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Behavior

Breaking New Ground: Mindfulness-Based Therapy Offers Hope for People with Difficult-to-Treat Depression

Mindfulness-based therapy can offer significant relief for individuals who are still depressed after receiving treatment, according to a new clinical trial.

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A groundbreaking clinical trial has found that mindfulness-based therapy (MBT) can offer significant relief for individuals who are still depressed after receiving treatment, according to a new study published in Lancet Psychiatry. The research, led by a team from the University of Surrey and sponsored by the Sussex Partnership NHS Foundation Trust, aimed to provide a new treatment pathway for people with depression who have not benefitted from previous treatment.

The study found that MBT significantly improved depression symptoms compared to continued treatment as usual. The average effect was in the small-to-moderate range and comparable to treatment with antidepressants. Crucially, the study also concludes that providing MBT as an alternative to usual treatment was cost-effective, at less than £100 per person.

The research highlights a significant gap in services for people with depression who haven’t got better through NHS Talking Therapies. These individuals often don’t qualify for further specialist mental health care and are left with no further options. The study’s findings offer a glimmer of hope for this group, showing that offering MBT can be effective and cost-efficient to deliver.

The UK NHS Talking Therapies programme is the world’s largest and most advanced publicly funded psychological therapies service, treating around 670,000 people each year. Approximately half of these individuals still have some degree of depression when their care ends. The study’s results could lead to a significant reduction in the number of people with depression who are left without further treatment options.

Mary Ryan, a patient adviser and co-author who has experienced many episodes of severe depression throughout her adult life, said: “For most people with severe depression, it’s more than a condition – it’s a recurring part of their life story. The findings of this trial are hugely important because we’re telling this group of people that they still matter – that there’s something else we can try that may work for them.”

The study involved over 200 patients who had received NHS talking therapies but still had depression. They were recruited across 20 NHS trial sites, with three lead sites: Sussex Partnership Foundation Trust, Devon Partnership Foundation Trust, and South London and Maudsley NHS Foundation Trust.

One group of participants received eight weekly group-based MBCT sessions delivered by videoconferences, aimed at developing mindfulness skills and guiding participants on how to respond more effectively to difficult emotions. The other group received treatment as usual. Six months after treatment, patients who had received MBCT had larger improvements in depression symptom scores on average than those who had received treatment as usual.

Study co-author Professor Barney Dunn from the University of Exeter said: “We’ve shown that offering MBT to this group can be effective and cost-efficient to deliver, and we hope this will lead to it being implemented widely. We need investment in this and other areas where there are gaps in service, to ultimately save the NHS money.”

Study co-author Barbara Barret, Professor of Health Economics at King’s College London, said: “We are highly encouraged by our findings, which reveal that MBT treatment offers a powerful dual benefit for this group: superior patient outcomes coupled with notable cost savings for the NHS.”

Clara Strauss, Professor of Clinical Psychology at the University of Sussex, said: “For vulnerable people with depression, MBCT is particularly helpful for a number of reasons. It helps people to recognise negative, self-critical thoughts as thoughts, rather than as facts and so helps to lessen their emotional impact. It helps people to be more accepting of their difficult experiences and to be kinder to themselves.”

Professor Kevin Munro, Director of NIHR’s Research for Patient Benefit Programme, said: “This NIHR-funded study shows that mindfulness-based therapy has the potential to benefit patients with difficult-to-treat depression, as well as the NHS and the wider economy. It’s a great example of practical research that could quickly help improve people’s quality of life.”

Alternative Medicine

“The Sleeping Giants: How Tai Chi, Yoga, and Jogging Rival Pills for Beating Insomnia”

Yoga, Tai Chi, walking, and jogging may be some of the best natural remedies for improving sleep and tackling insomnia, according to a large analysis comparing various treatments. While cognitive behavioral therapy (CBT) remains effective, exercise-based approaches—especially Tai Chi—were shown to deliver significant improvements in total sleep time, efficiency, and reducing how long people stay awake after falling asleep. Yoga stood out for boosting overall restfulness, and jogging helped ease insomnia symptoms.

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Tai chi, yoga, and jogging may be the best forms of exercise to improve sleep quality and ease insomnia, suggest the findings of a comparative pooled data analysis published in the online journal BMJ Evidence Based Medicine.

The study, which involved 1348 participants and 13 different treatment approaches to ease insomnia, found that these three exercise-based interventions showed promising results. Yoga likely resulted in a large increase in total sleep time of nearly 2 hours and may improve sleep efficiency by nearly 15%. Walking or jogging may result in a large reduction in insomnia severity of nearly 10 points, while Tai Chi may reduce poor sleep quality scores by more than 4 points, increase total sleep time by more than 50 minutes, and reduce time spent awake after falling asleep by over half an hour.

Further in-depth analyses revealed that Tai Chi performed significantly better on all subjectively and objectively assessed outcomes than existing treatments for up to 2 years. The researchers suggest that Tai Chi’s focus on body awareness, controlled breathing, and attentional training may alter brain activity, thereby alleviating anxiety and depressive symptoms which often interfere with a good night’s sleep.

