Gender Differences in Depression: Evidence From Genetics

Hyperhomocysteinemia and its effect on ageing and language functions - HEAL study

Hyperhomocysteinemia or high levels (> 15 µmol/L) of homocysteine (Hcy)in the blood has been suggested to affect the brain through vascular and neurodegenerative pathways and potentially impact cognition. The current study aims to explore the association of high homocysteine with cognition and brain volume changes in a cohort of middle and old agedr adults. The study recruited 1296 participants aged ≥ 45 years from Tata Longitudinal Study of Ageing (TLSA), an ongoing cohort study. The participants underwent detailed cognitive assessments using Addenbrooke's Cognitive Examination-III (ACE-III) and Computerized Assessment of Adult Information Processing (COGNITO) neuropsychological battery and MR imaging using a 3T scanner. The participants were classified based on the median homocysteine level (16.89 µmol/L) into low Hcy (≤ median) and high Hcy (> median) groups. When adjusted for age, gender, years of education, vitamin B12, folate and dyslipidaemia, Generalised Linear Model (GLM) found a significant association of high Hcy with vocabulary task [β (95% CI) - 1.354 (- 2.655, - 0.052); p = 0.041]. Significant associations was also obtained between cerebral white matter volume and high Hcy [β (95% CI) - 5617.182 (- 11062.762, - 173.602); p = 0.043]. The results suggest that people with high Hcy levels performed poorer in cognitive tasks related to language domain and had lesser cerebral white matter volume. This indicates that homocysteine might have a profound impact on brain structure as well as function.

Demyelination in Patients with POST-COVID Depression

Background: Depression is one of the most severe sequelae of COVID-19, with major depressive disorder often characterized by disruption in white matter (WM) connectivity stemming from changes in brain myelination. This study aimed to quantitatively assess brain myelination in clinically diagnosed post-COVID depression (PCD) using the recently proposed MRI method, macromolecular proton fraction (MPF) mapping. Methods: The study involved 63 recovered COVID-19 patients (52 mild, 11 moderate, and 2 severe) at 13.5 ± 10.0 months post-recovery, with matched controls without prior COVID-19 history (n = 19). A post-COVID depression group (PCD, n = 25) was identified based on psychiatric diagnosis, while a comparison group (noPCD, n = 38) included participants with neurological COVID-19 complications, excluding clinical depression. Results: Fast MPF mapping revealed extensive demyelination in PCD patients, particularly in juxtacortical WM (predominantly occipital lobe and medial surface), WM tracts (inferior fronto-occipital fasciculus (IFOF), posterior thalamic radiation, external capsule, sagittal stratum, tapetum), and grey matter (GM) structures (hippocampus, putamen, globus pallidus, and amygdala). The noPCD group also displayed notable demyelination, but with less magnitude and propagation. Multiple regression analysis highlighted IFOF demyelination as the primary predictor of Hamilton scores, PCD presence, and severity. The number of post-COVID symptoms was a significant predictor of PCD presence, while the number of acute symptoms was a significant predictor of PCD severity. Conclusions: This study, for the first time, reveals extensive demyelination in numerous WM and GM structures in PCD, outlining IFOF demyelination as a key biomarker.

Association of social gatherings and physical exercise with depressive symptoms among middle-aged and older adults during the COVID-19 pandemic

Strict social isolation and physical distancing measures implemented during the COVID-19 pandemic had significant implications for the psychological well-being of middle-aged and older adults. This study aimed to investigate factors associated with depressive symptoms during the pandemic period among individuals who reported no significant depressive symptoms before the pandemic. Individuals from the Korean Longitudinal Study of Aging without a previous report of significant depressive symptoms across Waves 6 (2016) and 7 (2018) were investigated for the development of depressive symptoms in Wave 8 (2020). The multivariable logistic regression results revealed that both men and women who participated in social gatherings and physical exercise less than once a week were associated with an increase in the likelihood of depressive symptoms (odds ratio [OR] 2.88; 95% confidence interval [CI] 1.80-4.61 and OR 2.61; 95% CI 1.64-4.15, respectively for men and OR 2.58; 95% CI 1.80-3.70 and OR 1.51; 95% CI 1.02-2.23, respectively for women). In addition, unmarried men (OR 2.38; 95% CI 1.37-4.14) and women with one chronic disease (OR 1.98; 95% CI 1.14-3.43) or two or more chronic diseases (OR 2.28; 95% CI 1.31-3.99) reported a significant increase in the likelihood of depressive symptoms. Regular social gatherings and physical exercise were identified as key factors in mitigating depressive symptoms among middle-aged and older adults. The findings can inform the development of public health strategies that promote regular social interactions and physical activity to enhance the psychological resilience and overall well-being of middle-aged and older adults in the endemic era.

Prevalence and correlates of depressive symptoms among undergraduate health science students at the University of Parakou, Benin

OBJECTIVES

Research on psychological distress in African students is scarce. This study aimed at exploring the epidemiology (prevalence and correlates) of depressive symptoms among undergraduate health sciences students at the University of Parakou (Benin).

METHODS

We conducted a cross-sectional survey from June to July 2022 at the University of Parakou, the second-largest university in the Republic of Benin. Depressive symptoms were assessed using the Patient Health Questionnaire depression scale (PHQ-9). Information on several independent factors was collected and their associations with depressive symptoms were investigated using logistic regression models.

RESULTS

Data from 560 students were analyzed (mean age: 21.3± 2.3 years, 60 % were male, and 50.4 % were registered in the first year of study). The overall prevalence of depressive symptoms was 39.1 % [95 % CI: 35.2 %-43.1 %]. Moderate and severe depressive symptoms were observed in 15.3 % and 1.8 % of participants, respectively. In the multivariable model, being aged 21-23 (adjusted Odds Ratio=1.8, p-value: 0.007), a female (aOR=1.5, p-value: 0.050), a medical student (aOR=2.9, p-value: <0.001), a public health student (aOR=3.6, p-value: <0.001), belonging to households with higher incomes (aOR= 2.4, p<0.001), and experiencing stress (aOR=1.5, p-value: 0.048) independently increased the probability of having depressive symptoms. However, having support from close relatives (aOR= 0.5, p-value: 0.026) was associated with a lower probability of depressive symptoms.

CONCLUSIONS

Our findings revealed a high prevalence of depressive symptoms among undergraduate health science students. Given the correlates identified, actions to promote coping skills in stress and encourage more parental support may be real avenues likely to help reduce the frequency and consequences of depressive symptoms.

Longitudinal cross-lagged analysis of depression, loneliness, and quality of life in 12 European countries

BACKGROUND

In the older population, depression, loneliness, and quality of life are closely related, significantly influencing health status. This paper aimed (1) to investigate autoregressive and cross-lagged associations over 2 years between depression, loneliness, and quality of life, and (2) to examine sex-related differences in the 2-year associations between depression, loneliness, and quality of life in a large sample of European citizens aged ≥ 50 years.

METHODS

This is a longitudinal analysis. We included 7.456 individuals (70.89 ± 7.64 years; (4.268 females) who responded to waves 7 (2017) and 8 (2019) of the SHARE project. The variables analyzed in both waves were depression, loneliness, and quality of life.

RESULTS

Comparatively, females indicated higher depression and loneliness scores than males and a lower perception of quality of life. Autoregressive associations pointed that past depression, loneliness, and quality of life predicted their future episodes 2 years later (p < 0.001). The cross-lagged analysis of males showed positive and significant bidirectional associations between depression and loneliness 2 years later. Females also showed a positive and significant association between depression and loneliness, but loneliness was not associated with depression 2 years later. In turn, previous high levels of quality of life had a protective role in late depression and loneliness up to 2 years.

