Global prevalence of depression and elevated depressive symptoms among adolescents: A systematic review and meta-analysis

Impaired lipid homeostasis and elevated lipid oxidation of erythrocyte membrane in adolescent depression

Adolescent depression is a globally concerned mental health issue, the pathophysiological mechanisms of which remain elusive. Membrane lipids play a crucial role in brain development and function, potentially serving as a crossroad for the abnormalities in neurotransmitters, neuroendocrine, inflammation, oxidative stress, and energy metabolism observed in depressed adolescents. The primary aim of this study was to investigate the erythrocyte membrane lipid profile in adolescent depression. A total of 2838 erythrocyte membrane lipids were detected and quantified in 81 adolescents with depression and 67 matched healthy adolescents using ultra-high performance liquid chromatography-mass spectrometry. Depressed adolescents exhibited significantly different membrane lipid characteristics compared to healthy controls. Specifically, the levels of cholesterol, sphingomyelins, and ceramides were increased, while ether lipids were decreased in patients. Moreover, the patients showed reduced polyunsaturated fatty acids and elevated lipophilic index in membrane, suggesting diminished membrane fluidity. The higher oxidized membrane lipids and plasma malondialdehyde were observed in adolescent depression, indicating the presence of oxidative stress. Importantly, membrane lipid damage was associated with more severe depressive symptoms and worse cognitive function in patients. In addition, reduced polyunsaturated fatty acids and membrane fluidity may be partly responsible for the blunted niacin skin flushing response found in depressed adolescents. In conclusion, our results reveal impaired erythrocyte membrane lipid homeostasis in adolescents with depression, which may implicate membrane dysfunction in the brain. These findings offer new insights into the underlying molecular mechanisms of adolescent depression, highlighting the potential of counteracting membrane damage as a promising avenue for future therapeutic interventions.

Experiential Learning in Mental Health Diversion: Interdisciplinary Approaches Using Kolb's Learning Theory

PURPOSE

This study evaluated student responses to an interprofessional experiential learning opportunity (ELO) grounded in Kolb's Learning Theory.

MATERIALS AND METHODS

Students from several disciplines, including Social Work, Criminal Justice, Communication, and Teacher Education, were placed in various internship roles within the court system to provide interventions, services, and resources to low-level offenders and families as an alternative to criminal consequences. Qualitative data from student discussions and reflections was reviewed using a thematic approach. The research sought to find meaningful patterns that emerged and better understand student experiences and perspectives as they developed throughout the project.

RESULTS

Students who participated in this study demonstrated increased empathy, critical thinking, self-efficacy, and enhanced professional skills.

DISCUSSION

This project offered students a real-world experience to develop practical knowledge and skills for increasing mental health literacy and effectively serving those with mental health issues within the criminal justice system.

Four weeks standard vs. one week accelerated intermittent Theta Burst Stimulation for the treatment of depression - A retrospective analysis

INTRODUCTION

Intermittent Theta Burst Stimulation (iTBS), a specific form of repetitive transcranial magnetic stimulation (rTMS) is increasingly used for treating affective disorders. Accelerated iTBS protocols (aiTBS) with shorter treatment duration may lead to equal but faster response rates compared to standard protocols.

METHODS

Here, we retrospectively analyzed the records of 66 rTMS in- and out-patients with major depressive disorder in a tertiary care hospital between April 2023 and September 2023. All patients received left prefrontal iTBS with 1200 pulses, either one session/workday over 4 weeks (n = 34) or left prefrontal aiTBS on five sessions/workday for one week (n = 32). Depressive symptoms were assessed with the 21-item Hamilton Depression Rating Scale (HAMD-21) and the Major Depression Inventory (MDI) before and at the end of the respective treatment.

RESULTS

With both treatments, iTBS and aiTBS, the severity of depression improved significantly according to HAMD-21 and MDI. Response rates for iTBS were 38 % (HAMD-21) and 35 % (MDI), for aiTBS 19 % (HAMD-21) and 16 % (MDI), respectively. Remission rates showed a similar pattern. Effect sizes for group differences were small to medium. No serious adverse events occurred in any group. Tolerability was lower in aiTBS. Overall satisfaction was low for aiTBS on a qualitative and subjective level.

CONCLUSION

aiTBS with 1200 pulses and five daily sessions lead to amelioration of symptoms within one week. But benefit, satisfaction, tolerability was slightly lower in contrast to four weeks of iTBS. For everyday clinical practice, aiTBS protocols can be considered after weighing up the logistical disadvantages, such as possible longer waiting time for new patients that want to start a therapy with TMS. Future studies should explore the optimal dosage regime (number of sessions per day, number of pulses per session) for fast and effective symptom reduction.

The joint and interactive effects of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and body mass index on the risk of depression, as well as the mediating role of NHHR: results from NHANES 2005-2023

BACKGROUND

Various research in the past has indicated that the NHHR, which represents the ratio of non-high-density lipoprotein cholesterol (non-HDL-C) to high-density lipoprotein cholesterol (HDL-C), and body mass index (BMI) each act independently as contributors to depression risk. Nonetheless, studies exploring the combination of NHHR with BMI in relation to depression are limited. Consequently, the central aim of this study is investigating the joint and interactive effects of NHHR and BMI on depression risk, as well as the mediating role of NHHR.

METHODS

Encompassing participants aged 20 years or over, this research incorporated a total of 39,704 individuals from the National Health and Nutrition Examination Survey (NHANES), which covered the period of 2005 to 2023. To analyze the impact of NHHR and its combination with BMI on depression, our analytical approach included multivariate logistic regression, restricted cubic spline modeling, interaction testing and subgroup analyses. Additionally, we studied the joint effects of NHHR and BMI. Finally, we applied a four-way decomposition analysis method to examine the interactions and mediating effects within the aforementioned relationships.

RESULTS

Among all participants in this study, the prevalence of depressive disorder (Patient Health Questionnaire-9 score ≥ 10) was 9.2%. Both the NHHR and BMI were associated with depression, which remained significant even after full adjustment for covariates [NHHR, OR (95% CI): 1.07 (1.04-1.09); BMI, OR (95% CI): 1.02 (1.02-1.03)]. Compared with the reference group, the OR (95% CI) for the highest groups of NHHR, BMI, and their product term NHHR-BMI were 1.41 (1.24-1.61), 1.35 (1.18-1.54), and 1.59 (1.37-1.84), respectively. Participants with NHHR in the fourth quartile and BMI exceeding 30 kg/m², had higher depression risk compared to other participants with NHHR in the first quartile and BMI below 25 kg/m² [OR (95% CI): 1.64 (1.34-2.00)]. Results of the four-way decomposition analyses indicated that NHHR played a mediating role in the association between BMI and depression, with the mediating effect accounting for 17.6%. Similarly, NHHR also mediated 11.0% of the mediating effect between BMI and PHQ-9 score. However, no interaction between NHHR and BMI related to depression was found in the general population. After stratifying by gender, it was found that the mediated interaction between NHHR and BMI had a statistically significant effect on depression and PHQ-9 score in males.

CONCLUSIONS

Depression risk is linked to both NHHR and BMI, and NHHR has a significant mediating impact on the association between BMI and depression. Notably, there is a non-negligible mediated interaction effect between BMI and NHHR in male participants. Compared to considering NHHR or BMI individually, participants had a higher risk of depression when the combined terms of the two were in the higher quartiles. These findings suggest that the combined assessment of these two indicators may help deepen the understanding and evaluation of depression, enhance the accuracy of risk stratification, and is worthy of further research.

Co-occurring cyber and in-person victimisation of bullying and sexual harassment: the associations to depressive symptoms in Swedish adolescents

BACKGROUND

Poor mental health has increased among adolescents in recent decades. Bullying and sexual harassment, both cyber and in-person, are each associated with increased depressive symptoms in adolescents and being victimised by co-occurring types is more common than just one single type of victimisation. The study aimed to investigate the association between co-occurring victimisation and depressive symptoms in adolescents when controlling for screen time, social support, physical activity, and personal relative affluence.

METHOD

Cross-sectional survey data from 1211 respondents (50.1% girls) aged 15-16 were used to conduct modified Poisson regression with robust error variance analyses for girls and boys separately. Four scales were used to measure cyber and in-person bullying and sexual harassment, and CESD-R10 was used to measure depressive symptoms.

RESULTS

About 47% of girls and 20% of boys experienced all four types of victimisation, and about 12% of girls and 25% of boys experienced none of them. When controlled for all included variables, all number of victimisation types of bullying and/or sexual harassment were associated with depressive symptoms in girls. In comparison, only four types of victimisation were associated with depressive symptoms in boys.

CONCLUSIONS

The study showed that co-occurring victimisation was associated with depressive symptoms even after controlling for other relevant factors in both genders. However, in girls, all numbers of victimisation were associated with depressive symptoms.

A new method for identifying and evaluating depressive disorders in young people based on cognitive neurocomputing: an exploratory study

Background

Depressive disorders are one of the most common mental disorders among young people. However, there is still a lack of objective means to identify and evaluate young people with depressive disorders quickly. Cognitive impairment is one of the core characteristics of depressive disorders, which is of great value in the identification and evaluation of young people with depressive disorders.

Methods

This study proposes a new method for identifying and evaluating depressive disorders in young people based on cognitive neurocomputing. The method evaluates cognitive impairments such as reduced attention, executive dysfunction, and slowed information processing speed that may exist in the youth depressive disorder population through an independently designed digital evaluation paradigm. It also mines digital biomarkers that can effectively identify these cognitive impairments. A total of 50 young patients with depressive disorders and 47 healthy controls were included in this study to validate the method's identification and evaluation capability.

