depression

Posted on Cancer, Rheumatoid arthritis

Socioeconomic status influences genetic risk for many complex diseases, including RA

Differences in socioeconomic status (SES) are known to be linked to differences in the risk of developing disease. While people with lower SES are more likely to develop complex diseases such as diabetes and cardiovascular disease, those with a higher SES are at increased risk of developing certain types of cancer. Using biobank and national register data, researchers from Finland have now found that people with lower SES (educational achievement and occupation) have a greater genetic susceptibility to develop many other complex diseases such as rheumatoid arthritis, lung cancer, depression, and alcohol use disorder, as well as Type 2 diabetes, whereas those with a higher SES are more at risk of developing breast, prostate, and all cancers.

Dr Fiona Hagenbeek, a postdoctoral researcher at the Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Finland, who will present her group‘s work at the annual conference of the European Society of Human Genetics today (Sunday), says that these promising initial results mean that it is likely that polygenic risk scores, which measure an individual‘s risk of a particular disease based on genetic information, could be added to the screening protocols for multiple diseases and in several countries. “Understanding that the impact of polygenic scores on disease risk is context-dependent may lead to further stratified screening protocols,“ she says. “For example, in the future, screening protocols for breast cancer may be adapted so that females with a high genetic risk and who are highly educated receive earlier or more frequent screening than females with lower genetic risk or less education.”

The researchers used genomics, SES, and health data from approximately 280,000 Finnish individuals in the FinnGen study, a research project in genomics and personalised medicine that aims to understand the genetic basis of diseases. The participants were aged 35 – 80 at the time of entry into the study. The study aimed to systematically assess the evidence of gene-environment interaction (GxE) through the differing genetic susceptibility to disease in diverse socioeconomic groups. While previous studies have shown the presence of such a difference in risk, this is the first to systematically assess GxE for SES in 19 complex diseases that have a high burden in high-income countries.

“Most clinical risk prediction models include basic demographic information such as biological sex and age, recognising that disease incidence differs between males and females, and is age-dependent,“ says Dr Hagenbeek. “Acknowledging that such context also matters when incorporating genetic information into healthcare is an important first step. But now, we can show that the genetic prediction of disease risk also depends on an individual’s socioeconomic background. So while our genetic information does not change throughout our lifetime, the impact of genetics on disease risk changes as we age or change our circumstances.“

The researchers hope that the study will be followed up to see whether further differences can be identified when looking at more specific aspects of educational and professional achievement. While their current results for profession generally mirror those for education, they do not match completely, indicating that each can provide unique information on the interplay of socioeconomic status and genetics on disease risk. Expanding the list of socioeconomic indices to be studied may bring about new insights into how the overlapping aspects of a person’s socioeconomic environment may, together with genetic information, influence their disease risk.

They will also compare their results across biobank studies from Finland, UK, Norway, and Estonia through the INTERVENE* consortium, allowing them to determine whether there are country or biobank-specific issues involved. “Our study focused solely on individuals of European ancestry, and it will also be important in the future to see whether our observations concerning the interplay of socioeconomic status and genetics for disease risk are replicated in people of multiple ancestries in higher and lower-income countries,“ says Dr Hagenbeek. “As the overall aim of incorporating genetic information into healthcare is to facilitate personalised medicine, we should not treat genetic information as ‘one size fits all‘. Rather, we should investigate and then include the circumstances that modify genetic risk when carrying out disease prediction.“

Posted on Mental health

Revolutionizing depression treatment online

A new study at Hebrew University examined the effects of guided internet-based cognitive behavioral therapy for depression, focusing on the therapeutic alliance and attachment styles. The study found significant improvements in depression and insomnia symptoms over time. These findings deepen our understanding of how depression can be treated through internet-based interventions, underscoring the crucial role of the therapeutic alliance and the wider benefits of this form of therapy.

A new study at Hebrew University examined the effects of guided internet-based cognitive behavioural therapy for depression, focusing on the therapeutic alliance and attachment styles. The study found significant improvements in depression and insomnia symptoms over time. These findings deepen our understanding of how depression can be treated through internet-based interventions, underscoring the crucial role of the therapeutic alliance and the wider benefits of this form of therapy.

A new study led by Dr Dina Zalaznik from Prof. Jonathan Huppert’s Laboratory for the Treatment and Study of Mental Health and Well-Being at the Hebrew University of Jerusalem has revealed significant advancements in treating depression. The study focused on two crucial aspects: the therapeutic alliance and attachment styles.

Participants for the study were recruited through ads for a free trial and underwent screening, including online surveys and a phone interview. Thirty-nine participants, mostly female (59%), with an average age of 37.9 years, were included. The internet-based cognitive behavioural therapy program consisted of six modules covering psychoeducation, cognitive work, behavioural activation, challenging thoughts, optional cognitive behavioural therapy for insomnia, and relapse prevention. Treatment was delivered by supervised doctoral students, with weekly guidance and homework assignments. Dropout rates and treatment adherence were also examined.

