Depression in young people

Emotional stimulated speech-based assisted early diagnosis of depressive disorders using personality-enhanced deep learning

BACKGROUND

Early diagnosis of depression is crucial, and speech-based early diagnosis of depression is promising, but insufficient data and lack of theoretical support make it difficult to be applied. Therefore, it is valuable to combine psychiatric theories, collect speech recognition data for depression, and develop a practicable recognition method for depression.

METHODS

In this study, 24 patients with major depressive disorders (MDDs) and 36 healthy controls (HCs) were recruited to participate in a multi-task speech experiment. Descriptive statistics and tests of variance were used to analyze subjects' personality and speech changes. Subsequently, the speech task with the most depressive cues was explored using the Bidirectional Long - Short Term Memory (Bi-LSTM) algorithm, on which a personality-assisted multitasking deep model, i.e., multi-task attentional temporal convolutional network model (TCN-MTA).

RESULTS

Statistical analyses of speech duration showed that the fable reading, neutral stimulus, and negative stimulus tasks had significant differences on subjects' speech duration, and the negative stimulus task had significant differences between the depressed and control groups (p < 0.001, 0.03, 0.04). Notably, the Big Five personality emotional stability scores were significantly different between the depressed and control groups (0.03). Depression was best identified using Bi-LSTM in negative (Youden index = 0.44) and positive stimulus speech (Youden index = 0.42). Further, the specificity of 0.72 and sensitivity of 0.87 for recognizing depression in negative stimulus speech using our proposed TCN-MTA outperforms existing methods.

LIMITATIONS

The sample size enrolled in this study is higher than the minimum sample size calculated through G-Power 3.1, but the sample size in this study is still small.

CONCLUSION

The proposed deep learning-based personality-assisted multitasking method could accurately recognize major depression, which demonstrated the potential of the method based on the fusion of specialized theories and artificial intelligence.

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.

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.

Mechanisms of acupuncture in treating depression: a review

BACKGROUND

Acupuncture as a representative treatment method of traditional Chinese medicine, has been found to have a significant effect on mild to moderate depression without obvious side effects, but the mechanism through which it exerts its antidepressant effect is still unclear.

METHODS

We searched PubMed, Web of Science, and Embase databases for basic research on acupuncture in the treatment of depression from the database established to June 14, 2024, and finally included 44 studies from 2020 to June 14, 2024, into the table analysis. The main outcomes of this study are the effects of acupuncture on the relevant biological indicators of depression model.

RESULTS

By analyzing the effect of acupuncture on rodent model of depression, the mechanism of acupuncture against depression was explored. In general, several acupuncture methods, mainly based on electroacupuncture (EA), regulate the levels of 5-hydroxytryptamine (5-HT), glutamic acid (Glu) and dopamine (DA), regulate the calcium signaling pathway, increase the expression of synaptic protein, promote mitochondrial repair and reduce oxidative stress, and enhance synaptic plasticity. Inhibition of key inflammatory pathways such as P2X7R/NLRP3 and NF-κB signaling pathways, regulation of hypothalamic-pituitary-adrenal axis (HPA axis) function, and tryptophan metabolism improved depression-like behavior in rodent models.

CONCLUSIONS

In summary, acupuncture treatment represented by EA has multiple mechanisms to play a role by regulating neurotransmitter balance, improving neuroplasticity, reducing inflammatory responses, and regulating the neuroendocrine system. However, the differences between acupoint catgut embedding (ACE), manual acupuncture (MA), and EA in the treatment of depression and the operating parameters of EA in the treatment of depression with different causes (such as frequency, intensity, duration, etc.) still need further research to be confirmed. This review has not been registered with PROSPERO or other protocol registration platforms because protocol registration was not a mandatory requirement for this study.

Exploration of brain imaging biomarkers in subthreshold depression patients across different ages: an ALE meta-analysis based on MRI studies

BACKGROUND

Structural neuroimaging findings in Subthreshold depression (StD) patients at different ages are highly heterogeneous. This study aims to investigate the pathophysiology of StD across different ages.