CONCLUSIONS

This study highlighted the need to simultaneously assess and manage depression, loneliness, and quality of life in the older European population. It is suggested that sex-specific policies can be created, including social support, in order to reduce depression and loneliness, and promote quality of life.

Epidemiology of DSM-5 psychiatric disorders in Kenyan Youth with Low and High Psychosis Risk

INTRODUCTION

There are few psychiatric epidemiology studies among Kenyan youth and fewer among those at high psychosis risk (HR).

METHODS

This study assessed the epidemiology of DSM-5 psychiatric disorders in HR and low-risk (LR) individuals to inform research and mental health services. 567 participants (aged 15-25) in HR (n = 246) and LR (n = 260) groups based on Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen scores. Diagnostic Interview Schedule, version 5 (DIS-5) assessed DSM-5 psychiatric disorder prevalence. Diagnostic comorbidity and demographic relationships were investigated.

RESULTS

A higher prevalence was observed for all DSM-5 disorders in the HR group, significantly for gambling disorder (13% vs. 5.8%), major depressive disorder (9.8% vs. 3.8%), antisocial personality disorder (5.7% vs. 2.3%), general anxiety disorder (4.9% vs. 0.4%), oppositional defiant disorder (3.3% vs. 0.4%), panic disorder (2.8% vs. 0.8%), and anorexia nervosa (2.8% vs. 0%). Gambling disorder was the most prevalent and showed significant gender effects (males>females).

DISCUSSION

Psychiatric disorders occur at increased rates among HR compared to LR. Prevalence rates found are lower than in US studies, except for gambling disorder which was highly prevalent. Large-population-based epidemiology studies in Africa are needed to estimate rates, particularly of disorders such as schizophrenia, accurately.

Prevalence of major depressive disorder and its associated factors among adult patients with neurolathyrism in Dawunt District, Ethiopia; 2022: community-based cross-sectional study

INTRODUCTION

Major Depressive Disorder (MDD) is one of the commonest mental disorders affecting more than 250 million people globally. Patients with chronic illnesses had higher risks for developing MDD than the general population. Neurolathyrism is a chronic illness characterized by lifelong incurable spastic paralysis of lower extremities; causing permanent disability. It is highly prevalent in Dawunt district, Ethiopia; with a point prevalence of 2.4%. Despite this, there were no previous studies assessing the prevalence of MDD among patients with neurolathyrism in Ethiopia.

OBJECTIVE

To assess the prevalence of MDD and to identify its associated factors among patients with neurolathyrism in Dawunt district, Ethiopia.

METHODS

A community based cross-sectional study was conducted on 260 samples in Dawunt district from February 01 to March 30/ 2021. Multistage sampling technique was used to select study participants. The patient Health Questionnaire-9 (PHQ-9) depression screening tool was used to diagnose MDD. PHQ-9 is a standardized depression screening tool and a PHQ-9 score of ≥ 10 has a sensitivity and specificity of 88.0% [95% CI (83.0-92.0%)] and 85.0% [95% CI (82.0-88.0%)] for screening MDD. Data were collected by interview; entered to EpiData version 4.2.0; exported to SPSS version 25.0 for analysis; descriptive statistics and binary logistic regression model were used; AOR with 95% CI was used to interpret the associations; and finally results were presented by texts, charts, graphs, and tables.

RESULTS

A total of 256 adult patients with neurolathyrism were participated; and the prevalence of MDD was found to be 38.7%. Being female [AOR = 3.00; 95% CI (1.15, 7.84)], living alone [AOR = 2.77; 95% CI (1.02-7.53)], being on neurolathyrism stage-3 [AOR = 3.22; 95% CI (1.09, 9.54)] or stage-4 [AOR = 4.00; 95% CI (1.28, 12.48)], stigma [AOR = 2.69; 95% CI (1.34, 5.39)], and lack of social/ family support [AOR = 3.61; 95% CI (1.80, 7.24)] were found to have statistically significant association with an increased odds of MDD; while regular exercise and ever formal counselling were found to have statistically significant association with a decreased odds of MDD.

CONCLUSION

The prevalence of MDD among neurolathyrism patients in Dawunt district was high. Lack of social support, stigma, not getting formal counselling, and not involving in regular exercise were modifiable risk factors. Therefore, social support, reducing stigma, formal counselling, and encouraging regular exercise might help to reduce the burden of MDD among neurolathyrism patients.

Annual Research Review: Sex, gender, and internalizing conditions among adolescents in the 21st century - trends, causes, consequences

Internalizing conditions of psychopathology include depressive and anxiety disorders; they most often onset in adolescence, are relatively common, and contribute to significant population morbidity and mortality. In this research review, we present the evidence that internalizing conditions, including depression and anxiety, as well as psychological distress, suicidal thoughts and self-harm, and fatal suicide, are considerably increasing in adolescent populations across many countries. Evidence indicates that increases are currently greatest in female adolescents. We present an epidemiological framework for evaluating the causes of these increases, and synthesize research on whether several established risk factors (e.g., age of pubertal transition and stressful life events) and novel risk factors (e.g., digital technology and social media) meet conditions necessary to be plausible causes of increases in adolescent internalizing conditions. We conclude that there are a multitude of potential causes of increases in adolescent internalizing conditions, outline evidence gaps including the lack of research on nonbinary and gender nonconforming populations, and recommend necessary prevention and intervention foci from a clinical and public health perspective.

Effect of job satisfaction on depression after adjusting for satisfaction with other life domains

Background

Studies on the association between job satisfaction and depression have often been reported. However, no study has examined how job satisfaction impacts depression while considering satisfaction with other aspects of life. In this study, we evaluated the effect of job satisfaction on depression after adjusting for satisfaction with other domains of life.

Methods

We used data from the 16th wave of the Korean Welfare Panel Study. A total of 3568 current employees without depression who completed a survey were included. Depression was measured using the abbreviated version of the CES-D scale. Various types of satisfaction, including job satisfaction, were measured using single-item questions and a 5-point Likert scale. The association between job satisfaction and depression after considering satisfaction with other life domains was analyzed using a multiple logistic regression model.

Results

Crude models showed a significant association between job satisfaction and depression in males (odds ratio [OR]: 7.90; 95% confidence interval [CI]: 4.11-15.23) and females (OR: 7.12; 95% CI: 4.40-11.50). When adjusted for sociodemographic factors, health-related factors, and work-related factors, the association remained significant in males (OR: 6.20; 95% CI: 3.10-12.41) and females (OR: 6.28; 95% confidence interval (CI): 3.79-10.40). However, when satisfaction with other life domains was included, the association remained significant only in females (OR: 3.55; 95% CI: 1.93-6.50).

Conclusions

This study shows an association between job satisfaction and depression in Korean employees. However, when satisfaction with other life domains was considered, this association remained significant only in women. Regular screening of job satisfaction should be considered as a means of preventing and managing depression among female employees.

Does coping style mediate the relationship between knowledge and psychosocial outcomes in women with atrial fibrillation?

Introduction

In patients affected by atrial fibrillation (AF) disease-specific knowledge and coping style may be associated with psychosocial well-being. This study aimed to determine if coping style (problem-focused, emotion-focused, avoidance-focused) mediated the relationship between patient knowledge and three psychosocial outcomes (anxiety, depression and life satisfaction).

