Metacognitions and Mindful Attention Awareness in Depression: A Comparison Of Currently Depressed, Previously Depressed and Never Depressed Individuals

Quercetin reshapes gut microbiota homeostasis and modulates brain metabolic profile to regulate depression-like behaviors induced by CUMS in rats

Quercetin, an abundant flavonoid compound in plants, is considered a novel antidepressant; however, its mechanisms of action are poorly understood. This study aimed to investigate the therapeutic effects of quercetin on chronic unpredictable mild stress (CUMS)-induced depression-like behaviors in rats and explore the underlying mechanisms by combining untargeted metabolomics and 16S rRNA sequencing analysis of brain tissue metabolites and gut microbiota. Gut microbiota analysis revealed that at the phylum level, quercetin reduced Firmicutes and the Firmicutes/Bacteroidetes (F/B) ratio and enhanced Cyanobacteria. At the genus level, quercetin downregulated 6 and upregulated 14 bacterial species. Metabolomics analysis revealed that quercetin regulated multiple metabolic pathways, including glycolysis/gluconeogenesis, sphingolipid metabolism, the pentose phosphate pathway, and coenzyme A biosynthesis. This modulation leads to improvements in depression-like phenotypes, anxiety-like phenotypes, and cognitive function, highlighting the therapeutic potential of quercetin in treating depression.

Effect of mindfulness-based stress reduction (MBSR) program on depression, emotion regulation, and sleep problems: A randomized controlled trial study on depressed elderly

BACKGROUND

Entering old age is associated with various physical and psychological disabilities. Therefore, the aim of this study is to determine the effect of mindfulness-based stress reduction program on emotion regulation and sleep problems in depressed elderly.

METHODS

This study was a clinical trial conducted on 60 elderly individuals with depression using purposive sampling. These elderly were referred by geriatricians and were included in the study based on the inclusion criteria. The participants were randomly assigned to two groups: the Mindfulness-Based Stress Reduction (MBSR) group and the control group. Both groups completed the Geriatric Depression Scale (GDS), the Gratz and Roemer Emotion Regulation Questionnaire, and the Pittsburgh Sleep Quality Index before and after the intervention. The MBSR sessions were held for the experimental group in 8 sessions of 90 min each, once a week. Finally, all the data were analyzed using SPSS software version 26 through descriptive and analytical statistics such as mean and standard deviation, t-tests and mixed analysis of covariance (ANCOVA) with repeated measures.

RESULTS

The results showed that the MBSR intervention led to a significant reduction in depression symptoms (p < 0.001) and improvement in emotion regulation and sleep quality (p < 0.001) among the elderly participants with depression in the intervention group.

DISCUSSION

The results of this study showed that MBSR can be effective in reducing depression levels, improving emotion regulation, and sleep quality among depressed elderly individuals compared to the control group. Caregivers and psychotherapists of nursing homes can use care programs such as MBSR program to improve the physical and mental condition of the elderly.

TRIAL REGISTRATION

First Registration: 13/01/2022, Registration Number: IRCT20211118053099N1, Access: https://www.irct.ir/trial/61207 .

Association between time perspective and metacognition among Lebanese adults: the mediating role of mindfulness

BACKGROUND

Mindfulness may serve as a component of metacognitive beliefs and can also be viewed as a form of time perspective. The interplay between time perspective and metacognitive beliefs remains understudied. Both aspects, however, display considerable stability over time and significantly influence an individual's life and well-being. Lebanon, marked by its diverse and complex history, struggles with various political, social, and economic challenges. This study offers a valuable and unprecedented opportunity to examine these connections within a distinct cultural context, shedding light on the unique experiences of the Lebanese population. Therefore, our research aims to investigate the connection between time perspective and metacognition, with a focus on the role of mindfulness as a mediator.

METHODS

This cross-sectional study was conducted from August to November 2022 and involved participants from various regions of Lebanon. The questionnaire included sociodemographic data and scales such as the Arabic versions of the 15-item Short Form of the Zimbardo Time Perspective Inventory, the Metacognitions Questionnaire, the Freiburg Mindfulness Inventory and the Acceptance and Action Questionnaire (AAQ-2).

RESULTS

Our investigation recruited 423 participants. The analysis showed that individuals with a positive stance on their past, a hedonistic present, or a future-oriented outlook exhibited heightened levels of mindfulness. This elevated state of mindfulness, in turn, demonstrated a significant link to augmented cognitive self-consciousness (An increased introspection into one's own thoughts). We also observed a direct association between a future-focused time perspective and high scores of cognitive self-consciousness. Furthermore, mindfulness emerged as a crucial mediator in the relationships between time perspectives and negative beliefs about the danger of worry. Similarly, individuals with a positive view on their past, a hedonistic present orientation, or a future-focused mindset demonstrated elevated levels of mindfulness, which was correlated with less negative beliefs about the danger of worry. Notably, a positive past perspective was directly associated with less negative views on worry and the subsequent loss of control, whereas higher future focused time perspective scores was significantly and directly associated with more negative beliefs about worry, whereas more future focused time perspective was significantly and directly associated with more negative beliefs about worry.

CONCLUSION

Our findings found several meaningful associations between our variables, but it primarily underscored the significance of considering distinct subcomponents within mindfulness and psychopathological metacognition that may overlap, shedding light on their differential impacts on psychological well-being. We were also able to mirror the dual pathway theory of time perspective suggested in previous studies. These insights carry notable implications for the development and refinement of mindfulness-based and metacognitive interventions, emphasizing the need for tailored approaches that consider varying time perspectives. Continued investigation in this area promises to advance our understanding of these constructs and refine their practical applications in mental health interventions and well-being enhancement strategies.

Decision making and its correlates in recurrent depressive disorder

Objective

Decision-making (DM) is simply choosing among alternatives or defining one's course of action. A depressed individual does not perceive himself as a decision-maker as ruminations reinforce dysfunctional metacognitive beliefs and poor executive functioning. The aim was to study and compare the relationship among DM, metacognition, and executive functioning in those with recurrent depressive disorder (RDD) and in healthy controls (HCs).