METHODS

Literature searches for MRI studies of StD were conducted in 11 databases, including PubMed and Embase, from database inception to June 18, 2024. An activation likelihood estimation (ALE) meta-analysis was performed on the studies across different ages.

RESULTS

A total of 24 studies were included. The results revealed that the significant convergent brain regions in StD patients across different ages were primarily located within the frontostriatal circuit. Age-related differences were observed. For adolescent patients, the significant convergent brain regions were the caudate, putamen, anterior cingulate cortex (ACC), and medial frontal gyrus (MFG). For young adult patients, the significant convergent brain regions were the inferior frontal gyrus, parahippocampal gyrus, insula, putamen, claustrum, and medial globus pallidus. For middle-aged and older patients, the significant convergent brain regions were the ACC, the MFG, and the superior frontal gyrus.

CONCLUSIONS

This study revealed that abnormalities in the frontostriatal circuit were neuroimaging features common in StD patients across different ages. Additionally, unique different brain regions were identified between age groups. These findings elucidated the mechanisms of StD and provided a theoretical basis for its prevention and treatment.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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.

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.

Social and non-social risk-taking in adolescence

The Social Risk Hypothesis of Depression proposes that individuals who perceive themselves as low in value to their social groups are at risk of developing depression. Behaviourally, lower self-perceived social value is proposed to reduce individuals' propensity to take social risks to avoid further lowering their social worth. This is in contrast with adolescent-typical behaviour, which is characterised by heightened risk-taking in social contexts. The current study aimed to investigate how low self-perceived social value influences risk-taking in social compared to non-social contexts during adolescence. 114 adolescents (aged 12-23 years) completed the Balloon Analogue Risk Task (BART) in individual and social contexts. The results showed that adolescents took more risks in social compared to individual contexts. Risk-taking across social and individual contexts also varied as a function of self-perceived social value. In older-but not younger-youth, lower self-perceived social value was associated with greater risk-taking in social compared to individual contexts. These findings suggest that self-perceived social value differentially influences social risk-taking across adolescence. In later youth, the heightened social risk-taking observed in individuals with low self-perceived social value aligns with developmental theories suggesting that risk-taking at this age serves to increase social rank and avoid social exclusion by peers.

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

BACKGROUND

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

Therapeutic effects of short-term trauma stabilization techniques combined with escitalopram in treating adolescent major depressive disorder: a pilot randomised controlled trial

OBJECTIVE

To explore the efficacy of short-term trauma stabilization techniques combined with escitalopram in the treatment of adolescent major depressive disorder (MDD).

METHODS

A total of 80 patients with MDD who were hospitalized in the Psychosomatic Department of our hospital were selected and randomly divided into two groups: the escitalopram combined with short-term trauma stabilization technique group (study group) and the escitalopram combined with mental health education group (control group). Upon hospitalization, patients completed the adolescent self-rating life events check list (ASLEC), impact of event scale-revised (IES-R), 17-item Hamilton depression scale (HAMD-17) and Hamilton anxiety scale (HAMA). After 2 and 4 weeks of treatment, the IES-R, HAMD-17-17 and HAMA scores were reevaluated.

RESULTS

There were no significant differences in the ASLEC, IES-R, HAMD-17 or HAMA scores between the two groups at admission. Compared with that of the control group, the IES-R score of the study group was significantly improved at the 2nd week of treatment (P < 0.01). By the 4th week of treatment, the IES-R scores in the study group had further improved compared to the control group (P < 0.01). Additionally, the HAMD-17 and HAMA scores in the study group were significantly improved compared to the control group (P < 0.01).

CONCLUSION

Escitalopram combined with short-term trauma stabilization is more effective in the treatment of MDD than escitalopram with mental health education, warranting further exploration.

