Depression in young people

Melatonin alleviates LPS-induced depression-like behavior in mice by inhibiting ferroptosis by regulating RNA methylation-mediated SIRT6/Nrf2/HO-1 pathway

PURPOSE

The objective of this study is to investigate the impact of ferroptosis on depression and elucidate the molecular mechanism underlying melatonin's inhibitory effect on ferroptosis in the treatment of depression.

METHODS

In this study, a depression-like behavior model was induced in mice using LPS, and the effect of melatonin on depression-like behavior was evaluated through behavioral experiments (such as forced swimming test (FST) and sucrose preference test (SPT)). Additionally, molecular biological techniques (including real-time fluorescence quantitative PCR, Western blotting, immunoprecipitation) were employed to detect the expression levels and interactions of METTL3, SIRT6 and ferroptosis-related genes in mouse brain tissue. Furthermore, both in vitro and in vivo experiments were conducted to verify the regulatory effect of melatonin on Nrf2/HO-1 pathway and explore its potential molecular mechanism for regulating ferroptosis.

RESULTS

Melatonin was found to significantly ameliorate depression-like behavior in mice, as evidenced by reduced immobility time in the forced swimming test and increased sucrose intake in the sucrose preference test. Subsequent investigations revealed that melatonin modulated SIRT6 stability through METTL3-mediated ubiquitination of SIRT6, leading to its degradation. As a deacetylase, SIRT6 plays a pivotal role in cellular metabolism regulation and antioxidative stress response. This study elucidated potential signaling pathways involving Nrf2/HO-1 through which SIRT6 may exert its effects.

CONCLUSION

The findings suggest that melatonin can improve depressive behavior by suppressing ferroptosis and protecting neurons through its antioxidant properties. Additionally, targeting the Nrf2/HO-1 pathway via METTL3 and NEDD4 regulation may be a potential therapeutic approach for depression.

Brain mechanisms of rumination and negative self-referential processing in adolescent depression

BACKGROUND

Depression is linked to cognitive biases towards more negative and less positive self-relevant information. Rumination, perseverative negative thinking about the past and the self, may contribute to these biases.

METHODS

159 adolescents (12-18 years), with a range of depression symptoms, completed the SRET during fMRI. Multiple regressions tested associations between conventional self-report and ecological momentary assessment (EMA) measured rumination, and neural and behavioral responses during a self-referent encoding task (SRET).

RESULTS

Higher rumination (conventional self-report and EMA) was associated with more negative and fewer positive words endorsed and recalled. Higher self-reported (but not EMA) rumination was associated with higher accuracy in recognizing negative words and greater insula and dorsal anterior cingulate activity to negative versus positive words.

LIMITATIONS

The sample included mostly non-Hispanic White participants with household incomes above the national average, highlighting the need for replication in more diverse samples. Word endorsement discrepancies required fMRI analyses to model neural response to viewing negative versus positive words.

CONCLUSIONS

Adolescents with higher rumination endorsed and recalled more negative and fewer positive words and recognized more negative words during the SRET. Higher insula reactivity, a key region for modulating externally-oriented attention and internally-oriented self-referential processes, may contribute to links between rumination and negative memory biases. These findings provide insight into neurocognitive mechanisms underlying depression.

Prevalence and correlates of irritability among U.S. adults

This study aimed to characterize the prevalence of irritability among U.S. adults, and the extent to which it co-occurs with major depressive and anxious symptoms. A non-probability internet survey of individuals 18 and older in 50 U.S. states and the District of Columbia was conducted between November 2, 2023, and January 8, 2024. Regression models with survey weighting were used to examine associations between the Brief Irritability Test (BITe5) and sociodemographic and clinical features. The survey cohort included 42,739 individuals, mean age 46.0 (SD 17.0) years; 25,001 (58.5%) identified as women, 17,281 (40.4%) as men, and 457 (1.1%) as nonbinary. A total of 1218(2.8%) identified as Asian American, 5971 (14.0%) as Black, 5348 (12.5%) as Hispanic, 1775 (4.2%) as another race, and 28,427 (66.5%) as white. Mean irritability score was 13.6 (SD 5.6) on a scale from 5 to 30. In linear regression models, irritability was greater among respondents who were female, younger, had lower levels of education, and lower household income. Greater irritability was associated with likelihood of thoughts of suicide in logistic regression models adjusted for sociodemographic features (OR 1.23, 95% CI 1.22-1.24). Among 1979 individuals without thoughts of suicide on the initial survey assessed for such thoughts on a subsequent survey, greater irritability was also associated with greater likelihood of thoughts of suicide being present (adjusted OR 1.17, 95% CI 1.12-1.23). The prevalence of irritability and its association with thoughts of suicide suggests the need to better understand its implications among adults outside of acute mood episodes.

The path of depression in rural children: A fuzzy-set qualitative comparative analysis across multiple provinces in China

OBJECTIVES

This study explores the combinations of conditional variables contributing to depressive symptoms in rural children.

METHODS

We analyzed data from 715 children from a rural mental health database, conducting detailed follow-up investigations on 129 children in Zhejiang and Henan provinces. We used fuzzy set Qualitative Comparative Analysis (fsQCA) and regression analysis to identify causal pathways leading to depression.

RESULTS

The results indicate that depression in rural children does not stem from a single, necessary condition but arises from multiple factors. Our findings highlight significant contributions from both maternal and paternal involvement. Specifically, maternal involvement, combined synergistically with peer support and problematic behaviors, as well as paternal involvement, together with peer support and anxiety, significantly affects depressive outcomes. Additionally, anxiety and strong peer relationships independently have a substantial impact on these outcomes. Effective mitigation strategies involve active parental engagement and robust peer support, reducing the influence of risk factors such as problematic behaviors and anxiety.

LIMITATIONS

The generalizability of the results is limited by cultural and geographical variations. The study also does not account for all potential factors influencing depression in rural children.

CONCLUSION

Depression in rural children results from multiple interacting factors. Tailored interventions addressing these specific combinations are recommended.

Characterizing human spontaneous thoughts and its application in major depressive disorder

BACKGROUND

Spontaneous thought is a universal, complex, and heterogeneous cognitive activity that significantly impacts mental activity and strongly correlates with mental disorders.

METHODS

Utilizing the think-aloud method, we captured spontaneous thoughts during rest from 38 diagnosed with depression, alongside 36 healthy controls and 137 healthy individuals. Through a comprehensive assessment of various dimensions of thought content, we compared thought content between individuals with depression and healthy controls, and between healthy women and men. Finally, we employed natural language processing (NLP) to develop regression models for multidimensional content assessment and a classification model to differentiate between individuals with and without depression.

RESULTS

Compared to healthy controls, individuals with depression had more internally oriented and less externally oriented spontaneous thoughts. They focused more on themselves and negative things, and less on positive things, experiencing higher levels of negative emotions and lower levels of positive emotions. Besides, we found that compared to healthy men, healthy women's spontaneous thoughts focus more on interoception, the self, past events, and negative events, and they experience higher levels of negative emotions. Meanwhile, we identified the potential application of the think-aloud method to collect spontaneous thoughts and integrate NLP in the field of depression.

CONCLUSIONS

This study offers direct insights into the stream of thought during individuals' resting state, revealing differences between individuals with depression and healthy controls, as well as sex differences in the content of spontaneous thoughts. It enhances our understanding of spontaneous thought and offers a new perspective for preventing, diagnosing, and treating depression.

Associations of childhood household dysfunction and healthy lifestyle with depressive symptoms in adolescents

OBJECTIVE

Limited understanding exists regarding the cumulative impact of childhood household dysfunction (CHD) on adolescent depressive symptoms in developing countries, as well as the role of lifestyles in this association. This study aims to explore the associations of individual and cumulative CHD indicators with depressive symptoms among Chinese adolescents. Additionally, we investigate potential interactions and joint associations of CHD and lifestyles on depressive symptoms.

METHODS

In the second phase of the Longitudinal Study of Adolescents' Mental and Behavioral Well-being Research, data on depressive symptoms, CHD indicators, lifestyle factors, and other covariates were collected from 3106 students (mean [SD] age, 15.16 [1.52] years). Linear and logistic mixed-effects models were employed, with both stratified and joint analyses conducted.

RESULTS

Except for parental death, each CHD indicator was associated with an increased risk of depressive symptoms. The accumulation of CHD indicators exhibited a positive, graded association with depressive symptoms scores (β = 3.22, 95% CI: 2.48 to 3.97 for one CHD indicator; β = 5.45, 95% CI: 4.41 to 6.49 for two or more CHD indicators, all P < 0.01). A significant interaction was found between the number of CHD indicators and the healthy lifestyle score (interaction β = -0.40, 95% CI: -0.78 to -0.03, P < 0.05), indicating that healthy lifestyles may mitigate the risk of depressive symptoms in individuals experiencing CHD. For example, the OR for having depressive symptoms among adolescents with favourable lifestyles compared with those with unfavourable lifestyles was 0.21 (95% CI: 0.10 to 0.45, P < 0.01) among those experiencing CHD. Moreover, adolescents with two or more CHD indicators and unfavourable lifestyles faced the highest risk of having depressive symptoms (OR = 8.03, 95% CI: 4.83 to 13.34, P < 0.01) compared with those with no CHD indicator and favourable lifestyles.

CONCLUSIONS

These findings underscore the importance of promoting comprehensive healthy lifestyles and reducing CHD exposure for the prevention of depressive symptoms in adolescents.