Methods

In 2021 a total of 188 women with reported AF, and ages ranging from 18 to 83 years (mean 48.7, sd 15.5 years), completed an online questionnaire consisting of sociodemographic, clinical and AF knowledge questions and psychosocial instruments (Anxiety and depression, the Hospital Anxiety and Depression (HADS) scale; life satisfaction, Satisfaction With Life Scale (SWLS); and coping style (Brief COPE). Using Jamovi statistical software three individual mediational models (for anxiety, depression and life satisfaction) were constructed assessing the direct and indirect relationships between knowledge, coping style and each psychosocial outcome. Age was a covariate in each model.

Results

The mediation analyses demonstrated significant direct negative associations between AF knowledge and HADS anxiety and depression and positive associations with SWLS. There were also direct associations between each of the three coping styles and the three psychosocial outcomes. There were significant indirect effects of coping style between AF knowledge and each of the three outcomes confirming partial mediation effects.

Discussion

These findings highlight the crucial role of coping style in mediating the association between AF knowledge and psychosocial outcomes. As such, interventions aimed at increasing patient knowledge of AF may be more effective if adaptive problem-solving coping strategies are also demonstrated to these patients. Additionally, modification of maladaptive coping strategies as part of the psychological management of patients with AF is highly recommended.

Examination of Gender Differences in Depression, Relationship Satisfaction, and Problematic Pornography Use Among Romanian Gay Men and Lesbian Women

This study investigates factors influencing the psychological well-being of gay and lesbian individuals in Romania. Participants (N = 172) included 61.6% gay and 38.4% lesbians, currently in relationships, aged between 18 and 62 years (M = 28.28; SD = 9.53). Surveys assessed relationship satisfaction, depression, and problematic pornography use. Significant associations were found among these variables, with gender differences observed. We tested a regression model for problematic pornography use, where depression provided additional explanatory power to the initial model. Age, gender, and depression accounted for 18% of the variance in problematic pornography use. The theoretical and practical implications are discussed.

Neurocognitive Changes in Patients with Post-COVID Depression

Background: Depression and cognitive impairment are recognized complications of COVID-19. This study aimed to assess cognitive performance in clinically diagnosed post-COVID depression (PCD, n = 25) patients using neuropsychological testing. Methods: The study involved 71 post-COVID patients with matched control groups: recovered COVID-19 individuals without complications (n = 18) and individuals without prior COVID-19 history (n = 19). A post-COVID depression group (PCD, n = 25) was identified based on psychiatric diagnosis, and a comparison group (noPCD, n = 46) included participants with neurological COVID-19 complications, excluding clinical depression. Results: The PCD patients showed gender-dependent significant cognitive impairment in the MoCA, Word Memory Test (WMT), Stroop task (SCWT), and Trail Making Test (TMT) compared to the controls and noPCD patients. Men with PCD showed worse performances on the SCWT, in MoCA attention score, and on the WMT (immediate and delayed word recall), while women with PCD showed a decline in MoCA total score, an increased processing time with less errors on the TMT, and worse immediate recall. No differences between groups in Sniffin's stick test were found. Conclusions: COVID-related direct (post-COVID symptoms) and depression-mediated (depression itself, male sex, and severity of COVID-19) predictors of decline in memory and information processing speed were identified. Our findings may help to personalize the treatment of depression, taking a patient's gender and severity of previous COVID-19 disease into account.

The relationship between childhood socioeconomic status and depression level in older adults: the mediating role of adult socioeconomic status and subjective well-being

BACKGROUND

There is a causal link between childhood socioeconomic status and health status in adulthood and beyond. It's vital to comprehend the relationship between childhood socioeconomic status and mental health among older Chinese individuals from the current generation who have undergone significant social changes in China. This understanding is critical to foster healthy demographic and social development in China.

METHODS

Using data from the 2020 China Family Panel Studies, we investigate the relationship between childhood socioeconomic status and depression in older adults. Additionally, we examine the mediating role of adult socioeconomic status and subjective well-being.

RESULTS

1) Childhood socioeconomic status of Chinese older adults differences by region of residence, while depression levels differences by gender, region of residence, and marital status. 2) Adult socioeconomic status mediated the relationship between childhood socioeconomic status and depression in older adults. 3) Adult socioeconomic status and subjective well-being had a chain-mediated role in the relationship between childhood socioeconomic status and depression in older adults.

CONCLUSIONS

In terms of childhood socioeconomic status, older adults in urban regions were significantly higher than those in rural regions. As for depression level, female older adults were more depressed than males; married older people have the lowest depression levels, while unmarried and widowed older people have higher depression levels; older adults in rural regions had higher depression levels than those in urban regions. Evidence from our study further suggests that childhood socioeconomic status can suppress the depression level in older adults through adult socioeconomic status; it can also further reduce the depression level in older adults through the chain mediation of adult economic status affecting subjective well-being. As depression is more prevalent among older individuals with a lower childhood socioeconomic status, it is vital to prioritize the extensive impact of childhood socioeconomic status as a distal factor and investigate "upstream" solutions to enhance childhood socioeconomic status and reduce the gap during the early years of life.

Gender differences in brain region activation during verbal fluency task as detected by fNIRS in patients with depression

BACKGROUND

Gender plays a role in the mechanisms of depression, but fewer studies have focused on gender differences in the abnormal activation of brain regions when patients perform specific cognitive tasks.

METHODS

A total of 110 major depressive disorder (MDD) patients and 106 healthy controls were recruited. The relative change in oxygen-haemoglobin (oxy-Hb) concentration during the verbal fluency task were measured by a 52-channel near-infra-red spectroscopy (NIRS) system. Differences in brain region activation between patients and healthy controls and between genders of depression patients were compared.

RESULTS

MDD patients demonstrated significantly decreased [oxy-Hb] changes in the right inferior frontal gyrus (p = 0.043) compared to healthy controls. A marked increase in leftward functional language lateralisation in the inferior frontal gyrus was observed in the MDD group in contrast to the HC group (p = 0.039). Furthermore, female patients in the MDD group exhibited significant reductions in [oxy-Hb] changes in the right frontal region (specifically, the superior and middle frontal gyrus; p = 0.037) compared with male patients.

CONCLUSIONS

Gender impacts depression-related brain activation during cognitive tasks, potentially influencing depression's pathogenesis.

Risk and Preventive Factors for Depressive Symptoms Among Older Chilean Adults During the SARS-CoV-2 Outbreak: A Longitudinal Study

OBJECTIVE

To specifically examine the multiple factors related to the increase in depressive symptoms during the COVID-19 outbreak in older adults in Chile.

METHOD

A longitudinal study was conducted using a dataset from a nationally representative survey cohort of Chilean older adults followed at three time points during the COVID-19 outbreak. The main outcome was depressive symptoms (Patient Health Questionnaire scale). The independent variables included: age, sex, educational level, geographic area, living alone, self-perceived health, self-reported resilience, loneliness, and social isolation.

RESULTS

A total of 424 older adults were included. Female sex (β = 0.95, 95% CI: 0.22 to 1.68) and loneliness (β = 1.21, 95% CI: 1.05 to 1.37) were the main risk factors for an increase in depressive symptoms in older adults. In contrast, living outside the metropolitan region (β=-0.70, 95% CI: -1.39 to -0.02), living in company (β=-0.34, 95% CI:-1.24 to 0.56), having better self-perceived health (β=-5.04, 95% CI:-6.33 to -3.75) and greater resilience (β=-0.30, 95% CI: -0.38 to -0.23) were preventive factors.

CONCLUSION

These results provide useful evidence to develop mental health prevention or control strategies for older adults.