The associations of brain-derived neurotrophic factor (BDNF) levels with psychopathology and lipid metabolism parameters in adolescents with major depressive disorder

Brain-derived neurotrophic factor (BDNF) is crucial for the growth, differentiation and maintenance of neuronal systems, which is closely associated with major depressive disorder (MDD). The objective of this study was to investigate the BDNF levels and their associations with psychopathology and lipid metabolism parameters in adolescents with MDD. From January to December 2021, the study included 141 adolescents with MDD and 90 healthy controls (HCs). The Center for Epidemiological Studies Depression Scale (CES-D), the Insomnia Severity Index Scale (ISI), the Epworth Sleepiness Scale (ESS) and the Positive and Negative Suicidal Ideation Scale (PANSI) were used to assess depressive symptoms, insomnia, excessive daytime sleepiness, and suicidal ideation, respectively. BDNF levels and lipid metabolism parameters were also measured. Compared to HCs, adolescents with MDD had significantly lower BDNF levels (p < 0.001). In patients, BDNF levels were positively correlated with age, BMI, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C); and negatively correlated with the scores of CES-D and ISI (all p < 0.05). The results of the multivariate linear regression analyses indicated that BDNF levels were positively associated with age (β = 0.198, t = 2.447, p = 0.016), first-episode MDD (β = 0.176, t = 2.234, p = 0.027) and TC level (β = 0.240, t = 3.048, p = 0.003), and negatively associated with the scores of ESS (β = -0.171, t = -2.203, p = 0.029) and ISI (β = -0.231, t = -2.996, p = 0.003). Of note, the associations between BDNF and psychopathology were observed only in female and first-episode patients. BDNF levels were decreased in adolescents with MDD. Patients with low BDNF levels were in a more severe psychiatric state and had changes in lipid metabolism parameters. This study provided preliminary evidence that BDNF may play a role in the onset and progression of MDD.

Optimizing depression detection in clinical doctor-patient interviews using a multi-instance learning framework

In recent years, the number of people suffering from depression has gradually increased, and early detection is of great significance for the well-being of the public. However, the current methods for detecting depression are relatively limited, typically relying on the self-rating depression scale (SDS) and interviews. These methods are influenced by subjective or environmental factors. To improve the objectivity and efficiency of diagnosis, deep learning techniques have been applied to the field of automatic depression detection (ADD), providing a more accurate and objective approach. During interviews, transcribed interview data is one of the most commonly used modalities in ADD. However, previous studies have only utilized response texts or selected question-answer pairs, resulting in information redundancy and loss. This paper is the first to apply the multiple instance learning (MIL) framework to the field of textual interview data, aiming to overcome issues of inadequate text representation and ineffective information extraction in long texts. In the MIL framework, each instance undergoes an independent feature extraction process, ensuring that the local features of each instance are fully captured. This not only enhances the overall text representation capability but also alleviates the issue of sample imbalance in the dataset. Additionally, this paper improves upon previous aggregation strategies by introducing two hyper-parameters to accommodate the uncertainties in the field of text sentiment. An ensemble model of MT5 and RoBERTa (referred to as multi-MTRB) was constructed to extract features from each instance and output confidence scores indicating the presence of depressive information in the instances. Due to the unique design of the MIL framework, the proposed method is highly interpretable and is able to identify specific sentences that identify people from depressed patients, while introducing LIME techniques to provide more in-depth interpretation of negative instance sentences. This provides a promising approach for depression detection in the context of text interview data patterns. We evaluated the proposed method on DAIC-WOZ and E-DAIC datasets with excellent results. The F1 score is 0.88 on the DAIC-WOZ dataset and 0.86 on the E-DAIC dataset.

