Older People with Anxiety Frequently Don’t Get Help. Here’s Why

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Source: CNN – Top Stories Anxiety is the most common psychological disorder affecting adults in the United States. In older people, it’s associated with considerable distress as well as ill health, diminished quality of life and elevated rates of disability. Yet when the U.S. Preventive Services Task Force, an independent, influential panel of experts, suggested […]

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Effectiveness of cognitive analytic therapy for mixed anxiety and depression in the context of borderline traits: A quasi-experimental single case design evaluation.

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Journal of Psychotherapy Integration, Vol 33(1), Mar 2023, 34-46; doi:10.1037/int0000281 The evidence base for the use of cognitive analytic therapy (CAT) as a short-term, integrative, and relational psychotherapy for anxiety and depression is building. This study contributes by intensively studying change in two types of quantitative outcomes (ideographic and nomothetic) over treatment time. The study

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The mental health of China and Pakistan, mental health laws and COVID-19 mental health policies: a comparative review

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Mental health is one of the major causes of disability worldwide, and mental health problems such as depression and anxiety are ranked among the top 25 leading causes of disease burden in the world. This burden is considerable over the lifetime of both men and women and in various settings and ages. This study aims to compare the mental health status of people in China and Pakistan and to highlight the mental health laws and policies during COVID-19 and afterwards. According to the literature on mental health, before the COVID-19 pandemic, mental health problems increased gradually, but during and after the COVID-19 pandemic, an abrupt surge occurred in mental health problems. To overcome mental health disorders, most (but not all) countries have mental health laws, but some countries ignore mental health disorders. China is one such country that has mental health laws and policies and, during the COVID-19 pandemic, China made beneficial and robust policies and laws, thereby succeeding in defeating the COVID-19 pandemic. The mortality rate and financial loss were also lower than in other countries. While Pakistan has mental health laws and general health policies, the law is only limited to paperwork and books. When it came to COVID-19, Pakistan did not make any specific laws to overcome the virus. Mental health problems are greater in Pakistan than in China, and China’s mental health laws and policies are more robust and more widely implemented than those in Pakistan. We conclude that there are fewer mental health issues in China than in Pakistan both before and since the COVID-19 pandemic. China has strong mental health laws and these are robustly implemented, while the mental health law in Pakistan is not applied in practice.

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Investigating genetic causal relationships between blood pressure and anxiety, depressive symptoms, neuroticism and subjective well-being

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Background
High blood pressure is a leading cardiovascular disease risk factor and considered to be associated with psychological factors. However, the causal relationships between blood pressure and anxiety, depressive symptoms, neuroticism and subjective well-being are not clear.

Aims
The current study explored the genetic causal relationships between blood pressure and anxiety, depressive symptoms, neuroticism and subjective well-being.

Methods
Mendelian randomisation (MR) analyses were performed using the generalised summary-data-based MR analysis method with eight large-scale genome-wide association study datasets for hypertension, systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure, anxiety, depressive symptoms, neuroticism and subjective well-being.

Results
A causal effect of DBP on neuroticism was found, and 1074 independent instrumental single nucleotide polymorphisms were identified by the incorporated Heterogeneity in Dependent Instruments-outlier test among the bidirectional causal relationship between blood pressure and the four psychological states.

Conclusions
DBP has a causal effect on neuroticism. Appropriate management of blood pressure may reduce neuroticism, neuroticism-inducing mood disorders and cardiovascular diseases.

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Proactive psychological and psychiatric support of patients with chronic non-communicable diseases in a randomised trial: a Ukrainian experience

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Background
Presently, approaches for the early treatment of pathological anxiety in patients with chronic non-communicable diseases are lacking, thus delaying the initiation of symptom management at the early onset of the illness. Proactive psychological and psychiatric support, to alleviate subclinical symptoms of anxiety and to improve the quality of life in patients with chronic non-communicable diseases, is a promising candidate for the role of such therapy.

Aims
To investigate and determine the effectiveness of proactive psychological and psychiatric support for alleviating subclinical symptoms of anxiety and improving quality of life, in patients with chronic non-communicable diseases.

Methods
The study design was a monocentric randomised controlled trial with parallel groups. The study, involving 193 inpatients with chronic non-communicable diseases, complied with the ethical and deontological norms in accordance with the principles set out in the Declaration of Helsinki. Instruments used in the study included the Hamilton Anxiety Scale (HAM-A) to assess subclinical symptoms, the Scale of Somatic Symptoms and the Chaban Quality of Life Scale. Block randomisation was used to randomise patients to a 2-month-long study group with a proactive counselling psychiatry model care or a control group with standard regulated treatment for chronic non-communicable diseases. The allocation ratio was 1.15:1 owing to the expectancy of a higher percentage of dropout in the intervention group.