CLINICAL IMPLICATIONS

The findings highlight the importance of a holistic approach to health care for older adults that integrates strategies to address loneliness, foster resilience, and promote an active social life.

Pre-mating administration of theophylline could prevent the transgenerational effects of maternal morphine dependence on offspring anxiety behavior: The role of dopamine receptors

Opioid addiction causes some molecular alterations in the brain reward pathway, such as changes in gene expression that may be transferred to the next generation via epigenetic mechanisms such as histone acetylation. This study aimed to evaluate the effect of theophylline as an HDAC (Histone deacetylases) activator on D1 and D2 dopamine receptor expression in the nucleus accumbens (NAc) and anxiety behavior in the offspring of morphine-dependent female rats. Female rats were exposed to escalating doses of morphine for six days and were then treated with theophylline (20 mg/kg) or saline for 10 days before mating with normal male rats. Male and female offspring were tested for anxiety behavior using an elevated plus maze apparatus. Besides, the expression of D1 and D2 dopamine receptors in the NAc was evaluated by real-time PCR (polymerase chain reaction). Results showed that offspring of morphine-dependent female rats had increased expression of both D1 and D2 receptors in the NAc, as well as decreased anxiety behavior, compared to control offspring. However, the mentioned effects were returned to normal levels in the offspring whose morphine-dependent mothers had received theophylline for 10 days before mating. It is concluded that theophylline may be therapeutically effective in minimizing the adverse consequences of maternal morphine dependence on offspring behavior by restoring normal dopamine receptor expression levels and modulating anxiety. To completely comprehend the underlying mechanisms of this phenomenon, more research is required.

The Patient Generated Index (PGI) as an early-warning system for predicting brain health challenges: a prospective cohort study for people living with Human Immunodeficiency Virus (HIV)

PURPOSE

In research people are often asked to fill out questionnaires about their health and functioning and some of the questions refer to serious health concerns. Typically, these concerns are not identified until the statistician analyses the data. An alternative is to use an individualized measure, the Patient Generated Index (PGI) where people are asked to self-nominate areas of concern which can then be dealt with in real-time. This study estimates the extent to which self-nominated areas of concern related to mood, anxiety and cognition predict the presence or occurrence of brain health outcomes such as depression, anxiety, psychological distress, or cognitive impairment among people aging with HIV at study entry and for successive assessments over 27 months.

METHODS

The data comes from participants enrolled in the Positive Brain Health Now (+ BHN) cohort (n = 856). We analyzed the self-nominated areas that participants wrote on the PGI and classified them into seven sentiment groups according to the type of sentiment expressed: emotional, interpersonal, anxiety, depressogenic, somatic, cognitive and positive sentiments. Tokenization was used to convert qualitative data into quantifiable tokens. A longitudinal design was used to link these sentiment groups to the presence or emergence of brain health outcomes as assessed using standardized measures of these constructs: the Hospital Anxiety and Depression Scale (HADS), the Mental Health Index (MHI) of the RAND-36, the Communicating Cognitive Concerns Questionnaire (C3Q) and the Brief Cognitive Ability Measure (B-CAM). Logistic regressions were used to estimate the goodness of fit of each model using the c-statistic.

RESULTS

Emotional sentiments predicted all of the brain health outcomes at all visits with adjusted odds ratios (OR) ranging from 1.61 to 2.00 and c-statistics > 0.73 (good to excellent prediction). Nominating an anxiety sentiment was specific to predicting anxiety and psychological distress (OR 1.65 & 1.52); nominating a cognitive concern was specific to predicting self-reported cognitive ability (OR 4.78). Positive sentiments were predictive of good cognitive function (OR 0.36) and protective of depressive symptoms (OR 0.55).

CONCLUSIONS

This study indicates the value of using this semi-qualitative approach as an early-warning system in predicting brain health outcomes.

Association between late-life depression or depressive symptoms and stroke morbidity in elders: A systematic review and meta-analysis of cohort studies

OBJECTIVE

Whether late-life depression or depressive symptoms are a risk factor of future stroke in elders is important for prevention measures. A systematic review and meta-analysis were used to investigate the association between depression or depressive symptoms and risk of stroke in elders.

METHODS

Embase, MEDLINE, PsychINFO, and Web of Science were searched for studies published from inception to January 6, 2023. Prospective cohort studies reporting quantitative estimates of the association between depression or depressive symptoms and stroke morbidity in participants aged over 60 years were included. Reviews, meta-analyses, case reports, retrospective, cross-sectional, and theoretical studies were excluded. Study screening and data extraction were conducted by two researchers independently. Random-effects meta-analysis was used to estimate pooled adjusted hazard ratios (HRs). Publication bias was evaluated via the symmetry of funnel plots and Egger tests. The Newcastle Ottawa Scale was used to assess the risk of bias. The quality of evidence of synthesis was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE). The primary outcome was any stroke, including non-fatal, fatal, ischemic and hemorrhagic sub-types.

RESULTS

Seventeen studies of 57,761 patients in total were included in the meta-analysis. A positive association was found between depressive disorder or symptoms and stroke risk (HR: 1.39; 95% CI: 1.22-1.58; p < 0.001).

CONCLUSIONS

Late-life depression or depressive symptoms are a significant risk factor for stroke in older people. Regular assessment and more effective management of associated comorbidities are recommended to reduce stroke risk.

Effect of Probiotic Therapy on Neuropsychiatric Manifestations in Children with Multiple Neurotransmitter Disorders: A Study

Probiotics, also known as psychobiotics, have been linked to cognitive functions, memory, learning, and behavior, in addition to their positive effects on the digestive tract. The purpose of this study is to examine the psychoemotional effects and cognitive functioning in children with gastrointestinal disorders who undergo psychobiotherapy. A total of 135 participants, aged 5-18 years, were divided into three groups based on the pediatrician's diagnosis: Group I (Control) consisted of 37 patients (27.4%), Group II included 65 patients (48.1%) with psychoanxiety disorders, and Group III comprised 33 individuals (24.4%) with psychiatric disorders. The study monitored neurotransmitter levels such as serotonin, GABA, glutamate, cortisol, and DHEA, as well as neuropsychiatric symptoms including headaches, fatigue, mood swings, hyperactivity, aggressiveness, sleep disorders, and lack of concentration in patients who had gastrointestinal issues such as constipation, diarrhea, and other gastrointestinal problems. The results indicate that psychobiotics have a significant impact on reducing hyperactivity and aggression, and improving concentration. While further extensive studies are needed, these findings offer promising insights into the complexity of a child's neuropsychic behavior and the potential for balancing certain behaviors through psychobiotics.

