Depression in young people

Association between skeletal muscle mass to visceral fat area ratio and depression: A cross-sectional study based on the National Health and Nutrition Examination Survey

BACKGROUND

Skeletal muscle mass to visceral fat area ratio (SVR) has emerged as a key indicator for evaluating sarcopenic obesity (SO). The study aimed to elucidate the association between SVR and depression among US adults.

METHODS

Utilizing data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018, this cross-sectional study employed weighted multivariable logistic regression and restricted cubic splines (RCS) to explore the association between SVR and depression. Subgroup and interaction analyses were also performed.

RESULTS

The analysis encompassed 7,262 US adults. In the fully adjusted model, a significant negative association between SVR and depression was observed (OR = 0.35, 95%CI: 0.14-0.87). Additionally, SVR was significantly negatively correlated with mild (OR = 0.53, 95 % CI: 0.30-0.96) and severe depression (OR = 0.19, 95 % CI: 0.05-0.84). When SVR was stratified into quartile (Q1-Q4), individuals in the highest quartile exhibited a lower likelihood of depression compared to those in the lowest quartile (OR = 0.65, 95 % CI: 0.42-0.99). Additionally, the third quartile of SVR was significantly negatively associated with mild depression (OR = 0.72, 95 % CI: 0.53-0.98). No significant non-linear dose-response relationship between SVR and depression prevalence was detected (P-nonlinear = 0.3387). The association remained significant in several subgroup analyses. However, the interaction test revealed that none of the stratified variables were significant (all P for interaction > 0.05).

CONCLUSION

The study was pioneering in establishing a negative association between SVR and depression within the US population.

Health-related quality of life and its factors in Chinese people with depression and anxiety: A national multi-center cross-sectional study

BACKGROUND

The prevalence of depression and anxiety in Chinese population has been increasing in recently years, yet the health-related quality of life (HRQoL) of people with depression and anxiety remains unclear.

OBJECTIVE

To evaluate the HRQoL of individuals with depression and anxiety in China and to explore the factors influencing it.

METHODS

The study population was divided into a depressed group and non-depressed group, as well as an anxious group and non-anxious group. The EuroQol five-dimensional five-level questionnaire (EQ-5D-5L) was used to assess HRQoL in these individuals. Regression with the least absolute shrinkage and selection operator (Lasso) was applied separately to the datasets of the depressed and anxious populations for variable selection. A Tobit regression model was then used to analyze the relationship between various influencing factors and HRQoL in individuals with depression and anxiety.

RESULTS

A total of 7920 valid samples were collected from the PBICR database, including 1406 individuals with depression and 933 with anxiety. The HRQoL for individuals with depression and anxiety was estimated at 80.38 ± 17.17 and 80 ± 17.57, respectively. Among those with depression, a significant decrease in HRQoL was observed in individuals with debt (P = 0.021) and ex-smokers (P = 0.022) compared to their control groups. Health literacy (P < 0.001) and self-efficacy (P = 0.008) were identified as significant factors influencing HRQoL. For participants with anxiety, HRQoL was also lower among individuals with debt (P = 0.047) and ex-smokers (P = 0.033) compared to their control groups. Health literacy (P < 0.001) was a significant factor influencing HRQoL. Among individuals with depression (P = 0.006) and anxiety (P = 0.001), males had significantly higher HRQoL than females.

CONCLUSION

Common factors influencing the HRQoL of both individuals with depression and those with anxiety include debt, gender, smoking status, and health literacy. Additionally, self-efficacy is a significant factor affecting the HRQoL of individuals with depression.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Long-term physical health conditions and youth anxiety and depression: Is there a causal link?

BACKGROUND

The prevalence of youth anxiety and depression has increased globally, with limited causal explanations. Long-term physical health conditions (LTCs) affect 20-40% of youth, with rates also rising. LTCs are associated with higher rates of youth depression and anxiety; however, it is uncertain whether observed associations are causal or explained by unmeasured confounding or reverse causation.

METHODS

Using data from the Norwegian Mother, Father, and Child Cohort Study (MoBa) and Norwegian National Patient Registry, we investigated phenotypic associations between childhood LTCs, and depression and anxiety diagnoses in youth (<19 years), defined using ICD-10 diagnoses and self-rated measures. We then conducted two-sample Mendelian Randomization (MR) analyses using SNPs associated with childhood LTCs from existing genome-wide association studies (GWAS) as instrumental variables. Outcomes were: (i) diagnoses of major depressive disorder (MDD) and anxiety disorders or elevated symptoms in MoBa, and (ii) youth-onset MDD using summary statistics from a GWAS in iPSYCH2015 cohort.

RESULTS

Having any childhood LTC phenotype was associated with elevated youth MDD (OR = 1.48 [95% CIs 1.19, 1.85], p = 4.2×10-4) and anxiety disorder risk (OR = 1.44 [1.20, 1.73], p = 7.9×10-5). Observational and MR analyses in MoBa were consistent with a causal relationship between migraine and depression (IVW OR = 1.38 [1.19, 1.60], pFDR = 1.8x10-4). MR analyses using iPSYCH2015 did not support a causal link between LTC genetic liabilities and youth-onset depression or in the reverse direction.

CONCLUSIONS

Childhood LTCs are associated with depression and anxiety in youth, however, little evidence of causation between LTCs genetic liability and youth depression/anxiety was identified from MR analyses, except for migraine.

Pathways linking loneliness and depressive symptoms among Chinese adolescents: The mediating role of sleep disturbance

BACKGROUND

Despite growing evidence linking loneliness and depressive symptoms, the underlying pathways remain unclear. This study aims to assess the impact of loneliness on depressive symptoms among Chinese adolescents and investigate the potential mediating role of sleep disturbance.

METHODS

A cross-sectional study was conducted between November and December 2021. Loneliness, depressive symptoms, and sleep disturbance were assessed using the UCLA Loneliness Scale, the 9-item Patient Health Questionnaire, and the Pittsburgh Sleep Quality Index questionnaire, respectively. Baron and Kenny's causal steps method and the Karlson-Holm-Breen method were applied to explore the mediating role of sleep disturbance. Subgroup analysis by gender was also conducted.

RESULTS

A total of 6838 adolescents were included, with 52.2 % boys and a mean age of 14.5 (SD = 1.6) years. Approximately 15.8 % of the adolescents reported depressive symptoms. Loneliness was positively associated with depressive symptoms after controlling for covariates (OR = 1.34, 95%CI = 1.31-1.36). After incorporating sleep disturbance into the model, the association was still significant (OR = 1.28, 95%CI = 1.25-1.31). Sleep disturbance partially mediated this association, contributing to 18.89 % of the total effects. The associations and mediation effects were consistent across both genders, with no moderating effect of gender observed.

LIMITATIONS

The cross-sectional design limits the ability to establish causality.

CONCLUSION

Loneliness was significantly associated with depressive symptoms in Chinese adolescents and this association was partially mediated by sleep disturbance. Interventions aimed at reducing loneliness and improving sleep quality may help lower the risk of depressive symptoms in Chinese adolescents, regardless of genders. Nevertheless, further randomized controlled trials are needed to confirm these findings.

Negative emotions among Chinese primary and middle school students and association with screen time: A network analysis

BACKGROUND

Psychological health is crucial for the physical and mental well-being of primary and secondary school students, however, the research on the interrelationships among negative emotions is still limited. This study aims to investigate the network structure of depression, anxiety, and stress, and explore their correlation with screen time in these populations.

