Mental health
Inflammation linked to depression in women with diabetes, study finds
Inflammation may help flag depression in women with type 2 diabetes, new research reveals, but the link appears to vary by symptoms and by how depression is measured.
The findings suggest both the promise and the challenge of identifying biomarkers, measurable indicators in blood or other tests, for depression.
Women with type 2 diabetes are at higher risk of depression, which can accelerate diabetes complications, impair functioning and increase the risk of death. Research suggests inflammation may be a key link between the two conditions, as certain inflammatory biomarkers are frequently found in both.
Scientists have yet to identify an objective diagnostic biomarker for depression, such as something measured through blood work, a genetic test or a brain scan.
To diagnose and measure depression, mental health providers usually use questionnaires. Some add up the number of symptoms as a checklist, while others measure the severity of different symptoms.
Depression can also look very different from one person to the next, with symptoms spanning physical effects such as sleeping too much or too little, mood-related issues such as persistent sadness, and cognitive difficulties such as trouble concentrating.
Nicole Beaulieu Perez, assistant professor at NYU Rory Meyers College of Nursing and study author, said: “Depression is the most measured construct in all of science, but part of our problem is that we’re not defining depression the same, there may be different types, but we’re lumping them all together.
“The variability in depression symptoms complicates how we diagnose and treat it, particularly in the absence of validated biological markers.”
To better understand the connection between inflammation and different symptoms and measures of depression, researchers at NYU Rory Meyers College of Nursing studied 38 women with type 2 diabetes, many of whom were also living with HIV.
They analysed blood samples for 10 different inflammatory biomarkers, including CRP, IL-6, IL-4 and IL-8.
They also assessed participants for depression using PROMIS, an NIH-developed series of short questionnaires that includes measures of depression, anxiety, sleep and fatigue, as well as the CES-D, an older measure that adds up depression symptoms.
The researchers found that certain inflammatory biomarkers were linked to depression, but the associations varied depending on the measures and symptoms used.
Higher levels of depression and anxiety measured using PROMIS were associated with lower levels of IL-4.
They also found contradictory associations for CRP and IL-6. Both were positively correlated with depression when it was measured using CES-D and negatively correlated when it was measured using PROMIS.
Sleep disturbances measured using PROMIS were associated with IL-8.
Perez said: “It was interesting to see that, in some cases, the direction of these associations flipped entirely based on which measure of depression we were using.”
The findings, while preliminary because of the small number of people studied, suggest that the link between inflammatory biomarkers and depression may not be consistent across all measures or symptoms.
More research is needed to tease out the role of inflammation and whether subtypes of depression can be identified based on symptoms and objective biological markers.
Perez said: “We think there’s something going on with inflammation and depression, but if we look closely, we may find that’s true for some forms of depression but not others.”
She said she hoped that in future, pairing depression measures with biomarkers such as blood tests could provide more objectivity in diagnosing depression, which could help further destigmatise mental illness, as well as help clinicians catch it earlier and guide treatment.
Perez said: “Precision mental health has great potential.
“If we can identify a specific type of depression, for instance, one that appears to be driven by inflammation, this may inform which medications to try to target an underlying biological pathology, hopefully reducing the trial and error often needed to find an effective treatment for depression.
“By identifying specific inflammatory biomarkers linked to different dimensions of mental health, our findings suggest a path toward precision mental health that moves beyond one-size-fits-all approaches.”
Women over 40 are seeking raves for mental and physical wellbeing, with a study suggesting the benefits go beyond nightlife.
The findings challenge the idea that nightlife and electronic dance music events are mainly for younger people.
Published in Psychology of Music, the study focused on the common misconception that nightlife is only for younger audiences.
Researchers surveyed 136 female clubbers aged 40 to 65 about their experiences at electronic dance music events.
The study, carried out at the University of Leeds in England, found women reported mental and physical wellbeing benefits from attending these events.
Seeing favourite DJs was the most common motivation, but many women also described dancing as a way to relieve stress and find emotional support.
The research found that 65.9 per cent of participants described attending a rave as “spiritual”, while 62.9 per cent said it offered an escape from everyday life.
A further 58.3 per cent said they felt like a different version of themselves in a club environment.
Nine in ten participants said they felt at home at electronic dance music events, with many pointing to a shared passion for music and the sense of community around it.
The study also suggested physical fitness played a role, with some women saying they had made clubbing part of their regular exercise routine.
However, the findings also highlighted challenges for older women in nightlife spaces.
One fifth of participants said they felt visibly out of place because of their age.
Nearly half reported unwanted physical contact, leading some to seek out different venues or attend only with friends.
Housing, work and fertility pressures are stopping many Britons growing the families they want, new research suggests.
A UK fertility report found that 79 per cent of people surveyed who had tried to conceive in the past five years would like more children than they currently have.
Among parents with one child, that figure rises to 88 per cent.
The report surveyed more than 1,000 people across the UK who had tried for a baby in the past five years.
While birth rates continue to fall, the findings suggest it is not because people no longer want children. Instead, many respondents said external pressures are making it harder to grow their families.
The findings, from wellness brand Wild Nutrition’s Fertility Disconnect report, highlight how financial pressures, fertility struggles and gaps in reproductive health knowledge are shaping modern family life in the UK.
