Large improvement of mental health during in outpatient short-term group psychotherapy treatment-a naturalistic pre-/post-observational study.

BACKGROUND: Group psychotherapy is an effective treatment for patients with mental health issues. This study aims to evaluate data on the effectiveness of a cost-free short-term outpatient group psychotherapy project for patients with mixed mental health issues in Tyrol, Austria. METHODS: In this naturalistic observational study, outpatients taking part in the psychotherapeutic group treatment between spring 2018 and spring 2020 were included. Patients completed the patient health questionnaire (PHQ-D), an item of the working ability index (WAI) and single items on symptom burden, treatment expectation and perceived benefit before the first (T0) and/or last group session (T1). Mean changes were investigated using repeated measure analyses of variance (rANOVA). RESULTS: A total of 98 patients were included in the study. Statistically significant improvements with medium to large effect sizes were observed for depression (η2 = 0.22, p < 0.001), somatization (η2 = 0.10, p = 0.008), anxiety (η2 = 0.18, p < 0.001), and subjective working ability (η2 = 0.22, p < 0.001). Neither age (p = 0.85), sex (p = 0.34), baseline symptoms (p = 0.29-0.77), nor previous experience with individual (p = 0.15) or group psychotherapy (p = 0.29) were associated with treatment outcome. However, treatment expectation at baseline was significantly associated with the patients' perception of the treatment benefit (r = 0.39, p < 0.001). CONCLUSION: Our study highlights the benefit of outpatient short-term group psychotherapy for individuals with mental health issues. Group psychotherapy should be offered free of charge to individuals with mental health issues by social health providers.

Human Platelet Mitochondrial Function Reflects Systemic Mitochondrial Alterations: A Protocol for Application in Field Studies.

Human blood cells may offer a minimally invasive strategy to study systemic alterations of mitochondrial function. Here we tested the reliability of a protocol designed to study mitochondrial respiratory control in human platelets (PLTs) in field studies, using high-resolution respirometry (HRR). Several factors may trigger PLT aggregation during the assay, altering the homogeneity of the cell suspension and distorting the number of cells added to the two chambers (A, B) of the Oroboros Oxygraph-2k (O2k). Thus, inter-chamber variability (∆ab) was calculated by normalizing oxygen consumption to chamber volume (JO2) or to a specific respiratory control state (flux control ratio, FCR) as a reliable parameter of experimental quality. The method's reliability was tested by comparing the ∆ab of laboratory-performed experiments (LAB, N = 9) to those of an ultramarathon field study (three sampling time-points: before competition (PRE, N = 7), immediately after (POST, N = 10) and 24 h after competition (REC; N = 10)). Our results show that ∆ab JO2 changed PRE-POST, but also for LAB-POST and LAB-REC, while all ∆ab FCR remained unchanged. Thus, we conclude that our method is reliable for assessing PLT mitochondrial function in LAB and field studies and after systemic stress conditions.

Effects of Ultramarathon Running on Mitochondrial Function of Platelets and Oxidative Stress Parameters: A Pilot Study.