Relationship between Cognitive Impairment and Depressive Symptoms with Somatosensory Functions in Diabetic and Non-Diabetic Older Adults and Its Impact on Quality of Life

Aging is an inevitable process that impacts the peripheral and central nervous systems and is considered one of the strongest risk factors for neurodegenerative diseases. In addition, when it also presents with diabetes mellitus, the risk of neurological damage may be further increased. This current study aimed to explore the relationships between peripheral sensory system decline and cognitive functions, the symptoms of depression, and quality of life (QoL) as metrics of central nervous system impairment in institutionalized older adults. A total of 95 individuals participated in this case-control study, which included diabetics and non-diabetics. The superficial sensory pathway was assessed in terms of thermal sensation, nociception, and non-discriminative touch, and the deep sensory pathway was evaluated by assessing vibration and light touch-pressure sensations. To assess function at the intellectual level, the Mini-Mental State Examination (MMSE) and Trail Making Test (TMT) cognitive functional tests were used, while the symptoms of depression and QoL were explored by employing the Yesavage Geriatric Depression Scale and EuroQol 5D questionnaire (EQ-5D), respectively. In the overall population analyses, altered thermal sensation was significantly associated with cognitive impairment (CI; p < 0.05). In turn, bivariate analyses and a binary logistic regression showed that the symptoms of depression and QoL were significantly related to altered vibratory sensation when assessed using a medical tuning fork (p < 0.05). In the group of diabetic patients, those with CI also had significantly lower thermal sensation (p < 0.05) and non-discriminative touch sensation, although this was only a trend (p = 0.055). Diabetics with depression had a significantly worse non-discriminative touch (p < 0.05) and vibratory sensation when tested with a tuning fork (p < 0.05). In addition, poorer QoL was associated with reduced sensitivity to heat (p < 0.05), light touch pressure (p < 0.05), and vibrations when assessed either with a tuning fork (p < 0.05) or a biothesiometer (p < 0.05). In contrast, no relationships were found between sensory functions and cognitive assessments in non-diabetic patients. These findings indicate that superficial sensitivity damage was related to CI, while deep sensation alterations were related to depression and poor QoL, with diabetes apparently further strengthening these relationships.

Depression, anxiety and quality of life of Afghan women living in urban areas under the Taliban government: a cross-sectional study

OBJECTIVES

According to the World Health Organization, depression is a common mental health illness that is characterised by a persistent feeling of sadness and loss of interest. The present study examined the association of two mental health variables (ie, depression, anxiety) with quality of life (QoL) and the sociodemographic characteristics of Afghan women living in urban areas under the rule of Taliban government in Afghanistan.

DESIGN

Cross-sectional study administered between 10 November 2021 to 25 December 2021 among women.

SETTING

Across major provinces of Afghanistan (Herat, Mazar-e-Sharif, Kabul and Samangan).

MEASUREMENTS

Data were collected using a pretested structured questionnaire. Data entry was carried out using Microsoft Excel 2016. And then exported to IBM SPSS V.26 for Microsoft Windows. Logistic regression models were used to examine the association of depression, anxiety with QoL and sociodemographic characteristics among women (N=438).

RESULTS

The prevalence of depression symptoms was 80.4%, and the prevalence of mild to extremely severe anxiety was 81.0%. Depression symptoms among Afghan women were associated with being older, having more children, lower education level, other individuals' bad behaviour, bad events experienced in the past month, and feeling physically ill. Multiple regression analysis indicated that low monthly household income (adjusted OR, AOR 2.260; 95% CI 1.179 to 4.331, p=0.014) poor physical domain of QoL (AOR 4.436; 95% CI 1.748 to 11.256, p=0.002) and poor psychological domain of QoL (AOR 23.499; 95% CI 7.737 to 71.369, p<0.001) were significantly associated with depression.

CONCLUSION

The prevalence of depression was high among women living under the government of the Taliban in Afghanistan. Considering the high prevalence of depression, anxiety and their impact on QoL and the overall quality of healthcare services, international health organisations should implement programmes for regular screening of depression and anxiety, and there should be psychological counselling services available for vulnerable women living under the government of the Taliban.

Differences of chronological seasonality in drug overdose

OBJECTIVE

To investigate the association between seasonality and intentional drug overdose (IDO), a commonly seen method of self-harm in daily emergency medicine practice.

METHODS

Cases of IDO were retrospectively selected using the International Classification of Diseases (ICD)-10 coding system (codes T36-T50), in patients who attended the Emergency Department of MacKay Memorial Hospital between January 2018 and August 2019. Data regarding age, sex, arrival time, marital status, vital signs, comorbidities, psychiatric history, social conflicts, substance of overdose, and length of hospital stay by season, were analysed using Student's t-test and χ2-test.

RESULTS

Of all included cases (n = 196), IDO occurred most frequently in spring (32.1%), particularly in male patients (28/49 male cases). First-time IDO occurred most frequently in spring (51/133 first-time cases) and most spring cases were first-time IDO (51/63 spring cases). Repeat IDO occurred most frequently in autumn (20/63 repeat cases). Female conflict with father and/or boyfriend, and personality disorder in patients who overdosed, showed seasonality with a spring peak. Hospital admission rate was highest in winter (10/45 winter cases [22.2%]).

CONCLUSION

Episodes of IDO exhibited seasonality, with a spring peak, particularly for male patients, female patients in conflict with father and/or boyfriend, and those with personality disorder. Clinicians should pay close attention to the abovementioned patient groups.

RETN gene polymorphisms interact with alcohol dependence in association with depression

BACKGROUND

Previous studies suggest that alcohol dependence is associated with increased risk of depression. The occurrence of depressive symptoms is related to polymorphisms in various genetic regions. This study aimed to investigate the interaction of RETN gene polymorphisms (rs1477341, rs3745368) with alcohol dependence on depressive symptoms in adult male during acute alcohol withdrawal.

METHODS

A total of 429 male adults were recruited in this study. Alcohol dependence was assessed using the Michigan alcoholism screening test (MAST). Depression was assessed using the 20-item self-rating depression scale (SDS). Hierarchical regression analysis was used to evaluate the interaction between genes and alcohol dependence on depression. Region of significance (ROS) test was used to explain the interaction effect. The strong and weak forms of the differential susceptibility and diathesis models were used to determine which fits the data better.

RESULTS

Our results showed that MAST scores were significantly positively associated with SDS scores (r = 0.23, p < 0.01) in alcohol-dependent patients during alcohol withdrawal. The interaction between genotype and alcohol dependence was significant (β = -0.14, p < 0.05) in a strong diathesis-stress model. Susceptibility for depression symptoms was associated with alcohol dependence in RETN rs1477341 A carriers. Specifically, those that showed more alcohol dependence and the A allele of RETN rs1477341 exhibited more depression symptoms. However, RETN rs3745368 had no significant interaction with alcohol dependence.

CONCLUSIONS

The A allele of RETN rs1477341 may correlate with susceptibility to depression symptoms in alcohol-dependent individuals during acute alcohol withdrawal.

Evaluation of nutritional status and clinical depression classification using an explainable machine learning method

Introduction

Depression is a prevalent disorder worldwide, with potentially severe implications. It contributes significantly to an increased risk of diseases associated with multiple risk factors. Early accurate diagnosis of depressive symptoms is a critical first step toward management, intervention, and prevention. Various nutritional and dietary compounds have been suggested to be involved in the onset, maintenance, and severity of depressive disorders. Despite the challenges to better understanding the association between nutritional risk factors and the occurrence of depression, assessing the interplay of these markers through supervised machine learning remains to be fully explored.

Methods

This study aimed to determine the ability of machine learning-based decision support methods to identify the presence of depression using publicly available health data from the Korean National Health and Nutrition Examination Survey. Two exploration techniques, namely, uniform manifold approximation and projection and Pearson correlation, were performed for explanatory analysis among datasets. A grid search optimization with cross-validation was performed to fine-tune the models for classifying depression with the highest accuracy. Several performance measures, including accuracy, precision, recall, F1 score, confusion matrix, areas under the precision-recall and receiver operating characteristic curves, and calibration plot, were used to compare classifier performances. We further investigated the importance of the features provided: visualized interpretation using ELI5, partial dependence plots, and local interpretable using model-agnostic explanations and Shapley additive explanation for the prediction at both the population and individual levels.

Results

The best model achieved an accuracy of 86.18% for XGBoost and an area under the curve of 84.96% for the random forest model in original dataset and the XGBoost algorithm with an accuracy of 86.02% and an area under the curve of 85.34% in the quantile-based dataset. The explainable results revealed a complementary observation of the relative changes in feature values, and, thus, the importance of emergent depression risks could be identified.

