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Neuropsychology

Sleep problems and fatigue ‘directly linked to COVID-19’

Mental illness as a direct result of COVID infection is less certain, say researchers

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The link between COVID-19 with sleep problems and fatigue has been confirmed by a new study into the impact of the virus – although doubt exists over whether infection is directly responsible for mental illness. 

People who tested positive for COVID were found to have an increased risk of such issues, with a six-fold increase in the likelihood of reporting fatigue to a GP, and a three-fold increase in the risk of sleep problems. 

There was also an 83 per cent increase in mental illness following a positive PCR test, although this was also recorded as being 71 per cent among those without COVID. 

The researchers on the study, led by the University of Manchester, say this does cast doubt as to whether COVID directly causes mental illness, as this finding also includes other mental health risk factors like pandemic-related anxieties, and whether people with mental illness may be more likely to seek a test. 

The findings were compiled through analysis of electronic primary care health records of 226,521 people from across the UK. 

Dr Matthias Pierce, who led the work at The University of Manchester, said: “When we began this research project we wanted to investigate whether we could find any evidence in primary health care records that COVID-19 was linked to an increased risk of mental health illness, sleep and fatigue problems.

“While fatigue is clearly a consequence of COVID-19 the risk of experiencing sleep problems is also very high. However, we are sceptical regarding the extent that COVID-19 is directly causing people to become mentally ill, or whether those with a predisposition to mental illness are more likely to get tested.”

“This study shows a clear association between COVID-19 infection and fatigue and sleep problems,” says Professor Trudie Chalder, a cognitive behavioural psychotherapy specialist at King’s College London’s Institute of Psychiatry, Psychology and Neuroscience (IoPPN).

The next research steps will be to explore mechanisms of such associations and targeted interventions.”

Professor Roger Webb, who co-leads the Mental Health research programme at the National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre (NIHR GM PSTRC), which funded the study, added: “Our findings align with those generated by investigations conducted in other countries in revealing elevated risks of mental illness, self-harm, fatigue, and disrupted sleep patterns among people testing positive for infection during the pandemic. 

“Establishing the mechanisms that have caused these outcomes to occur is the next major challenge for researchers in our field.”

Neuropsychology

Discrimination ‘can cause mental health and behaviour issues’

The UCLA study reveals both the short- and long-term psychological and behavioural impact on young adults

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Young adults who have experienced discrimination have a higher risk of both short- and long-term psychological and behavioural problems, a new study has found. 

Researchers at UCLA examined a decade’s worth of health data on 1,834 Americans who were between 18 and 28 years old when the study began. 

They found that the effects of discrimination may be cumulative — that the greater number of incidents of discrimination someone experiences, the more their risk for mental and behavioural problems increases.

The study also suggests that the effects of discrimination in young adults are connected with disparities in care for mental health concerns and institutional discrimination in health care overall, including inequities in diagnoses, treatment and health outcomes.

Previous studies have linked discrimination — whether due to disability, racism, sexism, ageism, physical appearance or other biases — to a higher risk for mental illness, psychological distress and drug use. 

While previous research has examined the correlation in childhood or later adulthood, this new study is the first to focus on the transition to adulthood and to follow the same group of individuals over time.

“With 75 per cent of all lifetime mental health disorders presenting by age 24, the transition to adulthood is a crucial time to prevent mental and behavioural health problems,” said Yvonne Lei, a medical student at the David Geffen School of Medicine at UCLA and the study’s corresponding author.

Lei also said the findings are particularly relevant in light of the stresses young adults are facing globally today.

“The COVID-19 pandemic has brought to the forefront new mental health challenges — particularly for vulnerable populations,” she said. 

“We have the opportunity to rethink and improve mental health services to acknowledge the impact of discrimination, so we can better address it to provide more equitable care delivery.”

Researchers used data spanning 2007 to 2017 from the University of Michigan’s Transition to Adulthood Supplement of the Panel Study of Income Dynamics survey. 

Approximately 93 per cent of the people in the study reported experiencing discrimination; the most common factors they cited were age (26 per cent), physical appearance (19 per cent), sex (14 per cent) and race (13 per cent).

The analysis showed that participants who experienced frequent discrimination, defined as a few times per month or more, were roughly 25 per cent more likely to be diagnosed with a mental illness and twice as likely to develop severe psychological distress than those who had not experienced discrimination or had experienced it a few times per year or less. 

Overall, people who experienced any amount of discrimination had a 26 per cent greater risk for poor health than people who said they did not experience discrimination.

During the ten-year period, young adults in the study who had experienced multiple successive years of high-frequency discrimination showed a much more pronounced, cumulative risk for mental illness, psychological distress, drug use and worse overall health.

The findings shed light on the multidimensional impact of discrimination on mental and behavioural health and overall well-being.

