Allergies may boost chances of anxiety or depression symptoms

Kids who have allergies at an early age are more likely than others to also have problems with anxiety and depression, according to a new study.

As the number of allergies increase, so do internalizing behavior scores, the researchers found.

Internalizing behaviors include disorders, like anxiety or depression, that develop when people keep their problems to themselves, or "internalize" them.

“I think the surprising finding for us was that allergic rhinitis has the strongest association with abnormal anxiety/depression/internalizing scores compared to other allergic diseases,” said lead author Dr. Maya K. Nanda of the division of Asthma, Allergy, and Immunology, at Children’s Mercy Hospital in Kansas City, Missouri.

Rhinitis includes the “hay fever” symptoms of runny nose, sneezing and itchy, watery eyes.

The researchers studied 546 children who had skin tests and exams at age one, two, three, four and seven and whose parents completed behavioral assessments at age seven. They looked for signs of sneezing and itchy eyes, wheezing or skin inflammation related to allergies.

Parents answered 160 questions about their child’s behaviors and emotions, including how often they seemed worried, nervous, fearful, or sad.

Kids who had allergic sneezing and itchy or watery eyes or persistent wheezing at age four tended to have higher depressive or anxiety scores than others at age seven, the researchers reported in Pediatrics.

Anxiety and depression scores increased as the number of allergies increased.

“This study can't prove causation. It only describes a significant association between these disorders, however we have hypotheses on why these diseases are associated,” Nanda told Reuters Health by email.

Children with allergic diseases may be at increased risk for abnormal internalizing scores due to an underlying biological mechanism, or because they modify their behavior in response to the allergies, she said.

Like other chronic diseases, allergic diseases may trigger maladaptive behaviors or emotions, she said, but some prior studies support a biologic mechanism that involves allergy antibodies triggering production of other substances that affect parts of the brain that control emotions.

Earlier studies have found links between allergies and anxiety disorders such as panic attacks or generalized anxiety disorders, Nanda said.

The new study took race, gender and other factors into account, “so the strong association between allergic disease and internalizing disorder we found is definitely present,” she said.

The severity of mental health symptoms varied in this study. Some children had anxiety and depression that needs treatment, while others were at risk and required monitoring, she said.

“We think this study calls for better screening by pediatricians, allergists, and parents of children with allergic disease,” she said. “Too often in my clinic I see allergic children with clinical anxiety [or] depressive symptoms; however, they are receiving no care for these conditions.”

“We don't know how treatment for allergic diseases may effect or change the risk for internalizing disorders and we hope to study this in the future,” Nanda said. — Reuters

Music not just good for the soul, it’s also good for the body

Music isn't just good for the soul, it's also good for helping the body heal after surgery, a research review suggests.

Surgery patients who listen to music may have lower levels of pain and anxiety as well as lower blood pressure and heart rate than people who don't, according to the analysis.

The benefits of music were bigger when patients get to pick their own playlists.

"As many patients have smartphones with personal music playlists, informing our patients before scheduled surgeries of the positive effect of music on their wellbeing could be a low cost intervention that may enhance wellbeing and possibly faster recover," lead study author Dr. Diana Vetter, a surgery researcher at the University of Zurich in Switzerland, said by email.

To assess the impact of music on surgical outcomes, Vetter and colleagues analyzed data from 47 studies, including 26 that looked at the effect of music before procedures, 25 looking at music in the operating room, and 25 looking at music during recovery.

Overall, music was linked to about 31 percent less pain, 29 percent lower odds of using pain medication, and 34 percent less anxiety.

In addition, music was tied to 40 percent lower blood pressure and 27 percent lower heart rate.

When patients choose their own tunes, the benefits sometimes increased, the researchers report in the Annals of Surgery.

For example, self-selected music was linked to 35 percent lower pain levels than no music, while music chosen by study personnel was linked to a 26 reduction in pain levels.