Discussion

The strength of our approach is the large sample size used for training with a fine-tuned model. The machine learning-based analysis showed that the hyper-tuned model has empirically higher accuracy in classifying patients with depressive disorder, as evidenced by the set of interpretable experiments, and can be an effective solution for disease control.

Entrapment, Hopelessness, and Cognitive Control: A Moderated Mediation Model of Depression

The present study aimed to examine the roles that hopelessness and cognitive control play in the relationship between entrapment and depression. Data were collected from 367 college students in South Korea. The participants completed a questionnaire that consisted of the Entrapment Scale, the Center for Epidemiologic Studies Depression Scale, the Beck Hopelessness Inventory, and the Cognitive Flexibility Inventory. Results showed that hopelessness partially mediated the relationship between entrapment and depression. In addition, cognitive control moderated the relationship between entrapment and hopelessness: greater cognitive control weakened the positive association between entrapment and hopelessness. Finally, the mediating effect of hopelessness was moderated by cognitive control. The findings of this study expand the understanding of the protective role of cognitive control, especially when an increased sense of entrapment and hopelessness intensifies depression.

Sex difference in the associations among risk factors with depression in a large Taiwanese population study

Background

Depression is a common psychiatric health issue affecting an estimated 5% of adults worldwide, and it can lead to disability and increased economic burden. Consequently, identifying the factors associated with depression as early as possible is a vital issue. The aim of this study was to explore these associations in a large cohort of 121,601 Taiwanese participants in the Taiwan Biobank, and also to identify sex differences in the associations.

Methods

The study cohort included 77,902 women and 43,699 men (mean age, 49.9 ± 11.0 years), who were further classified into those with depression (n = 4,362; 3.6%) and those without depression (n = 117,239; 96.4%).

Results

The results of multivariable analysis showed that female sex (vs. male sex; odds ratio = 2.578; 95% confidence interval = 2.319–2.866; p &lt; 0.001) was significantly associated with depression. Older age, diabetes mellitus (DM), hypertension, low systolic blood pressure (SBP), smoking history, living alone, low glycated hemoglobin (HbA1c), high triglycerides, and low uric acid were significantly associated with depression in the men. In the women, older age, DM, hypertension, low SBP, smoking history, alcohol history, education level of middle and high school (vs. lower than elementary school), living alone, high body mass index (BMI), menopause, low HbA1c, high triglycerides, high total cholesterol, low estimated glomerular filtration rate (eGFR), and low uric acid were significantly associated with depression. Further, there were significant interactions between sex and DM (p = 0.047), smoking history (p &lt; 0.001), alcohol use (p &lt; 0.001), BMI (p = 0.022), triglyceride (p = 0.033), eGFR (p = 0.001), and uric acid (p = 0.004) on depression.

Conclusion

In conclusion, our results showed sex differences in depression, and the women were significantly associated with depression compared to men. Furthermore, we also found sex differences among the risk factors associated with depression.

Assessment of depression in children and adolescents with sickle cell anemia in a low-resource setting: a comparative study

Children with sickle cell anemia (SCA) usually face psychological complications especially depression. Assessment of depression in resource-limited settings may help identify the extent to which the children with SCA in such settings may need its introduction as part of routine care. This study aimed to assess depression in children and adolescents with SCA in a low-resource setting. This cross-sectional observational study involved 84 children and adolescents with SCA aged 7-17 years who were selected using a systematic random sampling technique. Their controls were 84 age- and sex-matched individuals with AA hemoglobin genotype. A structured questionnaire was used to collect socio-demographic data while depression was assessed with the Children's Depression Inventory. The prevalence of depression was non-significantly higher in subjects compared to the controls (8.3% vs. 2.4%) (Fisher's χ² = 1.88, p = 0.171). Though not statistically significant, the subjects had 3.7 times higher odds of having depression compared to the controls (OR = 3.7; 95% CI 0.75-18.50; p = 0.107). Of the 5 depression subscales, the subjects had a significantly higher difference in the negative mood (p = 0.042). Despite the comparable prevalence of depression with their normal controls, children and adolescents with SCA had a higher negative mood and higher odds of having depression than normal individuals. Thus, there is a need for the introduction of depression assessment as a complement to routine care of these children with SCA in resource-poor settings.

Relationship between subjective well-being and depressive disorders: Novel findings of cohort variations and demographic heterogeneities

This paper uses a large-scale nationally representative dataset, the Chinese General Social Survey, to examine the relationship between subjective well-being and depressive disorders. Statistical results indicate that higher levels of subjective well-being help decrease perceived depression. Robustness checks are carried out using different types of explanatory and dependent variables, various regression models, penalized machine learning methods, instrumental variable approaches, and placebo tests, all of which lend further credence to the above findings. Based on it, heterogeneities in the relationship between subjective well-being and self-rated mental disorders are explored. In respect of variations in age cohorts, it is found that the absolute values of happiness's estimated coefficients are smaller in the 20-30 and 30-40 age groups, while that in the 40-50 age group increase substantially. In older cohorts, the estimates remain at higher levels while fluctuating to some degree. Furthermore, the significantly negative interaction between happiness and age proves that age amplifies subjective well-being's effect on perceived depressive disorders. With age increasing, the impact of happiness on reducing perceived depression tends to be stronger. Therefore, for older people, subjective well-being plays a more important role in suppressing self-rated depression. Heterogeneities of the relationship between happiness and perceived depressive disorders in subgroups with different demographic characteristics are also investigated. It is found that the negative correlation between subjective well-being and self-rated depression is stronger among those with higher educational levels, living in urban areas, being members of the Communist Party of China, having pensions, and owning more housing assets. However, gender, ethnic identity, religious belief, and marital status exert no significant moderating effects.

Major depressive disorder (mdd): emerging immune targets at preclinical level

BACKGROUND

Major depressive disorder is a mental health disorder that is characterized by a persistently low mood and loss of interest. MDD is affecting over 3.8% of the global population as a major health problem. Its etiology is complex, and involves the interaction between a number of factors, including genetic predisposition and the presence of environmental stresses.

AREAS COVERED

The role of the immune and inflammatory systems in depression has been gaining interest, with evidence suggesting the potential involvement of pro-inflammatory molecules like TNF, interleukins, prostaglandins, and other cytokines, among others, has been put forth. Along with this, the potential of agents, from NSAIDs to antibiotics, are being evaluated in therapy for depression. The current review will discuss emerging immune targets at the preclinical level.

EXPERT OPINION

With increasing evidence to show that immune and inflammatory mediators are implicated in MDD, increasing research toward their potential as drug targets is encouraged. At the same time, agents acting on these mediators and possessing anti-inflammatory potential are also being evaluated as future therapeutic options for MDD, and increasing focus toward non-conventional drugs which can act through these mechanisms is important as regards the future prospects of the use of anti-inflammatory agents in depression.

Intersection of Sex and Depression: Pathogenesis, Presentation, and Treatments

Major Depressive Disorder (MDD) is a highly prevalent, debilitating disorder. According to the World Health Organization, approximately 5% of adults suffer from depression worldwide and more women than men are affected. Yet, we have a very limited understanding of the pathogenesis of the disease, how sex and genetics influence the pathophenotype of MDD, and how they contribute to the responses to pharmacological treatment. This chapter addresses key theories about the etiology of depression, the variations in epidemiology and presentation, and the treatment options with respect to sex and gender. Additionally, we discuss the emerging wave of treatment modalities, diagnosis, and research focusing on MDD.