“The associations we found are likely also intertwined with mental health care service disparities — including inequities in care access, provider biases and structural and institutional discrimination in health care — leading to inequities in diagnoses, treatment and outcomes,” said the study’s senior author, Dr Adam Schickedanz, an assistant professor of paediatrics at the Geffen School of Medicine.

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Neuropsychology

Parental depression ‘can impact child’s mental health and academic progress’

Both maternal and paternal depression can impact on a child’s mental wellbeing and education, a study has revealed

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Children who live with a parent who has depression are more likely to develop depression themselves and to not achieve educational milestones, a new study has found. 

Maternal depression is a known risk factor for depression in children and is associated with a range of adverse child health and educational outcomes including poorer academic attainment. 

To date, however, risk factors associated with paternal depression have been less well examined.

Understanding the effects of timing of both maternal and paternal depression of offspring outcomes has implications for prevention and early intervention.

The authors, from Swansea University, said: “Children who live with a parent (mum or dad) who has depression are more likely to also develop depression and not achieve as well in school, compared to children who live with a parent with treated depression. 

“Working with families and treating parental depression (in dads as well as mums) is likely to have long-term benefits for children’s mental health and educational attainment. This has never been more important than after lockdown and COVID, as depression is contagious too.”

In the new study, a team – led by Sinead Brophy from Swansea University Medical School – used data from the Secure Anonymised Information Linkage (SAIL) databank assembled as part of the Born in Wales Study funded by the Welsh Government. 

Information on children born in Wales from 1987 to 2018, as well as their mothers and fathers—or stable, adult male figure in the same household—was used in the study. Both parental and child diagnosis of depression was attained from general practitioner records in the SAIL databank.

Overall, 34.5 per cent of mothers and 18 per cent of fathers/stable men had a diagnosis of depression. 

In offspring, 4.34 per cent of all children – 2.85 per cent of boys, and 5.89 per cent of girls – were diagnosed with depression. 

Children were more likely to develop depression if their mother had depression before or after their birth, a risk which increased when their father/stable man also had depression. 

In addition, the odds of achieving milestones at the end of primary school were significantly decreased if either parent had depression.

Other risk factors for children’s depression identified in the study included being female, their mother taking antidepressants and having no stable man in the household. 

The authors conclude that the impact of paternal depression requires more attention than has previously been given, and suggest that holistic approaches to whole family wellbeing and depression will help ensure positive outcomes for children.

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Neuropsychology

Brain’s role in anxiety disorders revealed

The study reveals that those with anxiety cannot regulate their behaviour or react positively to a known safe environment

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Anxiety cues have been found in the brain despite the person being in a safe environment, giving new insight into how the brain behaves in people with anxiety disorders. 

Through a virtual reality-led study to reveal the impact of anxiety on the brain, and how brain regions interact with one another to shape behaviour, it was found that those with an anxiety disorder were unable to regulate their behaviour.

“These findings tell us that anxiety disorders might be more than a lack of awareness of the environment or ignorance of safety, but rather that individuals suffering from an anxiety disorder cannot control their feelings and behaviour even if they wanted to,” says Dr Benjamin Suarez-Jimenez, assistant professor in the Del Monte Institute for Neuroscience at the University of Rochester and first author of the study. 

“The patients with an anxiety disorder could rationally say – I’m in a safe space – but we found their brain was behaving as if it was not.”

Using fMRI, the study observed the brain activity of volunteers with general and social anxiety as they navigated a virtual reality game of picking flowers. 

Half of the meadow had flowers without bees, the other half had flowers with bees that would sting them – as simulated by a mild electrical stimulation to the hand. 

Researchers found all study participants could distinguish between the safe and dangerous areas, but brain scans revealed volunteers with anxiety had increased insula and dorsomedial prefrontal cortex activation – indicating their brain was associating a known safe area to danger or threat.

“This is the first time we’ve looked at discrimination learning in this way. We know what brain areas to look at, but this is the first time we show this concert of activity in such a complex ‘real-world-like’ environment,” says Dr Suarez-Jimenez. 

“These findings point towards the need for treatments that focus on helping patients take back control of their body.”

Understanding the neural mechanisms by which the brain learns about the environment is the focus of Dr Suarez-Jimenez’s research, particularly how the brain predicts what is threatening and what is safe. 

He uses virtual reality environments to investigate neural signatures of anxiety disorders and post-traumatic stress disorder (PTSD). 

His goal is to understand how people build maps in the brain that are based on experience, and the role of those maps in psychopathologies of stress and anxiety.

“For next steps in this recent research, we still need to clarify if what we found in the brain of these patients is also the case in other disorders, such as PTSD,” he adds. 

“Understanding the differences and similarities across disorders characterised by deficits in behavioural regulation and feelings in safe environments, can help us create better personalised treatment options.”

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