Only a few studies have evaluated changes in mitochondrial function and oxidative stress associated with ultramarathon running. Invasive biopsies are needed to assess mitochondrial function of skeletal muscle, which may not be well tolerated by some individuals. Platelets (PLTs) as a metabolically highly active and homogenous cell population were suggested as a potentially valuable surrogate to investigate mitochondrial function. Thus, this study was aimed to evaluate mitochondrial function of PLTs and its association with individual race performance and markers of oxidative stress, muscle damage and renal dysfunction. Race performance and mitochondrial function (high-resolution respirometry, HRR) of PLTs using different substrates inducing ROUTINE, LEAK, N-pathway control state (Complex I linked oxidative phosphorylation; CI, OXPHOS), NS-pathway control state (CI + II linked OXPHOS and electron transfer pathway; ET), S-pathway control state (CII linked ET) as well as parameters of oxidative stress and antioxidant capacity, and markers of muscle and renal injury were assessed in eight male ultramarathon runners (26-45 years) before, immediately after and 24 h after an ultramarathon race (PRE, POST, and REC). Ultramarathon running induced an increase in LEAK O2 flux of PLT mitochondria and slight, largely non-significant changes in the oxidant/antioxidant balance. Levels of creatine kinase (CK), lactate dehydrogenase (LDH), blood urea nitrogen, and creatinine were all significantly elevated POST and remained high in REC. There were inverse correlations between race time and N-linked substrate state PRE-POST, and changes in CK and LDH levels were significantly related to PLT mitochondrial LEAK and N-linked respiration PRE. Although race-related changes in respirometry parameters of PLT mitochondria were rather small, a somewhat more pronounced increase in the relative N-linked respiration in faster runners might suggest PLT CI as indicator of physical fitness. The higher PLT LEAK PRE and diminished increase of CK during the race may represent a prophylactic preconditioning and the slight but non-significant elevation of the antioxidant potential post-race as a protective consequence of the race-related oxidative stress and potential threat to the kidney. Our findings point toward an interrelationship between mitochondrial function of PLTs, individual fitness levels and extreme physical and metal stresses, which stimulates further research.

Physiological and Pathophysiological Responses to Ultramarathon Running in Non-elite Runners.

Ultramarathon running represents a major physical challenge even for elite athletes. Runners wellbeing may be challenged by fluid and electrolyte disturbances, hemolysis and skeletal muscle damage, decline in hepatic function and kidney injury. We hypothesized that these effects may even be exacerbated in non-elite runners. Physiological, hematological and biochemical parameters of ten males (26-45 years, weekly training time 8.5 h), participating in a mountain ultramarathon (67 km; approximately 4,500 m of total ascent), were determined before (PRE), immediately after finishing the ultramarathon (POST), and 24 h after the individual finish (REC). Race times of the 8 finishers (2 drop-outs due to hot ambient temperature) varied between 10.4 and 16.1 h, which almost represents the range of the entire starter field (8.82 h-17.47 h). The following changes in mean values of selected markers for skeletal muscle damage and kidney injury were observed from PRE to POST: creatine kinase (CK) + 1289%, lactate dehydrogenase (LDH) + 87%, serum creatinine (CR) + 72%, blood urea nitrogen (BUN) + 96%, and estimated glomerular filtration rate (eGFR) - 45%. Values of CK + 1447%, LDH + 56%, and BUN + 71% remained elevated at REC. White blood cells were increased (+ 137%) only POST. In conclusion, CK and LDH levels and leucocytosis may be considered to be relatively harmless "side-effects" of prolonged running in this group of male subjects with rather moderate ultramarathon experience and training status. However, acute kidney injury may become clinically relevant in this population under the certain conditions, which should be considered by responsible race managers and medical advisors.

Short-term effects of bright light therapy in adults with chronic nonspecific back pain: a randomized controlled trial.

OBJECTIVE: The present trial evaluated incorporation of bright light therapy in the treatment of chronic nonspecific back pain (CNBP). DESIGN: A prospective, randomized, controlled, multicenter, open design with three parallel trial arms was used. SETTING: Subjects received a novel therapeutic, an expected therapeutic ineffective low dose, or no light exposure at three different medical centers. PATIENTS: A total of 125 CNBP patients reporting pain intensity of ≥3 points on item 5 of the Brief Pain Inventory (BPI) were included. INTERVENTION: Over 3 weeks, 36 active treatment, 36 placebo controls, and 33 controls received 3 or no supplementary light exposures of 5.000 lx or 230 lx, respectively. OUTCOME MEASURES: Changes in self-reported scores of pain intensity (BPI sub-score 1) and depression (Hospital Anxiety and Depression Questionnaire) were the primary outcome measures. Secondary outcome measures were changes in self-reported overall pain sensation (BPI total score), grade of everyday life impairment (BPI sub-score 2), mood (visual analog scale), and well-being (World Health Organization-Five Well-Being Index). RESULTS: Changes in pain intensity were higher (1.0 [0.8-1.6]) in the bright light group compared with controls (0.3 [-0.1-0.8]; effect size D = 0.46). Changes in the depression score were also higher in the intervention group (1.5 [0.0-2.5]) compared with controls (0.0 [0.0-2.0]; effect size D = 0.86). No differences were seen in change scores between intervention vs sham group. CONCLUSION: The present randomized controlled trial shows that light therapy even in low dose could improve depressive symptoms and reduce pain intensity in CNBP patients. Further research is needed for optimizing parameters of frequency, dose, and duration of therapeutic light exposure.

