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  • How has Gen Z uprising forced changes in Nepal? | Explainer

    How has Gen Z uprising forced changes in Nepal? | Explainer

    The story so far:

    On September 4, 2025 in Nepal, the (then) ruling Communist Party of Nepal (Unified Marxist-Leninist)’s K.P. Sharma Oli-led government banned 26 major social media platforms, citing non-compliance with registration requirements. This triggered widespread Gen Z-led protests from September 8, with demonstrators viewing it as an attempt to silence dissent. The protests quickly escalated from peaceful gatherings in Kathmandu to violent confrontations as demonstrators marched toward Parliament. At least 34 people have died and over 1,000 were hospitalised. The next day, multiple government buildings were attacked, including Parliament, the Supreme Court, and the Prime Minister’s office complex. Politicians’ homes were burnt down and prisoners freed from jails, including arrested politician and ex-minister Rabi Lamichhane of the Rastriya Swatantra Party (RSP).

    Prime Minister Oli also resigned on September 9. After three days of negotiations involving the President, Army Chief General Ashokraj Sigdel, and Gen Z leaders, former Supreme Court Chief Justice Sushila Karki was appointed as interim Prime Minister with a mandate to conduct elections by March 2026. She immediately recommended dissolving Parliament.

    Also read | ‘Unconstitutional’, ‘arbitrary’: Nepal parties slam House dissolution move

    What are the reasons for the protest beyond the social media ban?

    In recent years, many youngsters of Nepal have migrated out of the country for better job opportunities. Social media outlets are used by a bulk of such people and others, not just for venting about concerns on the nature of governance but also for communication and business. Shutting down these outlets, therefore, was seen as a major inconvenience. The youth, however, did not term the protests as something targeted at the social media ban, but as an agitation against corruption in governance.

    Ever since the 2015 Constitution, power has alternated between three veteran leaders – Mr. Oli, Mr. Pushpa Kamal Dahal (Prachanda) of the Communist Party of Nepal (Maoist-Centre), and Mr. Sher Bahadur Deuba of the Nepali Congress. Despite the relatively progressive Constitution, governments have been perceived as corrupt and unable to improve economic conditions, providing unstable governance through constantly changing alliances.

    What makes this uprising different from other Jan Andolans?

    The 2025 Gen Z uprising differs fundamentally from Jan Andolan 1 (1990) and Jan Andolan 2 (2006) in leadership, triggers, and objectives.

    Unlike previous movements led by established political parties like the Nepali Congress and UML in 1990, and the Seven Party Alliance with Maoists in 2006, the 2025 protests were driven by Gen Z activists with no traditional party affiliations. The movement was largely coordinated through social media platforms like Instagram and Discord rather than formal political structures.

    Jan Andolan 1 was triggered by an Indian trade embargo and aimed at ending the Panchayat system to establish constitutional monarchy. Jan Andolan 2 sought to end absolute monarchy and establish a republic through a Constituent Assembly. The 2025 uprising occurred within an existing democratic republic but challenged the entire political class, demanding dissolution of Parliament and establishment of a new leadership outside traditional party structures.

    The previous movements operated within or sought to create new constitutional frameworks. The 2025 protests represent a rejection of the post-2015 political settlement rather than seeking systemic constitutional change.

    Were monarchist forces behind the violence?

    In the violence on September 9, multiple government buildings were targeted, including Parliament, the Supreme Court, and the Singha Durbar office complex, which houses the Prime Minister’s office and other ministries. Politicians’ homes were also attacked and burnt. The buildings of Nepal’s largest media house, Kantipur, were also burnt, but the group’s flagship English-language newspaper, The Kathmandu Post, managed to bring out its print edition, even as its internet servers were down.

    Gen Z activists claimed that vandalism and arson were not done by them but by miscreants who infiltrated the protests. The protests evolved beyond the original movement’s peaceful intentions into widespread destruction of state infrastructure, suggesting involvement of other elements beyond the core Gen Z organisers.

    While it is too early to say that pro-monarchy activists were responsible for the September 2025 violence, there has been a pattern of pro-monarchist activity in recent months. In March 2025, pro-monarchy rallies turned violent, resulting in casualties when royalist forces clashed with security personnel. Former king Gyanendra’s arrival in Kathmandu that same month sparked rallies calling for monarchy’s return, supported by the Rastriya Prajatantra Party.