METHOD

This study was conducted from March to July 2022 in 157 counties across 18 cities in Henan Province. The Depression Anxiety Stress Scale (DASS-21) was used to assess the negative emotions experienced by students. Firstly, "Expected Influence" and "Bridge Expected Influence" were considered as key indicators within the symptom network to depict the structure of depressive, anxiety and stress symptoms. Secondly. a case-dropping bootstrap procedure was applied to assess the stability of the network. Finally, this study identified the central and bridge symptoms in the network, and explored their relationships with screen time.

RESULTS

The study included 52,782 students with an average age of 11.23±2.56 years. Network analysis showed that feelings of worthlessness, panic, and agitation are the predominant symptoms in the negative emotional networks. Depression, anxiety, and stress were interconnected through feelings of low mood, overreaction, and trembling. Additionally, lack of initiative and dry mouth exhibited the most significant direct associations with screen time.

CONCLUSION

The central and bridge symptoms identified in the negative emotion networks can serve as potential focal points for future research on negative emotions among primary and secondary school students.

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.

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

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

Unveiling the significance of AKAP79/150 in the nervous system disorders: An emerging opportunity for future therapies?

A-kinase anchoring protein 79/150 (AKAP79/150) is a crucial scaffolding protein that positions various proteins at specific synaptic sites to modulate excitatory synaptic intensity. As our understanding of AKAP79/150's biology deepens, along with its significant role in the pathophysiology of various human disorders, there is growing evidence that reveals new opportunities for therapeutic interventions. In this review, we examine the fundamental structure and primary functions of AKAP79/150, emphasizing its pathophysiological mechanisms in different nervous system disorders, particularly inflammatory pain, epilepsy, depression, and Alzheimer's disease. We also discuss its potential therapeutic implications for patients suffering from these conditions.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

The effect of stressful life events on depressive symptoms in Chinese university students: Moderated mediating effect of interpersonal relationship and gender

BACKGROUND

This study aimed to examine the impact of stressful life events on the depressive symptoms of Chinese first-year university students, while considering the influence of interpersonal relationships and gender on this association.

METHODS

A total of 8079 first-year Chinese university students were surveyed using the Adolescent Self-Rating Life Events Check List (ASLEC), Beck Depression Inventory (BDI), and Comprehensive Diagnostic Scale of Interpersonal Relationship (CDSIR).

RESULTS

Stressful life event were positively correlated with interpersonal relationships, depressive symptoms, and gender (r = 0.385, 0.264, 0.055, p < 0.001); there was a significant positive correlation between depressive symptoms and interpersonal relationships (r = 0.473, p < 0.001). Stressful life events partially predict depressive symptoms through the mediation of interpersonal relationships, and the proportion of indirect total effect was 63.26 %. The effect of stressful life events on depressive symptoms was moderated by gender. Stressful life events had a positive effect on depressive symptoms in both male and female individuals. Compared with male individuals (simple slope = 0.070, t = 3.467, p < 0.001), female individuals were more susceptible to stressful life events (simple slope = 0.185, t = 9.652, p < 0.001).

LIMITATIONS

The generalizability of the findings is constrained by the composition of the sample. The study's utilization of questionnaire methodology and cross-sectional design poses limitations in establishing definitive causality.

CONCLUSION

The effect of stressful life events on depressive symptoms might be mediated by interpersonal relationships and moderated by gender.

Identification of depressive symptoms in adolescents using machine learning combining childhood and adolescence features

BACKGROUND

Depressive symptoms in adolescents can significantly affect their daily lives and pose risks to their future development. These symptoms may be linked to various factors experienced during both childhood and adolescence. Machine learning (ML) has attracted substantial attention in the field of adolescent depression; however, studies establishing prediction models have primarily considered childhood or adolescent features separately, resulting in a lack of analyses that incorporate factors from both stages.

METHODS

We collected 39 features related to childhood and adolescence. Using the maximum relevance-minimum redundancy method and four ML algorithms, we determined the optimal feature subset for identifying depressive symptoms and constructed child-adolescent models. Stepwise logistic regression and four ML methods were employed to create demographic and combined models, respectively. The performance of each model was evaluated using a test set, and SHapley Additive exPlanations (SHAP) were utilized to interpret the models' prediction results.

RESULTS

The proposed child-adolescent models exhibited superior performance on the test set than the demographic and combined models (AUC: 0.835-0.879 versus 0.530 and 0.840-0.876, respectively). The optimal feature subset included two childhood features (relationship quality with peers and parental absence) and four adolescence features (social trust, academic pressure, importance of the internet for entertainment, and positive parenting behaviour). These features were found to be more effective than demographic characteristics in distinguishing depressive symptoms in adolescents.

CONCLUSIONS

This study demonstrates the correlation between adolescence depressive symptoms and specific factors from both childhood and adolescence, as well as the potential of ML to predict it. These findings may serve as a reference for future intervention studies.

Regulatory effects of Lactobacillus zhachilii HBUAS52074T on depression-like behavior induced by chronic social defeat stress in mice: modulation of the gut microbiota

The gut microbiome has emerged as a growing focus of research and public health interest, leading to the frequent exploration of probiotic dietary supplements as potential treatments for various disorders, such as anxiety and depression. In the present report, changes in inflammation and microbiome composition were assessed in model mice exhibiting depressive-like behaviors that were exposed to the probiotic Lactobacillus zhachilii HBUAS52074T. It was found that L. zhachilii HBUAS52074T alleviated the severity of depressive-like behaviors while increasing serum 5-HT concentrations. Moreover, L. zhachilii HBUAS52074T modulated the composition of the gut microbiota, resulting in a decrease in the abundance of Prevotella and an increase in the abundance of Lactobacillus. Additionally, supplementation with L. zhachilii HBUAS52074T enhanced intestinal barrier function and reduced inflammation in peripheral blood, as well as in the hippocampal and prefrontal cortical tissues. Correlational analyses indicated that the abundance of Lactobacillus was positively correlated with the social interaction ratio, time spent in the center, entries into the center, as well as serum 5-HT and serum IL-10 levels but negatively correlated with immobility time. Overall, chronic social defeat stress was found to be associated with inflammation and the exacerbation of depressive-like behaviors. The above findings suggested that L. zhachilii HBUAS52074T supplementation was sufficient to alter the parameters. Collectively, these data suggest that L. zhachilii HBUAS52074T, derived from naturally fermented foods, may possess therapeutic potential for the treatment of depression.

The Association Between Adherence to the Mediterranean Diet and Depression and Anxiety Symptoms in University Students: The Mediating Role of Lean Mass and the Muscle Strength Index

BACKGROUND/OBJECTIVES

recent studies have suggested that components typical of the Mediterranean diet (MedDiet) are associated with depression and anxiety prevention. In this sense, the main objective of this study was to analyse the associations between adherence to the MedDiet and depression and anxiety symptoms and to examine whether this relationship is mediated by lean mass and the muscle strength index (MSI).

METHODS

a cross-sectional study (based on data obtained from the Nuts4Brain-Z study) was conducted from 2023-2024, involving 428 university students, aged 18-30 years, from a Spanish public university. Depression was assessed using the Beck Depression Inventory (BDI-II), and anxiety was assessed via the General Anxiety Disorder-7 (GAD-7) tool. Adherence to the MedDiet was assessed using the MEDAS questionnaire. Lean mass was assessed via bioimpedance, and MSI was measured via a dynamometer. ANCOVA models were used to test the mean differences in depression and anxiety scores using MEDAS categories (low adherence < 9 points vs high adherence ≥ 9 points). Serial multiple mediation models, adjusted for the main confounders, were used to explore the role of lean mass and MSI in the relationships between adherence to the MedDiet and depression and anxiety symptoms.

