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Li X, Liu T, Mo X, Wang R, Kong X, Shao R, McIntyre RS, So KF, Lin K. Effects of Lycium barbarum polysaccharide on cytokines in adolescents with subthreshold depression: a randomized controlled study. Neural Regen Res 2024; 19:2036-2040. [PMID: 38227533 DOI: 10.4103/1673-5374.389360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 09/08/2023] [Indexed: 01/17/2024] Open
Abstract
JOURNAL/nrgr/04.03/01300535-202409000-00036/figure1/v/2024-01-16T170235Z/r/image-tiff Strong evidence has accumulated to show a correlation between depression symptoms and inflammatory responses. Moreover, anti-inflammatory treatment has shown partial effectiveness in alleviating depression symptoms. Lycium barbarum polysaccharide (LBP), derived from Goji berries, exhibits notable antioxidative and anti-inflammatory properties. In our recent double-blinded randomized placebo-controlled trial, we found that LBP significantly reduced depressive symptoms in adolescents with subthreshold depression. It is presumed that the antidepressant effect of LBP may be associated with its influence on inflammatory cytokines. In the double-blinded randomized controlled trial, we enrolled 29 adolescents with subthreshold depression and randomly divided them into an LBP group and a placebo group. In the LBP group, adolescents were given 300 mg/d LBP. A 6-week follow up was completed by 24 adolescents, comprising 14 adolescents from the LBP group (15.36 ± 2.06 years, 3 men and 11 women) and 10 adolescents from the placebo group (14.9 ± 1.6 years, 2 men and 8 women). Our results showed that after 6 weeks of treatment, the interleukin-17A level in the LBP group was lower than that in the placebo group. Network analysis showed that LBP reduced the correlations and connectivity between inflammatory factors, which were associated with the improvement in depressive symptoms. These findings suggest that 6-week administration of LBP suppresses the immune response by reducing interleukin-17A level, thereby exerting an antidepressant effect.
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Affiliation(s)
- Xiaoyue Li
- Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Tao Liu
- Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Xuan Mo
- Department of Psychiatry, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Runhua Wang
- Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Xueyan Kong
- Department of Psychiatry, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Robin Shao
- Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Brain and Cognition Discovery Foundation, Toronto, Canada
| | - Kwok-Fai So
- Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
- Ministry of Education Joint International Research Laboratory of CNS Regeneration, Jinan University, Guangzhou, Guangdong Province, China
- Neuroscience and Neurorehabilitation Institute, University of Health and Rehabilitation Sciences, Qingdao, Shandong Province, China
| | - Kangguang Lin
- Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong Province, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong Province, China
- Neuroscience and Neurorehabilitation Institute, University of Health and Rehabilitation Sciences, Qingdao, Shandong Province, China
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Keats L, Jose PE, Salmon K. Specificity and valence of adolescents' turning point memory narratives: Relationships with depressive symptoms over time. Behav Res Ther 2024; 179:104570. [PMID: 38776597 DOI: 10.1016/j.brat.2024.104570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 05/04/2024] [Accepted: 05/17/2024] [Indexed: 05/25/2024]
Abstract
Although recent research suggests that, for community youth, greater specific (episodic) detail in self-relevant turning point memory narratives predicts depressive symptoms over time, no research has investigated whether the narratives' specificity similarly predicts depression. Therefore, we investigated whether recalling a specific (unique, 24-hour or less) turning point narrative predicted youth depressive symptoms concurrently and across 6 months (Study 1), and, for a subset of participants, three years (Study 2). We also examined whether the valence of the implication of the experience for self (the resolution) explained additional variance and interacted with memory specificity. For Study 1 (N = 320, M = 16.9 years, 81% female), a specific (rather than a non-specific) turning point predicted greater depressive symptoms concurrently but not longitudinally, whereas a negative resolution predicted both concurrent and longitudinal depressive symptoms. The moderation result showed that a specific turning point predicted escalating depressive symptoms across six months when the resolution was negative. Study 2 (N = 68) additionally showed that a specific turning point predicted increased depressive symptoms three years later. These findings contrast with research suggesting that specific memories are related to better mental health and highlight the complexity of the role of memory in emerging youth depression.
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Affiliation(s)
- Laurel Keats
- School of Psychology, Victoria University of Wellington - Te Herenga Waka, New Zealand.
| | - Paul E Jose
- School of Psychology, Victoria University of Wellington - Te Herenga Waka, New Zealand
| | - Karen Salmon
- School of Psychology, Victoria University of Wellington - Te Herenga Waka, New Zealand
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Sakimoto M, Igusa T, Kobayashi T, Uchida H, Fukazawa A, Machida C, Fujii H, Sekine K, Kurosaki M, Tsuchiya K, Kikuchi S, Hirao K. Effects of a video-viewing intervention with positive word stimulation on the depressive symptoms of older patients with cardiac disease and subthreshold depression: a pilot randomized controlled trial protocol. Biopsychosoc Med 2024; 18:16. [PMID: 39014477 PMCID: PMC11251332 DOI: 10.1186/s13030-024-00312-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 07/11/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Intervention for older patients with cardiac disease and subthreshold depression (StD) may be an effective strategy to prevent the development of major depressive disorder. The subliminal priming with supraliminal reward stimulation (SPSRS) website developed by us is an advanced intervention that can improve depressive symptoms in individuals with StD by presenting positive word stimuli in videos. However, its efficacy for treating depressive symptoms in older patients with cardiac disease and StD has not been investigated. Here, we present a pilot randomized controlled trial protocol to investigate the preliminary efficacy of an intervention for older patients with cardiac disease with StD. METHODS The study was designed as a single-center, open-label, pilot, randomized, parallel-group trial. The participants will include 30 older patients with cardiac disease and StD who are hospitalized in acute wards. The Experimental group received the SPSRS intervention (video viewing with positive word stimuli; n = 15) and the Control group will receive the YouTube intervention (video viewing without positive word stimuli; n = 15). In both groups, the intervention will be administered for 10 min per day, five times per week for 1 week. The primary outcome will be the change in the scores on the Japanese version of the Beck Depression Inventory-II at 1 week after the baseline assessment. The secondary outcomes will be the changes in the Specific Activity Scale, New York Heart Association functional classification, as well as grip strength at 1 week after the baseline assessment. DISCUSSION This pilot randomized controlled trial will be the first to evaluate the SPSRS intervention for depressive symptoms in older patients with cardiac disease and StD who are admitted to acute wards. The results will provide tentative indications regarding the impact of the intervention on depressive symptoms among older patients with cardiac disease and StD who are admitted to acute wards, and will contribute to the planning of a full-scale study. TRIAL REGISTRATION UMIN, UMIN000052155. Registered September 8, 2023, https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000059526 . This study was registered with the University Hospital Medical Information Network (UMIN) (UMIN000052155) in Japan.
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Affiliation(s)
- Masataka Sakimoto
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan
- Department of Rehabilitation, Fujioka General Hospital, Fujioka, Japan
| | - Takumi Igusa
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Takuya Kobayashi
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan
- Department of Rehabilitation, Japan Community Healthcare Organization, Gunma Chuo Hospital, Maebashi, Japan
| | - Hiroyuki Uchida
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Aya Fukazawa
- Department of Rehabilitation, Fujioka General Hospital, Fujioka, Japan
| | - Chihaya Machida
- Department of Rehabilitation, Fujioka General Hospital, Fujioka, Japan
| | - Hirokuni Fujii
- Department of Rehabilitation, Fujioka General Hospital, Fujioka, Japan
| | - Keisuke Sekine
- Department of Rehabilitation, Fujioka General Hospital, Fujioka, Japan
| | - Minori Kurosaki
- Department of Rehabilitation, Fujioka General Hospital, Fujioka, Japan
| | - Kenji Tsuchiya
- Department of Rehabilitation, Faculty of Health Sciences, Nagano University of Health and Medicine, Nagano, Japan
| | - Senichiro Kikuchi
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan
| | - Kazuki Hirao
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan.
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Karhu J, Veijola J, Hintsanen M. The bidirectional relationships of optimism and pessimism with depressive symptoms in adulthood - A 15-year follow-up study from Northern Finland Birth Cohorts. J Affect Disord 2024; 362:468-476. [PMID: 39013521 DOI: 10.1016/j.jad.2024.07.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 06/17/2024] [Accepted: 07/12/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND Low optimism and high pessimism have predicted depressive symptoms in several studies, but the associations in the other direction, from depressive symptoms to future optimism and pessimism, have been unexplored. We examined bidirectional associations of optimism and pessimism with depressive symptoms in adulthood. METHODS A population-based sample of 4011 Finnish adults (55 % women) was analyzed with a 15-year prospective follow-up period from age 31 to age 46. Optimism and pessimism were measured with the Life Orientation Test-Revised, and depressive symptoms were measured with the Symptom Checklist-25. Temporal associations were investigated with cross-lagged panel models. RESULTS According to the model fit indices (RMSEA < 0.04, CFI ≥ 0.97) optimism and pessimism had bidirectional relationships with depressive symptoms: optimism predicted lower depressive symptoms (β = -0.09, p < .001), and depressive symptoms predicted lower optimism (β = -0.10, p < .001) in the follow-up. Also, pessimism predicted higher depressive symptoms (β = 0.08, p < .001), and depressive symptoms predicted higher pessimism (β = 0.09, p < .001) in the follow-up. In the participants with clinically high depressive symptoms at age 31, the predictive associations from optimism and pessimism to depressive symptoms remained, but associations in the other direction were attenuated. LIMITATIONS The follow-up study included only two time points with a 15-year time gap, which does not consider the possible fluctuation in the study variables between the measured times. CONCLUSION Dispositional optimism and pessimism may have bidirectional relationships with depressive symptoms in adulthood when the baseline depressive symptoms are below the clinical level.
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Affiliation(s)
- Jutta Karhu
- Unit of Psychology, Faculty of Education and Psychology, University of Oulu, P.O. Box 2000 (Erkki Koiso-Kanttilan katu 1), 90014 Oulu, Finland.
| | - Juha Veijola
- Research Unit of Clinical Neuroscience, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Department of Psychiatry, University Hospital of Oulu, 90220 Oulu, Finland; Medical Research Center, University of Oulu & University Hospital of Oulu, 90220 Oulu, Finland.
| | - Mirka Hintsanen
- Unit of Psychology, Faculty of Education and Psychology, University of Oulu, P.O. Box 2000 (Erkki Koiso-Kanttilan katu 1), 90014 Oulu, Finland.
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Lee ZL, Siew SKH, Yu J. Intrinsic functional connectivity mediates the effect of personality traits on depressive symptoms. PLoS One 2024; 19:e0300462. [PMID: 38985695 PMCID: PMC11236141 DOI: 10.1371/journal.pone.0300462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/27/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Personality traits have been proposed as risk factors for depressive symptoms. However, the neural mechanism behind these relationships is unclear. This study examined the possible mediating effect of resting-state functional connectivity networks on these relationships. METHODS Data from 153 healthy Germans were obtained from the MPI-Leipzig Mind-Brain-Body: Neuroanatomy & Connectivity Protocol database. Network-based statistics were used to identify significant functional connectivity networks that were positively and negatively associated with the personality traits of neuroticism, conscientiousness, and extraversion, with and without demographical covariates. Mediation analyses were performed for each personality trait and depressive symptoms with the significant positive and negative network strengths of the respective personality traits as mediators. RESULTS Neuroticism, conscientiousness, and extraversion were significantly correlated with depressive symptoms. Network-based statistics identified patterns of functional connectivity that were significantly associated with neuroticism and conscientiousness. After controlling for demographical covariates, significant conscientiousness-associated and extraversion-associated networks emerged. Mediation analysis concluded that only the neuroticism-positive network mediated the effect of neuroticism on depressive symptoms. When age and sex were controlled, the extraversion-positive network completely mediated the effect of extraversion on depressive symptoms. CONCLUSIONS These findings revealed that patterns of intrinsic functional networks predict personality traits and suggest that the relationship between personality traits and depressive symptoms may in part be due to their common patterns of intrinsic functional networks.
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Affiliation(s)
- Zheng Long Lee
- School of Social Sciences, Psychology, Nanyang Technological University, Singapore, Singapore
| | - Savannah Kiah Hui Siew
- School of Social Sciences, Psychology, Nanyang Technological University, Singapore, Singapore
| | - Junhong Yu
- School of Social Sciences, Psychology, Nanyang Technological University, Singapore, Singapore
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6
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Da H, Xiang N, Qiu M, Abbas S, Xiao Q, Zhang Y. Characteristics of oxyhemoglobin during the verbal fluency task in subthreshold depression: A multi-channel near-infrared spectroscopy study. J Affect Disord 2024; 356:88-96. [PMID: 38588729 DOI: 10.1016/j.jad.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 03/29/2024] [Accepted: 04/01/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVE Subthreshold depression is an essential precursor and risk factor for major depressive disorder, and its accurate identification and timely intervention are important for reducing the prevalence of major depressive disorder. Therefore, we used functional near-infrared spectroscopic imaging (fNIRS) to explore the characteristics of the brain neural activity of college students with subthreshold depression in the verbal fluency task. METHODS A total of 72 subthreshold depressed college students (SDs) and 67 healthy college students (HCs) were recruited, and all subjects were subjected to a verbal fluency task (VFT) while a 53-channel fNIRS device was used to collect the subjects' cerebral blood oxygenation signals. RESULTS The results of the independent samples t-test showed that the mean oxyhemoglobin in the right dorsolateral prefrontal (ch34, ch42, ch45) and Broca's area (ch51, ch53) of SDs was lower than that of HCs. The peak oxygenated hemoglobin of SDs was lower in the right dorsolateral prefrontal (ch34) and Broca's area (ch51, ch53).The brain functional connectivity strength was lower than that of HCs. Correlation analysis showed that the left DLPFC and Broca's area were significantly negatively correlated with the depression level. CONCLUSION SDs showed abnormally low, inadequate levels of brain activation and weak frontotemporal brain functional connectivity. The right DLPFC has a higher sensitivity for the differentiation of depressive symptoms and is suitable as a biomarker for the presence of depressive symptoms. Dysfunction in Broca's area can be used both as a marker of depressive symptoms and as a biomarker, indicating the severity of depressive symptoms.
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Affiliation(s)
- Hui Da
- School of Education, Huazhong University of Science and Technology, Wuhan, China.
| | - Nian Xiang
- Hospital of Huazhong University of Science and Technology, Wuhan, China.
| | - Min Qiu
- Hospital of Huazhong University of Science and Technology, Wuhan, China.
| | - Sadia Abbas
- School of Education, Huazhong University of Science and Technology, Wuhan, China.
| | - Qiang Xiao
- Hospital of Huazhong University of Science and Technology, Wuhan, China.
| | - Yan Zhang
- School of Education, Huazhong University of Science and Technology, Wuhan, China; Research Center for Innovative Education and Critical Thinking, Huazhong University of Science and Technology, Wuhan, China.