Gender, age, and longitudinal measurement invariance of child and adolescent depression scales: A systematic review

Understanding developmental trajectories and gender differences in depressive symptoms is clinically relevant. Discerning true differences across gender, age groups, and time is based on the often-neglected premise of measurement invariance (MI) of child and adolescent depression scales. In this systematic review, we assessed available evidence for MI across gender, age groups, and time for depression scales validated in children and adolescents, in studies with at least one assessment under age 18. A literature search using Medline, PsychInfo, Scopus, Web of Science, and Google Scholar databases identified 42 studies that examined MI. MI of eleven scales was tested in 1-9 studies per scale. Conclusions are hampered by different factor solutions tested within some scales. All included questionnaires showed preliminary evidence for MI across gender. Across some studies, crying had higher factor loadings in females compared to males, indicating that crying may be differently related to depression across gender. MI evidence was preliminary in just four scales across time, mostly confined to ages 13-17. One study showed developmental conclusions differed when non-invariance is not accounted for in observed scores. Overall, evidence for MI in child and adolescent depression scales is currently limited.

Investigating the neurodevelopmental correlates of early adolescent-onset emotional problems

BACKGROUND

Emotional problems (EPs) increase sharply after mid-adolescence. Earlier EPs are associated with poorer long-term outcomes, and their underlying mechanisms may differ to later-onset EPs. Given an established relationship between ADHD, autism, and later depression, we aimed to examine associations between neurodevelopmental conditions and correlates and early adolescent-onset EPs.

METHODS

Adolescents in two UK population cohorts, Avon Longitudinal Study of Parents and Children (ALSPAC) and Millennium Cohort Study (MCS), were included. Individuals scoring >6 on the Strengths and Difficulties Questionnaire (SDQ) emotional problems subscale between ages 11-14 were defined as having early adolescent-onset EP, whilst those scoring >6 for the first time at 16-25 were defined as having later-onset EP. We tested associations between early adolescent-onset EP (total cases = 887, controls = 19,582) and ICD-10/DSM-5 neurodevelopmental conditions and known correlates, including: sex, birth complications, low cognitive ability, special educational needs (SEND), and epilepsy. Analyses were conducted separately in ALSPAC and MCS then meta-analysed.

RESULTS

In the meta-analysis of both cohorts, early adolescent-onset EPs were associated with female sex and greater likelihood of low cognitive ability, SEND, autism, ADHD, and reading difficulties. Compared to later-onset EP, early adolescent-onset EPs were associated with male sex, low cognitive ability, SEND, epilepsy, ASD, ADHD, and reading difficulties.

LIMITATIONS

A clinical definition of depression/anxiety was available only in ALSPAC, instead we primarily defined EP via questionnaires, which capture a broader phenotype.

CONCLUSIONS

Individuals with early adolescent-onset EP are likely to have a co-occurring neurodevelopmental condition. Clinicians should consider assessing for neurodevelopmental conditions in young adolescents with EPs.

Lateral habenula IL-10 controls GABAA receptor trafficking and modulates depression susceptibility after maternal separation

Maternal separation (MS), a form of early life adversity, increases the risk of psychiatric disorders in adulthood by intricately linking cytokines and mood-regulating brain circuits. The Lateral Habenula (LHb) encodes aversive experiences, contributes to negative moods, and is pivotal in depression development. However, the precise impact of MS on LHb cytokine signaling and synaptic plasticity remains unclear. We reported that adolescent MS offspring mice displayed susceptibility to depression behavioral phylotypes, with neuronal hyperactivity and an imbalance in pro-inflammatory and anti-inflammatory cytokines in the LHb. Moreover, the decreased IL-10 level negatively correlated with depressive-like behaviors in susceptible mice. Functionally, LHb IL-10 overexpression restored decreased levels of PI3K, phosphorylated AKT (pAKT), gephyrin, and membrane GABAA receptor proteins while reducing abnormally elevated GSK3β and Fos expression, rescuing the MS-induced depression. Conversely, LHb neuronal IL-10 receptor knockdown in naive mice increased Fos expression and elicited depression-like symptoms, potentially through impaired membrane GABAA receptor trafficking by suppressing the PI3K/pAKT/gephyrin cascades. Hence, this work establishes a mechanism by which MS promotes susceptibility to adolescent depression by impeding the critical role of IL-10 signaling on neuronal GABAA receptor function.

Adolescent depressive symptoms and memory performance in young adulthood: Testing critical period, accumulation, and pathway models using a sibling comparison design

RATIONALE

Despite the existing literature connecting depressive symptoms with cognitive function in adulthood, there is limited knowledge about the longitudinal association between depressive symptoms in adolescence and memory function in adulthood, as well as the mechanisms underlying this relationship.

OBJECTIVES

This study aims to determine whether depressive symptoms in adolescence are associated with memory function in young adulthood. To explore the underlying mechanisms of this association, it employs a life course approach, testing the critical period, accumulation, and pathway models.

METHODS

Utilizing data from the sibling sample of the National Longitudinal Study of Adolescent to Adult Health (Add Health), this study employed sibling fixed effects models to control for unobserved heterogeneity at the family level. To test various life course models, the analysis incorporated adult depressive symptoms, as well as an array of behavioral, psychosocial, and educational mechanism variables.

RESULTS

Sibling fixed effects estimates indicated a longitudinal association between depressive symptoms in adolescence and memory function in young adulthood (b = -0.084, p < 0.01). Depressive symptoms in adulthood neither explained nor intensified this association. Mediation analysis revealed that educational attainment modestly accounted for about 11% of the relationship between adolescent depressive symptoms and adult memory function. Combined, these findings lend support to the life course approach, with a specific focus on the critical period model.

CONCLUSIONS

This study's findings suggest that depressive symptoms in adolescence are an independent risk factor for memory function in adulthood. The empirical support for the critical period model underscores the importance of implementing early intervention programs and targeted strategies to support adolescents experiencing depressive symptoms.

Global, regional, and national burden of bullying related mental disorders of adolescent from 1990 to 2019: A systematic analysis for the Global Burden of Disease Study 2019

Few studies have assessed the burden of mental disorders in adolescents related to bullying victimization at the global, regional, and national levels. We analyzed adolescent mental disorder disability-adjusted life years (DALYs) attributed to bullying in 204 countries, following the Global Burden of Disease study 2019 framework. The DALYs rate of adolescent for bullying-related mental disorders global increased from 110.45 (95 % uncertainty intervals (UI): 40.76, 218.62) per 100,000 in 1990 to 138.92 (95 % UI: 54.37, 268.19) per 100,000 in 2019. The largest increase in DALYs rates were obvious in low-SDI and high-SDI regions. In 2019, the DALYs rate of adolescents with bullying-related anxiety disorders was 1.4 times higher than those depressive disorders; the DALYs rate of adolescents with bullying-related mental disorder in females was 1.3 times higher than that of male, and older adolescent (15-19 years old) was 1.4 times higher than younger adolescent (10-14 years old). High-income North America had the fastest increase in DALYs rates of mental disorders related to bullying. In general, a positive correlation was observed between bullying DALY rate of adolescent and SDIs at the regional and national levels. Our study highlights significant disparities in adolescent mental health burden from bullying. Governments must implement adaptive policies to address diverse needs effectively.

Prediction of depressive symptoms in young adults by polygenic score and childhood maltreatment: Results from a population-based birth cohort

Childhood maltreatment is linked with later depressive symptoms, but not every maltreated child will experience symptoms later in life. Therefore, we investigate whether genetic predisposition for depression (i.e., polygenic score for depression, PGSDEP) modifies the association between maltreatment and depressive symptoms, while accounting for different types of maltreatment and whether it was evaluated through prospective and retrospective reports. The sample included 541-617 participants from the Quebec Longitudinal Study of Child Development with information on maltreatment, including threat, deprivation, assessed prospectively (5 months-17 years) and retrospectively (reported at 23 years), PGSDEP and self-reported depressive symptoms (20-23 years). Using hierarchical linear regressions, we found that retrospective, but not prospective indicators of maltreatment (threat/deprivation/cumulative) were associated with later depressive symptoms, above and beyond the PGSDEP. Our findings also show the presence of gene-environment interactions, whereby the association between maltreatment (retrospective cumulative maltreatment/threat, prospective deprivation) and depression was strengthened among youth with higher PGSDEP scores. Consistent with the Diathesis-Stress hypothesis, our findings suggest that a genetic predisposition for depression may exacerbate the putative impact of maltreatment on later depressive symptoms, especially when maltreatment is retrospective. Understanding the gene-environment interplay emerging in the context of maltreatment has the potential to guide prevention efforts.

Association of social support with depression and anxiety among the migrant population of Henan, China: Based on a large cross-sectional study

Amid China's rapid urbanization, the growing migrant population has increasingly drawn attention due to the rising prevalence of mental health concerns. Based on a large cross-sectional study, we explored the relationship between social factors and depression and anxiety among the migrant population and also quantified the correlations of different dimensions of social support and the varying levels of depression and anxiety. Results showed that the prevalence of depression and anxiety are 47.0% and 34.9%, respectively, among the 19,498 migrant populations. Females and individuals with chronic conditions were found to be more vulnerable to experiencing symptoms of anxiety and depression within the migrant population. Participants who received higher levels of social support were less likely to experience symptoms of depression and anxiety. Additionally, various dimensions of social support (including subjective, objective, and utilization) exhibited significant negative associations with different levels of depression and anxiety within the migrant population. Social support plays a crucial role in alleviating depression and anxiety among the migrant population, particularly in mitigating moderate and severe symptoms, which provides an important reference for improving the mental well-being of the migrant population.