RESULTS

university students with high adherence to the MedDiet exhibited lower scores for depression and anxiety symptoms (p < 0.05) than did students with low adherence to the MedDiet. The mediation analysis preliminarily revealed that both lean mass and MSI acted as mediators of the relationships between adherence to the MedDiet and depression and anxiety.

CONCLUSION

adherence to the MedDiet in university students per se does not appear to have a direct effect on depression and anxiety symptoms because these associations are partially (for depression) or entirely (for anxiety) explained by lean mass and MSI.

Social inequalities in youth mental health in Canada, 2007-2022: a population-based repeated cross-sectional study

PURPOSE

Rising concern surrounds youth mental health in Canada, with growing disparities between females and males. However, less is known about recent trends by other sociodemographic factors, including sexual orientation, ethnocultural background, and socioeconomic status.

METHODS

This study analyzed data from 96 683 youths aged 15-24 who participated in the nationally representative Canadian Community Health Survey (CCHS) between 2007 and 2022. Trends in absolute and relative inequalities in poor/fair self-rated mental health (SRMH) by sex, sexual orientation, racialized and Indigenous identity, and socioeconomic conditions were assessed.

RESULTS

The percent of youths reporting poor/fair SRMH quadrupled from 4.3% in 2007-08 to 20.1% in 2021-22. During the same period, absolute inequalities in SRMH increased by 9.9% points (95% CI: 6.6, 12.9) for females compared to males, 11.4% points (95% CI: 4.6, 18.2) for Indigenous versus non-racialized youth, and 15.4% points (95% CI: 5.7, 25.1) for youth (aged 18-24) identifying as lesbian, gay, or bisexual (LGB) compared to heterosexual.

CONCLUSION

The sustained deterioration in youth SRMH over the past decade and a half has been accompanied by widening inequalities across several dimensions important for health equity in Canada. Action is needed to identify and implement effective programs and policies to support youth mental health and address disparities.

Inverse association of oxidative balance score with depression and specific depressive symptoms among cancer population: Insights from the NHANES (2005-2020)

BACKGROUND

The rising prevalence of depression among cancer patients is alarming. This study examines the relationship between the Oxidative Balance Score (OBS)-a composite measure of dietary and lifestyle factors-and depression, including specific depressive symptoms in this population.

METHODS

Data were analyzed from 3,280 adult cancer patients collected in NHANES from 2005-2020. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9), where a score of 10 or above indicated depression. Symptoms experienced frequently were classified as specific depressive symptoms. Weighted logistic regression models were utilized to explore the correlation between OBS and depression, along with distinctive depressive symptoms.

RESULTS

There was a negative correlation between OBS and depression. The highest quartile of OBS (OR 0.313, 95% CI: 0.161-0.609), along with dietary OBS (OR 0.429, 95% CI: 0.234-0.786) and the third quartile of lifestyle OBS (OR 0.404, 95% CI: 0.226-0.722), was associated with reduced depression risk. OBS was correlated with lower risks of all four somatic depressive symptoms and one cognitive symptom. Dietary OBS was associated with fewer risks of three somatic symptoms and one cognitive symptom. Lifestyle OBS showed a negative correlation with two somatic symptoms. Stratified analyses indicated that the inverse relationship between OBS and depression risk was consistent across subgroups, including females and individuals under 65. a nonlinear association was observed between OBS (p = 0.024), dietary OBS (p<0.001), lifestyle OBS (p = 0.021), and depression.

CONCLUSIONS

OBS is inversely related to depression and specific depressive symptoms in cancer patients. Encouraging a diet and lifestyle rich in antioxidants may help reduce the risk of depression in this group.

Under the surface: Low cardiac vagal tone and poor interoception in young adults with subclinical depressive symptoms

INTRODUCTION

Depressive symptoms are associated with alterations in central and autonomic nervous system activity, including misperception of bodily activity (e.g., low interoception), somatic symptoms and decreased vagally mediated heart rate variability (vmHRV). However, there is a lack of studies that examine both perception of bodily activity and autonomic function in depression. The present study investigated the association between interoception, vmHRV, and subclinical depressive symptoms.

METHOD

Eighty-eight students were enrolled and vmHRV was calculated from a 5-minute resting electrocardiogram. Interoceptive accuracy (heartbeat tracking task; heartbeat discrimination task), interoceptive sensibility (Body Perception Questionnaire), and depressive symptoms (Depression, Anxiety and Stress Scale - 21 Items) were assessed.

RESULTS

Interoceptive accuracy and sensibility positively correlated with vmHRV and negatively correlates with depressive symptoms. Cluster analysis performed on vmHRV, interoceptive accuracy, and sensibility provided two clusters: the first characterized by a pattern of low interoceptive accuracy, sensibility, and decreased resting vmHRV, the second characterized by an opposite pattern. Regression analyses showed that the first cluster was characterized by significantly higher depressive symptoms compared to the second (β = 1.97; pBonferroni = 0.04), even after controlling for sex, BMI, anxiety, and stress levels.

CONCLUSIONS

Subclinical depressive symptoms are associated with a consistent impairment in the perception and interpretation of bodily activity and altered regulatory function of the autonomic nervous system. The present results suggest that the alteration of brain-body communication could be involved in subclinical depressive symptoms. Early identification of such alterations could help with targeted preventive strategies.

Visual analysis of research hotspots and trends in traditional Chinese medicine for depression in the 21st century: A bibliometric study based on citespace and VOSviewer

Background and objectives

Depression long been a key concern for scholars worldwide; however, the field of depression has not received sufficient attention in traditional Chinese medicine. It was not until the 21st century that research into depression gradually entered a period of rapid development, with an increasing number of academic studies published in major journals. However, one limitation of this field is that no scholars have yet summarised the development process and key research issues. Therefore, the present study aimed to summarise the research trends and progress in this field, providing relevant information and presenting potential future research directions for subsequent researchers.

Methods

Literature in this field was searched from January 1, 2000 to April 20, 2024 in the Web of Science Core Collection database, to analyse the current status of the literature and publication trends. Bibliographic information, including study authors, organisations, keywords, countries, references, citations, and co-citations, was extracted using CiteSpace and VOSviewer software for quantitative analysis, visual mapping, and scientific evaluation.

Results

A total of 921 papers were included, with a significant increase in the number of publications from 2017 to 2021, and a stable number of more than 140 publications between 2022 and 2023, with publications in these two years accounting for 31.38 % of the total. The Journal of Ethnopharmacology had the highest number of publications (97) and citations (2067), as well as the highest number of co-citations (1369). China (847 publications, 13256 citations), Beijing University of Chinese Medicine (90 publications, 1232 citations), and Qin Xuemei (30 publications, 759 citations) were the most prolific and influential countries, organisations, and authors in the field, respectively. Keyword clustering co-occurrence analysis revealed nine different clusters with good homogeneity. The top three clusters were randomised controlled trials, traditional Chinese medicine, and hippocampal neurogenesis. In the timeline analysis of keywords, from 2000 to 2010, keywords in this field were concentrated on hippocampal neurology and forced swimming test as clustering axes of Traditional Chinese Medicine. From 2010 to 2020, the research hotspots focused on randomised controlled trials and hippocampal neurogenesis. After 2020, keywords became more focused on network pharmacology. In addition, the occurrence time of explosive keywords were distributed before 2010 and after 2020. Before 2010, these keywords included the forced swimming test, Tail Suspension Test, Chronic Cold Stress, Neural Regeneration, and Banxia Houpu Decoction. Conversely, network Pparmacology and Molecular Docking arose as key buzzwords starting in 2020.