Results

The differences analysis results showed that the digital biomarkers of cognitive function on attention, executive function, and information processing speed extracted in this study were significantly different between young depressive disorder patients and healthy controls. Through stepwise regression analysis, four digital biomarkers of cognitive function were finally screened. The area under the curve for them to jointly distinguish patients with depressive disorders from healthy controls was 0.927.

Conclusion

This new method rapidly characterizes and quantifies cognitive impairment in young people with depressive disorders. It provides a new way for organizations, such as schools, to quickly identify and evaluate the population of young people with depressive disorders based on human-computer interaction.

A novel Adolescent Health Behavior Checklist

Purpose

Adolescents are experiencing rising rates of obesity, insufficient exercise, and sleep disorders. To provide a scientific basis for policymakers to develop targeted and evidence-based health behavior education and policies, this study employed structural equation modeling to design the Adolescent Health Behavior Checklist (AHBC).

Methods

We designed a draft 6-dimensional AHBC, which includes the dimensions of exercise, diet, personal responsibility, sleep, interpersonal relationships, and stress management. Each item is rated on a 5-point Likert scale, with higher scores indicating healthier behavior. Through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), we optimized the construct validity of the AHBC.

Results

The optimal factor structure was first determined using EFA with 177 middle school students participating in the process. EFA suggested a hierarchical, 6-factor AHBC with good internal consistency (global Cronbach's alpha = 0.96). Using an independent sample of 349 middle school students, CFA confirmed the construct validity of the AHBC. The final model demonstrated a good fit: SRMR = 0.058, CFI = 0.990. Five out of six latent variables had factor loadings higher than 0.7, and 81% of the item-level factor loadings exceeded 0.7. Additionally, all latent variables had McDonald's omega values higher than 0.7, indicating acceptable convergent validity. Finally, factor correlations showed that the AHBC has good discriminant validity.

Conclusions

The AHBC is a 31-item checklist that assesses adolescents' all-around health behaviors, using a score of four as the benchmark value. The shortcomings of the current checklist are discussed, along with future theoretical and practical directions for improvement.

Beyond weight loss: exploring the neurological ramifications of altered gut microbiota post-bariatric surgery

This review discusses findings related to neurological disorders, gut microbiota, and bariatric surgery, focusing on neurotransmitters, neuroendocrine, the pathophysiology of bacteria contributing to disorders, and possible therapeutic interventions. Research on neurotransmitters suggests that their levels are heavily influenced by gut microbiota, which may link them to neurological disorders such as Alzheimer's disease, Parkinson's disease, Multiple sclerosis, Depression, and Autism spectrum disorder. The pathophysiology of bacteria that reach and influence the central nervous system has been documented. Trends in microbiota are often observed in specific neurological disorders, with a prominence of pro-inflammatory bacteria and a reduction in anti-inflammatory types. Furthermore, bariatric surgery has been shown to alter microbiota profiles similar to those observed in neurological disorders. Therapeutic interventions, including fecal microbiota transplants and probiotics, have shown potential to alleviate neurological symptoms. We suggest a framework for future studies that integrates knowledge from diverse research areas, employs rigorous methodologies, and includes long-trial clinical control groups.

Depressive symptoms and risk of all-cause mortality among middle-aged and older populations with and without prediabetes in China

BACKGROUND

Although depressive symptoms have been associated with increased mortality risk in diabetes patients, the potential implications for individuals with prediabetes remain underexplored. This study aimed to investigate the association between depressive symptoms and all-cause mortality and to determine whether these associations differ between individuals with and without prediabetes in middle-aged and older Chinese adults.

METHODS

This is a cohort study from the 2011-2020 China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms were assessed by the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10). All-cause mortality was documented from the baseline through the end of follow-up in 2020. Cox proportional hazards regression was used to evaluate the association of depressive symptoms with all-cause mortality among adults with and without prediabetes, adjusting for potential confounders.

RESULTS

After multivariable adjustments, depressive symptoms were associated with a higher risk of all-cause mortality (HR, 1.40; 95 % CI: 1.16-1.68) for those with prediabetes, participants with moderate depressive symptoms exhibited an HR of 1.36 (95 %CI, 1.13-1.65), while those with severe depressive symptoms had an HR of 1.62 (95 %CI, 1.13-2.32) compared to those without depressive symptoms (P for trend <0.001). However, among individuals without prediabetes, depressive symptoms didn't increase the risk of all-cause mortality.

CONCLUSIONS

Elevated depressive symptoms are significantly associated with an increased risk of all-cause mortality among populations with prediabetes, the risk of death increased with the severity of depressive symptoms. Our findings suggest that careful monitoring and intervention in individuals with both prediabetes and depressive symptoms is needed.

Immune indicators and depression in adolescents: Associations with monocytes, lymphocytes, and direct bilirubin

BACKGROUND

Depression is a significant psychiatric disorder with particularly high prevalence among adolescents. This mental health condition can have severe consequences, including academic failure, social withdrawal, and suicidal behavior. Given the increasing rate of depression in this age group, understanding the underlying biological mechanisms is essential for early detection and intervention. Recent studies have suggested that immune markers play a role in the pathophysiology of depression, prompting further investigation of their potential association with depressive symptoms in adolescents.

AIM

To investigate the relationship between immune markers (monocytes, lymphocytes, and direct bilirubin) and the incidence and severity of depression among adolescents.

METHODS

This cross-sectional study recruited 145 adolescent patients with depression [male (M)/female (F) = 38/107] from Jiangbin Hospital in Guangxi, Zhuang and 163 healthy controls (M/F = 77/86) from routine health check-ups. Blood samples were collected after an overnight fast. Depression severity was measured using the Zung Self-Rating Depression Scale. The inclusion criteria were age 12-24 years, diagnosis of depressive disorder (ICD-10), and no recent antidepressant use. The exclusion criteria included psychiatric comorbidities and serious somatic diseases. Key statistical methods included group comparisons and correlation analyses.

RESULTS

There was a higher prevalence of females in the depression group (P < 0.001). Significant age differences were observed between the groups (Z = 9.43, P < 0.001). The depression group had higher monocyte (Z = 3.43, P < 0.001) and lymphocyte (t = 2.29, P < 0.05) counts, and higher serum direct bilirubin levels (Z = 4.72, P < 0.001). Monocyte count varied significantly according to depression severity, with lower counts in the mild group (Z = -2.90, P < 0.05). A negative correlation between age and lymphocyte counts was observed (ρ = -0.22, P < 0.01). Logistic regression analysis showed that serum direct bilirubin levels significantly predicted depression.

CONCLUSION

The potential role of elevated levels of immune markers in the early detection of depression in adolescents has been highlighted. Therefore, it is necessary to explore further the relationships between these immune markers and depression.

Childhood air pollution exposure is related to cognitive, educational and mental health outcomes in childhood and adolescence: A longitudinal birth cohort study

BACKGROUND

A growing body of evidence supports an association between air pollution exposure and adverse mental health outcomes, especially in adulthood however, very little is known about the effects of early life air pollution exposure during childhood. We examined longitudinal associations between the extent and timing of children's annual air pollution exposure from conception to age 10 years and a wide range of cognitive, educational and mental health outcomes in childhood and adolescence that were assessed prospectively as part of a large birth cohort study.

METHODS

We linked historical air pollution data (μg.m-3) from pregnancy to age 10 years (1976-1987) using the addresses of all cohort members (n = 1265) of the Christchurch Health and Development Study (CHDS) who were born in New Zealand in mid-1977. Latent Class Growth Mixture Models were used to characterise different trajectories of air pollution exposure from the prenatal period to age 10 years. We then examined associations between these air pollution exposure trajectories and 16 outcomes in childhood and adolescence using R Studio and Stata V18.

FINDINGS

Four air pollution exposure trajectories were identified: i) low, ii) persistently high, iii) high prenatal and postnatal, and iv) elevated pre-school exposure. While some associations were attenuated, after adjusting for a variety of covariates spanning childhood, family sociodemographic background and family functioning characteristics, several associations remained. Relative to the lowest exposure trajectory, persistently high and high prenatal and postnatal exposure were both related to attentional problems. High prenatal and postnatal was also related to higher risk of substance abuse. Elevated pre-school exposure was associated with conduct problems, lower educational attainment and substance abuse and persistently high childhood exposure increased risk of substance abuse.

CONCLUSIONS

Our study highlights potential adverse and longer-term impacts of air pollution exposure during childhood on subsequent development in later life.

Internet gaming disorder and depression mediated by impaired resilience and sleep distress: a three-wave longitudinal study among Chinese adolescents

AIMS

While the cross-sectional relationship between internet gaming disorder (IGD) and depression is well-established, whether IGD predicts future depression remains debated, and the underlying mechanisms are not fully understood. This large-scale, three-wave longitudinal study aimed to clarify the predictive role of IGD in depression and explore the mediating effects of resilience and sleep distress.

METHODS

A cohort of 41,215 middle school students from Zigong City was assessed at three time points: November 2021 (T1), November 2022 (T2) and November 2023 (T3). IGD, depression, sleep distress and resilience were measured using standardized questionnaires. Multiple logistic regression was used to examine the associations between baseline IGD and both concurrent and subsequent depression. Mediation analyses were conducted with T1 IGD as the predictor, T2 sleep distress and resilience as serial mediators and T3 depression as the outcome. To test the robustness of the findings, a series of sensitivity analyses were performed. Additionally, sex differences in the mediation pathways were explored.