Childhood trajectories of emotional and behavioral difficulties are related to polygenic liability for mood and anxiety disorders

BACKGROUND

Symptoms related to mood and anxiety disorders (emotional disorders) often present in childhood and adolescence. Some of the genetic liability for mental disorders, and emotional and behavioral difficulties seems to be shared. Yet, it is unclear how genetic liability for emotional disorders and related traits influence trajectories of childhood behavioral and emotional difficulties, and if specific developmental patterns are associated with higher genetic liability for these disorders.

METHODS

This study uses data from a genotyped sample of children (n = 54,839) from the Norwegian Mother, Father, and Child Cohort Study (MoBa). We use latent growth models (1.5-5 years) and latent profile analyses (1.5-8 years) to quantify childhood trajectories and profiles of emotional and behavioral difficulties and diagnoses. We examine associations between these trajectories and profiles with polygenic scores for bipolar disorder (PGSBD), anxiety (PGSANX), depression (PGSDEP), and neuroticism (PGSNEUR).

RESULTS

Associations between PGSDEP, PGSANX, and PGSNEUR, and emotional and behavioral difficulties in childhood were more persistent than age-specific across early childhood (1.5-5 years). Higher PGSANX and PGSDEP were associated with steeper increases in behavioral difficulties across early childhood. Latent profile analyses identified five profiles with different associations with emotional disorder diagnosis. All PGS were associated with the probability of classification into profiles characterized by some form of difficulties (vs. a normative reference profile), but only PGSBD was uniquely associated with a single developmental profile.

CONCLUSIONS

Genetic risk for mood disorders and related traits contribute to both a higher baseline level of, and a more rapid increase in, emotional and behavioral difficulties across early and middle childhood, with some indications for disorder-specific profiles. Our findings may inform research on developmental pathways to emotional disorders and the improvement of initiatives for early identification and targeted intervention.

Adaptation of an evidence-based, preventive intervention to promote mental health in Hispanic adolescents: eHealth Familias Unidas Mental Health

Youth internalizing symptoms (i.e., depression and anxiety), suicide ideation and attempts have been rising in recent years, including among Hispanics. Disparities in mental healthcare are concerning and require intervention, ideally prevention or early intervention. Familias Unidas is a culturally-syntonic, family-centered intervention effective in reducing youth drug use and sexual risk, with evidence of unanticipated effects on internalizing symptoms. This paper describes the systematic process used to adapt the eHealth version of the Familias Unidas intervention to more directly address internalizing symptoms and suicide risk in preparation for an effectiveness-implementation hybrid trial for youth with elevated internalizing symptoms, a history of suicide ideation/attempts, or poor parent-youth communication. The resulting eHealth Familias Unidas Mental Health intervention is described. Guided by a 4-phase framework, the steps in the adaptation process involved: assessment of the community and intervention delivery setting (pediatric primary care clinics); integration of previous intervention research, including intervention mechanisms of action; and expert and community consultation via focus groups. Focus group analyses showed that youth and parents perceived that the intervention was helpful. Their feedback was categorized into themes that were used to directly target mental health by addressing technology use, parent mental health, and social support. Effective and scalable preventive interventions are needed to address mental health disparities. The systematic adaptation process described in this paper is an efficient approach to expanding interventions while maintaining known, empirical and theoretical mechanisms of action. Findings from the ongoing effectiveness-implementation trial will be critical.

A novel dual-site OFC-dlPFC accelerated repetitive transcranial magnetic stimulation for depression: a pilot randomized controlled study

BACKGROUND

This study aimed to evaluate a novel rTMS protocol for treatment-resistant depression (TRD), using an EEG 10-20 system guided dual-target accelerated approach of right lateral orbitofrontal cortex (lOFC) inhibition followed by left dorsolateral prefrontal cortex (dlPFC) excitation, along with comparing 20 Hz dlPFC accelerated TMS v. sham.

METHODS

Seventy five patients participated in this trial consisting of 20 sessions over 5 consecutive days comparing dual-site (cTBS of right lOFC followed sequentially by 20 Hz rTMS of left dlPFC), active control (sham right lOFC followed by 20 Hz rTMS of left dlPFC) and sham control (sham for both targets). Resting-state fMRI was acquired prior to and following treatment.

RESULTS

Hamilton Rating Scale for Depression (HRSD-24) scores were similarly significantly improved at 4 weeks in both the Dual and Single group relative to Sham. Planned comparisons immediately after treatment highlighted greater HRSD-24 clinical responders (Dual: 47.8% v. Single:18.2% v. Sham:4.3%, χ2 = 13.0, p = 0.002) and in PHQ-9 scores by day 5 in the Dual relative to Sham group. We further showed that accelerated 20 Hz stimulation targeting the left dlPFC (active control) is significantly better than sham at 4 weeks. Dual stimulation decreased lOFC-subcallosal cingulate functional connectivity. Greater baseline lOFC-thalamic connectivity predicted better therapeutic response, while decreased lOFC-thalamic connectivity correlated with better response.

CONCLUSIONS

Our novel accelerated dual TMS protocol shows rapid clinically relevant antidepressant efficacy which may be related to state-modulation. This study has implications for community-based accessible TMS without neuronavigation and rapid onset targeting suicidal ideation and accelerated discharge from hospital.

Trend and predictive psychosocial factors of persistent depression/non-depression in Chinese adolescents: A three-year longitudinal study

BACKGROUND

Depressive symptoms are common in adolescents, while its prevalence trend in adolescents is seldom reported. In addition, few studies focus on adolescents without depressive symptoms. This study aimed to reveal the trend and predictors of persistent depression/non-depression among Chinese adolescents over three-year period.

METHODS

Three-wave data were collected from T1 to T3 in a sample from six junior high schools in Shenzhen, China. The 20-item of Center for Epidemiologic Studies Depression Scale was used, with scoring ≥16 as depression.

RESULTS

Of all 1301 adolescents, 33.4%, 15.5% and 9.0% reported depressive symptoms at baseline, T2 and T3 respectively, while 66.6%, 47.7% and 39.6% reported non-depressive symptoms at three time-points. At the individual level, baseline positive identity and general positive youth development significantly increased persistent non-depression at T2 and T3. At the family level, baseline family harmony and communication consistently prevented persistent depression at T2 and T3, while family communication consistently promoted non-depression. At the school level, baseline awareness of no expectation from teacher and poor interpersonal relationship consistently increased persistent depression and prevented non-depression.

CONCLUSIONS

The incidence of depression in adolescents aged 11-15 is not high. The rate of persistent non-depression is approximately 30% higher than that of persistent depression, and both have a downward trend over years. Positive youth development and healthy family function are protective factors of depression, while school maladjustment decreases persistent non-depression. During early adolescence, more attention should be paid to family function and school maladjustment to promote non-depression in adolescents from a new broader view.

The mediating role of systemic inflammation in the association between bedroom light at night and new-onset depressive symptoms among Chinese young adults: A prospective cohort study

BACKGROUND

The detrimental effects of exposure to light at night (LAN) have received increasing attention. However, the effects of LAN exposure on depressive symptoms and underlying mechanism are less explored.

OBJECTIVES

To investigate the association between LAN exposure with new-onset and trajectories of depressive symptoms, and the potential mediating role of systemic inflammation.

METHODS

Baseline bedroom LAN exposure was monitored every minute for 2 consecutive nights using a portable illuminance meter. Fasting blood samples were collected at the 1-year follow-up to determine high sensitivity C-reactive protein (hs-CRP). Depressive symptoms were assessed at baseline, 1- and 2-year follow-up using the Mood and Feelings Questionnaire (MFQ).

RESULTS

At baseline, the mean age of the 347 participants was 18.7 ± 0.8 years, and 35.2 % were men. At 2-year follow-up, the new-onset depressive symptoms were 14.7 %. Compared with low-LANavg (average light intensity from bedtime to rising time) intensity group (LANavg < 3 lx), those with high-LANavg intensity (LANavg ≥ 3 lx) were associated with an 125 % increase in risk for depressive symptoms (HR = 2.25; 95 % CI: 1.27, 4.00); Compared with short-LAN5 (duration of nighttime light intensity ≥5 lx) duration group (LAN5 < 45 min), those with long-LAN5 duration (LAN5 ≥ 45 min) were associated with an 119 % increase in risk for depressive symptoms (HR = 2.19; 95 % CI: 1.18, 4.06). Participants were classified into 3 trajectory groups: consistently low, slow or rapid increase depressive symptoms; both intensity and duration of LAN exposure were associated with higher likelihood of slow or rapid increase depressive symptoms. Additionally, hs-CRP partially mediated the relationship between intensity (mediation proportion: 7.1 %) and duration (mediation proportion: 10.6 %) of LAN exposure with depressive symptoms.

CONCLUSION

Excessive bedroom LAN exposure is associated with increased risk of depressive symptoms among young adults, and systemic inflammation may be a partial mediator in the LAN-depressive symptoms association.

The prevalence, course, and risk factors of suicidal ideation and suicide attempts among students in vocational education

BACKGROUND

Worldwide, suicide is one of the leading causes of death among adolescents and young adults. Given that suicide in this age group is common within vocational students, this study aims to provide insights into the prevalence, course, and risk factors of suicidal ideation (SI) and suicide attempts (SA) among students in vocational education over the past 10 years.

METHODS

This study has a repeated cross-sectional design, utilizing data from 2013 to 2023 provided by the 'Testjeleefstijl' foundation in the Netherlands ('Test Your Lifestyle'). In total, 101,182 students in vocational education completed a web-based standardized questionnaire. Univariate logistic regression was used to test the predictive value of risk factors separately (anxiety and depression, gender, age and school year) on SI and SA. In addition, a machine learning model (Berkelmans et al., 2023) ​was used for high-risk identification of combined risk factors (multivariate models).