    How was the interim government formed?

    Following Mr. Oli’s resignation, Nepal entered a three-day power vacuum with intense negotiations among key stakeholders. The selection process involved the President’s Office, the Nepal Army, Gen Z leaders, and major political parties, with the Army Chief playing a crucial mediating role.

    Hami Nepal, a non-profit organisation led by 36-year-old Sudan Gurung, originally established for earthquake relief in 2015, emerged as a key voice. The organisation had gained credibility through transparent disaster relief work during COVID-19. Gen Z youth conducted extensive online discussions through social media before collectively endorsing Sushila Karki, a former Chief Justice of the Supreme Court.

    Several prominent figures were considered, including Kathmandu Mayor Balendra Shah (who ultimately endorsed Ms. Karki), former Nepal Electricity Authority chief Kulman Ghising, ex-education minister Sumana Shrestha of the RSP, and Dharan Mayor Harka Sampang.

    President Ram Chandra Poudel appointed Ms. Karki under Article 61 of the Constitution after extended consultations, citing “extraordinary circumstances.”

    Is the dissolution of Parliament constitutional?

    The dissolution could likely be unconstitutional. Article 76(7) of Nepal’s 2015 Constitution allows dissolution only after failed Prime Minister appointments and requires the PM’s recommendation. Article 66(2) mandates Presidential actions must occur “on [the] recommendation of the Council of Ministers.” No constitutional provision permits dissolution based on public protests alone.

    The fact that dissolution occurred immediately after the interim PM’s appointment makes it constitutionally questionable, as it bypassed prescribed procedures and violated separation of powers principles. This could constitute grounds for judicial review by the Supreme Court’s Constitutional Bench.

    Major political parties including the Nepali Congress, CPN-UML, and CPN (Maoist Centre), along with the Nepal Bar Association, have condemned the dissolution as “unconstitutional” and “arbitrary,” with lawyers warning that it undermines constitutional supremacy and contradicts previous Supreme Court rulings on parliamentary reinstatement.

    What challenges do this crisis pose for Nepal’s democratic future?

    The 2025 uprising highlights fundamental flaws in Nepal’s post-2015 political settlement. While the 2015 Constitution established a progressive federal democratic republic with provisions for inclusive representation, its implementation has been marked by chronic political instability.

    Since 2015, power has rotated among the same three leaders through constantly shifting alliances rather than ideological differences. This “musical chairs” approach to governance has prevented consistent policy implementation and economic development, fuelling public disillusionment.

    Besides, the Constitution’s federal structure remains incomplete, with disputes over provincial boundaries and resource distribution unresolved. The Gen Z movement’s success in forcing extra-constitutional change was an outcome of its impatience with traditional democratic processes.

    The interim government’s ability to conduct credible elections by March 2026 and whether new political forces can emerge to challenge the established triumvirate will be crucial tests.

    Nepal’s democratic future depends on whether a newly reconstituted political class can move beyond patronage-based politics toward genuine policy competition, complete the federal transition envisioned in the Constitution, and address youth unemployment and migration.

    However, if anti-democratic forces exploit this moment to reverse the gains of the previous Jan Andolans, then Nepal will undergo a democratic regression – in line with what has transpired in Bangladesh following its own anti-government, student-driven protests last year.

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  • Canelo vs. Crawford odds, picks, predictions from boxing expert

    Canelo vs. Crawford odds, picks, predictions from boxing expert

    The undisputed super middleweight championship will be on the line when defending champion Canelo Alvarez battles WBA junior middleweight champion Terence Crawford in a 12-round bout on Saturday. The main Canelo vs. Crawford fight card, which will be carried on Netflix, is set to start at approximately 8 p.m. ET, with the main event at approximately 11:30 p.m. ET from Allegiant Stadium in Las Vegas. Alvarez became the undisputed super middleweight champion for the second time in his last fight when he earned a unanimous decision over William Scull in May. Crawford will be stripped of his WBA junior middleweight title when he enters the ring on Saturday. Interim champion Abass Baraou will then be upgraded to full champion.

