Relationship between childhood physical abuse and clinical severity of treatment-resistant depression in a geriatric population

Patient perspectives and experiences with psilocybin treatment for treatment-resistant depression: a qualitative study

Psilocybin is the most researched classic psychedelic for Treatment-Resistant Depression (TRD). While optimizing set and setting are considered essential for efficacy and safety, patient perspectives on these aspects have rarely been investigated. To address this knowledge gap, the current paper explored the experiences of 11 TRD patients (8 women, 3 men) participating in a double-blind randomized clinical trial with a single session of oral (1, 10 or 25 mg) psilocybin treatment. After qualitative analysis, three major themes were identified: (1) challenges with trust-building and expectation management; (2) navigating the experience; and (3) the need for a more comprehensive treatment. Subthemes of the first theme include a general distrust in mental healthcare, trust in study therapists, limited time for preparation, and managing expectations. The second theme included the following subthemes: trusting to surrender, profound and overwhelming experiences, and music as a guide. The third theme addressed a desire for multiple psilocybin sessions, and challenges with sensemaking. Patients' perspectives provided important insights into potential optimization of psilocybin treatment of TRD, including individualized preparation, investment in trust-building, offering additional psilocybin sessions, providing access to sustained (psycho)therapy with trusted therapists, and personalizing treatment approaches, which may also enhance real-world adaption of these treatments.

Association between Exposure to Domestic Violence during Childhood and Depressive Symptoms in Middle and Older Age: A Longitudinal Analysis in China

Exposure to domestic violence (EDV) is a constant threat to social stability and global solidarity and may be associated with an increased risk of depression in later life. This study assessed the association between EDV during childhood and depressive symptoms in middle and older age. A total of 10,521 respondents obtained from the China Health and Retirement Longitudinal Study were enrolled in our analysis. Depressive symptoms were measured using the 10-item form of the Center for Epidemiological Studies Depression (CES-D) scale, and EDV included parental conflict and corporal punishment. A random-effects linear regression was used to assess associations. The results showed positive relationships between "not very often" (β = 0.862; 95% CI:0.512 to 1.211; p < 0.001), "sometimes" (β = 1.692; 95% CI:1.227 to 2.158; p < 0.001) and "often" (β = 2.143; 95% CI:1.299 to 2.987; p < 0.001) in parental conflict and the CES-D scores, compared with that of those reported "never" in parental conflict. Similarly, positive relationships between "sometimes" (β = 0.389; 95% CI:0.091 to 0.687; p = 0.011) and "often" (β = 1.892; 95% CI:1.372 to 2.413; p < 0.001) in corporal punishment and the CES-D scores were observed. EDV is associated with an increased risk of depression in later life. Future research could develop interventions that target EDV and explore the mechanisms in China to further decrease lifetime depression risk and improve the population's mental health.

Measuring childhood trauma in young adults with depression: A latent profile analysis

Childhood traumas are important risk factors for depression in young adults. However, the co-occurrence of childhood traumas is complex, and the specific effects of different types of childhood traumas on depression need further exploration. The aim of this study was to assess the co-occurrence of childhood traumas and the impact of different profiles of childhood trauma on depression. A total of 1053 young adults with depression in China participated. PHQ-9, SHAPS, GAD-7, CTQ-SF, and NLES were evaluated. Latent profile analysis (LPA) was conducted to identify profiles of childhood trauma. The effects of different childhood trauma profiles on depression, anxiety, and anhedonia were assessed using stepwise linear regression. LPA suggested three profiles: no or low childhood traumas, moderate childhood trauma with emotional abuse and childhood neglect, and high childhood trauma with high levels of all trauma types. Regression analyses suggested that high levels of emotional abuse and childhood neglect significantly affected anhedonia. Childhood adverse events cluster in young adults with depression, allowing grouping into three distinct profiles. Specific childhood trauma patterns predict anhedonia symptoms in adult depression.

Sex Differences in Depression Caused by Early Life Stress and Related Mechanisms

Depression is a common psychiatric disease caused by various factors, manifesting with continuous low spirits, with its precise mechanism being unclear. Early life stress (ELS) is receiving more attention as a possible cause of depression. Many studies focused on the mechanisms underlying how ELS leads to changes in sex hormones, neurotransmitters, hypothalamic pituitary adrenocortical (HPA) axis function, and epigenetics. The adverse effects of ELS on adulthood are mainly dependent on the time window when stress occurs, sex and the developmental stage when evaluating the impacts. Therefore, with regard to the exact sex differences of adult depression, we found that ELS could lead to sex-differentiated depression through multiple mechanisms, including 5-HT, sex hormone, HPA axis, and epigenetics.