RESULTS

(1) IGD was independently associated with depression at baseline (T1: adjusted odds ratio [AOR] = 4.76, 95% confidence interval [CI]: 3.79-5.98, p < 0.001), 1 year later (T2: AOR = 1.42, 95% CI: 1.16-1.74, p < 0.001) and 2 years later (T3: AOR = 1.24, 95% CI: 1.01-1.53, p = 0.042); (2) A serial multiple mediation effect of sleep distress and resilience was identified in the relationship between IGD and depression. The mediation ratio was 60.7% in the unadjusted model and 33.3% in the fully adjusted model, accounting for baseline depression, sleep distress, resilience and other covariates. The robustness of our findings was supported by various sensitivity analyses; and (3) Sex differences were observed in the mediating roles of sleep distress and resilience, with the mediation ratio being higher in boys compared to girls.

CONCLUSIONS

IGD is a significant predictor of depression in adolescents, with resilience and sleep distress serving as key mediators. Early identification and targeted interventions for IGD may help prevent depression. Intervention strategies should prioritize enhancing resilience and improving sleep quality, particularly among boys at risk.

Efficacy of vigorous physical activity as an intervention for mitigating depressive symptoms in adolescents and young adults: a comprehensive systematic review and meta-analysis

Purpose

This study aimed to evaluate the effectiveness of vigorous physical activity as an intervention for alleviating depressive symptoms among adolescents and young adults.

Methods

A comprehensive search on systematically reliable databases was carried out, and studies running till August 2023 were considered in this study. The articles included in this meta-analysis assessed the impact of exercise interventions on depressive symptomatology in adolescents and young adults. Two independent investigators screened the studies, extracted data, and evaluated quality.

Results

Physical activity produced an important reduction in depressive symptoms [SMD] = -4.23, 95% CI: -7.02, -1.44, p = 0.0001; a moderate effect size in both the adolescent population with clinical depression and adolescents who presented with subclinical depressive symptoms. Notably, vigorous physical exercise worked most favorably for adolescent depressive symptomatology, while moderate-intensity exercise was the best choice for adolescents with diagnosed clinical depression.

Conclusion

This meta-analysis suggests that vigorous physical activity could reduce depressive symptoms in adolescents and young adults. However, further studies are needed to provide clearer recommendations regarding the type, duration, and intensity of exercise necessary to treat clinical depression in this population.

Exploring context, mechanisms and outcomes in group interpersonal therapy for adolescents with depression in Nepal: a qualitative realist analysis

Interpersonal Psychotherapy (IPT) is an evidence-based treatment for adolescent depression. However, since it does not work for all adolescents in all settings, more research on its heterogeneous effects is needed. Using a realist approach, we aimed to generate hypotheses about mechanisms and contextual contingencies in adolescent group IPT in Nepal. We analysed 26 transcripts from qualitative interviews with IPT participants aged 13-19, facilitators, supervisors and trainers. We analysed data using the Framework Method. The qualitative analytical framework was based on the VICTORE checklist, a realist tool to explore intervention complexity. Sharing, problem-solving, giving and receiving support, managing emotions and negotiating emerged as mechanisms through which adolescents improved their depression. Participants perceived that girls and older adolescents benefitted most from IPT. Girls had less family support than boys and therefore benefitted most from the group support. Older adolescents found it easier than younger ones to share problems and manage emotions. Adolescents exposed to violence and parental alcoholism struggled to overcome problems without family and school support. We formulated hypotheses on group IPT mechanisms and contextual interpersonal and school-level factors. Research is needed to test these hypotheses to better understand for whom IPT works and in what circumstances.

Cannabis and mental health in adolescents: changes in associations over 15 years

PURPOSE

Recent changes in the cannabis market, including decreased adolescence usage, increased Δ9-tetrahydrocannabinol levels and rising mental disorders over the last decade raises questions about the changing profile of cannabis consumers.

METHODS

This study explores the trends of associations between regular cannabis use and mental health in five waves of a national representative survey of 17-year-old French adolescents, including more than 150,000 participants. Multivariable models, adjusted for gender and socioeconomic variables, were used.

RESULTS

Cannabis use and mental health indicators showed some variations over time, with increasing divergence between 2017 and 2022. Regular use of cannabis decreased from 7.4% in 2008 to 3.8% in 2022 (p < 0.001). In contrast, suicidal ideation in the past year increased from 16% in 2008 to 18% in 2022 (p = 0.009), although it followed a U-shaped trend. The association between regular cannabis use and suicidal ideation in the past year increased from 1.44 (CI: 1.29-1.61) in 2008 to 2.52 (CI: 2.05-3.10) in 2022. Similarly, the association between cannabis use and antidepressant use in the past year increased from 2.57 (CI: 2.18-3.03) in 2008 to 4.47 (CI: 3.35-5.97) in 2022.

CONCLUSION

These results suggest that cannabis users are now more prone to mental health disorders compared to 15 years ago. Several mechanisms might explain these findings, including the self-selection of a population with both vulnerabilities, changes in the effects of cannabis, or the use of cannabis as a self-medication strategy.

Is oxytocin related to psychiatric symptoms in adolescents with obesity?

OBJECTIVES

We aimed to investigate the relation of oxytocin receptor (OXTR) gene variants (rs53576 and rs2254298) and serum oxytocin (OXT) levels with psychiatric symptoms in healthy adolescents and adolescents with obesity.

METHODS

A total of 250 adolescents with obesity and 250 healthy adolescents were included in this study. Attachment properties, anxiety, and depression were evaluated with self-reports while diagnoses were ascertained with KIDDIE-SADS-PL Turkish version. Serum OXT level was studied with the ELISA method, and OXTR gene variants were studied by quantitative polymerase chain reaction (rs53576) and restriction fragment length polymorphism (RFLP) (rs2254298) methods.

RESULTS

Serum OXT level was significantly lower in adolescents with obesity than in healthy controls. Self-reported symptoms of anxiety and depression were significantly elevated, especially in female adolescents with obesity, whereas parent/peer attachment was significantly lower. The rs53576 G/G genotype was found to be significantly more prevalent among obese youth. About 29.2 % of obese youth were diagnosed with psychopathology, especially anxiety and depression. OXT levels and receptor polymorphisms were not related to self-reported symptoms, attachment, and presence of psychopathology.

CONCLUSIONS

Further studies should evaluate the roles of other constructs (e.g., early adversity, parenting, social supports, coping, temperament, etc.) and discern the roles of parent-child synchrony in elucidating relationships between OXT, pediatric obesity, and psychopathology.

Longitudinal associations between family conflict, intergenerational transmission, and adolescents' depressive symptoms: evidence from China Family Panel studies (2016-2020)

BACKGROUND

Adolescent depression is increasing globally, and family conflict may contribute to its transmission across generations. However, longitudinal evidence on these dynamics remains sparse. This study examines the longitudinal associations between family conflict and adolescents' and parents' depressive symptoms from three waves of data.

METHODS

Data from the 2016-2020 China Family Panel Studies (CFPS) were analyzed, including 1,772 adolescents (Mean age = 12.4, SD = 1.68 in 2016) and their parents. Family conflict was measured using three questions from adolescents, while depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale (CESD). Multiplelinear regression, latent growth models (LGM), and cross-lagged panel models (CLPM) were employed to examine longitudinal associations between family conflict and depressive symptoms.

RESULTS

The results revealed that family conflict correlated with adolescents' depressive symptoms (r = 0.580,p < 0.001). Adolescents' depressive symptoms also exacerbated family conflict (β1 = 0.030, p < 0.05; β2 = 0.032, p < 0.01) across three waves, while family conflict had a limited contribution to parents' depressive symptoms. Mothers' depressive symptoms influenced adolescents' depressive symptoms significantly (β = 0.043,p < 0.05), while adolescents' depressive symptoms were transmitted to fathers' depressive symptoms (β = 0.080,p < 0.01) between Wave 2 and Wave 3. Moreover, the mother's education level negatively predicted adolescents' depressive symptoms (β = -0.296,p < 0.05).

CONCLUSIONS

Family conflict plays a critical role in adolescents' depressive symptoms and its intergenerational transmission. The findings underscore the pivotal role of family dynamics in mental health, especially in the development of adolescents' depressive symptoms. Interventions aimed at reducing family conflict may help mitigate depressive symptoms across generations.

Physical activity and risk of depression in adolescents: A systematic review and meta-analysis of prospective observational studies

BACKGROUND

While the benefits of physical activity (PA) on depression in adults have been well-established, its impact on depression in adolescents remains understudied. This study aimed to examine the relationship between PA and depression in adolescents, aggregating published prospective observational studies.

METHODS

We searched MEDLINE, Embase, Cochrane, and PsycINFO, for prospective observational studies that examined the relationship between PA and depression in adolescents from the inception of these databases to November 17, 2022, without any language restrictions. Two independent reviewers performed data extraction and assessed the risk of bias. We utilized a random-effects model to calculate the pooled odds ratios (ORs) and 95 % confidence intervals (95%CIs). Subgroup analyses were conducted to explore potential sources of heterogeneity.

RESULTS

This study included 11 original articles, involving 59,786 adolescents (46.4 % male). Primary analysis revealed that adolescents who engaged in higher levels of PA showed a 3 % significantly decreased risk of developing depression compared to those with lower levels (OR = 0.97, 95%CI = 0.94-0.99, P = 0.01; I2 = 41.7 %). Sensitivity analyses confirmed the robustness of these findings. Subgroup analyses demonstrated heterogeneity to be primarily attributed to data source, geographic region, and follow-up period (Pinteraction< 0.01, 0.01 and 0.01, respectively), while no significant sex-specific association was found (Pinteraction = 0.30).

CONCLUSIONS

Our systematic review and meta-analysis of prospective observational studies indicates that higher levels of PA are associated with a reduced risk of depression in adolescents. This highlights the need for policies to promote increased PA levels among adolescents for the prevention of depression.

Early parent-child separation and adolescent depressive symptoms: the mediating role of self-perceived pleasure in social interactions

BACKGROUND

Depressive symptoms are highly prevalent among adolescents with a history of parent-child separation. This study investigates whether self-perceived pleasure in social interactions mediates the relationship between early parent-child separation and depressive symptoms among Chinese adolescents.