Using MMPI-3-Derived Thwarted Belongingness and Perceived Burdensomeness Scales to Predict Suicide Ideation Among College Students with Elevated Depressive Symptoms

The interpersonal theory of suicide (ITS) conceptualizes thwarted belongingness (TB) and perceived burdensomeness (PB) as sufficient and proximal suicide ideation (SI) risk factors. The Interpersonal Needs Questionnaire (INQ) is used to assess TB and PB; however, it does not capture all aspects of these constructs. The MMPI-3 M3-TB and M3-PB proxy scales may measure additional facets. In this study, college students (N = 139) screened for elevated depressive symptoms completed MMPI-2-RF-EX (from which the MMPI-3 was scored), INQ and SI assessments at baseline, and then SI assessments over six weeks. Results indicated M3-TB and M3-PB showed convergent validity with significant concordant correlations with INQ-TB and INQ-PB. M3-TB and M3-PB did not demonstrate discriminant validity, as tests of differences between concordant (e.g., M3-TB with INQ-TB) and discordant correlations (e.g., M3-TB with INQ-PB) were not significant. All ITS variables were significantly associated with retrospective and prospective SI. Prospective findings, but not retrospective findings, were more consistently significant when adjusting for the SUI scale. Including ITS variable interaction terms (i.e., M3-TBxM3-PB and INQ-TBxINQ-PB) did not improve the prediction of SI outcomes. Findings are broadly congruent with other ITS research findings: TB and PB prospectively predict SI, and the TBxPB interaction does not improve prediction.

Assessing Causality Between Androgenetic Alopecia with Depression: A Bidirectional Mendelian Randomization Study

Background

Androgenetic alopecia (AGA) is the most common form of alopecia globally, which exerts a negative impact on patients' self-esteem and overall quality of life. Previous observational studies have found a significant increase in the prevalence of depression in AGA patients, but the causal relationship remains to be elucidated.

Methods

In this study, we conducted a bidirectional Mendelian randomization (MR) using genome-wide association studies (GWAS) datasets. The available GWAS dataset of AGA was obtained from the Neale Lab consortium (n=154988). The dataset for depression was obtained from the ebi-a-GCST90038650 (n=484598). The main analysis method for determining the causal link between AGA and depression was inverse variance weighted (IVW). Subsequently, pleiotropy and heterogeneity tests were performed to determine the reliability of the results.

Results

Utilizing the IVW method, depression does not significantly contribute to the incidence of AGA (IVW odds ratio [OR] = 1.101, 95% confidence interval [CI] =0.890-1.362, P = 0.374). Conversely, the data suggested a statistically significant association where AGA may precipitate the development of depression, with a notable increase in risk (IVW OR = 1.015, 95% CI = 1.002-1.029, P = 0.020).

Conclusion

We are the first to use MR analysis to explore the causal relationship between AGA and depression, revealing an increased risk of depression in individuals with AGA.

Gender differences in the associations of adverse childhood experiences with depression and anxiety: A systematic review and meta-analysis

BACKGROUND

Gender differences in the associations of adverse childhood experiences (ACEs) with depression and anxiety, remain underexplored. We aimed to quantify and directly compare gender-specific associations between ACEs and depression and anxiety.

METHODS

We systematically searched PubMed, Medline, and Embase for observational studies. Eligible articles should have reported effect sizes for depression or anxiety associated with varying number or specific types of ACEs. Using a random-effects model, we calculated the gender-specific pooled odds ratios (ORs) and derived the pooled women-to-men ratio of ORs (RORs) for the associations of ACEs with depression or anxiety, with corresponding 95 % confidence intervals (CIs).

RESULTS

In total, 42 articles met inclusion criteria. Regarding anxiety, gender differences were most pronounced for individuals exposed to 2 ACEs (compared to none), with women showing significantly higher odds of anxiety than men (ROR = 2.04, 95 % CI = 1.15-3.62), In addition, women exposed to emotional abuse (ROR = 0.66, 95 % CI = 0.52-0.83), sexual abuse (ROR = 0.58, 95 % CI = 0.37-0.91), and having a family member incarcerated (ROR = 0.83, 95 % CI = 0.71-0.98) showed lower odds of anxiety than men. For depression, women exposed to bullying showed lower odds of depression compared to men (ROR = 0.86, 95 % CI = 0.83-0.88).

