A Pilot Randomized Controlled Trial of a Text Message Intervention to Promote Help Seeking for Psychiatric Outpatients.

Mental illness often affects and is affected by other diseases, such as cardiovascular disease, cancer, and AIDS/HIV infection, and people living with mental illness require additional common services and resource mobilization efforts. Therefore, we developed a mobile phone intervention and conducted a randomized controlled trial with 45 psychiatric outpatients with mental illnesses. Data from 39 individuals (intervention group: 20, control group: 19; mean [SD] age, 44.64 [14.12] years) were included in the analyses. The intervention involved the promotion of help-seeking behaviors by sending text messages, including information about social welfare services, for 3 months. After the intervention period, no significant differences were found in the proportion of help-seeking behaviors between the intervention and control groups. However, concerning the reason for not using social services, the proportion of participants who answered "I do not know how to use it" in the intervention group was significantly lower compared to the control group. More than 80% of participants in the intervention group reported that the text messaging service was helpful and useful, and they wanted more messages and information. This was the first randomized controlled trial to promote psychiatric patients' help-seeking behavior using text messaging. Moreover, the text messaging intervention was found to be cost-effective.

Anti-stress effects of simplified aroma hand massage.

In order to be able to use the aroma hand massage as a skill that can be done by a nurse who does not have a special aromatherapy technique, we examine antistress effects of simplified aroma hand massage for healthy subjects. We evaluated the anti-stress action of aroma hand massage and the different components of the procedure in 20 healthy women in their twenties. We used autonomic nervous function measured via electrocardiogram as an index of stress. After conducting a baseline electrocardiogram, we induced stress in the participants by asking them to spend 30 minutes completing Kraepelin's arithmetic test. We then administered various treatments and examined the anti-stress effects. Kraepelin's test significantly increased sympathetic nervous function and significantly reduced parasympathetic nervous function. Compared with massage without essential oil or aroma inhalation, aroma hand massage significantly increased parasympathetic nervous function and significantly decreased sympathetic nervous function. The effect of the aroma hand massage persisted when the procedure was simplified. The anti-stress action of the aroma hand massage indicates that it might have beneficial application as a nursing technique. There are several limitations in this study; ambiguities of low component/high component ratio of heart rate variability and bias by small subjects groups of the same women.

The relaxation effect of prolonged expiratory breathing.

This study was performed to confirm that autonomic nervous activity is affected by breathing speed. I hypothesized that prolonged expiratory breathing would promote parasympathetic dominance, whereas rapid breathing would promote sympathetic dominance. Ten healthy men, ages 21-28 years old, were instructed to perform prolonged expiratory breathing (6 seconds expiration, 4 seconds inspiration) after spontaneous breathing and rapid breathing (1 second expiration, 1 second inspiration) after spontaneous breathing; changes in high frequency (HF) and low frequency (LF)/HF of heart rate variability (HRV) were measured during each type of breathing. During prolonged expiratory breathing, parasympathetic nervous function was significantly activated. Conversely, during rapid breathing, parasympathetic nervous function was significantly suppressed. The HRV method assessing sympathetic and parasympathetic modulation in this study is an indirect, non-invasive method with clear limitations. The use of additional techniques should be considered to clarify the relationships between the breathing speed and the mind.

Extreme prolongation of expiration breathing: Effects on electroencephalogram and autonomic nervous function.

To clarify the physiological and psychological effects of deep breathing, the effects of extreme prolongation of expiration breathing (Okinaga) were investigated using electroencephalogram (EEG) and electrocardiogram (ECG). Participants were five male Okinaga practitioners in their 50s and 60s. Participants performed Okinaga for 31 minutes while continuous EEG and ECG measurements were taken. After 16 minutes of Okinaga, and until the end of the session, the percentages of theta and alpha 2 waves were significantly higher than at baseline. After 20 minutes, and until the end of the session, the percentage of beta waves was significantly lower than at baseline. The high frequency component of heart rate variability was significantly lower after 12 minutes of Okinaga and lasted until 23 minutes. The low frequency/high frequency ratio was significantly lower after 18 minutes of Okinaga and until the end of the session. Okinaga produced relaxation, suggesting that deep breathing may relieve anxiety. However, study limitations include potential ambiguity in the interpretation of the low frequency/high frequency ratio, the small sample, and the fact that EEG was measured only on the forehead.

The Effects of Phosphatidylserine and Omega-3 Fatty Acid-Containing Supplement on Late Life Depression.