RESULTS

Within vocational students, 12-month SI and SA prevalence increased from respectively 17.7% and 2.3% in schoolyear 2013-2014 to 23% and 3.2% in 2022-2023. Although female gender significantly predicted SI and SA in the univariate analyses, the multivariate models revealed that female gender decreased the likelihood of both SI (OR 0.9) and SA (OR 0.7). A high risk for anxiety and depression was the strongest predictor in the multivariate models for SI (OR 42.8) and SA (OR 19.0).

CONCLUSION

Over the past decade, the prevalence of SI and SA increased in students in vocational education, with the risk of anxiety and depression being the strongest contributing factor. While females had a higher prevalence of anxiety and depression, the results suggest these conditions tend to lead to SI and SA more quickly among male students. Early intervention in suicide prevention is crucial, highlighting the need to identify and address anxiety and depression. Vocational education schools have a critical role in this, emphasizing early screening and intervention, with specific attention to gender-specific factors.

Single-blinded, randomised, parallel-group, controlled trial comparing the efficacy and cost-effectiveness of therapist- and self-guided internet-delivered behavioural activation versus treatment as usual for adolescents with mild to moderate depression: study protocol

INTRODUCTION

The number of adolescents seeking professional help for depression is increasing and, despite advances in treatment, large unmet treatment needs remain. In the current protocol, we describe the design and methodology of a randomised controlled trial (RCT) to evaluate the clinical efficacy of two forms of internet-delivered behavioural activation (I-BA), with and without therapist support, in reducing depressive symptoms, compared with treatment as usual (TAU). Secondary objectives include examining the 12-month maintenance of the treatment effects and conducting a health economic evaluation of the interventions.

METHODS AND ANALYSIS

In this single-blinded RCT, we aim to include 215 participants aged 13-17 years with mild to moderate depression who will be randomised (1:1:1 ratio) to 10 weeks of either therapist-guided or self-guided I-BA, or TAU provided by regular mental health clinics. Data will be collected at baseline, weekly for the initial 10 weeks, post-treatment and at 3 and 12-month follow-ups. The primary endpoint is the 3-month follow-up. The primary outcome is blinded clinician-rated severity of depressive symptoms, measured by the Children's Depression Rating Scale-Revised. Treatment response is defined as a score of 'Much improved' or 'Very much improved' on the Clinical Global Impression-Improvement Scale, administered at the primary endpoint. Outcome assessors will be blinded to treatment conditions at all assessment points. A health economic evaluation of I-BA will be performed, both in the short term (primary endpoint) and the long term (12-month follow-up).

ETHICS AND DISSEMINATION

Ethical approval was obtained from the Swedish Ethical Review Authority in June 2021. The final participant was enrolled on 3 May 2024 and expected to reach the primary endpoint by November 2024. The results of this study will be disseminated through publication in peer-reviewed journals, presented at conferences and communicated to healthcare providers and the public.

TRIAL REGISTRATION NUMBER

NCT04977856.

Deciphering the role of siRNA in anxiety and depression

Anxiety and depression are central nervous system illnesses that are among the most prevalent medical concerns of the twenty-first century. Patients with this condition and their families bear psychological, financial, and societal hardship. There are currently restrictions when utilizing the conventional course of treatment. RNA interference is expected to become an essential approach in anxiety and depression due to its potent and targeted gene silencing. Silencing of genes by post-transcriptional modification is the mechanism of action of small interfering RNA (siRNA). The suppression of genes linked to disease is typically accomplished by siRNA molecules in an efficient and targeted manner. Unfavourable immune responses, off-target effects, naked siRNA instability, nuclease vulnerability, and the requirement to create an appropriate delivery method are some of the challenges facing the clinical application of siRNA. This review focuses on the use of siRNA in the treatment of anxiety and depression.

Childhood violence exposure and anxiety and depression of children and adolescents

BACKGROUND

Mental disorders constitute a global public health problem worldwide and occurs in childhood and lasts to adulthood. The purpose of this study was to explore the association between childhood violence exposure and currently diagnosed depression and anxiety in children and adolescents and investigate whether the association differs by sex and age.

METHODS

This cross-sectional study used data from 2017 to 2021 National Survey of Children's Health (NSCH). Childhood violence exposure and anxiety or depression of children were reported from caregivers. Logistic regression analyses and subgroup analyses were conducted to assess the association between the childhood violence exposure and anxiety and depression.

RESULTS

This study included 113,400 participants aged 6 to 17 years (weighted mean [SD] age, 11.5 [3.4] years; 54,539 females [weighted proportions, 48.9 %]). 9603 of them (weighted proportions, 9.0 %) had childhood violence exposure. Childhood violence exposure was associated with higher risks of anxiety (adjusted risk difference: 7.8 %, 95%CI: 6.3-9.3 %; adjusted OR: 2.11, 95%CI: 1.87-2.39) and depression (adjusted risk difference: 6.2 %, 95%CI: 5.1-7.4 %; adjusted OR: 2.94, 95%CI: 2.54-3.41) after full adjustment. Stratified analyses demonstrated that the association appeared to be stronger in younger children and the association between violence exposure and anxiety was stronger in females than in males.

CONCLUSION

In this cross-sectional study, childhood violence exposure was significantly associated with higher risks of anxiety and depression. The associations appeared to be stronger in younger and female children. Differences in sex and age-specific associations highlight the importance of building age-specific and sex-specific patterns of childhood violence prevention and intervention.

Mental Health Problems Among Indonesian Adolescents: Findings of a Cross-Sectional Study Utilising Validated Scales and Innovative Sampling Methods

PURPOSE

This study aimed to estimate the prevalence of mental health problems and identify potential risk and protective exposures for adolescents in Indonesia.

METHODS

An innovative sampling approach was applied to simultaneously recruit school- and community-based adolescents aged 16-18 years old from Jakarta (urban megacity) and South Sulawesi (remote province). We used multistage cluster sampling for in-school (N = 1,337) and respondent driven sampling for out-of-school (N = 824) adolescents. Mental health was measured using two validated scales: Kessler-10 and Center for Epidemiologic Studies Depression Scale-Revised . Psychiatric interviews were conducted in a subsample (N = 196) of students from Jakarta to validate the self-report scales.

RESULTS

The estimated population prevalence of psychological distress and depression were 24.3% (95% CI = 21.5-27.2) and 12.6% (10.5-14.4) for in-school and 23.7% (20.7-26.7) and 23.5% (20.4-26.5) for out-of-school adolescents, respectively. In participants who completed a psychiatric interview, common psychiatric morbidities were social anxiety, depression, and suicidality. Compared to in-school females, male in-school adolescents reported a lower prevalence of psychological distress (16.9% (13.1-20.7) vs. 30.4% (26.4-34.4)) and depression (10.1% (7.2-13.1) vs. 14.6 (11.4-17.8)). By contrast, for out-of-school adolescents, males reported a higher prevalence of psychological distress (25.2% (21.6-28.9) vs. 20.2% (15.1-25.3)) and depression (26.3% (22.5-30.1) vs. 16.9% (11.8-21.9)). In-school adolescents who did not seek healthcare despite a perceived need were more likely to report psychological distress and depression.

DISCUSSION

Adolescent mental health problems are highly prevalent in Indonesia, with substantial variation by gender, geography, and school enrolment. This study and its approach to sampling and measurement may serve as a model to improving mental health surveillance across other settings.

"And I Can Remind Myself That I Am All Of This": adolescents' experiences of group-based acceptance and commitment therapy

Introduction

A growing body of literature supports the use of Acceptance-and commitment therapy (ACT) for a wide range of mental health problems in children and adolescents, but less is known about ACT when given to adolescents in a group format. Consequently, this study aimed to explore the subjective experiences of adolescents who had completed a group-based ACT for symptoms of anxiety and depression. Adolescents' perceptions of the core therapeutic processes of ACT and the means used to enhance them, as well as the interplay between ACT processes and the group format, were of primary interest.

Methods

Semi-structured qualitative interviews were conducted with seven adolescents, of which five were girls and two were boys, between 16 and 19 years old. Transcripts were analyzed using reflexive thematic analysis.

Results

The adolescents varied greatly in their experience of ACT's core processes and the methods used to enhance them. Most found the core processes meaningful and educational, especially appreciating the concept of values and value-based action. However, some perceived the core processes as irrelevant and provocative, particularly interpreting acceptance as "giving up." The metaphors and practical exercises were experiences as playful and instructive supplements to the more theoretical elements of therapy, but also as childish and embarrassing. The group format facilitated normalization and support and seemed to increase the adolescents' motivation and adherence to therapeutical work, but it also triggered socially anxious thoughts and self-censoring for some.

Conclusion

The results from the current study support previous literature indicating that group-based ACT is an acceptable and feasible treatment format for adolescents. Yet, the varying experiences underscores the need for further studies exploring how to accommodate the group format to the diverse personal and developmental disparities in this age group. Randomized controlled trials are also needed to compare the effectiveness of individual versus group format of ACT for adolescents.

Effectiveness of a peer-to-peer, self-management intervention for young people with depression and anxiety in Denmark: an observational study and a propensity score-matched comparison

Objective

This study investigated the effectiveness of a 7-weeks peer-to-peer program for young people aged 15 to 25 years with depression or anxiety symptoms in Denmark.

