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Mental Health, Public Health, Research

Survey shows nearly a quarter of U.S. workers have been diagnosed with depression in their lifetime

Survey shows nearly a quarter of U.S. workers have been diagnosed with depression in their lifetime

4369627924_ccd7f6f7ff_zDepression is a major contributor to absenteeism, reduced productivity and disability among adults in the United States. Now results from a survey examining the societal and economic burden of depression in the workplace show that almost a quarter of employees have been diagnosed with depression in their lifetime and that two in five patients have missed work, for an average of 10 day per year, because of it.

The findings underscore the importance of decreasing the stigma associated with mental-health conditions in the workplace and providing workers with support services and resources. According to a release, additional results also showed:

…64 percent of survey participants reported cognitive-related challenges, as defined by difficulty concentrating, indecisiveness and/or forgetfulness, have the most impact on their ability to perform tasks at work as normal. Presenteeism (being at work, but not engaged/productive) has been found to be exacerbated by these challenges related to thinking on the job.

Despite how depression is affecting our workforce, 58 percent of employees surveyed who have been diagnosed with depression indicate they had not told their employer of their disease. In addition, 49 percent felt telling their employer would put their job a risk and, given the economic climate, 24 percent felt it was too risky to share their diagnosis with their employer.

These figures directly contribute to the estimated $100 billion annually spent on depression costs by U.S. employers including $44 billion a year in lost productivity alone.

The survey was commissioned by Ohio-based Employers Health and conducted by market research company Ipsos MORI. Questions were asked via an online panel of 1,000 adults, aged 16-64, who have been workers or managers within the last year. Responses were weighted to ensure the sample was representative of this profile. Funding was provided by international pharmaceutical company H. Lundbeck A/S.

Previously: Anxiety shown to be important risk factor for workplace absence, Research shows working out may benefit work life and How work stress affects wellness, health-care costs
Photo by Ryan Hyde

Nutrition, Obesity, Public Health

A physician realizes that she had "officially joined our nation of fellow sugar addicts"

A physician realizes that she had "officially joined our nation of fellow sugar addicts"

sugar_11.11.14Over on CommonHealth, Terry Schraeder, MD, an internist at Mt. Auburn Hospital and a clinical assistant professor at Brown University, speaks candidly about her realization that she was consuming way too much sugar – likely more than 22 teaspoons – each day.

Her addiction started with a sugar-laden drink disguised as sparkling orange juice and spiraled into regular consumption of flavored coffees, muffins, snacks, desserts and “healthy foods” containing hidden corn syrup. In the piece, Schraeder explains that a high triglyceride level convinced her to change her eating habits:

For the past eight weeks, I have tried to limit adding sugar in any form to my food and started searching nutrition labels for sugar content. If the food lists the grams of sugar on the nutrition label (these may be natural or added), then I check the list of added ingredients to see if there is any added sugar in the form of corn syrup, sucrose, fructose, brown sugar, juice concentrate, honey, molasses, etc. If there is, I know it is “added” sugar. I try to limit my added sugar to less than 24 grams (or six teaspoons) each day.

It has not been easy but it has been well worth the effort. For the first time in years, my moods and energy are more level, the sweet cravings are gone and I feel calmer. The fat around my belly has disappeared. My teeth feel smoother and cleaner despite the same oral hygiene. The late afternoon slump and brain fog are no more. I will have my triglycerides rechecked soon.

I feel great but I am still in shock. I had no idea I was consuming too much sugar. If you had asked me, I would have denied it. For years, I have railed against fat and calories, smoking and lack of exercise. I had not considered my own sugar intake.

The piece is worth a read and may inspire you to take a closer look at your own daily sugar intake.

Previously: Study shows banning soda purchases using food stamps would reduce obesity and type-2 diabetes, What do Americans buy at the grocery store? and Mindful eating tips for the desk-bound
Photo by Moyan Brenn

Aging, Health and Fitness, Neuroscience, Public Health, Research

Neighborhood’s “walkability” helps older adults maintain physical and cognitive health

Neighborhood’s “walkability” helps older adults maintain physical and cognitive health

3275748024_c4914d4ae0_zLiving in a walkable neighborhood could be an important factor in helping older adults maintain their physical and cognitive health, according to new research from the University of Kansas.

In the small study, researchers monitored a group of adults diagnosed with mild Alzheimer’s disease and compared them to those without any cognitive impairment. Over a two-year period, individuals completed cognitive tests designed to measure attention, verbal memory and mental status. The “walkability” of participants’ neighborhoods was determined using geographic information systems (GIS). Medical News Today reports:

Results from the study suggest that communities that are easier to walk in are linked to better physical health outcomes – such as lower body mass and blood pressure – and cognition – including better memory.