CONCLUSIONS

Gender differences in the associations between ACEs and mental health outcomes vary by type and cumulative exposure to ACEs. This finding highlights the importance of incorporating gender-specific perspectives in research and interventions addressing the long-term mental health effects of ACEs.

The risk factors for the comorbidity of depression and self-injury in adolescents: a machine learning study

There has been a growing concern in utilizing machine learning models to identify risk factors for adolescent mental health. However, the comorbidity domain has not received adequate attention. Accordingly, this study aims to develop an efficient machine leaning model to predict the comorbidity of depression and self-injury among adolescents. 1,028,751 Chinese adolescents completed measures of depression, self-injury, and a range of items related to sociodemographic and psychosocial variables. We evaluated the performance of six machine learning models and established the optimal model for identifying the comorbidity of depression and self-injury. We selected the Top-N variable set corresponding to a cumulative probability of 80% for the optimal model to establish a risk model for the comorbidity of depression and self-injury in adolescents. The combined model of Random Forest and LightGBM can effectively identify adolescents with comorbidity risk based on 13 variables. Specifically, the predictive power of individual characteristics significantly outweighs environmental factors; within individual characteristics, emotional problems (anxiety) exhibit the strongest predictive power; among environmental factors, parental emotional maltreatment and cyber victimization demonstrate the highest predictive effect. This study extends the application of the Bioecological Model in the field of comorbidity research, demonstrating the advantages of using machine learning methods to predict comorbidity of depression and self-injury in adolescents. It holds practical value for preventing and intervening in comorbidity of depression and self-injury among adolescents.

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

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

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

The association between adaptability and the symptoms of depression and anxiety in early adolescents: a network analysis in a longitudinal design

BACKGROUND

The co-occurrence of depression and anxiety is relatively more common among adolescents. Emerging evidence suggests that adaptability might affect this phenomenon. Network analysis can provide insight into the dynamics between symptoms of mental disorders. Therefore, we used network analysis 1) to explore symptom networks and 2) to investigate the association between adaptability and symptoms based on a longitudinal design.

METHODS

833 Chinese adolescents (449 males and 384 female) were recruited, with adaptability, depressive and anxiety symptoms measured at T1, 426 of them were followed up one year later at T2. Symptom networks were constructed for all participants and for the two groups based on their adaptability scores at T1. Furthermore, mediation analysis was performed to examine the relationship between adaptability and bridge symptoms at both timepoints.

RESULTS

Irritable and Guilty showed the highest expected value at T1 (p < 0.05). The high adaptability group's symptom network (HGN) was less connected than the low adaptability group's symptom network (LGN) (p < 0.001). Furthermore, Irritable (T1) and adaptability (T2) were sequential mediators (p < 0.001) between adaptability (T1) and Irritable (T2).

CONCLUSIONS

These findings suggest that adaptability might affect the network dynamics, underscoring its importance to the occurrence of depression and anxiety among adolescents. Irritable and Guilty being the bridge symptoms may indicate the interventions to target in adolescents with comorbid depression and anxiety.

The U-Shape Association Between Noise and Individual Depression: Nationwide Longitudinal Evidence from Three Waves of CHARLS