METHODS

1250 teenagers (mean age = 12.95 years, SD = 1.55; 54.6% male) completed self-report surveys assessing early parent-child separation, self-perceived pleasure in social interactions, and depressive symptoms. Mediation analysis was conducted using the bootstrap method.

RESULTS

Early parent-child separation increased the risk for depressive symptoms in adolescents by 1.743 times (95% CI, 1.348-2.253). Self-perceived pleasure in social interaction partially mediated the association between early parent-child separation and adolescent depressive symptoms, after adjusting for age and gender (β = 0.095; 95%CI, 0.032-0.168). The mediating effect was significant and accounted for 19.87% of the total effect.

CONCLUSIONS

This study highlights the impact of self-perceived pleasure from social interactions on adolescent depressive symptoms. Improving perceived pleasure from social interactions may help reduce the negative effects of parent-child separation on depressive symptoms.

Depression and anxiety in childhood-onset systemic lupus erythematosus: prevalence, associated factors, and impact on quality of life and family

BACKGROUND

Depression and anxiety are common psychiatric manifestations in childhood-onset systemic lupus erythematosus (cSLE). This study aimed to determine the prevalence of clinically significant depression and anxiety, identify associated factors, and assess their impact on health-related quality of life (HRQOL) and family in patients with cSLE.

METHODS

We conducted a cross-sectional study of cSLE patients, aged 8-18 years. Patients completed the Children's Depression Inventory (CDI), Screening for Child Anxiety Related Disorders (SCARED), Pediatric Quality of Life Inventory Generic Core Scale (PedsQL-GC), and Visual Analog Scale of pain intensity. Their parents completed the Pediatric Quality of Life Family Impact module (PedsQL family impact).

RESULTS

Of 91 patients, the median disease duration was 3.4 years (IQR 3.5), and the median SLE disease activity index 2000 score was 2 (IQR 6). The prevalence of clinically significant depression (CDI > 15) and clinically significant anxiety (SCARED ≥ 25) were 31.9% and 49.5%, respectively. Coexisting clinically significant depression and anxiety were found in 26 patients (28.6%). In multivariable analyses, older age at diagnosis was associated with clinically significant depression (OR 1.56, 95% CI 1.12-2.16, p = 0.008), while organ damage (OR 4.27, 95% CI: 1.19-15.31, p = 0.026) and pain score (OR 1.61, 95% CI: 1.11-2.32, p = 0.012) were associated with clinically significant anxiety. Patients with clinically significant depression or anxiety had significantly lower PedsQL-GC and PedsQL family impact scores compared to those without these symptoms.

CONCLUSIONS

These results suggest that depression and anxiety are prevalent in cSLE and have negative impacts on HRQOL and family. Physicians should be aware of the presence of these psychological symptoms, particularly in patients with risk factors. Providing psychological counseling and prompt referral to psychiatrists could enhance HRQOL and family functioning.

The Longitudinal Relationship Between Self-Esteem, Life Satisfaction, and Depressive and Anxiety Symptoms Among Chinese Adolescents: Within- and Between-Person Effects

Adolescents are especially vulnerable to experiencing depression and anxiety. This longitudinal study, from within- and between-person perspectives, explores how self-esteem relates to depressive and anxiety symptoms in Chinese adolescents and identifies the mediating factors impacting this relationship. Data were collected from 1025 junior and high school students in Southwestern China at three points over an 18-month period. This study utilized both traditional and random-intercept cross-lagged panel models to understand the dynamic developmental relationships. The general occurrence of depressive and anxiety symptoms increased longitudinally, with a more pronounced upward trend among female students. Between-person level analyses indicated bidirectional associations among self-esteem, life satisfaction, and depressive and anxiety symptoms. Moreover, life satisfaction emerged as a significant mediator. At the within-person level, self-esteem uniquely predicted both life satisfaction and subsequent depressive and anxiety symptoms. This study clarifies the longitudinal interplay between these constructs. Self-esteem, which denotes internal self-assessments, and life satisfaction, which denotes external evaluations of life, both significantly buffer the emergence of depressive and anxiety symptoms.

Neutrophil to albumin ratio as a novel associated factor for depression; results from NHANES 2017-2018

BACKGROUND

Depression is a leading public health problem globally. Inflammatory mechanisms are thought to have a role in the pathophysiology of the disease.

METHODS

Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018 were analyzed. The study design was cross-sectional. The main variables of the study were Depression and NPAR. Covariates of the study were age, sex, race, educational level, marital status, body mass index (BMI), and alcohol intake, as well as hypertension, coronary artery disease, cancer or malignancy, and diabetes.

RESULTS

Finally, 302 participants with Depression and 3731 without Depression were included in the analysis. Multiple logistic regression analysis using backward elimination showed that participants in the fourth quartile for NPAR are at greater risk for Depression compared with participants in the first quartile (OR: 1.55, 95 % CI: 1.08-2.22). Areas under the receiver operating curve (AUROC) of the NPAR to classify depression were 57.6 % (95 % CI: 53.3-61.9), 60.4 % (95 % CI: 53.2-67.6), 61.5 % (95 % CI: 55.2-67.7), and 70.0 % (95 % CI: 52.4-87.6) in the general population, males, participants hypertension and diabetes, respectively.

CONCLUSION

In conclusion, these results suggested that NPAR is associated with depression and could serve as a fair biomarker in subpopulations including males, and patients with diabetes and hypertension. It is suggested to use NPAR in combination with other associated factors with depression to classify or screen the subjects regarding depression in the general population. Also, present findings could be used to further elucidate the underlying pathophysiology of the disease.

A comparison of the acute effects of high intensity interval training and moderate intensity continuous training on working memory and emotional state in adolescent women with subthreshold depression

Objective

Various guidelines emphasize the cognitive and emotional benefits of physical activity. However, it is not yet clear what kind of exercise intensity is suitable for individuals with subthreshold depression. Therefore, this study aims to examine the effects of high intensity interval training (HIIT) and moderate intensity continuous training (MICT) on the working memory and emotional state.

Methods

Forty-nine female students with subthreshold depression (mean age 16.3 ± 0.5 yrs) completed 20-min group of sit (SIT), MICT, and HIIT on separate days in a counterbalanced order. The modified n-back task was employed to evaluate working memory. Emotional state was assessed using the Feeling Scale (FS) and Felt Arousal Scale (FAS).

Results

Regarding working memory, for accuracy, SIT (82.41 ± 13.79%), MICT (81.79 ± 13.19%) and HIIT (82.06 ± 11.36%) have no significant difference (all p > 0.05). However, for reaction time, MICT (459.86 ± 131.47 ms) is significantly faster than HIIT (491.16 ± 115.68 ms) (p = 0.046), and there is no significant difference between MICT and SIT (462.71 ± 120.64 ms) (p > 0.05). Concerning emotional state, for arousal, FAS scores significantly increased after both HIIT (2.39 ± 1.30 to 3.76 ± 1.12, p < 0.001) and MICT (2.55 ± 0.88 to 3.94 ± 1.08, p < 0.001) compared to pre-exercise, and the increase caused by them was significantly higher than that of SIT (HIIT: p = 0.011; MICT: p < 0.01). For pleasure, the increase in FS score after MICT (-0.27 ± 1.13 to 1.06 ± 1.79) was significantly higher than that of SIT (0.32 ± 1.38 to 0.58 ± 1.53) (p < 0.01).

Conclusion

Acute MICT can enhance working memory and improve the emotional state of adolescent women with subthreshold depression, while HIIT may decrease working memory and pleasure in this particular population.

"Meaninglessness makes me unhappy": examining the role of a sense of alienation and life satisfaction in the relationship between the presence of meaning and depression among Chinese high school seniors

Introduction

Given the high incidence of depression among adolescents and its serious consequences, investigating its influencing factors and mechanisms is of great theoretical and practical significance. This study aims to explore the mediating effects of a sense of alienation and life satisfaction on the relationship between the presence of meaning in life and depression among Chinese high school seniors.

Methods

Six hundred and twenty-one senior high school students (17.09 ± 0.45 years, 266 boys) were recruited from Shandong, China, to participate in the study. Participants completed the Adolescent Students' Sense of Alienation (ASAS), Meaning in Life Questionnaire (MLQ), Satisfaction with Life Scale (SWLS), and Beck Depression Inventory-II (BDI-II).

Results

Our findings revealed that (1) the sense of alienation and life satisfaction play a chain mediating role between the presence of meaning in life and depression among Chinese high school seniors; (2) the sense of alienation plays a mediating role between the presence of meaning in life and depression; (3) there are gender differences in the chain mediation model of the influence of the presence of meaning in life on depression.

Conclusion

This study reveals potential pathways through which the presence of meaning in life affects depression among Chinese high school seniors, offering support and a basis for future mental health interventions for this population.

Comparison of bullying victimization and depression symptoms among Chinese adolescents before and after the end of the dynamic zero-COVID-19 policy: a repeated cross-sectional study

BACKGROUND

The COVID-19 pandemic has had a significant impact on the physical and mental health of human beings. Most adolescents in mainland of China have been infected with COVID-19 after the adjustment of the dynamic zero-COVID-19 policy. This study aims to analyze the relationship between the COVID-19 pandemic effect and depressive symptoms among adolescents in mainland China.

METHODS

This school-based repeated cross-sectional study was conducted on students aged 11-19 years from September to October 2022 and September to October 2023 in Ningbo, Zhejiang Province, China, using a stratified cluster, multistage sampling method. Data analysis occurred from January to June 2024. Depression symptoms and bullying victimization, exclusion of cyberbullying, were assessed using the 20-item Center for Epidemiological Studies Depression Scale (CES-D) and Bully/Victim Questionnaire, respectively.