Methods

A total of 483 participants (72% women) participated in the program and the evaluation. The participants completed questionnaires at baseline, postintervention, and at 5-month follow-up to assess changes in depression symptoms (using Beck's Depression Inventory-II), anxiety symptoms (using Spielbergers State-Trait Anxiety Inventory for Adults) and self-efficacy in controlling or managing the illness (using the personal control subscale from the Illness Perception Questionnaire-Revised). Analyses were done using repeated measures mixed linear regression models. Moreover, a register-based matched comparison group was derived as a comparison to assess changes in being in education and employment at 8-month follow-up.

Results

Within the intervention group, both depression and anxiety scores declined across the 5-month follow-up compared to baseline (b = -9.6, 95% CI: -11.2, -8.1 for depression symptoms). The self-efficacy score increased from baseline to post-intervention (b = 1.4, 95% CI: 1.0, 1.8) and this level was maintained at follow-up. More than half of the participants were in education at baseline while 24% received social transfer payments. Compared with matched comparison group, a lower proportion of the intervention group remaining in education (71% vs. 80%). Among participants who were employed at baseline, a higher proportion of the intervention group were enrolled in education (27% vs. 19%) and were unemployed (14% vs. 4%) compared to the matched comparison group.

Conclusion

This study supports the effectiveness of a peer-to-peer intervention for depression and anxiety symptoms, and self-efficacy in symptom control. However, mixed effects on education and employment were observed, indicating a negative impact on education among those initially enrolled and a higher proportion of employed participants starting education.

Prediction of adolescent depression from prenatal and childhood data from ALSPAC using machine learning

Depression is a major cause of disability and mortality for young people worldwide and is typically first diagnosed during adolescence. In this work, we present a machine learning framework to predict adolescent depression occurring between ages 12 and 18 years using environmental, biological, and lifestyle features of the child, mother, and partner from the child's prenatal period to age 10 years using data from 8467 participants enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC). We trained and compared several cross-sectional and longitudinal machine learning techniques and found the resulting models predicted adolescent depression with recall (0.59 ± 0.20), specificity (0.61 ± 0.17), and accuracy (0.64 ± 0.13), using on average 39 out of the 885 total features (4.4%) included in the models. The leading informative features in our predictive models of adolescent depression were female sex, parental depression and anxiety, and exposure to stressful events or environments. This work demonstrates how using a broad array of evidence-driven predictors from early in life can inform the development of preventative decision support tools to assist in the early detection of risk for mental illness.

Associations of black and sugar-sweetened coffee consumption with depressive symptoms: A longitudinal study of Chinese adolescents

BACKGROUND

Previous research revealed an association between coffee consumption and depressive symptoms. However, the results differed between studies in adults and adolescents. Additionally, limited research on coffee and depressive symptoms has distinguished between black and sugar-sweetened coffee. Furthermore, few studies have examined the potential sex differences in the abovementioned association. This longitudinal study aimed to explore the associations of black and sugar-sweetened coffee consumption with subsequent depressive symptoms in adolescents while also investigating sex disparities within these associations.

METHODS

In this longitudinal study, 10,770 individuals completing standardized questionnaires at baseline and follow-up were included in the main analysis. The data were analyzed using generalized linear mixed-effects models, and subgroup analyses were grouped according to sex.

RESULTS

After adjusting for covariates and baseline depressive symptoms status, adolescents who consumed black coffee daily (OR, 1.45; 95 % CI, 1.14-1.84) had a greater risk of experiencing depressive symptoms compared with those who did not consume it or consumed it monthly. Similarly, in comparison with none or monthly consumers, those who consumed sugar-sweetened coffee weekly (OR, 1.22; 95 % CI, 1.03-1.44) and daily (OR, 1.32; 95 % CI, 1.02-1.73) demonstrated an elevated risk of having depressive symptoms. Subgroup analyses showed that black and sugar-sweetened coffee consumption was associated with depressive symptoms only in males.

LIMITATIONS

Self-reported data on coffee consumption and depressive symptoms.

CONCLUSIONS

Adolescents who consume black or sugar-sweetened coffee weekly or daily are at a higher risk of developing depressive symptoms, with this association appearing to be more pronounced in male adolescents. Future studies are needed to confirm these findings.

Effects of virtual reality-based cognitive training for adolescents with depressive episodes: A pilot randomized controlled study

Cognitive impairment is a common symptom in depression, yet few intervention strategies target adolescents. This study investigated the effects of an attention and working memory cognitive training system based on virtual reality (VRCT) in adolescents with mild to moderate depressive episodes. Adolescents with depression were randomized into a VR training group (VRG, n = 47) or a waitlist control group (WT, n = 46). The VR training consisted of three 10-min tasks per session, conducted three sessions per week for 20 sessions over 7 weeks. Forty-four healthy adolescents participated as a comparison group for baseline cognitive assessment. Cognitive functions and depressive symptoms were assessed using the Das-Naglieri cognitive assessment system, driven by the Planning, Attention, Simultaneous, and Successive (PASS) processing theory, and the Hamilton Depression Rating Scale-24 at pre- and post-intervention. Baseline results indicated significantly lower cognitive scores in patients compared to healthy adolescents. Post-intervention, the VRG demonstrated significant improvements in all four cognitive scales (effect sizes 0.56 to 0.76) and a significant reduction in depressive symptoms compared to the WT. These findings suggest that VRCT holds potential for improving cognitive impairments and alleviating depressive symptoms in adolescents with depression. Further large-scale and follow-up studies are necessary to confirm long-term benefits.

Regional brain structural network topology mediates the associations between white matter damage and disease severity in first-episode, Treatment-naïve pubertal children with major depressive disorder

Puberty is a vulnerable period for the onset of major depressive disorder (MDD) due to considerable neurodevelopmental changes. Prior diffusion tensor imaging (DTI) studies in depressed youth have had heterogeneous participants, making assessment of early pathology challenging due to illness chronicity and medication confounds. This study leveraged whole-brain DTI and graph theory approaches to probe white matter (WM) abnormalities and disturbances in structural network topology related to first-episode, treatment-naïve pediatric MDD. Participants included 36 first-episode, unmedicated adolescents with MDD (mean age 15.8 years) and 29 age- and sex-matched healthy controls (mean age 15.2 years). Compared to controls, the MDD group showed reduced fractional anisotropy in the internal and external capsules, unveiling novel regions of WM disruption in early-onset depression. The right thalamus and superior temporal gyrus were identified as network hubs where betweenness centrality changes mediated links between WM anomalies and depression severity. A diagnostic model incorporating demographics, DTI, and network metrics achieved an AUROC of 0.88 and a F1 score of 0.80 using a neural network algorithm. By examining first-episode, treatment-naïve patients, this work identified novel WM abnormalities and a potential causal pathway linking WM damage to symptom severity via regional structural network alterations in brain hubs.

Examining network structure of impulsivity and depression in adolescents and young adults: A two-sample study

BACKGROUND

Depression ranks as one of the top five contributors to ill health in youth, the most formative period in life. Extensive research has highlighted the significant role of impulsivity in understanding depression. However, there has been limited exploration into how each dimension of impulsivity uniquely affect depressive symptoms, especially across crucial developmental stages like adolescence and young adulthood.

METHODS

This study investigates the unique relationships between impulsivity (assessed by the short UPPS-P scale) and depression (assessed by the Patient Health Questionnaire-9) via network analysis. We analysed data from a total of 2296 participants, comprising 858 adolescents aged 14-17 years and 1438 young adults aged 18-25 years, to estimate both a combined network and age-group specific networks. Key features of the networks, including their structure, global connectivity, and bridge nodes, were compared.

RESULTS

The results indicated that age differentially impacts individual depression symptoms, both directly and indirectly, via impulsivity dimensions. The comparison test revealed consistent network structures between the two age groups, with several robust pathways, such as lack of perseverance to concentration difficulties, sensation seeking to suicidal ideation, and negative urgency to feelings of worthlessness. Negative urgency and lack of perseverance were identified as bridge nodes across the two networks.

LIMITATIONS

The study employed a cross-sectional design, which limits the ability to estimate causal or temporal relationships.

CONCLUSIONS

The current findings highlight the significance of tailoring intervention strategies to individual symptom profiles and assessing negative urgency and lack of perseverance as potential early targets for depression among youth.

Sex-specific association of peripheral blood cell indices and inflammatory markers with depressive symptoms in early adolescence

BACKGROUND

Previous studies have reported the correlation of dysregulated blood cell indices and peripheral inflammatory markers with depression in adults but limited studies have examined this correlation in early adolescents.

METHODS

This study used data from the Chinese Early Adolescents Cohort Study, which was conducted in Anhui, China. Students' depression symptoms were repeatedly measured using the Chinese version of the Center for Epidemiological Studies Depression Scale for Children. Students' blood samples were collected in September 2019 and September 2021. The peripheral blood cell counts and inflammatory marker levels were determined using routine blood tests. Multivariable regression models were used to explore the associations between blood cell indices and adolescent depressive symptoms in both the whole sample and the sex-stratified samples.

RESULTS

The white blood cell (WBC) count, neutrophil count (NC), platelet (PLT) count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, and systemic immune inflammation index (SII) were positively correlated with the severity of depressive symptoms during follow-up. The mean corpuscular volume (MCV), mean hemoglobin (HGB) volume (MCH), and mean corpuscular HGB concentration (MCHC) exhibited negative temporal correlations with depressive symptoms. Additionally, several sex-specific blood cell markers were correlated with depression. Male adolescents with increased red blood cell (RBC) and female adolescents with decreased HGB levels and upregulated WBC, NC, NLR, and SII levels exhibited severe depressive symptoms at follow-up.

