Understanding the non-pharmacological correlates of self-reported efficacy of antidepressants

Objective: To explore the non-pharmacological correlates of the perceived effectiveness of antidepressants (ADs), thereby enhancing understanding of the mechanisms involved in recovery from depression while taking ADs. Method: An online survey was completed by 1781 New Zealand adults who had taken ADs in the previous 5 years. Results: All 18 psychosocial variables measured were associated with depression reduction, and 16 with improved quality of life (QoL). Logistic regression models revealed that the quality of the relationship with the prescriber was related to both depression reduction and improved QoL. In addition, depression reduction was related to younger age, higher income, being fully informed about ADs by the prescriber, fewer social causal beliefs for depression and not having lost a loved one in the 2 months prior to prescription. Furthermore, both outcome measures were positively related to belief in ‘chemical’ rather than ‘placebo’ effects. Conclusion: There are multiple non-pharmacological processes involved in recovery while taking ADs. Enhancing them, for example focusing on the prescriber–patient relationship and giving more information, may enhance recovery rates, with or without ADs.

Modulation of pain threshold by virtual body ownership

Background Appropriate sensorimotor correlations can result in the illusion of ownership of exogenous body parts. Nevertheless, whether and how the illusion of owning a new body part affects human perception, and in particular pain detection, is still poorly investigated. Recent findings have shown that seeing one’s own body is analgesic, but it is not known whether this effect is transferable to newly embodied, but exogenous, body parts. In recent years, results from our laboratory have demonstrated that a virtual body can be felt as one’s own, provided realistic multisensory correlations. Methods The current work aimed at investigating the impact of virtual body ownership on pain threshold. An immersive virtual environment allowed a first-person perspective of a virtual body that replaced the own. Passive movement of the index finger congruent with the movement of the virtual index finger was used in the “synchronous” condition to induce ownership of the virtual arm. The pain threshold was tested by thermal stimulation under four conditions: 1) synchronous movements of the real and virtual fingers, 2) asynchronous movements, 3) seeing a virtual object instead of an arm, and 4) not seeing any limb in real world. Results Our results show that, independently of attentional and stimulus adaptation processes, the ownership of a virtual arm per se can significantly increase the thermal pain threshold. Conclusions This finding may be relevant for the development and improvement of digital solutions for rehabilitation and pain treatment.

Do GPs and psychiatrists recommend alternatives when prescribing anti-depressants?

This study explores whether a partial explanation for high antidepressant prescription rates is the failure of prescribers to recommend alternatives. 1,829 New Zealand adults were asked which of six non-pharmacological treatment approaches were recommended when prescribed anti-depressants. The majority (82%) received at least one recommendation and 32% received three or more, most commonly ‘Counsellor/Psychologist/Psychotherapist’ (74%) and Exercise Schedule (43%). It cannot, therefore, be concluded that failing to consider non-pharmacological treatments is a major cause of high prescribing rates. Being younger and more severely depressed were both positively related to number of recommendations. Psychiatrists made significantly more recommendations than GPs.