Lifestyle risk factors (poor diet, physical inactivity and smoking) are key contributors to highly prevalent medical illnesses, with new data emerging of these risk factors for common mental disorders. Effective drug treatment and biomarker discovery is needed for diabetes, a widespread medical condition known to be highly comorbid with psychiatric conditions such as mood disorders. These important clinical and scientific topics have been addressed in several articles published in BMC Medicine.
Felice Jacka and colleagues discuss new evidence from studies on diet quality and common mental disorders and argue that depression and anxiety should be ranked amongst prevalent medical conditions influenced by lifestyle. The opinion article draws attention to the development of public health prevention strategies for these psychiatric conditions that builds on established and emerging approaches for somatic illnesses.
In a cross-sectional study using the Norwegian prescription database (NorPD) a stronger association was observed between the use of anti-diabetic agents and mood stabilizers in women than in men. This evidence suggests that diabetes and bipolar disorder may have shared pathophysiology and women are more at risk of having both conditions, due to greater side effects associated with weight gain following treatment with mood stabilizers.
Furthermore, a population based cohort study showed that there is a 2.6 fold increase risk of affective disorders in patients with type 2 diabetes, but treating patients with a combination of the oral anti-hyperglycemic agents, sulfonylurea and metformin, appears to minimize this risk. In an associated commentary, Michael Berk recommends validity of this clinical observation but argues that research into the genetic pathways involved will help to discover new drugs in neuropsychiatry in the future.
Continuing on the theme of diabetes, a review of clinical trials indicate that incretin based therapies are effective in patients with type 2 diabetes, but treatment with glucagon-like peptide 1 agonists (incretin mimetics) shows significantly higher magnitude of glycemic improvement and greater weight loss compared with using dipeptidyl peptidase 4 inhibitors (incretin enhancers). However, there is a need for individualized incretin-based therapies to be effective for coexisting morbidities and long term safety in patients.
Finally, in a metabolic profiling study amino acid levels are altered in patients with polycystic ovary syndrome (PCOS) and are related to insulin sensitivity. These potential biomarkers could be used to monitor PCOS development and assess the risk of developing diabetes. This study is the latest addition to our article collection on Clinical Biomarkers.
In summary, the current research and recommendations indicate how personalized treatment is becoming important for mental health disorders and diabetes. Consideration of lifestyle factors, drug interactions and biomarker discovery will greatly influence this latest therapeutic approach.