Gender differences in the association of polygenic risk and divergent depression trajectories from mid to late life: a national longitudinal study

Our research fills a critical gap in the depression literature by utilizing a life course perspective to examine gender-gene interactions in association with depression trajectories over time. Using data from the Health and Retirement Study, we estimated multi-level negative binomial and logistic mixed models to analyze gender-specific trajectories of depressive symptoms (CESD-8) and potential clinical depression risk from middle to late adulthood in relation to gender-by-polygenic-risk (PRS) interactions. We found increasingly greater female-male gaps in the CESD-8 scale and a higher probability of clinical depression risk with increasing polygenic risk scores. Furthermore, females' higher genetic vulnerabilities to depressive conditions than males vary from ages 51 to 90 years, with most salient larger differences at oldest old ages at 76-85 (e.g. 0.28 higher CESD-8 scale for females at ages 76-85 years than for similar-aged males; higher 3.44% probability of depression risk for females at ages 81-85 compared to similar-aged males) followed by old ages at 61-70  years (e.g. about 2.40% higher probability of depression risk for females at ages 61-70 years than for similar-aged males) in comparison to younger ages during middle adulthood. This study contributes to new knowledge of how gender-by-polygenic-risk interactions are associated with depression trajectories across the life course.

Dissecting the molecular mechanisms underlying the antidepressant activities of herbal medicines through the comprehensive review of the recent literatures

Depression is clinically defined as a mood disorder with persistent feeling of sadness, despair, fatigue, and loss of interest. The pathophysiology of depression is tightly regulated by the biosynthesis, transport and signaling of neurotransmitters [e.g., serotonin, norepinephrine, dopamine, or γ-aminobutyric acid (GABA)] in the central nervous system. The existing antidepressant drugs mainly target the dysfunctions of various neurotransmitters, while the efficacy of antidepressant therapeutics is undermined by different adverse side-effects. The present review aimed to dissect the molecular mechanisms underlying the antidepressant activities of herbal medicines toward the development of effective and safe antidepressant drugs. Our strategy involved comprehensive review and network pharmacology analysis for the active compounds and associated target proteins. As results, 45 different antidepressant herbal medicines were identified from various in vivo and in vitro studies. The antidepressant mechanisms might involve multiple signaling pathways that regulate neurotransmitters, neurogenesis, anti-inflammation, antioxidation, endocrine, and microbiota. Importantly, herbal medicines could modulate broader spectrum of the cellular pathways and processes to attenuate depression and avoid the side-effects of synthetic antidepressant drugs. The present review not only recognized the antidepressant potential of herbal medicines but also provided molecular insights for the development of novel antidepressant drugs.

Epidemiological status of depressive disorders in the Middle East and North Africa from 1990 to 2019

Background: Depressive disorders are one of the most common mental health diseases, which are associated with adverse life events such as increased risk of self-injury. This study was aimed to measure the epidemiological status and the burden of depressive disorders in the Middle East and North Africa (MENA) countries. Methods: The study population included 21 countries in the MENA region, covering a population of about 600 million. The Global Burden of Disease (GBD) 2019 database was used. The disability-adjusted life years (DALYs) were estimated by the years lived with disability (YLDs) component. The prevalence, incidence, and the DALYs rates per 100000 people by age-standardized rate (ASR) were measured. Results: In 2019, the highest prevalence 6198.95 (95% uncertainty interval [UI], 5402.41- 7108.39), incidence 7864.2 (95% UI, 6719.71-9216.83), and DALYs 1168.68 (95% UI, 802.95- 1624.31) per 100,000 were in Palestine by ASR. Between 1990 and 2019, the depressive disorders-related prevalence, incidence, and DALYs rates in the MENA region increased by 0.004%, 0.006%, and 0.005%. The highest increment of the prevalence, incidence, and DALYs rates was related to Saudi Arabia by 0.05%, 0.064%, and 0.055%. The highest percentage of major depressive disorder (MDD)-related DALYs attributed to intimate partner violence was related to Iran (101.1). Also, the highest percentage of MDD-related DALYs attributed to childhood sexual abuse (34.26) and bullying victimization (49.81) was related to Palestine. Conclusion: Given the increasing trend of depressive disorders in MENA region, mental health programs should be prioritized across the MENA countries, with significant contributions and involvement of the governments.

Body mass index trajectories from childhood concerning emotional states in young adulthood: Tehran Lipid and Glucose Study

This study aimed to identify body mass index (BMI) trajectories from childhood and their relationships with depression, anxiety, and stress symptoms in young adulthood. A total of 687 children aged 4-18 years were recruited from the Tehran Lipid and Glucose Study. Throughout 18 years of follow-up, BMI was measured every 3 years for a maximum of 6 data points. Participants completed the depression, anxiety, and stress scale in their young adulthood (aged 22-36). The group-based trajectory modelling was applied to identify BMI patterns. The logistic regression model was used to assess the association between BMI trajectories and depression, anxiety, and stress symptoms in adulthood. Two BMI trajectories were identified from childhood to young adulthood: healthy weight (HW = 69.6%) and persistent increasing overweight/obesity (PIO = 30.4%). After adjusting for potential confounders, compared with the HW group, men in the PIO group were more likely to experience higher stress levels (OR: 1.62, 95% CI: 0.99-2.63; p = 0.05). No significant association was observed between the PIO trajectory and depression and anxiety among both sexes and stress symptoms in females. Our results highlight that developing overweight and obesity from childhood may be related to increased stress in males.

Nutritional importance of tryptophan for improving treatment in depression and diabetes

The importance of nutrients in our diet is becoming increasingly recognized. From the viewpoint of protein synthesis and other physiologic and metabolic functions, all amino acids are important, but some of these amino acids are not synthesized endogenously. This subset, called essential amino acids, comprise dietarily indispensable nutrients. Tryptophan, an essential amino acid, is the sole precursor of neuronal as well as peripheral serotonin (5-hydroxytryptamine). Its systemic or oral administration increases serotonin synthesis because tryptophan hydroxylase, the rate-limiting enzyme of 5-hydroxytryptamine biosynthesis, is physiologically unsaturated with its substrate. Central serotonin is implicated in a number of psychiatric illnesses, including depression, and in responses to stress. Acting peripherally, serotonin affects vasoconstriction, intestinal motility, control of T cell–mediated immunity, and liver and pancreatic functions. Depression and diabetes are 2 highly prevalent diseases that often coexist. There is evidence that occurrence of depression is 2–3 times higher in people with diabetes mellitus. A comorbid condition of diabetes and depression worsens the treatment and increases risk for death. Stress, known for its causal role in depression, can also enhance risk for diabetes. Stress-induced decreases in the circulating levels of tryptophan can impair brain and pancreatic serotonin-dependent functions to precipitate these diseases. The importance of tryptophan supplementation for improving therapeutic intervention in depression and diabetes is the focus of this article. A deficiency of this essential amino acid may enhance risk for depression as well as diabetes, and can also weaken treatment efficacy of medicinal compounds for treating these diseases. Guidelines for optimal levels of circulating tryptophan can help if supplements of this amino acid can improve treatment efficacy.