Bright light therapy: Minimizing light induced side effects with an innovative light setup.

Abstract Objective. Bright light therapy (BLT) is regarded to be an effective treatment against seasonal depression (SAD). Conventional BLT devices are reported to evoke few, but inconvenient symptoms. This study evaluated side effects associated with a new technology for BLT in a healthy population. Methods. In an uncontrolled study design 20 healthy Caucasians received 30 min light exposures on three consecutive mornings. Immediate side effects were evaluated using questionnaires. The new light cabin was equipped with fluorescent lamps (light colour 965 = 6,500 K, CRI >90) with a maximum illumination of 5,000 lux and a maximum luminance of 1,500 cd/m(2). Occurrence of headache was determined to be the main objective. Results. Nineteen volunteers completed the study. No headache was reported at any time. With a prevalence of 21.1% blurring was observed to occur more often after light exposure. Conclusion. With the evaluated light cabin the most prominent short-term side effects of BLT can be minimized, enhancing patients' adherence.

Chronic pain syndromes and their relation to childhood abuse and stressful life events.

OBJECTIVE: Childhood abuse, stressful life events, and depression have been repeatedly reported to correlate with chronic pain, but little is known about the mutual relationships among these variables. METHODS: Forty-three women with chronic pelvic pain (CPP), 40 female patients with chronic low-back pain (CLBP), and a female pain-free control group (n=22) were investigated by means of a semistructured interview assessing childhood sexual and physical abuse as well as stressful life events. Additionally, the Beck Depression Inventory (BDI) was used. For multivariate analyses, structured equation modeling was applied. RESULTS: Childhood physical abuse, stressful life events, and depression had a significant impact on the occurrence of chronic pain in general, whereas childhood sexual abuse was correlated with CPP only. Moreover, childhood sexual abuse was related to depression. Both childhood sexual and physical abuse showed a close relationship to an increased occurrence of stressful life events. CONCLUSION: There are complex mutual interactions among childhood abuse, stressful life events, depression, and the occurrence of chronic pain. Therefore, clinicians should take into consideration these psychosocial factors while treating chronic pain patients.

Chronic low back pain measurement with visual analogue scales in different settings.

We asked 78 chronic low back pain patients to report on their usual pain intensity, and on the lifestyle changes caused by their pain, on a horizontally-oriented visual analogue scale (VAS). Also, the usual and the current pain intensities were examined on a vertical VAS. Statistical analysis showed normal distribution of data in the measurement of usual pain on the horizontal VAS, but no homogeneous distribution on the vertical VAS. Therefore, in the measurement of chronic low back pain VAS should be used horizontally rather than vertically, because of higher sensitivity. The intensity of usual pain was significantly correlated with the degree of lifestyle change. No correlation was found between current and usual pain. There was no significant difference in the failure rate between the vertical and horizontal VAS. Also, there was no reduction of the failure rate by giving additional oral explanations in the use of the scale to the patient. Owing to a negative influence in distribution of rates and an increase in the failure rate, complex questions should be avoided. A short written introduction to the scale is sufficient, and oral explanations are not essential.