    Alvarez is a -170 favorite (risk $170 to win $100), while Crawford comes back at +140 in the latest Canelo vs. Crawford odds from DraftKings Sportsbook. The over/under for number of rounds is 10.5, with the Over listed at -450. Canelo winning by decision of technical decision is the favored winning method result at +125. Before making any Canelo vs. Crawford picks, be sure to see the boxing predictions from SportsLine’s Josh Nagel.

    New users can also target the DraftKings promo code, which offers $200 in bonus bets instantly plus over $200 off NFL Sunday Ticket:

    Nagel is SportsLine’s top boxing analyst, and his recent winners include calling Dimitry Bivol (+110) to pull the slight upset of Artur Beterbiev in their February rematch. In April, he correctly called Jarron Ennis to beat Eimantas Stanionis by KO (+155), while also correctly predicting the Under 10.5 rounds (+165). 

    He also correctly called Jake Paul by decision (-110) against Julio Cesar Chavez Jr. in June. He kept his hot streak going by recommending Katie Taylor (+170) against Amanda Serrano in their trilogy showdown in July. Anyone who has followed Nagel’s combat sports picks this year could already be up more than $1,500. Anyone following at sportsbooks and on betting apps could have seen huge returns.

    Now, Nagel has studied Canelo vs. Crawford from every angle and revealed his top picks and best bets. You can only see his picks and analysis at SportsLine. 

    New users can also check out the latest FanDuel promo code and get $300 in bonus bets instantly at FanDuel if your $5 bet wins

    Why you should back Alvarez

    Alvarez, 35, first won the undisputed middleweight championship in November 2021 and served as champion until July 2024. At that time, he was stripped of the crown for not making a title defense against Scull. He later faced Scull this past May to regain his title. He is a four division world champion, holding titles at junior middleweight, middleweight, super middleweight and light heavyweight.

    Alvarez, who is from Guadalajara, Jalisco, Mexico, has compiled a 63-2-2 overall record, including 39 knockouts. He suffered his only losses to Floyd Mayweather Jr. in September 2013 and to Dmitry Bivol in May 2022. He holds a 24-2-1 record with 11 knockouts in world title fights. He enters as CBS Sports’ No. 7 pound-for-pound boxer, and has a 62% knockout percentage, going an average of 7.8 rounds per fight. See which fighter to back here.

    Why you should back Crawford

    Crawford, who turns 37 on Sept. 28, is from Omaha, Neb. He won the WBA junior middleweight and WBO interim junior middleweight titles in his last fight, a unanimous decision victory over Israil Madrimov in August 2024. He is a former two-time undisputed welterweight and junior welterweight champion. He is seeking to become the first male boxer in the four-belt era to be undisputed champion in three weight classes.

    Crawford is CBS Sports’ No. 4 ranked pound-for-pound boxer, and has compiled a 41-0 record with 31 knockouts. He is 19-0 with 15 knockouts in world title fights. He has a 76% knockout percentage and his fights last an average length of 6.0 rounds. Crawford has won 14 of his last 16 fights by knockout. See which fighter to back here.

    Also, check out the latest BetMGM promo code CBSSPORTS, where new users can get up to $1,500 in bonus bets if your first bet loses.

    How to make Canelo vs. Crawford picks 

    Nagel likes the Over on total rounds. He’s also locked in a confident money-line picks and a method-of-victory prop that returns around +200. Head to SportsLine to see what it is. 

    Who wins Canelo Alvarez vs. Terence Crawford and which method of victory prop could bring a massive return? Join SportsLine here to see which bets you need to make for the fight, all from the accomplished veteran combat sports analyst who has consistently delivered winners.


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  • Crocker-Donovan 2: Belfast fighter wins world title on split decision at Windsor Park

    Crocker-Donovan 2: Belfast fighter wins world title on split decision at Windsor Park

    Donovan entered to ‘Better Off Alone’ and although he was away from his native Limerick, he also had a large support to greet him.

    He also sought to greet Crocker into the ring but the Belfast man was not interested in engaging as he moved to his corner, gripping his feet to the canvas as a sign he was ready for action.

    The Belfast man seemed to be in something of a zone, refusing to be knocked out of stride which was perhaps a prelude of things to come as he boxed with discipline for the most part.

    It was the first fight at Windsor Park since Carl Frampton defeated Luke Jackson at the venue in 2018 and ‘The Jackal’ kept a close brief at ringside, watching as Belfast saluted its latest hero.

