Advancing the diagnosis of major depressive disorder: Integrating neuroimaging and machine learning

Major depressive disorder (MDD), a psychiatric disorder characterized by functional brain deficits, poses considerable diagnostic and treatment challenges, especially in adolescents owing to varying clinical presentations. Biomarkers hold substantial clinical potential in the field of mental health, enabling objective assessments of physiological and pathological states, facilitating early diagnosis, and enhancing clinical decision-making and patient outcomes. Recent breakthroughs combine neuroimaging with machine learning (ML) to distinguish brain activity patterns between MDD patients and healthy controls, paving the way for diagnostic support and personalized treatment. However, the accuracy of the results depends on the selection of neuroimaging features and algorithms. Ensuring privacy protection, ML model accuracy, and fostering trust are essential steps prior to clinical implementation. Future research should prioritize the establishment of comprehensive legal frameworks and regulatory mechanisms for using ML in MDD diagnosis while safeguarding patient privacy and rights. By doing so, we can advance accuracy and personalized care for MDD.

Repetitive transcranial magnetic stimulation guided by event-related potential P300 application in schizophrenia

BACKGROUND

Repetitive transcranial magnetic stimulation (rTMS) entered clinical practice in China after 2000, first used in psychiatric surgery, and then in neurology and other disciplines. The First Hospital of Jiaxing introduced TMS in 2015. In practical applications, it has been found that different models of instruments and technical parameters can lead to differences in therapeutic efficacy. Therefore, our hospital selected the Danish TMS instrument, which ranks second in China, to test patients with schizophrenia from March 2021 to July 2021, with a focus on comparing the results at 5 Hz, 10 Hz, and 15 Hz. The testing time is concentrated between 8:30 to 10:30 in the morning. A contingency plan was made for the quality after inspection before testing. Two evaluators independently control the quality of the contingency plan. The data is independently saved and proofread by two evaluators. The purpose of this study is to translate the research results into clinical practice and provide reference basis.

AIM

To investigate the effects of rehabilitation therapy using rTMS on the negative symptoms and event-related potential component of P300 in chronic schizophrenia.

METHODS

One hundred and five patients with chronic schizophrenia were randomly allocated to three groups based on the frequency of rTMS (5, 10, or 15 Hz). The patients underwent five sessions of rTMS per week for 5 weeks. We compared the pre- and post-treatment P300 latency and scores for the Scale for Assessment of Negative Symptoms (SANS).

RESULTS

A significant decrease in SANS score after rTMS was observed in the 10-Hz group (P < 0.05), which was not observed in the 5-Hz and 15-Hz groups. There was a significant increase in P300 amplitude in the 10-Hz group after rTMS treatment (P < 0.05), but there was no significant change in P300 latency (P > 0.05). The improvement of SANS score in the 10-Hz rTMS group was related to patient age and disease course.

CONCLUSION

rTMS at 10 Hz improved negative symptoms and cognitive function in chronic schizophrenia; however, further studies on the mechanism of action are required to validate our observations.

Effects of ADIET communication and delivery rehearsal on anxiety, labor process, and outcomes in vaginal trial delivery

BACKGROUND

In recent years, the obstetrics department has advocated vaginal delivery to reduce the rate of cesarean sections. However, in clinical practice, pregnant women are prone to anxiety before childbirth, making it difficult to perform a vaginal trial delivery smoothly. The combined approach of ADIET communication and delivery rehearsal for vaginal trial delivery can provide a reference for reducing prenatal anxiety, shortening labor duration, facilitating a smooth delivery, and ensuring the safety of both mothers and babies.

AIM

To analyze the effect of AIDET communication combined with labor rehearsal on vaginal trial delivery.

METHODS

A study conducted between January 2023 and December 2023 included 200 vaginal trials. Women were randomly assigned to an observation group (100 women), which received ADIET communication plus delivery intervention, and a control group (100 women), which received routine communication plus delivery intervention. This study aimed to compare antenatal anxiety status as measured using the Maternal Anxiety Scale, labor duration, delivery efficacy as assessed using the simplified Chinese version of the Childbirth Self-Efficacy Inventory, and delivery outcomes.

RESULTS

After the intervention, the observation group had a lower Maternal Anxiety Scale score and higher Childbirth Self-Efficacy Inventory score (P < 0.05) than the control group (P < 0.05), whereas the observation group had higher natural delivery, cesarean delivery, vaginal delivery, and neonatal asphyxia rates (P < 0.05).

CONCLUSION

For women undergoing vaginal trial delivery, a combination of AIDET communication and delivery rehearsal can relieve prenatal anxiety, enhance delivery efficiency, shorten labor duration, and somewhat improve delivery outcomes.

Retraction note to: Shugan Jieyu capsule effects on peripheral blood micro-124, micro-132, and brain-derived neurotrophic factor in patients with mild to moderate depression

[This retracts the article on p. 1354 in vol. 14, PMID: 39319232.].