CONCLUSIONS

These findings suggested the potential usefulness of peripheral blood cell indices in the assessment of depression in early adolescents.

Differences in cognitive impairment and its correlation with circulating cell-free mitochondrial DNA in medication-free depression and bipolar depression patients

OBJECTIVE

This study aimed to investigate whether there are differences in cognitive impairment between medication-free patients with bipolar depression (BD) and major depressive disorder (MDD) and whether these differences are related to circulating cell-free mtDNA (ccf-mtDNA).

METHODS

For this cross-sectional study, 76 outpatients with BD, 86 outpatients with MDD and 70 healthy controls (HCs) were enrolled. Sociodemographic and clinical data were collected. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Stroop Color-Word Test were used to assess cognitive function. Plasma ccf-mtDNA levels were measured via qPCR.

RESULTS

BD and MDD patients had similar scores for immediate memory, language, attention, delayed memory, the RBANS total score, Stroop color, Stroop word, and Stroop total score, which were significantly lower than the HCs. The visuospatial/constructive scores of the BD patients were significantly lower than those of the HCs (p < 0.001) and MDD patients (p = 0.008), but there was no difference between the HCs and MDD patients. The ccf-mtDNA levels in the BD and MDD patient groups were significantly higher than those in the HC group, and those in the MDD group were higher than those in the BD group (p = 0.016). Multiple stepwise regression analysis showed that ccf-mtDNA was negatively correlated with language in patients with depression (t = -2.11, p = 0.039).

CONCLUSION

There were differences in specific cognitive dimensions between patients with BD and MDD. Increased ccf-mtDNA levels were found in BD and MDD patients, suggesting ccf-mtDNA may be involved in the pathophysiology of MDD and BD.

Investigating the Link between Psychological Well-Being and Early-Stage Age-Related Macular Degeneration: A Mendelian Randomization Analysis

PURPOSE

While some studies have started to focus on the link between psychological well-being and age-related macular degeneration (AMD), the relationship remains uncertain. Our research aims to provide new insights into this association, laying a foundation for future interventions and addressing existing knowledge gaps.

METHODS

We utilized the "TwoSampleMR" package in R for a bidirectional Mendelian randomization analysis of psychological well-being (subjective well-being, depression, neuroticism, and Sensitivity to Environmental Stress and Adversity) and early-stage AMD. Causal effects were estimated using the inverse-variance weighted method, and additional methods included weighted median and MR-Egger regression. Sensitivity analyses included Cochran's Q test, MR-Egger intercept analysis, MR-PRESSO, and leave-one-out analysis.

RESULTS

The study found that the population with genetic predisposition to neuroticism had a 39.7% lower risk of early-stage AMD (OR = 0.603, 95% CI = 0.385-0.945, p = 0.027). Conversely, the population with genetic predisposition to subjective well-being had a 3.2% increased risk of early-stage AMD (OR = 1.032, 95% CI = 1.003-1.063, p = 0.029). No significant causal relationships were found from depression or Sensitivity to Environmental Stress and Adversity to early-stage AMD, nor from early-stage AMD to psychological well-being.

CONCLUSION

This study provides preliminary evidence that the relationship between psychological well-being and early-stage AMD may be complex and multifaceted. It suggests that moderate neuroticism levels might reduce early-stage AMD risk through health behaviors, pathophysiological mechanisms, and other factors, while high subjective well-being levels might increase this risk similarly. However, these findings are insufficient for preventive strategies due to a lack of substantial evidence and still require extensive experimental research for further validation.

Drug-Drug Interactions of Selective Serotonin Reuptake Inhibitors: A Pharmacovigilance Study on Real-World Evidence from the EudraVigilance Database

As the most common psychiatric symptom, depression represents a subject of high interest for the medical community. Background/Objectives: International guidelines consider selective serotonin reuptake inhibitors (SSRIs) the first-line treatment of depression. Although having better efficacy and tolerability in comparison to tricyclic antidepressants or monoamine oxidase inhibitors, the diversity and potential severity of adverse effects and interactions manifested by SSRIs, combined with the frequency of prescriptions, lead to the necessity of evaluating real-world data. The aim of this study was to identify and evaluate the drug interactions reported in EudraVigilance (EV) for the six SSRIs representatives that are authorized in Europe: fluoxetine (FXT), fluvoxamine (FVM), citalopram (CIT), escitalopram (ESC), paroxetine (PAR) and sertraline (SER). The entire class of SSRIs was examined as a comparator to identify whether one of the representatives was more prone to reporting. Methods: Descriptive analysis and disproportionality analysis were conducted on data extracted from the EV database. Results: A total of 326,450 adverse reactions (ADRs) were reported for the SSRIs group. Approximately a quarter of these (n = 83,201; 25.46%) were reported for SER and 22.37% (n = 73,131) for PAR. Of the total ADRs reported, 2.12% (n = 6925) represent preferred terms related to drug-drug interactions (DDIs): SER (n = 1474; 22.37%), CIT (n = 1272, 19.86), and FXT (n = 1309, 19.83%). Specific ADRs related to inhibitory activity represent 0.98%, and for potentiating activity, 1.89%. Conclusions: Although representing a small value of the total ADRs, DDIs may be related to severe outcomes. Awareness should be raised for this category of ADRs that can be reduced by the joined efforts of physicians and pharmacists.

The chain mediating role of social support and positive coping between neuroticism and depressive symptoms among graduate students

Introduction

Graduate students face unprecedented levels of neuroticism and pressure compared to their peers. Despite existing research examining the connection between neuroticism and depressive symptoms, a gap in the current understanding of the mediating mechanisms that act on this relationship, especially among this specific student population.

Methods

This study investigated the potential chain-mediating roles of social support and positive coping in the relationship between neuroticism and depressive symptoms among graduate students. The participants were 1845 graduate students who provided demographic information and complete assessments including the Eysenck Personality Questionnaire (EPQ), Depression Rating Scale (BDI-II), Social Support Rating Scale (SSRS), and Coping Style Questionnaire (SCSQ). The analysis involved correlational analysis and a chain mediation model was used to investigate the associations among neuroticism, social support, positive coping mechanisms, and depressive symptoms.

Results

The results show significant correlations among neuroticism, depressive symptoms, social support, and positive coping. Moreover, our findings verify that neuroticism affects depressive symptoms in graduate students through three pathways: the mediating effect of social support, the mediating effect of positive coping, and the chain-mediating effect of social support and positive coping.

Discussion

Overall, the hypothesized chain model conclusively fits the data: Neuroticism directly affects depressive symptoms among graduate students and influences depressive symptoms through the mediating effects of social support and positive coping, as well as the chain mediating effects of these two variables.

Past-year counseling and therapy use and severity of depression among university students with depression: The Healthy Minds Study

Background: This exploratory study examined the associations between sociodemographic factors and past-year counseling or therapy use by depression severity among college students with depression. Participants: This cross-sectional analysis included n = 8090 participants from the Healthy Minds Study Winter 2021 Survey. Methods: Main effects and stratified multivariable logistic regression models assessed the relationship between sociodemographic factors and counseling/therapy independently and by depression severity. Results: Depression severity and counseling or therapy use were not independently associated (χ2 = 1.34, p = 0.77). Fourth + year students showed a graded response for past-year counseling/therapy use across depression severity (aOR range: 0.57-0.78, 95% CI range: 0.49-1.24). Males and students living with relatives, and those with stressful financial situations also showed lower odds of past-year counseling/therapy use. Conclusion: Findings indicate vulnerable subpopulations of college students that need support. Future interventions should identify barriers to treatment and pathways to support these students.

Understanding Depression in Autism: The Role of Subjective Perception and Anterior Cingulate Cortex Volume

Background

The prevalence of depression is elevated in individuals with autism spectrum disorder (ASD) compared to the general population, yet the reasons for this disparity remain unclear. While social deficits central to ASD may contribute to depression, it is uncertain whether social interaction behavior themselves or individuals' introspection about their social behaviors are more impactful. Although the anterior cingulate cortex (ACC) and amygdala are frequently implicated in ASD, depression, and social functioning, it is unknown if these regions explain differences between ASD adults with and without co-occurring depression.

Methods

The present study contrasted observed vs. subjective perception of autism symptoms and social performances assessed with both standardized measures and a lab task, in 65 sex-balanced (52.24% male) autistic young adults. We also quantified ACC and amygdala volume with 7-Tesla structural neuroimaging to examine correlations with depression and social functioning.

Results

We found that ASD individuals with depression exhibited differences in subjective evaluations including heightened self-awareness of ASD symptoms, lower subjective satisfaction with social relations, and less perceived affiliation during the social interaction task, yet no differences in corresponding observed measures, compared to those without depression. Larger ACC volume was related to depression, greater self-awareness of ASD symptoms, and worse subjective satisfaction with social interactions. In contrast, amygdala volume, despite its association with clinician-rated ASD symptoms, was not related to depression.

Limitations

Due to the cross-sectional nature of our study, we cannot determine the directionality of the observed relationships. Additionally, we included only individuals with an IQ over 60 to ensure participants could complete the social task, which excluded many on the autism spectrum. We also utilized self-reported depression indices instead of clinically diagnosed depression, which may limit the comprehensiveness of the findings.

Conclusions

Our approach highlights the unique role of subjective perception of autism symptoms and social interactions, beyond the observable manifestation of social interaction in ASD, in contributing to depression, with the ACC playing a crucial role. These findings imply possible heterogeneity of ASD concerning co-occurring depression. Using neuroimaging, we were able to demarcate depressive phenotypes co-occurring alongside autistic phenotypes.