    It was a slow burner as although Donovan entered with his confidence sky high with a good performance in the first meeting despite losing by disqualification, but he was still clearly respectful of the danger in front.

    The pre-fight narrative was that Crocker perhaps needed a fast start, but he had his own game-plan and after a cagey couple of rounds from both, the first big moment arrived in the third.

    Crocker’s approach from the first fight had noticeably changed as he seemed happy to stay at range, seeking to draw Donovan’s lead and counter, getting a brief opportunity in the second as he let his right hand go in another tentative round from the pair.

    That approach paid off to an extent in the third as he timed the Limerick man was clipped on the way in and although it seemed more of a slip, a punch landed and Howard Foster issued a count.

    It injected some urgency into Donovan, who finished the round well, and the fight began to open up in the fourth, with both landing simultaneously with hooks, but it was Crocker who took the backwards step.

    Donovan seemed well on his way to winning the fifth off his jab and sought to put a stamp on it late in the round, but the counter right Crocker had been looking for was there and he detonated a rapid right that dropped Donovan for a second time.

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  • World Series of Darts: Luke Littler fights back to beat Jonny Clayton

    World Series of Darts: Luke Littler fights back to beat Jonny Clayton

    Defending champion Luke Littler had to come from behind to beat Jonny Clayton 6-4 and advance to the World Series of Darts quarter-finals.

    Clayton stormed into a 3-0 lead but Littler responded, winning the next five legs, which included back-to-back 180s, before seeing out victory in Amsterdam.

    Littler will face Ross Smith, a 6-4 winner over Dave Chisnall, next.

    “It was not easy and I can pull myself out of situations, I know I can do it,” said Littler.

    “I would rather get off to a good start, but Jonny did there. I managed to get over the line.”

    Elsewhere, Michael van Gerwen hit back-to-back 100-plus finishes to edge out Rob Cross 6-5, setting up a quarter-final against Luke Humphries, the world number one coming through 6-4 against Kevin Doets.

    Gerwyn Price beat Raymond van Barneveld 6-4, setting up a tie with Chris Dobey, who cruised to a 6-1 win over Cameron Menzies.

    The remaining quarter-final sees Josh Rock, who routed Danny Noppert 6-0 in a match that lasted just nine minutes, take on Mike de Decker after he beat Damon Heta 6-4.

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  • Ariana Grande addresses Eternal Sunshine Tour ticket resale controversy and promises solutions for fans

    Ariana Grande addresses Eternal Sunshine Tour ticket resale controversy and promises solutions for fans

    Ariana Grande has publicly responded to fans’ frustrations over difficulties securing tickets for her upcoming Eternal Sunshine Tour.

    The 32-year-old singer took to Instagram Stories on Saturday, September 13, acknowledging concerns about secondary ticket resellers. “Hi my angels, I have been on set all week, but I wanted to let you know that what’s been happening with the secondary ticket resellers has been brought to my attention,” she wrote. “Of course, I am incredibly bothered by it. I’ve been on the phone every second of my free time, fighting for a solution.”

    Grande said she is working with her team to ensure more tickets reach genuine fans instead of scalpers. “I hear you and, hopefully, we will be able to get more of these tickets into the right hands,” she added. “It’s not right. My team and I see it and care very much.”

    Tickets went on sale September 9 and sold out within minutes, leaving many fans stuck in Ticketmaster queues. Soon after, seats appeared on resale platforms at inflated prices, sparking anger across social media.

    Grande, who recently won Best Pop and Video of the Year at the 2025 MTV Video Music Awards for her single Brighter Days Ahead, described the tour as one of her most personal projects. Inspired by Eternal Sunshine of the Spotless Mind, the album explores themes of memory and healing.

    “I love you all so much,” Grande concluded. “Thank you for your patience and understanding.”