RESULTS

In the first survey wave in 2022 during the dynamic zero-COVID-19 policy period in Mainland China, 10,224 participants completed the questionnaires. In wave 2 survey in 2023 which was the first year after lifting of the dynamic zero-COVID-19 policy, 11,604 participants completed the questionnaires. This resulted in a sample of 10,224 in wave 1 and 11,604 in wave 2. The mean age in wave 1 was 15.2 (SD = 1.7) and 15.1 (SD = 1.8) in wave 2. The prevalence of depression symptoms in adolescents in wave 2 was higher than in wave 1 (17.0% vs. 14.6%, P < 0.05). The prevalence of bullying victimization and types of bullying victimization in school among adolescents were higher in 2023 than in 2022. A total of 3.2% of the 2023 participants and 1.7% of the 2022 participants experienced bullying victimization in school (P < 0.05). The odds ratio of experiencing depression (CES-D Score ≧ 16) and bullying victimization in school were 1.18 (95% CI, 1.10-1.28) and 1.86 (95% CI, 1.55-2.24) times higher, respectively, in 2023 than in 2022 (P < 0.01). The mediated regression analysis revealed that after lifting of the dynamic zero-COVID-19 had a significant association with an increase in depression symptoms, which was partially mediated by bullying victimization in school (total association:β = 0.175; SE = 0.038; P < 0.001; direct association:β = 0.138; SE = 0.039; P < 0.001; indirect association: a*b = 0.037; P < 0.001; the proportion of mediation: 20.88%, P < 0.001).

CONCLUSIONS

The findings of this repeated cross-sectional study suggest that an increased risk of depression symptoms or bullying victimization has been associated with the COVID-19 pandemic in mainland China after lifting the dynamic zero-COVID-19 policy. In addition, bullying victimization may play a mediating role in the associations between the pandemic and depression symptoms. These findings indicated that additional support should be offered to Chinese adolescents in the period of post-pandemic COVID-19.

CLINICAL TRIAL NUMBER

Not applicable.

Efficacy of agomelatine on sleep disorders and lateral habenula neuronal activity in chronic restraint stress depression model mice

BACKGROUND

Sleep disorders (SD) are one of the common manifestations of depression patients. This article aimed to explore the effect of Agomelatine (Ago) on SD in chronic restraint stress (CRS) depression model mice and its effect on the activity of neurons in the lateral habenula (LHb).

METHODS

30 C57BL/6 J mice were divided into normal (C57BL/6 J) group, CRS group, and Ago group. CRS experiment was used to establish the depression model, and Ago was used to treat CRS mice. Based on behavioral tests in mice and electrophysiology record, SD and LHb neuron activity were assessed. The expression levels of brain-derived neurotrophic factor (BDNF) and nuclear phosphoprotein (c-Fos) in LHb were detected by Western blot (WB).

RESULTS

As against the CRS group, the Ago group had a reduction in the immobility time during forced swimming training and an increase in the preference for sucrose in the sucrose preference test; The expression levels of c-Fos and BDNF proteins in the LHb neurons of the Ago group mice were lower than those in the CRS group (P < 0.05), and the values approached the levels of the normal control group. In both dark and light environments, the rapid eye movement (REM) sleep duration of the CRS group mice was significantly longer than that of the normal control group (P < 0.05).

CONCLUSION

It was concluded that Ago may intervene in the depressive-like behavior and overall sleep patterns of CRS depression model mice by regulating the activity of LHb neurons and inhibiting the neuroinflammatory process. This provides a potential drug target for the development of new treatment strategies for depression.

Smoking may increase the usage of antidepressant: evidence from genomic perspective analysis

This study uses the two-sample Mendelian randomization (TSMR) method to explore the causal relationships between smoking initiation (SMKI), never smoking (NSMK), past tobacco smoking (PTSMK), and the usage of antidepressants (ATD). Single-nucleotide polymorphisms (SNPs) with genome-wide significance (P < 5E-08) related to SMKI, NSMK, and PTSMK were selected from the genome-wide association study (GWAS) database as instrumental variables (IVs). The main method, inverse variance weighted (IVW), was utilized to investigate the causal relationship. The results demonstrated a positive causal relationship between SMKI and ATD use, where SMKI leads to an increase in ATD use. Conversely, NSMK and PTSMK showed a negative causal relationship with ATD use, meaning that NSMK and PTSMK lead to a reduction in ATD use. Additionally, sensitivity analysis showed that the results of this study were robust and reliable. Using the TSMR method and from a genetic perspective, this study found that SMKI leads to an increase in ATD use, while NSMK and PTSMK reduce ATD use.

The impact of interventions for depression on self-perceptions in young people: A systematic review & meta-analysis

Negative self-perceptions are implicated in the development and maintenance of depression in young people, but little is known about their receptiveness to change in response to treatment. This paper reports on a pre-registered meta-analysis examining the extent to which treatments for depression in young people aged 11-24 result in changes to self-perceptions. Controlled treatment trials examining outcomes related to self-perceptions were synthesised (k = 20, N = 2041), finding small reductions in both symptoms of depression (g = -0.30; 95 % CI: -0.52, -0.08) and self-perception outcomes (g = 0.33; 95 % CI: 0.16, 0.49) for interventions compared with control groups. Meta-regression analyses found no significant association between reductions in depressive symptoms and improvements in self-perception following treatment, suggesting that despite interventions generally improving both outcomes these changes may be unrelated to each other. Our results indicate that young people's self-perceptions are sensitive to change following treatment for depression, however effect sizes are small and treatments could be more effective in targeting and changing negative self-perceptions. Given the importance that young people place on integrating work on their sense of self into treatments for depression, future interventions could aim to support young people with depression to develop a positive sense of self.

Mental Disorder Spectrum in Children and Adolescents from 2014-2022: A Nine-year Epidemiological and Clinical Trend

OBJECTIVE

This study aimed to analyse the trend of the mental disorder spectrum in children and adolescents from 2014 to 2022 in one city in Central China and to provide actionable recommendations for the prevention and management of mental disorders.

METHODS

In this hospital-based retrospective study, we utilized child and adolescent medical records data from the Wuhan Mental Health Center from January 2014 to December 2022 and examined the top 5 mental disorders (schizophrenia, depressive episode, bipolar disorder, pervasive developmental disorder, and unspecified mood disorder) that accounted for the overall proportion of patients admitted. The rank and proportion of these mental disorders, demographic characteristics and disease indicators were analysed.

RESULTS

There was a significant upwards trend in the number of children and adolescents diagnosed with mental disorders over the past 9 years, with a sharp decline in 2020 due to the COVID-19 pandemic, followed by a rebound in 2021 and a sustained level above prepandemic figures by 2022. The average age of hospitalization decreased significantly from 20.7 to 16.2 years, with a marked increase in the 12-17-year-old age group. The proportion of female hospitalizations increased from 39.2% to 55.2%, with a corresponding decrease in male hospitalizations. There was a notable decrease in the proportion of schizophrenia cases and an ascent of depressive episode to the most prevalent position.

CONCLUSION

This study emphasizes the critical need for targeted interventions and resources for severe mental disorders in children and adolescents and the importance of early detection and management of mental disorders to mitigate long-term effects on well-being and development.

The effects of childhood maltreatment and social support on the trajectories of depressive symptoms from adolescence to young adulthood

BACKGROUND

Depression is one of the most common mental health concerns among adolescents and young adults. Childhood maltreatment is a particularly potent risk factor for the subsequent development of depressive symptoms. Meanwhile, social support has been identified as a robust protective factor against depressive symptoms. However, limited research has investigated the effects of childhood maltreatment and social support on the trajectories of depressive symptoms from adolescence to young adulthood.

OBJECTIVE

The present study aimed to explore trajectories of depressive symptoms from adolescence to young adulthood as well as identify childhood maltreatment as a potential risk factor and social support as a protective factor to depressive symptoms over time.

METHODS

We conducted growth curve modeling using public-use data from Add Health. Main variables (childhood maltreatment, social support, depressive symptoms from Wave I to Wave IV) and control variables (e.g., gender, race, poverty) were included in the analysis.

RESULTS

Depressive symptoms demonstrated a quadratic pattern, with a decline from adolescence to emerging adulthood, and a slight increase in young adulthood. Childhood maltreatment was only significantly associated with the initial level of depressive symptoms but not the trajectories of depressive symptoms. Social support was not only associated with the initial level of depressive symptoms, but also the changes of depressive symptoms over time.

CONCLUSION

The present study provides an avenue towards untangling potential factors contributing to the heterogeneity of depressive symptoms. Identifying risk and protective factors with varying trajectories of depressive symptoms will potentially improve related treatments and interventions.

Systematic Review: Measurement Properties of Patient-Reported Outcome Measures Used to Measure Depression Symptom Severity in Adolescents With Depression

OBJECTIVE

To systematically evaluate the measurement properties of 12 patient-reported outcome measures (PROMs) used to measure depression symptom severity in adolescents with depression. Depression symptom severity was chosen as the outcome of focus given its importance as an outcome to measure in adolescents with depression across clinical trials and/or care.

METHOD

MEDLINE, PsycInfo, Embase, Scopus, CINAHL, and Cochrane were searched from year of inception up to December 7, 2023. Study appraisal (ie, risk of bias), evaluation of measurement properties, and evidence synthesis followed the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Included studies evaluated at least 1 of 9 measurement properties as detailed in the COSMIN taxonomy within a reported sample or subgroup of youth ages 12 to 24 years, with at least 40% meeting criteria for any depressive disorder.