Results
After 60 days of treatment (T2), there was a statistically significant difference in all clinical parameters between the study and control groups. The median HAM-A value differed between the groups by 4.87 points, with statistically significant lower results in the study group. The comparison of the study group’s scale values on day 1 and day 60 demonstrated statistically significant changes in all three indicators.

Conclusions
Our results support existing evidence for the effectiveness of proactive psychological and psychiatric support to reduce subclinical anxiety and somatisation symptoms and to improve the quality of life for patients with common chronic non-communicable diseases. However, continued research on the effectiveness of proactive psychological and psychiatric support for patients with chronic non-communicable diseases is needed.

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Alteration of faecal microbiota balance related to long-term deep meditation

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Background
Advancements in research have confirmed that gut microbiota can influence health through the microbiota–gut–brain axis. Meditation, as an inner mental exercise, can positively impact the regulation of an individual’s physical and mental health. However, few studies have comprehensively investigated faecal microbiota following long-term (several years) deep meditation. Therefore, we propose that long-term meditation may regulate gut microbiota homeostasis and, in turn, affect physical and mental health.

Aims
To investigate the effects of long-term deep meditation on the gut microbiome structure.

Methods
To examine the intestinal flora, 16S rRNA gene sequencing was performed on faecal samples of 56 Tibetan Buddhist monks and neighbouring residents. Based on the sequencing data, linear discriminant analysis effect size (LEfSe) was employed to identify differential intestinal microbial communities between the two groups. Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) analysis was used to predict the function of faecal microbiota. In addition, we evaluated biochemical indices in the plasma.

Results
The α-diversity indices of the meditation and control groups differed significantly. At the genus level, Prevotella and Bacteroides were significantly enriched in the meditation group. According to the LEfSe analysis, two beneficial bacterial genera (Megamonas and Faecalibacterium) were significantly enriched in the meditation group. Functional predictive analysis further showed that several pathways—including glycan biosynthesis, metabolism and lipopolysaccharide biosynthesis—were significantly enriched in the meditation group. Moreover, plasma levels of clinical risk factors were significantly decreased in the meditation group, including total cholesterol and apolipoprotein B.

Conclusions
Long-term traditional Tibetan Buddhist meditation may positively impact physical and mental health. We confirmed that the gut microbiota composition differed between the monks and control subjects. The microbiota enriched in monks was associated with a reduced risk of anxiety, depression and cardiovascular disease and could enhance immune function. Overall, these results suggest that meditation plays a positive role in psychosomatic conditions and well-being.

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Improved lifestyle is associated with improved depression, anxiety and well-being over time in UK healthcare professionals during the COVID-19 pandemic: insights from the CoPE-HCP cohort study

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Background
One potential modifiable factor to improve the mental health of healthcare professionals (HCPs) during the pandemic is lifestyle.

Aims
This study aimed to assess whether an improved lifestyle during the pandemic is associated with improved mental health symptoms and mental well-being in HCPs over time.

Methods
This was a cohort study involving an online survey distributed at two separate time points during the pandemic (baseline (July–September 2020) and follow-up (December 2020–March 2021)) to HCPs working in primary or secondary care in the UK. Both surveys assessed for major depressive disorder (MDD) (Patient Health Questionnaire-9 (PHQ-9)), generalised anxiety disorder (GAD) (Generalised Anxiety Disorder-7 (GAD-7)), mental well-being (Short Warwick-Edinburgh Mental Well-being Score (SWEMWBS)) and self-reported lifestyle change (compared with the start of the pandemic) on multiple domains. Cumulative scores were calculated to estimate overall lifestyle change compared with that before the pandemic (at both baseline and follow-up). At each time point, separate logistic regression models were constructed to relate the lifestyle change score with the presence of MDD, GAD and low mental well-being. Linear regression models were also developed relating the change in lifestyle scores from baseline to follow-up to changes in PHQ-9, GAD-7 and SWEMWBS scores.

Results
613 HCPs completed both baseline assessment and follow-up assessment. Consistent significant cross-sectional associations between increased lifestyle change scores and a reduced risk of MDD, GAD and low mental well-being were observed at both baseline and follow-up. Over the study period, a whole unit increase in the change in novel scores (ie, improved overall lifestyle) over 4 months was inversely associated with changes in PHQ-9 (adjusted coefficient: –0.51, 95% confidence interval (CI): –0.73 to –0.30, p

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On the Supervisee’s Future Orientation

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While exploring the supervisee’s implicit contribution to therapeutic interactions, the supervisor can focus on the supervisee’s future orientation instead of exploring transference manifestations that might arouse the supervisee’s anxiety. I suggest that future orientation is shaped by an implicit urge described in the analytic literature as an unconscious hope to elicit yearned-for psychological nutrients from

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