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Exercise as a form of treatment for mental illness

Introduction

My name is Joe and I’ve just begun the 2nd year of my PhD in Medicine. I am researching how we can use physical exercise to improve people’s mental health. Specifically, I work with young people (from 18 years onwards), who are experiencing serious mental health problems for the first time in their lives – a condition which is referred to as “First Episode Psychosis”. I am investigating whether specially designed physical exercise routines can help people with First Episode Psychosis to feel healthier; in the body, and also in the mind. 


In Depth

What is First Episode Psychosis

First Episode Psychosis is the first 5 years of any ‘psychotic disorder’, such as Schizophrenia. This affects around 1 in 100 people, and most often starts around the age of 18. The most recognisable symptoms of first-episode psychosis are hearing voices, seeing things which other people cannot see (hallucinations), delusional beliefs and paranoia. Along with these, there are often less obvious symptoms of people severely lacking in motivation, feeling depressed, withdrawing from society and becoming reclusive.

Current Treatment

The most common treatment for first-episode psychosis is antipsychotic medications: There are tablets that sufferers can take which greatly reduce the symptoms of hearing voices, delusions etc. However, people taking these tablets often relapse within a few years, or need higher and higher doses overtime for them to remain effective. Furthermore, antipsychotics do not help with the symptoms of social withdrawal and inability to feel motivated. Unfortunately, it is these unseen symptoms which can really prevent people from living a happy and fulfilling life.

What do I Investigate?

I am investigating whether we can use physical exercise for first-episode psychosis, as an extra treatment for all the different types of symptoms so that they need fewer medications and feel better overall in life. To do this, people with first-episode psychosis are sent to me from their mental health service. I design them a special exercise routine and then take them to the gym twice-per-week for 10 weeks to train with them. In the exercise sessions, we do running, rowing and cycling to work on their fitness, and also weight training to work on the muscles. Past research has shown that these sorts of training can make people feel better, happier and more motivated – even in normal healthy people. It has never been tried for First Episode Psychosis (even though these are the people who may need it most!).

To see if it has worked, we score peoples’ mental health using a psychiatric interview before they start the 10 weeks of training, and then score them again after the 10 weeks to check if they have improved. I also look at peoples’ physical health, fitness, social life and brain functioning, as exercise is known to be able to help with these things too. If proven effective, exercise may eventually become part of NHS treatment programs for first-episode psychosis, and be available to any young person who is in need of treatment, like a new form of therapy! 


Going Further

If you want to know more about first-episode psychosis in general, such as what causes it, what it does, here is a great place to start: http://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/psychosis/first_episode_psychosis_information_guide/Pages/first_episode_psychosis_information_guide.aspx

For more information about my specific experiment, you can find the full details of the clinical trial here: http://www.controlled-trials.com/ISRCTN09150095/

If you’re interested in which physical exercise can improve mental health, this article goes through many different ways in which it may do this:
http://www.huffingtonpost.com/2013/03/27/mental-health-benefits-exercise_n_2956099.html


 

Mending a broken heart

by YPU Admin on December 11, 2014, Comments. Tags: britishheartfoundation, cardiovascular, cells, heart, medicine, Research, and treatment

Introduction

Hi! My name is Abi Robertson and I am a second year PhD student in the cardiovascular group at the University of Manchester. After finishing my A Levels I started an Anatomical Science degree at the University of Manchester. This was where my love for the heart began! Following my undergraduate degree I completed an MRes in Cardiovascular Health and Disease here and this enabled me to apply for a PhD funded by the British Heart Foundation. You can find more information on my PhD and the other cardiovascular courses available here .

My PhD project is called ‘Targeting the Hippo signalling pathway to enhance the protective effects of iPSC-derived cardiomyocytes’ (A bit of a mouthful!). In short this means I am looking at how cells signal within themselves to divide and to see if we can target this to help stem cells become heart cells and survive.

But why?

In Depth..

During a heart attack the blood supply to the heart is stopped. Lack of blood and oxygen damages the heart cells. This can result in a severe loss of cells in sections of your heart. Unlike other tissues in your body, such as your skin, cells in the heart cannot heal themselves. This leaves an area in the heart that cannot beat like the surrounding tissue. This is called an infarct area.  If the infarct area is quite large it can affect how your heart functions, leads to health problems and even heart failure.

For the heart to be able to function normally again the heart cells need to be replaced. Attempts are being made to heal the heart by creating heart cells in the lab from stem cells. Using new technology we can re-programme skin cells into stem cells. The skin is an excellent source of cells as they are easily available. These stem cells are called Induced Pluripotent Stem cells. These cells can then be turned into any cell type in the body including the beating cells in the heart. The hope for this therapy is that these cells can be used to make patches and be placed on the heart like a plaster.

Before this is possible we need to make sure the heart cells we are using are able to survive in the challenging environment of the infarct area. Firstly, the infarct area has low oxygen and nutrients, so the cells need to be able to cope with this. Secondly, it is estimated over a billion cells are lost after a heart attack so a lot of heart cells are needed!

This is why my PhD project is looking at the signalling within cells and seeing if we can create cells which survive but also divide in tough environments. We hope to create super heart cells!


Going further..

I really enjoy working in this area of research. It’s a relatively new area so there are always lots of exciting discoveries! Hopefully one day using stem cells as a therapy will become the treatment of choice for people who have suffered a heart attack!

Here are a few links if you would like any more information on the area:

The Stem Cell Network has created some excellent videos on ‘What are stem cells?’

http://www.stemcellnetwork.ca/index.php?page=what-are-stem-cells

Explore an interactive comic about stem cells:

http://www.smm.org/tissues/stem_cells.php

An excellent TED talk by Susan Soloman on the use of induced pluripotent stem cells:

http://www.ted.com/talks/susan_solomon_the_promise_of_research_with_stem_cells?language=en

The National Institute of Health has an excellent website that covers pretty much everything you could want to know about stem cells:

http://stemcells.nih.gov/info/basics/pages/basics1.aspx

A stem cell story:

http://www.eurostemcell.org/films/a-stem-cell-story/English

YouTube user John Schell has some great videos of beating heart cells that have been derived from Induced Pluripotent Stem Cells:

http://www.youtube.com/watch?v=5uvNPQDDbAc

This BBC article discusses a clinical trial that is underway to see if stem cells can heal broken hearts:

http://www.bbc.co.uk/news/health-26273707