Late life depression is often associated with a poor response to antidepressants; therefore an alternative strategy for therapy is required. Although several studies have reported that phosphatidylserine (PS) may be effective for late life depression and that omega-3 fatty acids DHA and EPA have also proven beneficial for many higher mental functions, including depression, no concrete conclusion has been reached. This study was performed to clarify the effect of PS and omega-3 fatty acid-containing supplement for late life depression by not only clinical evaluation but also salivary cortisol levels. Eighteen elderly subjects with major depression were selected for the study. In all, insufficient improvement had been obtained by antidepressant therapy for at least 6 months. The exclusion criteria from prior brain magnetic resonance images (MRI) included the presence of structural MRI findings compatible with stroke or other gross brain lesions or malformations, but not white matter hypersensitivities. They took a supplement containing PS 100 mg, DHA 119 mg and EPA 70 mg three times a day for 12 weeks. The effects of the supplement were assessed using the 17-item Hamilton depression scale (HAM-D17) and the basal levels and circadian rhythm of salivary cortisol. The study adopted them as indices because: salivary cortisol levels are high in patients with depression, their circadian rhythm related to salivary cortisol is often irregular, and these symptoms are alleviated as depression improves. The mean HAM-D17 in all subjects taking the supplement was significantly improved after 12 weeks of taking the supplement. These subjects were divided into 10 non-responders and 8 responders. The basal levels and circadian rhythm of salivary cortisol were normalized in the responders while not in non-responders. PS and omega-3 fatty acids, or other elements of the supplement, may be effective for late life depression, associated with the correction of basal levels and circadian rhythm of salivary cortisol.

Dipole source analysis of temporal slow waves in the elderly.

BACKGROUND: Temporal low-voltage irregular delta-waves (TLID) are often found in elderly subjects. The physiological significance of TLID has not been clarified; however, our previous studies suggest that TLID are associated with mild cerebrovascular dysfunction. OBJECTIVE: The present study aimed to reveal the origin of TLID and their neural mechanisms by dipole source modeling. METHODS: From electroencephalography records taken from 21 scalp electrodes, clear and typical TLID of 6 elderly subjects (mean age, 69 +/- 6.2 years) were selected. Among these, we selected and averaged 7-12 clear TLID on the left side in each subject, and estimated a single equivalent current dipole for the averaged TLID. RESULTS: The best equivalent current dipoles were estimated to be located in the medial part of the temporal lobe in or near the parahippocampal gyrus in the hemisphere ipsilateral to the TLID, with a high reliability in all subjects. CONCLUSIONS: Considering the source localization of TLID, TLID seem to indicate certain dysfunctions of the hippocampus or adjacent regions. This is the first study to report the cerebral origin of TLID and suggest its physiological significance.

The sleep-enhancing effect of valerian inhalation and sleep-shortening effect of lemon inhalation.

We examined the effects of odorant inhalation on the sleep-wake states in rats. Odorants used in the experiment were clove, jasmine, lavender, lemon, peppermint, pine, rose, sandalwood, valerian, and ylang-ylang. Valerian and rose inhalation significantly prolonged the pentobarbital-induced sleeping time, whereas lemon inhalation significantly shortened it. The effect of valerian inhalation was markedly noticeable. In the anosmic rats, a significant effect of odorants on the pentobarbital sleep time was not seen. Electroencephalographic studies on natural sleep revealed that rose inhalation did not exert any significant effect on sleep, but a significant shortening in sleep latency and a significant prolonging in total sleep time were observed with valerian inhalation, whereas a significant prolonging in sleep latency was observed with lemon inhalation. Such effects of valerian and lemon inhalation were not admitted in anosmic rats. gamma-Aminobutyric acid (GABA) transaminase assay indicates that valerian inhalation decreases the activity of the enzyme and enhances GABA activity. Although valerian has been reported to exert a good effect for sleep as a medicine for internal use, the present study is the first medical report suggesting that the inhalation of valerian may enhance the sleep. On the other hand, the present results may suggest the possibility that lemon inhalation may cause a worsening of insomnia symptoms.

Prior intraperitoneal injection of rat recombinant IL-6 increases hypothalamic IL-6 contents in subsequent forced swim stressor in rats.