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Ge P, Tan C, Liu JX, Cai Q, Zhao SQ, Hong WY, Liu KM, Qi JL, Hu C, Yu WL, Li YM, You Y, Guo JH, Hao MY, Chen Y, Pan LT, Liu DY, Yan MY, Zhang JZ, Li QY, Sun BY, Han X, Mo F, Wu YB, Bian Y. Prevalence of subthreshold depression and its related factors in Chinese college students: A cross-sectional study. Heliyon 2024; 10:e32595. [PMID: 38988518 PMCID: PMC11233893 DOI: 10.1016/j.heliyon.2024.e32595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 07/12/2024] Open
Abstract
Objective To investigate the prevalence of subthreshold depression among Chinese college students and to explore the related factors. Methods The research subjects were Chinese college students participating in the "2022 Psychology and Behavior Investigation of Chinese Residents (PBICR-2022)". Data on respondents' general characteristics, quality of life, perceived pressure, family communication, perceived social support, self-efficacy, and depression status were gathered. To investigate the association between each variable and the risk of subthreshold depression, statistical analyses, including chi-square tests and rank sum tests were conducted. Furthermore, a binary stepwise logistic regression was employed to establish the regression model of the factors related to subthreshold depression among Chinese college students. Results A prevalence of subthreshold depression of about 39.7 % was found among the 8934 respondents. Logistic regression analysis revealed that respondents who are female, have chronic diseases, are in debt, experience significant impacts from epidemic control policies, have lower self-assessed quality of life, experience challenges in family communication, perceive lower social support, have lower self-efficacy, and feel higher perceived pressure are more likely to develop subthreshold depression compared to the control group. (P < 0.05). Conclusion The prevalence rate of subthreshold depression among Chinese college students was found to be approximately 40 %. Female college students suffering from chronic diseases, with households in debt, greatly impacted by epidemic control policies, and experiencing high perceived stress, may be at risk for subthreshold depression among Chinese college students. On the other hand, strong family communication, perceived social support, and self-efficacy were identified as potential protective factors. In order to facilitate timely screening, diagnosis, and treatment of subthreshold depression in Chinese college students, it is crucial for the government, local communities, colleges, and families to prioritize the mental health of college students and implement targeted measures accordingly.
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Affiliation(s)
- Pu Ge
- Institute of Chinese Medical Sciences, University of Macau, Macau, China
- State Key Laboratory of Quality Research in Chinese Medicine, University of Macau, Macau, China
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macau, China
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Cheng Tan
- School of Government, Peking University, Beijing, China
| | - Jia-xin Liu
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Qiong Cai
- School of Public Health, Peking University, Beijing, China
| | | | - Wen-ying Hong
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macau, China
| | - Kun-meng Liu
- Center for Medical Artificial Intelligence, Qingdao Academy of Chinese Medical Sciences, Shandong University of Traditional Chinese Medicine, Qingdao, China
| | - Jia-le Qi
- School of Journalism&Communication, Zhengzhou University, Zhengzhou, China
| | - Chen Hu
- Zijin College of Nanjing University of Technology, Nanjing, China
| | - Wen-li Yu
- School for Sports Humanities and Social Science, Jilin Sport University, Changchun, China
| | - Yi-miao Li
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Yuan You
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Jin-han Guo
- Department of Economics, Belarus State University, Minsk, Belarus
| | | | - Yang Chen
- College of Clinical Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, Hubei Province, China
| | - Lu-tong Pan
- School of Public Health, ShanDong University, Jinan, Shandong, China
| | - Di-yue Liu
- International School of Public Health and One Health, Hainan Medical University, Haikou, China
| | - Meng-yao Yan
- School of Health Policy and Management, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jin-zi Zhang
- School of Humanities and Social Sciences, Harbin Medical University, Harbin, China
| | - Qi-yu Li
- School of Humanities and Health Management, Jinzhou Medical University, Jinzhou, China
| | - Bo-ya Sun
- Zhejiang University of Media and Communication, Zhejiang, China
| | - Xiao Han
- The Fifth Affiliated Hospital of Sun Yat-sat University, Zhuhai, China
| | - Fuer Mo
- Institute of Chinese Medical Sciences, University of Macau, Macau, China
- State Key Laboratory of Quality Research in Chinese Medicine, University of Macau, Macau, China
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macau, China
| | - Yi-bo Wu
- School of Public Health, Peking University, Beijing, China
| | - Ying Bian
- Institute of Chinese Medical Sciences, University of Macau, Macau, China
- State Key Laboratory of Quality Research in Chinese Medicine, University of Macau, Macau, China
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macau, China
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Li S, Li S, Ding T, Liu S, Guo X, Liu Z. Effects of attentional deployment training for relieving negative emotion in individuals with subthreshold depression. Clin Neurophysiol 2024; 165:97-106. [PMID: 38996613 DOI: 10.1016/j.clinph.2024.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 05/24/2024] [Accepted: 06/10/2024] [Indexed: 07/14/2024]
Abstract
OBJECTIVE As a prodromal stage to major depressive disorder (MDD), subthreshold depression (StD) has a higher prevalence in the population, resulting in a greater healthcare burden. StD individuals' current negative emotion could be moderated by attentional deployment. However, it remains unclear whether attentional deployment training can mitigate subsequent negative emotion in StD individuals. METHODS Based on 160 participants, we combined decision task (Experiment 1, N = 69), eye-tracking (Experiment 2, N = 40), and EEG (Experiment 3, N = 51) techniques to investigate how one-week attentional deployment (gain-focus, GF) training modulated the emotional processing of negative stimulus and its underlying neural correlates in StD individuals. RESULTS After one-week GF training, StD individuals significantly reduced the first fixation time and total fixation time on the negative part (missed opportunities) of decision outcome and showed a decrease in emotional sensitivity to missed opportunities. An increase in N1 and decrease in P3 and LPP (late positive potentials) amplitudes, as well as a decrease in alpha oscillation, were observed when StD individuals faced missed opportunities after training. Additionally, the extent of reduction in StD individuals' emotional sensitivity to missed opportunities could be significantly predicted by the degree of decrease in alpha oscillation. CONCLUSION One-week attentional deployment training could modulate negative emotion in StD individuals and the degree of change in alpha oscillation might act as an objective indicator for the effectiveness of training. SIGNIFICANCE Our study provides a convenient and effective approach to alleviate the negative emotion of StD individuals.
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Affiliation(s)
- Shuyu Li
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, School of Psychology, Shaanxi Normal University, Xi'an 710062, China
| | - Shuang Li
- Department of Mental Health Education for College Students, School of Marxism, Nanjing Forestry University, Nanjing 210037, China
| | - Tao Ding
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, School of Psychology, Shaanxi Normal University, Xi'an 710062, China
| | - Sijia Liu
- Fudan Institute on Ageing, Fudan University, Shanghai 200433, China; MOE Laboratory for National Development and Intelligent Governance, Fudan University, Shanghai 200433, China
| | - Xiuyan Guo
- Fudan Institute on Ageing, Fudan University, Shanghai 200433, China; MOE Laboratory for National Development and Intelligent Governance, Fudan University, Shanghai 200433, China
| | - Zhiyuan Liu
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, School of Psychology, Shaanxi Normal University, Xi'an 710062, China.
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Wang C, Wang Q, Liu M, Tang S, Huang X, Huang C. Effectiveness of psychological interventions among community-dwelling older adults with subthreshold depression: A systematic review and meta-analysis. J Affect Disord 2024; 354:368-375. [PMID: 38479506 DOI: 10.1016/j.jad.2024.03.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 02/22/2024] [Accepted: 03/09/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Little is known about the effectiveness of psychological interventions among older adults with subthreshold depression in the community. This systematic review and meta-analysis aimed to examine the effectiveness of psychological interventions on depressive symptoms, anxiety symptoms and quality of life. METHODS We searched five databases from inception to 20th September 2022 and included RCTs that evaluated the effectiveness of psychological interventions among older adults with subthreshold depression in the community. Standardized mean difference (SMD) and 95 % confidence intervals (CI) were used to calculate the effect sizes of treatment outcomes in the meta-analysis, using RevMan 5.4.1 and Stata 16.0. RESULTS This meta-analysis included thirteen RCT studies involving 2079 participants. Psychological interventions could significantly reduce depressive symptoms (post-intervention time: SMD = -0.58, 95 % CI = -0.76 to -0.40; follow-up time: SMD = -0.31, 95 % CI = -0.41 to -0.22) and anxiety symptoms (post-intervention time: SMD = -0.33, 95 % CI = -0.49 to -0.17; follow-up time: SMD = -0.24, 95 % CI = -0.36 to -0.12) and improve quality of life (post-intervention time: SMD = 0.30, 95 % CI = 0.05 to 0.55; follow-up time: SMD = 0.15, 95 % CI = 0.01 to 0.28). CONCLUSION Evidence suggests that psychological interventions could significantly reduce depressive symptoms and anxiety symptoms, and improve quality of life among community-dwelling older adults with subthreshold depression.
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Affiliation(s)
- Chunyu Wang
- School of Nursing, University of California, Los Angeles, CA 90024, USA
| | - Qing Wang
- Xiangya School of Nursing, Central South University, Changsha, Hunan 410013, China
| | - Minhui Liu
- School of Nursing, Ningxia Medical University, Yinchuan, Ningxia 750101, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, Hunan 410013, China
| | - Xiaoting Huang
- Xiangya School of Nursing, Central South University, Changsha, Hunan 410013, China.
| | - Chongmei Huang
- School of Nursing, Ningxia Medical University, Yinchuan, Ningxia 750101, China.
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10
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Li P, Alhumaid MM, Wang H, Li H, Zhao S. Correlation research on physical activity and executive function in female college students with subclinical depression. Front Psychiatry 2024; 15:1403471. [PMID: 38835550 PMCID: PMC11148427 DOI: 10.3389/fpsyt.2024.1403471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/06/2024] [Indexed: 06/06/2024] Open
Abstract
Researchers have found that there may be a correlation between physical activity, executive function, and depression for college students with depression. However, there is limited information available regarding the relationship and interaction between subclinical depression, physical activity, and executive function among college students with subclinical depression. The purpose of this study is to assess the correlation and interaction between subclinical depression, physical activity, and executive function in female college students with subclinical depression. The ActiGraph GT3X was utilized to measure physical activity time, and the colour-word Stroop task was employed to evaluate the executive function of the participants. The findings revealed that female college students with subclinical depression had a significantly lower time for moderate-intensity physical activity compared to healthy female college students. Additionally, the subclinical depression group took significantly longer to complete the colour-word Stroop task compared to the healthy group of female college students. The results of correlation and mediation analyses suggest a negative correlation between BDI-II scores and physical activity time and executive function in female college students with subclinical depression. Moreover, executive function appears to play a partial mediating role in the relationship between physical activity and subclinical depression.
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Affiliation(s)
- Ping Li
- Department of Psychiatry, The Second People's Hospital of Neijiang, Neijiang, China
| | - Majed M Alhumaid
- Department of Physical Education, College of Education, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Haiyan Wang
- School of Foreign Languages, Shanghai Jian Qiao University, Shanghai, China
| | - Hai Li
- College of Sport, Neijiang Normal University, Neijiang, China
| | - Shanguang Zhao
- Department of Physical Education, Shanghai Maritime University, Shanghai, China
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11
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Li J, Kuang S, Liu Y, Wu Y, Li H. Structural and functional brain alterations in subthreshold depression: A multimodal coordinate-based meta-analysis. Hum Brain Mapp 2024; 45:e26702. [PMID: 38726998 PMCID: PMC11083971 DOI: 10.1002/hbm.26702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 04/09/2024] [Accepted: 04/17/2024] [Indexed: 05/13/2024] Open
Abstract
Imaging studies of subthreshold depression (StD) have reported structural and functional abnormalities in a variety of spatially diverse brain regions. However, there is no consensus among different studies. In the present study, we applied a multimodal meta-analytic approach, the Activation Likelihood Estimation (ALE), to test the hypothesis that StD exhibits spatially convergent structural and functional brain abnormalities compared to healthy controls. A total of 31 articles with 25 experiments were included, collectively representing 1001 subjects with StD. We found consistent differences between StD and healthy controls mainly in the left insula across studies with various neuroimaging methods. Further exploratory analyses found structural atrophy and decreased functional activities in the right pallidum and thalamus in StD, and abnormal spontaneous activity converged to the middle frontal gyrus. Coordinate-based meta-analysis found spatially convergent structural and functional impairments in StD. These findings provide novel insights for understanding the neural underpinnings of subthreshold depression and enlighten the potential targets for its early screening and therapeutic interventions in the future.
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Affiliation(s)
- Jingyu Li
- School of PsychologyShanghai Normal UniversityShanghaiChina
- Lab for Educational Big Data and Policymaking, Ministry of EducationShanghai Normal UniversityShanghaiChina
| | - Shunrong Kuang
- School of PsychologyShanghai Normal UniversityShanghaiChina
- Lab for Educational Big Data and Policymaking, Ministry of EducationShanghai Normal UniversityShanghaiChina
| | - Yang Liu
- School of PsychologyShanghai Normal UniversityShanghaiChina
- Department of PsychologyUniversity of WashingtonSeattleWashingtonUSA
| | - Yuedong Wu
- Lab for Educational Big Data and Policymaking, Ministry of EducationShanghai Normal UniversityShanghaiChina
| | - Haijiang Li
- School of PsychologyShanghai Normal UniversityShanghaiChina
- Lab for Educational Big Data and Policymaking, Ministry of EducationShanghai Normal UniversityShanghaiChina
- The Research Base of Online Education for Shanghai Middle and Primary SchoolsShanghaiChina
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12
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Zarski AC, Weisel KK, Berger T, Krieger T, Schaub MP, Berking M, Görlich D, Jacobi C, Ebert DD. Efficacy of an Internet- and Mobile-Based Intervention for Subclinical Anxiety and Depression (ICare Prevent) with Two Guidance Formats: Results from a Three-Armed Randomized Controlled Trial. PSYCHOTHERAPY AND PSYCHOSOMATICS 2024; 93:155-168. [PMID: 38688243 PMCID: PMC11151970 DOI: 10.1159/000536149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 12/29/2023] [Indexed: 05/02/2024]
Abstract
INTRODUCTION Limited research exists on intervention efficacy for comorbid subclinical anxiety and depressive disorders, despite their common co-occurrence. Internet- and mobile-based interventions (IMIs) are promising to reach individuals facing subclinical symptoms. OBJECTIVE This study aimed to evaluate the efficacy of a transdiagnostic and self-tailored IMI in reducing subclinical anxiety and depressive symptom severity with either individualized (IG-IMI) or automated (AG-IMI) guidance compared to a waitlist control group with care-as-usual access (WLC). METHODS Participants included 566 adults with subclinical anxiety (GAD-7 ≥ 5) and/or depressive (CES-D ≥16) symptoms, who did not meet criteria for a full-syndrome depressive or anxiety disorder. In a three-arm randomized clinical trial, participants were randomized to a cognitive behavioral 7-session IMI plus booster session with IG-IMI (n = 186) or AG-IMI (n = 189) or WLC (n = 191). Primary outcomes included observer-rated anxiety (HAM-A) and depressive (QIDS) symptom severity 8 weeks after randomization assessed by blinded raters via telephone. Follow-up outcomes at 6 and 12 months are reported. RESULTS Symptom severity was significantly lower with small to medium effects in IG-IMI (anxiety: d = 0.45, depression: d = 0.43) and AG-IMI (anxiety: d = 0.31, depression: d = 0.32) compared to WLC. No significant differences emerged between guidance formats in primary outcomes. There was a significant effect in HAM-A after 6 months favoring AG-IMI. On average, participants completed 85.38% of IG-IMI and 77.38% of AG-IMI. CONCLUSIONS A transdiagnostic, self-tailored IMI can reduce subclinical anxiety and depressive symptom severity, but 12-month long-term effects were absent. Automated guidance holds promise for enhancing the scalability of IMIs in broad prevention initiatives.