Work-family behavioral role conflict and daytime sleepiness on suicide risk among Chinese nurses: A cross-sectional study

BACKGROUND

Work-family conflicts and daytime sleepiness are related to the risk of suicide. At present, no study has investigated the relationship between nurses' work-family behavioral role conflict and suicide risk. Moreover, it has not been confirmed whether, considering the effect of daytime sleepiness on suicide risk, daytime sleepiness mediates the effect of work-family behavioral role conflict and suicide risk.

AIM

To explore the pathway relationships among nurses' work-family behavioral role conflict, daytime sleepiness, and suicide risk.

METHODS

Convenience and purposive sampling methods were used to select 750 nurses from six provinces, including Jiangxi, Sichuan, and Shanxi. The work-family behavioral role conflict scale, the Chinese adult daytime sleepiness scale, and the suicide behavior questionnaire were used for the survey. The data were statistically analyzed via SPSS 25.0 software, Pearson correlation analysis was used to explore the correlations between the variables, the PROCESS 4.0 program was used for the mediation effect analysis, and the mediation effect model was tested via the bootstrap method.

RESULTS

Nurses' work-family behavioral role conflict and daytime sleepiness were positively correlated with suicide risk (r = 734, 0.717). Work-family behavioral role conflict positively predicted suicide risk (β = 0.118), and daytime sleepiness positively predicted suicide risk (β = 0.152). Daytime sleepiness partially mediated the role of nurses' work-family behavioral role conflict and suicide risk, with a mediation effect value of 0.046 and a mediation effect accounting for 38.98%.

CONCLUSION

The results of the Pearson correlation analysis and mediation effect analysis revealed that nurses' work-family behavioral role conflict has a direct effect on suicide risk and indirectly affects suicide risk through daytime drowsiness symptoms.

Evaluating the impact of virtual reality on reducing restrictive practices in psychiatric wards

This manuscript critically evaluates the randomized controlled trial (RCT) conducted by Phiri et al, which assessed the effectiveness of virtual reality (VR) training for psychiatric staff in reducing restrictive practices (RPs). Specifically, this RCT investigated the impact of VR on the handling of aggressive patients by psychiatric staff compared to traditional training methods. Despite significant reductions in perceived discrimination in the VR group, there were no major improvements in self-efficacy or anxiety levels. The system usability scale rated the VR platform highly, but it did not consistently outperform traditional training methods. Indeed, the study shows the potential for VR to reduce RPs, although fluctuations in RP rates suggest that external factors, such as staff turnover, influenced the outcomes. This manuscript evaluates the study's methodology, results, and broader implications for mental health training. Additionally, it highlights the need for more comprehensive research to establish VR as a standard tool for psychiatric staff education, focusing on patient care outcomes and real-world applicability. Finally, this study explores future research directions, technological improvements, and the potential impact of policies that could enhance the integration of VR in clinical training.

Refining smart healthcare care for mental health and substance use disorders: A patient-centred, evidence-based approach

In this article, we comment on the article by Zhang et al, which explores the familiarity, awareness, and usage of smart medical care and its correlation with mental health and personality traits. The use of intelligent healthcare technologies in treating mental disorders and substance use disorders shows significant promise, but involves certain challenges, such as limited access, low technological literacy, and privacy concerns. These barriers disproportionately affect deprived populations and individuals with severe mental health conditions. We highlight the positive impact of smart healthcare solutions, such as telemedicine and wearable technologies, on patient engagement, remote monitoring, and treatment adherence. To overcome these challenges, we propose strategies, such as improving user-friendliness, ensuring equitable access to digital interventions, enhancing cybersecurity, and integrating smart healthcare into clinical workflows. Training healthcare providers and developing policies to ensure the ethical use of patient data are essential. When implemented thoughtfully, smart healthcare technologies can revolutionize mental health and substance use disorder treatment, improve patient outcomes, and reduce healthcare inequities.

Cerebral hemodynamic characteristics of patients with auditory verbal hallucinations and the construction of nomogram models

BACKGROUND

The characteristics of cerebral hemodynamic indexes of patients with different types of auditory verbal hallucinations (AVHs) was not clear.

AIM

To explore the characteristics of cerebral hemodynamic indexes of patients with different types of AVHs and construct the risk nomogram prediction model of patients with different types of AVHs.

METHODS

Patients with different types of verbal hallucinations who visited Wenzhou Seventh People’s Hospital were retrospectively selected from March 2021 to March 2023, and these patients were classified into 117 cases of schizophrenia (SCZ) with AVHs, 108 cases of post-traumatic stress disorder (PTSD) with AVHs, and 105 cases of recurrent depressive disorder with AVHs according to type. Transcranial doppler was performed to measure the hemodynamic parameters of the anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA), basilar artery (BA) and vertebral artery (VA). Logistic regression modelling was used to explore the factors affecting patients with different types of AVHs and odds ratio, 95% confidence interval (CI). A clinical prediction model was constructed, and the efficacy of the clinical prediction model was evaluated by using receiver operating characteristic, Hosmer-Lemeshow Goodness-of-Fit test, calibration curves and decision curve analysis.

