Event: Depression (and anxiety) in Paediatric Chronic Fatigue Syndrome (CFS) - Dr Maria Loades, 28 Jan 2020

Maria Loades is due to be repeating this presentation at BACMEs 2020 conference.
Seems to be about an ongoing study:
Depression in paediatric chronic fatigue syndrome (CFS/ME)
Description
NIHR doctoral research fellowship, hosted by the University of Bristol
Short title 311479
Status Active
Effective start/end date 1/10/16 → 30/09/21

https://researchportal.bath.ac.uk/e...-in-paediatric-chronic-fatigue-syndrome-cfsme
 
I just wish i was able to attend this event. I recently attended a one-day conference regarding diseases like depression, anxiety disorders, schizophrenia,etc.


Several scientists -including one from the prestigious Johns Hopkins- identified the importance of both genes and the environment for the onset of these diseases.

Coming now to ME/CFS : I believe that anxiety and ME/CFS are closely tied together, at least for a subset of patients. This has nothing to do with "it's all in your head" nor i suggest that ME/CFS is a psychiatric disease.

As the paper i link below , discusses :


In agreement with the importance of bioenergetics in brain function and dysfunction [17,18,20,29] mentioned earlier, emerging evidence implicates brain energy metabolism in anxiety. However, this is not the full story. An increasing number of studies are revealing that several other mitochondrial functions, such as oxidative stress, apoptosis, neurosteroid production, and mitochondrial biogenesis, are also altered in individuals with high anxiety
Click to expand...


Hypothetically, given the fundamental role of mitochondria in the synthesis of the main excitatory neurotransmitter (glutamate) and the inhibitory one (GABA), mito- chondrial adaptations observed in the context of anxiety may contribute to the neural excitation– inhibition imbalance thought to underlie several neuropsychiatric disorders [41]. Importantly, glutamate excitotoxicity is a major trigger of oxidative stress in the brain [122] and high cortical glutamate levels have been documented in highly anxious individuals [123]. Chronic stress pro- motes anxiety [124] as well as oxidative stress damage [125]. In addition, stress increases brain glutamate levels and shifts the excitatory/inhibitory balance towards increased excitation
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Let's hope for interesting findings ahead, as soon as possible.


https://www.sciencedirect.com/science/article/abs/pii/S0166223619301237
 
mariovitali said:
Several scientists -including one from the prestigious Johns Hopkins- identified the importance of both genes and the environment for the onset of these diseases.
Click to expand...

It seems anti-scientific to be influenced by the purported "prestige" of the institution rather than the evidence supporting the particular work. Some of us, (well, I,) hold other views, as it was work from John Hopkins and the US Army Chemical Corps that got us into this mess in the first place. Conjuring tricks indeed.
 
chrisb said:
It seems anti-scientific to be influenced by the purported "prestige" of the institution rather than the evidence supporting the particular work. Some of us, (well, I,) hold other views, as it was work from John Hopkins and the US Army Chemical Corps that got us into this mess in the first place. Conjuring tricks indeed.
Click to expand...

Please note I wrote that several scientists discussed the importance of both genes and the environment and not just one researcher from Johns Hopkins.
 
Sly Saint said:
Maria Loades is due to be repeating this presentation at BACMEs 2020 conference.
Seems to be about an ongoing study:
Depression in paediatric chronic fatigue syndrome (CFS/ME)
Description
NIHR doctoral research fellowship, hosted by the University of Bristol
Short title 311479
Status Active
Effective start/end date 1/10/16 → 30/09/21

https://researchportal.bath.ac.uk/e...-in-paediatric-chronic-fatigue-syndrome-cfsme
Click to expand...
From the funding notice.

Depression in paediatric chronic fatigue syndrome (CFS/ME)

Abstract:

Background: Chronic fatigue syndrome (CFS), or myalgic encephalomyelitis (ME) is characterised by persistent, disabling fatigue in the absence of an underlying cause. It is relatively common (1 - 2.4%) and disabling. Approximately 30% of adolescents with CFS/ME probably have depression. Those with probable co-morbid depression are more disabled, have worse fatigue and more pain than those without depression. Despite this, we know remarkably little about co-morbid depression in paediatric CFS/ME. We do not know whether depression in paediatric CFS/ME changes treatment outcome as it may do in adult CFS/ME. Epidemiological studies, clinical services and treatment trials in CFS/ME have only used questionnaires (for example, the Hospital Anxiety and Depression Scale, HADS) and not the gold standard structured diagnostic interview to identify those with depression. We are therefore not certain what the prevalence of DSM-IV defined co-morbid clinical depression is in paediatric CFS/ME, whether particular groups of adolescents are at higher risk of developing depression and how depression affects prognosis.

Aim: To improve the recognition and treatment of adolescents with CFS/ME and co-morbid depression. Question to be addressed: What is the best way to identify and treat paediatric CFS/ME and co-morbid depression?

Plan of Investigation:

Study 1. I will establish the prevalence of co-morbid depression in a clinical cohort (N=323, age 11-18 with diagnosis of CFS/ME) using a structured diagnostic interview (Kiddie Schedule for Affective Disorders and Schizophrenia, KSADS). I will use Receiver Operating Characteristic (ROC) curves to quantify diagnostic accuracy and investigate the sensitivity and specificity and determine the optimum threshold for both the HADS and the Revised Child Anxiety and Depression Scale (RCADS).