Self-selected music was also linked to 47 percent lower anxiety levels, compared to a scant 6 percent reduction with music chosen by study personnel.

There wasn't much difference in heart rate or blood pressure based on whether patients chose their own music or listened to music selected by study personnel.

One shortcoming of the analysis is that it might give rather conservative effect estimates because the early studies generally tended to overestimate effects or were only published with spectacular findings, the authors acknowledge. Their analysis covered research in the past 15 years.

The researchers had also hoped to examine the impact of architecture, design and art on surgical outcomes but they didn't find enough studies to assess this.

Even though the scientific evidence may be limited when it comes to music interventions, the current findings add to a growing body of evidence that makes a good case for letting patients listen to music in the hospital, said Marianne van der Heijden, a researcher at Erasmus Medical Center - Sophia Children's Hospital in Rotterdam, The Netherlands.

"Music interventions are not yet part of the system because for an intervention to be formally adapted in medicine and hospitals, efficacy needs to be shown," van der Heijden, who wasn't involved in the study, said by email. She added, "There now seems to be enough evidence to support the formal adaptation of music interventions in clinical guidelines."

"Self-selected music interventions shouldn't be difficult to provide at all and could be realized by creating awareness among hospital staff, patients and their family members about the positive effects of music," van der Heijden added. — Reuters

Scientists researching brain disorders create super-clever mice

Scientists have genetically modified mice to be super-intelligent and found they are also less anxious, a discovery that may help the search for treatments for disorders such as Alzheimer's, schizophrenia and post traumatic stress disorder (PTSD).

Researchers from Britain and Canada found that altering a single gene to block the phosphodiesterase-4B (PDE4B) enzyme, which is found in many organs including the brain, made mice cleverer and at the same time less fearful.

"Our work using mice has identified phosphodiesterase-4B as a promising target for potential new treatments," said Steve Clapcote, a lecturer in pharmacology at Britain's Leeds University, who led the study.

He said his team is now working on developing drugs that will specifically inhibit PDE4B. The drugs will be tested first in animals to see whether any of them might be suitable to go forward into clinical trials in humans.

In the experiments, published on Friday in the journal Neuropsychopharmacology, the scientists ran a series of behavioural tests on the PDE4B-inhibited mice and found they tended to learn faster, remember events longer and solve complex problems better than normal mice.

The "brainy" mice were better at recognising a mouse they had seen the previous day, the researchers said, and were also quicker at learning the location of a hidden escape platform.

They were also less able to recall a fearful event after several days than ordinary mice, and as PDE4B is also found in humans, this could be of interest in the search for treatments for brain conditions as well as mental decline linked to ageing.

The experiments also showed that PDE4B-inhibited mice suffered less anxiety, choosing to spend more time in open, brightly lit spaces than normal mice, which preferred dark, enclosed spaces.

And while mice are naturally scared of cats, the modified mice responded less fearfully to cat urine, suggesting that inhibiting PDE4B could increase risk-taking behaviour. (Editing by Louise Ireland) — Reuters

Air pollution may be tied to anxiety

Women who live in areas with higher air pollution may also have higher anxiety, according to a new analysis.

“It’s a really interesting finding and definitely suggests that air pollution may be related to mental health,” said lead author Melinda C. Power of Johns Hopkins University in Baltimore.

“If this is truly causal this is going to have a huge effect on the population because everyone is exposed, but we need more research to build this body of evidence,” Power added.

The researchers used data on more than 70,000 women in the Nurses’ Health Study who filled out an eight-question anxiety survey between ages 57 and 85.

Overall, about 15 percent of the women had high anxiety symptoms.

Using their previous home addresses from before they filled out the anxiety questionnaire, the researchers were able to estimate the women’s exposure to so-called particulate matter in the air during the past 15 years, based on factors like distance to major roadways, population density, local sources of emissions and wind speeds.