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Affiliation(s)
- Anna-Carlotta Zarski
- Division of eHealth in Clinical Psychology, Department of Clinical Psychology, Philipps University of Marburg, Marburg, Germany
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Kiona K. Weisel
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Thomas Berger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Tobias Krieger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Michael P. Schaub
- Swiss Research Institute for Public Health and Addiction (ISGF), Associated to the University of Zurich, Zurich, Switzerland
| | - Matthias Berking
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Dennis Görlich
- Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany
| | - Corinna Jacobi
- Institute for Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany
| | - David D. Ebert
- Professorship Psychology and Digital Mental Health Care, Technical University of Munich, Munich, Germany
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13
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Huang L, Li Q, He D, Cheng Z, Zhang H, Shen W, Zhan L, Zhang J, Hao Z, Ding Q. Modulatory effects of aerobic training on the degree centrality of brain functional activity in subthreshold depression. Brain Res 2024; 1827:148767. [PMID: 38224827 DOI: 10.1016/j.brainres.2024.148767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/07/2023] [Accepted: 01/12/2024] [Indexed: 01/17/2024]
Abstract
BACKGROUND Aerobic training has been shown to effectively prevent the progression of depressive symptoms from subthreshold depression (StD) to major depressive disorder (MDD), and understanding how aerobic training promotes changes in neuroplasticity is essential to comprehending its antidepressant effects. Few studies, however, have quantified the alterations in spontaneous brain activity before and after aerobic training for StD. METHODS Participants included 44 individuals with StD and 34 healthy controls (HCs). Both groups underwent moderate aerobic training for eight weeks, and resting state functional magnetic resonance imaging (rs-fMRI) data were collected before and after training. The degree centrality (DC) changes between the two groups and the DC changes in each group before and after training were quantified. RESULTS The rs-fMRI results showed that compared with the HCs, the DC values of the StD group in the orbital region of the left inferior frontal gyrus significantly depreciated at baseline. After aerobic training, the results of the follow-up examination revealed no significant difference in the DC values between the two groups. In addition, compared with baseline, the StD group exhibited an significant decrease in the DC values of the left dorsolateral superior frontal gyrus; while the HCs group exhibited an significant decrease in the DC values of the left thalamus. No statistically significant connection was seen between changes in DC values and psychological scale scores in the StD group. CONCLUSIONS Our findings suggest that regular aerobic training can enhance brain plasticity in StD. In addition, we demonstrated that DC is a relevant and accessible method for evaluating the functional plasticity of the brain induced by aerobic training in StD.
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Affiliation(s)
- Lina Huang
- Department of Radiology, Changshu Hospital Affiliated to Nantong University, Jiangsu, China
| | - Qin Li
- Department of Radiology, Changshu Hospital Affiliated to Nantong University, Jiangsu, China
| | - Di He
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Zhixiang Cheng
- School of Information Science and Engineering, Dalian Polytechnic University, Dalian 116030, Liaoning, China
| | - Hongqiang Zhang
- Department of Radiology, Changshu Hospital Affiliated to Nantong University, Jiangsu, China
| | - Wenbin Shen
- Department of Radiology, Changshu Hospital Affiliated to Nantong University, Jiangsu, China
| | - Linlin Zhan
- School of Western Studies, Heilongjiang University, Harbin, China
| | - Jun Zhang
- Department of Psychiatry, Changshu Third People's Hospital, Changshu, Jiangsu, China
| | - Zeqi Hao
- School of Psychology, Zhejiang Normal University, Jinhua, China.
| | - Qingguo Ding
- Department of Radiology, Changshu Hospital Affiliated to Nantong University, Jiangsu, China.
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14
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Shiraishi N, Sakata M, Toyomoto R, Yoshida K, Luo Y, Nakagami Y, Tajika A, Suga H, Ito H, Sumi M, Muto T, Ichikawa H, Ikegawa M, Watanabe T, Sahker E, Uwatoko T, Noma H, Horikoshi M, Iwami T, Furukawa TA. Three types of university students with subthreshold depression characterized by distinctive cognitive behavioral skills. Cogn Behav Ther 2024; 53:207-219. [PMID: 38008940 DOI: 10.1080/16506073.2023.2288557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 11/15/2023] [Indexed: 11/28/2023]
Abstract
Subthreshold depression impairs young people's quality of life and places them at greater risk of developing major depression. Cognitive behavioral therapy (CBT) is an evidence-based approach for addressing such depressive states. This study identified subtypes of university students with subthreshold depression and revealed discrete profiles of five CBT skills: self-monitoring, cognitive restructuring, behavioral activation, assertive communication, and problem solving. Using data from the Healthy Campus Trial (registration number: UMINCTR-000031307), a hierarchical clustering analysis categorized 1,080 students into three clusters: Reflective Low-skilled, Non-reflective High-skilled, and Non-reflective Low-skilled students. Non-reflective Low-skilled students were significantly more depressed than other students (p < .001). The severity of depression seemed to be related to the combination of self-monitoring skills and other CBT skills. Considering the high prevalence of poor self-monitoring skills in persons with autism, the most severe depression was observed in the significant association between Non-reflective Low-skilled students and autistic traits (p = .008). These findings suggest that subthreshold depression can be categorized into three subtypes based on CBT skill profiles. The assessment of autistic traits is also suggested when we provide CBT interventions for Non-reflective Low-skilled students.
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Affiliation(s)
- Nao Shiraishi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - Masatsugu Sakata
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Rie Toyomoto
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Kazufumi Yoshida
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Yan Luo
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Yukako Nakagami
- Department of Health Service, Kyoto University, Kyoto, Japan
| | - Aran Tajika
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | | | - Hiroshi Ito
- Department of Medical Service Center, Ritsumeikan University, Kyoto, Japan
| | - Michihisa Sumi
- Department of Medical Service Center, Ritsumeikan University, Kyoto, Japan
| | - Takashi Muto
- Department of Psychology, Doshisha University, Kyoto, Japan
| | - Hiroshi Ichikawa
- Department of Medical Life Systems, Doshisha University, Kyoto, Japan
| | - Masaya Ikegawa
- Department of Medical Life Systems, Doshisha University, Kyoto, Japan
| | - Takafumi Watanabe
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - Ethan Sahker
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
- Medical Education Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Teruhisa Uwatoko
- Department of Psychiatry, Kyoto University Hospital, Kyoto, Japan
| | - Hisashi Noma
- Department of Data Science, The Institute of Statistical Mathematics, Tokyo, Japan
| | - Masaru Horikoshi
- Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Taku Iwami
- Department of Health Service, Kyoto University, Kyoto, Japan
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
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15
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Kong F, Yu L, Hou Y, Zhu L, Zhou J, Huang L, Lv Y, Wang L, Zhang L, Yang Y, Ying Y. Efficacy of Internet-Based Cognitive Behavioral Therapy for Subthreshold Depression Among Older Adults in Institutional Long-Term Care Settings: Pragmatic Randomized Controlled Trial. J Med Internet Res 2024; 26:e40187. [PMID: 38427424 PMCID: PMC10943436 DOI: 10.2196/40187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 01/03/2023] [Accepted: 01/31/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Subthreshold depression (sD) is prevalent in older populations in long-term care (LTC) settings, but psychological therapy in LTC settings in China is not readily available. Thus, internet-based cognitive behavioral therapy (ICBT) may be suitable for this population, but research on the efficacy of ICBT for older adults with sD, especially those living in LTC settings, is limited. OBJECTIVE This study aimed to evaluate the efficacy and acceptability of ICBT treatment for sD among LTC residents in China. We also examined whether ICBT is as effective as group-based cognitive behavioral therapy (CBT) for treating sD in this population. METHODS We conducted a pragmatic randomized controlled trial, which included 18 LTC institutions. A total of 354 participants were randomized to ICBT, group-based CBT, or a waiting list and were followed up for 12 months. The primary outcome was self-reported depressive symptoms on the Center for Epidemiological Studies Depression Scale (CES-D). Secondary outcomes were the scores of the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-Item (GAD-7), and Geriatric Depression Scale (GDS). A mixed-effects model was used to assess the efficacy of ICBT. RESULTS The ICBT group showed a significant improvement in self-reported depressive symptoms, which was maintained at the 12-month follow-up (all P<.001). The ICBT group exhibited a significantly larger reduction in the scores of the CES-D (Cohen d=0.07, 95% CI 0.04-0.09; P=.01), PHQ-9 (d=0.30, 95% CI 0.28-0.33; P<.001), GDS (d=0.10, 95% CI 0.08-0.13; P<.001), and GAD-7 (d=0.19, 95% CI 0.17-0.22; P<.001) compared with a waiting list at postintervention. ICBT had significantly stronger effects than CBT on the PHQ-9 and GAD-7 at postintervention (d=0.15, 95% CI 0.13-0.17; P<.001 and d=0.21, 95% CI 0.19-0.23; P<.001, respectively), 6-month follow-up (d=0.18, 95% CI 0.16-0.21; P<.001 and d=0.18, 95% CI 0.15-0.21; P<.001, respectively), and 12-month follow-up (d=0.15, 95% CI 0.11-0.19; P<.001 and d=0.18, 95% CI 0.14-0.21; P<.001, respectively). CONCLUSIONS ICBT is a relatively effective and acceptable intervention for reducing depressive symptoms among Chinese LTC residents with sD. These findings indicate the usefulness of ICBT application for sD in LTC settings. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2000030697; https://www.chictr.org.cn/showproj.aspx?proj=50781.
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Affiliation(s)
- Fanqian Kong
- Ningbo Medical Center Lihuili Hospital, Ningbo, China
| | - Libo Yu
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | | | - Lijie Zhu
- Pfizer Research and Development Co, Ltd, Shanghai, China
| | - Jing Zhou
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Lingjie Huang
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Yueer Lv
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Li Wang
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Li Zhang
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Yiling Yang
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Yuchen Ying
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
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16
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Song X, Niu L, Admon R, Long J, Li Q, Peng L, Lee TM, Zhang R. Aberrant positive affect dynamics in individuals with subthreshold depression: Evidence from laboratory and real-world assessments. Int J Clin Health Psychol 2024; 24:100427. [PMID: 38173985 PMCID: PMC10761788 DOI: 10.1016/j.ijchp.2023.100427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 11/30/2023] [Indexed: 01/05/2024] Open
Abstract
Background/Objective Reduced positive affect (PA) is a core feature of major depressive disorder (MDD). However, the precursor of MDD, subthreshold depression (StD), has received less attention in this regard. Therefore, we examined PA dynamics in StD, integrating laboratory-based and ecological momentary assessment (EMA) approaches. Method Participants were college students recruited from Chinese universities (31 with StD, and 39 healthy controls (HC)). Positive mood was induced in the laboratory by an eight-minute comedy clip used to assess PA reactivity and maintenance. To extend findings to the real world and explore mechanisms of PA maintenance, 53 participants with StD and 64 HC reported their emotional states 14 times daily for one week via EMA. Multilevel models were used to test for predictors of PA inertia. Results In the laboratory, participants with StD achieved the same PA reactivity as HC when facing positive stimuli, yet the curve-fitting revealed difficulties for the StD group in maintaining PA over time. Such reduced capacity was further observed in real-world settings, manifesting in significantly greater PA inertia. Conclusions High PA inertia in daily life may reflect resistance to mood change in StD, explaining anhedonia and difficulties with emotional maintenance, and highlighting the need for early identification.
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Affiliation(s)
- Xiaoqi Song
- Cognitive control and Brain Healthy Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Lijing Niu
- Cognitive control and Brain Healthy Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Roee Admon
- School of Psychological Sciences, University of Haifa, Haifa, Israel
- The Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa, Israel
| | - Jixin Long
- Cognitive control and Brain Healthy Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Qian Li
- Cognitive control and Brain Healthy Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Lanxin Peng
- Cognitive control and Brain Healthy Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Tatia M.C. Lee
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, SAR China
- Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong, SAR China
- Center for Brain Science and Brain-Inspired Intelligence, Guangdong-Hong Kong-Macao Greater Bay Area, Guangzhou, China
| | - Ruibin Zhang
- Cognitive control and Brain Healthy Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
- Center for Brain Science and Brain-Inspired Intelligence, Guangdong-Hong Kong-Macao Greater Bay Area, Guangzhou, China
- Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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17
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Klein DN. Assessment of Depression in Adults and Youth. Assessment 2024; 31:110-125. [PMID: 37081793 DOI: 10.1177/10731911231167446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
This article selectively reviews the key issues and measures for the assessment of depressive disorders and symptoms in youth and adults. The first portion of the article addresses the nature and conceptualization of depression and some key issues that must be considered in its assessment. Next, the diagnostic interview and clinician- and self-administered rating scales that are most widely used to diagnose, screen for, and assess the severity of depression in adults and youth are selectively reviewed. In addition, the assessment of three transdiagnostic clinical features (anhedonia, irritability, and suicidality) that are frequently associated with both depression and other forms of psychopathology is discussed. The article concludes with some broad recommendations for assessing depression in research and clinical practice and suggestions for future research.
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18
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Yang Z, Xia L, Fu Y, Zheng Y, Zhao M, Feng Z, Shi C. Altered EEG Microstates Dynamics in Individuals with Subthreshold Depression When Generating Negative Future Events. Brain Topogr 2024; 37:52-62. [PMID: 37812293 DOI: 10.1007/s10548-023-01011-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/25/2023] [Indexed: 10/10/2023]
Abstract
Negative bias in prospection may play a crucial role in driving and maintaining depression. Recent research suggests abnormal activation and functional connectivity in regions of the default mode network (DMN) during future event generation in depressed individuals. However, the neural dynamics during prospection in these individuals remain unknown. To capture network dynamics at high temporal resolution, we employed electroencephalogram (EEG) microstate analysis. We examined microstate properties during both positive and negative prospection in 35 individuals with subthreshold depression (SD) and 35 controls. We identified similar sets of four canonical microstates (A-D) across groups and conditions. Source analysis indicated that each microstate map partially overlapped with a subsystem of the DMN (A: verbal; B: visual-spatial; C: self-referential; and D: modulation). Notably, alterations in EEG microstates were primarily observed in negative prospection of individuals with SD. Specifically, when generating negative future events, the coverage, occurrence, and duration of microstate A increased, while the coverage and duration of microstates B and D decreased in the SD group compared to controls. Furthermore, we observed altered transitions, particularly involving microstate C, during negative prospection in the SD group. These altered dynamics suggest dysconnectivity between subsystems of the DMN during negative prospection in individuals with SD. In conclusion, we provide novel insights into the neural mechanisms of negative bias in depression. These alterations could serve as specific markers for depression and potential targets for future interventions.
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Affiliation(s)
- Zhuoya Yang
- Department of Basic Psychology, School of Medical Psychology, Army Medical University, Chongqing, 400038, China
- School of Medical Psychology, Army Medical University, 30 Gaotanyan Street, Chongqing, 400038, China
| | - Lei Xia
- Experimental Research Center for Medical and Psychological Science, School of Medical Psychology, Army Medical University, Chongqing, 400038, China
- School of Medical Psychology, Army Medical University, 30 Gaotanyan Street, Chongqing, 400038, China
| | - Yixiao Fu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Yingcan Zheng
- Department of Developmental Psychology for Armyman, School of Medical Psychology, Army Medical University, Chongqing, 400038, China
- School of Medical Psychology, Army Medical University, 30 Gaotanyan Street, Chongqing, 400038, China
| | - Mengxue Zhao
- Department of Military Psychology, School of Medical Psychology, Army Medical University, Chongqing, 400038, China
- School of Medical Psychology, Army Medical University, 30 Gaotanyan Street, Chongqing, 400038, China
| | - Zhengzhi Feng
- School of Medical Psychology, Army Medical University, 30 Gaotanyan Street, Chongqing, 400038, China.
| | - Chunmeng Shi
- Institute of Rocket Force Medicine, State Key Laboratory of Trauma, Burns and Combined Injury, Army Medical University, 30 Gaotanyan Street, Chongqing, 400038, China.
