trends in the exploratory condition. Behavioral intention changes were comparable across conditions, while overall readiness for change increased across participants. Conversational log analyses indicated that greater depth and volume of user self-narrative were associated with larger shifts in cognitive appraisals, whereas the frequency of chatbot questions alone was not. The pilot usability study indicated generally positive evaluations of system usability and content credibility, while identifying areas for improvement in emotional responsiveness and conversational naturalness. Conclusions: These findings suggest that a Socratic questioning–based and self-decision–based conversational structure is usable and feasible as a supportive interaction layer within dCBT-I systems. Rather than altering the directive behavioral structure of CBT-I, such an approach may complement existing protocols by facilitating cognitive exploration and supporting user-perceived autonomy. This study provides design-oriented evidence to inform the refinement of dialogue-supported digital CBT-I systems aimed at enhancing user engagement with CBT-I practices.
<img src="https://jmir-production.s3.us-east-2.amazonaws.com/thumbs/53b6f3cffbd734291f43739e09584341" />

Posted on

The Intersectionality of OCD and the Shame Surrounding Sexuality 

By Mike Vatter

Obsessive-Compulsive Disorder (OCD) is often misunderstood as a condition involving excessive cleanliness, organization, or ritualistic behavior. In reality, OCD is a complex mental health disorder characterized by intrusive thoughts, unwanted images, fears, and compulsive behaviors intended to reduce anxiety. One of the least understood and most painful aspects of OCD occurs when intrusive thoughts intersect with sexuality, creating a profound sense of shame, confusion, and isolation. 

Sexuality is already a deeply personal aspect of human identity. Many people grow up receiving messages, whether from family, religion, culture, or society, that certain thoughts, desires, or identities are inappropriate or unacceptable. When OCD enters this landscape, it can weaponize these fears and vulnerabilities. Intrusive thoughts often target what a person values most or fears most. As a result, individuals with OCD may experience unwanted sexual thoughts that feel completely inconsistent with their values, identity, or desires.

Someone with OCD may become trapped in relentless questioning: “What if I am attracted to someone I shouldn’t be attracted to?” “What if these thoughts mean something about who I really am?” “What if I am secretly a bad person?” These questions are not driven by genuine desire but by overwhelming anxiety and uncertainty. Nevertheless, the individual often feels compelled to seek reassurance, analyze their reactions, or avoid situations that trigger distress. 

The shame surrounding sexuality intensifies this struggle. Society frequently treats sexual thoughts as reflections of character rather than recognizing that thoughts can occur without intent, desire, or meaning. For people with OCD, this misunderstanding can be devastating. Many become terrified that simply having an intrusive thought makes them immoral, dangerous, or fundamentally flawed. As a result, they often suffer in silence, afraid that disclosing their thoughts will lead to judgment or rejection. 

The intersection of OCD and sexuality can affect people of all sexual orientations and gender identities. Some individuals experience obsessions centered on questioning their sexual orientation, regardless of whether they identify as heterosexual, gay, bisexual, or otherwise. Others experience intrusive thoughts involving taboo or unwanted sexual scenarios. In each case, the distress comes not from the thoughts themselves but from the meaning the individual fears those thoughts represent. 

This experience is particularly challenging because shame thrives in secrecy. The more a person attempts to suppress, analyze, or eliminate intrusive thoughts, the stronger and more persistent those thoughts often become. OCD feeds on certainty-seeking, convincing individuals that if they can just think hard enough or find enough reassurance, they will finally feel safe. Unfortunately, the cycle rarely ends that way. 

Recovery begins when individuals learn to separate intrusive thoughts from identity and intention. Evidence-based treatments such as Exposure and Response Prevention (ERP) help people tolerate uncertainty and reduce compulsive responses. Through treatment, many discover that thoughts are not actions, urges are not intentions, and anxiety is not evidence. They learn that having an intrusive thought says far less about their character than the courage it takes to face that thought without engaging in compulsions. 

Understanding the intersectionality of OCD and sexual shame requires compassion, education, and nuance. It demands that we challenge cultural assumptions about thoughts and morality while recognizing the unique suffering OCD can create. When people understand that intrusive thoughts are a symptom of a disorder rather than a reflection of character, shame begins to lose its power. 

Ultimately, healing occurs not when every intrusive thought disappears, but when individuals no longer measure their worth by the thoughts that enter their minds. By replacing shame with understanding and fear with self-compassion, people living with OCD can reclaim both their mental health and their sense of identity.

The post The Intersectionality of OCD and the Shame Surrounding Sexuality  appeared first on International OCD Foundation.

Posted on

Trajectories and predictors of self-care from pre-discharge to 12 months after discharge in people with spinal cord injury: a longitudinal study using growth mixture modeling

