Self-help books 'treat depression'

Prescribing self-help books on the NHS is an effective treatment for depression, a study suggests.

Patients offered books, plus sessions guiding them in how to use them, had lower levels of depression a year later than those offered usual GP care.

The effect was seen in addition to the benefits of other treatments such as antidepressants, Scottish researchers report in the journal Plos One.

Such an approach may help the NHS tackle demand for therapy, they said.

More than 200 patients who had been diagnosed with depression by their GP took part in the study, half of whom were also on antidepressant drugs.

Some were provided with a self-help guide dealing with different aspects of depression, such as being assertive or overcoming sleep problems.

Patients also had three sessions with an adviser who helped them get the most out of the books and plan what changes to make.

After four months those who had been prescribed the self-help books had significantly lower levels of depression than those who received usual GP care.

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Depression saps people's motivation and makes it hard to believe change is possible”

Prof Christopher Williams

A year later, those in the self-help group were more likely to be keeping on top of their depression.

Study leader Prof Christopher Williams, from the University of Glasgow, who also wrote the books called Overcoming Depression and Low Mood, said the guided sessions were the key to getting people engaged.

The sessions can be delivered in general practice without referral to a specialist, taking pressure off waiting lists.

In Scotland, a telephone support service has now been set up to help support those using the books, which can be freely copied and disseminated, he added.

"We found this had a really significant clinical impact and the findings are very encouraging," he said.

"Depression saps people's motivation and makes it hard to believe change is possible."

The challenge for the NHS, where self-help books are already used in many places, is how to implement this model so people have easy supported access in primary care, he said.

'Worth investing in'

There has been huge investment in better treatment for depression in the UK in recent years with the Improving Access to Psychological Therapies programme in England set up to widen access.

It has been estimated this approach could save the NHS up to £272m and the wider public sector £700m.

But, says Prof Williams, despite the huge levels of investment, it is just not possible to refer everyone with depression to mental health services.

Dr Paul Blenkiron, consultant in adult psychiatry at Leeds and York Partnership NHS Foundation Trust, said the results showed that guided self-help is effective and is "something the NHS should be investing in".

He is currently advising on behalf of the Royal College of Psychiatrists, on a National Books On Prescription Scheme, to be rolled out across UK public libraries this year.

Thirty books, including the one used in the study, have been selected.

But Dr Blenkiron said self-help would not be suitable for everyone: "The key thing is that the person is committed to doing some work."

READMORE:http://www.bbc.co.uk/news/health-21083458

Leprosy bacteria use 'biological alchemy'

Infectious bacteria have for the first time been caught performing "biological alchemy" to transform parts of a host body into those more suited to their purposes, by a team in Edinburgh.

The study, in the journal Cell, showed leprosy-causing bacteria turning nerves into stem cells and muscle.

The authors said the "clever and sophisticated" technique could further therapies and stem-cell research.

Experts described the discovery as "amazing" and "exciting".

Alchemists may have failed to morph base metals into gold, but a team at the University of Edinburgh has shown that bacteria can transform parts of the body into something more valuable to them.

It is a feat that scientists have already achieved in the laboratory. Skin cells have been transformed into flexible stem cells that can become any of the body's building blocks from heart muscle to brain cells.

One of the researchers, Prof Anura Rambukana, said: "Our body's cells can be manipulated and why would a bacterium not take advantage of that?"

Master manipulators

Experiments on mice and cells grown in the laboratory showed the leprosy bug infected nerve cells. Then over a period of a few weeks the bacteria began to subvert the nerves for their own ends. The chemistry of the cells changed and they became stem cells.

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The ability of bacteria to convert one mammalian cell type to another is 'alchemy' by nature on a grand scale”

Prof Chris MasonStem cell scientist

These can grow and spread around the body, unlike the static nerves.

"This is a stem cell that is generated by the body's own tissue so the immune system does not recognise it and they can get any place they want without being attacked," said Prof Rambukana.

Those cells could lodge inside muscle and become muscle cells.

"We realised, 'Wow, this is something very, very striking'.

"It's the first time a bacterial infection has been shown to make stem cells, that's the big thing here."

'Alchemy'

He hopes the findings will increase understanding of leprosy and lead to new ways of developing stem cells - which have been touted as future treatments for a range of diseases.

Prof Rambukana also believes it is "probable" that other species of bacteria would have evolved the same ability to reprogramme their host.

Prof Chris Mason, a specialist in stem cell research at University College London, said: "The ability of bacteria to convert one mammalian cell type to another is 'alchemy' by nature on a grand scale.

"Whilst this amazing discovery is in a mouse model, it highlights the extraordinary complexity of the interactions between mammals and bacteria and the ingenuity of scientists to uncover disease mechanisms that a decade ago would have been beyond science fiction.

"The next essential step is to translate this valuable piece of knowledge into tangible benefits for patients - a process that may take a decade before its relevance to clinical medicine is fully understood."

Prof Diana Lockwood, from the London School of Hygiene and Tropical Medicine, said: "Their finding that bacteria can reprogramme cells is very interesting and exciting."

However, she cautioned that there was "quite a gap between this and clinical leprosy and I don't think it's going to lead to new treatments".