Methods

A cross-sectional comparative group study design was used with a sample size of 40, with 20 participants in each group. The tools used were Mini International Neuropsychiatric Interview, General Health Questionnaire, Melbourne Decision Making Questionnaire, Metacognitive Questionnaire, Wisconsin Card Sorting Test, and Controlled Oral Word Association Test.

Results

The RDD group had significantly higher scores on buck-passing (BP), procrastination (PR), hypervigilance, and dysfunctional metacognitive beliefs, and poor performance on executive functioning than HC. PR was inversely correlated with executive functioning and dysfunctional metacognitive beliefs in the RDD group, whereas in the HC group, BP was positively correlated with executive functioning and dysfunctional metacognitive beliefs.

Conclusion

DM has a significant relationship with executive functions and dysfunctional metacognitive beliefs; therefore, changes in any one variable contribute to changes in the other two. The altered attentional and executive control due to dysfunctional metacognitive beliefs leads to poor DM, resulting in psychosocial dysfunction. The underlying metacognitive beliefs and executive functioning play a crucial role in DM, the process determining psychosocial functioning.

The effect and safety of probiotics on depression: a systematic review and meta-analysis of randomized controlled trials

PURPOSE

With the escalating social pressures, there has been a continuous rise in the prevalence of depression among the population, leading to substantial healthcare burdens. Moreover, conventional pharmacological interventions still exhibit certain limitations. Therefore, the primary objective of this study is to systematically evaluate the clinical efficacy of probiotics in the treatment of depression.

METHODS

Randomized controlled trials of probiotics in treating depressive symptoms were retrieved from Pubmed, Cochrane Library, Web of Science, Wan Fang database, and CNKI between the establishment of the database and March 2022. The primary outcome was Beck's depression rating scale (BDI) scores, while the secondary outcomes were depression scores on the DASS-21 scale, biochemical indicators (IL-6, NO, and TNF-α levels), and adverse events. In addition, Revman 5.3 was used for Meta-analysis and quality evaluation, and Stata 17 was used for the Egger test and Begg's test. A total of 776 patients, including 397 and 379 patients in the experimental and control groups, respectively, were included.

RESULTS

The total BDI score of the experimental group was lower than that of the control group (MD = - 1.98, 95%CI - 3.14 to - 0.82), and the score of DASS (MD = 0.90, 95%CI - 1.17 to 2.98), the IL-6 level (SMD = - 0.55, 95%CI - 0.88 to - 0.23), the NO level (MD = 5.27, 95% CI 2.51 to 8.03), and the TNF-α level (SMD = 0.19, 95% CI - 0.25 to 0.63).

CONCLUSION

The findings substantiate the therapeutic potential of probiotics in mitigating depressive symptoms by significantly reducing Beck's Depression Inventory (BDI) scores and alleviating the overall manifestation of depression.

Mindfulness and Sex Education for Sexual Interest/Arousal Disorder: Mediators and Moderators of Treatment Outcome

Sexual Interest/Arousal Disorder (SIAD) is a common sexual dysfunction in women. Both mindfulness-based cognitive therapy (MBCT) plus psychoeducation and sex therapy, education, and support (STEP; which contains the same educational information as in the MBCT arm but also integrates supportive-expressive therapy), are effective. We tested mediators and moderators of improvements. Each treatment arm consisted of eight sessions delivered weekly, and participants completed measures online pre-treatment, immediately post-treatment, and at 6- and 12-month post-treatment. Depression, self-reported interoceptive awareness, self-compassion, self-criticism, and mindfulness were examined as mediators, and expectations for improvement as a moderator. Of 148 cisgender women who consented, 70 were randomized to the MBCT plus psychoeducation group (mean age 39.3 ± 13.2 yrs) and 78 to the STEP group (mean age 37.9 ± 12.2 yrs). Decreases in depression mediated decreases in sexual distress in the MBCT plus psychoeducation group only. Improvements in interoceptive awareness mediated changes in both sexual desire and arousal, and sexual distress, and to a greater degree after MBCT plus psychoeducation. Changes in self-compassion mediated changes in sexual desire and arousal only for the MBCT plus psychoeducation group and mediated changes in sexual distress in both groups. Reductions in self-criticism mediated improvements in sexual distress to a greater extent after MBCT plus psychoeducation. Changes in mindfulness predicted changes in desire and arousal, and distress only in the MBCT plus psychoeducation group. Expectations for improvement did not moderate any outcomes. The findings have implications for understanding common and potentially distinct pathways by which MBCT plus psychoeducation and supportive sex education improve symptoms of SIAD.

The psychometric properties of positive and negative beliefs about the rumination scale in Chinese undergraduates

BACKGROUND

Rumination, a transdiagnostic factor in different psychopathological conditions, is believed to be activated and sustained by dysfunctional metacognition. The Positive Beliefs about Rumination Scale (PBRS) and the Negative Beliefs about Rumination Scale (NBRS) have been used to measure the metacognitive beliefs of rumination and have been investigated in many cultural contexts. However, it remains unclear whether these scales can work as well for the Chinese population. Therefore, this study aimed to explore the psychometric properties of the Chinese versions of these scales and to test the metacognitive model of rumination for students with different levels of depression.

METHODS

The PBRS and NBRS were forward-backward translated into Mandarin. In total 1,025 college students were recruited to complete a battery of web-based questionnaires. Exploratory factor analysis, confirmatory factor analysis, and correlation analysis were used to test the structure, validity, and reliability of the two scales, as well as their item correlations with rumination.

RESULTS

A new two-factor structure of the PBRS (rather than the original one-factor model) and a new three-factor structure of the NBRS (rather than the original two-factor model) were extracted. The goodness-of-fit indices of these two factor models showed they had a good to very good fit with the data. The internal consistency and construct validity of PBRS and NBRS were also affirmed.

CONCLUSION

The Chinese versions of the PBRS and the NBRS were generally shown to be reliable and valid, but their newly extracted structures fit the Chinese college students better than their original structures. These new models of PBRS and NBRS are of value to be further explored in Chinese population.