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  • New Insights Presented at STARS Conference

    New Insights Presented at STARS Conference

    CONFERENCE REPORTER

    At a recent conference on stuttering, Shahriar SheikhBahaei, PhD, assistant professor of neurobiology and behavior at SUNY Stony Brook University, discussed new insights into the neurobiology of speech and the mechanisms that may contribute to stuttering. The STARS (Stuttering Treatment and Research Society) Inaugural Education and Research Conference was held in Dana Point, California, September 13 2025. SheikhBahaei, who also stutters, is an advisory committee member of STARS.1

    SheikhBahaei emphasized the complexity of speech production. “Speech is a very complex motor behavior,” he said in an exclusive interview with Psychiatric Times during the conference, adding that it involves “more than 100 muscles in the body that…have to work together in concert.” Although researchers know some of the brain circuits and auditory feedback systems involved, he explained that the development of animal models has transformed the field by allowing scientists to examine cellular and circuit-level processes. “Now we know what type of circuits are involved. We know the role of inhibitory circuits, excitatory circuits. All of those lead us to a more comprehensive understanding about the neurobiology of speech.”

    One key focus has been the role of dopamine, which is central to both motor function and learning. “Dopamine has been taught to be important for speech,” SheikhBahaei said, adding that regions rich in dopamine are deeply involved in vocal motor behaviors.

    He also highlighted findings on the coordination between speech and breathing. “Almost all species except frogs…only make meaningful vocalization during exhalation,” he explained. In both animal models of stuttering and human studies, abnormalities in respiratory circuits have been identified, suggesting that “this coordination of activities between these two important circuits are affected.”

    SheikhBahaei noted one of the enduring mysteries in the field: why some children naturally outgrow stuttering while others do not. “It persists in about 1% of population which is still huge—that’s close to 80 million people worldwide,” he said. Evidence suggests that disrupted development and refinement of motor circuits controlling respiration, orofacial movement, and vocalization may play a role.

    Finally, SheikhBahaei addressed the interaction between stuttering and anxiety. “From existing data from human subjects, we know that people who stutter, they are not more anxious, but we also know that anxiety makes stuttering worse,” he explained. Because speaking requires rapid, tightly coordinated brain activity, even small disruptions in timing may tip the balance and trigger stuttering in some individuals.

    Reference

    1. SheikhBahaei S. A Neurobiologic Understanding of Stuttering. Presented at STARS Inaugural Education and Research Conference; Dana Point, California; September 13, 2025.

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  • Animal Models Provide Greater Understanding Into the Neurobiology of Stuttering

    Animal Models Provide Greater Understanding Into the Neurobiology of Stuttering

    CONFERENCE REPORTER

    At the STARS (Stuttering Treatment and Research Society) Inaugural Education and Research Conference, Shahriar SheikhBahaei, PhD, assistant professor of neurobiology and behavior at SUNY Stony Brook University, described how animal models are transforming research into the disorder and opening pathways toward potential new treatments.1

    “In my lab we are using animal model to study stuttering at the cellular and circuit level,” SheikhBahaei told Psychiatric Times in an exclusive interview. While speech itself is uniquely human, he emphasized that “because of this existing of same similar behavior, similar circuits in the brain between human and an animal model…using those animal models could help us understand this disorder at the cellular and circuit level.”

    His team’s work has already identified disruptions in breathing-related processes. “Our data, for example, provided evidence that respiratory behavior is disorganized in our animal model,” he explained. Researchers in the lab have developed methods “to make the respiratory system function in a more organized way with the other circuits,” he said. “These types of treatment, show promising results both in animals and humans as well,” SheikhBahaei said.

    Beyond testing therapies, animal models allow unprecedented access to neural activity. “We can visualize cells like astrocytes that are electrically silent. And with the current imaging system it’s impossible to look at their function online and how they modulate the activity of neuronal circuit,” he noted. The animal model approach provides “a window to look at the function at the cellular level, circuit level, and behavioral level.”

    SheikhBahaei’s commitment to the field is also personal. “As a person who stutters, speaking is always a challenging task for me,” he shared. “Every career decision that I made was based on this goal to know more about the disorder and also research to finding a treatment or a way that we can help people who stutter.”

    Early work convinced him of the critical need for better models. He recognized “animal models were lacking in this field, and we would need novel animal models with human quality vocal repertoire that could help us understand this disorder at the cellular and circuit level,” he said.

    Today, he sees progress. “With availability of animal model and artificial intelligence and big data, we are in a strong position to know more about this disorder at the fundamental level and generate treatments for this condition.”

    Reference

    1. SheikhBahaei S. A Neurobiologic Understanding of Stuttering. Presented at STARS Inaugural Education and Research Conference; Dana Point, California; September 13, 2025.