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19
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Qiu S, Luo X, Luo Y, Wei D, Mei G. State-dependent alterations of implicit emotional dominance during binocular rivalry in subthreshold depression. Psych J 2023; 12:809-823. [PMID: 37905936 DOI: 10.1002/pchj.686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 08/14/2023] [Indexed: 11/02/2023]
Abstract
Binocular rivalry, a visual perception phenomenon where two or more percepts alternate every few seconds when distinct stimuli are presented to the two eyes, has been reported as a biomarker in several psychiatric disorders. It is unclear whether abnormalities of binocular rivalry in depression could occur when emotional rivaling stimuli are used, and if so, whether an emotional binocular rivalry test could provide a trait-dependent or state-dependent biomarker. In the current study, 34 individuals with subthreshold depression and 31 non-depressed individuals performed a binocular rivalry task associated with implicit emotional processing. Participants were required to report their perceived orientations of the rival gratings in the foreground and to neglect emotional face stimuli in the background. The participants were retested after an approximately 4-month time interval. Compared to the non-depressed group, the subthreshold depression group showed significantly longer perceptual dominance durations of the grating with emotional faces as the background (i.e., implicit emotional dominance) at the initial assessment. However, the abnormality was not found at the follow-up assessment. More importantly, we found smaller changes in depressive severity at the follow-up assessment for individuals displaying longer emotional dominance at the initial assessment than for individuals with weaker emotional dominance. The current emotional binocular rivalry test may provide an objective, state-dependent biomarker for distinguishing individuals with subthreshold depression from non-depressed individuals.
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Affiliation(s)
- Shiming Qiu
- School of Psychology, Guizhou Normal University, Guiyang, People's Republic of China
- School of Psychology, Central China Normal University, Wuhan, People's Republic of China
| | - Xu Luo
- School of Psychology, Guizhou Normal University, Guiyang, People's Republic of China
| | - Yuhong Luo
- School of Psychology, Guizhou Normal University, Guiyang, People's Republic of China
| | - Dandan Wei
- School of Psychology, Guizhou Normal University, Guiyang, People's Republic of China
| | - Gaoxing Mei
- School of Psychology, Guizhou Normal University, Guiyang, People's Republic of China
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20
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Keats L, Jose P, Salmon K. My Turning Point Tells the Story: A Longitudinal Examination of Greater Episodic Detail and Youth Depressive Symptoms. Res Child Adolesc Psychopathol 2023; 51:1669-1682. [PMID: 37505325 PMCID: PMC10627942 DOI: 10.1007/s10802-023-01096-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2023] [Indexed: 07/29/2023]
Abstract
Although research findings show that the personal memories of people who are depressed are characterized by sparse episodic detail, under some circumstances, the opposite pattern emerges. Specifically, a recent study (Salmon et al., 2021) has shown that for community youth, greater episodic detail in a highly self-relevant narrative (a life turning point) predicted increased depressive symptoms concurrently and one year later. In a new longitudinal study of young people (N = 320 at Time 1, M = 16.9 years; 81% female) followed up over six months, we aimed to replicate and extend this finding. In Study A, we compared the turning point with a narrative about a conflict event, to establish whether the detail in a turning point memory uniquely predicted depressive symptoms. Supporting the first hypothesis, at both time-points, greater episodic detail was concurrently positively associated with depressive symptoms for turning point narratives only. Contrary to our second hypothesis, greater detail did not predict increased depressive symptoms longitudinally. The reverse pattern was significant, however, in that greater initial depressive symptoms predicted greater detail uniquely in the turning point narrative six months later. In Study B, we determined that the concurrent association between episodic detail and depressive symptoms in turning points (but not conflict events) was exacerbated by linguistic markers of self-focus (greater I-talk and lower distancing language). These findings suggest that greater detail in a turning point narrative may uniquely signify risk of psychological distress when youth narrate the experience with heightened self-focus.
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Affiliation(s)
- Laurel Keats
- School of Psychology, Victoria University of Wellington - Te Herenga Waka, PO Box 600, Wellington, New Zealand.
| | - Paul Jose
- School of Psychology, Victoria University of Wellington - Te Herenga Waka, PO Box 600, Wellington, New Zealand
| | - Karen Salmon
- School of Psychology, Victoria University of Wellington - Te Herenga Waka, PO Box 600, Wellington, New Zealand
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21
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Hao X, Jia Y, Chen J, Zou C, Jiang C. Subthreshold Depression: A Systematic Review and Network Meta-Analysis of Non-Pharmacological Interventions. Neuropsychiatr Dis Treat 2023; 19:2149-2169. [PMID: 37867932 PMCID: PMC10588757 DOI: 10.2147/ndt.s425509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/22/2023] [Indexed: 10/24/2023] Open
Abstract
Background Subthreshold depression (StD) is considered to be the "precursor" stage of major depressive disorder (MDD), which could cause higher risk of suicide, disease burden and functional impairment. There have been various non-pharmacological interventions for StD. However, the comparison of their effectiveness still lacks sufficient evidence. We performed a systematic review and network meta-analysis to evaluate and rank the efficacy of multiple non-pharmacological interventions targeting StD. Methods We conducted a thorough search across various databases including PubMed, Medline, Embase, Web of Science and PsycINFO from inception to December 2022. All included studies were randomized controlled trials (RCTs) of non-pharmacological interventions for patients with StD compared with control group (CG). Several universal scales for measuring depression severity were used as efficacy outcomes. The surface under the cumulative ranking curve (SUCRA) was used to separately rank each intervention using the "Stata 17.0" software. Results A total of thirty-six trials were included, involving twenty-eight interventions and 7417 participants. The research found that most non-pharmacological interventions were superior to controls for StD. In each outcome evaluation by different scales for measuring depression, psychotherapy always ranked first in terms of treatment effectiveness, especially Problem-solving Therapy (PST), Behavioral Activation Therapy (BAT), Cognitive Behavioral Therapy (CBT)/Internet-based CBT (I-CBT)/Telephone-based CBT (T-CBT). Since different groups could not be directly compared, the total optimal intervention could not be determined. Conclusion Here, we show that psychotherapy may be the better choice for the treatment of StD. This study provides some evidence on StD management selection for clinical workers. However, to establish its intervention effect more conclusively, the content, format and operators of psychotherapy still require extensive exploration to conduct more effective, convenient and cost-effective implementation in primary healthcare. Notably, further research is also urgently needed to find the biological and neural mechanisms of StD by examining whether psychotherapy alters neuroplasticity in patients with StD.
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Affiliation(s)
- Xiaofei Hao
- Department of General Medicine, Chengdu Fifth People’s Hospital, Chengdu, Sichuan, 611130, People’s Republic of China
| | - Yuying Jia
- Department of Outpatient, The General Hospital of Western Theater Command, Chengdu, Sichuan, 610083, People’s Republic of China
| | - Jie Chen
- Department of Outpatient, The General Hospital of Western Theater Command, Chengdu, Sichuan, 610083, People’s Republic of China
| | - Chuan Zou
- Department of General Medicine, Chengdu Fifth People’s Hospital, Chengdu, Sichuan, 611130, People’s Republic of China
| | - Cuinan Jiang
- Department of General Surgery, The Third People’s Hospital of Chengdu & The Affiliated Hospital of Southwest Jiaotong University, Chengdu, Sichuan, 610031, People’s Republic of China
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22
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Huang K, You S, Yue X, Yan S, Bai L, He R, Jiao Y, Han B, Momin K, Wu J, Jia Y, Chen L. Effects of non-pharmacological interventions on depressive symptoms and risk of major depressive disorder in adults with subthreshold depression: A systematic review and meta-analysis. Psychiatry Res 2023; 326:115333. [PMID: 37482046 DOI: 10.1016/j.psychres.2023.115333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/02/2023] [Accepted: 07/03/2023] [Indexed: 07/25/2023]
Abstract
Subthreshold depression (StD) is a condition that significantly reduces the quality of life and increases the risk of developing major depressive disorder (MDD). In order to investigate the effectiveness of non-pharmacological interventions (NPIs) in preventing the onset of MDD and improving depressive symptoms in adults with StD (AStDs), we conducted a systematic search of nine databases and included a total of 15 studies. Standardized mean differences (SMDs) were calculated using random effects models. RoB2 tool and GRADEpro software were used to assess the methodological quality and evidence. Funnel plots, Egger's, and Begg's tests were used to analyze publication bias. Sensitivity, subgroup and meta-regression analyses were performed to explore potential sources of heterogeneity. The results showed that NPIs had a significant effect in preventing the onset of MDD and improving depressive symptoms. Subgroup analysis revealed that NPIs were particularly effective in general adult populations, during short-term follow-up (FU) periods, among pregnant women, and in universal prevention programs. The results were found to be robust and credible, as they were less sensitive to changes in the analysis method. Timely detection and treatment of StD is feasible and important, as it can effectively delay or prevent the onset of MDD.
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Affiliation(s)
- Kexin Huang
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin 130012, China
| | - Simiao You
- School of Sport Health and Technology, Jilin Sport University, No.2476 Ziyou Street, Changchun 130022, China
| | - Xin Yue
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin 130012, China
| | - Shoumeng Yan
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin 130012, China
| | - Linquan Bai
- Faculty of English, Jagiellonian University, Golebia 24, Kraków 31-007, Poland
| | - Rendong He
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin 130012, China
| | - Yongliang Jiao
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin 130012, China; School of Sport Health and Technology, Jilin Sport University, No.2476 Ziyou Street, Changchun 130022, China
| | - Bingyue Han
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin 130012, China
| | - Kadierya Momin
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin 130012, China
| | - Jiangmei Wu
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin 130012, China
| | - Yong Jia
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin 130012, China.
| | - Li Chen
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, Jilin 130012, China.
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23
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Ejiri H, Uchida H, Tsuchiya K, Fujiwara K, Kikuchi S, Hirao K. Immediate Effects of Mobile Phone App for Depressed Mood in Young Adults with Subthreshold Depression: A Pilot Randomized Controlled Trial. Neuropsychiatr Dis Treat 2023; 19:1695-1707. [PMID: 37546515 PMCID: PMC10402716 DOI: 10.2147/ndt.s415937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/25/2023] [Indexed: 08/08/2023] Open
Abstract
Background Preventive interventions for subthreshold depression (StD) are essential to reduce the incidence of major depressive disorder. Our smartphone application presenting positive word stimulation in video (ie, Subliminal Priming with Supraliminal Reward Stimulation, SPSRS) was suggested to improve depressive symptoms in people with StD, although it is unclear whether it can immediately improve depressed mood. This pilot randomized controlled trial (RCT) aimed to investigate the preliminary efficacy of SPSRS application intervention on depressive mood in people with StD. Methods Thirty-two participants with StD were randomly assigned to the experimental (n = 16) or control group (n = 16). The experimental group received SPSRS application intervention (10-minute video with positive word stimulation) and the control group received YouTube application intervention (10-minute video without positive word stimulation). Both groups used identical iPhones managed by the research team. The primary outcome was the change from baseline in depression-dejection on the Profile of Mood States 2nd Edition-Adult Short (POMS 2-A Short) after the intervention. Results No participants dropped out of the study. The experimental group showed a small improvement in depression-dejection on the POMS 2-A Short score (adjusted Hedges's g = -0.32) compared to the control group. Post-hoc power analyses estimated a sample size of 56 per group (112 total) to evaluate depression-dejection on the POMS 2-A Short in a future full-scale RCT. Conclusion SPSRS application intervention may be effective in immediately improving depressive mood in people with StD. A future full-scale RCT based on a formally calculated sample size should be conducted to replicate these findings.
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Affiliation(s)
- Hitomi Ejiri
- Department of Occupational Therapy, Faculty of Medicine, Gunma University, Maebashi, Japan
| | - Hiroyuki Uchida
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Kenji Tsuchiya
- Department of Rehabilitation, Faculty of Health Sciences, Nagano University of Health and Medicine, Nagano, Japan
| | - Kazuhiko Fujiwara
- Department of Rehabilitation Sciences, Faculty of Rehabilitation Sciences, Nishikyushu University, Kanzaki, Japan
| | - Senichiro Kikuchi
- Department of Occupational Therapy, Faculty of Medicine, Gunma University, Maebashi, Japan
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
| | - Kazuki Hirao
- Department of Occupational Therapy, Faculty of Medicine, Gunma University, Maebashi, Japan
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
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24
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Liu T, Peng MM, Wong FHC, Leung DKY, Zhang W, Wong GHY, Lum TYS. Differential Associations Between Depressive Symptom-Domains With Anxiety, Loneliness, and Cognition in a Sample of Community Older Chinese Adults: A Multiple Indicators Multiple Causes Approach. Innov Aging 2023; 7:igad075. [PMID: 37727600 PMCID: PMC10506173 DOI: 10.1093/geroni/igad075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Indexed: 09/21/2023] Open
Abstract
Background and Objectives Depressive symptoms are common in older adults, and often co-occur with other mental health problems. However, knowledge about depressive symptom-domains and their associations with other conditions is limited. This study examined depressive symptom-domains and associations with anxiety, cognition, and loneliness. Research Design and Methods A sample of 3,795 participants aged 60 years and older were recruited from the community in Hong Kong. They were assessed for depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]), anxiety (Generalized Anxiety Disorder 7-item), loneliness (UCLA 3-item), and cognition (Montreal Cognitive Assessment 5-Minute Protocol). Summary descriptive statistics were calculated, followed by confirmatory factor analysis of PHQ-9. Multiple Indicators Multiple Causes analysis was used to examine the associations between mental health conditions in the general sample and subgroups based on depressive symptom severity. Results A 4-factor model based on the Research Domain Criteria showed the best model fit of PHQ-9 (χ2/df = 10.63, Root-Mean-Square Error of Approximation = 0.05, Comparative Fit Index = 0.96, Tucker-Lewis Index = 0.93). After adjusting for demographics, 4 depressive symptom-domains were differentially associated with anxiety, loneliness, and cognition across different depression severity groups. The Negative Valance Systems and Internalizing domain (NVS-I; guilt and self-harm) were consistently associated with anxiety (β = 0.45, 0.44) and loneliness (β = 0.11, 0.27) regardless of depression severity (at risk/mild vs moderate and more severe, respectively, all p < .001). Discussion and Implications The consistent associations between the NVS-I domain of depression with anxiety and loneliness warrant attention. Simultaneous considerations of depressive symptom-domains and symptom severity are needed for designing more personalized care. Clinical Trials Registration Number NCT03593889.
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Affiliation(s)
- Tianyin Liu
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Man-Man Peng
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University, Zhuhai, China
| | - Frankie H C Wong
- Philip Merrill College of Journalism, University of Maryland, College Park, Maryland, USA
| | - Dara K Y Leung
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China
| | - Wen Zhang
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
| | - Gloria H Y Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Terry Y S Lum
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China
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25
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Seely HD, Gaskins J, Pössel P, Hautzinger M. Comprehensive Prevention: An Evaluation of Peripheral Outcomes of a School-based Prevention Program. Res Child Adolesc Psychopathol 2023; 51:921-936. [PMID: 36870013 DOI: 10.1007/s10802-023-01043-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2023] [Indexed: 03/05/2023]
Abstract
By age 18, 22-27% of adolescents have experienced depressive symptoms increasing their risk of peripheral mental health and social issues. Despite the development of effective depression prevention programs, issues related to dissemination persist. This study aims to identify ways of increasing the likelihood of dissemination by a) investigating how prevention effects differ based on the professional background of the prevention program group leader and b) evaluating adolescent depression prevention in terms of comprehensive prevention - prevention with the breadth to reduce peripheral mental health and social issues. This cluster-randomized trial included 646 eighth-grade students recruited from German secondary schools. Adolescents were randomized into three conditions: teacher-led prevention, psychologist-led prevention, or school-as-usual. Results from hierarchical linear models reveal differences in effects based on implementation type and adolescent gender and provide preliminary evidence for a wider reach of depression prevention such that, regardless of implementation type or gender, the tested program was effective in reducing hyperactivity over time. Taken together, our findings warrant further research and suggest that depression prevention programs may have an effect on some peripheral outcomes, but not others, and that these effects may differ based on the profession of the group leader and adolescent gender. With continued empirical research investigating the efficaciousness of comprehensive prevention, this type of prevention has the potential to impact a larger proportion of the population and improve the cost-benefit ratio of prevention, thus increasing the likelihood of dissemination.