Conclusions

This study comprehensively analysed and summarised the research hotspots and trends in this field of research in the 21st century from a bibliometric perspective, further generating a series of visual graphs to help researchers understand the current research status, potential collaborators, collaborating institutions, and potential future research hotspots in this field.

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.

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.

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.

Overweight and glucose/lipid metabolism abnormality associated with SSRIs: a pharmacovigilance study based on the FDA adverse event reporting system

Background

In the past few decades, selective serotonin reuptake inhibitors (SSRIs) became widely used antidepressants worldwide. Therefore, the adverse reactions of patients after SSRI administration became a public and clinical concern. In this study, we conducted a pharmacovigilance study using the Adverse Event Reporting System (FAERS) database of the US Food and Drug Administration. Our main goal was to evaluate adverse events related to SSRIs, with a particular focus on abnormal weight gain and glucose/lipid metabolism disorders.

Method

The adverse event data for representative SSRIs (citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline) was extracted from the FAERS database from 2004Q1 to 2023Q4. The reporting odds ratio and proportional reporting ratio were employed to explore relevant adverse event reports (ADEs) signals. Univariate logistic regression analysis was utilized to explore factors associated with glucose/lipid metabolism abnormality following SSRIs treatment.

Results

We identified 143,744 ADE reports associated with SSRIs and revealed significant abnormal signals related to weight gain and glucose/lipid metabolism in depressed patients. Variations were observed among different SSRIs medications. Specifically, citalopram was associated with abnormal weight gain (ROR: 4, 95% CI: 3.1-5.2) and hepatic steatosis (ROR: 2.8, 95% CI: 2.1-3.6); escitalopram was correlated with gestational diabetes (ROR: 9.1, 95% CI: 6.6-12.4) and cholestasis (ROR: 2.4, 95% CI: 1.75-3.38); fluoxetine was associated with obesity (ROR: 2.8, 95% CI: 2.08-3.78); fluvoxamine was linked to arteriospasm coronary (ROR: 13.87, 95% CI: 4.47-43.1); and sertraline was implicated in neonatal jaundice (ROR: 16.1, 95% CI: 12.6-20.6). Females and younger age are important risk factors for the development of associated adverse effects.

Conclusion

Our study screened for adverse effects associated with abnormal glucose/lipid metabolism, such as abnormal body weight and fatty liver, in depressed patients taking selective serotonin reuptake inhibitors by utilizing FAERS database. This provides valuable insights for healthcare professionals in accepting and managing patients treated with SSRIs.

Do coping mechanisms moderate the effect of stressful life events on depression and anxiety in young people? A case-control study from Latin America

BACKGROUND

Stressful life events (SLEs) are associated with increased risk of depression or anxiety. Coping mechanisms may moderate this relationship but little is known on this topic in young people or in Latin America.

AIM

To investigate whether coping strategies predict odds of depression and/or anxiety and moderate the relationship between SLEs and depression and/or anxiety in young people in Peru, Lima and Bogotá.

METHOD

Using case-control data from people aged 15-24, we used logistic regression to examine associations between coping mechanism, SLEs and caseness for depression or anxiety, adjusting for sociodemographic and socioeconomic factors. We included interaction terms to model whether this association varied depending on coping mechanisms (positive cognitive restructuring, problem focused, support seeking, distraction, avoidant).

RESULTS

We included 1437 cases and 965 controls. Cases reported less use of positive cognitive restructuring (OR 0.66; 95% CI 0.57 to 0.75) and problem-focused coping (OR 0.82; 95% CI 0.73 to 0.93), and more use of avoidance than controls (OR 1.33; 95% CI 1.19 to 1.50) in adjusted models. They had greater odds of reporting lifetime (OR 1.07; 95% CI 1.04 to 1.10) and past-year (OR 1.05; 95% CI 1.01 to 1.10) SLEs than controls. We found weak but consistent evidence of effect modification; the association between lifetime SLEs and case-control status was stronger in those who used less support seeking (p=0.09), problem-focused coping (p=0.08) or positive cognitive restructuring (p=0.09).

CONCLUSIONS

Relationships between SLEs, coping mechanisms and depression/anxiety appear similar in these Latin American cities to other contexts. Active coping strategies may ameliorate the impact of SLEs on mental health of young people.

The Dark Side of Empathy: the Role of Excessive Affective Empathy on Mental Health Disorders

Empathy, typically regarded as a positive attribute, is now being critically evaluated for its potential negative implications on mental health. A growing body of research indicates that excessive empathy, particularly high level of affective empathy, can lead to overwhelming emotional states, increasing susceptibility to psychological distress and psychiatric disorders. This review aims to explore the negative effects of empathy on mental health. We review both human and animal studies concerning the relationship between empathy and psychological disorders, revealing that while empathy enhances social interactions and emotional understanding, it may also heighten empathic distress and potentially contribute to the development of pain, internalizing disorders, depression, anxiety, emotional over-involvement, burnout, vicarious trauma and post-traumatic stress disorder. This review contributes to the broader discourse on empathy by delineating its dual impacts, integrating insights from neurobiology, psychology, and behavioral studies. This review may enhance our understanding of empathy's complex role in mental health, offering a nuanced perspective that acknowledges both its beneficial and detrimental impacts.

The impact of published guidance on trends in the pharmacological management of depression in children and adolescents- a whole population e-cohort data linkage study in Wales, UK

BACKGROUND

This study evaluated the impact of 2015/2016 prescribing guidance on antidepressant prescribing choices in children.

METHODS

A retrospective e-cohort study of whole population routine electronic healthcare records was conducted. Poisson regression was undertaken to explore trends over time for depression, antidepressant prescribing, indications and secondary care contacts. Time trend analysis was conducted to assess the impact of guidance.

RESULTS

A total of 643 322 primary care patients in Wales UK, aged 6-17 years from 2010-2019 contributed 3 215 584 person-years of follow-up. Adjusted incidence of depression more than doubled (IRR for 2019 = 2.8 [2.5-3.2]) with similar trends seen for antidepressants. Fluoxetine was the most frequently prescribed first-line antidepressant. Citalopram comprised less than 5% of first prescriptions in younger children but 22.9% (95% CI 22.0-23.8; 95% CI 2533) in 16-17-year-olds. Approximately half of new antidepressant prescribing was associated with depression. Segmented regression analysis showed that prescriptions of 'all' antidepressants, Fluoxetine and Sertraline were increasing before the guidance. This upward trend flattened for both 'all' antidepressants and Fluoxetine and steepened for Sertraline. Citalopram prescribing was decreasing significantly pre guidance being issued with no significant change afterward.

CONCLUSIONS

Targeted intervention is needed to address rising rates of depression in children. Practitioners are partially adhering to local and national guidance. The decision-making process behind prescribing choices is likely to be multi-factorial. Activities to support implementation of guidance should be adopted in relation to safety in prescribing of antidepressants in children including timely availability of talking therapies and specialist mental health services.