Health-Promoting Activities and Associated Mechanisms of Polygonati Rhizoma Polysaccharides

Polygonati Rhizoma, a typical homology of medicine and food, possesses remarkable anti-fatigue, anti-aging, metabolic regulatory, immunomodulatory, anti-inflammatory, neuroprotective, anti-diabetes, and anti-cancer effects. Among bioactive phytochemicals in Polygonati Rhizoma, polysaccharides play important roles in the health-promoting activities through the mechanisms mentioned above and potential synergistic effects with other bioactives. In this review, we briefly introduce the updated biosynthesis of polysaccharides, the purification method, the structure characterization, and food applications, and discuss in detail the biological activities of Polygonati Rhizoma polysaccharides and associated mechanisms, aiming at broadening the usage of Polygonati Rhizoma as functional food and medicine.

Polysaccharides from Polygonatum cyrtonema Hua Reduce Depression-Like Behavior in Mice by Inhibiting Oxidative Stress-Calpain-1-NLRP3 Signaling Axis

Polysaccharides from Polygonatum cyrtonema Hua (PSP) exert antioxidant, anti-inflammatory, and antidepressant effects. Production of reactive oxygen species (ROS) and activation of the calpain system and the NOD-like receptor protein 3 (NLRP3) inflammasome are closely related to the pathogenesis of depression. However, the relationships among those pathways and the protective effects of PSP have not been characterized. In this study, lipopolysaccharide (LPS) and chronic unpredictable mild stress- (CUMS-) induced depression models were used to evaluate the protective mechanisms of PSP against depression. ROS levels were measured in HT-22 cells using flow cytometry. Brain tissues were collected to determine the levels of oxidation-related indicators and inflammatory cytokines. The protein levels of calpain-1, calpain-2, calpastatin, phosphatase and Tensin Homolog deleted on Chromosome 10 (PTEN), suprachiasmatic nucleus circadian oscillatory protein (SCOP), nuclear factor-erythroid factor 2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), NLRP3, apoptosis-associated speck-like protein (ASC), caspase-1, cleaved-caspase-1, ionized calcium binding adapter molecule 1 (Iba1), phosphorylation of extracellular signal-regulated kinase (p-ERK), nuclear factor-kappa B (NF-κB), interleukin-1β (IL-1β), and glial fibrillary acidic protein (GFAP) were measured using western blotting or immunofluorescence. In cellular experiments, we showed that PSP attenuated LPS-induced production of ROS in HT-22 cells. In animal experiments, we found that LPS increased the expression of calpain-1, NLRP3, ASC, caspase-1, cleaved-caspase-1, Iba1, p-ERK, NF-κB, and GFAP and reduced the expression of calpastatin, PTEN, SCOP, and Nrf2. Administration of PSP reversed these changes. N-Acetyl-L-cysteine (NAC) administration also inhibited oxidative stress and activation of the calpain system and the NLRP3 inflammasome. Furthermore, PSP, calpeptin, MCC950 (a selective NLRP3 inflammasome inhibitor), and NAC reduced LPS-induced proinflammatory cytokine release. We also showed that PSP prevented CUMS-induced changes in the calpain system and the Nrf2 and NLRP3 signaling pathways and reduced depression-like behavior. These results indicate that PSP exerts antidepressant effects through regulation of the oxidative stress-calpain-1-NLRP3 signaling axis.

Flavonoids for depression and anxiety: a systematic review and meta-analysis

Natural flavonoids are the most plentiful form of polyphenols. Given the anti-inflammatory and antioxidant properties of flavonoids, researchers discovered that it might be effective in treating depression and anxiety. The effect of flavonoids on depression and anxiety was investigated by a meta-analysis and systematic review. We searched PubMed, Embase, and Medline databases up to October 15, 2021. We selected 11 studies, among them, 10 studies were chosen to evaluate the depression effects of flavonoids and 7 studies were used to assess anxiety disorder. The meta-analysis showed that flavonoids have an overall significant effect on depression (p = 0.004, Hedge's g = -0.487, 95% CI -0.814 to -0.160) and anxiety (p = 0.006, Hedge's g = -0.741, 95% CI -1.266 to -0.217). Subgroup analysis indicated that the symptoms of depression were significantly improved in the studies when the dose of flavonoids was 50-100mg/day or the treatment duration was ≥8weeks. Anxiety symptoms were improved in the studies with the dose of flavonoids was ≥50mg/day. There was no evidence of publication bias. Our findings suggest that flavonoids might improve symptoms of depression and anxiety. However, a small number of participants and studies were included in this meta-analysis. Therefore, the results should be interpreted with caution.

Probiotics as an effective therapeutic approach in alleviating depression symptoms: an umbrella meta-analysis

Growing evidence has suggested that the consumption of probiotics can decrease depressive symptoms. However, even the results of meta-analyses are conflicting. In this regard, we performed an umbrella meta-analysis and proposed the decisive impacts of probiotics on depressive symptoms. The following international databases were searched up to July 2021: PubMed/Medline, Web of Science, Scopus, EMBASE, and Google Scholar. Meta-analyses investigating the impact of supplementation of probiotics on depression symptoms in adults were included. According to the studies, random-effects model was used to perform the analysis. Subgroup analysis was performed by dosage of probiotics, duration of supplementation and total sample size. Publication bias was assessed using Egger's, Begg's and visual inspection of funnel plot. Ten meta-analyses (n = 8886 participants) were included in study. The pooled data indicated that probiotic supplementation significantly reduced depression symptoms (ES= -1.41; 95% CI: -2.53, -0.30, p = 0.016; I2 = 99.4, p = <0.001). Subgroup analysis of studies with intervention duration >8 weeks and dosage >10 × 109 CFU demonstrated a more robust effect of probiotics on decreasing depression symptoms. There was also significant between-study heterogeneity in which dosage was identified as source of it. The results of present umbrella meta-analysis suggest administration of probiotics for relieving depression symptoms for >8 weeks with dosage of >10 × 109 CFU.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2022.2051164.

How does mindfulness relate to benign/malicious envy? The mediating role of resilience, internal locus of control and self-esteem

The present study aimed to explore the roles of resilience, internal locus of control, and self-esteem in the link between mindfulness and benign/malicious envy (BE/ME). Nine hundred ninety-one participants (299 males, 692 females; mean age = 19.05 ± 1.54) completed a survey that assessed mindfulness, internal locus of control, resilience, self-esteem, and BE/ME. The results suggest that resilience, internal locus of control, and self-esteem independently mediate the relationship between mindfulness and BE/ME. Additionally, "internal locus of control → resilience" and "self-esteem → resilience" play chain mediating roles in the relationship between mindfulness and BE/ME. Namely, mindfulness is positively associated with resilience via improving internal control and self-esteem, thereby inhibiting malicious envy and promoting benign envy. The present study advances our knowledge of the mindfulness reperceiving theory, and thus provides a new explanation for the inhibition of negative emotions from the perspective of resilience, internal locus of control, and self-esteem.