RESULTS

Of the 15,560 records identified, 31 studies for 7 PROMs were included in the COSMIN appraisal. Although several PROMs have the potential to accurately measure depression symptom severity in adolescents with depression, at this time none of the PROMs can be recommended for use without further evaluative work. High-quality evidence was generally lacking, largely due to few or inconsistent findings, small sample sizes, and other methodological concerns.

CONCLUSION

This systematic review of the measurement properties of 12 PROMs used to measure depression symptom severity in adolescents with depression found that none of the PROMs can be recommended for use until further evaluative work is conducted. Clinicians and researchers should proceed with caution when using these PROMs.

PLAIN LANGUAGE SUMMARY

This systematic review evaluated 12 patient report outcome measures (PROMs) commonly used to measure depression symptom severity in adolescents with depression. Only 7 of these PROMs had studies to evaluate; none of them had the necessary measurement properties to indicate that they could be recommended for use or that results could be trusted. The authors suggest that more evaluative work is required to ensure the validity of the measurement properties of the tools utilized to measure depression symptom severity in adolescents with depression. This work should include engagement of youth and caregivers in evaluation of the content validity (eg, the relevance, comprehensibility, and comprehensiveness) of these PROMs.

DIVERSITY AND INCLUSION STATEMENT

One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.

The Effects of Universal Educational Interventions in Improving Mental Health Literacy, Depression, and Anxiety Among Adolescents: A Systematic Review and Meta-Analysis

Adolescents are susceptible to developing depression and anxiety, and educational interventions could improve their mental well-being. This systematic review aimed to evaluate the effectiveness of universal educational prevention interventions in improving mental health literacy, depression, and anxiety among adolescents. Eight electronic databases were searched until June 2024: Cochrane Library, PubMed, EMBASE, CINAHL, PsycINFO, Scopus, Web of Science, ProQuest Dissertations, and Theses Global. Since the included studies assessed various aspects of mental health literacy, the results for mental health literacy were synthesized narratively. In contrast, a meta-analysis using a random-effects model was applied to the depression and anxiety outcomes. Heterogeneity was examined using I2 statistics and Cochran's Q Chi-squared test. The Cochrane risk of bias tool and the GRADE approach conducted quality appraisal at the study and outcome levels, respectively. The review was reported according to the PRISMA guidelines. This review included 34 randomized controlled trials. Universal education prevention interventions were found to be promising in improving adolescents' mental health literacy but showed limited effects on individual mental health literacy components and on reducing depression (SMD = -0.06, 95%CI: [-0.11, -0.02], Z = 2.58, p = 0.01, I2 = 45%) and anxiety (SMD = -0.00, 95%CI: [-0.06, 0.06], Z = 0.07, p = 0.94, I2 = 58%) at post-intervention. Future trials should consider using a hybrid delivery model utilizing health care and the non-health care professionals. These interventions must incorporate skills-based sessions to develop emotional regulation strategies, complemented by extended follow-up periods that include booster sessions to reinforce learning. Given the very low quality of evidence as rated by the GRADE approach, current findings need to be interpreted with caution.

Inhibition of emotional faces in clinical and subclinical depression

Impaired inhibition of emotional material is an important cognitive component of depression. The current aim was to determine if participants with major depression (MDD) and/or subclinical depression (dysphoria) exhibit impaired inhibition of sad faces on a face-word variant of the Stroop task. Study 1: patients with MDD (n = 28) and healthy controls (n = 32) were presented with positive and negative words superimposed across happy, sad, and neutral faces. Study 2: dysphoric (n = 23) and non-dysphoric (n = 35) participants were presented with positive and negative words superimposed across happy and sad faces (shown upright and inverted). Participants were told to ignore the faces and categorise the words. Patients with MDD experienced greater interference from sad faces than did the controls. Healthy controls experienced greater interference from happy than sad faces, whereas interference levels from happy and sad faces did not differ in patients with MDD. Dysphoric participants experienced greater interference from sad faces than did non-dysphoric participants, and from sad faces than happy. The amount of interference from happy and sad faces did not differ in the non-dysphoric participants. Clinical and subclinical depression are linked to impaired inhibition of sad faces, which might represent a risk factor for depression and a potential target for intervention.

Childhood Physical Fitness as a Predictor of Cognition and Mental Health in Adolescence: The PANIC Study

BACKGROUND

Cognitive and mental health problems are highly prevalent in adolescence. While higher levels of physical fitness may mitigate these problems, there is a lack of long-term follow-up studies on the associations of physical fitness from childhood with cognition and mental health in adolescence.

OBJECTIVE

We investigated the associations of physical fitness from childhood to adolescence over an 8-year follow-up with cognition and mental health in adolescence.

METHODS

The participants were 241 adolescents (112 girls), who were 6-9 years at baseline and 15-17 years at 8-year follow-up. Average and change scores for cardiorespiratory fitness (maximal power output [Wmax]; peak oxygen uptake [VO2peak]), motor fitness (10 × 5-m shuttle run), and muscular fitness (standing long jump; hand grip strength) were calculated. Global cognition score was computed from six individual cognitive tasks, and perceived stress and depressive symptoms were assessed at the 8-year follow-up. The data were analysed using linear regression models adjusted for age, sex, and parental education.

RESULTS

Average motor fitness was positively associated with global cognition score (standardised regression coefficient [β] - 0.164, 95% confidence interval [CI] - 0.318 to - 0.010) and inversely with perceived stress (β = 0.182, 95% CI 0.032-0.333) and depressive symptoms (β = 0.181, 95% CI 0.028-0.333). Average cardiorespiratory fitness was inversely associated with perceived stress (Wmax: β =  - 0.166, 95% CI - 0.296 to - 0.036; VO2peak: β =  - 0.149, 95% CI - 0.295 to - 0.002) and depressive symptoms (Wmax: β =  - 0.276, 95% CI - 0.405 to - 0.147; VO2peak: β =  - 0.247, 95% CI - 0.393 to - 0.102). A larger increase in cardiorespiratory fitness was associated with lower perceived stress (Wmax: β =  - 0.158, 95% CI - 0.312 to - 0.003; VO2peak: β =  - 0.220, 95% CI - 0.395 to - 0.044) and depressive symptoms (Wmax: β =  - 0.216, 95% CI - 0.371 to - 0.061; VO2peak: β =  - 0.257, 95% CI - 0.433 to - 0.080).

CONCLUSIONS

Higher levels of motor fitness in childhood and adolescence were associated with better cognition in adolescence. Higher levels of and larger increases in cardiorespiratory fitness from childhood to adolescence were associated with better mental health in adolescence.

Can infliximab serve as a new therapy for neuropsychiatric symptoms?

Neuropsychiatric disorders present a global challenge to public health. Mechanisms associated with neuropsychiatric disorders etiology include apoptosis, oxidative stress, and neuroinflammation. Tumor necrosis factor alpha, an inflammatory cytokine, mediates pathophysiology of neuropsychiatric disorders. Therefore, its inhibition by infliximab might afford a valuable target for intervention. Infliximab is commonly used to treat inflammatory diseases, including ulcerative colitis, Crohn's disease, and rheumatoid arthritis. Recently, it has been shown that infliximab improves cognitive dysfunction, depression, anxiety, and life quality. Here, we review contemporary knowledge supporting the need to further characterize infliximab as a potential treatment for neuropsychiatric disorders.

Personality traits and co-occurrence of depressive symptoms and high BMI: a prospective cohort study

We assess the associations between personality traits and co-occurrence of depressive symptoms and high BMI from adolescence to early adulthood. We employed a nationally representative cohort in China from 2010 to 2020 year. We included adolescents aged 10-19 years without depressive symptoms and unhealthy weight status (obesity, overweight, or thinness) at baseline and excluded those without any measurement of depressive symptoms or BMI at follow-ups. We assessed baseline personality traits in 7 dimensions of conscientiousness, openness, neuroticism, agreeableness, extraversion, self-esteem, and responsibility. We also assessed the combined effects of these 7 dimensions of personality traits by generating individual-level personality trait risk scores based on the weighted sum of all these 7 dimensions of personality traits. We measured the co-occurrence of depressive symptoms and high BMI using both a single measurement of depressive symptoms and BMI at the last follow-up and repeated measurements of them over 10 years. We used the multinomial logistic regression models to examine the exposure-outcome associations. At baseline, we included 1778 individuals (mean age: 14.4 year; female: 853 (48.0%)). At follow-ups, we observed increased risk of co-occurrence of depressive symptoms and high BMI per 1-SD increase in neuroticism score (1.95-2.38 odds ratio) or 1-SD decrease in self-esteem and conscientiousness (0.63-0.80 odds ratio; all P values < 0.05); we observed no evidence of associations between openness, agreeableness, extraversion, or responsibility and the risk of co-occurrence of depressive symptoms and high BMI (all P values > 0.05). For the combined effects of the 7 dimensions of personality traits, we found an elevated risk of co-occurrence of depressive symptoms and high BMI per 1-SD increase in the personality trait risk scores (OR (95% CI), single measurement at the last follow-up: 2.01, 1.66 to 2.43; trajectory classification using the repeated measurements 2.30, 1.55 to 3.42; average level using the repeated measurements: 2.27, 1.93 to 2.67). In this national cohort in China, personality traits were found to be associated with the co-occurrence of depressive symptoms and high BMI from adolescence to early adulthood. These findings highlight the importance of stratifying individuals based on their personality traits and providing targeted interventions for those at risk of comorbid depression and obesity.