Associations of time spent on different types of digital media with self-rated general and mental health in Swedish adolescents

Although previous studies have suggested an association between digital media use and health, detailed knowledge about how different types of digital media impact adolescent health is limited. This cross-sectional population-based study explored the relationship between time spent on various digital media and adolescents' self-rated general and mental health. The study included 3566 Swedish high school students aged 16-17 years. Associations between time spent on digital media (social media, gaming, watching movies/series/video clips etc. and digital schoolwork) and self-rated health outcomes (general health, self-esteem, symptoms of worry/anxiety and low mood/depression, trust in other people, head/neck/shoulder pain and sleep quality) was assessed. Statistical analyses employed logistic regression models adjusted for covariates (sociodemographic variables and health behaviours). In the adjusted models, spending very high amounts of time (≥ 6 h/day) on any digital media, except schoolwork, was associated with poor self-esteem, symptoms of low mood/depression and poor sleep (ORs 1.35-2.93, p < 0.05). Spending six hours or more on digital media was also associated with worry/anxiety (for social media and gaming), head/neck/shoulder pain (for social media, watching movies/series/video clips and schoolwork), poor general health (for gaming and watching movies/series/video clips) and low trust (for gaming) (ORs 1.39-3.18, p < 0.05). High amounts of time (4-5 h/day) of watching movies/series/video clips was associated with daily symptoms of low mood/depression, neck/shoulder pain, and low trust in other people (ORs 1.46, 1.41, and 1.32, p < 0.05). This study indicates a dose-response relationship between digital media use and adverse health outcomes in adolescents, where adverse associations start to appear after 4-5 h, particularly for watching movies/series/video clips. However, further longitudinal studies, randomized controlled trials and public health interventions focused on healthy and balanced use of digital media are warranted.

Recovery and Recurrence From Major Depression in Adolescence and Adulthood

OBJECTIVE

The study aimed to estimate 5-year recurrence rates of first-episode major depressive disorder (MDD) and assess the impact of adolescence on recurrence likelihood after the first episode, compared to adults.

METHODS

A pre-registered retrospective cohort study that utilized epidemiological data from the Stockholm MDD Cohort (1997-2018), including all individuals registered with a depression diagnosis in Region Stockholm from 2010 to 2018. This dataset combines longitudinal information from primary and secondary care, socioeconomic data, drug dispensations, psychotherapy sessions, brain stimulation treatments, and inpatient treatment. The study included 9124 individuals (1727 adolescents aged 13-17 and 7397 adults aged 18-40) who experienced their first MDD episode between 2011 and 2012, with at least three months of remission. Propensity score weighting balanced cohorts for biological sex, socioeconomic status, depression severity, psychiatric comorbidities, and treatments.

RESULTS

The 5-year recurrence rates were 46.1% for adolescents and 49.0% for adults. The study had over 80% power to detect a minimum absolute difference in recurrence rates of approximately 5.5 percentage points. No significant difference in recurrence likelihood (p = 0.364) or time from remission to recurrence (median 379 days for adolescents, 326 days for adults, p = 0.836) was found between groups. Findings were consistent across bootstrap replicates and sensitivity analyses with extended remission periods.

CONCLUSIONS

Approximately half of individuals with a first MDD episode experience recurrence within five years. Recurrence rates were higher than expected for adults but consistent with expectations for adolescents. The study underscores the need for relapse prevention from adolescence through adulthood and indicates a similar clinical course of MDD across age groups.

Aggression and patterns of co-occurrence mental health problems in Chinese adolescents: a latent class analysis

BACKGROUND

Mental health is an important aspect of adolescents' development and well-being. Mental health problems, such as depression, anxiety, non-suicidal self-injury, suicide ideation, and suicide attempt, are recognized to be interconnected and to occur often. Research has found that aggression is connected to a variety of mental health problems. However, there's limited knowledge about the patterns of how depression, anxiety, non-suicidal self-injury, suicide ideation, and suicide attempt co-occur, and only few studies describe their association with aggression and sex differences.

METHODS

A cross-sectional study that involved 18,555 Chinese adolescents was performed to explore the mental health latent classes and the relationship with aggression.

RESULTS

The results showed four latent classes of mental health problems: low-symptom class (70.8%), self-harm class (9.1%), emotional symptom class (13.4%), and high-symptom class (6.7%). A significant co-occurrence between depression, anxiety, non-suicidal self-injury, suicide ideation, and suicide attempt was found in the high-symptom class. Notably, higher levels of adolescent aggression were associated with comorbid moderate to high mental health problems. Similar four latent classes and associations were found across sexes.

CONCLUSIONS

The present study emphasized the heterogeneity of mental health problems and revealed their co-occurrence patterns. Aggression levels are associated with the latent classes in adolescents, with the most pronounced association observed in the high-symptom class. Preventing aggression could contribute to reducing the severity and co-occurring patterns of mental health problems among adolescents.

Therapeutic Approaches to Tackle the Challenge of Depression That Is Resistant to Treatment-A Narrative Review

Background and Aims

The lack of therapeutic response characterizes treatment-resistant depression despite undergoing at least two adequate monotherapy trials with medications from distinct pharmacologic classes. The inability to attain remission in patients diagnosed with major depressive disorder (MDD) is a significant issue of concern within public health. Therefore, the management of treatment-resistant depression (TRD) poses significant obstacles for both patients and healthcare professionals. Our goal was to investigate the published literature concerning different options for treatment for TRD, including those that do not involve the use of medications.

Methods

We thoroughly searched the literature in the Google Scholar, PubMed, and ScienceDirect databases to find publications relevant to our narrative review and extracted data from appropriate data. For this review, literary works written solely in English were chosen.

Results

Ongoing research is being conducted to explore the treatment options for TRD, including pharmacological and nonpharmacological interventions. Pharmacological interventions include a wide range of therapeutic approaches, including but not limited to investigating innovative medications and strategies such as augmentation, switching, and combination therapies involving established and emerging drugs. Nonpharmacological interventions, including brain stimulation such as theta burst stimulation, deep brain stimulation, electroconvulsive therapy, repetitive transcranial magnetic stimulation, intermittent transcranial magnetic stimulation, and magnetic seizure therapy, as well as psychotherapeutic approaches, are being explored for the management of TRD in both present and future contexts.

Conclusion

Researchers are dedicating significant resources to the aforementioned therapeutic interventions to advance the development of novel and efficacious treatment options for TRD and enhance our comprehension of the underlying disease. This review focused on looking at recent research concerning therapeutic interventions for TRD.

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.

The relationship between emotional eating, mindful eating, and depression in young adults

The aim of this study was to examine the relationship between eating behavior, eating awareness, and depression in young adults. Young adults aged between 18 and 25 years were included in the study. Questionnaires and body composition measurements were made face-to-face by the researcher in the interview room. The demographic characteristics were questioned through the questionnaire form. Three Factor Eating Questionnaire (TFEQ), Mindful Eating Questionnaire (MEQ), and Beck Depression Inventory (BDI) were used. It was determined that the Mindful Eating Questionnaire total score and Beck Depression Inventory total score affected emotional eating. A statistically significant positive correlation was found between the Beck Depression Inventory total score and the Three Factor Eating Questionnaire sub-scores. There was a statistically significant negative correlation Beck Depression Inventory total score and the Mindful Eating Questionnaire total score and sub-scores of mindless eating and emotional eating. In summary, depression seems to be a factor that triggers emotional eating, and emotional eating is a factor that negatively affects mindful eating.

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.