RESULTS

The differences between the three groups of patients in mean velocity (Vm)-MCA, end-diastolic velocity (Vd)-MCA, Vm-ACA, pulsatility index (PI)-ACA, Vm-PCA, peak systolic velocity (Vs)-PCA, Vd-PCA, Vm-BA, Vs-BA, Vd-BA, PI-BA, resistance index (RI)-BA, Vm-VA, Vs-VA, Vd-VA, PI-VA, and RI-VA indexes were statistically significant. Rising Vm-ACA is an independent risk factor for SCZ with AVHs, and falling Vm-VA, Vd-MCA, and Vd-VA are independent risk factors for SCZ with AVHs. Rising Vm-ACA, Vm-PCA, Vs-PCA, Vd-PCA, Vm-BA, and Vs-BA are independent risk factors for PTSD with AVHs, and Vm-MCA, Vs-MCA, Vd-MCA, PI-PCA, and RI-BA are independent protective factors for PTSD with AVHs. Elevated Vm-MCA, Vd-MCA, RI-BA, Vm-VA, and Vd-VA were independent risk factors, and elevated Vm-ACA, Vs-ACA, Vm-PCA, Vs-PCA, and Vd-PCA were independent protective factors. The areas under the curve of the three models were 0.82 (95%CI: 0.76-0.87), 0.88 (95%CI: 0.83-0.92), and 0.81 (95%CI: 0.77-0.86), respectively; the Hosmer-Lemeshow Goodness-of-Fit test of the calibration curves of the three models suggests that P > 0.05.

CONCLUSION

Monitoring the cerebral hemodynamic indexes of patients with AVHs is of practical significance in determining the type of mental disorder, which helps clinicians identify the type of AVHs and adopt more efficient treatment strategies to help patients recover.

Central obesity and post-stroke depression: Implications for stroke recovery

Post-stroke depression (PSD) is a prevalent but often underdiagnosed complication affecting stroke survivors, with significant implications for recovery and quality of life. Emerging evidence suggests that central obesity, as measured by the weight-to-waist index (WWI), may play a crucial role in PSD risk and severity. Traditional obesity metrics, such as body mass index, may not accurately capture the impact of visceral fat distribution on neuropsychiatric outcomes. This letter highlights the growing recognition of WWI as a precise indicator of metabolic and inflammatory disturbances linked to post-stroke mental health. Integrating WWI into routine stroke rehabilitation assessments could facilitate early identification of high-risk patients and improve intervention strategies. Further research is needed to establish standardized WWI cutoff values and explore potential therapeutic targets for PSD prevention.

Adolescent non-suicidal self-injury: The moderating influence of social support utilization on depression

BACKGROUND

Adolescence is a period marked by physiological and psychological imbalances, which pose an increased risk for adolescents with major depressive disorder (MDD) to commit non-suicidal self-injury (NSSI).

AIM

To investigate the moderating role of social support utilization in depression and NSSI among adolescents with MDD.

METHODS

This cross-sectional study enrolled 314 adolescents with MDD (258 with NSSI, 56 without) from a Chinese tertiary psychiatric hospital (2021-2023). Participants completed validated scales, including the self-esteem scale, the Barratt impulsiveness scale, the self-rating depression scale, and the teenager social support rating scale. Logistic regression and hierarchical regression analyses were used to examine predictors of NSSI and the moderating effect of social support utilization.

RESULTS

Results showed that the NSSI group had higher depression levels, lower self-esteem, and greater impulsivity. While overall social support was higher in the NSSI group, social support utilization significantly moderated the depression-NSSI relationship. Specifically, higher utilization levels weakened the association between depression and NSSI (β = -0.001, P < 0.05).

CONCLUSION

These findings suggest that effective utilization of social support, rather than its mere presence, is crucial in reducing NSSI risk among depressed adolescents.

Efficacy of electroconvulsive therapy in treating auditory verbal hallucinations in a deaf patient with schizophrenia: A case report

BACKGROUND

Auditory verbal hallucinations (AVHs) are believed to be characteristic symptoms of schizophrenia. The prevalence of AVHs in deaf patients with schizophrenia is comparable to that in patients with schizophrenia who have normal hearing ability. AVHs in deaf patients with schizophrenia require treatment.

CASE SUMMARY

A 22-year-old deaf woman with schizophrenia had experienced AVHs for 3 months. Her psychotic symptoms were not alleviated by antipsychotic medication alone. Modified electroconvulsive therapy in combination with antipsychotic drugs effectively alleviated her AVHs and disorganized behavior. During outpatient follow-up for 6 months, her condition have remained stable, and she has been able to take care of herself.