One of the study’s key findings was the importance of the alliance between the therapist and the patient, as well as the alliance with the program, in predicting adherence and dropout rates. While both alliances played a role in treatment outcomes, only the alliance with the therapist was significantly related to symptom improvement. This highlights the unique contributions of each aspect of the alliance in the effectiveness of internet-based cognitive behavioural therapy.

The study also addressed the role of attachment styles in internet-based cognitive behavioural therapy, with results indicating that avoidant attachment style scores improved significantly during internet-based cognitive behavioural therapy, whereas anxious attachment did not show significant improvement. This finding suggests that even though internet-based cognitive behavioural therapy focuses not on interpersonal relationships and the therapist’s involvement is limited, the emotional and cognitive components of attachment can still be positively impacted.

Results from the study demonstrate the effectiveness of a culturally adapted Hebrew version of guided internet-based cognitive behavioural therapy for depression and insomnia. Depression symptoms and insomnia improved significantly over time, with noticeable and meaningful changes observed for all variables.

This study suggests that in internet-based therapy, the relationship with the therapist and the program is crucial for maintaining motivation and commitment to the treatment. Clinicians should consider using a weekly questionnaire to track these relationships and make necessary improvements. Future studies should explore factors influencing these relationships further.

Dr. Zalaznik’s study reveals the critical role of interpersonal factors in internet-based cognitive behavioral therapy, highlighting the distinct impacts of the therapist and program alliances. These findings advance our understanding of depression treatment through internet interventions, emphasizing the therapeutic alliance’s importance and the therapy’s broader benefits.

Posted on neurological conditions, Parkinson's Disease

Hitting the target with non-invasive deep brain stimulation: Potential therapy for addiction, depression, and OCD

Researchers at EPFL have successfully tested a novel technique for probing deep into the human brain, without surgery, for potential therapeutic purposes.

Non-invasive stimulation of the striatum

A model image of the targeted deep brain zone, the striatum, a key player in reward and reinforcement mechanisms. CREDIT EPFL

Neurological disorders, such as addiction, depression, and obsessive-compulsive disorder (OCD), affect millions of people worldwide and are often characterized by complex pathologies involving multiple brain regions and circuits. These conditions are notoriously difficult to treat due to the intricate and poorly understood nature of brain functions and the challenge of delivering therapies to deep brain structures without invasive procedures.



In the rapidly evolving field of neuroscience, non-invasive brain stimulation is a new hope for understanding and treating a myriad of neurological and psychiatric conditions without surgical intervention or implants. Researchers, led by Friedhelm Hummel, who holds the Defitchech Chair of Clinical Neuroengineering at EPFL’s School of Life Sciences, and postdoc Pierre Vassiliadis, are pioneering a new approach in the field, opening frontiers in treating conditions like addiction and depression.

Their research, leveraging transcranial Temporal Interference Electric Stimulation (TMS), specifically targets deep brain regions that are the control centres of several important cognitive functions involved in different neurological and psychiatric pathologies. The research highlights the interdisciplinary approach that integrates medicine, neuroscience, computation, and engineering to improve our understanding of the brain and develop potentially life-changing therapies.

“Invasive deep brain stimulation (DBS) has already successfully been applied to the deeply seated neural control centres to curb addiction and treat Parkinson’s, OCD or depression,” says Hummel. “The key difference with our approach is that it is non-invasive, meaning that we use low-level electrical stimulation on the scalp to target these regions.”

Vassiliadis, lead author of the paper, a medical doctor with a joint PhD, describes tTIS as using two pairs of electrodes attached to the scalp to apply weak electrical fields inside the brain. “Up until now, we couldn’t specifically target these regions with non-invasive techniques, as the low-level electrical fields would stimulate all the regions between the skull and the deeper zones—rendering any treatments ineffective. This approach allows us to selectively stimulate deep brain regions that are important in neuropsychiatric disorders,” he explains.

The innovative technique is based on temporal interference, initially explored in rodent models, and now successfully translated to human applications by the EPFL team. In this experiment, one pair of electrodes is set to a frequency of 2,000 Hz, while another is set to 2,080 Hz. Thanks to detailed computational models of the brain structure, the electrodes are specifically positioned on the scalp to ensure that their signals intersect in the target region.

At this juncture, the magic of interference occurs: the slight frequency disparity of 80 Hz between the two currents becomes the effective stimulation frequency within the target zone. The brilliance of this method lies in its selectivity; the high base frequencies (e.g., 2,000 Hz) do not stimulate neural activity directly, leaving the intervening brain tissue unaffected and focusing the effect solely on the targeted region.

This latest research focuses on the human striatum, a key player in reward and reinforcement mechanisms. “We’re examining how reinforcement learning, essentially how we learn through rewards, can be influenced by targeting specific brain frequencies,” says Vassiliadis. By stimulating the striatum at 80 Hz, the team found they could disrupt its normal functioning, directly affecting the learning process.

