Restoring vision by gene therapy in macular degeneration

Humans rely dominantly on their eyesight. Losing vision means not being able to read, recognize faces or find objects. Macular degeneration is one of the major reasons for visual impairment, round the globe, close to 200 million people are affected. Photoreceptors in the retina are responsible to capture the light coming from the environment through the eye. Diseased photoreceptors lose their sensitivity to light, which can lead to impaired vision or even complete blindness.

Scientists of the Institute of Molecular and Clinical Ophthalmology Basel (IOB) together with colleagues from the German Primate Center (DPZ) — Leibniz Institute for Primate Research in Göttingen have developed a completely new therapeutic approach based on gene therapy. They managed to activate degenerated photoreceptors using near-infrared light. Their findings are published in the journal Science.
The main cause of blindness in industrialized countries is the degeneration of photoreceptors, including age-related macular degeneration and retinitis pigmentosa. During the progression of degenerative photoreceptor diseases, light-sensitive and light-insensitive photoreceptor regions in the retina coexist. For example, macular degeneration patients lose vision in the central portion of their retina but retain peripheral eyesight.
Scientists have now succeeded in developing a new therapeutic approach to restore light sensitivity in degenerating retina without negatively affecting remaining vision. They were inspired by species found in nature, such as bats and snakes, that can localize near-infrared light emitted by the bodies of their preys. This is done by using heat-sensitive ion channels which are able to detect the heat of the near-infrared light. This enables the bats and snakes to superimpose thermal and visual images in the brain and thus react to their environment with greater precision. To equip retinal photoreceptors with near-infrared sensitivity, the researchers devised a three-component system. The first component contains engineered DNA that ensures that the gene coding for the heat-sensitive channel is only expressed in photoreceptors. The second component is a gold nanorod, a small particle, that efficiently absorbs near-infrared light. The third component is an antibody that ensures strong binding between the heat-sensitive channel expressed in photoreceptors and the gold nanorods that locally capture near-infrared light and locally release heat.
The researchers first tested their system in engineered mice with retinal degeneration, confirming that near-infrared light effectively excites photoreceptors and that this signal is transmitted to retinal ganglion cells, the latter representing the output of the retina towards higher visual centers in the brain. Next, they showed that stimulating the mouse eye with near-infrared light is also picked up by neurons in a brain area that is important for conscious vision, the primary visual cortex. They also designed a behavioral test in which untreated blind mice were not able to use near-infrared stimulation to learn a simple task whereas blind mice treated with the three-component system could perform the task related to near-infrared stimulus.
In collaboration with Arnold Szabo, a co-author of the paper and Assistant Professor at the Semmelweis University in Hungary, the researchers could test their new approach on human retinas that can be kept alive in culture medium for months, though blindness sets in a day or so after death by photoreceptors losing their ability to detect light. Experimental results showed that following treatment with the three-component gene therapy method, near-infrared light exposures reactivated the human retina’s visual circuitry.
“We believe that near-infrared stimulation is an important step towards providing useful vision to blind patients so that they can regain their ability to read or see faces,” says Daniel Hillier, head of the junior research group Visual Circuits and Repair at DPZ, and adds: “We want to give hope to blind people with these findings and will further intensify our research activities in this area here at DPZ within our main project, which focuses on the restoration of vision.”

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Story Source:
Materials provided by Deutsches Primatenzentrum (DPZ)/German Primate Center. Note: Content may be edited for style and length.

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Journal Reference:

1. Dasha Nelidova, Rei K. Morikawa, Cameron S. Cowan, Zoltan Raics, David Goldblum, Hendrik P. N. Scholl, Tamas Szikra, Arnold Szabo, Daniel Hillier, Botond Roska. Restoring light sensitivity using tunable near-infrared sensors. Science, 2020; 368 (6495): 1108 DOI: 10.1126/science.aaz5887

https://www.sciencedaily.com/releases/2020/06/200604152048.htm

Applying symptom tracking to COVID-19 outpatient care using famotidine [Pepcid]

A patient-reported symptom tracking method used for patients with cancer has now been adapted for patients with COVID-19. Investigating the effect of famotidine, a potential treatment for COVID-19, on non-hospitalized patients with COVID-19, clinicians at Northwell Health and cancer researchers at Cold Spring Harbor Laboratory (CSHL) developed the method to use in addition to laboratory tests. This outpatient approach addresses the need to care for the majority of COVID-19 patients who do not require hospitalization. The first clinical case series showed that famotidine may help patients with mild to moderately severe symptoms from COVID-19. Next, the team will test the drug in a randomized clinical trial.