[Researchers] believe their findings could benefit older adults, health care professionals, caregivers and even architects and urban planners.

Finding also showed that environments with more complex layouts appeared to aid residents in staying mentally sharp, rather than confusing them. Researchers presented their findings over the weekend at the Gerontological Society of America’s annual meeting in Washington, DC.

Previously: Walking and aging: A historical perspective, Even old brains can stay healthy, says Stanford neurologist,  Exercise and your brain: Stanford research highlighted on NIH Director’s blog , Moderate exercise program for older adults reduces mobility disability, study shows and Creating safer neighborhoods for healthier lifestyles
Photo by Ed Yourdon

Ask Stanford Med, Chronic Disease, Events, Health and Fitness

Examining the role of exercise in managing and preventing diabetes

Examining the role of exercise in managing and preventing diabetes

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More than 29 million adults and children in the United States are living with diabetes, and it’s estimated (.pdf) that an additional 86 million Americans ages 20 years or older have prediabetes, putting them at increased risk of developing the disease.

The good news is that lifestyle modifications can be an effective method for managing or preventing diabetes. In recognition of National Diabetes Month, I reached out to Baldeep Singh, MD, a clinical professor at Stanford who focuses on chronic disease management, to discuss the importance of regular physical activity for patients diagnosed with diabetes and those working to limit their risk of developing the disease. This Thursday, Singh will explore the topic more in-depth during a Stanford Health Library event at the Arrillaga Alumni Center on campus, where attendees can also have their blood glucose checked. The discussion will also be webcasted for those unable to attend in person.

In this Q&A, Singh highlights scientific evidence showing that staying active has a beneficial effect on insulin sensitivity, and discusses the potential of exercise, in combination with other behavioral changes, to induce partial, or full, remission of type 2 diabetes.

How does regularly exercising help in preventing or delaying type 2 diabetes?

The benefit of exercise in preventing diabetes has been demonstrated in several studies. A meta-analysis of 10 studies of physical activity and type 2 diabetes reported a lower risk of developing diabetes with regular moderate physical activity, including brisk walking, compared with being sedentary

Additionally, in a subsequent prospective cohort study in men, either weight training or aerobic exercise for at least 150 minutes per week was associated with a lower risk of developing type 2 diabetes compared to those with  a control group who did no physical activity.

Why is engaging in physical activity important in managing type 2 diabetes?

In patients with type 2 diabetes, studies show that short-term exercise training improves insulin sensitivity just as it does in non-diabetics. In patients with type 2 diabetes treated with medication, exercise tends to lower blood glucose concentrations.

Exercise improves glycemic control in patients with type 2 diabetes, as illustrated by the findings of several meta-analyses of trials examining the effect of exercise on glycemic control in patients with type 2 diabetes. Exercise training reduces glycosylated hemoglobin (A1C) values by approximately 0.5 to 0.7 percentage points compared with control participants.

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Global Health, Health Costs, Health Disparities, Stanford News

Stanford undergrad works to redistribute unused medications and reduce health-care costs

Stanford undergrad works to redistribute unused medications and reduce health-care costs

1Sanchay Gupta arrived at Stanford with a strong interest in income inequality. In 2013, he spent two weeks of his summer vacation in Guatemala exploring issues of global chronic underdevelopment as part of an intensive field research internship sponsored by the Freeman Spogli Institute for International Studies. While on the trip, he shadowed Stanford doctors in ad-hoc rural clinics serving the indigenous communities and got a firsthand look at the country’s rural health-care system. He also interviewed patients about how their health status affected their family’s welfare while conducting field research.

Among the patients he interviewed was a father of nine children who made his living carrying firewood. One day the man injured himself carrying a particularly heavy load and was declared unfit for work. Seemingly overnight, the family income drastically fell below $3 a day and the father could no longer afford to see a doctor for treatment. But until he received proper medical care, there was no way that he could recover from his injury and resume supporting his family.

“It was during my time in these community settings that I witnessed how disparities in access to medical care can perpetuate inequality,” said Gupta, who was recently named one of the “15 incredibly impressive students at Stanford” by Business Insider. “As a result, I became really interested in how solving issues of inequality could break the cyclical theme of poverty.”

At the same time, Gupta was  fostering a vested interest in the fate of America’s health-care system. He had taken a few courses on U.S. health policy and strategies for health-care delivery innovation, and the experiences sparked a desire to get involved in efforts to eliminate costly inefficiencies within the health-care sector.

In looking for opportunities to get involved in helping reduce inefficiencies in health care, he learned about Supporting Initiatives to Redistribute Unused Medicine (SIRUM), a non-profit launched by Stanford students that engages with health-facility donors, converting their regulated medicine destruction process into medicine donation.