Empirical Evidence of the Metacognitive Model of Rumination and Depression in Clinical and Nonclinical Samples: A Systematic Review and Meta-Analysis

Rumination is considered a cognitive vulnerability factor in the development and maintenance of depression. The metacognitive model of rumination and depression suggests that the development of rumination and its association with depression partly depends on metacognitive beliefs. Two metacognitive beliefs about rumination have been identified: positive beliefs about its utility and negative beliefs about the uncontrollability and its negative social consequences. We conducted a systematic review and meta-analysis aimed: (1) to analyze the associations between metacognitive beliefs and rumination and depression; (2) to test the metacognitive model, using a Two-Stage Structural Equation Modeling approach (TSSEM). Literature search retrieved 41 studies. These 41 studies (N = 10,607) were included in the narrative synthesis and meta-analysis, and 16 studies (N = 4477) were comprised for the TSSEM. Results indicated metacognitive beliefs are associated with rumination and depression. Measures on metacognitive beliefs about rumination indicated that positive beliefs showed moderate associations with rumination (r = 0.50), and low with depression (r = 0.27); whereas negative beliefs showed moderate associations with both rumination (r = 0.46) and depression (r = 0.49). These results were consistent across studies using different instruments to measure metacognitive beliefs, and in both clinical and nonclinical samples. Moreover, results of the TSSEM analyses showed that the metacognitive model had a good fit. In sum, our results are in line with the metacognitive model of rumination and depression, highlighting that metacognitive beliefs are relevant factors to understand why people ruminate and get depressed. Future directions and clinical implications are discussed.

Long Noncoding RNA SNHG1 Promotes Lipopolysaccharide-Induced Activation and Inflammation in Microglia via Targeting miR-181b

INTRODUCTION

Long noncoding RNA small nuclear host gene 1 (SNHG1) was involved in neuroinflammation in microglial BV-2 cells; however, its interaction with microRNA (miR)-181b in lipopolysaccharide (LPS)-induced BV-2 cells remained poor.

METHODS

BV-2 cells were treated with LPS and then were subjected to observation on morphology and immunofluorescence staining. After transfection, levels of inflammatory cytokines interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) were determined with enzyme-linked immunosorbent assay (ELISA). The potential binding sites between SNHG1 and miR-181b were confirmed using dual-luciferase reporter assay. Quantitative real-time polymerase chain reaction and Western blot were applied for detecting the mRNA and protein expressions of proinflammatory cytokines, ionized calcium-binding adapter molecule 1 (Iba1), cyclooxygenase-2 (COX-2), and inducible nitric oxide synthase (iNOS).

RESULTS

LPS led to the morphological changes and activation of BV-2 cells. The transfection of SNHG1 overexpression vector further promoted LPS-induced SNHG1 upregulation, inflammatory cytokines (IL-1β, IL-6, and TNF-α) generation and Iba-1, COX-2, and iNOS expressions, whereas silencing SNHG1 did the opposite. miR-181b functions as a downstream miRNA of SNHG1. In LPS-treated cells, the inhibition of miR-181b induced by SNHG1 promoted inflammation response and the expressions of Iba-1, COX-2, and iNOS.

CONCLUSION

SNHG1 was involved in LPS-induced microglial activation and inflammation response via targeting miR-181b, providing another evidence of the roles of SNHG1 implicated in neuroinflammation of microglia.

Polygonatum sibiricum polysaccharide prevents depression-like behaviors by reducing oxidative stress, inflammation, and cellular and synaptic damage

ETHNOPHARMACOLOGICAL RELEVANCE

According to traditional Chinese medicine (TCM) theory (Yi Xue Zheng Zhuan), the main factors associated with the pathogenesis of depression are deficiencies relating to five zang organs, Qi, and blood. Polygonatum sibiricum F. Delaroche (PS), which may avert these pathological changes, has been used in a variety of formulas to treat depression. However, the effects and mechanism of action of PS, alone, and especially those of its main active component PS polysaccharide (PSP), on depression remain unexplored.

AIM OF THE STUDY

To determine the effects of PSP on depression-like behaviors and to elucidate its mechanism of action.

METHODS

PSP was isolated from dried PS rhizomes and qualified using transmission electron microscopy and Fourier transform infrared spectroscopy. Lipopolysaccharide (LPS) and chronic unpredictable mild stress (CUMS)-induced depression models were used to evaluate the antidepressive effects of PSP. Veinal blood and brain tissue were collected to determine the levels of hippocampal 5-HT, serum cortisol (CORT), brain and serum cytokines, and hippocampal oxidation-related indicators. The protein expression levels of phosphorylated extracellular signal-regulated kinase (p-ERK1/2), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), glial fibrillary acidic protein (GFAP), phosphorylated protein kinase B (p-Akt), phosphorylation of the mammalian target of rapamycin (mTOR), caspase-3, GluA1 and GluA2, and GluN2A and GluN2B were determined using western blotting and immunofluorescence. Nissl staining was performed to detect histopathological changes in brain tissues.

RESULTS

Injection of LPS (i.p.) induced depression-like behaviors, reduced the level of hippocampal 5-HT, increased the serum CORT level and hippocampal oxidative stress (ROS), and prompted the activation of ERK1/2, NF-κB, and GFAP and an inflammatory response. Conversely, PSP administration reduced these changes and prevented depression-like behaviors. PSP administration also promoted hippocampal expression of p-Akt, p-mTOR, GluA1, and GluA2; reduced the expression of caspase-3, GluN2A, and GluN2B; and prohibited the loss of granular cells in the DG region.

CONCLUSION

These results indicate that PSP prevents depression-like behaviors, and synaptic and neuronal damage probably by reducing ROS/HPA axis hyperfunction and the inflammatory response.