Dr Rob Buckle, head of regenerative medicine at the Me Redical Research Council, said: "This discovery is important not just for our understanding and treatment of bacterial disease, but for the rapidly progressing field of regenerative medicine."

READMOREl:http://www.bbc.co.uk/news/health-21056644

Weight loss 'is body's way of fighting off gut worms'

Weight loss following infection with intestinal worms is the body's way of fighting off the parasites, University of Manchester researchers have said.

The immune system hijacks a hormone that controls when to stop eating, their study of mice suggests.

This then triggers the type of immune response needed to expel the worms from the gut, PLOS Pathogens reports.

The finding could lead to new ways to treat people with intestinal worms, researchers say.

Researchers first saw a potential link when they were measuring levels of a hormone called cholecystokinin in volunteers after they had been fed a meal.

One man had incredibly high levels and on further investigation it was found he had an intestinal worm infection he had picked up on holiday.

Joining forces with a team specialising in gut worm infections the researchers did a study in mice infected with a worm called Trichinella spiralis.

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Naturally you would think that if you are losing weight you are going to have less energy to fight off infection.”

Dr John WorthingtonUniversity of Manchester

They found that immune cells called T-cells responded to the worm infection by driving up levels of cholecystokinin.

This increase has a knock-on effect of driving down another hunger hormone, leptin, which influences what type of immune response the body needs to produce.

When they artificially added leptin back into the infected mice, the immune system mounted the wrong response and the intestinal worms remained in the gut for longer.

Global problem

Nearly one in every four of the world's population are infected with gastrointestinal parasites.

It has long been known that these infections often result in a period of reduced appetite and weight loss but why or how this happens was not understood.

Study author Dr John Worthington said the researchers had looked at only one type of parasitic worm but were now doing tests to see if the same response was produced in response to other worms.

"Naturally you would think that if you are losing weight you are going to have less energy to fight off infection," he said.

"This does the opposite of what you would expect."

Dr Worthington added that eventually they would be looking at whether different treatment or nutrition strategies could be designed to boost this immune effect in people affected with intestinal worms.

Dr Mark Robinson, lecturer in parasite proteomics at Queen's University Belfast, said that diseases of humans and animals caused by parasitic worms were among the most widespread and economically devastating throughout the world and drug resistance was becoming a problem.

"The best way to combat worm infections in the future will be the development of vaccines which represent safer, more environmentally-friendly, alternatives to drugs," he said.

"At present, vaccine development is hampered by a lack of basic understanding of how parasitic worms interact with, and influence, our immune system, so research in this area will hope

READMORE:http://www.bbc.co.uk/news/health-21060527

Mum's testing affects HPV jab uptake, says survey

A mother's attitude towards cervical cancer screening influences decisions to vaccinate daughters against the cancer, researchers in Manchester say.

Data from 117,000 girls was analysed.

Teenagers were at least three times more likely to have had the HPV vaccination if their mothers had been tested in the past five years.

The study, in the European Journal of Cancer, also showed daughters were more likely to have been vaccinated if their mothers received an abnormal result.

The cervical cancer vaccine was introduced in the UK in 2008 and is offered to girls with parental consent in their second year of secondary school with catch-up campaigns in older teenagers.

It provides immunity to the sexually transmitted infection responsible for most cases of cervical cancer.

New finding

The team from the University of Manchester linked cervical screening records and HPV vaccination records in the north-east of England by address.

It is the first time such a link has been studied in the UK.

They found that the uptake of HPV vaccination among 12-13-year-olds in those whose mothers had never been screened for cervical cancer was 58%.

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"It shows there is a link within families and that targeting both mothers and daughters may have an influence on uptake of prevention programmes”

Angela SpencerUniversity of Manchester researcher

In the same age group whose mothers had been screened for cervical cancer in the past five years, the uptake was almost 84%.

Further analysis showed mothers who had personally decided to stop screening were less likely to have vaccinated their daughters than those who had stopped for medical reasons.

The researchers are now planning to carry out in-depth interviews. They want to out what influences a mother's decision to give consent for her daughter to be vaccinated and whether socio-economic factors play a part.

But they pointed out that there were important public health implications to the findings.

They said not only are teenagers of mothers not engaging with screening less likely to be vaccinated they are also less likely to engage with screening themselves when they get older, putting them at risk.

And maintaining high HPV vaccine coverage is extremely important because figures show cervical screening coverage is declining among 25-29-year-olds with some evidence of increasing cancer incidence at younger ages, they pointed out.

Family pattern

Research assistant Angela Spencer said the results suggest that a mother's attitudes and behaviour with respect to her own cervical screening attendance or to preventive programmes in general, are important determinants in her decision to vaccinate her daughter, particularly at younger ages.

She added: "It shows there is a link within families and that targeting both mothers and daughters may have an influence on uptake of prevention programmes."

Dr Claire Knight, Cancer Research UK's health information manager, said: "HPV vaccination and screening are the best ways of reducing the risk of cervical cancer.

"This study adds to our knowledge about the factors that affect vaccination behaviour, including the influence of family and friends.

"It's important to ensure all women understand the importance of HPV vaccination and cervical screening and their role in saving lives."

READMORE:http://www.bbc.co.uk/news/health-20983325