Achievement Goals as Mediators of the Links Between Self-Esteem and Depressive Symptoms From Mid-Adolescence to Early Adulthood

Numerous studies have sought to determine whether low self-esteem acts as a risk factor for depressive symptoms (i.e., a vulnerability model) or whether depressive symptoms lead to a decrease in self-esteem (i.e., a scar model). Although both models have received some support, very little research has: (a) addressed this question across critical life transitions likely to modify this pattern of associations, such as the transition to adulthood; (b) sought to identify the psychological mechanisms (i.e., mediators) underpinning these associations. The present study was designed to address these two limitations, focusing on the directionality of the associations between depressive symptoms and self-esteem from mid-adolescence to early adulthood while considering the role of motivational factors, namely mastery (intrinsic/extrinsic) and performance (approach/avoidance) goals as conceptualized in achievement goal theory. A sample of 707 Finnish adolescents aged 15-16 (52.1% boys) was surveyed six times up to the age of 25. Results from a cross-lagged panel model (CLPM) revealed that depressed individuals were more likely to have low self-esteem, although self-esteem protected against depressive symptoms between ages 16-17 to 20-21. Moreover, while self-esteem promoted mastery-extrinsic goals which in turn reinforced self-esteem, depressive symptoms promoted performance-avoidance goals which led to more depressive symptoms and lower self-esteem. Overall, these findings highlight (1) the long-lasting negative consequences of depressive symptoms on self-esteem and (2) the crucial role played by academic motivation in explaining the development of depressive symptoms and self-esteem over time. In turn, these results help refine the vulnerability and scar models, and suggest that motivational factors should be considered in prevention and intervention efforts among young populations.

"Internet+" pharmacy in psychiatric hospital amid COVID-19 and post-pandemic period: analysis and development

Objective

This study aims to explore the differences in "Internet+" pharmacy prescriptions in psychiatric hospitals before and after the outbreak of the coronavirus disease 2019 (COVID-19) pandemic. It also seeks to examine changes in patient healthcare behaviors in the post-pandemic era and to identify the potential role of "Internet+" pharmacy in improving the current healthcare system.

Methods

Prescriptions from the "Internet+" pharmacy at The Affiliated Mental Health Center of Jiangnan University, collected between December 1, 2021, and November 30, 2023, were analyzed. The period was divided into four stages based on the COVID-19 pandemic's progression in China. Descriptive statistical analysis was conducted on various prescription-related factors, including patient information, prescription type, disease distribution, medication type, frequency of medication use, pharmacist review time, and instances of irrational medication use.

Results

A total of 2914 prescriptions were collected. The male-to-female ratio (MFR) varied significantly across different stages of the epidemic. In the pre-pandemic II period, females represented the highest proportion (66.10%, MFR 0.51), and individuals aged 18-39 made up the majority (56.70%) across all stages. The proportion of psycho-counseling prescriptions was highest in the pre-pandemic II period (76.74%), while the total number of psycho-counseling prescriptions was greatest during the epidemic, with 798 cases. A total of 38 diseases were involved, with depression accounting for the largest proportion (38.98%) at each stage, followed by the highest usage of antidepressants (49.60%). A total of 85 types of medications were used, with quetiapine representing the highest proportion before the epidemic (16.56%, 10.92%), while escitalopram accounted for the highest proportion after the epidemic (10.98%). The majority of patients (70.87%) took medication once daily. 42.23% of pharmacist review times were ≤1 minute, and the mean review time was longest in the post-pandemic period (6175.1 seconds). During the pre-pandemic and epidemic periods, the most common pharmacist review time occurred between 12:00 and 17:59 (41.46%), while in the post-pandemic period, the most common review time was between 18:00 and 23:59 (36.70%). The initial rate of irrational prescriptions was 37.85%. After manual review by pharmacists, the irrational prescription rate of Internet prescriptions decreased to 1.13%.

Conclusion

The development of "Internet+" pharmacy has effectively addressed the medical needs of the relevant population and played a crucial role in combating the COVID-19 pandemic. Future advancements should focus on optimizing the allocation of healthcare resources and expanding innovative pharmacy services to broaden the developmental pathways of the 'Internet+' pharmacy ecosystem.

Does dose matter? Parental attendance in a preventive intervention for anxious and sad children

BACKGROUND

International studies show increasing prevalence of anxiety and depression among children. Parents are vital for children in all aspects of life, also in supporting their offspring in promoting better mental health, life skills and reducing emotional difficulties. Therefore, involving parents in interventions aimed at preventing development of anxiety and depression is natural. In treatment studies, targeted parental involvement has been difficult to prove effective. However, few existing studies investigate the effect of parental involvement in preventive interventions.

OBJECTIVE

We aimed to explore whether attendance influenced the change in child's emotional symptoms post intervention and one-year later reported by parents.

METHOD

Parents of children attending an indicated preventive intervention named EMOTION, who took part in a high parental involvement condition were included in this study (n = 385). High involvement entailed 5 parent group sessions. Using linear mixed models, we investigated whether attendance in the parent groups influenced the parent-reported levels of children's emotional symptoms post-intervention and at one-year follow-up.

RESULTS

Parents who did not attend parent sessions reported significantly larger reductions in child anxiety symptoms over time than attending parents. There was no such effect on child depression. However, parents who attended sessions reported significantly higher depression symptoms than non-attendees at baseline. Further, attending more parent sessions did not significantly impact either symptom measure.

DISCUSSION

Given the non-significant differences of parental attendance in this study, future studies could examine less resource demanding interventions for children with emotional difficulties. When the child is struggling with anxiety and depression, the parent's role in child's life could be vital for symptom amelioration. The challenge is finding effective, evidence-based methods to involve parents, to reduce child emotional difficulties and improve their quality of life.

CONCLUSIONS

In this preventive study, attendance in parent sessions has limited effect on parent-reported symptoms of child emotional difficulties.

Using hierarchical drift diffusion models to elucidate computational mechanisms of reduced reward sensitivity in adolescent major depressive disorder

BACKGROUND

Anhedonia-a core symptom of major depressive disorder (MDD)-is closely related to diminished reward sensitivity. Nonetheless, the psychopathological and computational mechanism underlying anhedonia in young patients with MDD remains unclear. Therefore, this study aims to investigate reward sensitivity in adolescents and young adults with MDD using computational modelling.

METHODS

Overall, 70 patients with MDD and 54 age- and sex-matched healthy controls (HC) completed a probabilistic reward task (PRT) to assess their general behavioral inclination towards more frequently reinforced stimuli (i.e., "response bias"). Bayesian hierarchical drift diffusion modeling (HDDM) was employed to determine changes in reward sensitivity and computational process during decision-making.

RESULTS

Adolescents with depression showed a trend toward reduced response bias compared to those in HC. HDDM analysis revealed wider decision thresholds in both adolescents and young adults with MDD group. Adolescents with MDD exhibited significantly lower drift rates and reduced starting point bias compared to those in HC. Higher anhedonia levels were linked to lower drift rates and wider decision thresholds. Additionally, increased discriminability correlated with higher drift rates, while higher response bias was linked to larger starting points.

CONCLUSIONS

Our findings suggest that reduced reward sensitivity and slower evidence accumulation during reward learning may serve as potential indicators of anhedonia in adolescents with MDD. These findings provided crucial insights into the dysregulated positive affect model, underscoring a dysfunctional reward system as a key factor in anhedonia developmental psychopathology in depression.

Sociodemographic factors associated with trajectories of depression among urban refugee youth in Kampala, Uganda: A longitudinal cohort study

Background

There is a high prevalence of depression among refugee youth in low- and middle-income countries, yet depression trajectories are understudied. This study examined depression trajectories, and factors associated with trajectories, among urban refugee youth in Kampala, Uganda.

Methods

We conducted a longitudinal cohort study with refugee youth aged 16-24 in Kampala, Uganda. We assessed depression using the Patient Health Questionnaire-9 and conducted latent class growth analysis (LCGA) to identify depression trajectories. Sociodemographic and socioecological factors were examined as predictors of trajectory clusters using multivariable logistic regression.