CONCLUSION

Treatment with modified electroconvulsive therapy was found to be safe and might be indicated for deaf patients whose symptoms are not well managed with antipsychotic medication alone. Deaf people might be unable to communicate through spoken language; therefore, to make proper diagnoses and provide appropriate treatment for these patients, psychiatrists must have patience and seek to understand patients’ mental state.

Bidirectional link between mood disorders and diabetic retinopathy

The recently published article by Gao et al identifies risk factors for anxiety and depression in patients with diabetic retinopathy. We supplement that there is pathophysiological evidence to show a complex and possibly bidirectional relation between diabetes, diabetic retinopathy, and mood disorders, especially depression. Longitudinal studies may strengthen proof of a causal relationship between these diseases. A better understanding can help in the holistic management of these patients.

Investigation of contemporary college students' mental health status and construction of a risk prediction model

BACKGROUND

Due to academic pressure, social relations, and the change of adapting to independent life, college students are under high levels of pressure. Therefore, it is very important to study the mental health problems of college students. Developing a predictive model that can detect early warning signals of college students' mental health risks can help support early intervention and improve overall well-being.

AIM

To investigate college students' present psychological well-being, identify the contributing factors to its decline, and construct a predictive nomogram model.

METHODS

We analyzed the psychological health status of 40874 university students in selected universities in Hubei Province, China from March 1 to 15, 2022, using online questionnaires and random sampling. Factors influencing their mental health were also analyzed using the logistic regression approach, and R4.2.3 software was employed to develop a nomogram model for risk prediction.

RESULTS

We randomly selected 918 valid data and found that 11.3% of college students had psychological problems. The results of the general data survey showed that the mental health problems of doctoral students were more prominent than those of junior college students, and the mental health of students from rural areas was more likely to be abnormal than that of urban students. In addition, students who had experienced significant life events and divorced parents were more likely to have an abnormal status. The abnormal group exhibited significantly higher Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 scores than the healthy group, with these differences being statistically significant (P < 0.05). The nomogram prediction model drawn by multivariate analysis included six predictors: The place of origin, whether they were single children, whether there were significant life events, parents' marital status, regular exercise, intimate friends, and the PHQ-9 score. The training set demonstrated an area under the receiver operating characteristic (ROC) curve (AUC) of 0.972 [95% confidence interval (CI): 0.947-0.997], a specificity of 0.888 and a sensitivity of 0.972. Similarly, the validation set had a ROC AUC of 0.979 (95%CI: 0.955-1.000), with a specificity of 0.942 and a sensitivity of 0.939. The H-L deviation test result was χ2 = 32.476, P = 0.000007, suggesting that the model calibration was good.

CONCLUSION

In this study, nearly 11.3% of contemporary college students had psychological problems, the risk factors include students from rural areas, divorced parents, non-single children, infrequent exercise, and significant life events.

Harmonizing the mind and body: The interrelationship between traditional Chinese medicine body constitution, mental health and sleep quality

BACKGROUND

Traditional Chinese medicine (TCM) body constitution is a key factor in determining and influencing the occurrence, development, and variation of diseases. As the mind interact with the body, TCM body constitution is useful in preventing and treating psychiatric disorders and insomnia.

AIM

To investigate the interrelationship between TCM body constitution, psychiatric disorders and sleep quality.

METHODS

A total of 2441 participants were enrolled in our study. TCM body constitution was measured using the Constitution in Chinese Medicine Questionnaire, sleep quality was assessed using the Chinese version of the Pittsburgh Sleep Quality Index, and psychopathological symptoms were evaluated using Symptom Checklist-90. Logistic regression was used to estimate the interrelationship between TCM body constitution, psychiatric disorders and sleep quality.

RESULTS

The Pittsburgh Sleep Quality Index score and the proportions of participants with Qi-deficiency constitution, Qi-stagnation constitution, and blood-stasis constitution were significantly higher in the psychiatric symptoms group. Additionally, psychiatric symptoms were considerably associated with sleep quality, Qi-deficiency constitution, and Qi-stagnation constitution, but were inversely associated with male sex. Obsessive-compulsive symptoms were considerably associated with sleep quality, Qi-deficiency constitution and Qi-stagnation constitution. Depression was considerably associated with sleep quality, hyperuricemia, and Qi-stagnation constitution. Anxiety was considerably associated with sleep quality, diabetes, and Qi-stagnation constitution. Finally, poor sleep quality was considerably associated with Qi-deficiency constitution, Qi-stagnation constitution, dampness-heat constitution, phlegm-dampness constitution, and blood-stasis constitution but was inversely associated with male sex and body mass index > 23.9.

CONCLUSION

TCM body constitutions are strongly associated with psychiatric symptoms and sleep quality. Further research is needed to verify whether TCM body constitution can be used to treat and prevent psychiatric conditions as well as enhance sleep quality.

