Dr Sarah Hiles
School of Nursing and Midwifery
- Phone:(02) 4042 0060
Sarah Hiles is a Postdoctoral Research Associate in the Faculty of Health. Her research focus is on psychosomatic medicine: the intersection between mental and physical health. Sarah's research career to date has focused primarily on relationships between depression, inflammatory biomarkers and cardiometabolic risk factors. Most recently, she has taken a new direction, starting to work on projects in severe asthma.
Sarah is a former EU Marie Sklodowska-Curie Research Fellow and an Australian Endeavour Research Fellow. She spent her fellowships working in a premier psychiatric epidemiology research group at VU University Medical Centre in Amsterdam, The Netherlands.
Sarah was awarded her PhD in 2014 at the University of Newcastle, under the supervision of Professors Amanda Baker and John Attia. Her thesis explored the epidemiological evidence for the inflammatory hypothesis of depression.
- Doctor of Philosophy, University of Newcastle
- Bachelor of Psychology, University of Newcastle
- Cohort study
- Inflammatory biomarkers
- Risk factors
Fields of Research
|Title||Organisation / Department|
|Research Associate||University of Newcastle
School of Nursing and Midwifery
|Dates||Title||Organisation / Department|
|1/02/2017 - 30/06/2017||Research Associate||School of Medicine & Public Health, Faculty of Health & Medicine, University of Newcastle | Australia
Young Investigator Scholar
American Psychosomatic Society
Best Research Higher Degree Publication
Faculty of Health, University of Newcastle
|Year||Title / Rationale|
|2016||The interplay between biological stress and cellular aging. An epidemiological perspective|
For publications that are currently unpublished or in-press, details are shown in italics.
Chapter (1 outputs)
Baker A, Hiles S, Thornton L, Searl A, Kelly P, Kay-Lambkin F, 'From Comorbidity to Multiple Health Behaviour Change', Emerging Perspectives on Substance Misuse, Wiley, Oxford 152-169 (2013) [B1]
Journal article (15 outputs)
Hiles SA, Lamers F, Milaneschi Y, Penninx BWJH, 'Sit, step, sweat: Longitudinal associations between physical activity patterns, anxiety and depression', Psychological Medicine, 47 1466-1477 (2017)
Â© Cambridge University Press 2017. Background Physical inactivity has been identified as a risk factor for depression and, less often, as a long-term consequence of depression. U... [more]
Â© Cambridge University Press 2017. Background Physical inactivity has been identified as a risk factor for depression and, less often, as a long-term consequence of depression. Underexplored is whether similar bi-directional longitudinal relationships are observed for anxiety disorders, particularly in relation to three distinct indicators of activity levels - sports participation, general physical activity and sedentary behavior. Method Participants were from the Netherlands Study of Depression and Anxiety (NESDA; N = 2932, 18-65 years old; 57% current anxiety or depressive disorder, 21% remitted disorder, 22% healthy controls). At baseline, 2, 4, and 6 years, participants completed a diagnostic interview and self-report questionnaires assessing psychopathology symptom severity, physical activity indicators, and sociodemographic and health covariates. Results Consistently across assessment waves, people with anxiety and/or depressive disorders had lower sports participation and general physical activity compared to healthy controls. Greater anxiety or depressive symptoms were associated with lower activity according to all three indicators. Over time, a diagnosis or greater symptom severity at one assessment was associated with poorer sports participation and general physical activity 2 years later. In the opposite direction, only low sports participation was associated with greater symptom severity and increased odds of disorder onset 2 years later. Stronger effects were observed for chronicity, with lower activity according to all indicators increasing the odds of disorder chronicity after 2 years. Conclusions Over time, there seems to a mutually reinforcing, bidirectional relationship between psychopathology and lower physical activity, particularly low sports participation. People with anxiety are as adversely affected as those with depression.