Published in the journal GUT, the Northwell-CSHL case series is unique in its adaptation of quantitative tracking of patient-reported outcome measures. The methodology is suitable for testing drugs in patients well enough to be managed at home and allows the recruitment of diverse subjects via community-based health organizations and individual practitioners.
The lead author of the study, CSHL Assistant Professor Tobias Janowitz, is a Medical Oncologist and a Cancer Researcher, who investigates the whole-body causes and effects of diseases. “The experience of a patient at one point in time is very valuable, but learning about the change in their experience over time is even more important,” says Janowitz. “Change indicates if the patients’ condition is getting better or worse. A graded symptom score enables the physician and the patient to track symptoms using numbers.”
Observing that for COVID-19, most symptomatic people do not require hospitalization, Janowitz and colleagues developed a 4-point scale for six common COVID-19 associated symptoms that patients score every day. Janowitz simplifies how the scale can help track the course of a patient’s disease:
“You may call up your doctor and say, I have headaches and shortness of breath, and am only able to do the basics for self-care, which would be grade 3 symptoms. If you still had the symptoms two days later, but are now able to do light work, these symptoms would now be scored at grade 2. This approach makes it very easy for you and your doctor to document that your symptoms are improving. The value of this approach from a research perspective is that experiences from many patients become comparable and can be pooled for analysis.”
If a drug speeds recovery, then most patients will report more rapid improvement of symptoms.
The innovations in this study are the product of scientists and physicians who never expected to work on a pandemic infection. But the collaborative, multidisciplinary approach is a hallmark of the strategic research affiliation between CSHL and the academic physicians at Northwell Health. Chief, General Internal Medicine, Northwell Health and Professor at the Feinstein Institutes, and a co-author on the study, Joseph Conigliaro says:
“There are a lot of things that we were doing that worked well in how we address this pandemic. I’m a health services addiction researcher. I didn’t think I’d ever be the person who would be studying this pandemic and this virus. And Tobias does cancer research. What we did is we used our existing tools and talents that were not specifically geared towards studying a viral pandemic, but we used it and modified it in ways that were very, very helpful.”
CSHL Professor David Tuveson, Director of the CSHL Cancer Center and another co-author, is interested in the broader implications of the patient-oriented research approach as a way to better connect science and healthcare. CSHL’s commitment to bridging the gap between research and the clinic is evident in an initiative championed by Janowitz to study how disease impacts the entire body. Tuveson says:
“You’re trying to scientifically assess a symptom, is what you’re really doing. Tobias and his colleagues can look at the whole body while they study cancer. And so Tobias is someone who thinks about the big picture of health. He’s basically shifting his approach to solving complex problems to COVID-19 and he started by saying ‘how can we describe one patient relative to the next?'”
Janowitz agrees, “It seems reasonable to me to make that extension to this healthcare crisis and to acknowledge that we can learn a lot from the individual who has the disease as long as we find a way to make it quantifiable.”
Once validated, the patient-reported symptom tracking method will be a key component in a clinical trial that is “double-blind,” meaning that neither patient nor doctor know whether the patient is getting the test drug or a placebo until the trial is completed. Without a double-blind clinical trial and a careful scientific examination of the mechanism of action of a drug and its side effects, it is impossible to rule out that the preliminary findings were due to factors other than the drug. The early findings of this case series were communicated to co-author Dr. Timothy Wang at Columbia University Medical Center. Interestingly, Dr. Wang and colleagues were also able to find an association between famotidine usage and the improved outcomes of patients hospitalized for COVID-19. Based on the findings in the case series, a double-blind clinical trial of famotidine is the next step in the joint plan of the Northwell-CSHL team. Other treatments may also be explored.
Conigliaro explains why he is hopeful that the study will work as designed to find drugs that will be effective against COVID-19:
“We had about a thousand patients that we tracked in our practices, just in my couple of academic practices, that never made it to the hospital. And my Doc’s were calling them every day and asking all those questions: ‘Do you have aches and pains? Do you have fever today? How’s your breathing today?’ We didn’t know what their blood levels were. We didn’t know what their oxygen levels, because we didn’t have access to that. So these surrogate measures are very common and the best way to assess what’s going on in the outpatient. I’m actually pretty confident. I think there’ll be another surge but I think we’ll be much better prepared and I think that hopefully lives will be saved.”