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26
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Zhang R, Peng X, Song X, Long J, Wang C, Zhang C, Huang R, Lee TMC. The prevalence and risk of developing major depression among individuals with subthreshold depression in the general population. Psychol Med 2023; 53:3611-3620. [PMID: 35156595 PMCID: PMC10277767 DOI: 10.1017/s0033291722000241] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/10/2022] [Accepted: 01/17/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Subthreshold depression could be a significant precursor to and a risk factor for major depression. However, reliable estimates of the prevalence and its contribution to developing major depression under different terminologies depicting subthreshold depression have to be established. METHODS By searching PubMed and Web of Science using predefined inclusion criteria, we included 1 129 969 individuals from 113 studies conducted. The prevalence estimates were calculated using the random effect model. The incidence risk ratio (IRR) was estimated by measuring the ratio of individuals with subthreshold depression who developed major depression compared to that of non-depressed individuals from 19 studies (88, 882 individuals). RESULTS No significant difference in the prevalence among the different terminologies depicting subthreshold depression (Q = 1.96, p = 0.5801) was found. By pooling the prevalence estimates of subthreshold depression in 113 studies, we obtained a summary prevalence of 11.02% [95% confidence interval (CI) 9.78-12.33%]. The youth group had the highest prevalence (14.17%, 95% CI 8.82-20.55%), followed by the elderly group (12.95%, 95% CI 11.41-14.58%) and the adult group (8.92%, 95% CI 7.51-10.45%). Further analysis of 19 studies' incidence rates showed individuals with subthreshold depression had an increased risk of developing major depression (IRR = 2.95, 95% CI 2.33-3.73), and the term minor depression showed the highest IRR compared with other terms (IRR = 3.97, 95% CI 3.17-4.96). CONCLUSIONS Depression could be a spectrum disorder, with subthreshold depression being a significant precursor to and a risk factor for major depression. Proactive management of subthreshold depression could be effective for managing the increasing prevalence of major depression.
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Affiliation(s)
- Ruibin Zhang
- Laboratory of Cognitive Control and Brain Healthy, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | | | - Xiaoqi Song
- Laboratory of Cognitive Control and Brain Healthy, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Jixin Long
- Laboratory of Cognitive Control and Brain Healthy, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Chanyu Wang
- Laboratory of Cognitive Control and Brain Healthy, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Chichen Zhang
- School of Management, Southern Medical University, Guangzhou, China
| | - Ruiwang Huang
- School of Psychology, South China Normal University, Guangzhou, China
| | - Tatia M. C. Lee
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, SAR China
- Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong, SAR China
- Center for Brain Science and Brain-Inspired Intelligence, Guangdong-Hong Kong-Macao Greater Bay Area, Guangzhou, China
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27
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Chan LLY, Brodie MA, Lord SR. Prediction of Incident Depression in Middle-aged and Older Adults Using Digital Gait Biomarkers Extracted From Large-Scale Wrist Sensor Data. J Am Med Dir Assoc 2023:S1525-8610(23)00399-7. [PMID: 37236263 DOI: 10.1016/j.jamda.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/26/2023] [Accepted: 04/08/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVES To determine if digital gait biomarkers captured by a wrist-worn device can predict the incidence of depressive episodes in middle-age and older people. DESIGN Longitudinal cohort study. SETTING AND PARTICIPANTS A total of 72,359 participants recruited in the United Kingdom. METHODS Participants were assessed at baseline on gait quantity, speed, intensity, quality, walk length distribution, and walk-related arm movement proportions using wrist-worn accelerometers for up to 7 days. Univariable and multivariable Cox proportional-hazard regression models were used to analyze the associations between these parameters and diagnosed incident depressive episodes for up to 9 years. RESULTS A total of 1332 participants (1.8%) had incident depressive episodes over a mean of 7.4 ± 1.1 years. All gait variables, except some walk-related arm movement proportions, were significantly associated with the incidence of depressive episodes (P < .05). After adjusting for sociodemographic, lifestyle, and comorbidity covariates; daily running duration, steps per day, and step regularity were identified as independent and significant predictors (P < .001). These associations held consistent in subgroup analysis of older people and individuals with serious medical conditions. CONCLUSIONS AND IMPLICATIONS The study findings indicate digital gait quality and quantity biomarkers derived from wrist-worn sensors are important predictors of incident depression in middle-aged and older people. These gait biomarkers may facilitate screening programs for at-risk individuals and the early implementation of preventive measures.
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Affiliation(s)
- Lloyd L Y Chan
- Neuroscience Research Australia, University of New South Wales, Sydney, Australia; School of Population Health, University of New South Wales, Sydney, Australia
| | - Matthew A Brodie
- Neuroscience Research Australia, University of New South Wales, Sydney, Australia; Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia
| | - Stephen R Lord
- Neuroscience Research Australia, University of New South Wales, Sydney, Australia; School of Population Health, University of New South Wales, Sydney, Australia.
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28
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Liao DD, Dong M, Ding KR, Hou CL, Tan WY, Ke YF, Jia FJ, Wang SB. Prevalence and patterns of major depressive disorder and subthreshold depressive symptoms in south China. J Affect Disord 2023; 329:131-140. [PMID: 36828143 DOI: 10.1016/j.jad.2023.02.069] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/09/2023] [Accepted: 02/15/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Information on major depressive disorder (MDD) and subthreshold depressive symptoms (SDS) is rarely reported in south China. This study examines the prevalence rates and patterns of MDD and SDS of a large representative sample of adult residents in south China. METHODS The Guangdong Mental Health Survey was conducted on adults (over 18 years) from September to December 2021. Multistage stratified cluster sampling was used and face-to-face interviews were done with a two-stage design by trained lay interviewers and psychiatrists. A total of 16,377 inhabitants were interviewed using standardized assessment tools. Data were weighted to adjust for differential probabilities of selection and differential response. RESULTS The weighted prevalence rates of MDD and SDS were 2.5 % (95%CI: 2.2 %-2.9 %) and 14.7 % (95%CI: 14.0 %-15.5 %), respectively. Multinomial logistic regression analysis revealed that female, younger age, living in urban area, higher education, unmarried, irregular meal pattern, lack of physical exercise, chronic diseases, irregular napping pattern and short sleep were positively associated with SDS. Besides, female, younger age, unmarried, irregular meal pattern, lack of physical exercise, chronic diseases, short sleep and poor mental health were positively associated with MDD. LIMITATIONS The cross-sectional nature of the study limited causal inferences. CONCLUSIONS The prevalence of MDD in Guangdong province in 2021 is higher than in mainland China in 2013. Given the higher prevalence of SDS, and high burden of depression, it also offers valuable opportunities for policymakers and health-care professionals to explore the factors affecting mental health in Guangdong province, especially during the COVID-19 epidemic.
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Affiliation(s)
- Dan-Dan Liao
- Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, China; Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China
| | - Min Dong
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China
| | - Kai-Rong Ding
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China; Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Cai-Lan Hou
- Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, China; Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China; Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Wen-Yan Tan
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China
| | - Yun-Fei Ke
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China
| | - Fu-Jun Jia
- Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, China; Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China; Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong Province, China.
| | - Shi-Bin Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China.
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29
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Martin-Romero N, Sanchez-Lopez A. Negative interpretation bias as a clinical marker and a scar of depression: New insights from a large-scale study of the scrambled sentence task in formerly, subclinically and clinically depressed individuals. Behav Res Ther 2023; 163:104276. [PMID: 36821874 DOI: 10.1016/j.brat.2023.104276] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/25/2022] [Accepted: 02/12/2023] [Indexed: 02/15/2023]
Abstract
Negative interpretation biases are thought to be clinical markers of depression and risk factors for its recurrence that would remain active after remission. Evidence on the conditions under which negative interpretation biases are active after remission is still unclear, and further studies are required to clarify whether negative interpretation biases are equivalent in magnitude at different depression conditions. A large-scale study of the Scrambled Sentence Task (SST) was conducted (639 participants), where different depression and never-depressed samples were compared in their performance in the SST through three experiments (i.e., formerly - Studies 1 and 2 -, subclinically - Study 2 - and clinically depressed individuals - Study 3 -). Cognitive load manipulations were used while completing the task. Formerly compared to never-depressed individuals showed higher negative interpretation biases at conditions of cognitive load only (Study 1). Formerly and subclinically depressed showed equivalent biases compared to never-depressed individuals (Study 2). Negative interpretation biases were further supported for clinically depressed (Study 3). Comparative analyses showed that both formerly and subclinically differed from clinically depressed individuals in their negative bias magnitude. These results prove the utility of the SST to detect negative interpretation biases in different depression conditions, including those recovered from depression. Results further show that negative bias magnitudes tend to decrease after remission but remain at subclinical levels, potentially conferring risk for depression recurrence.
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Affiliation(s)
- Nuria Martin-Romero
- Department of Clinical Psychology, Complutense University of Madrid, Spain; Department of Educational Sciences, University of Alcala, Spain.
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30
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Associations of stressful life events with subthreshold depressive symptoms and major depressive disorder: The moderating role of gender. J Affect Disord 2023; 325:588-595. [PMID: 36657495 DOI: 10.1016/j.jad.2023.01.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 12/27/2022] [Accepted: 01/11/2023] [Indexed: 01/18/2023]
Abstract
BACKGROUND Stressful life events (SLEs) are high-risk factors for subthreshold depressive symptoms (SDS) and major depressive disorder (MDD). This study sought to assess the association of SLEs with SDS and MDD, with a focus on gender effects. METHODS A total of 4132 participants were recruited from 34 primary health care settings. The Stressful Life Events Screening Questionnaire (SLESQ) was used to measure SLEs that participants had experienced in the past time. The Patient Health Questionnaire 9 (PHQ-9) was used to assess SDS, and the Mini-International Neuropsychiatry Interview (MINI) depression module was used to assess the diagnosis of MDD by trained psychiatrists. RESULTS In our sample (N = 4132), exposure to any SLEs was more common in individuals with SDS and MDD than in non-depressed population, and the proportion of emotional abuse was relatively high (SDS: 10.6 %; MDD: 33.9 %). After adjusting for control variables, people who experienced SLEs were at a higher risk of SDS and MDD. For males, those experiencing only one event were not at a higher risk of SDS (P = 0.061). For individuals who had experienced multiple SLEs, the association between SLEs and SDS was stronger in females than males. However, the association between SLEs and MDD was stronger in males than females. LIMITATIONS The cross-sectional study design and self-reported SLEs. CONCLUSIONS SLEs were associated with the increased risks of SDS and MDD. The associations of SLEs with SDS were more robust for females than males. In contrast, the association between SLEs and MDD was stronger in males than females.
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lv Q, Li X, Zhang Y, Lu D, Lu J, Xie Q, Li H, Wu Y, Wang C, Yi Z. Sex differences in subjective cognitive impairment and clinical correlates in Chinese patients with subthreshold depression. Biol Sex Differ 2023; 14:6. [PMID: 36782299 PMCID: PMC9926784 DOI: 10.1186/s13293-023-00488-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 01/23/2023] [Indexed: 02/15/2023] Open
Abstract
OBJECTIVE Subthreshold depression (SD) is a global mental health problem given its high prevalence, comorbidity, functional impairment, and its association with increased service utilization. However, currently little is known about sex differences of SD in cognitive impairment with clinical correlates. This study aims to explore sex differences in subjective cognitive impairment and clinically associated risk factors in Chinese patients with subthreshold depression (SD). METHODS A total of 126 patients with SD, 40 males and 86 females, aged 18-45 years, were included in this cross-sectional observational study. Their general information, psychological assessments, and psychiatric symptom assessments were collected online. The Patient Health Questionnaire depression-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Perceived Deficits Questionnaire-Depression (PDQ-D), and Toronto Alexithymia Scale (TAS-20) with 3 subdomains were used. The obtained scores were analyzed with partial correlation and multiple linear regression analysis models. RESULTS Our results showed that females had significantly higher PDQ-D-20 total score than males. However, the differences in TAS-20 and subdomain score according to sex were not significant. Notably, TAS-20 and DDF (difficulty describing feelings) subdomain contributed to cognitive impairment in males, whereas both PHQ-9 total score and TAS-20 or DDF subdomain contributed to cognitive impairment in females. CONCLUSION These findings revealed significant sex differences in cognitive impairment and clinical correlates in SD, which should be further followed-up in the future.
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Affiliation(s)
- Qinyu lv
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030 China ,grid.8547.e0000 0001 0125 2443Institute of Mental Health, Fudan University, Shanghai, 200040 China ,grid.8547.e0000 0001 0125 2443Department of Psychiatry, Huashan Hospital, School of Medicine, Fudan University, No. 12 Wulumuqi Road (Middle), Shanghai, 200040 People’s Republic of China
| | - Xin Li
- grid.8547.e0000 0001 0125 2443Department of Psychiatry, Huashan Hospital, School of Medicine, Fudan University, No. 12 Wulumuqi Road (Middle), Shanghai, 200040 People’s Republic of China
| | - Yao Zhang
- grid.8547.e0000 0001 0125 2443Department of Psychiatry, Huashan Hospital, School of Medicine, Fudan University, No. 12 Wulumuqi Road (Middle), Shanghai, 200040 People’s Republic of China
| | - Daofeng Lu
- grid.8547.e0000 0001 0125 2443Department of Psychiatry, Huashan Hospital, School of Medicine, Fudan University, No. 12 Wulumuqi Road (Middle), Shanghai, 200040 People’s Republic of China
| | - Jiajing Lu
- grid.8547.e0000 0001 0125 2443Department of Psychiatry, Huashan Hospital, School of Medicine, Fudan University, No. 12 Wulumuqi Road (Middle), Shanghai, 200040 People’s Republic of China
| | - Qingfang Xie
- Shanghai Baoshan Mental Health Center, Shanghai, 201900 China
| | - Hong Li
- Shanghai Baoshan Mental Health Center, Shanghai, 201900 China
| | - Yiming Wu
- Shanghai Yangpu Mental Health Center, Shanghai, 200093 China
| | - Chongze Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China.
| | - Zhenghui Yi
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China. .,Institute of Mental Health, Fudan University, Shanghai, 200040, China. .,Department of Psychiatry, Huashan Hospital, School of Medicine, Fudan University, No. 12 Wulumuqi Road (Middle), Shanghai, 200040, People's Republic of China.
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Takagaki K, Yokoyama S. Factors Associated with University Students' Deterioration from Subthreshold Depression to Depression before and during the COVID-19 Pandemic. Behav Sci (Basel) 2023; 13:bs13010072. [PMID: 36661644 PMCID: PMC9854505 DOI: 10.3390/bs13010072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/23/2022] [Accepted: 01/10/2023] [Indexed: 01/18/2023] Open
Abstract
COVID-19 has exposed university students to high-stress situations, and the percentage of individuals with depressive symptoms was high during the COVID-19 pandemic. Furthermore, subthreshold depression carries a risk for the subsequent development of major depressive disorder (MDD). During the COVID-19 pandemic, we examined whether differences exist between university students who deteriorated from subthreshold depression to MDD and those who remained stable or improved. Four hundred seventeen participants completed all the measures twice over a one-year interval. One hundred twenty-three participants met the criteria for subthreshold depression at Time 1. One year later, 42 participants no longer met the criteria for subthreshold depression, 68 participants maintained the criteria for subthreshold depression, and 13 participants met the criteria for MDD. We conducted two-way repeated measures ANOVA to examine the differences between those who deteriorated from subthreshold depression to MDD and those who did not. The study results suggest that avoidance behavior is associated with the development of MDD from subthreshold depression. Additionally, the study showed that experiencing isolation relates to MDD onset. Therefore, we should monitor avoidance behavior and isolation in pandemic conditions. Consequently, attention to avoidance behavior and isolation may be important; however, further research is required.