Clark VL, Gibson PG, Genn G, Hiles SA, Pavord ID, McDonald VM, 'Multidimensional assessment of severe asthma: A systematic review and meta-analysis', Respirology, 22 1262-1275 (2017)
Â© 2017 Asian Pacific Society of Respirology The management of severe asthma is complex. Multidimensional assessment (MDA) of specific traits has been proposed as an effective str... [more]
Â© 2017 Asian Pacific Society of Respirology The management of severe asthma is complex. Multidimensional assessment (MDA) of specific traits has been proposed as an effective strategy to manage severe asthma, although it is supported by few prospective studies. We aimed to systematically review the literature published on MDA in severe asthma, to identify the traits included in MDA and to determine the effect of MDA on asthma-related outcomes. We identified 26 studies and classified these based on study type (cohort/cross-sectional studies; experimental/outcome studies; and severe asthma disease registries). Study type determined the comprehensiveness of the assessment. Assessed traits were classified into three domains (airways, co-morbidities and risk factors). The airway domain had the largest number of traits assessed (mean Â± SD = 4.2 Â± 1.7) compared with co-morbidities (3.6 Â± 2.2) and risk factors (3.9 Â± 2.1). Bronchodilator reversibility and airflow limitation were assessed in 92% of studies, whereas airway inflammation was only assessed in 50%. Commonly assessed co-morbidities were psychological dysfunction, sinusitis (both 73%) and gastro-oesophageal reflux disease (GORD; 69%). Atopic and smoking statuses were the most commonly assessed risk factors (85% and 86%, respectively). There were six outcome studies, of which five concluded that MDA is effective at improving asthma-related outcomes. Among these studies, significantly more traits were assessed than treated. MDA studies have assessed a variety of different traits and have shown evidence of improved outcomes. This promising model of care requires more research to inform which traits should be assessed, which traits should be treated and what effect MDA has on patient outcomes.
Hu MX, Lamers F, Hiles SA, Penninx BWJH, de Geus EJC, 'Basal autonomic activity, stress reactivity, and increases in metabolic syndrome components over time', Psychoneuroendocrinology, 71 119-126 (2016)
Â© 2016 Elsevier Ltd. Context: Basal autonomic nervous system (ANS) functioning has been linked to the metabolic syndrome (MetS), but the role of ANS reactivity in response to str... [more]
Â© 2016 Elsevier Ltd. Context: Basal autonomic nervous system (ANS) functioning has been linked to the metabolic syndrome (MetS), but the role of ANS reactivity in response to stress remains unclear. Objective: To examine cross-sectionally and longitudinally to what extent ANS basal level and stress reactivity are related to MetS. Design: 2-year and 6-year data from a prospective cohort: the Netherlands Study of Depression and Anxiety. Setting: Participants were recruited from the general community, primary care, and mental health care organizations. Participants: 1922 respondents (mean age = 43.7 years). Main outcome measures: Indicators of ANS functioning were heart rate (HR), respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP). ANS stress reactivity was measured during a cognitively challenging stressor and a personal-emotional stressor. MetS components included triglycerides, high-density lipoprotein cholesterol, blood pressure, glucose and waist circumference. Results: Cross-sectional analyses indicated that higher basal HR, lower basal values of RSA and PEP, and higher RSA reactivity during cognitive challenge were related to less favorable values of almost all individual MetS components. Longitudinal analyses showed that higher basal HR and shorter basal PEP predicted 4-year increase in many MetS abnormalities. Higher RSA stress reactivity during cognitive challenge predicted 4-year increase in number of MetS components. Conclusion: Higher basal sympathetic, lower basal parasympathetic activity, and increased parasympathetic withdrawal during stress are associated with multiple MetS components, and higher basal sympathetic activity predicts an increase in metabolic abnormalities over time. These findings support a role for ANS dysregulation in the risk for MetS and, consequently, the development of cardiovascular disease .
Lai JS, Oldmeadow C, Hure AJ, McEvoy M, Hiles SA, Boyle M, Attia J, 'Inflammation mediates the association between fatty acid intake and depression in older men and women', Nutrition Research, 36 234-245 (2016) [C1]
Â© 2016 Elsevier Inc. Antioxidants and fatty acids are associated with depression and inflammation, and inflammation appears to predict depression risk; hence, the associations be... [more]
Â© 2016 Elsevier Inc. Antioxidants and fatty acids are associated with depression and inflammation, and inflammation appears to predict depression risk; hence, the associations between these nutrients and depression may be mediated by inflammation. We hypothesized that inflammatory markers interleukin (IL)-6 and C-reactive protein (CRP) mediate the associations between antioxidant and fatty acid intakes, and depression. Participants were from the Hunter Community Study, a longitudinal cohort of adults aged 55-85 years. Dietary intake was assessed using the Older Australian's Food Frequency Questionnaire. Fasting blood samples were drawn for analysis of nutrient and inflammatory biomarkers. Depressive symptoms were assessed using the 20-item Center for Epidemiologic Studies-Depression scale at baseline and at 5-year follow-up. Linear mixed models were used to investigate longitudinal associations between dietary intakes and depression, and mediation analyses were carried out to determine if IL-6 and/or CRP were the mediators. Analyses were conducted on men and women separately and adjusted for potential confounders. Fruit and monounsaturated fat intakes were negatively associated with depression, whereas total fat and saturated fat intakes were positively associated with depression in both sexes. Omega-3 polyunsaturated fat was inversely associated with depression in men only. IL-6 was a significant mediator of the association between fruits with low carotenoid content and depression in women. CRP significantly mediated the relationship between total fat, saturated fat, and monounsaturated fat intakes and depression in women, and saturated fat intake and depression in men. Our findings raise the possibility that the association between fatty acid intake and depression is partially mediated by inflammatory markers.