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Story Source:
Materials provided by Cold Spring Harbor Laboratory. Original written by Eliene Augenbraun. Note: Content may be edited for style and length.

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Journal Reference:

1. Tobias Janowitz, Eva Gablenz, David Pattinson, Timothy C Wang, Joseph Conigliaro, Kevin Tracey, David Tuveson. Famotidine use and quantitative symptom tracking for COVID-19 in non-hospitalised patients: a case series. Gut, 2020; gutjnl-2020-321852 DOI: 10.1136/gutjnl-2020-321852

https://www.sciencedaily.com/releases/2020/06/200605004329.htm

Hospitalized COVID-19 patients with diabetes are over 20% of ICU population

The COVID-19 pandemic presents new challenges for clinicians caring for infected patients with diabetes, according to new guidance published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

Hospitalized patients with COVID-19 and diabetes need to receive glucose-lowering therapy in addition to other complex medical management as a way of minimizing risk for complications and death. However, appropriate glycemic management — including bedside glucose monitoring and insulin administration — requires intensive patient interactions and puts clinicians at risk.
“This manuscript provides guidance for healthcare providers caring for patients hospitalized for COVID-19 who also have a prior history of diabetes or who have high blood sugar levels at the time of hospitalization,” said lead author Mary T. Korytkowski, M.D., of the University of Pittsburgh School of Medicine in Pittsburgh, Pa. “These healthcare providers are at risk for contracting COVID-19, and while glycemic management in the hospital improves patient outcomes, it also intensifies the amount of time with direct patient contact.”
Clinicians may limit their risk of exposure by minimizing the use of IV insulin infusions and using remote glucose monitoring devices and non-insulin therapies when possible. Diabetes self-management by selected patients who are knowledgeable and capable of this in the hospital also can be considered as a way of limiting direct patient interactions. Clinicians should be aware that some medications used in treating COVID-19 patients, including glucocorticoids and hydroxychloroquine, can affect blood glucose levels.
Other authors include Kellie Antinori-Lent of the University of Pittsburgh Medical Center Shadyside Hospital in Pittsburgh, Pa.; Andjela Drincic of the University of Nebraska Medical Center in Omaha, Neb.; Irl B. Hirsch of the University of Washington in Seattle, Wash.; Marie E. McDonnell of Brigham and Women’s Hospital and Harvard Medical School in Boston, Mass.; Robert Rushakoff of the University of California in San Francisco, Calif.; and Ranganath Muniyappa of the National Institutes of Health in Bethesda, Md.

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Story Source:
Materials provided by The Endocrine Society. Note: Content may be edited for style and length.

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Journal Reference:

1. Ranganath Muniyappa, Robert Rushakoff, Marie E McDonnell, Irl B Hirsch, Andjela Drincic, Kellie Antinori-Lent, Mary Korytkowski. A Pragmatic Approach to Inpatient Diabetes Management during the COVID-19 Pandemic. The Journal of Clinical Endocrinology & Metabolism, 2020; DOI: 10.1210/clinem/dgaa342

https://www.sciencedaily.com/releases/2020/06/200605121518.htm

Ketamine effect on serotonin1B receptor binding in SSRI-resistant depression

Abstract

The glutamate N-methyl-d-aspartate receptor antagonist ketamine has a rapid antidepressant effect. Despite large research efforts, ketamine’s mechanism of action in major depressive disorder (MDD) has still not been determined. In rodents, the antidepressant properties of ketamine were found to be dependent on both the α-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) and the serotonin (5-HT)_1B receptor. Low 5-HT_1B receptor binding in limbic brain regions is a replicated finding in MDD. In non-human primates, AMPA-dependent increase in 5-HT_1B receptor binding in the ventral striatum (VST) has been demonstrated after ketamine infusion. Thirty selective serotonin reuptake inhibitor-resistant MDD patients were recruited via advertisement and randomized to double-blind monotherapy with 0.5 mg/kg ketamine or placebo infusion. The patients were examined with the 5-HT_1B receptor selective radioligand [¹¹C]AZ10419369 and positron emission tomography (PET) before and 24–72 h after treatment. 5-HT_1B receptor binding did not significantly alter in patients treated with ketamine compared with placebo. An increase in 5-HT_1B receptor binding with 16.7 % (p = 0.036) was found in the hippocampus after one ketamine treatment. 5-HT_1B receptor binding in VST at baseline correlated with MDD symptom ratings (r = −0.426, p = 0.019) and with reduction of depressive symptoms with ketamine (r = −0.644, p = 0.002). In conclusion, reduction of depressive symptoms in MDD patients after ketamine treatment is correlated inversely with baseline 5-HT_1B receptor binding in VST. Further studies examining the role of 5-HT_1B receptors in the antidepressant mechanism of action of ketamine should be conducted, homing in on the 5-HT_1B receptor as an MDD treatment response marker.
https://www.nature.com/articles/s41398-020-0844-4