Nearly one-third of patients don’t fill first-time prescriptions and many say concerns about costs are a key reason for their non-compliance. At the same time, an estimated $5 billion of unused and unexpired prescriptions drugs are destroyed in the United States annually. To address these problems, SIRUM has developed an online platform that allows medical facilities, manufacturers, wholesalers and pharmacies to donate unused drugs instead of destroying them.

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In the News, Science, Videos

Using dance to explain science

Using dance to explain science

Circus enthusiast and University of Georgia PhD candidate Uma Nagendra used her aerial talent to create this year’s winning “Dance Your PhD” video. The contest is sponsored by Science AAAS and challenges scientists to use dance to translate their work. For the contest, Nagendra joined forces with her aerialist colleagues to produce the above video based on her research on how tornadoes can alter the dynamic of the ecosystem.

Science recently reported:

Tornadoes are destructive events, ripping up the surface of Earth, crushing buildings, and tossing automobiles in their paths. And based on some models of climate change, they are likely to become more frequent and damaging. But according to a study of forest soil ecology, tornadoes also do some good—for trees, that is. It turns out that tree seedlings get a respite from certain parasitic fungi in a tornado’s aftermath, allowing them to flourish.

For winning the BIOLOGY category and the overall prize, Nagendra receives $1000 and a free trip to Stanford University in May 2015, where her video will be screened.

Previously: “Dance Your PhD” finalists announced

Neuroscience, Research, Sleep

Memory of everyday events may be compromised by sleep apnea

Memory of everyday events may be compromised by sleep apnea

sleeping_11.3.14Previous imaging studies have shown that sleep apnea, which causes periods of disrupted breathing during the night, is associated with tissue loss in regions of the brain that process memory. Now new research published in the Journal of Neuroscience offers more evidence that the sleep disorder can cause difficulty in remembering where you left your keys and other daily events.

In a small study (subscription required), people with severe sleep apnea spent two separate nights at the NYU Sleep Disorders Center. At the lab, individuals were administered a baseline examination consisting of playing a video game requiring them to navigate three-dimensional spatial mazes. During one night of the experiment, participants’ use of their continuous positive airway pressure (CPAP) machine was reduced during REM sleep allowing sleep apnea to naturally occur. On the second night, they resumed normal use of the CPAP. Individuals played the video game before and after each sleep period.

As Medical News Today reports:

When sleep was aided by therapeutic CPAP all night, researchers observed a 30 percent overnight improvement in maze completion time from their baseline examinations. However, when REM sleep was disrupted by sleep apnea, there was not only no improvement from baseline testing, but, in fact, subjects took 4 percent longer to complete the maze tests.

Equally important, when sleep apnea occurred in REM sleep, subjects did not experience delayed reaction times on a separate test to measure attention, called a psychomotor vigilance test. [Lead researcher Andrew Varga, MD, PhD,] says that this suggests that sleepiness or lack of attention were not reasons for the decline in spatial memory, as indicated by the maze performance after experiencing sleep apnea in REM sleep.

Sleep apnea affects approximately 18 million adults in the United States. While the disorder is difficult to diagnose in children because of monitoring techniques, it’s estimated that a minimum of 2 to 3 percent of kids suffer from sleep apnea and some believe it could be as high as 10 to 20 percent, according to data from the National Sleep Foundation.

Previously: “Sleep drunkenness” more prevalent than previously thought, Study shows women with gestational diabetes at increased risk for obstructive sleep apnea, Why untreated sleep apnea may cause more harm to your health than feeling fatigued and How effective are surgical options for sleep apnea?
Photo by Jared Polin

In the News, Science

Luminous mouse brain among photomicrography competition winners

Luminous mouse brain among photomicrography competition winners

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Nikon announced the winners of its annual Small World Photomicrography Competition yesterday, and among the group was this stunning image.

The photo was taken by Ali Ertürk, PhD, a researcher at the Institute for Stroke and Dementia Research at Ludwig Maximillian’s University in Munich, Germany. Ertürk and his colleagues’ research is focused on better understanding the “key mechanisms leading to neurodegeneration after acute brain injury.” This image depicts the mouse brain vasculature.

Via Wired Science
Previously: Video of innate immune reaction in the lymph node, Image of the Week: Osteosarcoma cell and Tiny wonders: Small World in Motion competition winners bring microscopic activity to life
Photo by Ali Erturk/Nikon Small World Photomicrography Competition

Ask Stanford Med, Neuroscience, Surgery

A Stanford neurosurgeon discusses advances in treating brain tumors

A Stanford neurosurgeon discusses advances in treating brain tumors

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Last year, an estimated 70,000 people were diagnosed with a primary brain tumor, which originates and remains in the brain, and far more will develop metastatic brain tumors, those that begin as cancer elsewhere in the body and spread to the brain. Although physicians face a number of challenges in treating these tumors, the encouraging news is that advances in technology and new therapies are improving patient outcomes.