Rapid Eye Movement Sleep Deprivation Combined With Fluoxetine Protects Against Depression-Induced Damage and Apoptosis in Rat Hippocampi via A1 Adenosine Receptor

Background: Rapid eye movement sleep deprivation (REMSD) and fluoxetine affect depression, yet the detailed molecular mechanisms were not clear. Methods: Rat depression chronic unpredictable stress was constructed, and the body weight of rats was measured. The efficacy of REMSD and fluoxetine on the pleasure experience, exploration, and cognition of rats with depression was determined by the Sucrose preference test, the open field test, and Morris water task, respectively. The effects of REMSD and fluoxetine on depression-induced damage and apoptosis in rat hippocampi were detected using hematoxylin-eosin staining and terminal transferase-mediated biotin 2'-deoxyuridine, 5'-triphosphate nick end labeling. A1 adenosine receptor content was measured by immunohistochemistry. Relative expressions of the A1 adenosine receptor, proteins related to apoptosis (B Bcl-2-associated X protein; B-cell lymphoma 2), phosphoinositide 3-kinase, P38 mitogen-activated protein kinase, cFos, and adenosine deaminase RNA specific two were quantified by quantitative real-time polymerase chain reaction and Western blot as needed. Results: Depression decreased rat weight. REMSD combined with fluoxetine increased body weight, prompted rat behavior, alleviated depression-induced damage, attenuated apoptosis, and promoted A1 adenosine receptor level in rat hippocampi. Furthermore, the combined therapy upregulated expressions of A1 adenosine receptor, B-cell lymphoma 2, and phosphoinositide 3-kinase but downregulated those of B-cell lymphoma 2-associated X protein, P38 mitogen-activated protein kinase, cFos, and adenosine deaminase RNA specific 2 in the hippocampi of rats with depression. Conclusion:REMSD combined with fluoxetine protected rats against depression-induced damage and apoptosis in the hippocampus via the A1 adenosine receptor, providing a possible treatment strategy for depression.

Relaxation techniques for depressive disorders in adults: a systematic review and meta-analysis of randomised controlled trials

Objectives: The aim of this study was to identify, evaluate, and synthesise existing randomised controlled trials (RCTs) that examined the effect of relaxation techniques in the treatment of patients with depressive disorders.Methods: A systematic review of the literature was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines.Results: Nine studies were finally included in this meta-analysis. It was found that relaxation techniques might effectively reduce depressive symptoms among adults with depression (standardised mean difference (SMD) -0.42, 95% CI -0.72 to -0.11, p  =  0.008).Conclusions: Relaxation techniques are cost-effective, safe, and low-risk techniques that can be easily taught and used. Consequently, they have several benefits if practised regularly daily for more than an 8-week period.KEY POINTS/HIGHLIGHTSThe implication of this study for practice is that these relaxation techniques, cost-effective, safe, and low-risk techniques that can be easily taught and used.Consequently, practitioners will access benefits if practised regularly daily for more than an 8-week period.The relaxation technique is not complex, does not need any special device or place, does not need any change in lifestyle and is easily learned.

Flavonoid-Rich Orange Juice Intake and Altered Gut Microbiome in Young Adults with Depressive Symptom: A Randomized Controlled Study

Depression is not just a general mental health problem but a serious medical illness that can worsen without treatment. The gut microbiome plays a major role in the two-way communication system between the intestines and brain. The current study examined the effects of flavonoids on depression by observing the changes in the gut microbiome and depressive symptoms of young participants consuming flavonoid-rich orange juice. The depressive symptom was assessed using the Center for Epidemiological Studies Depression Scale (CES-D), a psychiatric screening tool used to detect preexisting mental disorders. The study population was randomly divided into two groups: the flavonoid-rich orange juice (FR) and an equicaloric flavonoid-low orange cordial (FL) group. For 8 weeks, participants consumed FR (serving a daily 380 mL, 600 ± 5.4 mg flavonoids) or FL (serving a daily 380 mL, 108 ± 2.6 mg flavonoids). In total, 80 fecal samples from 40 participants (mean age, 21.83 years) were sequenced. Regarding depression, we observed positive correlations between brain-derived neurotrophic factor (BDNF) and the Lachnospiraceae family (Lachnospiraceae_uc and Murimonas) before flavonoid orange juice treatment. Most notably, the abundance of the Lachnospiraceae family (Lachnospiraceae_uc, Eubacterium_g4, Roseburia_uc, Coprococcus_g2_uc, Agathobacter_uc) increased after FR treatment compared to that after FL treatment. We also validated the presence of unclassified Lachnospiraceae through sensitive real-time quantitative polymerase chain reaction using stool samples from participants before and after flavonoid treatment. Our results provide novel interventional evidence that alteration in the microbiome due to flavonoid treatment is related to a potential improvement in depression in young adults.

Metacognitive beliefs in depressed in-patients: adaptation and validation of the short version of the Metacognitions Questionnaire (MCQ-30) for French clinical and non-clinical samples

BACKGROUND

The short form of the Metacognitions Questionnaire (MCQ-30) is a brief multi-dimensional measure which explores the metacognitive processes and beliefs about worry and cognition that are central to the vulnerability and maintenance of emotional disorders.

AIMS

The first aim of the study was to create and validate a French version of the MCQ-30 in a non-clinical and a clinical sample of depressed in-patients.

METHOD

A French adaptation of the MCQ-30 was administered to a sample of 467 individuals from the general population and 73 hospitalized patients with major depressive disorder. Internal consistency was measured by Cronbach's alpha reliability coefficients. Factor structure was assessed using a confirmatory factor analysis on the non-clinical group and a multi-trait-multi-method analysis on the psychiatric group. Criterion validity was explored by comparing the scores of the two samples. Measures of rumination, worry and depression were used to explore convergent validity.

RESULTS

Confirmatory factor analysis in the non-clinical sample indicated that the French version of the MCQ-30 has the same factor structure as the MCQ-30's original five-factor solution. In the clinical sample, the multi-trait-multi-method analysis revealed discrepancies with the original factor structure, and the MCQ-30 and its subscales were less reliable. Our results provide evidence of a convergent validity. The MCQ-30 scores were also able to discriminate between psychiatric and non-clinical samples.

