Journal Digest: Social Media; Opioid-Stimulant Deaths; Antidepressant Effects; Testosterone; Menstruation

The relationship between social media use and well-being among youth is more nuanced than previously reported, according to a study published in PNAS.

Previous research has found that spending too much time on social media has negative effects on mood, happiness, and other measures of well-being. These results by and large have come from cross-sectional studies, which compare different people at the same time point. For the PNAS study, researchers at the University of Oxford and the University of Hohenheim explored changes in life satisfaction of individual youth following social media use.

Using data from a multi-year study of U.K. households, the researchers observed a reciprocal relationship between social media use and feelings of satisfaction among youth aged 10 to 15 years old: Increased social media use led to future reductions in life satisfaction, and improved life satisfaction led to future reductions in social media use. However, the effects in either direction were minor.

The authors also observed sex differences in the effects of social media on life satisfaction. Among boys, increased social media use only affected future life satisfaction, while in females, social media use influenced satisfaction with friends, family, school, schoolwork, and life. Satisfaction with appearance was not influenced by social media for either sex.

Over half of the people who died from an opioid overdose in Massachusetts from 2014 to 2015 had a mental illness. Opioid users with mental illness also were much more likely to overdose on multiple substances as opposed to opioids alone.

These findings were part of a larger analysis of Massachusetts state toxicology data to explore sociodemographic factors that affect the risk of opioid overdose. The analysis was conducted by investigators at Boston University School of Medicine and colleagues and was published in Drug and Alcohol Dependence.

For the study, the researchers analyzed toxicology reports for 2,244 people reported to have died from an opioid-related overdose in Massachusetts from 2014 to 2015. The toxicology reports indicated that 83% of these deaths involved the presence of another substance in addition to opioids, with stimulants being the most common class of drug. People with a mental illness were about 1.5 times as likely as those without mental illness to have an opioid plus stimulant combination in their system at time of overdose. Other groups at increased risk of opioid plus stimulant overdose death included blacks (2.2 times as likely compared with whites) and people with a history of homelessness (1.9 times more likely than people with no history). In contrast, people who had recently been incarcerated were about twice as likely as people who had not been incarcerated to overdose on solely opioids rather than multiple substances.

“Our study draws attention to the heterogeneity of the problem at hand and that there is not a one-size-fits-all approach to addressing the overdose epidemic, which is increasingly driven by polysubstance use,” the authors wrote. “The type of opioid, the presence of polysubstance use, and the social context all influence the type of education and prevention approaches that are needed.”

The diabetes drug metformin helps alleviate depressive and anxious symptoms in mice, according to a study published in the Journal of Neuroscience.

Researchers at the University of Toulouse in France and colleagues tested the effects of metformin on mice with insulin resistance as a result of being on a chronic high-fat diet. In addition to metabolic problems, the mice on a high-fat diet displayed anxious and depressive behaviors.

When the researchers gave the mice on the high-fat diet metformin, the mice showed improved body weight, lower fasting glucose levels, and fewer depressive-like behaviors. The antidepressant effects of metformin were similar to those seen if mice on a high-fat diet were given fluoxetine.

Since metformin works in part by reducing the levels of branched-chain amino acids (BCAA), the researchers tested the effects of a dietary intervention: a modified high-fat diet with reduced BCAA. Though mice on this diet still had poor metabolic profiles, they had fewer anxious and depressive behaviors than mice on high-fat diet only. The mice on the modified diet also showed a stronger response to fluoxetine than mice on high-fat diet only.

“These findings lead us to envision that a diet poor in BCAAs, provided either alone or as add-on therapy to conventional antidepressant drugs, could help relieve depressive symptoms in patients with metabolic comorbidities,” the authors wrote.

There is accumulating evidence that obesity is a risk factor for depression, especially in women. Elevated testosterone levels might contribute to depression in overweight, premenopausal women, according to a study in Translational Psychiatry.

Researchers at the University of Leipzig and colleagues analyzed health data from 970 premenopausal and 2,154 postmenopausal women enrolled in a large population study of adults in eastern Germany.

The researchers found that being overweight (BMI >25) was associated with depressive symptoms (assessed with the Centre for Epidemiological Studies Depression Scale) in premenopausal but not in postmenopausal women. Other obesity-related measures such as waist circumference or waist-hip ratio were not associated with depressive symptoms in either group of women. The researchers also found that premenopausal women who were overweight had higher blood levels of free testosterone compared with women of normal weight (BMI between 18.5 and 25).

Additional analysis revealed that premenopausal women of normal weight with elevated testosterone also had a slightly increased risk of depressive symptoms.

“Based on this insight, pharmacological approaches targeting androgen [testosterone] levels in overweight depressed females, in particular when standard anti-depressive treatments fail, could be of specific clinical relevance,” the researchers wrote.

Women with psychotic disorders may be more likely to be admitted into the hospital in the days immediately before or during menstruation than at other points during their menstrual cycle, according to a meta-analysis appearing in Schizophrenia Bulletin. The findings suggest that these women may experience worsening symptoms of psychosis at times when their estrogen levels are low.

Researchers at King’s College London and colleagues reviewed 19 studies (comprising 1,193 women diagnosed with a psychotic disorder) that examined exacerbations in psychiatric symptoms in relation to the menstrual cycle. Eleven studies examined psychiatric admission rates, five examined symptom scores, two examined self-reported exacerbation, and one examined both admission rates and symptom scores. To compare findings across studies, the researchers standardized the results to a 28-day menstrual cycle.

They found that psychiatric admission rates were 1.48 times higher during the perimenstrual phase (days before and during menstruation) than during the other days of the menstrual cycle. Four of the six studies that examined symptom scores also suggested that the participants’ symptoms worsened during the perimenstrual phase, but the time points when symptoms were assessed varied considerably.

“Further research is needed to characterize the effect of the menstrual cycle on the symptomatology of psychosis, whether there is a subgroup of women who individually have a strong correlation between psychotic symptoms and menstrual cycles, and whether this subgroup is amenable to intervention in the form of hormonal therapy,” the authors concluded. ■