Gail Madalena, fertility nutritional therapist at Wild Nutrition, said: “People often assume fertility begins the moment they decide to try [for a baby].
“In reality, egg and sperm health are shaped months and years earlier.
“By the time someone starts thinking about fertility, their body has already been responding to its environment for a long time.”
Among the biggest barriers, 26 per cent said career progression affected their family plans, 25 per cent cited housing affordability and lack of space, and 52 per cent said they required medical intervention during their fertility journey.
The report also found that almost a quarter of respondents had spent more than two years trying to conceive.
Trying for a baby can take a significant toll on mental health and relationships, especially for those navigating fertility treatment.
According to the research, 38 per cent of respondents said trying to conceive had negatively affected their mental health. That figure rose to 99 per cent among people undergoing fertility treatment.
Julianne Boutaleb is a perinatal psychologist.
She said: “Navigating a fertility journey is about so much more than medical appointments and procedures.
“It’s an emotional marathon that can take a huge toll on your mental wellbeing.
“Sadly, the stats show that 15 per cent of couples going through fertility treatment say their relationship has been irrevocably impaired.”
The report also highlighted the realities of secondary infertility, which affects around one in 20 people, challenging the assumption that having one child means conceiving again will be straightforward.
Researchers found many people felt under-informed about fertility, particularly younger adults.
Ten per cent of Gen Z respondents said they “know nothing” about fertility, while only one in five respondents said they know “a lot” about egg health.
The report also found that 60 per cent of women were unaware of fertility testing options, and one in five Gen Z respondents said they felt uncomfortable discussing fertility, even with their partner.
Around 40 per cent of those surveyed supported fertility education being included in schools, covering topics such as egg health, sperm health and hormonal health.
The report also explored how lifestyle and long-term health may influence fertility outcomes.
Many respondents said they only made changes once they started trying to conceive.
Some 44 per cent improved their diet when trying for a baby, while 32 per cent reduced alcohol intake at that stage.
The report also referenced emerging research that suggests ultra-processed foods and microplastics could have an impact on reproductive health.
While fertility conversations often focus on women, the findings showed male fertility issues are also affecting many families.
Seventeen per cent of respondents cited sperm health issues as a barrier to conception, while male factors contribute to around half of all fertility challenges.
Only one in four men said they would share fertility struggles with friends.
“Many causes of male infertility are entirely treatable yet so often the last resort is the first response,” said Ian Stones, co-founder at Test Him Ltd.
The findings come as UK birth rates remain below replacement level.
The report noted that the UK fertility rate is now 1.41, meaning that on average women give birth to 1.41 children over their lifetimes. The replacement rate, or rate that maintains population numbers, is 2.1.
It also said the average age of mothers has risen to 31, while birth rates are falling across most age groups except among over-40s.
“There is no single fertility story, and it is rarely a simple, linear narrative,” said Dr Zeynep Gurtin, lecturer in women’s health at UCL.
Dr Gurtin added that better fertility education, fairer access to treatment and more open conversations around infertility and pregnancy loss are needed.
Cognitive behavioural therapy (CBT) may offer short-term relief for menopause insomnia and night-time hot flushes, a pilot study suggests.
CBT is a structured, short-term talking treatment that helps people change thoughts and behaviours that can worsen sleep problems.
Researchers found the intervention was linked to meaningful short-term improvements in insomnia severity, hot flush interference, sleep self-efficacy, or confidence around sleep, and depressive symptoms.
The Menopause Society said insomnia affects an estimated 20 to 60 per cent of perimenopausal and postmenopausal women in the US.
Ongoing research is focusing on effective treatments because insomnia can have serious physical and psychological effects.
Dr Monica Christmas, associate medical director for The Menopause Society, said: “Nocturnal hot flushes (night sweats) and sleep disruption can have a significant effect on the quality of life with many women claiming extreme impairment due to symptoms that often start in early perimenopause and last 10 or more years.”
“Sleep disturbances can persist even in those using pharmacological therapy to manage hot flushes.
“The study’s findings highlight the utility of cognitive-behavioural therapy as a standalone treatment for insomnia and hot flushes, offering women an alternative or adjunct to pharmacological treatments.”
Insomnia is defined as disturbed sleep associated with distress or impaired daily functioning and is one of the most common complaints in perimenopause and postmenopause.
It can reduce quality of life and is linked to higher healthcare use and costs, disability, depression and cardiovascular disease.
Hot flushes occur in 60 to 80 per cent of women during the menopause transition and can persist for four to five years on average.
Night-time hot flushes are linked to sleep disruption, and women may respond by napping or spending longer in bed, which can help keep insomnia going.
Previous studies have shown that cognitive behavioural therapy is an effective treatment for insomnia and may also help women cope with hot flushes and other menopause symptoms.
However, few trials have looked at both insomnia and hot flushes together.
Insomnia during and after the menopause transition is complex and can have many causes, including ageing, hormone fluctuation, hot flushes, other sleep disorders, psychiatric and medical conditions and psychosocial stressors.
Because women with acute and sustained insomnia can experience greater negative health effects, effective treatment is important.
The pilot study concluded that CBT was feasible and may be a promising approach for menopause-related insomnia and nocturnal hot flushes, although the benefits appeared to lessen after three months.
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