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  • Shibarium bridge suffers 'sophisticated' flash loan attack, with $2.4 million drained – The Block

    1. Shibarium bridge suffers ‘sophisticated’ flash loan attack, with $2.4 million drained  The Block
    2. 4,600,000 BONE Frozen Following Shibarium Hack Threats: Details  Yahoo Finance
    3. PeckShield flags weird activity tied to Shib token  Cryptopolitan
    4. BONE Price Surges 40% After Shibarium Flash Loan Exploit  CoinDesk
    5. Shiba Inu Update: Team Freezes 4.6M BONE Amid New SHIB Upgrades  CoinGape

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  • Ethnicity and social class affect lung cancer survival rates

    Ethnicity and social class affect lung cancer survival rates

    People from different backgrounds interacting in London. Image by Tim Sandle.

    The most comprehensive study yet conducted of lung cancer diagnosis in England has revealed significant disparities between ethnic groups and striking evidence that people living in the most deprived areas were diagnosed with lung cancer at twice the rate of those in affluent areas.

    The study, published in the journal The Lancet Regional Health – Europe, which is the largest of its kind, analysed health records of over 17.5 million people and more than 84,000 lung cancer cases, found that Bangladeshi men had the highest rates of lung cancer, while people from the most deprived areas developed the disease at twice the rate of those from affluent areas.

    Among those who developed lung cancer, people from deprived areas had a 35% higher risk of being diagnosed with more aggressive forms of the disease.

    Researchers from Oxford’s Nuffield Department of Primary Care Health Sciences found clear evidence that different ethnic groups show distinct patterns of lung cancer types, with important implications for screening and early detection.

    Professor Julia Hippisley-Cox, senior author of the study, states: “This research provides the strongest evidence yet of how your ethnic background and social circumstances affect both your risk of developing lung cancer and the type of cancer you may develop. These findings are particularly timely as the NHS rolls out its targeted lung cancer screening programme.”

    Key findings

    • Bangladeshi men showed the highest lung cancer rates, followed by White, Chinese and Caribbean men
    • Women and people from Indian, Caribbean, Black African, Chinese and other Asian backgrounds were twice as likely to be diagnosed with adenocarcinoma, one of the most common types of lung cancer
    • Lung cancer occurred twice as frequently in the most deprived areas compared to the least deprived areas (215 vs 94 cases per 100,000 person-years for men; 147 vs 62 for women)
    • Men and current smokers were more likely to be diagnosed at later stages of cancer than women and non-smokers

    These data show clear patterns in how lung cancer affects different communities across England. This infers that ethnic background and social circumstances play crucial roles in both cancer risk and how the disease develops.

    The findings come in the context of the UK NHS rolling out its Targeted Lung Health Check Programme across England. This screening initiative currently focuses on areas with high lung cancer rates and social deprivation, aiming to detect cancer earlier when it’s more treatable. The new research could help ensure these vital health checks reach those most at risk and are tailored to different community needs.

    Early detection through targeted screening could significantly reduce treatment costs for the NHS, as late-stage cancer care is considerably more expensive. More importantly, catching cancer earlier could save thousands of lives each year.

    The research highlights how social factors like poverty and healthcare access affect cancer outcomes.

    To address this, cancer services need to reach out to all communities effectively so that everyone has the same opportunity for early diagnosis, regardless of their background or where they live.

    This needs to go hand-in-hand with policies that address fundamental inequalities in healthcare access and to reduce social deprivation.

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  • Research: Diabetes-Depression Links Similar Across Europe

    Research: Diabetes-Depression Links Similar Across Europe

    The relative increase in odds of an individual with diabetes developing severe symptoms of depression – and vice versa – is the same, regardless of where they live, a study of over-50s in 18 countries in Europe that is being presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) in Vienna, Austria (15-19 September) has found.

    Individuals with depression are more likely to develop diabetes and vice versa. In addition, previous research has shown that the strength of this association depends on the quality of diabetes care, with the links between diabetes and depression weaker in countries with good diabetes care.

    For the new study funded by Ireland’s Health Research Board, Jaroslav Gottfried, of University College Dublin, Dublin, Ireland, and colleagues examined whether a wide range of country and individual-level factors, from wealth inequality in a country, to whether a person smokes, influence the association between diabetes and depression. For example, is someone with diabetes more likely to develop depression, and vice versa, if they also smoke? Or does smoking not make a difference?