The study also found that exercise-based interventions, including yoga, Tai Chi, and walking or jogging, have the potential to serve as viable primary treatment options for insomnia. The researchers conclude that these interventions are well-suited for integration into primary care and community health programs due to their low cost, minimal side effects, and high accessibility.

Overall, the findings of this study further underscore the therapeutic potential of exercise interventions in the treatment of insomnia, suggesting that their role may extend beyond adjunctive support to serve as viable primary treatment options.

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Behavior

Unraveling the Mind: How a Scent Can Change Your Decisions

Mice taught to link smells with tastes, and later fear, revealed how the amygdala teams up with cortical regions to let the brain draw powerful indirect connections. Disabling this circuit erased the links, hinting that similar pathways in humans could underlie disorders like PTSD and psychosis, and might be tuned with future brain-modulation therapies.

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The human brain is a masterful machine that makes decisions based on associations between stimuli in our environment. But did you know that these decisions can also be influenced by indirect associations between seemingly unrelated events? A recent study by the Cellular Mechanisms in Physiological and Pathological Behavior Research Group at the Hospital del Mar Research Institute has shed new light on this process, revealing how a specific scent can alter our mind’s decision-making processes.

The research team, led by PhD student José Antonio González Parra and supervised by Dr. Arnau Busquets, conducted experiments with mice to understand the mechanisms behind indirect associations between different stimuli. They trained the mice to associate two distinct smells – banana and almond – with sweet and salty tastes respectively. Later, a negative stimulus was linked to the smell of banana, causing the mice to reject the sweet taste associated with it.

The researchers used genetic techniques to observe which brain areas were activated throughout this process. They found that the amygdala, a region linked to responses such as fear and anxiety, played a crucial role in encoding and consolidating these associations. Other brain areas also interacted with the amygdala, forming a brain circuit that controls indirect associations between stimuli.

Dr. Busquets explained that if amygdala activity was inhibited while the mice were exposed to the stimuli, they were unable to form these indirect associations. This finding has significant implications for treating mental disorders linked to amygdala activity, such as PTSD and psychosis.

The researchers believe that the brain circuits involved in decision-making processes in humans are similar to those in mice. Therefore, understanding these complex cognitive processes can help us design therapeutic strategies for humans, including brain stimulation or modulation of activity in specific areas.

In conclusion, this study has revealed how a scent can change our mind’s decisions by altering indirect associations between stimuli. By exploring the neural mechanisms behind this process, we may be able to develop innovative treatments for mental disorders that affect millions of people worldwide.

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Autism

Unpacking the Gene That Hijacks Fear: How PTEN Rewires the Brain’s Anxiety Circuit

Deleting a gene called PTEN in certain brain cells disrupts the brain’s fear circuitry and triggers anxiety-like behavior in mice — key traits seen in autism. Researchers mapped how this genetic tweak throws off the brain’s delicate balance of excitation and inhibition in the amygdala, offering deep insights into how one gene can drive specific ASD symptoms.

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The gene PTEN has emerged as one of the most significant autism risk genes. Variations in this gene are found in a significant proportion of people with autism who also exhibit brain overgrowth. Researchers at the Max Planck Florida Institute for Neuroscience have discovered how loss of this gene rewires circuits and alters behavior, leading to increased fear learning and anxiety in mice – core traits seen in ASD.

PTEN has been linked to alterations in the function of inhibitory neurons in the development of ASD. The researchers focused on the changes in the central lateral amygdala driven by loss of PTEN in a critical neuronal population – somatostatin-expressing inhibitory neurons. They found that deleting PTEN specifically in these interneurons disrupted local inhibitory connectivity in the amygdala by roughly 50% and reduced the strength of the remaining inhibitory connections.

This diminished connectivity between inhibitory connections within the amygdala was contrasted by an increase in the strength of excitatory inputs received from the basolateral amygdala, a nearby brain region that relays emotionally-relevant sensory information to the amygdala. Behavioral analysis demonstrated that this imbalance in neural signaling was linked to heightened anxiety and increased fear learning, but not alterations in social behavior or repetitive behavior traits commonly observed in ASD.

The results confirm that PTEN loss in this specific cell type is sufficient to induce specific ASD-like behaviors and provide one of the most detailed maps to date of how local inhibitory networks in the amygdala are affected by genetic variations associated with neurological disorders. Importantly, the altered circuitry did not affect all ASD-relevant behaviors – social interactions remained largely intact – suggesting that PTEN-related anxiety and fear behaviors may stem from specific microcircuit changes.

By teasing out the local circuitry underlying specific traits, researchers hope to differentiate the roles of specific microcircuits within the umbrella of neurological disorders, which may one day help in developing targeted therapeutics for specific cognitive and behavioral characteristics. In future studies, they plan to evaluate these circuits in different genetic models to determine if these microcircuit alterations are convergent changes that underlie heightened fear and anxiety expression across diverse genetic profiles.

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