Study 2. I will perform the following secondary data analysis from 6 month follow-up data from study 1, the RECOVERY study (a prospective cohort study, N=214) and the MAGENTA trial (a RCT comparing behavioural treatments for CFS/ME, N = 28 as of January, 2016, anticipated 220 by February, 2018). 1. Identify the characteristics associated with co-morbid depression at baseline using logistic regression. 2. Investigate whether depression affects prognosis by comparing physical function (SF-36 physical function subscale) at 6 months between those who are and are not depressed using multivariable linear regression adjusting for baseline SF36-PFS, and variables shown to be associated with depression. Additional analyses will adjust for allocated treatment in the trial. Sensitivity analyses will exclude adolescents who received CBT in the prospective cohorts.

Study 3: I will add two further questionnaires (Children's Negative Cognitive Errors Questionnaire - Revised; Cognitive and Behavioural Responses to Symptoms Questionnaire) to the FITNET-NHS trial comparing internet delivered therapies for CFS/ME (CBT versus activity management, N = 734) to investigate whether there is a difference in negative cognitive errors and cognitive and behavioural responses to CFS/ME in adolescents with and without co-morbid depression.

Study 4 -h; I will run two expert groups (15-20 multidisciplinary clinicians) and two patient advisory groups to support the development of a theoretical model of factors contributing to depression in adolescents with CFS/ME using the findings of studies 2 and 3. This will inform the development of a new treatment approach for paediatric CFS/ME with co-morbid depression. Benefits to patients and the NHS: NHS commissioners and service providers will benefit from knowing the actual prevalence of co-morbid depression in paediatric CFS/ME. Clinicians and those conducting treatment trials will benefit from knowing how best to screen for depression, and what thresholds to use on the screening tools. Clinicians will improve the targeting of treatment as they will know the characteristics of adolescents at risk of depression. Developing improved treatment will benefit patients, their families and NHS providers.

Lead Investigator(s):
Dr Maria Loades

Award:
£317,866.00

Start Date:
October 2016

End Date:
February 2022

https://fundingawards.nihr.ac.uk/award/DRF-2016-09-021
 
Andy said:
From the funding notice.

Depression in paediatric chronic fatigue syndrome (CFS/ME)

Abstract:

Background: Chronic fatigue syndrome (CFS), or myalgic encephalomyelitis (ME) is characterised by persistent, disabling fatigue in the absence of an underlying cause. It is relatively common (1 - 2.4%) and disabling. Approximately 30% of adolescents with CFS/ME probably have depression. Those with probable co-morbid depression are more disabled, have worse fatigue and more pain than those without depression. Despite this, we know remarkably little about co-morbid depression in paediatric CFS/ME. We do not know whether depression in paediatric CFS/ME changes treatment outcome as it may do in adult CFS/ME. Epidemiological studies, clinical services and treatment trials in CFS/ME have only used questionnaires (for example, the Hospital Anxiety and Depression Scale, HADS) and not the gold standard structured diagnostic interview to identify those with depression. We are therefore not certain what the prevalence of DSM-IV defined co-morbid clinical depression is in paediatric CFS/ME, whether particular groups of adolescents are at higher risk of developing depression and how depression affects prognosis.

Aim: To improve the recognition and treatment of adolescents with CFS/ME and co-morbid depression. Question to be addressed: What is the best way to identify and treat paediatric CFS/ME and co-morbid depression?

Plan of Investigation:

Study 1. I will establish the prevalence of co-morbid depression in a clinical cohort (N=323, age 11-18 with diagnosis of CFS/ME) using a structured diagnostic interview (Kiddie Schedule for Affective Disorders and Schizophrenia, KSADS). I will use Receiver Operating Characteristic (ROC) curves to quantify diagnostic accuracy and investigate the sensitivity and specificity and determine the optimum threshold for both the HADS and the Revised Child Anxiety and Depression Scale (RCADS).

Study 2. I will perform the following secondary data analysis from 6 month follow-up data from study 1, the RECOVERY study (a prospective cohort study, N=214) and the MAGENTA trial (a RCT comparing behavioural treatments for CFS/ME, N = 28 as of January, 2016, anticipated 220 by February, 2018). 1. Identify the characteristics associated with co-morbid depression at baseline using logistic regression. 2. Investigate whether depression affects prognosis by comparing physical function (SF-36 physical function subscale) at 6 months between those who are and are not depressed using multivariable linear regression adjusting for baseline SF36-PFS, and variables shown to be associated with depression. Additional analyses will adjust for allocated treatment in the trial. Sensitivity analyses will exclude adolescents who received CBT in the prospective cohorts.

Study 3: I will add two further questionnaires (Children's Negative Cognitive Errors Questionnaire - Revised; Cognitive and Behavioural Responses to Symptoms Questionnaire) to the FITNET-NHS trial comparing internet delivered therapies for CFS/ME (CBT versus activity management, N = 734) to investigate whether there is a difference in negative cognitive errors and cognitive and behavioural responses to CFS/ME in adolescents with and without co-morbid depression.

Study 4 -h; I will run two expert groups (15-20 multidisciplinary clinicians) and two patient advisory groups to support the development of a theoretical model of factors contributing to depression in adolescents with CFS/ME using the findings of studies 2 and 3. This will inform the development of a new treatment approach for paediatric CFS/ME with co-morbid depression. Benefits to patients and the NHS: NHS commissioners and service providers will benefit from knowing the actual prevalence of co-morbid depression in paediatric CFS/ME. Clinicians and those conducting treatment trials will benefit from knowing how best to screen for depression, and what thresholds to use on the screening tools. Clinicians will improve the targeting of treatment as they will know the characteristics of adolescents at risk of depression. Developing improved treatment will benefit patients, their families and NHS providers.

Lead Investigator(s):
Dr Maria Loades

Award:
£317,866.00

Start Date:
October 2016

End Date:
February 2022

https://fundingawards.nihr.ac.uk/award/DRF-2016-09-021
Click to expand...
And one more for the copy-paste factory. Identical to all others before. The never-ending funding for this junk is a scandal all on its own.
 
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