Medical Bulletin 17/Jul/2025 - Video

A new study published in Menopause, the journal of The Menopause Society, reveals that psychosocial factors such as lack of emotional support, grief over infertility, and severity of menopause symptoms are key drivers of depression in women diagnosed with premature menopause rather than hormone levels or therapy alone.

Premature menopause, also known as premature or primary ovarian insufficiency, occurs when ovarian function stops before the age of 40. Women with primary ovarian insufficiency often face not only estrogen deficiency and its related symptoms like hot flashes and vaginal dryness but also the unexpected loss of fertility, which can deeply affect mental health.

To better understand why some women are more severely affected than others, researchers conducted a large study involving nearly 350 women diagnosed with primary ovarian insufficiency. They examined a range of factors, including age at diagnosis, severity of symptoms, fertility-related grief, hormone therapy use, emotional support systems, and genetic causes.

The study found that 29.9% of participants experienced depressive symptoms. Women who were younger at the time of their primary ovarian insufficiency diagnosis, reported severe menopausal symptoms, and lacked emotional support were more likely to suffer from depression. Fertility-related grief also emerged as a significant contributor. Interestingly, hormone therapy estrogen with or without progestogen did not significantly reduce the risk of depression. A genetic cause of primary ovarian insufficiency, however, was associated with fewer depressive symptoms. Additionally, hot flashes and night sweats were not individually linked to mood disturbances.

The findings stress the need for early, holistic care that incorporates psychological support. “The high prevalence of depressive symptoms in those with primary ovarian insufficiency highlights the importance of routine screening in this vulnerable population. Although hormone therapy is recognized as the standard of care for those with primary ovarian insufficiency for management of some menopause-related symptoms and preventive care, it is not first-line treatment for mood disorders. This was evident in this study in which there was no difference in depressive symptoms between those using hormones and those not using hormone therapy. Addressing behavioral-health concerns with evidence-based interventions should be part of any comprehensive primary ovarian insufficiency care plan,” says Dr. Monica Christmas, associate medical director for The Menopause Society.

Reference: https://menopause.org/wp-content/uploads/press-release/MENO-D-25-00043.pdf

Diet, Income, and City Living Raise Antibiotic Resistance and Mortality Risk: Study Finds

A large population-based study published by researchers from the University of Turku, Finland, in Nature Communications, has found that the burden of antibiotic resistance genes in the gut microbiome is significantly associated with a higher risk of sepsis and all-cause mortality. The study also identified key lifestyle, demographic, and dietary factors contributing to resistance, offering new insights into how everyday choices may influence long-term health outcomes.

Antibiotic-resistant bacteria are a growing global threat, responsible for over one million deaths annually. While previous studies have examined short-term clinical impacts, this new research followed over 7,000 Finnish adults for nearly two decades as part of the FINRISK population study, analyzing their stool samples to measure antibiotic resistance gene prevalence in gut bacteria and its association with health outcomes.

The study confirmed that antibiotic use was the most significant factor contributing to the resistance burden, with tetracyclines showing the strongest link. However, resistance was also associated with certain dietary patterns and social factors. A diet rich in fibre such as berries, potatoes, and rye bread was linked to lower resistance, while consumption of raw vegetables, salad, and chicken was associated with higher levels. Notably, beneficial gut bacteria like bifidobacteria and Prevotella were connected with reduced resistance, whereas Escherichia coli and Bacteroides, more common in western diets, were linked to increased resistance.

Unexpectedly, women, urban residents, and individuals from higher-income households showed higher resistance burdens factors typically associated with better health.

The study revealed that individuals with a high resistance burden had a 40% higher risk of all-cause mortality and more than double the risk of sepsis over 17 years. While causality wasn’t established, the researchers emphasize that resistance burden may serve as an important marker of overall health.

“Prevention of infections, good hand hygiene, food hygiene and a balanced diet support gut health. By paying attention to these, everyone can help prevent the spread of antibiotic resistance,”said Katariina Pärnänen, Academy Research Fellow at the Research Council of Finland.

Reference: Pärnänen, K., Ruuskanen, M.O., Sommeria-Klein, G. et al. Variation and prognostic potential of the gut antibiotic resistome in the FINRISK 2002 cohort. Nat Commun 16, 5963 (2025). https://doi.org/10.1038/s41467-025-61137-x

Why Do People with ADHD Traits Experience Depression and Lower Quality of Life?

A new study published in BMJ Mental Health found that insomnia, or sleep disturbances, that happen due to ADHD's impulsivity could be the reason why adults with ADHD symptoms experience a reduced quality of life. The research provides compelling evidence that heightened cognitive activity before sleep may be a key factor in the poor sleep quality.

ADHD, a neurodevelopmental disorder affecting approximately 2.5% of adults, is often accompanied by chronic sleep difficulties. Up to 90% of people with ADHD report problems such as insomnia and excessive daytime sleepiness. While the link between ADHD and sleep issues has been well documented, the mechanisms behind this connection have remained largely unclear.

To explore the potential mediating role of pre-sleep arousal, researchers collected data from two independent groups—104 online participants and 96 in-person respondents recruited a year later to replicate the initial findings. Participants completed self-report questionnaires that measured ADHD traits, levels of pre-sleep arousal, and overall sleep quality. The study adhered to strict ethical protocols, with all participants providing informed consent and the freedom to withdraw at any time.

The results revealed a strong correlation between ADHD-like traits and poor sleep quality, primarily driven by elevated levels of cognitive arousal before bedtime. Cognitive arousal refers to racing thoughts, worry, or mental overactivity that occurs prior to falling asleep. Researchers found that this mental restlessness had a far greater impact on sleep quality than physical signs of arousal, such as a racing heart—by up to ten times. These findings have important clinical implications.

“There needs to be more research to understand this complex interplay. By improving our understanding, we could uncover treatment options that improve the quality of life of people with ADHD. For instance, targeting insomnia complaints in individuals with higher ADHD traits, with cognitive behavioral therapy for insomnia (CBT-I) or sleep restriction therapy may help improve their quality of life,” said study co-author Samuele Cortese, a professor at the University of Southampton.

The study underscores the complexity of ADHD and associated sleep problems and highlights the need for integrated treatment approaches.

Reference: Siddhi Nair, Neha Deshpande, Catherine Hill, Samuele Cortese, Eus J W Van Someren, Sarah Laxhmi Chellappa - Associations of ADHD traits, sleep/circadian factors, depression and quality of life: BMJ Mental Health 2025;28:e301625.