The researchers found no link between anxiety levels and large air pollution particles, but exposure to fine particles was tied to increasing anxiety levels, according to results in BMJ. The more recent the exposure, the higher the level of anxiety tended to be.

For example, women who were exposed to the most small particles in the air one month before their anxiety test were about 12 percent more likely to have high anxiety symptoms, compared to those estimated to be exposed to the least particles one month previously.

Fine particulates come from combustion sources, including cars and power plants, Power told Reuters Health by phone. The smaller the particle, the deeper it may travel into the lungs.

“Our study can only comment on the population level, on average people who were more highly exposed had a higher level of anxiety,” she said. It did not assess distance to pollution sources or the amount of air pollution an individual would need to experience to have increased anxiety.

Since it was an observational study, it does not necessarily indicate that pollution causes anxiety, she said. Women living in more polluted areas may experience other sources of stress that would be linked to anxiety as well.

The authors suspect that fine particulate pollution may be linked to certain subtle conditions, like inflammation, which may increase the risk of anxiety. Further research will need to explore this possibility, and to look for a similar link among men and people of a younger age, Power said.

It is too soon to think about intervening or giving individuals recommendations based on this result, she said.

However, there is substantial evidence that lowering air pollution would improve cardiovascular health and respiratory health and reduce the risk of stroke, she said. Short-term exposure to particulate pollution is tied to an increase in stroke risk according to an analysis of all published research on the subject, which appears in the same issue of BMJ.

The relationship between atmospheric pollution and risk of heart attack and heart failure had already been established, and this new paper, supported by the British Heart Foundation, adds stroke risk to that category, said lead author Dr. Anoop Shah of the University of Edinburgh in the U.K.

There’s not much an individual can do to decrease their exposure to air pollution as it's ubiquitous, Shah told Reuters Health by phone. But policymakers do have the power to improve public transport systems in urban areas and reduce the number of vehicles on the roads, which are the major source of damaging pollution, he said.

In fact, as reported by Reuters today, Beijing has introduced measures to limit the number of motorists on heavily polluted days. It's the latest move by authorities there to battle the choking smog that has blanketed the city in recent years. — Reuters

Athlete anxiety no excuse to skip heart test – study

NEW YORK - After finding that student-athletes felt no more distress about heart screening with electrocardiograms, or ECGs, than they did with physical exams, a new study concludes that anxiety should not be considered a reason to avoid giving the test.

An ECG measures the electrical activity of the heart and can detect disturbances that could predispose people to rare but dangerous cardiac arrests. Sudden cardiac death is the most common cause of death during exercise, researchers note.

Italy and Israel mandate ECG screening as part of sports pre-participation examinations, while the debate over whether to require athletes to get the test has become increasingly contentious in the United States.

One of the downsides of ECGs is that they sometimes suggest a heart problem that turns out to be a false alarm upon further testing. In the interim, athletes may fear for their health or their future in sports.

“This is the first study to look at the psychological impact to athletes when they get screened,” lead author Dr. Irfan Asif told Reuters Health. “There’s nothing to indicate you shouldn’t get an ECG because of stress.”

Asif, from the University of Tennessee Graduate School of Medicine in Knoxville, and his team studied 952 high school athletes who participated in a range of sports. The students all received a medical history and physical examination to screen for underlying heart problems. All but 150, who served as a comparison group, also received an ECG.

Of the 802 participants who were screened with ECG, 220 had an abnormal finding at some point during the screening process. Six of those represented serious heart conditions, and the rest were false positives.

Reviews of a student’s medical history led to 127 of the false positives. An additional 50 false positives were a result of physical exams, 14 were from ECG readings and 29 were due to multiple indications.

The researchers found no difference in students’ distress levels immediately after screening based on whether their testing had included an ECG.

A 2007 American Heart Association statement on cardiovascular screening warns that false-positive results from ECGs could lead to unnecessary anxiety, the authors write in the British Journal of Sports Medicine.