    “Not everyone with diabetes will develop depression; and similarly, not everyone with depression will develop diabetes,” explains Dr Gottfried. “Greater knowledge of the factors that influence the association between diabetes and depression would make it easier to predict which people with diabetes are most likely to develop depression and vice versa.

    “This would allow healthcare professionals and policymakers to then, for example, target medical and mental health care at the most vulnerable people with one of the conditions, in an effort to prevent them from developing the other condition.”

    The country-level factors included quality of diabetes healthcare (Euro Diabetes Index 2014), diabetes-related expenditure (Eurostat), age-specific risk of poverty (Eurostat), gender inequality (Gender Inequality Index) and wealth inequality (Gini Index).

    Three large prospective studies – the English Longitudinal Study on Ageing, the Irish Longitudinal study on Ageing and the Survey on Health, Ageing and Retirement in Europe – provided individual-level data on over 45,000 individuals aged 50-plus (average age approx. 65 years, approx. 57% female) from 18 European countries1, with a follow-up period of up to 11 years. About 20% of the participants were from Ireland or the UK (more than 5,000 from Ireland and more than 3,850 were from the UK).

    The individual-level factors included age, gender, BMI, smoking and physical activity, as well as whether the participant had been diagnosed with diabetes (type 1 or type 2) and their score on symptoms of depression (CES-D and EURO-D scale). (The 15% of participants with the highest scores were categorised as having high depressive symptoms.)

    Austria was used as the ‘comparator’ country, as it was the first in alphabetical order in the countries studied – although the authors also note by coincidence the EASD meeting is taking place in Vienna, Austria this year. The study found that the odds of someone without diabetes or high depressive symptoms going to develop one of the conditions varied from country to country.

    The odds of developing diabetes were lowest in the Netherlands and highest in Portugal. Compared with a person living in Austria, a person in the Netherlands had about 65% lower odds of developing diabetes, while someone living in Portugal had over 90% higher odds of doing so.

    Meanwhile, the odds of developing high depressive symptoms were lowest in Denmark and highest in Italy. A person living in Denmark had about 20% lower odds of developing high depressive symptoms than one in Austria, while a person in Italy had odds nearly 150% higher.

    (See tables in links to editor for other countries including UK and Ireland)

    Despite this, the association between depression and diabetes was broadly similar for all of the country-level factors studied. People with high depressive symptoms had 15% higher odds of developing diabetes during the follow-up period than people with lower depressive symptoms, regardless of country’s quality of diabetes healthcare, expenditure, risk of poverty and gender and wealth inequality.

    Conversely, people who were living with diabetes were at 48% higher odds of developing high depressive symptoms than people without diabetes.

    All of the factors studied affected the risk of developing diabetes. They all also affected the risk of developing depression.

    However, only one of the factors, BMI, influenced the association between diabetes and depression. The higher the BMI of a person with diabetes, the greater their likelihood of developing high depressive symptoms.

    Specifically, each one-point increase in BMI in a person with diabetes increased their odds of developing high depressive symptoms by 2.1%. This compares to a 1.3% increase per BMI point in a person without diabetes.

    Unlike previous research this study did not find that the quality of diabetes care influenced the link between diabetes and depression. This may be because of differences in the populations analysed. For example, this study focused on people aged 50-plus and quality of diabetes care may have a greater impact on younger people.

    It could also reflect the different methods of research. The previous study was cross-sectional, meaning it looked at just one point in time. This study was longitudinal and so measured levels of diabetes and depression over time.

    Together, the results suggest that the association between diabetes and depressive symptoms varies little between different countries and different sociodemographic groups.

    Dr Gottfried concludes: “The way diabetes and high depressive symptoms are connected in people aged 50-plus is similar across European countries regardless of the quality of diabetes healthcare and other country-level factors like poverty rates or wealth inequality.

    “As a result, the strategies that prevent someone with diabetes developing depression – or a person with depression developing diabetes – in one country should also be beneficial when implemented elsewhere.” re

    /Public Release. This material from the originating organization/author(s) might be of the point-in-time nature, and edited for clarity, style and length. Mirage.News does not take institutional positions or sides, and all views, positions, and conclusions expressed herein are solely those of the author(s).View in full here.

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