Hiles SA, Baker AL, de Malmanche T, McEvoy M, Boyle M, Attia J, 'Unhealthy lifestyle may increase later depression via inflammation in older women but not men', Journal of Psychiatric Research, 63 65-74 (2015) [C1]
Â© 2015 Elsevier Ltd. Depression and inflammatory markers have a reliable cross-sectional association although less is known about the prospective relationship. The current study ... [more]
Â© 2015 Elsevier Ltd. Depression and inflammatory markers have a reliable cross-sectional association although less is known about the prospective relationship. The current study investigated whether pro-inflammatory markers are prospectively associated with depression, and whether indicators of unhealthy lifestyle, physical health and psychosocial functioning may drive this association. Participants were drawn from the Hunter Community Study, a community-dwelling cohort of individuals aged 55-85 years (N=1410). Participants completed baseline physiological assessment, health-related questionnaires, and blood sampling for the analysis of inflammatory markers, C-reactive protein (CRP) and interleukin (IL)-6. Participants completed the same depressive symptom questionnaire again after 3.5-5.5 years. Depression outcomes at follow-up were analysed dichotomously using established scale cut-off scores and continuously as a "residual score", representing the variation in follow-up depressive symptoms not explained by baseline symptoms and age. Analyses were conducted on males and females separately. At baseline, indicators of unhealthy lifestyle, physical health and psychosocial functioning were associated with depressive symptoms and inflammatory markers. For males, there were no relationships between inflammatory markers and follow-up depression outcomes. In females, IL-6 was significantly associated with depression outcomes in univariate, but not multivariate analyses. However, IL-6 significantly mediated the association between the predictors of waist-to-hip ratio, smoking and psychological coping at baseline, and follow-up depression outcomes. The results support the inflammatory hypothesis of depression, although females may be more vulnerable to effects. The findings raise the possibility that unhealthy lifestyle and psychosocial stress may drive inflammation and subsequent depressive symptoms.
Hiles S, Bergen H, Hawton K, Lewin T, Whyte I, Carter G, 'General hospital-treated self-poisoning in England and Australia: Comparison of presentation rates, clinical characteristics and aftercare based on sentinel unit data', Journal of Psychosomatic Research, 78 356-362 (2015) [C1]
Â© 2015 Elsevier Inc. Objective: Hospital-treated deliberate self-poisoning (DSP) is common and the existing national monitoring systems are often deficient. Clinical Practice Gui... [more]
Â© 2015 Elsevier Inc. Objective: Hospital-treated deliberate self-poisoning (DSP) is common and the existing national monitoring systems are often deficient. Clinical Practice Guidelines (UK and Australia) recommend universal psychosocial assessment within the general hospital as standard care. We compared presentation rates, patient characteristics, psychosocial assessment and aftercare in UK and Australia. Methods: We used a cross sectional design, for a ten year study of all DSP presentations identified through sentinel units in Oxford, UK (n. = 3042) and Newcastle, Australia (n. = 3492). Results: Oxford had higher presentation rates for females (standardised rate ratio 2.4: CI 99% 1.9, 3.2) and males (SRR 2.5: CI 99% 1.7, 3.5). Female to male ratio was 1.6:1, 70% presented after-hours, 95% were admitted to a general hospital and co-ingestion of alcohol occurred in a substantial minority (Oxford 24%, Newcastle 32%). Paracetamol, minor tranquilisers and antidepressants were the commonest drug groups ingested, although the overall pattern differed. Psychosocial assessment rates were high (Oxford 80%, Newcastle 93%). Discharge referral for psychiatric inpatient admission (Oxford 8%, Newcastle 28%), discharge to home (Oxford 80%, Newcastle 70%) and absconding (Oxford 11%, Newcastle 2%) differed between the two units. Conclusions: Oxford has higher age-standardised rates of DSP than Newcastle, although many other characteristics of patients are similar. Services can provide a high level of assessment as recommended in clinical guidelines. There is some variation in after-care. Sentinel service monitoring routine care of DSP patients can provide valuable comparisons between countries.