Unraveling the complexities of adolescent depression: A call for action

The adolescent years are a period of profound change, both physically and psychologically. For many, these years are marked by excitement and exploration, but for others, they are fraught with challenges that can lead to significant mental health issues. Depression, in particular, has become an increasingly prevalent concern among adolescents worldwide, and its multifaceted etiology requires a comprehensive approach to understanding and intervention. A recent study on the relationships among negative life events, dysfunctional attitudes, social support, and depressive symptoms in Chinese adolescents offers valuable insights into the complex interplay between various factors contributing to adolescent depression. The authors explore a moderated mediation model to better understand how these factors interact with and contribute to the onset of depression. This article aims to delve into the key findings of the study, highlight its implications for clinical practice, and encourage further research in this critical area.

Tanshinone IIA improves Alzheimer's disease via RNA nuclear-enriched abundant transcript 1/microRNA-291a-3p/member RAS oncogene family Rab22a axis

BACKGROUND

Alzheimer's disease (AD) is a neurodegenerative condition characterized by oxidative stress and neuroinflammation. Tanshinone IIA (Tan-IIA), a bioactive compound isolated from Salvia miltiorrhiza plants, has shown potential neuroprotective effects; however, the mechanisms underlying such a function remain unclear.

AIM

To investigate potential Tan-IIA neuroprotective effects in AD and to elucidate their underlying mechanisms.

METHODS

Hematoxylin and eosin staining was utilized to analyze structural brain tissue morphology. To assess changes in oxidative stress and neuroinflammation, we performed enzyme-linked immunosorbent assay and western blotting. Additionally, the effect of Tan-IIA on AD cell models was evaluated in vitro using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Genetic changes related to the long non-coding RNA (lncRNA) nuclear-enriched abundant transcript 1 (NEAT1)/microRNA (miRNA, miR)-291a-3p/member RAS oncogene family Rab22a axis were assessed through reverse transcription quantitative polymerase chain reaction.

RESULTS

In vivo, Tan-IIA treatment improved neuronal morphology and attenuated oxidative stress and neuroinflammation in the brain tissue of AD mice. In vitro experiments showed that Tan-IIA dose-dependently ameliorated the amyloid-beta 1-42-induced reduction of neural stem cell viability, apoptosis, oxidative stress, and neuroinflammation. In this process, the lncRNA NEAT1 - a potential therapeutic target - is highly expressed in AD mice and downregulated via Tan-IIA treatment. Mechanistically, NEAT1 promotes the transcription and translation of Rab22a via miR-291a-3p, which activates nuclear factor kappa-B (NF-κB) signaling, leading to activation of the pro-apoptotic B-cell lymphoma 2-associated X protein and inhibition of the anti-apoptotic B-cell lymphoma 2 protein, which exacerbates AD. Tan-IIA intervention effectively blocked this process by inhibiting the NEAT1/miR-291a-3p/Rab22a axis and NF-κB signaling.

CONCLUSION

This study demonstrates that Tan-IIA exerts neuroprotective effects in AD by modulating the NEAT1/miR-291a-3p/Rab22a/NF-κB signaling pathway, serving as a foundation for the development of innovative approaches for AD therapy.

Structural network communication differences in drug-naive depressed adolescents with non-suicidal self-injury and suicide attempts

BACKGROUND

Depression, non-suicidal self-injury (NSSI), and suicide attempts (SA) often co-occur during adolescence and are associated with long-term adverse health outcomes. Unfortunately, neural mechanisms underlying self-injury and SA are poorly understood in depressed adolescents but likely relate to the structural abnormalities in brain regions.

AIM

To investigate structural network communication within large-scale brain networks in adolescents with depression.

METHODS

We constructed five distinct network communication models to evaluate structural network efficiency at the whole-brain level in adolescents with depression. Diffusion magnetic resonance imaging data were acquired from 32 healthy controls and 85 depressed adolescents, including 17 depressed adolescents without SA or NSSI (major depressive disorder group), 27 depressed adolescents with NSSI but no SA (NSSI group), and 41 depressed adolescents with SA and NSSI (NSSI + SA group).

RESULTS

Significant differences in structural network communication were observed across the four groups, involving spatially widespread brain regions, particularly encompassing cortico-cortical connections (e.g., dorsal posterior cingulate gyrus and the right ventral posterior cingulate gyrus; connections based on precentral gyrus) and cortico-subcortical circuits (e.g., the nucleus accumbens-frontal circuit). In addition, we examined whether compromised communication efficiency was linked to clinical symptoms in the depressed adolescents. We observed significant correlations between network communication efficiencies and clinical scale scores derived from depressed adolescents with NSSI and SA.

CONCLUSION

This study provides evidence of structural network communication differences in depressed adolescents with NSSI and SA, highlighting impaired neuroanatomical communication efficiency as a potential contributor to their symptoms. These findings offer new insights into the pathophysiological mechanisms underlying the comorbidity of NSSI and SA in adolescent depression.