Effect of Personality Traits on Risk of Incident Pre‐dementia Syndromes

Abstract

OBJECTIVES

Personality traits have been shown to be associated with the risk of dementia; less is known about their association with pre‐dementia syndromes. The aim of the present study was to examine the role of personality traits as predictors of incident pre‐dementia, motoric cognitive risk (MCR), and mild cognitive impairment (MCI) syndromes.

DESIGN

We prospectively examined the association between five personality traits (neuroticism, extraversion, conscientiousness, agreeableness, and openness) and the risk of incident MCR or MCI. MCR builds on MCI operational definitions, substituting the cognitive impairment criterion with slow gait, and it is associated with increased risk for both Alzheimer’s disease and vascular dementia.

SETTING

Community based.

PARTICIPANTS

Nondemented participants (n = 524; 62% women) aged 65 years and older.

MEASUREMENTS

Cox proportional hazard analysis, adjusted for demographics and disease burden, was used to evaluate the risk of each pre‐dementia syndrome based on baseline personality traits, measured using the Big Five Inventory.

RESULTS

Over a median follow‐up of 3 years, 38 participants developed incident MCR, and 69 developed incident MCI (41 non‐amnestic and 28 amnestic subtypes). Openness was associated with a reduced risk of developing incident MCR (adjusted hazard ratio [aHR] = .94; 95% confidence interval [CI] = .89‐.99), whereas neuroticism was associated with an increased risk of incident non‐amnestic MCI (aHR = 1.06; 95% CI = 1.01‐1.11). These associations remained significant even after considering the confounding effects of lifestyle or mood. None of the personality traits were associated with MCI overall or amnestic MCI.

CONCLUSION

These findings provide evidence of a distinct relationship between personality traits and development of specific pre‐dementia syndromes.

The five‐factor model (neuroticism, extraversion, openness, agreeableness, and conscientiousness) is widely used to describe and define aspects of personality.1 Longitudinal associations between personality traits with cognitive outcomes in older adults have been described, and they link neuroticism and conscientiousness to incident cognitive syndromes.2–7 However, results regarding effects of other personality traits on cognitive states are more mixed. Several studies have reported associations between lower levels of openness and increased risk for mild cognitive impairment (MCI)5 and Alzheimer’s disease,8 whereas others report no association.6 An association between lower agreeableness and increased risk for dementia was reported in one study3 but not in others.7 Extraversion was not associated with risk for MCI or dementia in previous studies.7 The mixed results reported for certain personality traits may be due to the relationship between certain personality traits and specific cognitive domains.9 The association between personality traits and motoric cognitive risk (MCR) syndrome10 was recently examined.11 MCR builds on the operational definition of MCI, substituting the objective cognitive criterion assessed through neuropsychological testing with slow gait, increasing clinical accessibility.10, 12 MCR is common in older adults and predictive of dementia.10, 12 Only partial overlap between individuals diagnosed with MCR and MCI syndromes was reported,10, 12 indicating that risk factors and cognitive trajectories for these syndromes may vary. Stephan et al identified cross‐sectional associations of prevalent MCR with lower openness, extraversion, and conscientiousness as well as higher neuroticism in two large aging cohorts.11
This prospective study builds on previous research to examine whether the five major personality traits1 are associated with risk of incident pre‐dementia syndromes, MCR and MCI syndromes, as well as MCI subtypes (amnestic and non‐amnestic MCI). We hypothesized that higher levels of openness and conscientiousness would be associated with a lower risk of MCR and MCI, and higher levels of neuroticism would be associated with an increased risk of MCI and MCR. We did not expect to find a relationship between agreeableness with either pre‐dementia syndrome, and we expected to find a relationship between extraversion and MCR alone.

