Problematic eating behaviours, changes in appetite, and weight gain in Major Depressive Disorder: The role of leptin.

BACKGROUND: Appetite and weight changes are core symptoms of Major Depressive Disorder (MDD), and those with MDD are at increased risk of obesity, cardiovascular disease and metabolic disorders. Leptin promotes satiety, with leptin dysregulation and resistance noted in obesity. However, the role of leptin in weight changes in MDD is not established. This study investigates leptin levels in relation to appetite and weight changes and problematic eating behaviours in MDD. METHODS: Plasma leptin levels, psychopathology and biometrics were compared between participants meeting DSM-5 diagnostic criteria for MDD (n = 63) and healthy controls (n = 60). Depressed participants were also sub-categorised according to increased, decreased or unchanged appetite and weight. The Dutch Eating Behaviour Questionnaire and Yale Food Addiction Scale were examined in a subset of participants with MDD. RESULTS: Females with increased appetite/weight had higher leptin levels than those with stable or reduced appetite/weight, however males showed the opposite effect. Leptin levels were positively correlated with problematic eating behaviours. One quarter of the depressed subset, all females, met the Yale criteria for food addiction, approximately double the rates reported in general community samples. LIMITATIONS: The study is limited by a cross sectional design and a small sample size in the subset analysis of eating behaviours. CONCLUSIONS: The results provide new information about associations between leptin, sex-specific weight and appetite changes and problematic eating behaviours, which may be risk factors for cardiovascular and metabolic diseases in MDD, particularly in females. Future longitudinal research investigating leptin as a risk factor for weight gain in MDD is warranted, and may lead to early interventions aimed at preventing weight gain in at-risk individuals.

A narrative review of potential treatment strategies for food addiction.

The concept of food addiction (FA) remains controversial with research being in the nascent stages; FA like any addiction can have a devastating impact on the lives of those afflicted. There exists a clinical need for treatment strategies for those affected. This article reviews potential treatment strategies for FA. The treatment strategies target four core behaviours of the addiction phenotype specifically craving through the opioid system, impulsivity as a personality trait, compulsivity through the serotonergic system and lastly motivation through the dopaminergic system. A range of pharmacological and psychological interventions are reviewed. Future research should seek to test and validate the proposed clinical treatment strategies.

A pilot study of mental health and quality-of-life of caregivers of children with cleft lip/palate in India.

BACKGROUND: There has been insufficient and contradictory research to date on the impacts of caring for a child with cleft lip/palate. Therefore this pilot study sought to investigate the mental health and quality of life of primary caregivers of children with cleft lip/palate. MATERIALS AND METHODS: Seventy-nine primary caregivers of children with cleft lip/palate awaiting a surgical procedure in India completed questionnaires to measure their mental health, quality of life, and demographic variables. RESULTS: The results indicated that half of the sample suffered from poor mental health and a reduced quality of life. Overall perceptions of quality of life were significantly associated with the age of the child requiring care and the contact hours per day spent with the child. CONCLUSION: It is apparent that caregivers for this population do suffer from a reduced quality of life and poorer mental health. This is especially relevant for older caregivers and those with greater caring responsibilities.

Mental health literacy survey among Sri Lankan carers of patients with schizophrenia and depression.

INTRODUCTION: Mental health literacy has been defined as knowledge and beliefs about mental disorders which aid their recognition, management or prevention. AIM: Preliminary investigation on mental health literacy among Sri Lankan carers of patients with Schizophrenia and Depression. METHOD: Cross sectional descriptive study investigated a convenience sample of 119 carers of a person with Depression or Schizophrenia attending a community clinic using vignettes adapted from an existing mental health literacy survey. RESULTS: The Schizophrenia vignette was reported as a crisis by 28% and 35.6% reported the Depression vignette as a crisis. Schizophrenia and Depression were identified as mental illnesses by 72% and 64% respectively. Persons with Schizophrenia and Depression were reported to be more violent than a member of the community by 61% and 60%. Psychiatrist's help was preferred as the therapeutic intervention in Schizophrenia (86.7%) and Depression (91.5%), whereas only 21.7% preferred traditional healers. Carers of persons with Schizophrenia (72%) and Depression (61%) held the attitude that the problem is a sign of personal weakness. Sixteen percent of carers wanted to avoid people with similar problems. DISCUSSION: Carers had stigmatising attitudes such as persons with mental illness were violent and the illness was a sign of personal weakness. A minority wanted to avoid persons with similar problems, indicating that maintaining social distance was not a major issue. Carers had good knowledge of help seeking locations with a majority identifying psychiatrists and psychiatric wards in general hospitals. CONCLUSION: The mental health literacy amongst the carers are lacking in certain areas. They have stigmatising attitudes towards people with mental illness.

The effect of a brief family intervention on primary carer's functioning and their schizophrenic relatives levels of psychopathology in India.

This study examined the short term effects of a brief familial intervention on schizophrenic the patient's levels of psychopathology and their primary caregiver's functioning in India. Caregiver functioning was measured by the caregiver's levels of burden and coping along with the patient's perceived level of expressed emotion (EE). The participants were 18 schizophrenic patients and their related primary carer from a medical facility in India. The patients' levels of psychopathology and EE were assessed at baseline and at completion of the study with the Positive and Negative Syndrome Scale (PANSS; Kay et al., 1987) and the Family Emotional Involvement And Criticism Scale (FEICS; Shields et al., 1992), respectively. The primary caregiver's levels of burden and coping were also measured at baseline and upon completion of the study by the Burden Assessment Scale (BAS; Thara et al., 1998) and the Family Crisis Oriented Personal Evaluation Scale (F-COPES; McCubbin et al., 1981), respectively. The brief intervention was comprised of 3 one hour sessions aimed at educating the primary caregiver and patient about schizophrenia; along with improving their communication, problem solving skills and expression of emotions. A significant improvement was found between baseline and the final 3-month follow-up on measures of psychopathology for the patients, as well as family functioning for both the caregivers and patients. The implications of the findings are discussed, along with future research directions.

A comparative study of sexual dysfunction involving risperidone, quetiapine, and olanzapine.

BACKGROUND: With the advent of newer antipsychotic drugs, side effects such as sexual dysfunction have been a major contributor toward treatment compliance. There are only a few studies that have compared different atypical antipsychotic agents regarding sexual dysfunction. We have not come across any data in this area on Indian population. AIMS: To determine and compare the frequency of sexual dysfunction associated with risperidone, olanzapine, and quetiapine, among patients with clinically stable schizophrenia. SETTINGS AND DESIGN: It is a cross-sectional hospital-based study. The subjects were recruited for the study by the purposive sampling technique. MATERIALS AND METHODS: The total sample size was 102, consisting of 25 each in the quetiapine and risperidone groups, 22 in the olanzapine group, and 30 healthy volunteers. A Brief Psychiatric Rating Scale and Sexual Functioning Questionnaire (SFQ) were administered. The Kruskal Wallis test was used to compare the variables in the demographic data and the mean chlorpromazine equivalent doses of the study groups. To analyze the sexual dysfunction, the mean scores on all the domains of sexual functioning in SFQ were compared across the study groups using the Chi square test, for proportions. RESULTS AND CONCLUSION: Twenty-three percent of the healthy volunteers had some impairment in one or more domains of sexual functioning. For the medication groups this was 96, 88, and 90%, respectively for risperidone, quetiapine, and olanzapine. However, there was statistically no significant difference across the study groups although it was relatively less with quetiapine.