Rational

Ketamine has been investigated as a treatment alternative for PTSD for the last 20 years, yet there have been limited reports of biological changes or biomarker characterisation related to treatment.

Objectives

To address this significant gap, this study analysed blood samples from 25 participants with PTSD who took part in an open-label 6-week trial of low dose oral ketamine treatment.

Methods

Serum and plasma samples were quantified before and after ketamine treatment for brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor A (VEGF-A), serotonin, FK506 binding protein 51 (FKBP51) and a panel of cytokines (interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-12p70, IL-17 A and tumour necrosis factor alpha (TNFα)).

Results

Analysis of BDNF and VEGF-A levels from serum detected a significant positive correlation between the two biomarkers and a small but statistically significant decrease in both measures after ketamine treatment. This novel finding reinforces theories that ketamine’s effects may rely on a reciprocal interaction between BDNF and VEGF-A, offering potential insights into a biological mechanism underpinning PTSD symptom reduction. Additionally, the analysis of FKBP51 and serotonin revealed novel relationships between these biomarkers and clinical scales, before and after ketamine treatment. Finally, significant changes or relationships involving the immune cytokines were not detected, possibly because half the participants presented with low-grade inflammation while the other half did not.

Conclusions

This study represents a much-needed broad analysis of blood biomarkers before and after ketamine treatment for PTSD and reveals important biological changes and relationships related to this treatment.

The COVID-19 pandemic highlighted growing demand on mental health services and the need for scalable early interventions. Lifestyle medicine is a first-line treatment for common mental health disorders. Combining health coaching with lifestyle medicine and online delivery may improve accessibility and effectiveness. This study evaluated the EMERALD program, an 8-week online lifestyle medicine and health coaching intervention delivered as a clinical service during the pandemic. A single arm, pre–post observational design was used, with assessments completed at baseline (week 1) and post-intervention (week 8). Eighty-five adults (M_age = 46.47, SD = 15.47) completed all outcome measures; most participants identified as female (83.5%). Eligible community participants reported mild to moderate anxiety or mood symptoms (PHQ-9 < 14; GAD-7 < 14). Individuals with severe symptoms, suicide risk, or current engagement in psychological or psychiatric treatment were excluded. Depression, anxiety, wellbeing, loneliness, and functioning across life domains (e.g., occupational, social, daily responsibilities) were assessed using validated self-report measures. Significant improvements were observed across all measures, with greater wellbeing gains among those with higher baseline depression severity. These findings support the benefits of online mental health coaching and lifestyle medicine interventions for improving psychological wellbeing during periods of elevated need.

No abstract available.

Objective

The rising prevalence of mental health symptoms brought on by the COVID19 pandemic led to the inception and development of EMERging Anxiety, Loneliness, Depression (EMERALD) well-being programme. EMERALD was designed to improve psychological well-being of the general population who had not previously sought mental health support. The programme incorporated a focus on lifestyle medicine and was underpinned by solution focused health coaching. The aim of the paper is to describe the programme according to the Template for Intervention Description and Replication (TIDieR) checklist to provide detailed reporting of the intervention's elements.

Methods

The TIDieR checklist was utilised to comprehensively describe the programme, including theoretical underpinnings, materials, procedures, providers, mode of delivery and tailoring of the programme. The Behaviour Change Technique Taxonomy v2 was used to identify the specific behaviour change techniques used within the solution focused health coaching framework.

Results

The programme was developed to align with the latest evidence-based literature in lifestyle medicine and solution focused coaching. The programme also offered allied health expertise, online educational modules and was tailored to the participants. The programme was delivered online through a telehealth platform.

Conclusion

The TIDieR checklist has enabled the provision of a detailed structure of the EMERALD program intervention. The behaviour change taxonomy has facilitated the outlining of specific techniques used in health coaching sessions. Both structures have operationalised the detail of the intervention for the purposes of replication and informing the literature.

Analysis of cognitive behavioural therapy apps for generalised anxiety disorder: Evidence-based content and user experience. Abstract Mental illness substantially contributes to the global burden of disease, with anxiety high in prevalence. The increase of mobile technology, mental health apps have potential to lessen this burden. However, within apps, the use of evidence-based interventions, such as cognitive behavioural therapy (CBT) are limited. Regardless, many commercially available mental health apps are highly rated by users, highlighting the need to understand what makes mental health apps valuable to the user. The contribution of this study was to uncover apps that support generalised anxiety disorder (GAD) and worry with a CBT basis, explore app functionality, and user experience. Firstly, by identifying apps that support GAD and worry and included CBT. Secondly, by identifying and analysing therapeutic and engagement functions within the apps, and finally, by thematically analysing user reviews. Six apps were identified to support GAD and worry that purported to be CBT-based. However, CBT therapeutic features and engagement features were minimally present in the apps. User reviews yielded 112 comments about the apps and key themes were identified about the app users' global experiences with the app, and about the combination of technological (e.g., useability, reliability) and therapeutic experiences (e.g., learning and using skills). Future development of quality apps to support GAD and worry must consider the empirical standing of both therapeutic and technology aspects, to provide efficacious and engaging interventions.