CONCLUSIONS

Our results show that the French version of the MCQ-30 is a valid instrument for measuring metacognitive beliefs in non-clinical population. Further research is needed to support its use among depressed in-patients.

An Integrated Pharmacology-Based Analysis for Antidepressant Mechanism of Chinese Herbal Formula Xiao-Yao-San

Clinical studies and basic science experiments have widely demonstrated the antidepressant and anxiolytic effects of the herbal formula Xiao-Yao-San (XYS). However, the system mechanism of these effects has not been fully characterized. The present study conducted a comprehensive network pharmacological analysis of XYS and sorted all pharmacologically active components (149) through the TCMSP webserver. Then, all potential molecular targets (449) were predicted, of which there were 99 genes clearly related to depression. To further investigate the mechanism of antidepressant effects of XYS, a compound-depression targets (C-DTs) network was constructed, and Gene Ontology (GO) functional and KEGG pathway enrichment analyses were performed for the 99 targets. Enrichment results revealed that XYS could regulate multiple aspects of depression through these targets, related to metabolism, neuroendocrine function, and neuroimmunity. Prediction and analysis of protein–protein interactions resulted in selection of three hub genes (AKT1, TP53, and VEGFA). In addition, a total of seven ingredients from XYS could act on these hub genes and they were identified through ultra-high-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-Q/TOF-MS), including paeoniflorin, quercetin, luteolin, acacetin, aloe-emodin, Glyasperin C, kaempferol. Hereafter, we investigated the effects of paeoniflorin and its predicted target, the results suggest that it can reverse the neurotoxicity produced by CORT and could be a neuroprotective effect by promoting the phosphorylation of Akt. Overall, our research revealed the complicated antidepressant mechanism of XYS, and also provided a rational strategy for revealing the complex composition and function of Chinese herbal formula.

The Role of Metacognitions on the Relationship Between Adult Attachment and Mood Symptoms in Individuals with Obesity

In order to examine psychological mechanisms contributing to the development and maintenance of mood symptoms experienced by individuals with obesity, this study focused on the mediator role of metacognitions in the relationship between adult attachment dimensions (anxious and avoidant) and mood symptoms (depression and anxiety). A 184 individuals with Body Mass Index (BMI) of 30 or above completed a battery of instruments including measures of attachment styles, metacognitive beliefs and processes, depression, and anxiety symptoms. Multiple mediation analyses with bootstrapping demonstrated that while attachment anxiety was predictive of greater levels of depression and anxiety through the effect of beliefs about uncontrollability and dangerousness of worry, metacognitive factors have no mediator role in the relationship between avoidant attachment and mood symptoms. Findings suggest in particular that anxious attachment and metacognitive characteristics might be considered in case conceptualizations and intervention strategies for the psychological problems experienced by individuals with obesity.Level of Evidence: Level V: Descriptive (cross-sectional) study.

Differences in metacognitive beliefs among patients with bipolar disorder with or without previous suicide attempts

Purpose: The aim of this study is to compare differences in metacognitive beliefs between patients with bipolar disorder type I (BPDI) with previous suicide attempts (BPDI+), those without suicide attempts (BPDI-), and a control group. It also discusses the relationship between metacognitive beliefs and suicidal behavioral parameters. Materials and methods: The study included 72 BPDI+ and 73 BPDI- euthymic patients and 86 healthy age- and gender-matched individuals. All participants completed a sociodemographic data form, the Beck Depression Inventory, Metacognition Questionnaire-30 (MCQ-30), Suicide Behaviors Questionnaire, and Structured Clinical Interview for DSM-IV Axis I. In addition, the Young Mania Rating Scale was used for the patient groups. Results: Both the BPDI+ and BPDI- patients had higher MCQ-30 scores than the control group (p < .01). Scores for the 'need to control thoughts' subscale were higher in the BPDI+ group than in the BPDI- group and were also higher in both the BPDI+ and BPDI- groups compared to the control group (p < .01). In addition, the 'cognitive self-consciousness' sub-scores of the BPDI- group were higher than those of the BPDI+ and the control group. Conclusion: The scores of 'cognitive self-consciousness' and 'need to control thoughts' vary across BPDI+ and BPDI- patients. It seems important to consider metacognitive beliefs regarding 'need to control thoughts' and 'cognitive self-consciousness' in terms of suicide prevention.

Factors associated with quality of life in patients with depression: A nationwide population-based study

Background

Depression, one of the most costly and common mental disorders, is reported to be associated with lower quality of life (QoL) in several studies. Improved understanding of the associated factors with QoL is necessary to optimize long-term outcomes and reduce disability in patients with depression. Therefore, the aim of this study was to identify factors that are associated with lower QoL among patients with depression.

Methods

The study was based on the Korea National Health and Nutrition Examination Survey, a cross-sectional health examination, years 2008 to 2014. The final analyzed sample consisted of a total of 1,502 study subjects who had been diagnosed by clinicians as having depression. A multivariate logistic regression model was performed to exam the association between the clinical characteristics (age, sex, demographic and health-related characteristics) and QoL. Analysis of covariance was also used to analyze EQ-5D according to mental health.

Results

Older age, lower level of education, lower income, worse subjective perception of health, unemployment, obesity and mental health struggles were found to be significantly associated with low QoL in depressive individuals after adjustment for multiple covariates.

Conclusions

This study has outlined grounding data in identifying patients who are at risk of QoL impairment. Policy makers should direct their interests to these individuals and provide appropriate management.

Relations of mindfulness facets with psychological symptoms among individuals with a diagnosis of obsessive-compulsive disorder, major depressive disorder, or borderline personality disorder

OBJECTIVES

To explore differences in mindfulness facets among patients with a diagnosis of either obsessive-compulsive disorder (OCD), major depressive disorder (MDD), or borderline personality disorder (BPD), and healthy controls (HC), and their associations with clinical features.

DESIGN AND METHOD

One hundred and fifty-three patients and 50 HC underwent a clinical assessment including measures of mindfulness (Five Facets Mindfulness Questionnaire - FFMQ), psychopathological symptoms (Symptom Check List-90-R), dissociation (Dissociative Experience Scale), alexithymia (Alexithymia Scale 20), and depression (Beck Depression Inventory-II). Analysis of variance (ANOVA) and analysis of covariance (ANCOVA) were performed to assess differences in mindfulness scores and their associations with clinical features.

