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The effectiveness of a Lactobacillus probiotic on measures of psychosocial health in adults diagnosed with subthreshold depression: a double-blind, randomised, placebo-controlled trial
- G. Moschonis, K. Sarapis, S. Resciniti, R. Hall, K. Yim, M. Tonkovic, C. Fitzgerald, F. Anixiadis, Q. Nhu Dinh, M. Hale, B. Wright, M. Pane, C.J. Tuck, J.R. Biesiekierski
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- Journal:
- Proceedings of the Nutrition Society / Volume 83 / Issue OCE1 / April 2024
- Published online by Cambridge University Press:
- 07 May 2024, E58
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- Article
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Depression is the leading cause of disability worldwide(1). The microbiota-gut-brain axis may play a role in the aetiology of depression, and probiotics show promise for improving mood and depressive state(2). Further evidence is required to support mechanisms and in high-risk populations, such as those with sub-threshold depression (which may be 2-3 times more prevalent than diagnosed depression)(3). The aims were to assess the efficacy of a probiotic compared with placebo in reducing the severity of depressive symptoms in participants with subthreshold depression, and to investigate potential mechanistic markers of inflammatory, antioxidant status and stress response. A double-blind, randomised, placebo-controlled trial was conducted in participants meeting diagnosis of subthreshold depression (DSM-5); aged 18-65 years; ≥18.5 kg/m2 body mass index; not taking antidepressants, centrally acting medications, probiotics nor antibiotics for at least 6 weeks. The probiotic (4 × 109 AFU/CFU, 2.5 g freeze-dried powder containing Lactobacillus fermentum LF16 (DSM26956), L. rhamnosus LR06 (DSM21981), L. plantarum LP01 (LMG P-21021), Bifidobacterium longum BL04 (DSM 23233)) or placebo was taken daily for 3-months. Data was collected at 3 study visits (pre-, mid- (6 weeks), post-intervention). Self-reported questionnaires measured psychological symptoms (Beck Depression Inventory, BDI; Hospital Anxiety Depression Scale, HADS) and quality of life. Blood and salivary samples were collected for biomarkers including cortisol awakening response (CAR). General linear models examined within-group and between-group differences across all time points. Thirty-nine participants completed the study (n = 19 probiotic; n = 20 placebo) using intention-to-treat analysis. The probiotic group decreased in BDI score by −6.5 (95% CI −12.3; −0.7) and −7.6 (95% CI −13.4; −1.8) at 6 and 12 weeks, respectively. The HADS-A score decreased in the probiotic group by −2.8 (95% CI −5.2; −0.4) and −2.7 (95% CI −5.1; −0.3) at 6 and 12, respectively. The HADS-D score decreased in the probiotic group by −3.0 (95% CI −5.4; −0.7) and −2.5 (−4.9; −0.2) at 6 and 12 weeks of intervention, respectively. No between group differences were found. There were no changes in perceived stress or quality of life scores. The probiotic group had reduced hs-CRP levels (7286.2 ± 1205.8 ng/dL vs. 5976.4 ± 1408.3; P = 0.003) and increased total glutathione (14.2 ± 8.9 ng/dL vs. 9.3 ± 4.7; P = 0.049) compared to placebo, post intervention. Lower levels of CAR were found in the probiotic compared to placebo (−0.04 ± 0.17 μg/dL vs. 0.16 ± 0.25; P = 0.009). A significant reduction in depressive symptoms and anxiety was observed within the probiotic group only. These results were supported by improvements observed in biomarkers, suggesting probiotics may improve psychological wellbeing in adults experiencing sub-threshold depression, by potential pathways involved in central nervous system homeostasis and inflammation. Future analyses are required to understand changes within the intestinal microbiota and to clarify how their metabolites facilitate emotional processing.
CHAPTER VII - ARMIES, NAVIES AND THE ART OF WAR
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- By J.R. Hale, University of Warwick
- Edited by R. B. Wernham
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- Book:
- The New Cambridge Modern History
- Published online:
- 28 March 2008
- Print publication:
- 01 November 1968, pp 171-208
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Summary
In every year of the two generations that followed the treaty of Cateau-Cambrésis in 1559 European soldiers were somewhere engaged in battle, skirmish or siege. Few of these actions were on a large scale and none of them was decisive. Christian fought Turk and Catholic power fought Protestant by land and sea; France was distracted by civil wars for thirty years, the Netherlands for forty. Yet when the fighting petered out, the frontiers ran as geography, economic vitality, religion and patriotism dictated, not in patterns cut out by the sword. The costs of war continued to grow, and the sums raised were never enough to release into effectiveness the tactical lessons or the technical advances of the previous period, let alone the flood of advice offered by a new race of military experts. The need for regular pay, increased professionalism and something like a permanent establishment was recognised, but little was done about it. Ambitious plans laid at home were passed to the front in sieves of peculation and inefficiency. It was not a period of achievement, it was not in any real sense a period of transition, yet in no previous age had war loomed so large in men's lives and, through the pulpit, the stage, the fine arts and the press, in their imaginations.
The recurrence of wars was taken for granted. ‘To speak of peace perpetual in this world of contention’, wrote Thomas Digges, ‘is but as Aristotles foelix, Xenophons Cyrus, Quintilians Orator, or Sir Thomas Moores Utopia, a matter of mere contemplation, the warre being in this iron age si bien enracinée qu'il est impossible de l'en oster, si non avec la ruine de l'universe’. But if there was less pacifism than in the first half of the century, there was a greater self-consciousness about the legitimacy of war as such, and a more widespread urge to explain the difference between a just and an unjust war.