Analysis of influencing factors on the nutritional status of non-dialysis elderly patients with chronic kidney disease and depression

BACKGROUND

The assessment of nutritional status in non-dialysis elderly patients with chronic kidney disease (CKD) and comorbid depression is clinically important. Determining key determinants of nutritional status in this population significantly improves nutritional management strategies and assists these patients overcome the disease.

AIM

To investigate the factors influencing the nutritional status of non-dialysis elderly patients with CKD and comorbid depression.

METHODS

This study retrospectively collected the clinical data of 182 non-dialysis elderly patients with CKD and comorbid depression admitted at Tangdu Hospital, Air Force Medical University, from January 2022 to June 2023. The participants were categorized based on the presence of malnutrition into the nutritionally normal group (n = 97) and the malnutrition group (n = 85). The clinical data of the two groups were subjected to unifactorial and multifactorial regression to analyze the factors influencing malnutrition among the participants. Data included sex, age, body mass index (BMI), percentage body fat, basal metabolic rate (BMR), blood urea nitrogen (BUN), creatinine (Cr), albumin (Alb), hemoglobin (Hb), pre-albumin (PA), patient-generated subjective global assessment, and Patient Health Questionnaire-9 (PHQ-9) score to identify depressive symptoms. After admitting the patients to the hospital, 5 mL of peripheral serum was withdrawn, the centrifuge was operated at 3500 rpm/minute with a centrifugal radius of 10 cm for 10 minutes, serum was collected, and serum Alb, Hb, PA, BUN, and Cr levels were detected using a fully automatic biochemical analyzer. The results were assessed using Statistical Package for the Social Sciences version 21.0 for conducting technical analyses. Metric data are presented as the mean ± standard error of the mean and replaced using the t-test. Count data are expressed as case counts and percentages and were replaced using the χ² test. Effective factors were modeled using logistic return modeling.

RESULTS

BMI, BMR, and serum Alb, Hb, PA, and Cr levels were lower in the nutritionally normal group than in the malnutrition group. Furthermore, BUN levels, PHQ-9 scores, and the percentage of anxiety symptoms were greater in the nutritionally normal group than in the normal nutrition group, with statistically significant differences (P < 0.05). Multiple factorial interpretations revealed anxiety and serum Alb, Hb, and PA levels as factors influencing the nutritional status of non-dialysis elderly patients with CKD and depression (P < 0.05).

CONCLUSION

Serum Alb, Hb, PA levels, and anxiety symptoms are all factors influencing malnutrition in non-dialysis elderly patients with CKD and depression; hence, clinical interventions can be targeted to patients with the above characteristics.

Potential clinical benefits of probiotics, prebiotics, synbiotics, and postbiotics for depression via the microbiota-gut-brain axis

BACKGROUND

Depression is a common mental-health disorder worldwide. Several studies have demonstrated the effects of gut microbiota-targeting interventions, such as probiotics, prebiotics, synbiotics, and postbiotics (PPSP), on depression.

AIM

To assess the potential benefits of PPSP on patients diagnosed with depressive disorder.

METHODS

A literature search of the PubMed, Web of Science, and Elsevier Science Direct databases for relevant studies published from database inception to March 2024 was performed. Studies that used a randomized controlled trial design and evaluated differences in depression between PPSP and placebo were included. Depressive symptoms were assessed using a validated scale. Analysis was performed using Review Manager version 5.4 (The Cochrane Collaboration, 2020).

RESULTS

Fourteen studies comprising 906 patients with depressive symptoms were included. PPSP improved depression compared with placebo [SMD: -0.39 (95%CI: -0.60 to -0.17); P < 0.001]. PPSP resulted in significant reductions in Hamilton Depression Rating Scale [MD: -1.72 (95%CI: -2.57 to -0.88); P < 0.001] and Beck Depression Inventory [MD: -2.69 (95%CI: -4.67 to -0.71); P < 0.001] scores. Sub-analysis confirmed the antidepressant effects of probiotics on depressive symptoms [SMD: -0.32 (95%CI: -0.48 to -0.16); P < 0.001], with prebiotics exerting no apparent effect [SMD: -0.08 (95%CI: -0.39 to -0.23); P = 0.62], and synbiotics exerting statistically significant benefits [SMD: -1.09 (95%CI: -1.45 to -0.73); P < 0.001].

CONCLUSION

PPSP effectively alleviates depressive symptoms, and subgroup analysis supports the benefits of probiotics and synbiotics. Nevertheless, evidence supporting the use of PPSP for the treatment of depression remains insufficient.

