News round-up (2 August 2024)

As if the new health secretary didn’t have enough in his in-tray, this week sees concerning news that this year the number of psychiatric patients sent to units outside their local area increased by 25%. There has also been a damning report into failings at the CQC, where internal problems have hampered the regulator’s ability to do its job properly. But we also highlight some innovative research studies on mental illness, including one finding that anxiety or depression can significantly increase the risk of deep vein thrombosis, and another identifying the possible mechanism by which exercise reduces depression.

 

Main stories from the week

New online therapies enable more people with anxiety to receive treatment

New online therapies could help double or even treble the number of people who recover from anxiety and post-traumatic stress disorder (PTSD), research has found.

 

User-led youth mental health training developed for marginalised communities

A new training programme developed jointly between University of Birmingham researchers and young Black people is aiming to improve access to mental health services for marginalised communities.

 

Poverty can lead to mental illness, and vice-versa, study finds

There is a causal relationship between mental illness and poverty, according to new research.

 

Hospitals ordered to stop discharging people with severe mental illness

Hospitals have been ordered to carry out an urgent review of safety in NHS mental health services, following incidents where discharged patients have gone on to kill people, according to a report in the Times.

 

Other stories from the week

Anxiety and depression raise risk of dangerous blood clots, study finds 

Having anxiety or depression may increase the risk of deep vein thrombosis (DVT).

Researchers at Massachusetts General Hospital looked retrospectively at data from almost 119,000 people. The data included measurements of stress-related brain activity obtained using positron emission tomography (PET) scans.

About 106,450 people had a diagnosis of anxiety, while 108,790 had depression (some people had both conditions).

Over an average follow-up time of 3.6 years, about 1,780 study participants experienced DVT. Those with a history of anxiety or depression were 53% and 48% more likely to experience DVT, respectively, compared with those with no history of either condition. Similar trends were seen among people with both conditions.

Three potential mechanisms connect anxiety and depression to DVT, the researchers said: higher stress-related neural activity (SNA), higher inflammation and reduced heart rate variability. The more stress a person experiences, the higher their risk of DVT, the researchers concluded.

 

‘Significant failings’ in CQC identified in independent report

An independent review into the Care Quality Commission (CQC), which regulates health and social care in England, has revealed “significant internal failings” that are hampering its ability to do its job effectively.

The interim report published by Dr Penny Dash found that the CQC’s ability to identify poor performance at hospitals, care homes and GP practices had been hindered by problems such as low levels of inspections, a lack of clinical expertise among those carrying them out, a lack of consistency in assessments and IT issues.

It found that the regulator was unable to effectively judge the quality of health and care services, and said that social care providers were left waiting too long for registration and ratings to be updated, leading to an impact on local capacity.

The CQC introduced new IT systems in 2021, but the report found that this “resulted in significant problems for users”, such as not being able to easily upload documents, problems if a named user was away, taking hours to receive a password reset and taking staff away from delivering or supporting frontline care.

 

More psychiatric patients being sent far from home for treatment

More people with mental health problems are being sent far from home for in-patient psychiatric treatment, figures show.

NHS data shows that the numbers almost halved between 2018-19 and 2022-23 but rose by 25% in 2023-24. In the year to March 2024, 5,500 people were sent for treatment out of their local area because no beds were available locally. The Greater Manchester area had the largest increases.

In 2016, the government said it wanted to eliminate out-of-area placements by 2021.

Dr Lade Smith, president of the Royal College of Psychiatrists, said that financial and housing pressures and the pandemic had led to a rise in people needing care, although “there were already ongoing problems”.

Out-of-area placements cost NHS England £164m in 2023-24, up £49m (43%) from 2022-23.

 

New tool can predict dementia and depression risk, study finds 

Last year, doctors at Massachusetts General Hospital created the Brain Care Score (BCS), a tool for assessing dementia or stroke risk without medical procedures.

That score may also be able to predict the odds of developing depression later in life, a new study published in Frontiers in Psychiatry has found.

The 21-point BCS captures how a person fares on 12 factors relating to the physical, lifestyle and social-emotional components of health. A higher BCS is associated with a lower risk of developing depression after the age of 60, the study found.

The four physical components of the BCS are blood pressure, cholesterol, haemoglobin A1c and body mass index, while the five lifestyle factors are nutrition, alcohol consumption, aerobic activities, sleep and smoking. The three social-emotional aspects relate to relationships, stress management and meaning in life.

The research team used health data from more than 350,000 people who had been recruited for the UK Biobank study between 2006 and 2010 and participated in follow-up assessments three times over the next decade.

They found that every five-point positive difference in a person’s BCS was associated with a 33% lower risk of late-life depression, as well as a 27% lower composite risk of late-life depression, dementia and stroke over a follow-up period of 13 years on average.

 

Exercise Boosts Motivation to Combat Depression

Exercise reduces depression by boosting motivation through decreased inflammation and enhanced dopamine function, a new study suggests.

Researchers from University College London carried out a review of existing research to explore why exercise is effective at tackling depression, and concluded that depression, especially anhedonia, is associated with elevated inflammation (caused by the body’s immune response). Inflammation is also linked to disrupted dopamine transmission.

They argue that exercise reduces inflammation and boosts dopamine, and therefore enhances motivation. They believe this could be an important reason as to why exercise exerts an antidepressant effect.

The research team suggests that large trials are needed to test this hypothesis and explore barriers to exercise. The lead author, Dr Emily Hird, said: “We are proposing that exercise – particularly aerobic activities that make you sweaty and out of breath – decreases inflammation and boosts dopamine transmission, which in turn increases the desire to exert effort, and therefore boosts motivation generally.”

 

Scottish teachers take 400,000 days off due to stress and anxiety  

Teachers in primary and secondary schools in Scotland have taken 400,000 days off in the past three years as a result of stress and anxiety, new figures show.

Statistics from 31 of Scotland’s 32 local authorities show that ­secondary school teachers took 174,471 days of absence owing to mental ill health, including for stress and anxiety, in 2021/22, 2022/23 and 2023/24. Over the same period, 225,476 days of primary teaching were lost to mental stress.

The NASUWT teaching union said that the stress was being caused in part by poor behaviour in Scottish schools. Darren Wapplington, a representative of NASUWT Scotland, said that 93% of teachers surveyed in Scotland reported that there had been an increase in the number of pupils exhibiting “violent and abusive behaviours”. He added: “Three-quarters said it was ­making the job more stressful, and a fifth said they were suffering with depression.”

 

Cancer drug could ease cognitive function for autism-linked condition 

An experimental cancer drug could make thinking easier for individuals with Rett syndrome, a rare disorder linked to autism, a study has found.

The research, published in Stem Cell Reports, highlights the role of microglia, a type of white blood cell found in the central nervous system, in the formation of the human brain.

Pinar Mesci, of the University of California San Diego, used brain organoids that mimic the developing brain of an embryo grown from skin-derived stem cells of consenting patients, some of whom were healthy, and some of whom had Rett syndrome, a disorder characterised by loss of speech, purposeful use of hands, mobility and muscle tone. Mesci then added healthy microglia to the Rett syndrome brain organoids and found that the functioning of synapses, where neurons connect and communicate, was “rescued.”

The discovery that could lead to therapies for patients with other neurological conditions.