Hiles SA, Baker AL, de Malmanche T, McEvoy M, Boyle M, Attia J, 'The role of inflammatory markers in explaining the association between depression and cardiovascular hospitalisations', Journal of Behavioral Medicine, 38 609-619 (2015) [C1]
Â© 2015, Springer Science+Business Media New York. This study investigated whether inflammation may explain the relationship between depression and incident cardiovascular hospita... [more]
Â© 2015, Springer Science+Business Media New York. This study investigated whether inflammation may explain the relationship between depression and incident cardiovascular hospitalisations. Participants (55Â¿85Â¿years) completed baseline depression and physical assessment. Those without self-reported cardiovascular events were followed prospectively for hospital admissions for angina, myocardial infarction and cerebral infarction (median 937Â¿days). Across 5140 person-years of risk (NÂ¿=Â¿1692), there were 47 incident cardiovascular hospitalisations (2.8Â¿%). Controlling for age and gender, interleukin (IL)-6, C-reactive protein (CRP), body mass index (BMI) and waist-to-hip ratio were associated with future cardiovascular events. Mediation analysis showed that CRP accounted for 8.1Â¿% and IL-6 10.9Â¿% of the effect of depression on cardiovascular events, and including the indirect effect in the model substantially reduced the direct relationship between depression and cardiovascular hospitalisations. BMI and waist-to-hip ratio accounted for indirect effects of 7.7 and 10.4Â¿%, respectively. Inflammatory markers partly explain the association between depression and cardiovascular events, although other shared factors also likely contribute.
Lai JS, Hiles S, Bisquera A, Hure AJ, McEvoy M, Attia J, 'A systematic review and meta-analysis of dietary patterns and depression in community-dwelling adults', AMERICAN JOURNAL OF CLINICAL NUTRITION, 99 181-197 (2014) [C1]
Handley TE, Hiles SA, Inder KJ, Kay-Lambkin FJ, Kelly BJ, Lewin TJ, et al., 'Predictors of Suicidal Ideation in Older People: A Decision Tree Analysis', AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY, 22 1325-1335 (2014) [C1]
Baker AL, Hiles SA, Thornton LK, Hides L, Lubman DI, 'A systematic review of psychological interventions for excessive alcohol consumption among people with psychotic disorders', Acta Psychiatrica Scandinavica, 126 243-255 (2012) [C1]
Hiles SA, Baker AL, De Malmanche T, Attia JR, 'Interleukin-6, C-reactive protein and interleukin-10 after antidepressant treatment in people with depression: A meta-analysis', Psychological Medicine, 42 2015-2026 (2012) [C1]
Baker AL, Thornton LK, Hiles SA, Hides L, Lubman DI, 'Psychological interventions for alcohol misuse among people with co-occurring depression or anxiety disorders: A systematic review', Journal of Affective Disorders, 139 217-229 (2012) [C1]
Hiles SA, Baker AL, De Malmanche T, Attia JR, 'A meta-analysis of differences in IL-6 and IL-10 between people with and without depression: Exploring the causes of heterogeneity', Brain, Behavior, and Immunity, 26 1180-1188 (2012) [C1]
Walker AK, Hiles SA, Sominsky Bar L, McLaughlin EA, Hodgson DM, 'Neonatal lipopolysaccharide exposure impairs sexual development and reproductive success in the Wistar rat', Brain, Behavior, and Immunity, 25 674-684 (2011) [C1]
|Show 12 more journal articles|
Grants and Funding
|Number of grants||4|
Click on a grant title below to expand the full details for that specific grant.
20152 grants / $213,140
Funding body: European Commission, European Union
|Funding body||European Commission, European Union|
Prof. Brenda WJH Penninx; Dr Sarah A Hiles
|Type Of Funding||International - Competitive|
Funding body: Australian Government Department of Education
|Funding body||Australian Government Department of Education|
Dr Sarah A Hiles
|Scheme||Endeavour Research Fellowship|
|Type Of Funding||Aust Competitive - Commonwealth|
20131 grants / $6,000
Funding body: Hunter Medical Research Institute
|Funding body||Hunter Medical Research Institute|
|Project Team||Doctor Sarah Hiles|
|Type Of Funding||Contract - Aust Non Government|
20101 grants / $21,000
A longitudinal investigation of the temporal relationships between depression and immune functioning in an older Hunter cohort$21,000
Funding body: John Hunter Charitable Trust Grant
|Funding body||John Hunter Charitable Trust Grant|
Dr Sarah A Hiles, Prof Amanda Baker, Dr Michael J Boyle, Dr Theo De Malmanche, Prof Brian Kelly, Prof John Attia
|Scheme||John Hunter Charitable Trust Grant|
|Type Of Funding||External|