Results

Data were collected from n = 164 participants (n = 89 cisgender women, n = 73 cisgender men, n = 2 transgender persons; mean age: 19.9, standard deviation: 2.5 at seven timepoints; n = 1,116 observations). Two distinct trajectory clusters were identified: "sustained low depression level" (n = 803, 71.9%) and "sustained high depression level" (n = 313, 28.1%). Sociodemographic (older age, gender [cisgender women vs. cisgender men], longer time in Uganda), and socioecological (structural: unemployment, food insecurity; interpersonal: parenthood, recent intimate partner violence) factors were significantly associated with the sustained high trajectory of depression.

Conclusions

The chronicity of depression highlights the critical need for early depression screening with urban refugee youth in Kampala. Addressing multilevel depression drivers prompts age and gender-tailored strategies and considering social determinants of health.

Associations between sexual activity frequency and depression in women: insights from the NHANES data

BACKGROUND

Existing research is very limited in providing nationally representative data on the relationship between sexual activity and depression in U.S. female adults aged 20-59 years, particularly with regard to marital status differences.

OBJECTIVES

Our specific objective was to explore the relationship between sexual activity and depression in adult women in the United States.

METHODS

We conducted a study utilizing depression and sexuality data from the U.S. National Health and Nutrition Examination Survey (NHANES) for women aged 20-59 years between 2007 and 2016. Subsequently, we used survey-weighted logistic regression models to examine the relationship between low-frequency sexual activity and the risk of depression. To further explore the effects of different stratification factors on the relationship between low-frequency sexual activity and depression, we conducted subgroup analyses based on age, race, marital status, poverty-to-income ratio (PIR), education level, BMI, hypertension, diabetes mellitus, smoking, trouble sleeping, and urine Leakage. In addition, sensitivity analysis and smoothed curve fitting were performed to ensure the reliability of the results.

MAIN OUTCOME MEASURE

Sexual activity was assessed by sexual frequency, ≤11 sexual encounters in a 12-month period were categorized as low-frequency sexual activity; depression was diagnosed by the Patient Health Questionnaire (PHQ-9, ≥10 scores).

RESULTS

From the 2007 to 2016 NHANES, a total of 6061 participants were enrolled in the study. Of these participants, 1869 (30.84%) reported a sexual frequency of 0-11 times/year categorized as low-frequency sexual activity. After adjustment for the full covariates, the risk of depression was found to be higher in low-frequency sexual activity participants (sexual frequency ≤ 11) compared to normal-frequency sexual activity participants (sexual frequency > 11) (OR = 1.37, 95 % CI: 1.08, 1.73; P = 0.010), this association varied according to marital status.

CLINICAL IMPLICATIONS

Our findings have important clinical implications and suggest that clinicians should pay attention to the mental health of female patients with low-frequency sexual activity and screen depressed patients for sexual activity.

STRENGTHS & LIMITATIONS

Our study is the large, nationally representative study to assess the relationship between low-frequency sexual activity and depression in women aged 20 to 59 years. However, the cross-sectional study design was unable to demonstrate a causal relationship between low-frequency sexual activity and depression.

CONCLUSION

In conclusion, our study demonstrates a significant association between low frequency of sexual activity and risk of depression in a population of women aged 20 -59 years in the U.S, which may be bidirectional.

Sex Differences in Depression: Insights from Multimodal Gray Matter Morphology and Peripheral Inflammatory Factors

Major depressive disorder (MDD) exhibits notable sex differences in prevalence and clinical and neurobiological manifestations. Though the relationship between peripheral inflammation and MDD-related brain changes is well studied, the role of sex as a modifying factor is underexplored. This study aims to assess how sex influences brain and inflammatory markers in MDD. We utilized voxel-based and surface-based morphometry to analyze gray matter (GM) structure, along with GM-based spatial statistics (GBSS) to examine GM microstructure among treatment-naive patients with depression (n = 174) and age-matched healthy controls (n = 133). We uncovered sex-by-diagnosis interactions in several limbic system structures, the frontoparietal operculum and temporal regions. Post hoc analyses revealed that male patients exhibit pronounced brain abnormalities, while no significant differences were noted in females despite their higher depressive scores. Additionally, heightened inflammation levels in MDD were observed in both sexes, with sex-specific effects on sex-specific brain phenotypes, particularly including a general negative correlation in males. Intriguingly, mediation analyses highlight the specific role of the parahippocampal gyrus (PHG) in mediating interleukin (IL)-8 and depression in men. The findings suggest that in clinical practice, it would be beneficial to prioritize sex-specific assessments and interventions for MDD. This includes recognizing the possibility that male patients may experience significant brain alterations, especially when identifying male patients who may underreport symptoms. Possible limitations encompass a small sample size and the cross-sectional design. In future research, the incorporation of longitudinal studies or diverse populations, while considering illness duration, will enhance our understanding of how inflammation interacts with brain changes in depression.

Single-Case Study of the Feasibility of Parent Training and Change in Parenting in Comparison to Baseline, in Adolescents With a Major Depressive Disorder

Existing research has shown that parental behavior can influence the onset and persistence of adolescent depression; however, the initial treatment guidelines do not include parental involvement, and there is no established protocol for engaging parents. For this study, the Doepressie parent training protocol was designed to teach parents ways to help their child cope with depression, and this study sought to evaluate the feasibility and changes in parenting of combining individual cognitive behavioral therapy (CBT) for adolescents with parent training. Because of the heterogeneity observed in adolescents with depression, a single-case design study with daily diaries for parents was conducted. Adolescents (N = 9; mean age = 15.9, SD = 1.05) with major depressive disorder and their parents participated in this study. Parents reported that the parent training was feasible. After treatment, two-thirds of the adolescents no longer met the criteria for major depressive disorder. Most of the parents reported positive effects on their child's mood and activity level, problem-solving skills with their child, and parental responsiveness and competence. Four parents demonstrated medium positive change. Involving parents in the treatment of adolescent depression has significant clinical benefits. Because of the heterogeneity of adolescent depression, the impact of parental involvement varies.

Perspectives on Enhanced Measurement-Based Care Among Healthcare Providers, Adults, Adolescent Patients with Major Depressive Disorder and Pediatric Family Members: A Multicenter Online Investigation

Objective

Measurement-based care (MBC) is an emerging, objective, and systematic evidence-based practice for monitoring symptom severity and treatment efficacy to assist clinicians in developing individualized treatment strategies for patients with major depressive disorder (MDD). This study aimed to identify the barriers and facilitators of enhanced MBC (eMBC) in the outpatient setting to clarify the eMBC utilization dilemma.

Methods

Between September 2022 and June 2023, we collected the opinions of healthcare providers, adult and adolescent patients, and family members of adolescent patients via online surveys. Specifically, we surveyed their acceptance and perspectives on MBC and eMBC primarily through custom-designed Likert scales developed for this study.

Results

We received responses from 270 adult patients, 144 adolescent patients, 109 family members, and 355 healthcare providers. The results showed that 85.3% of patients and family members were willing to use the eMBC intervention. However, adolescent patients responded significantly differently from the other two groups, with lower acceptance and confidence. Among healthcare providers, while only 69.9% used MBC in practice, 94% believed standardized scales would be effective in treatment, and 91.8% were willing to try eMBC. Additionally, we received 277 remarks regarding eMBC from patients and families.

Conclusion

In general, both clinicians and patients looked forward to using eMBC and recognized the potential benefits. However, they still had many concerns about privacy, professionalism, and time consumption. Responses from adolescent patients appeared more conservative and lacked confidence in eMBC. Further implementations are required to explore how eMBC can be operationalized in the outpatient setting to help different patients.

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.