RESULTS

The three diagnostic groups scored lower on all mindfulness facets (apart from FFMQobserving) compared to the HC group. OCD group had a significant higher FFMQ total score (FFMQ-TS) and FFMQacting with awareness compared to the BPD group, and scored higher on FFMQdescribing compared to BPD and MDD groups. The scores in non-judging facet were significantly lower in all the three diagnostic groups compared to the HC group. Interestingly, higher FFMQ-TS was inversely related to all psychological measures, regardless of diagnostic group.

CONCLUSIONS

Deficits in mindfulness skills were present in all diagnostic groups. Furthermore, we found disease-specific relationships between some mindfulness facets and specific psychological variables. Clinical implications are discussed.

PRACTITIONER POINTS

The study showed deficits in mindfulness scores in all diagnostic groups compared to a healthy control group. Overall, mindfulness construct has a significantly negative association with indexes of global distress, dissociative symptoms, alexithymia, and depression. Mindfulness-based interventions in clinical settings should take into account different patterns of mindfulness skills and their impact on disease-specific maladaptive cognitive strategies or symptomatology.

The combined effects of yogurt and exercise in healthy adults: Implications for biomarkers of depression and cardiovascular diseases

Several studies have reported individual benefits of yogurt and exercise on health; however, their combined effects remain unclear. Twenty-four healthy individuals participated in the study and were randomly assigned to the following four groups: control, yogurt, exercise, and combination. The participants consumed yogurt and exercised for 2 weeks, and we examined the combined effects of yogurt and exercise on physiological biomarkers. Individually, yogurt and exercise did not exert a significant effect on biomarkers of depression or cardiovascular disease, although vitamin D levels increased in the exercise group. However, in the combination group, serotonin levels increased, while levels of triglycerides and high-sensitivity C-reactive protein, which are biomarkers for cardiovascular diseases, decreased. In conclusion, the results of the study showed that, in healthy individuals, a combination of yogurt and exercise led to greater increases in serotonin levels and reductions in triglyceride and high-sensitivity C-reactive protein levels, relative to those observed for yogurt or exercise alone; therefore, this combination could have implications for the prevention of depression and cardiovascular disease.

Assessing the validity and reliability of the Turkish versions of craving beliefs and beliefs about substance use questionnaire in patients with heroin use disorder: demonstrating valid tools to assess cognition-emotion interplay

Background

Cognitions associated with craving and substance use are important contributors for the psychological theories of Substance use disorders (SUD), as they may affect the course and treatment. In this study, we aimed to validate Turkish version of two major scales ‘Beliefs About Substance Use’(BSU) and ‘Craving Beliefs Questionnaire’(CBQ) in patients with heroin use disorder and define the interaction of these beliefs with patient profile, depression and anxiety symptoms, with an aim to use these thoughts as targets for treatment.

Methods

One hundred seventy-six inpatients diagnosed with heroin use disorder and 120 participants in the healthy comparison group were evaluated with CBQ, BSU, Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and sociodemographic data questionnaire. Patient group was also evaluated with Addiction Profile Index. Reliability and validity analysis for scales were conducted. Linear regression analysis was conducted to evaluate the determinants of BSU and CBQ scores.

Results

Cronbach alpha level was 0.93 for BSU and 0.94 for CBQ. Patient group showed significantly higher CBQ, BSU, BAI and BDI scores (p < 0.001). BSU score significantly correlated with API-substance use profile score, API-diagnosis, BAI, BDI and CBQ (p < 0.005), whereas CBQ scores significantly correlated with API-diagnosis, API-impact on life, API-craving, API-total score, BSU, BAI, BDI and amount of cigarette smoking (p < 0.002). Number of previous treatments and age of onset for substance use were not correlated with either BSU or CBQ. BAI and BDI scores significantly predicted BSU score, however only BDI score predicted CBQ score (p < 0.003).

Conclusions

Craving beliefs were highly correlated with addiction profile. Anxiety and depression are significant modulators for patients’ beliefs about substance use and depression is a modulator for craving and maladaptive beliefs, validating emotion-cognition interplay in addiction.

Influence of adjuvant mindfulness-based cognitive therapy (MBCT) on symptoms of post-traumatic stress disorder (PTSD) in veterans - results from a randomized control study

Even 30 or more years after the end of a war, veterans can suffer from post-traumatic stress disorder (PTSD). In the present study, we explored the influence on symptoms of PTSD among Iranian veterans of the Iran-Iraq war of mindfulness-based cognitive therapy (MBCT) as add-on to a standard treatment with citalopram. Forty-eight male veterans with PTSD (mean age: 52.97 years) took part in this eight-week intervention study. Standard treatment for all patients consisted of citalopram (30-50 mg/day at therapeutic dosages). Patients were randomly assigned either to the treatment or to the control condition. Treatment involved MBCT delivered in group sessions once a week. Patients in the control condition met at the hospital with the same frequency and duration for socio-therapeutic events. At baseline and at study completion, patients completed questionnaires covering symptoms of PTSD, depression, anxiety, and stress. At study completion after eight weeks, scores for PTSD (re-experiencing events, avoidance, negative mood and cognition, hyperarousal), depression, anxiety, and stress were lower, but more so in the intervention than the control group. Data suggest that, as adjuvant to standard SSRI medication, MBCT is an effective intervention to significantly reduce symptoms of PTSD, depression, anxiety, and stress among veterans.

Development and testing of a self-regulation model for recurrent depression

Self-regulation is a strategy for self-management of depression. Study aims were to (1) describe development of an intervention based on metacognition and self-regulation, (2) test intervention feasibility and utility, and (3) determine its effectiveness in reducing depressive symptoms. The Self-Regulated Illness Management of Depression intervention was developed and taught to 22 participants with recurrent depression. There was no attrition 6 months post intervention. At 6 months, there was a significant decrease in depressive symptoms (M = 10.21, standard deviation = 8.0), t(18) = 5.60, p < .001, and 73 percent of participants used Self-Regulated Illness Management of Depression frequently. Results indicated that Self-Regulated Illness Management of Depression was feasible and useful.