Bioactive compounds from Chinese herbal plants for neurological health: mechanisms, pathways, and functional food applications

Neurological disorders pose significant global public health challenges, with a rising prevalence and complex pathophysiological mechanisms that impose substantial social and economic burdens. Traditional Chinese Medicine (TCM), with its holistic approach and multi-target effects, has gained increasing attention in the treatment of neurological diseases. This review explores bioactive compounds derived from Chinese herbal plants, focusing on their mechanisms of action, underlying pathways, and potential applications in functional food development. The review highlights the neuroprotective properties of flavonoids, alkaloids, polysaccharides, and polyphenols found in key TCM herbs such as Scutellaria baicalensis, Salvia miltiorrhiza, Ligusticum chuanxiong, and Gastrodia elata. These compounds have demonstrated significant anti-inflammatory, antioxidant, and neurogenic effects, making them promising candidates for the prevention and treatment of neurological conditions, including Alzheimer's disease (AD), Parkinson's disease (PD), and depression. Furthermore, the synergistic effects of TCM formulations targeting multiple signaling pathways offer advantages over single-target therapies, especially in combating neurodegenerative diseases. The review also discusses the challenges and future directions for integrating these bioactive compounds into functional foods and dietary supplements, aiming to improve neurological health and enhance clinical outcomes. Ultimately, this work aims to provide valuable insights into the potential of TCM-based interventions for promoting neurological well-being and addressing the global burden of neurological disorders.

Relationship Between Stressful Life Events and Depression Among Adolescents: The Mediating Roles of Subcomponents of Executive Function

Stressful life events are important risk factors in the development of adolescent depression. Executive function is significant in the stress-depression link. However, it is not clear whether there is a specific effect for subcomponents of executive function (working memory, inhibition, and shifting). Therefore, the present study recruited 213 adolescents (mean age (Mage) = 15.19 years, SD = 1.27, range = 12.00-18.00 years, and 53.00% girls) and measured their perceived stress using the questionnaire of the Adolescent Self-Rating Life Events Checklist, working memory ability by two-back tasks, inhibition ability by Stroop tasks, and shifting ability by Wisconsin Card-Sorting tasks. Results showed that stressful life events positively correlated with adolescents' depression, while stressful life events negatively linked with working memory and inhibition. Depression was negatively associated with working memory and inhibition. No significant correlation was found between shifting and either stressful life events or depression. Mediation analyses revealed that working memory and inhibition mediated the link between stressful life events and adolescent depression, while shifting did not show a mediating effect. Our findings provide further evidence for the precise effect of executive function in the stress-depression link, implicating that different subcomponents should be considered to provide targeted intervention to alleviate adolescents' depressive symptoms.

Depression in adolescence and the understanding of health-A phenomenographic study

Health is multifaceted, with divergent interpretations in diverse cultures and groups of individuals. The ways individuals understand health might aid in developing future interventions. There is scant knowledge on how adolescents with depression conceptualise health. A descriptive qualitative design with a phenomenographic approach was used to describe the different ways adolescents with depression conceptualise health. Interviews were performed with adolescents 13-17 years old (n = 33) who participated in a randomised controlled trial evaluating the effects of aerobic group exercise versus leisure group activities for adolescents with depression. The results were interpreted into four metaphors to embody the understanding of health as described by adolescents with depression: 1) establishing sound routines by managing everyday life, 2) connecting to others by having access to social resources, 3) managing depression symptoms by having control over the mental illness, and 4) attaining inner drive by experiencing joy in everyday life. The various conceptions of health among adolescents with depression provide valuable insights for enhancing evidence-based treatments with person-centred care. Key aspects include establishing routines, fostering connections, finding strategies for symptom control, and incorporating joy through exercise. Given that adolescents highlighted these aspects as essential to health, future research could explore individualised health promotion, particularly focusing on routine-building, social connections, or finding an inner drive as an add-on to evidence-based treatments for adolescent depression.

Antioxidant-Rich Functional Foods and Exercise: Unlocking Metabolic Health Through Nrf2 and Related Pathways

This article reviews the synergistic effects of antioxidant-enriched functional foods and exercise in improving metabolic health, focusing on the underlying molecular mechanisms. The review incorporates evidence from PubMed, SCOPUS, Web of Science, PsycINFO, and reference lists of relevant reviews up to 20 December 2024, highlighting the central role of the Nrf2 pathway. As a critical regulator of oxidative stress and metabolic adaptation, Nrf2 mediates the benefits of these interventions. This article presents an innovative approach to understanding the role of Nrf2 in the regulation of oxidative stress and inflammation, highlighting its potential in the prevention and treatment of various diseases, including cancer, neurodegenerative disorders, cardiovascular and pulmonary diseases, diabetes, inflammatory conditions, ageing, and infections such as COVID-19. The novelty of this study is to investigate the synergistic effects of bioactive compounds found in functional foods (such as polyphenols, flavonoids, and vitamins) and exercise-induced oxidative stress on the activation of the Nrf2 pathway. This combined approach reveals their potential to improve insulin sensitivity and lipid metabolism and reduce inflammation, offering a promising strategy for the management of chronic diseases. However, there are significant gaps in current research, particularly regarding the molecular mechanisms underlying the interaction between diet, physical activity, and Nrf2 activation, as well as their long-term effects in different populations, including those with chronic diseases. In addition, the interactions between Nrf2 and other critical signalling pathways, including AMPK, NF-κB, and PI3K/Akt, and their collective contributions to metabolic health are explored. Furthermore, novel biomarkers are presented to assess the impact of these synergistic strategies, such as the NAD+/NADH ratio, the GSH ratio, and markers of mitochondrial health. The findings provide valuable insights into how the integration of an antioxidant-rich diet and regular exercise can improve metabolic health by activating Nrf2 and related molecular pathways and represent promising strategies for the prevention and treatment of metabolic disorders. Further studies are needed to fully understand the therapeutic potential of these interventions in diseases related to oxidative stress, such as cardiovascular disease, neurodegenerative disease, diabetes, and cancer.

Could physical activity promote indicators of physical and psychological health among children and adolescents? An umbrella review of meta-analyses of randomized controlled trials

BACKGROUND

We performed an umbrella review to synthesize evidence on the effects of physical activity (PA) interventions on indicators of physical and psychological health among children and adolescents, including body mass index (BMI), blood pressure (BP), depressive symptoms, and cognitive function.

METHODS

PubMed, Embase, Web of Science, and the Cochrane Library were systematically searched from inception through 31 July 2023. We included meta-analyses of randomized controlled trials exploring the effects of PA interventions on BMI, BP, depressive symptoms, or cognitive function in healthy or general children and adolescents. Standard Mean Difference (SMD) was calculated for continuous outcome indicators, while Relative Risk (RR) was calculated for categorical outcome indicators.

RESULTS

A total of 21 meta-analyses were included. The evidence for the effects of PA interventions on reducing BMI [n = 68,368, SMD = - 0.04, 95% confidence interval (CI) = - 0.07 to - 0.01, P = 0.012, I2 = 46.6%], relieving diastolic BP (n = 8204, SMD = - 1.16, 95% CI = - 2.12 to - 0.20, P = 0.018, I2 = 83.1%), preventing depressive symptoms (n = 5146, SMD = - 0.21, 95% CI = - 0.31 to - 0.12, P < 0.001, I2 = 29.0%), and promoting cognitive function (n = 19,955, SMD = 0.40, 95% CI = 0.27-0.54, P < 0.001, I2 = 88.0%) was all weak but significant (class IV evidence). Subgroup analyses demonstrated that school-based and after-school PA interventions, curricular PA interventions, and PA interventions emphasizing enjoyment were more effective in reducing BMI, while curricular PA and sports programs achieved greater executive function.

CONCLUSION

PA interventions could weakly reduce BMI, relieve BP, prevent depressive symptoms, and promote cognitive function in general children and adolescents. Targeted interventions on PA should be a priority to promote physical and psychological health for children and adolescents, especially the curricular PA emphasizing enjoyment in the school settings.

Neurological mechanism-based analysis of the role and characteristics of physical activity in the improvement of depressive symptoms

Depression is a common mental disorder characterized by a high prevalence and significant adverse effects, making the searching for effective interventions an urgent priority. In recent years, physical activity (PA) has increasingly been recognized as a standard adjunctive treatment for mental disorders owing to its low cost, easy application, and high efficiency. Epidemiological data shows positive preventive and therapeutic effects of PA on mental illnesses such as depression. This article systematically describes the prophylactic and therapeutic effects of PA on depression and its biological basis. A comprehensive literature analysis reveals that PA significantly improves depressive symptoms by upregulating the expression of "exerkines" such as irisin, adiponectin, and BDNF to positively impacting neuropsychiatric conditions. In particular, lactate could also play a critical role in the ameliorating effects of PA on depression due to the findings about protein lactylation as a novel protein post-transcriptional modification. The literature also suggests that in terms of brain structure, PA may improve hippocampal volume, basal ganglia (neostriatum, caudate-crustal nucleus) and PFC density in patients with MDD. In summary, this study elucidates the multifaceted positive effects of PA on depression and its potential biological mechanisms with a particular emphasis on the roles of various exerkines. Future research may further investigate the effects of different types, intensities, and durations of PA on depression, as well as how to better integrate PA interventions into existing treatment strategies to achieve optimal outcomes in mental health interventions.

Protocol for a nested case-control study: identifying neuroimaging biomarkers for the progression of subclinical depression and qi-stagnation constitution to major depressive disorder in adolescents

Background

Major depressive disorder (MDD) frequently results in suboptimal treatment outcomes and elevated recurrence rate, with patients frequently engaging in self-harm and suicidal behavior, thereby placing a heavy burden on families and society. Specifically, MDD in adolescents is linked to an elevated suicide risk. Thus, early identification and intervention is crucial for adolescents at high risk for developing MDD. Subclinical depression (SD), characterized by depressive symptoms that do not meet the full criteria for MDD, substantially increases the risk of developing MDD. According to Traditional Chinese Medicine body constitution theory, Qi-stagnation constitution (QSC) is also considered a significant risk factor for the progression to MDD. This study protocol aims to identify neuroimaging biomarkers for the progression from adolescents with SD and QSC to those with MDD, facilitating early intervention strategies.