Depression is a common mental disorder formed by a combination of various factors. Existing researches have already demonstrated that noise indeed impacts the level of depression, but their results were inconsistent. To reconcile seemingly contradictory findings, this study aims to investigate how noise affects individual depression using big data mining and analysis techniques. The individual data was obtained from the China Health and Retirement Longitudinal Study (CHARLS) over 3 years (2013, 2015, and 2018) totaling 9693 participants coming from 125 different cities. The Chinese version of the 10-item Center for Epidemiologic Studies Depression Scale (CES-D) was employed to assess depression scores, while the search index for noise-related keywords was obtained from Baidu Index to measure noise levels across different cities. A curvilinear model with fixed effects was applied to analyze the relationship between noise and depression. Additionally, moderating effect analyses were conducted to examine the influence of city size and green space. The results indicate a U-shaped relationship between depression and noise, wherein depression initially decreases with increased noise, then subsequently rises. The moderating effect analysis suggests that both city size and green space influence this U-shaped curve; notably, in cities with larger populations or higher green coverage rates, the curve flattens. This study reveals that the impact of noise on depression is complex, which is the result of a multifactorial synergy. It underscores the necessity for urban planning and management to prioritize the creation of friendly sound environments, which could enhance the physical and mental health of urban residents.

A study on the differences in the gut microbiota and metabolism between male and female mice in different stress periods

The sex difference in depression has long been an unsolved issue. Women are twice as likely to suffer from depression as men. However, there were significant differences in the composition of gut microbiota between women and men. There is a lack of studies linking sex differences in depression to microbiota, and the specific mechanisms of this process have not been explained in detail. The main purpose of this study was to explore the gender differences in the intestinal tract of male and female depressed mice. In this study, chronic restraint stress (CRS) mouse models were used to simulate chronic stress, and behavioral tests were conducted, including the open field test (OFT), tail suspension test (TST) and forced swimming test (FST). Microbial diversity analysis and metabolomics were performed on collected mouse feces. The results showed that female mice were highly active and prone to anxious behavior before stress, and the levels of f-Rikenellaceae, f-Ruminococcaceae and 16α-hydroxyestrone were significantly different from those in male mice. After 21 days (Days) of stress, female mice showed depression-like behavior, and the levels of f-Erysipelotrichaceae, 5α-pregnane-3,20-dione, and 2-hydroxyestradiol were significantly different from those in male mice. After 14 days of stress withdrawal, the depression-like behavior continued to worsen in female mice, and the levels of 5α-pregnane-3,20-dione, estrone glucuronide and f-Erysipelotrichaceae were significantly different from those in male mice. In summary, female mice have stronger stress sensitivity and weaker resilience than male mice, which may be related to differences in bacterial diversity and estrogen metabolism disorders.

Understanding depression in autism: the role of subjective perception and anterior cingulate cortex volume

BACKGROUND

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

METHODS

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

RESULTS

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

LIMITATIONS

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

CONCLUSIONS

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

Evaluating the association of depressive symptoms on serum folate and erythrocyte folate levels based on the 2017-2020 NHANES database

Objective

To improve further the management of the nutritional status and dietary habits of depressed patients.

Methods

This study investigated the effect of different severity states of depressive symptoms on serum and erythrocyte folate levels using the Nutrition Examination Survey (NHANES) database from 2017 to 2020. We comprised a sample of 4,872 cases from NHANES database. We developed 3 linear regression models to assess the effect of depressive symptoms on erythrocyte folate and serum folate by collating and analyzing the data. The relationship between depression severity and erythrocyte folate as well as serum folate was also mutually validated by the results of multiple logistic regression. Finally, we made restricted cubic spline plots using the glm function of R.

Results

Depression remained negatively correlated with serum folate levels with a OR value of -0.02, 95% CI of -0.05 ~ -0.00. Moderate depression was negatively correlated with folate, with a OR value of -0.03, 95% CI of -0.05 ~ -0.00. When exploring the association between different degrees of depressive symptoms and erythrocyte folate, it was unexpectedly found that major depression was negatively associated with erythrocyte folate with a OR value of -0.18, 95% CI of -0.31 ~ -0.04 after adjusting for all covariates.