Nutritional status of elderly hypertensive patients and its relation to the occurrence of cognitive impairment

BACKGROUND

Hypertension is a common chronic disease in the elderly population, and its association with cognitive impairment has been increasingly recognized. Cognitive impairment, including mild cognitive impairment and dementia, can significantly affect the quality of life and independence of elderly individuals. Therefore, identifying risk factors for cognitive impairment in elderly hypertensive patients is crucial for developing effective interventions and improving health outcomes. Nutritional status is one of the potential factors that may influence cognitive function in elderly hypertensive patients. Malnutrition or inadequate nutrition can lead to various health problems, including weakened immune system, increased susceptibility to infections, and impaired physical and mental function. Furthermore, poor nutritional status has been linked to increased risk of cognitive decline and dementia in various populations. In this observational study, we aimed to investigate the nutritional status of elderly hypertensive patients and its relationship to the occurrence of cognitive impairment. By collecting baseline data on general information, body composition, and clinical indicators, we hope to identify risk factors for cognitive impairment in this patient population. The results of this study are expected to provide more scientific basis for the health management of elderly patients with hypertension, particularly in terms of maintaining good nutritional status and reducing the risk of cognitive impairment.

AIM

To explore the differences between clinical data and cognitive function of elderly hypertensive patients with different nutritional status, analyze the internal relationship between nutritional statuses and cognitive impairment, and build a nomogram model for predicting nutritional status in elderly hypertensive patients.

METHODS

The present study retrospectively analyzed 200 elderly patients admitted to our hospital for a hypertension during the period July 1, 2024 to September 30, 2024 as study subjects, and the 200 patients were divided into a modeling cohort (140 patients) and a validation cohort (60 patients) according to the ratio of 7:3. The modeling cohort were divided into a malnutrition group (26 cases), a malnutrition risk group (42 cases), and a normal nutritional status group (72 cases) according to the patients' Mini-Nutritional Assessment Scale (MNA) scores, and the modeling cohort was divided into a hypertension combined with cognitive impairment group (34 cases) and a hypertension cognitively normal group (106 cases) according to the Montreal Cognitive Assessment Scale (MoCA) scores, and the validation cohort was divided into a hypertension combined with cognitive impairment group (14 cases) and hypertension cognitively normal group (46 cases). The study outcome was the occurrence of cognitive impairment in elderly hypertensive patients. Univariate and multivariate logistic regression was used to explore the relationship between the general information of the elderly hypertensive patients and the influence indicators and the occurrence of cognitive impairment, the roadmap prediction model was established and validated, the patient work receiver operating characteristic curve was used to evaluate the predictive efficacy of the model, the calibration curve was used to assess the consistency between the predicted events and the actual events, and the decision curve analysis was used to evaluate the validity of the model. Pearson correlation analysis was used to explore the relationship between nutrition-related indicators and MoCA scores.

RESULTS

In this research, the modeling cohort comprised 140 cases, while the verification cohort consisted of 60 cases, with no notable discrepancy in the data between the two groups. In the modeling cohort, there were significant differences in body mass index (BMI), albumin (ALB), hemoglobin (Hb) and homocysteine levels among the malnourished group, the malnourished risk group and the normal nutritional status group. The results of univariate and multivariate analysis showed that BMI [odds ratio (OR) = 0.830, P = 0.014], ALB (OR = 0.860, P = 0.028), Hb (OR = 0.939, P = 0.035) and MNA score (OR = 0.640, P = 0.000) were independent protective factors for patients without cognitive impairment, and alkaline phosphatase (ALP) (OR = 1.074, P = 0.000) was an independent risk factor for patients with cognitive impairment. In this study, the prediction nomogram tailored for cognitive deterioration in elderly patients with hypertension demonstrated robust predictive power and a close correspondence between predicted and observed outcomes. This model offers significant potential as a means to forestall cognitive decline in hypertensive elderly patients. ALP was negatively correlated with MoCA score, while BMI, MNA score, Hb and ALB were positively correlated with MoCA score.

CONCLUSION

BMI, MNA score, Hb and ALB were independent protective factors for cognitive impairment in elderly hypertensive patients and were positively correlated with MoCA score. ALP was an independent risk factor for cognitive impairment in elderly hypertensive patients and was negatively correlated with the MoCA score. The column line graph model established in the study has a good predictive value.

Comprehensive bibliometric analysis of transcranial magnetic stimulation-based depression treatment from 2003 to 2022: Research hotspots and trends

BACKGROUND

Depression has become a global public health problem. In recent years, transcranial magnetic stimulation (TMS) has gained considerable attention as a non-invasive treatment for depression.

AIM

To investigate the research hotspots and trends in the field of TMS-based depression treatment from a bibliometric perspective.

METHODS

Using the Web of Science Core Collection, articles published between 2003 and 2022 on TMS-based depression treatment were retrieved from the science citation index expanded. The publication trends and research hotspots were analyzed using VOSviewer, CiteSpace, and the bibliometric online analysis platform. Regression analysis was performed using Microsoft Excel 2021 to predict publication growth trends.