But the current investigation showed no differences in distress levels based on the reason for the false-positive evaluation - the vast majority of which resulted from a review of a student’s personal and family medical history.

“The athletes we’ve interviewed are actually very grateful that someone’s tried to save their lives,” Asif said. “We’re not really seeing negative consequences. We’re seeing very positive benefits.”

But pediatric cardiologist Dr. Peter Fischbach from Children’s Healthcare of Atlanta told Reuters Health the study protocol limited its generalizability. Fischbach, who is also affiliated with Emory University School of Medicine, was not involved with the new study.

Students whose ECGs showed possible problems in the current investigation had follow-up tests on the same day at the same location. Most student-athletes have to wait for follow-up appointments with cardiologists, Fischbach said.

“If you’re not allowed to practice until you get a note from a cardiologist, and you have to go home and stew on it for three weeks, I worry that kids would become a little more stressed out,” he said. “Maybe they’d get a little more anxious and wonder if they’re ever going to be able to play again.”

The authors acknowledge that on-site, same-day tests to evaluate the abnormal ECG findings could have minimized anxiety among students.

“I imagine people having to wait for additional testing might have anxiety,” Asif said.

He and Fischbach both said there should be ways to address delays in follow-up in the real world.

But even if expected delays between tests could be shortened, Fischbach said the problem of funding to screen all U.S. student-athletes would remain. “In this era of cost-containment, this has the potential to be an explosive cost,” he said.

Some doctors have called for regular testing of U.S. student-athletes to try to prevent sudden cardiac deaths. So far, though, data have failed to show that screening could reliably weed out only the most at-risk youth at an affordable price. Based on Italian data, British researchers have calculated that close to 800 athletes would have to be benched from their sports for every death prevented (see Reuters Health story of October 11, 2012 here: reut.rs/1oF5cHu).

Nevertheless, Asif believes in ECG screening. He noted that reviews of family history and physical examinations are substantially flawed in their ability to detect heart defects, yet schools require them for students to participate in sports.

“People are asking for evidence. Where’s the evidence for a history and physical?” he asked.

“My message is you should do all three,” he said. “With screening with an ECG, we can save lives. Your ability to detect disease is much higher, and it looks like it doesn’t cause additional anxiety in people.” — Reuters

source: gmanetwork.com

Heart attacks often misdiagnosed as anxiety in women: study

OTTAWA - Women are more likely to die of heart attacks because their symptoms are often misdiagnosed as anxiety so they do not get vital swift treatment, said a study Monday.

Researchers at McGill University in Montreal set out to understand sex differences in mortality rates for men and women with acute coronary syndrome.

They asked 1,123 patients aged 18 to 55 to fill out a survey after being admitted to one of 24 hospitals in Canada, one in the United States and one in Switzerland.

The women in the study, the researchers found, generally came from lower income brackets, were more likely to have diabetes, high blood pressure and a family history of heart disease.

They also had substantially higher levels of anxiety and depression than the men.

The researchers noted that the men received faster access to electrocardiograms (ECGs) to check heart rhythms and fibrinolysis to prevent blood clots than the women.

Early treatment for a heart attack can prevent or limit damage to the heart muscle, while saving the person's life.

On average it took 15 minutes and 28 minutes, respectively, for men to be given ECGs or fibrinolysis from the time they arrived at an emergency room.

In contrast, it took 21 minutes and 36 minutes for women.

The researchers pointed to the women's higher levels of anxiety as the primary reason for the discrepancy.

"Patients with anxiety who present to the emergency department with non-cardiac chest pain tend to be women, and the prevalence of acute coronary syndrome is lower among young women than among young men," said lead researcher Louise Pilote.

"These findings suggest that triage personnel might initially dismiss a cardiac event among young women with anxiety, which would result in a longer door-to-ECG interval."

The findings were published in the current issue of the Canadian Medical Association Journal. — Agence France-Presse

source: gmanetwork.com