The therapeutic potential of their work is immense, particularly for conditions like addiction, apathy and depression, where reward mechanisms play a crucial role. “With addiction, for example, people tend to over-approach rewards. Our method could help reduce this pathological overemphasis,” Vassiliadis, also a researcher at UCLouvain’s Institute of Neuroscience, points out.

Furthermore, the team is exploring how different stimulation patterns can disrupt and potentially enhance brain functions. “This first step was to prove the hypothesis of 80 Hz affecting the striatum, and we did it by disrupting its functioning. Our research also shows promise in improving motor behaviour and increasing striatum activity, particularly in older adults with reduced learning abilities,” Vassiliadis adds.

Hummel, a trained neurologist, sees this technology as the beginning of a new chapter in brain stimulation, offering personalized treatment with less invasive methods. “We’re looking at a non-invasive approach that allows us to experiment and personalize treatment for deep brain stimulation in the early stages,” he says. Another key advantage of tTIS is its minimal side effects. Most study participants reported only mild sensations on the skin, making it a highly tolerable and patient-friendly approach.

Hummel and Vassiliadis are optimistic about the impact of their research. They envision a future where non-invasive neuromodulation therapies could be readily available in hospitals, offering a cost-effective and expansive treatment scope.

Posted on Diabetes, Mental health

Physical activity in nature helps prevent several diseases, including depression and type 2 diabetes.

Physical activity in natural environments prevent almost 13,000 cases of non-communicable diseases a year in England and save treatment costs of more than £100m, new research from the University of Exeter has found
Physical activity in natural environments prevents almost 13,000 cases of non-communicable diseases a year in England and saves treatment costs of more than £100m, new research from the University of Exeter has found.


According to the World Health Organization (WHO) the most common non-communicable diseases – including heart disease, stroke, cancer, diabetes, and chronic lung disease – cause 74 percent of global mortality. Non communicable diseases, also known as chronic diseases, are not passed from person to person and deaths attributed to these diseases are increasing in most countries.
Physical inactivity is associated with a range of non-communicable diseases, including cardiovascular diseases, type-2 diabetes, cancers, and mental health outcomes. In their Global Status Report on Physical Activity 2022, the WHO estimated 500 million new cases will occur globally between 2020 and 2030 should physical activity remain at today’s levels, incurring more than £21b a year in treatment costs. Non-communicable diseases, also known as chronic diseases, are not passed from person to person, and deaths attributed to these diseases are increasing in most countries. Natural environments support recreational physical activity, with this new study focusing particularly on places such as beaches and coast, countryside, and open spaces in towns and cities like parks. Using data including a representative cross-sectional survey of the English population, researchers at the University of Exeter have estimated how many cases of six non-communicable diseases – major depressive disorder, type 2 diabetes, ischaemic heart disease, ischaemic stroke, colon cancer, and breast cancer – are prevented through nature-based recreational physical activity.
Speaking about the findings, published in Environment International, Dr James Grellier from the University of Exeter Medical School said: “We believe this is the first time an assessment like this has been conducted on a national scale, and we’ve almost certainly underestimated the true value of nature-based physical activity in terms of disease prevention. Although we have focused on six of the most common non-communicable diseases, several less common diseases can be prevented by physical activity, including other types of cancer and mental ill health. It’s important to note that our estimates represent annual costs. Since chronic diseases can affect people for many years, the overall value of physical activity at preventing each case is certainly much higher.”
Increasing population levels of physical activity is an increasingly important strategic goal for public health institutions globally. The WHO recommends that adults aged 18 to 64 do at least 150 to 300 minutes of moderate-intensity aerobic physical activity (or at least 75 to 150 minutes of vigorous-intensity aerobic physical activity) per week to maintain good health. However, 27.5 per cent of adults do not meet these recommendations globally.
In 2019, 22 million adults in England aged 16 years or older visited natural environments at least once a week. At reported volumes of nature-based physical activity, Exeter researchers estimate this prevented 12,763 cases of non-communicable diseases, creating annual healthcare savings of £108.7m.
Population-representative data from the Monitor of Engagement with the Natural Environment survey were used to estimate the weekly volume of nature-based recreational physical activity by adults in England in 2019. Researchers used epidemiological dose-response data to calculate incident cases of six non-communicable diseases prevented through nature-based physical activity and estimated associated savings using published healthcare costs, informal care, and productivity losses. It’s estimated that the healthcare cost of physical inactivity in England in 2019 is approximately £1b.
Dr James Grellier from the University of Exeter Medical School said: “For people without the access, desire, or confidence to participate in organised sports or fitness activities, nature-based physical activity is a far more widely available and informal option. We believe that our study should motivate decision-makers seeking to increase physical activity in the local population to invest in natural spaces, such as parks, to make it easier for people to be physically active.”