Mediation model of comorbid anxiety disorders in late-life depression

Depression, anxiety, and insomnia symptoms among Chinese college students: A network analysis across pandemic stages

BACKGROUND

As the stages of the COVID-19 pandemic evolved, the symptoms of depression, anxiety, and insomnia have increasingly manifested among Chinese college students. The aim of this study is to investigate the relationships between these symptoms through network analysis among Chinese college students during COVID-19.

METHOD

A three-wave cross-sectional survey was conducted at 22 colleges in Guangdong Province, involving 381,152 students during three specific time intervals: T1 (baseline, February 3 to 10, 2020), T2 (19 months after baseline, June 10 to 18, 2021), and T3 (37 months after baseline, March 15 to April 22, 2023). Depression (PHQ-9), anxiety (GAD-7), and insomnia (YSIS) were used separately. We analyzed two key network indices: "Expected influence" and "Bridge expected influence". Network stability was assessed through a case-dropping bootstrap program.

RESULT

The effective sample sizes for the three periods were as follows: T1 - 164,101 (103,645 females, 63.2 %), T2 - 86,767 (52,146 females, 60.1 %), and T3 - 130,284 (76,720 females, 58.9 %). Across these three periods, the key central symptoms were "Fatigue" (PHQ4), "Restlessness" (GAD5), "Uncontrollable worrying" (GAD2), "Worry too much" (GAD3) and "Sleep insufficiency" (YSIS6). Notably, "Fatigue" (PHQ4), "Restlessness" (GAD5) and "Irritability" (GAD6) consistently served as bridge symptoms. In the T1 and T2 period, "Motor" (PHQ8) acted as a bridge symptom but weakened in T3.

CONCLUSION

Throughout the three periods, the mental health issues among Chinese college students displayed characteristics of somatization within the depression-anxiety-insomnia comorbidity network. Over time, anxiety symptoms appeared to become more prominent. Consequently, this study highlights the importance of accurately identifying and promptly intervening in these core symptoms of mental health among college students, as these symptoms may evolve across different stages of a pandemic.

A structural equation modeling approach using behavioral and neuroimaging markers in major depressive disorder

Major depressive disorder (MDD) has consistently proven to be a multifactorial and highly comorbid disease. Despite recent depression-related research demonstrating causalities between MDD-related factors and a small number of variables, including brain structural changes, a high-statistical power analysis of the various factors is yet to be conducted. We retrospectively analyzed data from 155 participants (84 healthy controls and 71 patients with MDD). We used magnetic resonance imaging and diffusion tensor imaging data, scales assessing childhood trauma, depression severity, cognitive dysfunction, impulsivity, and suicidal ideation. To simultaneously evaluate the causalities between multivariable, we implemented two types of MDD-specified structural equation models (SEM), the behavioral and neurobehavioral models. Behavioral SEM showed significant results in the MDD group: Comparative Fit Index [CFI] = 1.000, Root Mean Square Error of Approximation [RMSEA]) = 0.000), with a strong correlation in the scales for childhood trauma, depression severity, suicidal ideation, impulsivity, and cognitive dysfunction. Based on behavioral SEM, we established neurobehavioral models showing the best-fit in MDD, especially including the right cingulate cortex, central to the posterior corpus callosum, right putamen, pallidum, whole brainstem, and ventral diencephalon, including the thalamus (CFI >0.96, RMSEA <0.05). Our MDD-specific model revealed that the limbic-associated regions are strongly connected with childhood trauma rather than depression severity, and that they independently affect suicidal ideation and cognitive dysfunction. Furthermore, cognitive dysfunction could affect impulsivity.

Perceived stress and psychological disorders in healthcare professionals: a multiple chain mediating model of effort-reward imbalance and resilience

Background

Healthcare professionals have shown more psychological disorders such as anxiety and depression due to the nature of work, which can cause job burnout, decrease the quality of medical services, and even endanger medical safety. The aim of the study is to explore the serial multiple mediating role of effort- reward imbalance and resilience between perceived stress and psychological disorders among healthcare professionals.

Methods

A cross-sectional study was conducted in China from February to April 2023. A total of 2098 healthcare professionals at a tertiary general hospital was investigated by the following self-reported questionnaires: Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS), The Effort-Reward Imbalance (ERI), Healthcare professionals Resilience Scale (MSRS).