RESULTS

We identified a total of 702 articles on TMS-based depression treatment with a predominance of clinical studies. Analysis of collaborative networks showed that the United States, the University of Toronto, and Daskalakis ZJ were identified as the most impactful country, institution, and researcher, respectively. In keyword burst analysis, it was found that theta burst stimulation (TBS), functional connectivity, and frequency were the most recent research hotspots.

CONCLUSION

TMS provides a novel therapeutic option for patients with treatment-resistant depression. Neuroimaging technology enables more precise TMS treatment, while the novel TMS modality, TBS, enhances both therapeutic efficacy and patient experience in TMS-based depression treatment. The integration of neuroimaging techniques with TBS represents a promising research direction for advancing TMS-based depression treatment. This study presents systematic information and recommendations to guide future research on TMS-based depression treatment.

Perceptions of sex education among college students: A case study of a medical school

BACKGROUND

Sex education was introduced early in foreign countries. For example, there is a more systematic sex education system abroad, which can better achieve the popularization of sex education. China's sex education started relatively late, yet there are many problems in the development of sex education in China; for example, college students lack knowledge of sexuality.

AIM

To explore the perception of sex education among medical college students.

METHODS

Students majoring in medicine in a medical school were selected as the survey subjects. Anonymous online questionnaires were used to conduct the survey, and the results were analyzed using GraphPad Prism, SPSS, Microsoft Excel, and other software. The questionnaire was administered to understand the source of sexual knowledge, sexual responsibility, mastery of sexual knowledge, and distress caused by sexual problems.

RESULTS

Most students majoring in medicine had no formal sex education, lacked sexual knowledge, or had a biased understanding of sexual responsibility. This study analyzed future research trends in sex education based on relevant achievements in the Chinese context and abroad to further realize the practical significance and value of sex education popularization in China and provide recommendations for parents and schools at different levels.

CONCLUSION

Sex education should be conducted among college students, and medical colleges and universities should strengthen scientific sex education.

Self-compassion, automatic thoughts, and mental pain in depression: Mediating effects and clinical implications

BACKGROUND

Depression is a leading global health concern with high suicide rates and recurrence. Cognitive models suggest that mental pain and automatic thoughts are central to depression's impact. The hypothesis is that self-compassion will be negatively associated with mental pain, mediated by automatic thoughts.

AIM

To determine the mediating role of automatic thoughts in the relationship between self-compassion and mental pain in individuals with depression.

METHODS

This cross-sectional study included 389 inpatients with depression from Tianjin Anding Hospital. Participants completed the Self-Compassion Scale-Chinese Version (SCS-C), Automatic Thought Questionnaire (ATQ), and Orbach & Mikulincer Mental Pain Scale-Chinese Version (OMMP). Data were analyzed using Pearson correlations, multiple linear regressions, and mediation analysis.

RESULTS

The SCS-C total score was 68.95 ± 14.89, ATQ was 87.02 ± 28.91, and OMMP was 129.01 ± 36.74. Correlation analysis showed mental pain was positively associated with automatic thoughts (r = 0.802, P < 0.001) and negatively with self-compassion (r = -0.636, P < 0.001). Regression analysis indicated automatic thoughts (β = 0.623, P < 0.001) and self-compassion (β = -0.301, P < 0.001) significantly predicted mental pain. Mediation analysis confirmed automatic thoughts partially mediated the relationship between self-compassion and mental pain (ab = -0.269, 95%CI: -0.363 to -0.212).

CONCLUSION

Self-compassion is inversely related to mental pain in depression, with automatic thoughts playing a mediating role. These findings suggest potential therapeutic targets for alleviating mental pain in depressed patients.

Effects of cognitive combined with mindfulness-based stress reduction and sleep in patients with diabetes and endometrial cancer

BACKGROUND

Seek highly effective treatment measures for improving mood and sleep.

AIM

To explore the effects of mood and depression in patients with endometrial cancer after cognitive behavioral therapy (CBT) and mindfulness-based stress reduction.

METHODS

In a prospective study, 90 patients with diabetes, endometrial cancer, and depression were selected from January 2023 to January 2024 in our hospital. There were 45 patients in the control group and 45 patients in the observation group. In addition to the conventional treatment, the control group received cognitive behavioral treatment, and the observation group: Control group was given to compare changes in mood state and sleep quality before and after the intervention. Follow-up was performed3 months after treatment completion.

RESULTS

Before treatment, the mood and sleep quality scores between the two groups (P > 0.05); in the observation group, the 5 negative mood scores were lower and lower than the control group; the 2 positive mood scores were higher than in the control group, and the difference was statistically significant (P < 0.05); compared with before treatment, the 7 sleep quality scores and Pittsburgh sleep quality index scale total score in the observation group and lower in the control group (P < 0.05).

CONCLUSION

In patients with diabetes and endometrial cancer, mood state and sleep quality significantly improved after CBT and breathing relaxation. These findings provide new and effective treatment strategies in clinical practice.