Methods and analysis

This nested case-control study includes both longitudinal follow-up and cross-sectional comparison. Three hundred first-year senior high school students diagnosed with SD and QSC will be recruited. The 300 adolescents will undergo rs-fMRI scans at baseline and again after one year. We then divide the 300 adolescents with SD and QSC into two groups based on whether they progress to MDD after one year. Functional brain networks will be constructed based on 400 regions of interest (ROIs). Neuroimaging measures, including regional homogeneity and low-frequency fluctuation for each ROI, as well as graph-based global efficiency, nodal efficiency, and nodal centrality from the binary networks, will then be calculated. Finally, differences in these neuroimaging measures between the two groups at baseline will be analyzed to identify biomarkers that can predict the progression from adolescents with SD and QSC to those with MDD.

Study registration

This study protocol does not involve clinical interventions and is classified as an observational study, so it was not subject to prior registration.

Systematic Review and Meta-Analysis: The Association Between Newer-Generation Antidepressants and Insomnia in Children and Adolescents With Major Depressive Disorder

OBJECTIVE

To examine the association between newer generation antidepressants and insomnia as an adverse event (AE) in the treatment of children and adolescents with major depressive disorder (MDD).

METHOD

A systematic search was performed in major databases (inception to August 31, 2023) to retrieve double-blind, placebo-controlled, randomized controlled trials (RCTs) evaluating the safety of 19 antidepressants in the acute treatment (initial 6-12 weeks) of children and adolescents ≤18 years of age with MDD (primary analyses). RCTs in anxiety disorders and obsessive-compulsive disorder (OCD) were retrieved from a recent meta-analysis and included in complementary analyses. A mixed-effects logistic regression model was used to compare the frequency of insomnia in the antidepressant relative to the placebo group. Risk of bias was evaluated using the Cochrane Risk of Bias 2 tool.

RESULTS

In total, 20 trials in MDD (N = 5,357) and 8 trials in anxiety disorders and OCD (N = 1,271) evaluating selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) were included. In MDD, antidepressant treatment was associated with a modest increase in the odds of insomnia compared with placebo (odds ratio [OR] = 1.65, 95% CI = 1.21-2.27, p = .002), with no significant difference between SSRIs and SNRIs. The RCTs showed low risk of bias or minor concerns for the assessment of insomnia. The odds of treatment-emergent insomnia were significantly lower in MDD (OR = 1.62; 95% CI = 1.21-2.15) compared to anxiety disorders and OCD (OR = 2.89; 95% CI = 1.83-4.57) for treatment with SSRIs (p = .03). Among individual antidepressants with evidence from ≥3 studies, sertraline had the highest OR (3.45; 95% CI = 1.91-6.24), whereas duloxetine had the lowest OR (1.38; 95% CI = 0.79-2.43).

CONCLUSION

Children and adolescents are at a modestly increased risk for experiencing insomnia during the first 6 to 12 weeks of treatment with SSRIs and SNRIs. Antidepressant- and disorder-specific variability in the risk of treatment-emergent insomnia may be relevant to consider in clinical decision making.

STUDY PREREGISTRATION INFORMATION

The association between newer generation antidepressants and insomnia in children and adolescents with major depressive disorder: a meta-analysis of randomized controlled trials; https://www.crd.york.ac.uk; CRD42023330506.

Hybrid electroconvulsive therapy in an adolescent with major depressive disorder: a case report

The incidence of depression is increasing in adolescents, who are at a stage of education and therefore more concerned about their cognitive changes. We tried to preserve the rapid relief of depressive symptoms in electroconvulsive therapy (ECT) while causing less cognitive impairment, thus designing the hybrid-ECT (HECT), a modified ECT therapy. Here, we report a case study of a 14-year-old male student with major depressive disorder (MDD) suffering from severe suicidality and significant impairment in social functioning who achieved effective antidepressant effects with HECT and improved cognitive function. HECT showed safety and effectiveness in adolescent MDD patient.

Universal depressive symptom screening in middle schools in Istanbul: An epidemiologic study

INTRODUCTION

Depression is a significant public health concern, with severe adolescent morbidity and mortality. Promoting adolescents' mental health is increasingly recognized, and schools are proposed as screening and preventive intervention sites. This cross-sectional study aimed to screen self-reported elevated depressive symptom prevalence among secondary school students in Istanbul, Turkey. The secondary objectives were determining behavioral problems, resilience, positive attitudes, and risk factors associated with depressive symptoms.

METHODS

Data collection was conducted between April-June 2022. Six thousand one hundred ten students from nine randomly selected schools from different city districts were approached. Depression was screened by the Centre for Epidemiological Studies Depression Scale for Children (CES-DC). The Strengths and Difficulties Questionnaire (SDQ) was used for screening behavioral problems and positive attitudes. Resilience was evaluated by the Child and Youth Resilience Measure (CYRM).

RESULTS

The final study sample comprised 2780 participants (response rate 47.7 %) with a mean age of 12.4 ± 1.1 years (females:52.7 %). Elevated depressive symptoms were detected in 31.2 % of the students. Female students exhibited higher scores in CES-DC and total difficulties but lower resilience scores in CYRM than male students. In a multiple regression analysis, female gender, higher total difficulties score, lower resilience score, and lower perceived academic performance significantly predicted CES-DC [F(6,2279) = 421, p < 0.01].

DISCUSSION

Our findings showed high rates of elevated self-reported depressive symptoms in a city sample among Turkish adolescents at middle schools, in addition to coexisting behavioral difficulties and decreased resilience indicating poor psychosocial functioning. Given the prevalent depressive symptoms, screening and intervention programs involving resilience promotion may involve school systems to prevent adolescent depression.

Prevalence of congenital heart defects in people with Down syndrome: a systematic review and meta-analysis

BACKGROUND

The prevalence of congenital heart defects (CHD) in Down syndrome (DS) varies considerably across studies (from 16% to 84%). This study aimed to estimate the prevalence of CHD in people with DS (CHD-DS).

METHODS

PubMed, Web of Science and the Chinese National Knowledge Infrastructure databases were searched through to 5 January 2023. English-language and Chinese-language articles reporting data on the prevalence of CHD in people with DS were included. Two independent observers performed data extraction and we used a random effects model for all statistical analyses by the Comprehensive Meta-Analysis V.3.3.070 software.

RESULTS

A pooled analysis, based on 102 studies that included 60 610 individuals, revealed the prevalence of CHD was 49.9% (95% CI: 46.8% to 53.0%) in people with DS. Most of the studies included in this meta-analysis were from North America, Europe and Asia, and subgroup analyses showed a slightly higher prevalence of CHD-DS in Asia (27 studies) compared with North America (28 studies) and Europe (35 studies) (Asia vs North America vs Europe; 54.2% vs 51.6% vs 46.2%).

CONCLUSION

These results demonstrated that approximately one-half of people with DS had CHD, reinforcing the need to screen all newborns suspected of Down syndrome for CHD.

Inequalities in adolescent mental health and allocation of students to selective classes in comprehensive schools in Finland: a longitudinal study

BACKGROUND

Lower socioeconomic positions (SEP) and poor academic achievement increase children's risk for mental health problems. The Finnish education system is officially non-selective and unified, but a part of children can be selected into emphasised teaching classes by aptitude tests, which are known to segregate students by SEP and academic achievement. We study here if allocation of students to mainstream and selective classes segregates students by mental health, too.

METHODS

Students from primary school (6th grade) were followed to lower secondary school (7th grade). The number in selective classes was n=209 and in mainstream classes n=551. Outcomes were depressed mood, anxiety and daily health complaints. Association between class type and the outcomes was analysed by cross-tabulation and logistic regression models. Gender, academic achievement, SEP and previous mental health were independent and confounding/moderating variables.

RESULTS

Students in selective classes had better academic achievement and higher SEP compared with students in mainstream classes. Girls reported poorer mental health than boys. Depressive mood did not vary by class type, but anxiety and daily health complaints were more common among girls in mainstream classes. When academic achievement and background factors were considered, among girls only anxiety was more common in mainstream classes, but among boys, anxiety appeared to be statistically significantly more common in selective classes.

CONCLUSION

Grouping students by aptitude tests to different classes may select them by mental health, too. Longer follow-up and gender-specific studies would give more reliable answers for education policy makers about student grouping by aptitude test and its effects on segregation.

Is Artificial Intelligence the Next Co-Pilot for Primary Care in Diagnosing and Recommending Treatments for Depression?

Depression poses significant challenges to global healthcare systems and impacts the quality of life of individuals and their family members. Recent advancements in artificial intelligence (AI) have had a transformative impact on the diagnosis and treatment of depression. These innovations have the potential to significantly enhance clinical decision-making processes and improve patient outcomes in healthcare settings. AI-powered tools can analyze extensive patient data-including medical records, genetic information, and behavioral patterns-to identify early warning signs of depression, thereby enhancing diagnostic accuracy. By recognizing subtle indicators that traditional assessments may overlook, these tools enable healthcare providers to make timely and precise diagnostic decisions that are crucial in preventing the onset or escalation of depressive episodes. In terms of treatment, AI algorithms can assist in personalizing therapeutic interventions by predicting the effectiveness of various approaches for individual patients based on their unique characteristics and medical history. This includes recommending tailored treatment plans that consider the patient's specific symptoms. Such personalized strategies aim to optimize therapeutic outcomes and improve the overall efficiency of healthcare. This theoretical review uniquely synthesizes current evidence on AI applications in primary care depression management, offering a comprehensive analysis of both diagnostic and treatment personalization capabilities. Alongside these advancements, we also address the conflicting findings in the field and the presence of biases that necessitate important limitations.