Results

Anxiety and depression are interrelated (r = 0.362, p < 0.01), and they were positively related to perceived stress (r = 0.640/0.607, p < 0.01) and ERI (r = 0.422/0.383, p < 0.01), and negatively related to resilience (r = -0.343/-0.320, p < 0.01). After controlling demographic factors, the variance in anxiety and depression was explained by perceived stress was 37.7 and 35.0%. Bootstrap analyses examining the pathway of perceived stress-ERI-resilience-anxiety revealed significant direct effects [B = 0.560, 95%CI (0.528, 0.591)], as well as indirect effects mediated independently by ERI [B = 0.045, 95%CI (0.029, 0.060)], resilience [B = 0.031, 95%CI (0.017, 0.047)], or a combination of both [B = 0.004, 95%CI (0.002, 0.007)]. Similarly, in the path of perceived stress-ERI-resilience-anxiety-depression, significant direct effects were found [B = -0.310, 95%CI(0.265, 0.351)], along with indirect effects mediated individually by ERI [B = 0.033, 95%CI(0.013, 0.052)], resilience [B = 0.014, 95%CI (0.001, 0.028)], and anxiety [B = 0.218, 95%CI (0.190, 0.246)], or by both or three together (B = 0.032).

Conclusion

This study proved the hypothesis that ERI and resilience played a mediating role in perceived stress and psychological disorders, revealed the potential mechanism of anxiety in stress and depression, and proposed a solution for perceived stress to psychological distress, which can provide a basis for the intervention of healthcare professionals in the face of mental health crisis.

Factors Associated with Anxiety and Depression in Infertile Couples—Study Protocol

(1) Background: Infertility refers to the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Infertility is an important medical and social problem that causes individual distress, family conflict and emotional impact experienced by about 15% of couples worldwide. Anxiety and depression are the main psychological problems associated with infertility with many potential contributing factors which are yet to be fully elucidated. This study aims to investigate factors related to anxiety and depression among infertile couples. (2) Methods/Design: This study will employ an analytical cross-sectional survey. Sociodemographic information will be collected. Validated tools will be used to assess anxiety and depression (Outcome Inventory-21(OI-21), marital satisfaction (ENRICH Marital Satisfaction Scale, sufficiency economy (Sufficiency Economy Scale (SES) and personality traits (Zuckerman-Kuhlman-Aluja Personality Questionnaire (ZKA-PQ). The Actor-Partner Interdependence Model estimated by multilevel modeling will be used for dyadic analysis. (3) Discussion: This study will provide evidence about factors associated with anxiety and depression in infertile couples. Outcomes will raise awareness about mental health problems among infertile couples and guide future research for interventions.

Effect of sensorimotor rehabilitation based on an immersive virtual reality model on mental health

The aim of this study was to determine the immersive virtual reality-based sensorimotor rehabilitation (IVR-SRB) effect on mental health (global mental health, depression, anxiety and well-being) in older adults.

METHODS

This study was experimental, with a sample of 111 older adults (control-experimental), considering an application of IVR-SRB in four different virtual settings with exteroceptive synchronization, proprioceptive and vestibular stimuli, for 6 weeks.

OUTCOME VARIABLES

symptoms associated with depression and anxiety; positive mental health (psychological well-being). A descriptive and inferential approach was used to analyze the data, and the ANCOVA test was used to compare the post-intervention groups, controlled by the baseline; In case of baseline moderation, a linear regression model was applied to identify the level of moderation and a region of significance analysis.

RESULTS

An IVR-SRB positive net effect was found in the reduction of symptoms of global mental health (p < 0.0001) and depression (p < 0.0001), without baseline moderation. The anxiety scores showed moderation at the beginning (p < 0.0001; b = -0.53), identifying that the greater the presence of anxiety symptoms, the greater the effect of IVR-SRB in reducing these symptoms; its effect is present from scores of 2.9 (Goldberg-12). There were no changes in well-being.

CONCLUSION

IVR-SRB is recognized as a great intervention tool among elderly population, showing its multidimensional approach capacity, properly responding to the reduction of symptoms associated with mental disorders.