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Affiliation(s)
- Koki Takagaki
- Health Service Center, Hiroshima University, Higashi-Hiroshima 739-8514, Japan
- Correspondence:
| | - Satoshi Yokoyama
- Department of Psychiatry and Neurosciences, Hiroshima University, Hiroshima 734-8551, Japan
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Berhe O, Höflich A, Moessnang C, Reichert M, Kremer T, Gan G, Ma R, Braun U, Reininghaus U, Ebner-Priemer U, Meyer-Lindenberg A, Tost H. Reduced Real-life Affective Well-being and Amygdala Habituation in Unmedicated Community Individuals at Risk for Depression and Anxiety. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:111-120. [PMID: 35760353 DOI: 10.1016/j.bpsc.2022.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/27/2022] [Accepted: 06/15/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Early identification of risk for depression and anxiety disorders is important for prevention, but real-life affective well-being and its biological underpinnings in the population remain understudied. Here, we combined methods from epidemiology, psychology, ecological momentary assessment, and functional magnetic resonance imaging to study real-life and neural affective functions in individuals with subclinical anxiety and depression from a population-based cohort of young adults. METHODS We examined psychological measures, real-life affective valence, functional magnetic resonance imaging amygdala habituation to negative affective stimuli, and the relevance of neural readouts for daily-life affective function in 132 non-help-seeking community individuals. We compared psychological and ecological momentary assessment measures of 61 unmedicated individuals at clinical risk for depression and anxiety (operationalized as subthreshold depression and anxiety symptoms or a former mood or anxiety disorder) with those of 48 nonrisk individuals and 23 persons with a mood or anxiety disorder. We studied risk-associated functional magnetic resonance imaging signals in subsamples with balanced sociodemographic and image quality parameters (26 nonrisk, 26 at-risk persons). RESULTS Compared with nonrisk persons, at-risk individuals showed significantly decreased real-life affective valence (p = .038), reduced amygdala habituation (familywise error-corrected p = .024, region of interest corrected), and an intermediate psychological risk profile. Amygdala habituation predicted real-life affective valence in control subjects but not in participants at risk (familywise error-corrected p = .005, region of interest corrected). CONCLUSIONS Our data suggest real-life and neural markers for affective alterations in unmedicated community individuals at risk for depression and anxiety and highlight the significance of amygdala habituation measures for the momentary affective experience in real-world environments.
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Affiliation(s)
- Oksana Berhe
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Anna Höflich
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Carolin Moessnang
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Markus Reichert
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Mental mHealth Lab, Department of Sport and Sport Science, Karlsruhe Institute of Technology, Karlsruhe, Germany; Department of eHealth and Sports Analytics, Ruhr-University Bochum, Bochum, Germany
| | - Thomas Kremer
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Gabriela Gan
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Ren Ma
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Urs Braun
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; ESRC Centre for Society and Mental Health, King's College London, London, United Kingdom
| | - Ulrich Ebner-Priemer
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Mental mHealth Lab, Department of Sport and Sport Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Heike Tost
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
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Li X, Zhang H, Han X, Guo L, Ceban F, Liao Y, Shi J, Wang W, Liu Y, Song W, Zhu D, Wang H, Li L, Fan B, Lu C, McIntyre RS. Predictive potential of somatic symptoms for the identification of subthreshold depression and major depressive disorder in primary care settings. Front Psychiatry 2023; 14:999047. [PMID: 36865073 PMCID: PMC9971499 DOI: 10.3389/fpsyt.2023.999047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 01/30/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND The presence of heterogenous somatic symptoms frequently obscures the recognition of depression in primary care. We aimed to explore the association between somatic symptoms and subthreshold depression (SD) and Major Depressive Disorder (MDD), as well as to determine the predictive potential of somatic symptoms in identifying SD and MDD in primary care. METHODS Data were derived from the Depression Cohort in China study (ChiCTR registry number: 1900022145). The Patient Health Questionnaire-9 (PHQ-9) was used to assess SD by trained general practitioners (GPs), and the Mini International Neuropsychiatric Interview depression module was used to diagnose MDD by professional psychiatrists. Somatic symptoms were assessed using the 28-item Somatic Symptoms Inventory (SSI). RESULTS In total of 4,139 participants aged 18-64 years recruited from 34 primary health care settings were included. The prevalence of all 28 somatic symptoms increased in a dose-dependent manner from non-depressed controls to SD, and to MDD (P for trend <0.001). Hierarchical clustering analysis grouped the 28 heterogeneous somatic symptoms into three clusters (Cluster 1: energy-related symptoms, Cluster 2: vegetative symptoms, and Cluster 3: muscle, joint, and central nervous symptoms). Following adjustment for potential confounders and the other two clusters of symptoms, per 1 increase of energy-related symptoms exhibited significant association with SD (OR = 1.24, 95% CI, 1.18-1.31) and MDD (OR = 1.50, 95% CI, 1.41-1.60) The predictive performance of energy-related symptoms in identifying individuals with SD (AUC = 0.715, 95% CI, 0.697-0.732) and MDD (AUC = 0.941, 95% CI, 0.926-0.963) was superior to the performance of total SSI and the other two clusters (P < 0.05). CONCLUSIONS Somatic symptoms were associated with the presence of SD and MDD. In addition, somatic symptoms, notably those related to energy, showed good predictive potential in identifying SD and MDD in primary care. The clinical implication of the present study is that GPs should consider the closely related somatic symptoms for early recognition for depression in practice.
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Affiliation(s)
- Xiuwen Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.,Department of Nutrition, Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Huimin Zhang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.,Department of Nutrition, Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China.,Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Xue Han
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.,Department of Nutrition, Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Felicia Ceban
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.,Brain and Cognition Discovery Foundation, Toronto, ON, Canada.,Braxia Health, Mississauga, ON, Canada
| | - Yuhua Liao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.,Department of Nutrition, Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China.,Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Jingman Shi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.,Department of Nutrition, Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.,Department of Nutrition, Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Yifeng Liu
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Weidong Song
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Dongjian Zhu
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Hongqiong Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.,Department of Nutrition, Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Lingjiang Li
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Beifang Fan
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.,Department of Nutrition, Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, China
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.,Brain and Cognition Discovery Foundation, Toronto, ON, Canada.,Braxia Health, Mississauga, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Pharmacology, University of Toronto, Toronto, ON, Canada
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Kong Z, Zhu X, Chang S, Bao Y, Ma Y, Yu W, Zhu R, Sun Q, Sun W, Deng J, Sun H. Somatic symptoms mediate the association between subclinical anxiety and depressive symptoms and its neuroimaging mechanisms. BMC Psychiatry 2022; 22:835. [PMID: 36581819 PMCID: PMC9798660 DOI: 10.1186/s12888-022-04488-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 12/20/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Subclinical anxiety, depressive and somatic symptoms appear closely related. However, it remains unclear whether somatic symptoms mediate the association between subclinical anxiety and depressive symptoms and what the underlying neuroimaging mechanisms are for the mediating effect. METHODS Data of healthy participants (n = 466) and participants in remission of major depressive disorder (n = 53) were obtained from the Human Connectome Project. The Achenbach Adult Self-Report was adopted to assess anxiety, depressive and somatic symptoms. All participants completed four runs of resting-state functional magnetic resonance imaging. Mediation analyses were utilized to explore the interactions among these symptoms and their neuroimaging mechanisms. RESULTS Somatic symptoms partially mediated the association between subclinical anxiety and depressive symptoms in healthy participants (anxiety→somatic→depression: effect: 0.2785, Boot 95% CI: 0.0958-0.3729; depression→somatic→anxiety: effect: 0.0753, Boot 95% CI: 0.0232-0.1314) and participants in remission of MDD (anxiety→somatic→depression: effect: 0.2948, Boot 95% CI: 0.0357-0.7382; depression→somatic→anxiety: effect: 0.0984, Boot 95% CI: 0.0007-0.2438). Resting-state functional connectivity (FC) between the right medial superior frontal gyrus and the left thalamus and somatic symptoms as chain mediators partially mediated the effect of subclinical depressive symptoms on subclinical anxiety symptoms in healthy participants (effect: 0.0020, Boot 95% CI: 0.0003-0.0043). The mean strength of common FCs of subclinical depressive and somatic symptoms, somatic symptoms, and the mean strength of common FCs of subclinical anxiety and somatic symptoms as chain mediators partially mediated the effect of subclinical depressive symptoms on subclinical anxiety symptoms in remission of MDD (effect: 0.0437, Boot 95% CI: 0.0024-0.1190). These common FCs mainly involved the insula, precentral gyri, postcentral gyri and cingulate gyri. Furthermore, FC between the triangular part of the left inferior frontal gyrus and the left postcentral gyrus was positively associated with subclinical anxiety, depressive and somatic symptoms in remission of MDD (FDR-corrected p < 0.01). CONCLUSIONS Somatic symptoms partially mediate the interaction between subclinical anxiety and depressive symptoms. FCs involving the right medial superior frontal gyrus, left thalamus, triangular part of left inferior frontal gyrus, bilateral insula, precentral gyri, postcentral gyri and cingulate gyri maybe underlie the mediating effect of somatic symptoms.
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Affiliation(s)
- Zhifei Kong
- grid.459847.30000 0004 1798 0615Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191 China
| | - Ximei Zhu
- grid.459847.30000 0004 1798 0615Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191 China
| | - Suhua Chang
- grid.459847.30000 0004 1798 0615Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191 China
| | - Yanping Bao
- grid.11135.370000 0001 2256 9319National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, 100191 China ,grid.11135.370000 0001 2256 9319School of Public Health, Peking University, Beijing, 100191 China
| | - Yundong Ma
- grid.459847.30000 0004 1798 0615Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191 China
| | - Wenwen Yu
- grid.459847.30000 0004 1798 0615Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191 China
| | - Ran Zhu
- grid.459847.30000 0004 1798 0615Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191 China
| | - Qiqing Sun
- grid.459847.30000 0004 1798 0615Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191 China
| | - Wei Sun
- grid.459847.30000 0004 1798 0615Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191 China
| | - Jiahui Deng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
| | - Hongqiang Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
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Gradone AM, Champion G, McGregor KM, Nocera JR, Barber SJ, Krishnamurthy LC, Dotson VM. Rostral anterior cingulate connectivity in older adults with subthreshold depressive symptoms: A preliminary study. AGING BRAIN 2022; 3:100059. [PMID: 36911261 PMCID: PMC9997166 DOI: 10.1016/j.nbas.2022.100059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 12/07/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Subthreshold depressive symptoms are highly prevalent among older adults and are associated with numerous health risks including cognitive decline and decreased physical health. One brain region central to neuroanatomical models of depressive disorders is the anterior cingulate cortex (ACC). The rostral portion of the ACC-comprised of the pregenual ACC and subgenual ACC-is implicated in emotion control and reward processing. The goal of the current study was to examine how functional connectivity in subregions of the rostral ACC relate to depressive symptoms, measured by the Beck Depression Inventory-Second Edition, in an ethnically diverse sample of 28 community-dwelling older adults. Based on meta-analyses of previous studies in primarily young adults with clinical depression, we hypothesized that greater depressive symptoms would be associated with primarily increased resting-state functional connectivity from both the subgenual ACC and pregenual ACC to default mode network regions and the dorsolateral PFC. We instead found that higher depressive symptoms were associated with lower functional connectivity of the ACC to the dorsolateral PFC and regions within the default mode network, including from the subgenual ACC to the dorsolateral PFC and anterior cingulate and from the pregenual ACC to the middle cingulate gyrus. This preliminary study highlights brain alterations at subthreshold levels of depressive symptoms in older adults, which could serve as targets for interventions.
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Affiliation(s)
- Andrew M. Gradone
- Department of Psychology, Georgia State University, Atlanta, GA, United States
| | - Gabriell Champion
- Department of Psychology, Georgia State University, Atlanta, GA, United States
- VA Rehabilitation Research & Development Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Health Care System, Decatur, GA, United States
| | - Keith M. McGregor
- VA Rehabilitation Research & Development Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Health Care System, Decatur, GA, United States
- Department of Neurology, Emory University, Atlanta, GA, United States
- Birmingham VA Geriatrics Research Education and Clinical Center, Birmingham, AL, United States
- University of Alabama –Birmingham, School of Health Professions, Department of Clinical and Diagnostic Sciences, Birmingham, United States
| | - Joe R. Nocera
- VA Rehabilitation Research & Development Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Health Care System, Decatur, GA, United States
- Department of Neurology, Emory University, Atlanta, GA, United States
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, United States
| | - Sarah J. Barber
- Department of Psychology, Georgia State University, Atlanta, GA, United States
- Gerontology Institute, Georgia State University, Atlanta, GA, United States
| | - Lisa C. Krishnamurthy
- VA Rehabilitation Research & Development Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Health Care System, Decatur, GA, United States
- Department of Physics & Astronomy, Georgia State University, Atlanta, GA, United States
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, United States
| | - Vonetta M. Dotson
- Department of Psychology, Georgia State University, Atlanta, GA, United States
- Gerontology Institute, Georgia State University, Atlanta, GA, United States
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37
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Cosentino L, Zidda F, Dukal H, Witt SH, De Filippis B, Flor H. Low levels of Methyl-CpG binding protein 2 are accompanied by an increased vulnerability to the negative outcomes of stress exposure during childhood in healthy women. Transl Psychiatry 2022; 12:506. [PMID: 36481643 PMCID: PMC9731965 DOI: 10.1038/s41398-022-02259-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 12/13/2022] Open
Abstract
Numerous mental illnesses arise following stressful events in vulnerable individuals, with females being generally more affected than males. Adverse childhood experiences are known to increase the risk of developing psychopathologies and DNA methylation was demonstrated to drive the long-lasting effects of early life stress and promote stress susceptibility. Methyl-CpG binding protein 2 (MECP2), an X-linked reader of the DNA methylome, is altered in many mental disorders of stress origin, suggesting MECP2 as a marker of stress susceptibility; previous works also suggest a link between MECP2 and early stress experiences. The present work explored whether a reduced expression of MECP2 is paralleled by an increased vulnerability to the negative outcomes of stress exposure during childhood. To this aim, blood MECP2 mRNA levels were analyzed in 63 people without history of mental disorders and traits pertaining to depressive and anxiety symptom clusters were assessed as proxies of the vulnerability to develop stress-related disorders; stress exposure during childhood was also evaluated. Using structural equation modeling, we demonstrate that reduced MECP2 expression is accompanied by symptoms of anxiety/depression in association with exposure to stress in early life, selectively in healthy women. These results suggest a gender-specific involvement of MECP2 in the maladaptive outcomes of childhood adversities, and shed new light on the complex biology underlying gender bias in stress susceptibility.
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Affiliation(s)
- Livia Cosentino
- grid.416651.10000 0000 9120 6856Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Roma, Italy ,grid.7700.00000 0001 2190 4373Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Francesca Zidda
- grid.7700.00000 0001 2190 4373Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Helene Dukal
- grid.7700.00000 0001 2190 4373Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stephanie H. Witt
- grid.7700.00000 0001 2190 4373Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Bianca De Filippis
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Roma, Italy.