METHODS

Participants

We studied community‐residing adults age 65 years and older enrolled in the Central Control of Mobility in Aging (CCMA) study. The primary goal of CCMA is to determine cognitive control of mobility.13, 14 CCMA procedures have been reported.13, 14 In brief, potential participants were identified from a Westchester County registered voter list that included individuals aged 65 years and older who voted in local or national elections in the past 2 years. They were first contacted by mail and then by telephone inviting them to participate. Potential participants were assessed for eligibility using a structured telephone screening interview and to rule out dementia using cognitive screeners.13, 14 Exclusion criteria included inability to speak English, inability to ambulate independently, presence of dementia (previous physician diagnosis or using cut scores on the validated cognitive screeners15, 16), significant loss of vision and/or hearing, current or history of neurologic or psychiatric disorders, recent or anticipated medical procedures that may affect mobility, and receiving hemodialysis.
Eligible individuals were scheduled for in‐person visits at the research center. During study visits, participants received comprehensive cognitive, psychological, and mobility assessments. Neuropsychological tests were administered by research assistants under the supervision of a licensed neuropsychologist and included a test of general cognitive function, Repeatable Battery for the Assessment of Neuropsychological Status (RBANS),17 as well as tests to assess various cognitive domains including the Digit Symbol Substitution Test (subtest of Wechsler Adult Intelligence Scale‐Third Edition),18 the Trail Making Test,19 Free and Cued Selective Reminding Test,20 Controlled Oral Word Association Test‐Semantic and Phonemic Fluency,21 and Boston Naming Test.22 Diagnosis of dementia was assigned according to the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM‐IV )23 at consensus diagnostic case conferences, as previously described.24 CCMA participants were followed longitudinally at yearly intervals. The study protocols were approved by the Albert Einstein College of Medicine institutional review board, and written informed consent was obtained at study visits.

The Big Five Inventory

The Big Five Inventory (BFI) is a 44‐item self‐report measure designed to assess five dimensions of personality25 (neuroticism, extraversion, conscientiousness, agreeableness, and openness).1 Participants were asked by trained research assistants to rate the extent to which they agreed or disagreed with each item using a 5‐point Likert scale where 1 = “Disagree strongly” and 5 = “Agree strongly.” Scores range from 0 to 40 for each of the five personality traits. The scale was shown to have good validity and reliability (α = .83) in previous studies.26

Pre‐Dementia Syndrome Diagnoses

MCI and MCR diagnostic procedures in CCMA were reported,12, 24, 27 based on published guidelines.28 In brief, nondemented participants with subjective cognitive complaints but without a dementia diagnosis or functional limitations were classified as amnestic MCI if they had impairments on tests of the memory domain or non‐amnestic MCI if they had impairments on tests of nonmemory domains. Impairment was defined as 1.5 standard deviations (SDs) below age‐ and education‐adjusted norms on relevant cognitive tests. MCI was diagnosed at consensus case conferences attended by study clinicians and neuropsychologists using DSM‐IV criteria.23
MCR syndrome is defined as the presence of subjective cognitive complaints and slow gait speed in older individuals without dementia or mobility disability.10, 12, 29 Subjective cognitive complaints were assessed by a score of 1 or higher on the AD8‐dementia screener15 or a “yes” response to the memory item on the Geriatric Depression Scale (GDS) (“Do you feel that you have more problems with memory than most?”).30 Gait speed at “normal pace” was measured on a computerized walkway (180 × 35.5 × .25 inches) with embedded pressure sensors (GAITRite; CIR Systems, Franklin, NJ).31 From footfalls recorded on the walkway, the software computes gait parameters including gait speed (cm/s). GAITRite is widely used and has excellent reliability.31 Slow gait was defined as walking speed 1 SD or more below age‐ and sex‐specific means.10, 12, 29
https://onlinelibrary.wiley.com/doi/full/10.1111/jgs.16424

Impact of children’s loneliness today may manifest in depression for years to come

Children and adolescents are likely to experience high rates of depression and anxiety long after current lockdown and social isolation ends and clinical services need to be prepared for a future spike in demand, according to the authors of a new rapid review into the long-term mental health effects of lockdown.

