Category: Research

Neuromodulating agents in functional dyspepsia: a comprehensive review

Functional dyspepsia is a frequent chronic condition characterized by upper abdominal discomfort without an identifiable organic cause. Usual first-line treatments include proton pump inhibitors or Helicobacter pylori eradication, but many patients continue to have persistent symptoms. Because of this, neuromodulating agents are frequently used in clinical practice, although current European, American and Canadian guidelines primarily mention tricyclic antidepressants (TCAs).

This review analyzed randomized controlled trials in adults meeting Rome criteria or with normal endoscopy findings. Out of 386 studies screened, 14 met inclusion criteria.

The findings indicate that TCAs, such as amitriptyline and imipramine, show the strongest evidence of benefit for symptom relief in functional dyspepsia. Other agents, including tetracyclic antidepressants, levosulpiride, and anxiolytics, may be helpful, but current data are insufficient to draw firm conclusions. By contrast, SSRIs and SNRIs do not appear effective for this condition.

Learn more about this review here: https://doi.org/10.51821/86.1.10998

Reference

Bosman, L., Wauters, L., & Vanuytsel, T. (2023). Neuromodulating agents in functional dyspepsia: a comprehensive review. Acta gastro-enterologica Belgica, 86(1), 49–57
Association of mental health conditions and functional gastrointestinal disorders among Vietnamese new-entry medical students

Functional gastrointestinal disorders (FGIDs), sometimes called disorders of gut–brain interaction, do not affect only older people, they are also common in young adults. A study among 400 first-year medical students in Vietnam investigated how these gut disorders relate to mental health.

About 10% of students had an FGID such as functional dyspepsia or irritable bowel syndrome, and 3% had overlapping conditions including acid reflux. Depression and anxiety were also frequent, with around 10% showing signs of major depressive disorder and 7% showing generalized anxiety disorder. Helicobacter pylori infection was detected in 45% of participants.

The key finding was that depression was strongly associated with gut disorders. Students with major depressive disorder were much more likely to have FGIDs and overlapping gastrointestinal problems than students without depression.

Interestingly, in this study, this risk was also greater in women.

These results support the strong link between mental health and digestive symptoms in young adults, highlighting the importance of screening and early support for both areas in student populations.

Learn more about this study here: https://doi.org/10.1371/journal.pone.0289123

Reference

Tran, T. T. T., Luu, M. N., Tran, L. L., Nguyen, D., Quach, D. T., & Hiyama, T. (2023). Association of mental health conditions and functional gastrointestinal disorders among Vietnamese new-entry medical students. PloS one, 18(7), e0289123.
Systematic review and meta-analysis of performance of wearable artificial intelligence in detecting and predicting depression

The systematic review and meta-analysis found that wearable AI systems demonstrate promising performance in detecting and predicting depression. However, substantial variability exists among algorithms and devices, thereby indicating that performance can vary significantly.

What this means is that disparities across different algorithms and devices were identified, suggesting that certain demographic groups may be underrepresented or inadequately served by current wearable AI systems. This variability underscores the need for further research to enhance the generalizability and fairness of these technologies in clinical practice.

Learn more about this review here: https://doi.org/10.1038/s41746 -023-00828-5

Reference

Abd-Alrazaq, A., AlSaad, R., Shuweihdi, F. et al. Systematic review and meta-analysis of performance of wearable artificial intelligence in detecting and predicting depression. npj Digit. Med. 6, 84 (2023).
Helicobacter Pylori Associated Depression among Patients Presenting with Epigastric Pain

Helicobacter pylori infection is an extremely prevalent infection that has been connected not only to a number of illnesses such as stomach cancer and peptic ulcer disease. H. pylori has also been linked to depression but the mechanisms behind this connection are still poorly understood.

A research study by Mohamed and colleagues aimed to better explore this relation by assessing the presence and severity of depression in 150 patients with or without H. pylori infection.

When comparing both groups, the authors found that H. pylori infection was significantly associated with depression and, more interestingly, with its severity. These findings point to the importance of assessing the presence of gastrointestinal symptoms or dyspepsia in patients with depression.

Learn more about this study here: https://healthcitizens.org/wp-content/uploads/Mohamed-and-Elrassas_Helicobacter-Pylori-.pdf

Reference

Dina M. Mohamed and Hanan Elrassas, “Helicobacter Pylori Associated Depression among Patients Presenting with Epigastric Pain”, The Egyptian Journal of Hospital Medicine (January 2023) Vol. 90 (2), Page 2315-2320
Depression among people with dyspepsia and H. pylori infection: A community based cross-sectional study in Ethiopia

A 2022 community-based study in southwest Ethiopia explored potential links between Helicobacter pylori infection, dyspepsia, and depression in residents aged 13 years and older.

Among the 871 participants – most of whom were married, had no formal education, and lived in rural areas – around 11% showed signs of probable depression. The prevalence was slightly higher (13%) among those experiencing at least one symptom of dyspepsia. Interestingly, in this study, H. pylori infection alone was not linked to higher depression rates, nor were age or gender.

The findings suggest digestive symptoms may increase the risk of depression, highlighting the importance of addressing both mental and gut health when managing gastrointestinal symptoms.

