Can electronic wearable devices improve mental health outcomes?

Do Wearables Improve Mental Health?

Physical activity improves mental health outcomes, but many people living with mental illness have high rates of physical inactivity. Onyeaka and colleagues¹ investigated the potential for electronic wearable devices (EWDs) to promote physical activity in those living with mental illness in a real-world setting. Previous studies have generally been small and limited to inpatient settings. They used the Health Information National Trends Survey 2019 to study a sample of 1139 adults with self-reported depression and anxiety. Results showed that 28.1% had used an EWD in the past year and, after adjusting for covariates, this was significantly associated with higher odds of reporting intention to lose weight (odds ratio 2.12; confidence interval 1.04, 4.35; p=0.04). The authors concluded that EWDs may serve as an opening for clinicians to discuss physical health and identify patients primed for behavioural change.

Physical activity improves mental health, but most people with mental illness are more likely to be physically inactive. Onieka and colleagues1 studied the potential of wearable devices (EWDs) to facilitate physical activity in people with mental illness in real-world situations ^. Previous studies were largely small and limited to inpatients. Onieka et al studied a sample of 1,139 adults with self-reported depression and anxiety using the Health Information National Trends Survey 2019. The results showed that 28.1% had used a wearable device in the past year and were more likely to report weight loss after adjusting for covariates (odds ratio 2.12; confidence interval 1.04, 4.35; p=0.04). It concluded that wearable devices could be a means for clinicians to discuss physical health and identify patients in need of behavioral change.

Electronic wearable devices may identify patients primed for behavioural change

Wearable devices can identify patients who are ready for behavioral change

Differing responses to antidepressant treatment

Different responses to antidepressant treatment

Xu et al. ² studied changes in depression and anxiety symptoms in 577 patients initiating antidepressant treatment, with repeated measurements of Patient Health Questionniare-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) scores over 12 weeks. They used group-based trajectory modelling to identify six subgroups – three showing response and three non-response to antidepressants. One of the response subgroups had severe baseline depression (n=49 [8.5%]) and showed a steady improvement in symptoms, while the other two (n=93 [16.1%] and n=106 [18.4%]) had moderate baseline symptoms and demonstrated a more rapid response and remission. Of the three nonresponse subgroups, two had moderate (n=137 [23.7%] and n=130 [22.5%]) and one (n=62 [10.8%]) had severe baseline depressive symptoms. The group concluded that the observed trajectory patterns were examples of the various responses that can occur to antidepressant treatment.

Xu et ^al.2 studied changes in symptoms of depression and anxiety in 577 patients who started antidepressant treatment by repeatedly measuring Depression Assessment Tool (PHQ-9) and Anxiety Disorder Scale (GAD-7) scores over a 12-week period. Xu et al identified six subgroups using a group-centered trend model. Three groups responded to the antidepressant and the other three did not. One of the response subgroups had severe depressive symptoms at the start of the study (n=49 [8.5%]) and steadily improved symptoms, whereas the other two (n=93 [16.1%] and n=106 [18.4%]) had severe depressive symptoms. ]) had moderate symptoms at onset and demonstrated a more rapid response and remission. Of the 3 unresponsive subgroups, 2 had moderate depressive symptoms at onset (n=137 [23.7%] and n=130 [22.5%]) and 1 group had severe (n=62 [10.8%]). ). The researchers concluded that the observed trend pattern is illustrative of the diverse responses that may occur with antidepressant treatment.

Observed trajectory patterns were examples of the various responses that can occur to antidepressant treatment

The trend patterns observed were illustrative of the different responses that can occur with antidepressant treatment.

The hippocampus and depression-associated cognitive dysfunction

Hippocampus and Depression-Related Cognitive Dysfunction

Diego Garces Grosse³ summarized current research findings regarding cognitive dysfunction in patients with depression, a common symptom that can often be overlooked. Imaging studies have shown reduced volume of the hippocampus and medial prefrontal cortex in depression, although it is unclear if this is cause or effect. Hippocampal volume is inversely proportional to duration and severity of the depression and number of episodes. Depression has also been associated with reduced neurogenesis and neural plasticity, leading to structural atrophy. Proposed mechanisms include dysregulation of the hypothalamic-pituitary-adrenal axis, systemic inflammation, and oxidative stress. Both structural changes and symptoms of cognitive dysfunction can be reversed following treatment of depression.

디에고 가르세스 그로세(Diego Garces Grosse)³는 간과되는 경우가 많은 일반 증상인 우울증 환자의 인지 기능 장애에 관한 현재 연구 결과를 요약했습니다. 영상 검사 결과, 우울증 환자에서 해마와 내측 전전두 피질의 부피가 감소한 것으로 나타났지만, 이것이 원인인지 결과인지는 분명하지 않습니다. 해마 부피는 우울증의 지속 기간, 중증도, 에피소드 수에 반비례합니다. 또한 우울증은 감소된 신경발생 및 신경가소성과 관련이 있어 구조적 위축으로 이어졌습니다. 제시된 메커니즘으로는 시상하부-뇌하수체-부신 축의 조절 장애, 전신 염증, 산화 스트레스 등이 있었습니다. 구조적 변화와 인지 기능 장애의 증상은 우울증 치료를 통해 회복될 수 있습니다.

Structural brain changes and symptoms of cognitive dysfunction can be reversed following treatment of depression

구조적 뇌 변화와 인지 기능 장애의 증상은 우울증 치료를 통해 회복될 수 있습니다

Targeting salience networks in depression and anxiety

우울증 및 불안에서의 현저성 네트워크 표적화

Sachdev and Amanullah⁴ reviewed current literature regarding the role of salience networks (SN) in predicting and improving outcomes in geriatric patients suffering from depression or anxiety. The SN is made up of a number of brain structures including the anterior insula and dorsal anterior cingulate. Its primary functions include selection of salient environmental information and segregation of relevant internal and external stimuli. Preliminary results from the few studies available suggest that depression and anxiety may be associated with abnormalities within the SN domain, although there is inconsistency about the specific changes. If this is confirmed in future research, then treatments may be targeted at the SN including serious games, mindfulness-based cognitive therapy, and pharmacological options.

Sachidev and Amanullah ⁴ reviewed the current literature on the role of salience networks (SNs) in predicting and improving outcomes in elderly patients suffering from depression or anxiety. The SN consists of many brain structures, including the anterior insula and dorsolateral anterior cingulate cortex. Its main function is to separate the selection of salient environmental information and related internal and external stimuli. Although there is disagreement about specific changes, preliminary results from the few studies suggest that depression and anxiety may be related to abnormalities within the SN domain. If future studies confirm this, treatments such as functional games, mindfulness-based cognitive therapy, and pharmacological options may target the SN.

Depression and anxiety may be associated with abnormalities within the salience network domain

Depression and anxiety may be related to abnormalities within the salience network domain