The research, which draws on over 60 pre-existing, peer-reviewed studies into topics spanning isolation, loneliness and mental health for young people aged 4 — 21, is published today (Monday 1 June 2020) in the Journal of the American Academy of Child and Adolescent Psychiatry.
According to the review, young people who are lonely might be as much as three times more likely to develop depression in the future, and that the impact of loneliness on mental health could last for at least 9 years.
The studies highlight an association between loneliness and an increased risk of mental health problems for young people. There is also evidence that duration of loneliness may be more important than the intensity of loneliness in increasing the risk of future depression among young people.
This, say the authors, should act as a warning to policymakers of the expected rise in demand for mental health services from young people and young adults in the years to come — both here in the UK and around the world.
Dr Maria Loades, clinical psychologist from the Department of Psychology at the University of Bath who led the work, explained: “From our analysis, it is clear there are strong associations between loneliness and depression in young people, both in the immediate and the longer-term. We know this effect can sometimes be lagged, meaning it can take up to 10 years to really understand the scale of the mental health impact the covid-19 crisis has created.”
For teachers and policymakers currently preparing for a phased re-start of schools in the UK, scheduled from today, Monday 1 June, Dr Loades suggests the research could have important implications for how this process is managed too.
She adds: “There is evidence that it’s the duration of loneliness as opposed to the intensity which seems to have the biggest impact on depression rates in young people. This means that returning to some degree of normality as soon as possible is of course important. However, how this process is managed matters when it comes to shaping young people’s feelings and experiences about this period.
“For our youngest and their return to school from this week, we need to prioritise the importance of play in helping them to reconnect with friends and adjust following this intense period of isolation.”
Members of the review team were also involved in a recent open letter to UK Education Secretary, Gavin Williamson MP, focusing on support for children’s social and emotional wellbeing during and after lockdown. In their letter they suggested that:
– The easing of lockdown restrictions should be done in a way that provides all children with the time and opportunity to play with peers, in and outside of school, and even while social distancing measures remain in place;
– Schools should be appropriately resourced and given clear guidance on how to support children’s emotional wellbeing during the transition period as schools reopen and that play — rather than academic progress — should be the priority during this time;
– The social and emotional benefits of play and interaction with peers must be clearly communicated, alongside guidance on the objective risks to children.
Acknowledging the trade-offs that need to be struck in terms of restarting the economy and reducing educational disparities, their letter to the Education Secretary concludes: ‘Poor emotional health in children leads to long term mental health problems, poorer educational attainment and has a considerable economic burden.’

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Story Source:
Materials provided by University of Bath. Note: Content may be edited for style and length.

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Journal Reference:

1. M. Loades et al. Rapid Systematic Review: The impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19. Journal of the American Academy of Child and Adolescent Psychiatry, 2020 DOI: 10.1016/j.jaac.2020.05.009

https://www.sciencedaily.com/releases/2020/05/200531200333.htm

Google adds anxiety self-assessment to search

Google is partnering with grassroots organization the National Alliance on Mental Illness to provide access to more mental health resources, including a clinically validated anxiety self-assessment, according to a release on Thursday.

Starting on Thursday, when Google users in the US search for information about anxiety, they will be directed to the self-assessment in Google’s knowledge panel, the box of key facts and information at the top of the search results. Medically validated information about symptoms and common treatments of anxiety will also appear in the box.

The assessment is called the Generalized Anxiety Disorder-7, GAD-7, and will ask seven questions that health care professionals may ask when screening for anxiety. The assessment will also provide access to resources developed by NAMI.
“Anxiety disorders affect 48 million adults in the U.S. Anxiety presents itself as a wide range of symptoms and can be a result of biological factors or triggered by a change in environment or exposure to a stressful event,” said Daniel H. Gillison Jr., CEO of NAMI, in a release. “With COVID-19 introducing new points of stress, communities are seeing a rise in mental health issues and needs.”

New data released by the Census Bureau last week revealed that a third of Americans are showing signs of clinical anxiety or depression.
The anxiety self-assessment is the third mental health screen available on Google Search. NAMI has previous partners with Google to provide clinically validated questionnaires and resources for depression and PTSD.
Google says that it does not collect or share answers of results from the questionnaires to ensure results will be private and secure.
https://www.cnet.com/health/google-adds-anxiety-self-assessment-to-search/