The association between neutrophil percentage-to-albumin ratio (NPAR) and depression among US adults: a cross-sectional study

Inflammation plays an important role in depression, and the neutrophil-to-albumin ratio (NPAR) is a cost-effective and readily available novel biomarker of inflammation. The association between NPAR and depression is unclear; therefore, to assess the relationship between NPAR and depression, we conducted a cross-sectional study of 33,768 participants ≥ 18 years of age from the 2005-2018 NHANES database. NPAR was calculated as Neutrophil percentage (in total WBC count) (%) × 100/Albumin (g/dL). Multivariate logistic regression models were used to test the independent association between NPAR and depression, adjusting for demographic factors, education, smoking status, alcohol consumption, hypertension, diabetes mellitus, body mass index, the ratio of income to poverty, and history of cardiovascular disease. Results showed that NPAR was significantly and positively associated with depression. When NPAR were analyzed as a categorical variable, there was a 20% increase in the prevalence of depression in the quartile with the highest NPAR compared to the quartile with the lowest NPAR (OR 1.20[95% CI 1.06, 1.36]). Smoothed curve fitting and threshold effect analyses also showed a positive association between NPAR and depression, with an inflection point for threshold and saturation effects of 12.65. NPAR was positively associated with the likelihood of developing depression when NPAR > 12.65 (OR 1.06[95% CI 1.04, 1.09]). The results of subgroup analyses and interaction tests indicated that smoking status had a significant effect on the relationship between NPAR and depression (P < 0.05). Our study reveals a positive association between NPAR levels and depression, suggesting that higher NPAR levels are associated with an increased likelihood of developing depression.

Association between the platelet/high-density lipoprotein cholesterol ratio and depression: A cross-sectional analysis in United States adults

BACKGROUND

The primary objective of this study was to elucidate the relationship between the platelet/high-density lipoprotein cholesterol ratio (PHR) and the risk of depression in adults in the US.

METHODS

We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2016. Depression was assessed using the PHQ-9 questionnaire. Weighted multivariable logistic regression models and restricted cubic spline (RCS) models were used to study the relationship between PHR and the risk of depression. Subgroup and interaction analyses were performed to further understand these associations.

RESULTS

A total of 21,454 participants were included in this study. After full adjustment, PHR was significantly positively correlated with depression (OR = 1.33, 95%CI: 1.03-1.73). When PHR was converted into a categorical variable based on quartiles (Q1-Q4), the highest quartile of PHR was associated with an increased risk of depression compared to the lowest reference group (OR = 1.22, 95%CI: 1.01-1.48). There was a linear dose-response relationship between PHR and the risk of depression (P-non-linear = 0.8038). The association remained significant in several subgroup analyses. However, the interaction test showed that none of the stratified variables were significant (all P for interaction >0.05).

LIMITATION

Using self-assessment scales and inability to assess causality.

CONCLUSION

This population-based cross-sectional study elucidated that PHR is significantly associated with an increased prevalence of depression in adults in the US.

Effect of dietary live microbe intake on the prevalence and mortality risks of depression and suicidal ideation in adults: Evidence from a nationwide population-based study

BACKGROUND

Gut microbial dysbiosis has been implicated in the pathogenesis of depression. Dietary interventions offer promising microbial-targeted therapeutics for depression. However, limited evidence exists regarding the associations between dietary live microbe intake and the prevalence of depression, as well as its impact on mortality risks.

METHODS

This study included 28,133 participants from the U.S. National Health and Nutrition Examination Survey (2005-2018), and ascertained their underlying causes of death. Weighted logistic regression was utilized to assess the relationships between live microbe intake and risks of depression and suicidal ideation. Independent and joint associations between live microbe and mortality outcomes were evaluated using multivariable Cox regression and Kaplan-Meier survival curves to calculate relative risks.

RESULTS

In the fully adjusted model, participants with high dietary live microbe intake had a significantly lower prevalence of depression (OR = 0.727, 95%CI: 0.627,0.844) and suicidal ideation (OR = 0.778, 95%CI: 0.648,0.935) than those with low intake. The multivariable-adjusted HRs for individuals in the G1 were 1.217 (95%CI, 1.081, 1.370) for all-cause mortality and 1.307 (95%CI, 1.029,1.661) for cardiovascular disease mortality, compared to participants in the G3. Kaplan-Meier survival analysis revealed that cumulative hazard of cardiovascular mortality was progressively lower among participants with depression in the G3 than those without depression.

CONCLUSIONS

Higher live microbe intake was associated with a lower prevalence of depression and suicidal ideation, and was linked to significantly decreased risks of all-cause and cardiovascular mortality. Further larger prospective studies are essential to verify the health effects of live microbes, and personalized dietary recommendations are necessary.

Time Trends in Adolescent Diagnoses of Major Depressive Disorder and Co-occurring Psychiatric Conditions in Electronic Health Records

Major depressive disorder (MDD) is highly prevalent in youth and generally characterized by psychiatric comorbidities. Secular trends in co-occurring diagnoses remain unclear, especially in healthcare settings. Using large-scale electronic health records data from a major U.S. healthcare system, we examined the prevalence of MDD diagnoses and co-occurring psychiatric conditions during adolescence (12-18 years; N = 133,753) across four generations (birth years spanning 1985 to 2002) and by sex. Then using a phenome-wide association analysis, we explored which of 67 psychiatric conditions were associated with adolescent MDD diagnosis in earlier versus recent generations. Adolescent MDD diagnosis prevalence increased (8.9 to 11.4%) over time. Over 60% with an MDD diagnosis had co-occurring psychiatric diagnoses, especially neurodevelopmental and anxiety disorders. Co-occurring diagnoses generally increased over time, especially for anxiety disorders (14 to 50%) and suicidal behaviors (6 to 23%), across both sexes. Eight comorbidities interacted with generation, showing stronger associations with MDD diagnosis in earlier (e.g., conduct disorder) versus more recent (e.g., suicidal ideation and behaviors) generations. The findings underscore the importance of assessing psychiatric complexity in adolescents diagnosed with MDD, applying transdiagnostic approaches to address co-occurring presentations, and further investigating potential causes for generational increases.

Relationship between atherosclerotic burden and depressive symptoms in hypertensive patients: A cross-sectional study based on the NHANES database

OBJECTIVE

The relationship between atherosclerotic burden, depressive symptoms, and clinically relevant depression (CRD) in hypertensive patients is unclear. In this study, we used the atherosclerotic index of plasma (AIP) to quantify atherosclerotic burden and explore its association with depressive symptoms and CRD in hypertensive patients.

METHODS

Hypertension-diagnosed patients were extracted from the National Health and Nutrition Examination Survey (NHANES) database. The relationships between AIP and depressive symptoms and CRD risk in patients were examined through the weighted logistic regression and the weighted linear regression models. Restrictive cubic spline curves were employed to analyze potential nonlinear associations between AIP and outcome indicators. Additionally, subgroup analyses and intergroup interaction tests were conducted.

RESULTS

The AIP was considerably associated with the severity of depressive symptoms in hypertensive patients, according to the findings of weighted linear regression. Weighted logistic regression analysis showed that high AIP was significantly associated with a high risk of clinically relevant depression in hypertensive patients. This trend was consistent across various subgroups within the population.

CONCLUSION

AIP was observed to be a significant risk factor for clinically relevant depression in hypertensive patients. Atherosclerotic burden in hypertensive patients was significantly associated with the severity of their depressive symptoms.

Multilevel barriers to guideline implementation: a nationwide multi-professional cross-sectional study within child and adolescent psychiatry

BACKGROUND

Despite efforts to promote guideline use, guideline adoption is often suboptimal due to failure to identify and address relevant barriers. Barriers vary not only between guidelines but also between settings, intended users, and targeted patients. Multi-professional guidelines are often used in child and adolescent mental health services (CAMHS), making the implementation process more difficult. Despite this, there is a lack of knowledge about which barriers to consider or if barriers vary by profession. The aim of this study was to address these gaps by examining barriers to adopting a multi-professional depression guideline in the context of a nationwide implementation study.

METHODS

440 CAMHS clinicians across Sweden (52%) completed the Barriers and Facilitators Assessment Instrument (BFAI) ahead of an implementation endeavour. BFAI is a widely used and validated measure of guideline implementation on four scales: Innovation, Provider, Context, and Patient. Barriers were calculated at scale and at item levels. ANOVA and chi-square tests were used to analyse differences by profession and effect sizes were calculated.

RESULTS

Overall, clinicians were optimistic about guideline uptake, particularly about guideline characteristics and their own adoption ability. Barriers were related to the patient and the context domains, as well as to individual clinician knowledge and training. Perceptions differed across professions; psychiatrists were most, and counsellors were least positive about guideline embeddedness.

CONCLUSION

This large-scale quantitative study suggests that CAMHS clinicians have an overall favourable attitude towards guideline adoption but highlights the need for adaptations to certain patient groups. Strategies to improve guideline use should primarily address these patient issues while securing proper support to the implementation. Implementation efforts, particularly those targeting staff knowledge, training, and involvement, may benefit from being tailored to different professional needs. These findings may inform implementation projects in CAMHS and future research.

Effectiveness of internet-based self-help interventions for depression in adolescents and young adults: a systematic review and meta-analysis

OBJECTIVE

To assess the effectiveness of Internet-based self-help interventions in treating depression in adolescents and young adults.

METHODS

A systematic search was conducted across six databases, including PubMed, to identify randomized controlled trials (RCTs) that satisfied the specified inclusion and exclusion criteria. The intervention measure consisted of Internet-based self-help interventions.