Influence of adjuvant detached mindfulness and stress management training compared to pharmacologic treatment in primiparae with postpartum depression

Ten to 15% of mothers experience postpartum depression (PPD). If untreated, PPD may negatively affect mothers' and infants' mental health in the long term. Accordingly, effective treatments are required. In the present study, we investigated the effect of detached mindfulness (DM) and stress management training (SMT) as adjuvants, compared to pharmacologic treatment only, on symptoms of depression in women with PPD. Forty-five primiparae (mean age: M = 24.5 years) with diagnosed PPD and treated with an SSRI (citalopram; CIT) took part in the study. At baseline, they completed questionnaires covering socio-demographic data and symptoms of depression. Experts rated also symptoms of depression. Next, participants were randomly assigned to one of the following study conditions: adjuvant detached mindfulness (CIT+DM); adjuvant stress management training (CIT+SMT); control condition (CIT). Self- and experts' ratings were completed at the end of the study 8 weeks later, and again at 8 weeks follow-up. Symptoms of depression decreased significantly over time, but more so in the CIT+DM and CIT+SMT group, compared to the control condition. The pattern of results remained stable at follow-up. In primiparae with PPD and treated with a standard SSRI, adjuvant psychotherapeutic interventions led to significant and longer-lasting improvements.

Detached mindfulness reduced both depression and anxiety in elderly women with major depressive disorders

We investigated the influence of detached mindfulness (DM) in treating symptoms of depression and anxiety among elderly women. Thirty-four elderly females (mean age: 69.23 years) suffering from moderate major depressive disorders (MDD) and treated with a standard medication (citalopram) at therapeutic doses were randomly assigned either to an intervention condition (DM; group treatment, twice weekly) or to a control condition (with leisure activities, twice weekly). At baseline (BL), four weeks later at study completion (SC), and four weeks after that at follow-up (FU), participants completed ratings for symptoms of depression and anxiety; experts blind to patients' group assignments rated patients' symptoms of depression. Symptoms of depression (self and experts' ratings) and anxiety declined significantly over time in the DM, but not in the control condition. Effects remained stable at FU. The pattern of results suggests that, compared to a control condition, a specific psychotherapeutic intervention such as DM can have a beneficial effect in elderly female patients with MDD.

Cognitive and Metacognitive Mechanisms of Change in Metacognitive Training for Depression

Metacognitive Training for Depression (D-MCT), a low-threshold group intervention, has been shown to improve depressive symptoms. It aims at the reduction of depression by changing dysfunctional cognitive as well as metacognitive beliefs. The purpose of the present study was to investigate whether the mechanisms of change in D-MCT are cognitive (and thus primarily concern the content of cognition) or metacognitive in nature. Eighty-four outpatients with depression were included in a randomized controlled trial comparing D-MCT to an active control intervention. Level of depression, dysfunctional cognitive beliefs (DAS), and metacognitive beliefs (MCQ subscales: Positive Beliefs, Negative Beliefs, Need for Control) were assessed before (t0) and after treatment (t1). Severity of depression was also assessed 6 months later (t2). Linear regression analyses were used to determine whether change in depression from t0 to t2 was mediated by change in cognitive vs. metacognitive beliefs from t0 to t1. D-MCT's effect on change in depression was mediated by a decrease in dysfunctional metacognitive beliefs, particularly 'need for control'. Our findings underline that one of the key mechanisms of improvement in D-MCT is the change in metacognitive beliefs. The current study provides further support for the importance of metacognition in the treatment of depression.

An exploration of metacognitive beliefs and thought control strategies in bipolar disorder

BACKGROUND

Metacognitive factors influence depression, but are largely unexplored in bipolar disorders. We examined i) differences in metacognitive beliefs and thought control strategies between individuals with bipolar disorder and controls, and ii) to what extent clinical characteristics were related to levels of metacognitive beliefs and thought control strategies in bipolar disorder.

METHOD

Eighty patients with bipolar disorder were assessed for age at onset of affective disorder, number of affective episodes, symptoms of mania and depression, metacognitive beliefs (MCQ-30) and thought control strategies (TCQ). Control subjects (N=166) completed MCQ-30 and TCQ. Factors impacting on metacognitive beliefs and thought control strategies were explored with multiple linear regressions.

RESULTS

Patients with bipolar disorder reported higher levels of unhelpful metacognitive beliefs and thought control strategies than controls. Metacognitive beliefs were mainly influenced by depressive symptoms, and age at onset of affective illness. Thought control strategies were mainly influenced by metacognitive beliefs and age at onset of affective illness.

CONCLUSION

Our findings suggest that metacognitive beliefs and control strategies are relevant in bipolar disorder. Depression and age at onset of affective disorder could contribute to metacognitive beliefs in bipolar disorder, and influence the use of thought control strategies. This indicates potential relationships that warrant further investigation for clinical relevance.

Effect of Probiotics on Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

It has been reported that gut probiotics play a major role in the bidirectional communication between the gut and the brain. Probiotics may be essential to people with depression, which remains a global health challenge, as depression is a metabolic brain disorder. However, the efficacy of probiotics for depression is controversial. This study aimed to systematically review the existing evidence on the effect of probiotics-based interventions on depression. Randomized, controlled trials, identified through screening multiple databases and grey literature, were included in the meta-analysis. The meta-analysis was performed using Review Manager 5.3 software using a fixed-effects model. The meta-analysis showed that probiotics significantly decreased the depression scale score (MD (depressive disorder) = −0.30, 95% CI (−0.51–−0.09), p = 0.005) in the subjects. Probiotics had an effect on both the healthy population (MD = −0.25, 95% CI (−0.47–−0.03), p = 0.03) and patients with major depressive disorder (MDD) (MD = −0.73, 95% CI (−1.37–−0.09), p = 0.03). Probiotics had an effect on the population aged under 60 (MD = −0.43, 95% CI (−0.72–−0.13), p = 0.005), while it had no effect on people aged over 65 (MD = −0.18, 95% CI (−0.47–0.11), p = 0.22). This is the first systematic review and meta-analysis with the goal of determining the effect of probiotics on depression. We found that probiotics were associated with a significant reduction in depression, underscoring the need for additional research on this potential preventive strategy for depression.