BACKGROUND: Cytokines do not only mediate responses to infection, but are also involved in behavioral and physiological responses to psychological stressors. IL-6 has received special attention in relation to the development of posttraumatic stress disorders and depression. OBJECTIVE: We tested effects of prior injection of rat recombinant IL-6 (rrIL-6) on behaviors induced by the forced swim (FS) stressor, and central and peripheral responses of IL-6 to FS. METHODS: Rats were injected intraperitoneally with either rrIL-6 (250 ng/0.5 ml) or equal-volume sterile saline twice within an interval of 24 h. One hour after each injection, the rats were exposed to FS or remained at the home cage (control). RESULTS: Injection of rrIL-6 did not affect immobility, swimming or climbing behaviors during FS compared with the saline control. Although FS was not a significant factor for hypothalamic and midbrain IL-6 mRNA and plasma IL-6 responses, FS with prior administration of rrIL-6 significantly increased hypothalamic IL-6 contents in response to FS compared with the saline injection-FS condition. CONCLUSIONS: Our results suggested that stressor alone had no influence on plasma IL-6 levels and IL-6 mRNA expression levels in midbrain and hypothalamus, but administration of rrIL-6 followed by FS significantly increased hypothalamic IL-6. Our results support the notion that the interaction between IL-6 and stressor might have implications for the pathophysiology of IL-6-induced depressive symptoms.

Effects of odorants on the hypothalamic-pituitary-adrenal axis and interleukin-6 (IL-6) and IL-6 receptor mRNA expression in rat hypothalamus after restraint stress.

We recently reported that stress alters interleukin (IL)-6 and IL-6 receptor (IL-6R) mRNA levels in the hypothalamus. Odorants are reported to exert anti-stress effects. The aim of our study was to determine the effects of odorants on IL-6 and IL-6R mRNA expression in the hypothalamus, using reverse transcriptase-polymerase chain reaction and on serum levels of adrenocorticotropic hormone (ACTH) and corticosterone in rats exposed to stress. Control rats were not exposed to stress; test control rats were exposed to 4 h stress then immediately killed. In other groups, rats were exposed to the same stress followed by 30 min exposure air, dimethoxymethylbenzene (DMMB), or citralva. In the air group, IL-6 and IL-6R mRNA levels were significantly reduced and serum levels of ACTH and corticosterone significantly increased relative to the control. Exposure to DMMB significantly augmented IL-6 mRNA expression but restored that of IL-6R mRNA, did not change serum corticosterone level relative to that of the air group and significantly reduced ACTH. In comparison, citralva restored the expression of IL-6 and IL-6R mRNAs and significantly increased serum ACTH and corticosterone levels. Our results indicate that citralva enhances stress-induced activation of the hypothalamic-pituitary-adrenal axis by corticotropin-releasing hormone (CRH)-mediated stimulation of IL-6, while DMMB enhances the beneficial action of IL-6 without affecting CRH.

Effects of single and repeated prolonged stress on mu-opioid receptor mRNA expression in rat gross hypothalamic and midbrain homogenates.

This study tested the hypothesis that stress-induced opioid peptides may have stimulative and inhibitive influence on mu opioid receptor (MOR) mRNA expression and hypothalamus. Several studies have investigated the effects of stress on MOR mRNA expression in rat brain, but almost none compared the response to single versus repeated stresses. Here, we examined the effects of single and repeated stress on MOR mRNA expression in different rat brain regions using reverse transcriptase-polymerase chain reaction (RT-PCR). Following a single episode of restraint stress for 4 h (1R) or 4 h per day on 2 (2R) or 3 (3R) consecutive days, the hypothalamus and midbrain were removed immediately and MOR mRNA levels in both regions were determined by RT-PCR. Blood samples were also collected for simultaneous measurement of serum adrenocorticotropic hormone (ACTH) and corticosterone (CS). MOR mRNA expression was significantly higher in both regions in the 2R group, whereas expression levels in the 3R group did not differ from controls. In the 1R group, hypothalamic MOR expression was equivalent to that in controls, but expression was significantly higher in the midbrain. Serum ACTH levels were significantly higher only in the 1R group, whereas serum CS was significantly higher in both the 1R and 3R groups. Our findings indicate that the influence of restraint stress on MOR mRNA expression in the hypothalamus is different than in the midbrain region in rats. Endogenous opioid peptides released in response to stress may paradoxically have an effect on the HPA axis.

Effects of single and repeated restraint stresses on the expression of beta(1)-adrenoceptor mRNA in the rat hypothalamus and midbrain.

We examined the effects of single and repeated restraint stresses on the expression of beta(1)-adrenoceptor mRNA in the rat midbrain and hypothalamus using reverse transcriptase-polymerase chain reaction (RT-PCR). After the rats had been restrained for 4 h (single stress), or for 4 h per day during 2 or 3 consecutive days, the hypothalamus and midbrain were removed immediately and beta(1)-adrenoceptor mRNA levels in these regions were determined by RT-PCR. Single stress significantly decreased the mRNA level in the hypothalamus, but the mRNA level was near control levels after 2 and 3 days of stress. In the midbrain, single stress had no effect on the mRNA level, but 2 days of stress significantly increased it.