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
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Han X, Li J, Yang Y, Liu J, Zhang J, Han X, Reyila A, Liu Z, Ge P. Efficacy of psychotherapy in subthreshold depression patients: A protocol for an overview of systematic reviews and meta-analyses. Front Public Health 2022; 10:1017907. [PMID: 36568778 PMCID: PMC9768364 DOI: 10.3389/fpubh.2022.1017907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
Background Subthreshold depression is a risk factor for major depression. Psychotherapy is a kind of intervention for subthreshold depression. There have been many systematic reviews synthesized the evidence for its effectiveness toward subthreshold depression. However, there is currently no overview of these systematic reviews. Objective To undertake an overview of meta-analyses and systematic reviews to identify the efficacy of psychotherapy in subthreshold depression patients. Methods We will search several databases such as PubMed, Embase, the Cochrane Library, Web of Science, PsycINFO, CNKI, WanFang and VIP database, for systematic reviews and meta-analyses on psychotherapy in subthreshold depression patients. The search timeline will be from inception up to August 2022. Two researchers will screen related studies back-to-back. We will include studies that evaluate the efficacy of psychotherapy in subthreshold depression patients. We will evaluate the methodological quality, the reporting quality and the quality of evidence for outcomes by AMSTAR-2, the PRISMA 2020 checklist and the GRADE grading system. We will present the results of the overview in alignment with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The anticipated start and completion dates for this overview are 1 August 2022 and 30 December 2022, respectively. Results From this study, we will evaluate the methodological quality and the level of evidence of the included systematic reviews and meta-analyses, and evaluate the efficacy of psychotherapy in patients with subthreshold depression. Implications We will ascertain the efficacy of psychotherapy in subthreshold depression patients, to provide evidence to guide the treatment of subthreshold depression in the future. Registration number Our research protocol has been registered with PROSPERO. The registration number of the protocol is CRD42021278871.
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Affiliation(s)
- Xu Han
- School of Marxism, Liaoning University, Shenyang, China
| | - Jiaxin Li
- Department of Psychology, Renmin University of China, Beijing, China
| | - Yajie Yang
- School of Nursing, Peking University, Beijing, China
| | - Jiaxin Liu
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Jinzi Zhang
- School of Humanities and Social Sciences, Harbin Medical University, Harbin, China
| | - Xiao Han
- Department of Pharmacy, The Fifth Affiliated Hospital of Sun Yat-sat University, Zhuhai, China
| | | | - Zhizhong Liu
- School of Finance and Trade, Liaoning University, Shenyang, China,*Correspondence: Zhizhong Liu
| | - Pu Ge
- Institute of Chinese Medical Sciences, University of Macau, Macao, Macao SAR, China,Pu Ge
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Sakata M, Toyomoto R, Yoshida K, Luo Y, Nakagami Y, Uwatoko T, Shimamoto T, Tajika A, Suga H, Ito H, Sumi M, Muto T, Ito M, Ichikawa H, Ikegawa M, Shiraishi N, Watanabe T, Sahker E, Ogawa Y, Hollon SD, Collins LM, Watkins ER, Wason J, Noma H, Horikoshi M, Iwami T, Furukawa TA. Components of smartphone cognitive-behavioural therapy for subthreshold depression among 1093 university students: a factorial trial. EVIDENCE-BASED MENTAL HEALTH 2022; 25:e18-e25. [PMID: 35577537 PMCID: PMC9811098 DOI: 10.1136/ebmental-2022-300455] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 03/23/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Internet-based cognitive-behavioural therapy (iCBT) is effective for subthreshold depression. However, which skills provided in iCBT packages are more effective than others is unclear. Such knowledge can inform construction of more effective and efficient iCBT programmes. OBJECTIVE To examine the efficacy of five components of iCBT for subthreshold depression. METHODS We conducted an factorial trial using a smartphone app, randomly allocating presence or absence of five iCBT skills including self-monitoring, behavioural activation (BA), cognitive restructuring (CR), assertiveness training (AT) and problem-solving. Participants were university students with subthreshold depression. The primary outcome was the change on the Patient Health Questionnaire-9 (PHQ-9) from baseline to week 8. Secondary outcomes included changes in CBT skills. FINDINGS We randomised a total of 1093 participants. In all groups, participants had a significant PHQ-9 reduction from baseline to week 8. Depression reduction was not significantly different between presence or absence of any component, with corresponding standardised mean differences (negative values indicate specific efficacy in favour of the component) ranging between -0.04 (95% CI -0.16 to 0.08) for BA and 0.06 (95% CI -0.06 to 0.18) for AT. Specific CBT skill improvements were noted for CR and AT but not for the others. CONCLUSIONS There was significant reduction in depression for all participants regardless of the presence and absence of the examined iCBT components. CLINICAL IMPLICATION We cannot yet make evidence-based recommendations for specific iCBT components. We suggest that future iCBT optimisation research should scrutinise the amount and structure of components to examine. TRIAL REGISTRATION NUMBER UMINCTR-000031307.
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Affiliation(s)
- Masatsugu Sakata
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Rie Toyomoto
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Kazufumi Yoshida
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Yan Luo
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | | | - Teruhisa Uwatoko
- Department of Psychiatry, Kyoto University Hospital, Kyoto, Japan
| | | | - Aran Tajika
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | | | - Hiroshi Ito
- Ritsumeikan Medical Service Center, Kyoto, Japan
| | | | - Takashi Muto
- Faculty of Psychology, Doshisha University, Kyoto, Japan
| | - Masataka Ito
- Department of Life Design, Biwako Gakuin University, Higashiomi, Japan
| | - Hiroshi Ichikawa
- Department of Medical Life Systems, Doshisha University, Kyoto, Japan
| | - Masaya Ikegawa
- Department of Medical Life Systems, Doshisha University, Kyoto, Japan
| | - Nao Shiraishi
- Department of Psychitary and Cognitive-Behavioral Medicine, Nagoya City University, Nagoya, Japan
| | - Takafumi Watanabe
- Department of Psychitary and Cognitive-Behavioral Medicine, Nagoya City University, Nagoya, Japan
| | - Ethan Sahker
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
- Population Health and Policy Research Unit, Medical Education Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yusuke Ogawa
- Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto, Japan
| | - Steven D Hollon
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Linda M Collins
- Department of Scoial and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, USA
| | | | - James Wason
- Population Health Scineces Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Hisashi Noma
- Institute of Statistical Mathematics, Tachikawa, Tokyo, Japan
| | - Masaru Horikoshi
- National Center of Neurology and psychiatry/National Center for Cognitive Behavior Therapy and Research, Kodaira, Tokyo, Japan
| | - Taku Iwami
- Kyoto University Health Service, Kyoto, Japan
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
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Liao Y, Zhang H, Guo L, Fan B, Wang W, Teopiz KM, Lui LMW, Lee Y, Li L, Han X, Lu C, McIntyre RS. Impact of cognitive-affective and somatic symptoms in subthreshold depression transition in adults: Evidence from Depression Cohort in China (DCC). J Affect Disord 2022; 315:274-281. [PMID: 35952931 DOI: 10.1016/j.jad.2022.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Symptoms of subthreshold depression may differentially affect the illness transition. We examined the impact of cognitive-affective and somatic symptoms on different subthreshold depression transitions as well as risk factors influencing the aforementioned symptoms changes. METHODS Adults with subthreshold depression in the Depression Cohort in China were enrolled. Data collection was conducted at baseline, 6 and 12 months from 2019 to 2020. Cognitive-affective and somatic symptoms were assessed using the Patient Health Questionnaire-9. A total of 993 participants completed 12-month follow-up and were divided into persistent, intermittent and remission groups according to change in depressive symptoms. The longitudinal change of cognitive-affective and somatic symptoms in the three groups, as well as risk factors was analyzed using the generalized linear mixed-model. RESULTS There were 24.07 %, 34.04 % and 41.89 % of participants proceeding into persistent, intermittent and remission subthreshold depression groups, respectively. Cognitive-affective symptoms were the core symptoms for predicting the deterioration in persistent subthreshold depression (t = 2.48, P = 0.013), whereas somatic symptoms improved over time (t = -2.82, P = 0.005). Anxiety symptoms were the primary risk factors for worsening cognitive-affective symptoms (P < 0.001), following by insomnia symptoms, age, marital status, resilience and social functions. Somatic symptoms were affected by insomnia symptoms, anxiety symptoms and Body Mass Index successively. LIMITATIONS Major Depressive Episode was not explored in follow-up. CONCLUSION Cognitive-affective symptoms in subthreshold depression are at greater risk of illness deterioration. Future studies should endeavor to identify specific risk factors in different symptoms to forestall the transition from subthreshold to Major Depressive Disorder.
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Affiliation(s)
- Yuhua Liao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China; Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, People's Republic of China
| | - Huimin Zhang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China; Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, People's Republic of China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Beifang Fan
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, People's Republic of China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Kayla M Teopiz
- Mood Disorder Psychopharmacology Unit, University Health Network; University of Toronto, Toronto, ON, Canada
| | - Leanna M W Lui
- Mood Disorder Psychopharmacology Unit, University Health Network; University of Toronto, Toronto, ON, Canada
| | - Yena Lee
- Mood Disorder Psychopharmacology Unit, University Health Network; University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - LingJiang Li
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Xue Han
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, People's Republic of China.
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.
| | - Roger S McIntyre
- Mood Disorder Psychopharmacology Unit, University Health Network; University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada
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Ma H, Zhang D, Sun D, Wang H, Yang J. Gray and white matter structural examination for diagnosis of major depressive disorder and subthreshold depression in adolescents and young adults: a preliminary radiomics analysis. BMC Med Imaging 2022; 22:164. [PMID: 36096776 PMCID: PMC9465920 DOI: 10.1186/s12880-022-00892-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 09/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Radiomics is an emerging image analysis framework that provides more details than conventional methods. In present study, we aimed to identify structural radiomics features of gray matter (GM) and white matter (WM), and to develop and validate the classification model for major depressive disorder (MDD) and subthreshold depression (StD) diagnosis using radiomics analysis. METHODS A consecutive cohort of 142 adolescents and young adults, including 43 cases with MDD, 49 cases with StD and 50 healthy controls (HC), were recruited and underwent the three-dimensional T1 weighted imaging (3D-T1WI) and diffusion tensor imaging (DTI). We extracted radiomics features representing the shape and diffusion properties of GM and WM from all participants. Then, an all-relevant feature selection process embedded in a 10-fold cross-validation framework was used to identify features with significant power for discrimination. Random forest classifiers (RFC) were established and evaluated successively using identified features. RESULTS The results showed that a total of 3030 features were extracted after preprocessing, including 2262 shape-related features from each T1-weighted image representing GM morphometry and 768 features from each DTI representing the diffusion properties of WM. 25 features were selected ultimately, including ten features for MDD versus HC, eight features for StD versus HC, and seven features for MDD versus StD. The accuracies and area under curve (AUC) the RFC achieved were 86.75%, 0.93 for distinguishing MDD from HC with significant radiomics features located in the left medial orbitofrontal cortex, right superior and middle temporal regions, right anterior cingulate, left cuneus and hippocampus, 70.51%, 0.69 for discriminating StD from HC within left cuneus, medial orbitofrontal cortex, cerebellar vermis, hippocampus, anterior cingulate and amygdala, right superior and middle temporal regions, and 59.15%, 0.66 for differentiating MDD from StD within left medial orbitofrontal cortex, middle temporal and cuneus, right superior frontal, superior temporal regions and hippocampus, anterior cingulate, respectively. CONCLUSION These findings provide preliminary evidence that radiomics features of brain structure are valid for discriminating MDD and StD subjects from healthy controls. The MRI-based radiomics approach, with further improvement and validation, might be a potential facilitating method to clinical diagnosis of MDD or StD.
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Affiliation(s)
- Huan Ma
- Department of Radiology, The Third Affiliated Hospital of Kunming Medical University, Kunming, 650018, China
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, 374# DianMian Road, 650101, Kunming, China
| | - Dafu Zhang
- Department of Radiology, The Third Affiliated Hospital of Kunming Medical University, Kunming, 650018, China
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, 650018, Kunming, China
| | - Dewei Sun
- Department of Radiology, The Third Affiliated Hospital of Kunming Medical University, Kunming, 650018, China
| | - Hongbo Wang
- Department of Radiology, The Third Affiliated Hospital of Kunming Medical University, Kunming, 650018, China
| | - Jianzhong Yang
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, 374# DianMian Road, 650101, Kunming, China.
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Belvederi Murri M, Cattelani L, Chesani F, Palumbo P, Triolo F, Alexopoulos GS. Risk Prediction Models for Depression in Community-Dwelling Older Adults. Am J Geriatr Psychiatry 2022; 30:949-960. [PMID: 35821215 DOI: 10.1016/j.jagp.2022.05.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To develop streamlined Risk Prediction Models (Manto RPMs) for late-life depression. DESIGN Prospective study. SETTING The Survey of Health, Ageing and Retirement in Europe (SHARE) study. PARTICIPANTS Participants were community residing adults aged 55 years or older. MEASUREMENTS The outcome was presence of depression at a 2-year follow up evaluation. Risk factors were identified after a literature review of longitudinal studies. Separate RPMs were developed in the 29,116 participants who were not depressed at baseline and in the combined sample of 39,439 of non-depressed and depressed subjects. Models derived from the combined sample were used to develop a web-based risk calculator. RESULTS The authors identified 129 predictors of late-life depression after reviewing 227 studies. In non-depressed participants at baseline, the RPMs based on regression and Least Absolute Shrinkage and Selection Operator (LASSO) penalty (34 and 58 predictors, respectively) and the RPM based on Artificial Neural Networks (124 predictors) had a similar performance (AUC: 0.730-0.743). In the combined depressed and non-depressed participants at baseline, the RPM based on neural networks (35 predictors; AUC: 0.807; 95% CI: 0.80-0.82) and the model based on linear regression and LASSO penalty (32 predictors; AUC: 0.81; 95% CI: 0.79-0.82) had satisfactory accuracy. CONCLUSIONS The Manto RPMs can identify community-dwelling older individuals at risk for developing depression over 2 years. A web-based calculator based on the streamlined Manto model is freely available at https://manto.unife.it/ for use by individuals, clinicians, and policy makers and may be used to target prevention interventions at the individual and the population levels.
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Affiliation(s)
- Martino Belvederi Murri
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara (MBM), Ferrara, Italy
| | - Luca Cattelani
- Department of Computer Science and Engineering, University of Bologna (LC, FC), Bologna, Italy; Faculty of Medicine and Health Technologies, Tampere University (LC), Tampere, Finland; Institute of Biomedicine, University of Eastern Finland (LC), Kuopio, Finland
| | - Federico Chesani
- Department of Computer Science and Engineering, University of Bologna (LC, FC), Bologna, Italy
| | - Pierpaolo Palumbo
- Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi", University of Bologna (PP), Bologna, Italy
| | - Federico Triolo
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet (FT), Stockholm, Sweden
| | - George S Alexopoulos
- Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine (GA), White Plains, NY.
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Taylor AK, Palmer VJ, Davidson S, Fletcher S, Gunn J. Patient reported self-help strategies and the perceived benefits for managing sub-threshold depressive symptoms: A nested qualitative study of Australian primary care attendees. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2097-e2108. [PMID: 34766664 DOI: 10.1111/hsc.13646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/20/2021] [Accepted: 10/27/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Subthreshold depression is common in primary care, but there is little information about the self-help strategies that patients use and the perceived benefits of these. AIM This study sought to elicit the self-help strategies that primary care attendees identified as beneficial for the self-management of subthreshold depressive symptoms and the implications for general practitioners. METHOD Semi-structured telephone interviews were conducted with 14 people (April-May 2017) from the Target-D randomised controlled trial (RCT). Target-D investigated whether using a patient-centred clinical prediction tool and an e-health platform to match mental health management options to prognosis was beneficial for improving depressive symptoms at 3 months compared to usual care. Interviews were thematically analysed to identify self-help strategies and their perceived benefits. RESULTS Four overarching domains for the self-management strategies were identified: social, cognitive, behavioural and restorative. Interviewees reported using strategies across multiple domains, which included undertaking enjoyable, immersive activities, that provided relief from automatic negative thoughts and had a perceived cognitive benefit. Differences in the perceived sense of agency were noted around the self-regulation of mood, which indicated more explicit direction to patient-identified self-help management strategies by general practitioners for some may be of benefit in routine care. CONCLUSION Some of the reported self-management strategies aligned with evidence-based approaches such as physical activity and mindfulness for mental health symptom management. These findings can inform low-intensity interventions within stepped care models for mental health in primary care, social prescribing models and, help to guide the management of patients by GPs for subthreshold depression.