RESULTS

A total of 23 randomized controlled trials (RCTs) were included in this analysis. Meta-analysis indicated that Internet-based self-help therapies significantly reduced depression scores in adolescents and young adults. (OR = -0.68, 95%CI [-0.88, -0.47], P < 0.001). We examined the effects of patient recruitment from various regions, medication usage, therapist involvement, weekly intervention time, and intervention duration. Patients selected from school, primary healthcare centers, clinics and local communities had better results. Intervention lasting 30 to 60 min and 60 to180 minutes per week were effective in the short term.

CONCLUSION

The internet-based self-help intervention can be effective in treating depression in adolescents and young adults. However, factors such as patient recruitment locations, medication usage, Therapists' involvement, weekly intervention time, and intervention duration interacted with the outcome. Subgroup analysis on potential adverse effects and gender was impossible due to insufficient data from the included studies.

Associations between keystroke and stylus metadata and depressive symptoms in adolescents

BACKGROUND

Adolescents often experience a heightened incidence of depressive symptoms, which can persist without early intervention. However, adolescents often struggle to identify depressive symptoms, and even when they are aware of these symptoms, seeking help is not always their immediate response. This study aimed to explore the relationship between passively collected digital data, specifically keystroke and stylus data collected via mobile devices, and the manifestation of depressive symptoms.

METHODS

A total of 927 first-year middle school students from schools in Seoul solved Korean language and math problems. Throughout this study, 77 types of keystroke and stylus data were collected, including parameters such as the number of key presses, tap pressure, stroke speed, and stroke acceleration. Depressive symptoms were measured using the self-rated Patient Health Questionnaire-9 (PHQ-9).

RESULTS

Multiple regression analysis highlighted the significance of stroke length, speed, and acceleration, the average y-coordinate, the tap pressure, and the number of incorrect answers in relation to PHQ-9 scores. The keystroke and stylus metadata were able to reflect mood, energy, cognitive abilities, and psychomotor symptoms among adolescents with depressive symptoms.

CONCLUSIONS

This study demonstrates the potential of automatically collected data during school exams or classes for the early screening of clinical depressive symptoms in students. This study has the potential to serve as a cornerstone in the development of digital data frameworks for the early detection of depressive symptoms in adolescents.

Community Asset Density and Past-Year Mental Health Symptoms Among Youths

Importance

Many youths experience mental health challenges. Identifying which neighborhood and community factors may influence mental health may guide health policy and practice.

Objective

To explore associations between community assets (eg, schools, parks, libraries, and barbershops) and past-year mental health symptoms among youths.

Design, Setting, and Participants

This cross-sectional study leveraged 3 datasets, which were linked by 26 zip codes: the Western Pennsylvania Regional Data Center, the Child Opportunity Index 2.0 database, and the Allegheny County Youth Risk Behavior Survey (YRBS). The YRBS was administered during the study period in 2018 to youths across 13 high schools in Allegheny County, Pennsylvania; the study dates were from October 15 to October 19, 2018. Dates of analysis were from August 1, 2023, to July 15, 2024.

Exposures

Asset density in each zip code across 8 asset categories (transportation, education, parks and recreation, faith-based entities, health services, food resources, personal care services, and social infrastructure) was calculated.

Main Outcomes and Measures

The main outcomes were mental health measures included in the past 12 months, which comprised feelings of hopelessness (feeing so sad or hopeless that you stopped doing activities), nonsuicidal self-injury (hurt yourself on purpose without wanting to die), and suicidal ideation (seriously considered attempting suicide). All were operationalized to any or none. Data were analyzed using multivariable generalized linear mixed models and were adjusted for age, sex assigned at birth, race and ethnicity, and identification as sexually or gender diverse.

Results

Among 6306 students who were eligible for the YRBS based on their enrollment in participating high schools, 4487 students completed surveys, and 2162 were included in the analytic sample (mean [SD] age, 15.8 [1.2] years; 1245 [57.6%] were assigned female sex at birth). Over one-third of the participants (811 [37.5%]) reported past-year feelings of hopelessness; 587 (27.2%), past-year nonsuicidal self-injury; and 450 (20.8%), past-year suicidal ideation. High total asset population density (adjusted odds ratio [AOR], 0.85 [95% CI, 0.75-0.97]; P = .01), as well as population density of transportation assets (AOR, 0.77 [95% CI, 0.66-0.90]; P < .001), educational resources (AOR, 0.78 [95% CI, 0.67-0.92]; P = .002), and health services (AOR, 0.74 [95% CI, 0.60-0.91]; P = .006), were associated with lower odds of past-year hopelessness after adjusting for covariates. There were no correlations between asset density, Child Opportunity Index, and other mental health measures.

Conclusions and Relevance

The findings of this cross-sectional study suggest that access to certain community assets was associated with lower odds of feelings of hopelessness among youths. Ongoing work is needed to characterize other forms of social and cultural capital, which may mitigate negative mental health outcomes among adolescent youths.

Examining the Relationship Between Anxiety, Depression, and Gastrointestinal Symptoms Among University Students: A Campus-Wide Survey Analysis

STUDY PURPOSE

This study investigates the relationship between anxiety, depression, and gastrointestinal (GI) symptoms among university students through a comprehensive campus-wide survey.

METHODS

A cross-sectional online survey design was adopted in this study. A total of 437 students from three public medical universities in Saudi Arabia participated in the survey, which assessed anxiety and depression using standardized scales and GI symptoms through a tailored questionnaire.

RESULTS

The findings reveal a significant overlap between mental health disorders and GI symptoms, highlighting that students experiencing high levels of anxiety and depression frequently report GI issues. This correlation underscores the importance of integrated health strategies to address both mental and physical well-being.

CONCLUSION

This study concludes that there is a significant correlation between anxiety, depression, and GI symptoms among university students. This highlights the need for comprehensive and integrated health interventions that address both mental and physical health to improve overall well-being and academic success in this population.

Obstructive Sleep Apnea and Mental Health Disorders in the Pediatric Population: A Retrospective, Population-based Cohort Study

Rationale: Information is limited about the association between obstructive sleep apnea (OSA) and mental health disorders in children. Objectives: In children, 1) to evaluate the association between OSA and new mental healthcare encounters; and 2) to compare mental healthcare encounters 2 years after to 2 years before OSA treatment initiation. Methods: We conducted a retrospective longitudinal cohort study using Ontario health administrative data (Canada). Children (0-18 yr) who underwent diagnostic polysomnography (PSG) 2009-2016 and met criteria for definition of moderate-severe OSA (PSG-OSA) were propensity score weighted by baseline characteristics and compared with children who underwent PSG in the same period but did not meet the OSA definition (PSG-No-OSA). Children were followed until March 2021. Weighted cause-specific Cox proportional hazards and modified Poisson regression models were used to compare time from PSG to first mental healthcare encounter and frequency of new mental healthcare encounters per person time, respectively. Among those who underwent adenotonsillectomy (AT) or were prescribed and claimed positive airway pressure therapy (PAP), we used age-adjusted conditional logistic regression models to compare 2 years post-treatment to pretreatment odds of mental healthcare encounters. Results: Of 32,791 children analyzed, 7,724 (23.6%) children met criteria for moderate-severe OSA. In the PSG-OSA group, 7,080 (91.7%) were treated (AT or PAP). Compared with PSG-No-OSA, the PSG-OSA group had a shorter time from PSG to first mental healthcare encounter (hazard ratio, 1.08; 95% confidence interval [CI], 1.05-1.12) but less frequent mental healthcare encounters in follow-up (rate ratio, 0.92; 95% CI, 0.87-0.97). OSA treatment (AT or PAP) was associated with lower odds of mental healthcare encounters 2 years after treatment initiation compared with 2 years before (odds ratio, 0.69; 95% CI, 0.65-0.74). Conclusions: In this large, population-based study of children who underwent PSG for sleep disorder assessment, OSA diagnosis/treatment was associated with an improvement in some mental health indicators, such as fewer new mental healthcare encounters compared with no OSA and lower odds of mental healthcare encounters compared with before OSA treatment.

Pediatric suicide: Review of a preventable tragedy

Concepts of suicide are explored in this issue with a focus on suicide in children and adolescents. The epidemiology of pediatric suicide in the United States is reviewed; also, risk and protective factors, as well as prevention strategies, are discussed. Suicide in the pediatric athlete and the potential protective effect of exercise are examined. In addition, this analysis addresses the beneficial role of psychological management as well as current research on pharmacologic treatment and brain stimulation procedures as part of comprehensive pediatric suicide prevention. Though death by suicide in pediatric persons has been and remains a tragic phenomenon, there is much that clinicians, other healthcare professionals, and society itself can accomplish in the prevention of pediatric suicide as well as the management of suicidality in our children and adolescents.

Recent Progress in Biosensors for Depression Monitoring-Advancing Personalized Treatment

Depression is currently a major contributor to unnatural deaths and the healthcare burden globally, and a patient's battle with depression is often a long one. Because the causes, symptoms, and effects of medications are complex and highly individualized, early identification and personalized treatment of depression are key to improving treatment outcomes. The development of wearable electronics, machine learning, and other technologies in recent years has provided more possibilities for the realization of this goal. Conducting regular monitoring through biosensing technology allows for a more comprehensive and objective analysis than previous self-evaluations. This includes identifying depressive episodes, distinguishing somatization symptoms, analyzing etiology, and evaluating the effectiveness of treatment programs. This review summarizes recent research on biosensing technologies for depression. Special attention is given to technologies that can be portable or wearable, with the potential to enable patient use outside of the hospital, for long periods.