Learn more about this study here: https://doi.org/10.1371/journal.pone.0275424

Reference

Soboka, M., Gudina, E. K., Gashaw, M., Amare, H., Berhane, M., Desalegn, H., Tewolde, D., Jebena, M. G., Ali, S., Wieser, A., Froeschl, G., & Tesfaye, M. (2022). Depression among people with dyspepsia and H. pylori infection: A community based cross-sectional study in Ethiopia. PloS one, 17(10), e0275424.
Digital health tools for the passive monitoring of depression: a systematic review of methods

This systematic review examines studies linking passive data from smartphones and wearables to depression, identifying key methodological flaws and threats to reproducibility. It highlights biases such as representation, measurement, and evaluation bias, stemming from small, homogenous samples and inconsistent feature construction.

Although gender and race are not explicitly discussed, the lack of diversity in study populations suggests potential demographic bias. The review calls for improved reporting standards and broader sample inclusion to enhance generalizability and clinical relevance. These improvements are essential for ensuring that digital mental health tools are equitable and reliable across diverse populations.

Learn more about this review here: https://doi.org/10.1038/s41746-021-00548-8

Reference

De Angel, V., Lewis, S., White, K., Oetzmann, C., Leightley, D., Oprea, E., Lavelle, G., Matcham, F., Pace, A., Mohr, D. C., Dobson, R., & Hotopf, M. (2022). Digital health tools for the passive monitoring of depression: a systematic review of methods. NPJ digital medicine, 5(1), 3.
Rapamycin Attenuates Anxiety and Depressive Behavior Induced by Helicobacter pylori in Association with Reduced Circulating Levels of Ghrelin

In this experimental study, researchers investigated how H. pylori infection influences depression-like behavior and certain biological markers in mice, focusing especially on the hormone ghrelin.

Mice infected with the bacteria showed more anxiety- and depression-like behaviors in standard laboratory tests compared with healthy mice. They moved less, showed more signs of stress, and had lower preference for sweet solutions, a common indicator of loss of pleasure.
Biologically, H. pylori infection led to reduced circulating ghrelin levels and activation of the mTOR signaling pathway in the stomach. It was also associated with increased markers of brain inflammation and cell injury in the hippocampus, a brain region important for mood regulation. When mice were treated with rapamycin, an mTOR inhibitor, ghrelin levels increased and brain-inflammation markers were reduced.

Overall, the study suggests that H. pylori infection may contribute to anxiety- and depression-like behaviors by lowering ghrelin levels and increasing neuroinflammation, highlighting a potential biological link between gut infection and mental health.

Learn more about this study here: https://doi.org/10.1155/2022/2847672

Reference

Tian, Jiageng, Wang, Zeyu, Ren, Yadi, Jiang, Yong, Zhao, Ying, Li, Man, Zhang, Zhiguang, Rapamycin Attenuates Anxiety and Depressive Behavior Induced by Helicobacter pylori in Association with Reduced Circulating Levels of Ghrelin, Neural Plasticity, 2022, 2847672, 8 pages, 2022.
Bias Discovery in Machine Learning Models for Mental Health

This article examined how AI can unintentionally reproduce social and demographic biases when applied to mental health prediction. Using benzodiazepine prescriptions as a proxy for conditions such as depression and anxiety, a study analyzed machine learning models trained on patient data to identify systematic disparities.

It found that women are more frequently predicted to receive such treatments, reflecting gender bias, while the models perform less accurately for minority ethnic groups, indicating representation and evaluation bias. The AI models here are not used to prescribe drugs but rather to predict treatment likelihoods, revealing how bias in healthcare data can lead to inequitable AI performance in the context of depression-related care.

Learn more about the article here: https://doi.org/10.3390/info13050237

Reference

Mosteiro, P.J., Kuiper, J., Masthoff, J., Scheepers, F., & Spruit, M. (2022). Bias Discovery in Machine Learning Models for Mental Health. Inf., 13, 237.
Increased risk of short-term depressive disorder after Helicobacter pylori eradication: A population-based nested cohort study

A study using Taiwan’s National Health Insurance data found that antibiotic therapy for H. pylori in patients with peptic ulcer disease was linked to a short-term increase in psychiatrist-diagnosed depression within 30 days. Women and patients treated with clarithromycin were particularly at higher risk.

The researchers reported that the increased risk of depression after H. pylori eradication therapy may involve alterations in the brain-gut-microbiome axis induced by antibiotic treatment, as is it well known that antibiotics can change the gut microbial composition, metabolism, and function, thereby affecting human health and possibly contributing to the pathophysiology of depression.

Based on these findings, the authors recommend that clinicians should monitor mental health shortly after H. pylori eradication, as short-term depressive symptoms may occur and be easily overlooked.

Learn more about this study here: https://doi.org/10.1111/hel.12824

Reference

Tsai C-F, Chen M-H, Wang Y-P, et al. Increased risk of short-term depressive disorder after Helicobacter pylori eradication: A population-based nested cohort study. Helicobacter. 2021; 26:e12824.
GWAS of peptic ulcer disease implicates Helicobacter pylori infection, other gastrointestinal disorders and depression

A study of over 450,000 people in the UK Biobank identified 8 independent genes that affect stomach acid, gut movement, and the body’s response to infection, including susceptibility to Helicobacter pylori infection.

The study also explored connections between these gut conditions and depression, which often occurs alongside digestive problems, providing new insights into the complex interplay between gut health and mental well-being.

Learn more about this study here: https://doi.org/10.1038/s41467-021-21280-7

Reference

Wu, Y., Murray, G.K., Byrne, E.M. et al. GWAS of peptic ulcer disease implicates Helicobacter pylori infection, other gastrointestinal disorders and depression. Nat Commun 12, 1146 (2021)