Conclusion

Depression is associated with folate levels. The risk of serum folate insufficiency or erythrocyte folate insufficiency is higher after a positive depression. For different degrees of depressive symptoms, serum folate levels were significantly lower than normal in patients with moderate depression, while erythrocyte folate levels were lower than normal in patients with major depression. Therefore, attention should be paid to the dietary habits and nutritional status of patients with depression or depressive symptoms when they are undergoing long-term antidepressant treatment. Folic acid supplementation is recommended for patients with moderate or severe depression or for depressed patients who have developed unhealthy eating habits.

Stress and Anxiety Are Associated with Increased Metabolic Syndrome Risk Among Young Adults Living in the Deep South

Background/Objectives: This study assessed the association among perceived stress, anxiety, and depression with both the metabolic syndrome (MetS) risk and diagnostic status among young adults in the Deep South. Methods: Participants included 132 young adults aged 18-39 (Mage = 27.73, SD = 11.11; MBMI = 27.6, SD = 6.8; 56.5% female; 55.7% White) living in Mississippi. In addition to completing self-report measures of perceived stress, anxiety, and depression, all of the participants underwent anthropometric, blood pressure, and fasting blood glucose and lipid assessments to ascertain the MetS status. The participants were provided with both a MetS diagnosis (defined as a dichotomous yes/no variable) as well as a continuous MetS risk severity score determined using existing equations. The risk scores ranged from -1 to +1, with positive scores indicating an increased risk for MetS. Results: After controlling for age, biological sex, race, medication use, and education level, multiple regression models revealed significant positive relationships between perceived stress (b = 0.03; p = 0.017) and anxiety symptoms (b = 0.01; p = 0.039) with the MetS severity. Perceived stress (p = 0.017) and anxiety symptoms (p = 0.043) were also significantly higher among participants with MetS compared to those without. There were no significant associations between the MetS severity and depressive symptoms, and no differences in depressive symptoms in participants with versus without MetS. Conclusions: The results highlight the role of stress and anxiety not only in MetS but in the overall metabolic risk among young adults living in the Deep South. The results highlight the importance of intervening on stress and anxiety early in adulthood to help mitigate cardiometabolic health risk.

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.

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

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

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.

The association between a body shape index and depressive symptoms: a cross-sectional study using NHANES data (2011-2018)

Objective

This study aimed to explore the relationship between A Body Shape Index (ABSI) and depressive symptoms, and to evaluate the moderating effects of sociodemographic, lifestyle, and health factors.

Methods

We analyzed data from 19,659 participants in the 2011-2018 National Health and Nutrition Examination Survey (NHANES). Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). ABSI was calculated from waist circumference, height, and BMI. Multiple linear regression models were employed to investigate the association between ABSI and depressive symptoms, with subgroup analyses to examine potential associations within specific populations.

Results

Higher ABSI was significantly associated with increased depressive symptoms, after adjusting for covariates including age, sex, race, marital status, poverty-income ratio, smoking, alcohol consumption, physical activity, diabetes, and hypertension. Individuals in the highest ABSI quartile (Q4) had significantly more depressive symptoms compared to those in the lowest quartile (Q1) (β = 0.22, 95% CI = 0.02-0.41, p = 0.0323). Subgroup analyses revealed that marital status and hypertension significantly moderated the association between ABSI and depressive symptoms.

Conclusion

This study provides the first comprehensive analysis of the link between ABSI and depressive symptoms, suggesting that higher ABSI is associated with greater depressive symptoms. These findings highlight the potential importance of waist circumference and abdominal fat distribution in assessing depression risk. Future research should explore the causal mechanisms underlying this association and investigate the biological pathways involved, to inform more effective strategies for depression prevention and intervention.

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.

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.

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.

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

Empathy, which is typically regarded as a positive attribute, is now being critically evaluated for its potential negative implications for mental health. A growing body of research indicates that excessive empathy, particularly a high level of affective empathy, can lead to overwhelming emotional states, thereby increasing susceptibility to psychological distress and psychiatric disorders. In this review, we aim 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 overinvolvement, burnout, vicarious trauma, and posttraumatic 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.

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.

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 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.