Association of different types of milk with depression and anxiety: a prospective cohort study and Mendelian randomization analysis

Background

The relationship between different types of milk and depression and anxiety remains unclear, with limited evidence from prospective cohort studies. This study aims to evaluate this relationship using data from the UK Biobank cohort and to explore its potential causality through Mendelian randomization (MR) analysis.

Methods

Cox proportional hazards models were used to assess the association between different milk types and the risk of depression and anxiety among 357,568 UK Biobank participants free of these conditions at baseline. To further explore causality, a 2-sample MR analysis was conducted using data from the FinnGen study.

Results

During a median follow-up period of 13.5 years (interquartile range, 12.6-14.2 years), among 357,568 participants (mean [SD] age, 56.83 [8.06] years, 171,246 male individuals [47.9%]), a total of 13,065 and 13,339 participants were diagnosed with depression and anxiety, respectively. In the fully adjusted model (adjusted for sociodemographics characteristics, lifestyle behaviors and health indicators), full cream milk was related to a lower risk of anxiety (HR = 0.84, 95% CI: 0.75-0.94). Semi-skimmed milk had a lower risk of depression (HR = 0.88, 95% CI: 0.80-0.96) and anxiety (HR = 0.90, 95% CI: 0.82-0.98). No significant relationships were found between skimmed milk and depression/anxiety. Other types were related to an increased risk of depression (HR = 1.14, 95% CI: 1.02-1.28). After Bonferroni correction, the 2-sample MR analysis revealed a potential protective causal relationship between semi-skimmed milk and depression (OR = 0.83, 95% CI: 0.73-0.95, p = 0.006) and anxiety (OR = 0.71, 95% CI: 0.59-0.85, p < 0.001).

Conclusion

These findings indicate that semi-skimmed milk consumption may be linked to a lower risk of depression and anxiety, potentially highlighting its role in dietary strategies to promote mental health.

Association between C-reactive protein-triglyceride glucose index and depressive symptoms in American adults: results from the NHANES 2005 to 2010

BACKGROUND

The novel serum C-reactive protein-triglyceride glucose index (CTI) has been identified as an ideal parameter that integrates inflammation and insulin resistance, which are potential mechanisms underlying depressive symptoms. Our research aimed to investigate the association between CTI and depressive symptoms.

METHODS

Our cross-sectional investigation utilized data from the National Health and Nutrition Examination Survey conducted between 2005 and 2010. The integrated CTI was calculated as 0.412 × Ln (C-reactive protein) (mg/dL) + Ln [triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. The severity of depressive symptoms was evaluated through the continuous Patient Health Questionnaire-9 (PHQ-9) scores, and the categorical definition of depressive symptoms (PHQ-9 score ≥ 10) reflected moderate to severe symptoms. Survey-weighted linear and logistic regression models were conducted to establish the correlation between CTI and PHQ-9 scores, and between CTI and depressive symptoms. Moreover, subgroup analyses, interaction tests, and smoothed curve fitting were performed to scrutinize the steadiness of the results.

RESULTS

A total of 5,954 participants were enrolled in our study, including 477 with depressive symptoms and 5,477 without. The results revealed a significant positive relationship between CTI and PHQ-9 scores (β: 0.40, 95% CI: 0.25,0.55, p < 0.001) and depressive symptoms (OR: 1.30, 95% CI: 1.06,1.61, p = 0.02). Additionally, individuals in the fourth quartile of CTI exhibited a higher likelihood of depressive symptoms than those in the first quartile (PHQ-9 score: β: 0.83, 95% CI: 0.39,1.26, p < 0.001; depressive symptoms: OR: 2.00, 95% CI:1.19,3.36, p = 0.01). Smooth curve fitting and subgroup analyses consistently demonstrated the positive relationship.

CONCLUSIONS

Elevated CTI was correlated with a higher risk of depressive symptoms, underscoring CTI as a potential clinical indicator for identifying and stratifying depressive symptoms.

CLINICAL TRIAL NUMBER

Not applicable.

Mental Health Problems Among Indonesian Adolescents: Findings of a Cross-Sectional Study Utilizing 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.

Depressive symptoms among Chinese adolescents from single parent families present a downward trend in the past 25 years: A cross-temporal meta-analysis

BACKGROUND

In recent decades, depressive symptoms have intensified among Chinese adolescents, particularly those from single-parent homes, who are presumed to face heightened mental health risks. Nonetheless, economic growth, fertility policy reforms, and cultural openness have enhanced the adaptability of these adolescents, enabling them to better manage depressive symptom risks.

AIM AND METHOD

This study aims to scrutinize the evolving trends of depressive symptoms and explore the related social factors among Chinese adolescents from single-parent families. We involved 109 studies by a Cross-temporal meta-analysis.

RESULTS

Over the past 25 years, the prevalence of depressive symptoms in adolescents from single-parent homes has annually declined. Economic status negatively correlates with depressive symptoms in the current year and 5 years prior. Birth rate, household size negatively impact symptoms, while urbanization level inversely correlates in the present and 5 years ago. Unemployment rate shows negative correlations 5 years apart but positive in the current year. Divorce rates exhibit similar patterns, negative before and now.

CONCLUSION

The above results indicate that depressive symptoms among Chinese adolescents from single-parent families present a downward trend over time with social development. Macro-level factors such as economic instability, policy dynamics, and shifting attitudes towards marriage had a correlation with depression among adolescents from single-parent families. Future studies can dig into the details of the impact on the mental health of adolescents from single-parent families.

Augmented Depression Therapy for young adults: A mixed methods randomised multiple baseline case series evaluation

Augmented Depression Therapy (ADepT) is an individual psychotherapy for depression, which has been shown to be effective in the general adult population. A randomised multiple baseline case series evaluated the feasibility, acceptability, and effectiveness of ADepT in young adults (aged 20-24). Eleven depressed young adults were recruited from a UK university wellbeing service to receive ADepT during the COVID-19 pandemic, with outcomes evaluated relative to pre-specified continuation targets. All participants received a minimum adequate treatment dose (>60% target); 89% judged ADepT as acceptable and satisfactory and would recommend it to others (>60% target); only 9% showed reliable deterioration for depression or wellbeing (meeting <30% target); and there were no trial- or treatment-related serious adverse events. Qualitative interviews revealed most participants were satisfied with and experienced benefits from ADepT. At post-treatment, reliable improvement was shown by 33% of participants for depression and 67% of participants for wellbeing (not meeting target of both >60%), with medium effect size improvements for depression (g = 0.78) and large effect size improvement for wellbeing (g = 0.93; not meeting target of both >0.80). ADepT is feasible, acceptable, and safe in young adults but may require modification to maximise effectiveness. Further research outside of the COVID-19 pandemic is warranted.

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.

Beyond developmental psychopathology: Positive child development

The field of developmental psychopathology has made significant contributions to our understanding of both typical and atypical development. However, while there are established theories for developmental psychopathology with detailed criteria for pathological outcomes, there is less agreement regarding development under optimal conditions and the definition of positive outcomes. In this conceptual paper, I make the case that a better understanding of positive child development is crucial because it will not only advance our general knowledge on human development but also complement current work on developmental psychopathology. After defining positive development as the development of positive functioning in children, such as skills, strengths, competencies, and wellbeing, rather than the absence of problems, current concepts with relevance for positive development are reviewed, before highlighting gaps in our knowledge on positive development and suggestions for future research. Although several of the reviewed frameworks provide important contributions to the conceptualization of positive development, most of them focus on positive functioning in adults with limited consideration of development in the early years. More research is needed that specifically targets the development of positive outcomes from early childhood onward in order to develop a more comprehensive and holistic theory of positive child development.

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.