IntroductionSelf-care is essential for preventing secondary complications and supporting community reintegration after spinal cord injury (SCI). However, evidence is limited on how self-care changes over time after discharge and whether distinct subgroups exhibit different trajectories.MethodsUsing convenience sampling, 220 patients with SCI were recruited from a tertiary hospital in northern China between August 2023 and December 2024. Self-care was measured with the Self-Care in Spinal Cord Injuries Inventory (SC-SCII) at pre-discharge baseline and at 1, 3, 6, and 12 months after discharge. Baseline mental health literacy and perceived social support were assessed using the Multicomponent Mental Health Literacy Scale (MMHL) and the Perceived Social Support Scale (PSSS). Repeated-measures ANOVA was used to describe the population-average time trend, and growth mixture modeling (GMM) was used as the primary person-centered analysis to identify latent trajectory classes. Multinomial logistic regression examined predictors of class membership.ResultsA total of 209 patients completed all assessments (attrition rate: 5.0%). Mean SC-SCII scores peaked at 1 month post-discharge and then declined gradually over 12 months (F = 25.965, p < 0.001). GMM identified three distinct self-care trajectories: low-level decreasing (31.1%), moderate-level stable (39.7%), and high-level increasing (29.2%), with high classification accuracy (entropy = 0.965). Sex, educational level, mental health literacy, and perceived social support were associated with trajectory membership.ConclusionSelf-care trajectories after SCI are heterogeneous, and early post-discharge improvements may be transient for many individuals. The identified trajectories provide preliminary evidence for developing future prediction tools and trajectory-informed transitional nursing interventions.
Posted on

Beyond aesthetic outcomes: psychodermatological benefits of botulinum toxin treatment in the upper facial third. A narrative review

BackgroundBotulinum toxin type A (BoNT-A) is widely used in aesthetic dermatology, particularly for dynamic wrinkles in the upper facial third. Beyond cosmetic effects, BoNT-A may influence emotional processing through the skin-brain axis. This narrative review synthesizes evidence on psychological and psychiatric outcomes of upper facial BoNT-A treatment, with a focus on mechanisms extending beyond aesthetics.MethodsA structured search was conducted in PubMed, Scopus, and Web of Science through January 2026. Search terms included “botulinum toxin,” “upper facial third,” “psychodermatology,” “facial feedback,” “depression,” “anxiety,” and “psychiatric disorders.” Original studies, randomized controlled trials (RCTs), observational studies, systematic reviews, and meta-analyses assessing psychological, psychiatric, or neurobiological outcomes were included.ResultsUpper facial BoNT-A is associated with clinically meaningful reductions in depressive and anxiety symptoms, and improvements in self-perception and social functioning. Inhibition of corrugator and procerus muscles modulates afferent signaling to limbic structures, supporting the facial feedback hypothesis. Neuroimaging evidence demonstrates attenuated amygdala activation after BoNT-A treatment. Psychosocial improvements may reinforce these neurobiological effects. Evidence in bipolar disorder and personality disorders remains limited and methodologically heterogeneous. Caution is advised in patients with body dysmorphic disorder.ConclusionsBoNT-A in the upper facial third provides psychodermatological benefits beyond aesthetics, improving emotional regulation and affective symptoms. It should be considered a complementary intervention within a biopsychosocial framework. Future large-scale RCTs with standardized psychiatric and neurobiological endpoints are warranted.
Posted on

Genome Wide Analysis Broadens Genetic Knowledge of Anxiety

A large European meta-analysis led by King’s College London has revealed 39 new areas of the genome linked to symptoms of anxiety and provided new estimates of heritability of this common condition.

Writing in Nature Human Behaviour, the researchers explain they found 80 variants linked to anxiety in 74 specific areas of the genome, but 35 were already known to be linked to the disorder from previous research.

“These correlations highlight the interconnection between mental and physical health,” said Brittany Mitchell, PhD, a senior researcher at the QIMR Berghofer medical research institute and co-first author on the study in a press statement.

“Importantly, while some shared genetic variants may increase risk for both a physical health condition and more severe anxiety symptoms, it’s also true that living with chronic pain or illness can contribute to anxiety symptoms. Our findings don’t reveal causation or the direction of effect, but they do open up important questions for future research.”

Anxiety disorders are very common mental health conditions across the globe with large variations in severity from mild to debilitating. Previous research has attempted to assess the genetic heritability of anxiety but estimates of how heritable this condition is vary widely.

In this study, genetic data from 14 cohorts of people with generalized anxiety symptoms assessed via self-report questionnaires between 2007 and 2023 was combined to carry out a large meta-analysis of 693,869 people. Most of the cohorts were largely made up of people of European ancestry, for example, the UK Biobank, and mostly came from Europe or North America.

In addition to finding the new variants, the team also created a polygenic risk score for anxiety aggregating genome-wide SNP effects. Overall, the estimated SNP-based heritability was around 6% and the team estimated that about 1-3% of variance in anxiety symptom severity could be attributed to genetics according to the polygenic risk score.

Notably the research also highlighted some links between the genetics of anxiety and other conditions like irritable bowel syndrome, coronary artery disease, and migraine.

“Given the high and rising rates of anxiety, especially in young adults, it is more important than ever to improve our ability to identify and understand sources of risk,” write the authors.

“Despite its public health impact, progress in anxiety genetics lags behind other major mental health conditions. We hope our findings encourage genome-wide investigations leveraging existing but potentially underutilized anxiety severity data in genotyped cohorts, accelerating our progress in understanding the genetic architecture of anxiety.”

The post Genome Wide Analysis Broadens Genetic Knowledge of Anxiety appeared first on Inside Precision Medicine.

Posted on

VOCALE LBD: Online Peer Support for Caregivers of People With Lewy Body Dementia

Conditions: Lewy Bodies Disease; Depression Disorder; Caregiver Burden; Caregivers

Interventions: Behavioral: VOCALE LBD: Virtual Online Communities for Aging Life Experiences: Lewy Body Dementia; Other: Standard of Care Educational Materials

Sponsors: University of Washington; National Institute of Mental Health (NIMH); The Lewy Body Dementia Association (LBDA); National Institute on Aging (NIA); National Institutes of Health (NIH)

Not yet recruiting