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Affiliation(s)
- Anna Kathryn Taylor
- School of Medicine, Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Victoria J Palmer
- The ALIVE National Centre for Mental Health Research Translation, The Department of General Practice, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
- The Department of General Practice, Melbourne Medical School, The Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sandra Davidson
- The Department of General Practice, Melbourne Medical School, The Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Susan Fletcher
- The Department of General Practice, Melbourne Medical School, The Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jane Gunn
- The ALIVE National Centre for Mental Health Research Translation, The Department of General Practice, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
- The Department of General Practice, Melbourne Medical School, The Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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O'Shields J, Patel D, Mowbray OP. Childhood maltreatment and inflammation: Leveraging structural equation modeling to test the social signal transduction theory of depression. J Affect Disord 2022; 311:173-180. [PMID: 35594973 DOI: 10.1016/j.jad.2022.05.077] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 05/03/2022] [Accepted: 05/15/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The experience of childhood maltreatment has long been understood to increase the risk for experiencing depressive symptoms and is often associated with an overall worse course of illness when these symptoms are elevated to a major depressive episode. Despite this, current treatments for depression continue to require a need for a greater understanding of the underlying mechanisms. METHOD We utilized structural equation modeling to test the effects of childhood maltreatment on inflammation and depressive symptoms. Inflammation was conceptualized as a latent variable, estimated by CRP, fibrinogen, IL-6, sICAM-1, sE-selectin, and TNF- α; whereas depressive symptoms were estimated using the subscales for the Center for Epidemiological Studies-Depression scale and childhood maltreatment was estimated using the subscales for the Childhood Trauma Questionnaire. RESULTS Multivariate results identified that childhood maltreatment had a significant positive relationship with inflammation as well as depressive symptoms, and inflammation had a significant positive relationship with depressive symptoms. Notably, childhood maltreatment also had a significant positive relationship with perceived stress over the last month and this perceived stress had a positive relationship with depressive symptoms; however perceived stress had no relationship with inflammation. LIMITATIONS Data from the present study is cross-sectional, requiring replication with longitudinal data. Some measures such as childhood maltreatment were measured by self-report and should be replicated with verified reports. CONCLUSIONS These results provide support for the Social Signal Transduction Theory of Depression, emphasizing the importance of the immune system and inflammation as a relevant mediator between early social treats and adulthood depressive symptoms.
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Affiliation(s)
- Jay O'Shields
- University of Georgia, School of Social Work, United States of America.
| | - Dipali Patel
- University of Georgia, School of Social Work, United States of America
| | - Orion P Mowbray
- University of Georgia, School of Social Work, United States of America
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Volz HP, Stirnweiß J, Kasper S, Möller HJ, Seifritz E. Subthreshold depression - concept, operationalisation and epidemiological data. A scoping review. Int J Psychiatry Clin Pract 2022; 27:92-106. [PMID: 35736807 DOI: 10.1080/13651501.2022.2087530] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Purpose: In diagnostic systems (e.g., DSM-5, ICD-10), depression is defined categorically. However, the concept of subthreshold depression (SD) has gained increasing interest in recent years. The purpose of the present paper was to review, based on a scoping review, the relevant papers in this field published between October 2011 and September 2020.Materials and methods: Of the 1,160 papers identified, 64 records could be included in further analysis. The scoping review was conducted using both electronic and manual methods.Results: The main result of the analysis is that the operationalisation criteria used are highly heterogeneous, which also leads to very heterogenous epidemiological data.Conclusions: Clear conclusions are not possible scrutinising the reported results. Most definitions seem to be arbitrary, with considerable overlap (e.g., between SD and minor depression). The review also revealed that the impact of SD on quality of life and related parameters appear to be in the range of the respective impact of major depression (MD) and therapeutic approaches might be helpful for SD and also for the prevention of conversion from SD to MD. Keeping the presented difficulties in mind, a proposal for the definition of SD is made in the present paper in order to facilitate the discussion leading to more homogeneous criteria.
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Affiliation(s)
- Hans-Peter Volz
- Hospital for Psychiatry, Psychotherapy und Psychosomatic Medicine Schloss Werneck, Werneck, Germany
| | - Johanna Stirnweiß
- Hospital for Psychiatry, Psychotherapy und Psychosomatic Medicine Schloss Werneck, Werneck, Germany
| | - Siegfried Kasper
- Center of Brain Research, Medical University of Vienna, Vienna, Austria
| | - Hans-Jürgen Möller
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy, and Psychosomatics. Psychiatric Hospital, University of Zürich, Zürich, Switzerland
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Wu Q, Feng J, Pan CW. Risk factors for depression in the elderly: An umbrella review of published meta-analyses and systematic reviews. J Affect Disord 2022; 307:37-45. [PMID: 35351490 DOI: 10.1016/j.jad.2022.03.062] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Depression has been identified as one of the leading causes of the disease burden worldwide. Identification of the potential factors that increased or decreased the risk of depression could be important to provide prevention strategies. We aimed to conduct an umbrella review of risk factors for depression in the elderly and assessed the credibility of evidence of the association between each factor and depression. METHODS We searched PubMed and Web of Science from 1990 to April 11, 2021 for articles investigating associations between potential factors and depression. For each association, we recalculated the summary effect size and 95% confidence intervals using random effects models. The 95% prediction interval and between-heterogeneity were also reported. For publication bias, small-study effect and excess of significance bias were assessed. RESULTS Twenty-five publications met the inclusion criteria, including twenty-two meta-analyses and three qualitative systematic reviews. Approximately 1,199,927 participants and 82 unique factors were reported. Two factors were rated as convincing evidence and four factors showed highly suggestive evidence. These risk factors were aspirin use, individuals aged 80 years and above, sleep disturbances and persistent sleep disturbances, hearing problem, poor vision, and cardiac disease. LIMITATIONS Most studies that we included were of low quality. CONCLUSIONS We found several risk factors for depression with different levels of evidence, in which aspirin use and individuals aged 80 years and above presented the strongest evidence. Further research is warranted to support other findings from this umbrella review using a large, well-designed cohort study.
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Affiliation(s)
- Qian Wu
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jian Feng
- Kunshan Mental Health Center, Suzhou, China.
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, Suzhou, China.
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Emotion regulation, negative self-evaluation, and social anxiety symptoms: The mediating role of depressive symptoms. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03225-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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48
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Zhang H, Liao Y, Han X, Fan B, Liu Y, Lui LMW, Lee Y, Subramaniapillai M, Li L, Guo L, Lu C, McIntyre RS. Screening Depressive Symptoms and Incident Major Depressive Disorder Among Chinese Community Residents Using a Mobile App-Based Integrated Mental Health Care Model: Cohort Study. J Med Internet Res 2022; 24:e30907. [PMID: 35594137 PMCID: PMC9166637 DOI: 10.2196/30907] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 02/18/2022] [Accepted: 03/30/2022] [Indexed: 02/06/2023] Open
Abstract
Background Depression is associated with significant morbidity and human capital costs globally. Early screening for depressive symptoms and timely depressive disorder case identification and intervention may improve health outcomes and cost-effectiveness among affected individuals. China’s public and academic communities have reached a consensus on the need to improve access to early screening, diagnosis, and treatment of depression. Objective This study aims to estimate the screening prevalence and associated factors of subthreshold depressive symptoms among Chinese residents enrolled in the cohort study using a mobile app–based integrated mental health care model and investigate the 12-month incidence rate and related factors of major depressive disorder (MDD) among those with subthreshold depressive symptoms. Methods Data were drawn from the Depression Cohort in China (DCC) study. A total of 4243 community residents aged 18 to 64 years living in Nanshan district, Shenzhen city, in Guangdong province, China, were encouraged to participate in the DCC study when visiting the participating primary health care centers, and 4066 (95.83%) residents who met the DCC study criteria were screened for subthreshold depressive symptoms using the Patient Health Questionnaire-9 at baseline. Of the 4066 screened residents, 3168 (77.91%) with subthreshold depressive symptoms were referred to hospitals to receive a psychiatric diagnosis of MDD within 12 months. Sleep duration, anxiety symptoms, well-being, insomnia symptoms, and resilience were also investigated. The diagnosis of MDD was provided by trained psychiatrists using the Mini-International Neuropsychiatric Interview. Univariate and multivariate logistic regression models were performed to explore the potential factors related to subthreshold depressive symptoms at baseline, and Cox proportional hazards models were performed to explore the potential factors related to incident MDD. Results Anxiety symptoms (adjusted odds ratio [AOR] 1.63, 95% CI 1.42-1.87) and insomnia symptoms (AOR 1.13, 95% CI 1.05-1.22) were associated with an increased risk of subthreshold depressive symptoms, whereas well-being (AOR 0.93, 95% CI 0.87-0.99) was negatively associated with depressive symptoms. During the follow-up period, the 12-month incidence rate of MDD among participants with subthreshold depressive symptoms was 5.97% (189/3168). After incorporating all significant variables from the univariate analyses, the multivariate Cox proportional hazards model reported that a history of comorbidities (adjusted hazard ratio [AHR] 1.49, 95% CI 1.04-2.14) and anxiety symptoms (AHR 1.13, 95% CI 1.09-1.17) were independently associated with an increased risk of incident MDD. The 5-item World Health Organization Well-Being Index was associated with a decreased risk of incident MDD (AHR 0.90, 95% CI 0.86-0.94). Conclusions Elevated anxiety symptoms and unfavorable general well-being were significantly associated with subthreshold depressive symptoms and incident MDD among Chinese residents in Shenzhen. Early screening for subthreshold depressive symptoms and related factors may be helpful for identifying populations at high risk of incident MDD.
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Affiliation(s)
- Huimin Zhang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Yuhua Liao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Xue Han
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Beifang Fan
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Yifeng Liu
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Leanna M W Lui
- Mood Disorders Psychopharmacology Unit, University Health Network, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit, University Health Network, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Mehala Subramaniapillai
- Mood Disorders Psychopharmacology Unit, University Health Network, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Lingjiang Li
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Department of Pharmacology, University of Toronto, Toronto, ON, Canada
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Langer ÁI, Crockett MA, Bravo-Contreras M, Carrillo-Naipayan C, Chaura-Marió M, Gómez-Curumilla B, Henríquez-Pacheco C, Vergara RC, Santander J, Antúnez Z, Baader T. Social and Economic Factors Associated With Subthreshold and Major Depressive Episode in University Students During the COVID-19 Pandemic. Front Public Health 2022; 10:893483. [PMID: 35664111 PMCID: PMC9157787 DOI: 10.3389/fpubh.2022.893483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/11/2022] [Indexed: 11/28/2022] Open
Abstract
Depression is one of the most frequent mental health disorders in college students and variations according to social and economic factors have been reported, however, whether social and economic variations also exist in subthreshold depression is still unknown, especially during the COVID-19 pandemic. The aim of this study was to estimate the prevalence of subthreshold depressive episode (SDE) and major depressive episode (MDE) and to examine the association between social and economic factors with SDE and MDE in undergraduate students during the COVID-19 pandemic. The participants were 1,577 college students from a university in the south of Chile (64.6% females, 22 years old on average). The participants took an online survey in November 2020 which collected information about social and economic variables, depressive symptoms, and perceived social support. Bivariate and multinomial logistic regression analysis were used. The results showed a high prevalence of SDE (14.3%) and MDE (32.3%) in the sample. Belonging to a social group and perceiving positive social support were the only variables examined that were associated with SDE. Instead, female sex, poorer quintiles, living with other relatives but not parents, economic difficulties due to the pandemic, being a parent, and perceiving positive social support were associated with MDE. Subthreshold and threshold depressive symptoms are frequent in college students, and associations with social and economic factors differ according to the level of such symptoms. These results should be considered in the development of tailored preventive and early interventions for depression in college students.
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Affiliation(s)
- Álvaro I. Langer
- Mind-Body Lab, Institute of Psychological Studies, Austral University, Valdivia, Chile,Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago, Chile,Millennium Institute for Research on Depression and Personality, MIDAP, Santiago, Chile,*Correspondence: Álvaro I. Langer
| | - Marcelo A. Crockett
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago, Chile,Millennium Institute for Research on Depression and Personality, MIDAP, Santiago, Chile,Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | | | | | - Matías Chaura-Marió
- Faculty of Medicine, School of Psychology, Austral University, Valdivia, Chile
| | | | | | - Rodrigo C. Vergara
- Departamento de Kinesiología, Facultad de Artes y Educación Física, Universidad Metropolitana de Ciencias de la Educación, Santiago, Chile,Centro Nacional de Inteligencia Artificial CENIA, Santiago, Chile
| | - Jorge Santander
- Faculty of Medicine, Institute of Clinical Neuroscience, Austral University, Valdivia, Chile
| | - Zayra Antúnez
- Faculty of Medicine, School of Psychology, Austral University, Valdivia, Chile,Faculty of Medicine, Institute of Psychological Studies, Austral University, Valdivia, Chile
| | - Tomas Baader
- Alianza Chilena Contra la Depresión y el Suicidio, Valdivia, Chile
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Dell'Acqua C, Dal Bò E, Moretta T, Palomba D, Messerotti Benvenuti S. EEG time-frequency analysis reveals blunted tendency to approach and increased processing of unpleasant stimuli in dysphoria. Sci Rep 2022; 12:8161. [PMID: 35581359 PMCID: PMC9113991 DOI: 10.1038/s41598-022-12263-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 05/06/2022] [Indexed: 12/02/2022] Open
Abstract
To date, affective and cognitive processing of emotional information in individuals with depressive symptoms have been examined through peripheral psychophysiological measures, event-related potentials, and time–frequency analysis of oscillatory activity. However, electrocortical correlates of emotional and cognitive processing of affective content in depression have not been fully understood. Time–frequency analysis of electroencephalographic activity allows disentangling the brain's parallel processing of information. The present study employed a time–frequency approach to simultaneously examine affective disposition and cognitive processing during the viewing of emotional stimuli in dysphoria. Time–frequency event-related changes were examined during the viewing of pleasant, neutral and unpleasant pictures in 24 individuals with dysphoria and 24 controls. Affective disposition was indexed by delta and alpha power, while theta power was employed as a correlate of cognitive elaboration of the stimuli. Cluster-based statistics revealed a centro-parietal reduction in delta power for pleasant stimuli in individuals with dysphoria relative to controls. Also, dysphoria was characterized by an early fronto-central increase in theta power for unpleasant stimuli relative to neutral and pleasant ones. Comparatively, controls were characterized by a late fronto-central and occipital reduction in theta power for unpleasant stimuli relative to neutral and pleasant. The present study granted novel insights on the interrelated facets of affective elaboration in dysphoria, mainly characterized by a hypoactivation of the approach-related motivational system and a sustained facilitated cognitive processing of unpleasant stimuli.
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Affiliation(s)
- Carola Dell'Acqua
- Department of General Psychology, University of Padua, Via Venezia 8, 35131, Padua, Italy. .,Padova Neuroscience Center (PNC), University of Padua, Via Orus 2/B, 35131, Padua, Italy.
| | - Elisa Dal Bò
- Department of General Psychology, University of Padua, Via Venezia 8, 35131, Padua, Italy.,Padova Neuroscience Center (PNC), University of Padua, Via Orus 2/B, 35131, Padua, Italy
| | - Tania Moretta
- Department of General Psychology, University of Padua, Via Venezia 8, 35131, Padua, Italy
| | - Daniela Palomba
- Department of General Psychology, University of Padua, Via Venezia 8, 35131, Padua, Italy.,Padova Neuroscience Center (PNC), University of Padua, Via Orus 2/B, 35131, Padua, Italy
| | - Simone Messerotti Benvenuti
- Department of General Psychology, University of Padua, Via Venezia 8, 35131, Padua, Italy.,Padova Neuroscience Center (PNC), University of Padua, Via Orus 2/B, 35131, Padua, Italy
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