During a Stanford Health Library event on Thursday, Steven Chang, MD, director of the Stanford Neurogenetics Program and the Stanford Neuromolecular Innovation Program, will deliver an update on the latest in surgical and non-surgical treatments of brain tumors. (The lecture will also be webcasted for those unable to attend.) In anticipation of the talk, Chang answered some questions related to the topics he’ll be addressing.

Why has a greater understanding of genetics and the biology of tumors improved physicians’ understanding of how patients will respond to certain therapies?

Having a greater understanding of the genetics and biology of brain tumors helps neurosurgeons to tailor treatments for each patient. In essence, we are able to deliver personalized medicine if we understand which subsets of brain tumors respond to specific treatments. For example, we now understand that gliomas with certain genetic makers are more likely to respond to chemotherapy treatments. The presence or absence of these genetic markers will also help guide patients in determining which clinical trials it may be most appropriate for them to enroll in.

How have advances in brain-mapping technologies made a difference in treating low-grade gliomas, which are slow growing and often affect younger patients?

Low-grade gliomas don’t typically contrast enhance on brain MRI scans. Furthermore, low-grade gliomas are more likely than higher-grade gliomas to have appearances similar to normal brain tissue, with no obvious color or consistency distinction between tumor and normal brain. These factors make resection of low-grade gliomas potentially more complex than high-grade gliomas, which often have distinct appearances from normal brain tissue. Advances in brain-mapping technologies include both image guided navigation and electrophysiologic mapping. Image-guided navigation consists of the use of MR imaging to provide real-time guidance during tumor resections. High-speed computer workstations provide images that show neurosurgeons exactly where they are with respect to brain anatomy during tumor resections. Electrophysiologic mapping is the use of specific electrical simulations of the brain tissue to identify eloquent brain cortex. By mapping out these critical brain regions, the neurosurgeon can safely avoid them when performing tumor resection.

In what ways have improvements in imaging technology over the last decade changed the treatment approach for both surgical and non-surgical treatment of brain tumors?

Improvements in imaging technology over the last several years have provided valuable tools for neurosurgeons in the treatment of brain tumors. A significant advance in surgical treatment of brain tumors has been the development of intraoperative MRI scanners. This allows a surgeon to perform a tumor resection, and then, post resection, perform a set of MR imaging directly in the operating room. If this MR imaging shows residual tumor, the surgeon has an opportunity to perform a further resection prior to completing the surgical operation. Additional imaging advances include functional MR imaging. This provides a graphic representation of critical functions such as speech or motor function. This is useful in determining both whether a patient is inoperative candidate and in assessing risk of the surgical resection.

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Aging, Mental Health, Parenting, Research

Girls at high risk for developing depression show signs of stress and premature aging

Girls at high risk for developing depression show signs of stress and premature aging

14465-telomeres_newsAs we age and our cells divide, caps at the ends of our chromosomes called telomeres shorten. When a telomere grows too short, it will die or lose its ability to divide, which causes our skin to wrinkle or sag, as well as damage to our organs. Previous research has shown that depression, chronic stress and inflammation can accelerate this process, causing premature aging and making our bodies more susceptible to infections and disease.

In an effort to better understand the connection between stress, depression and changes in the body, Stanford psychologist Ian Gotlib, PhD, and colleagues studied healthy girls with a family history of depression and compared them to a group of their peers without that medical background. During the experiment, researchers measured participants’ stress response through a series of tests and analyzed their DNA samples for telomere length. According to a Stanford Report story:

Before this study, “No one had examined telomere length in young children who are at risk for developing depression,” Gotlib said.

Healthy but high-risk 12-year-old girls had significantly shorter telomeres, a sign of premature aging.

“It’s the equivalent in adults of six years of biological aging,” Gotlib said, but “it’s not at all clear that that makes them 18, because no one has done this measurement in children.”

The researchers are continuing to monitor the girls from the original study. “It’s looking like telomere length is predicting who’s going to become depressed and who’s not,” Gotlib said.

Based on these findings, researchers recommended that girls at high-risk for depression learn stress reduction techniques.

Previously: How meditation can influence gene activity, Shrinking chromosome caps spell aging cells, sniffles, sneezes… and cognitive decline?, Study finds phobias may speed biological aging and Study suggests anticipation of stress may accelerate cellular aging
Photo by Paulius Brazauskas/Shutterstock

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