Genetic and environmental contributions to psychopathological symptoms stability and change across the COVID-19 pandemic

Several longitudinal studies investigated changes in mental health related to the pandemic event. However, little research has focused on the mediating role of environmental and genetic factors. The current prospective study aimed to evaluate the genetic and environmental contributions to the stability of symptoms of depression, anxiety and stress during the COVID-19 crisis. A total of 798 adult twins, previously enrolled in the Italian Twin Register, participated in the study and completed on-line questionnaires sent out on June 2020 and December 2020. The nine-item Patient Health Questionnaire (PHQ-9), the six-item State-Trait Anxiety Inventory (STAI-6), and the Impact of Event Scale - Revised (IES-R) were administered to assess depressive and anxiety symptoms, and pandemic-related subjective distress, respectively. A considerable longitudinal stability was observed for each trait (range: 0.57, STAI-6 - 0.67, PHQ-9). Bivariate Cholesky decomposition indicated that genetic factors explained from 53% (IES-R) to 61% (STAI-6) of between-wave covariance and that genetic overlap between the two waves was almost complete (range: 0.91, STAI-6 - 0.99, PHQ-9). Our findings support the hypothesis, at least over the 6-month period examined, of a genetic stability between waves and of an environmental discontinuity due to changes in life conditions during the pandemic.

Elective aortic arch surgery: cerebral perfusion flows and transient neurological dysfunctions

AIMS

Selective antegrade cerebral perfusion technique is a method of cerebral protection used worldwide during aortic arch surgery. This study was designed to identify a potential correlation between perfusion flows and the development of postoperative transient neurological dysfunctions.

METHODS

From January 2015 to May 2020, 175 patients underwent elective surgical replacement of the aortic arch using selective antegrade cerebral perfusion at the Cardiac Surgery Unit of Sant'Orsola Hospital in Bologna. Considering that patients who developed a permanent neurological dysfunction and those who died before a possible evaluation of neurological status were excluded, the study population included 160 patients. The perfusion flows were collected and analyzed. Univariate and multivariate analyses were performed to identify the statistical risk factors involved in the onset of transient neurological dysfunctions.

RESULTS

The study population was divided into two groups: 138 patients (86.3%) without and 22 (13.8%) with postoperative transient neurological complications. Among the intra-operative parameters collected in the study, the univariate analysis showed that the indexed medium perfusion flow of selective antegrade cerebral perfusion was significantly lower in the transient neurological dysfunctions group (11.63 ± 2.41 ml/kg/min vs 12.62 ± 2.39 ml/kg/min, P -value = 0.03). The multivariate logistic regression analysis showed that the female gender ( P  = 0.004, OR = 4.816, IC = 1.636-14.174) was predictor of transient neurological dysfunctions.

CONCLUSION

The results of the study showed that lower perfusion flows seem to be related to a higher probability of developing transient neurological dysfunctions. However, the analysis of a wider population is required to confirm these preliminary data.

Sex Differences in Depression and Sleep Disturbance as Inter-Related Risk Factors of Diabetes

Objectives

Previous studies identified depression and sleep disturbance as risk factors for diabetes. Sleep disturbance and depression are known to be inter-related. Further, women relative to men are more prone to depression. Here, we investigated how depression and sleep disturbance may jointly influence the risk of diabetes and the effects of sex on these influences.

Methods

Using the data of 21,229 participants from the 2018 National Health Interview Survey, we performed multivariate logistic regression with diabetes diagnosis as the dependent variable, sex, self-reported frequency of weekly depression and nightly sleep duration, and their interactions with sex as independent variables, and age, race, income, body mass index and physical activity as covariates. We employed Bayesian and Akaike Information criteria to identify the best model, evaluated the accuracy of the model in predicting diabetes using receiver operating characteristic analysis, and computed the odds ratios of these risk factors.

Results

In the two best models, depression frequency and sleep hours interact with sex in determining the diagnosis of diabetes, with higher depression frequency and nightly duration of sleep longer or shorter than 7 to 8 hours associated with higher likelihood of diabetes. The two models both predicted diabetes at an accuracy (area under the receiver operating characteristic curve) of 0.86. Further, these effects were stronger in men than in women at each depression and sleep level.

Conclusions

Depression and sleep inter-relatedly rather than independently contributes to diabetes. Depression and sleep hours associate with diabetes more significantly in men than in women. The current findings indicate a sex-dependent relationship between depression, sleep disturbance and diabetes risk and add to a growing body of evidence linking mental and physical health.

Prevalence of Sleep Disturbance in Patients With Cancer: A Systematic Review and Meta-Analysis

Sleep disturbance is one of the most common and troubling symptoms that harm the quality of life throughout all phases of treatment and stages of the illness among patients with cancer. The aim of this meta-analysis is to examine the present status of sleep disturbance prevalence in patients with cancer. The following databases were searched: PubMed, CINAHL, MEDLINE, EMBASE, PsycINFO, from inception to April 2021. Prevalence rates were pooled with meta-analysis using a random-effects model. A total of 160 studies (N = 46,279) published between 1998 and 2021 met the inclusion criteria. The overall prevalence of sleep disturbance was 60.7% (26,448/46,279 participants, 95% CI 58.1-63.3%) with significant heterogeneity between studies (p < .000, τ2 = .0000, I2 = 96.4%). This meta-analysis highlights the importance of developing optimal monitoring strategies to reduce sleep disturbance and improve the quality of life of cancer patients.

The Impact of Sex Chromosomes in the Sexual Dimorphism of Pulmonary Arterial Hypertension

Pulmonary arterial hypertension (PAH) is a sex-biased disease with a poorly understood female prevalence. Emerging research suggests that nonhormonal factors, such as the XX or XY sex chromosome complement and sex bias in gene expression, may also lead to sex-based differences in PAH incidence, penetrance, and progression. Typically, one of females' two X chromosomes is epigenetically silenced to offer a gender-balanced gene expression. Recent data demonstrate that the long noncoding RNA X-inactive specific transcript, essential for X chromosome inactivation and dosage compensation of X-linked gene expression, shows elevated levels in female PAH lung specimens compared with controls. This molecular event leads to incomplete inactivation of the females' second X chromosome, abnormal expression of X-linked gene(s) involved in PAH pathophysiology, and a pulmonary artery endothelial cell (PAEC) proliferative phenotype. Moreover, the pathogenic proliferative p38 mitogen-activated protein kinase/ETS transcription factor ELK1 (Elk1)/cFos signaling is mechanistically linked to the sexually dimorphic proliferative response of PAECs in PAH. Apprehending the complicated relationship between long noncoding RNA X-inactive specific transcript and X-linked genes and how this relationship integrates into a sexually dimorphic proliferation of PAECs and PAH sex paradox remain challenging. We highlight herein new findings related to how the sex chromosome complement and sex-differentiated epigenetic mechanisms to control gene expression are decisive players in the sexual dimorphism of PAH. Pharmacologic interventions in the light of the newly elucidated mechanisms are discussed.

Platelet Parameters, C-Reactive Protein, and Depression: An Association Study

Objective

This study aims to investigate the correlation of platelet parameters and C-reactive protein (CRP) with depression.

Methods

The clinical data of 61 patients with depression and 30 healthy control subjects were collected to compare the platelet parameters, CRP levels, and Hamilton Depression Rating Scale (HAMD) scores of the two groups for correlation analysis.

Results

The results revealed that the body mass index (BMI) of patients with depression was lower (P < 0.05) than that of the healthy control subjects, and that this difference was more significant in women than in men. Patients with severe depression showed an increased mean platelet volume (MPV) (P < 0.05). In the patients with depression, MPV was positively correlated (P < 0.05) with HAMD scores for work and interest, gastrointestinal symptoms, hopelessness, the anxiety/somatization factor, and the hopelessness factor. Platelet count (PLT) was negatively correlated (P < 0.05) with HAMD scores for hypochondriasis, and plateletcrit (PCT) was negatively correlated (P < 0.05) with HAMD scores for middle insomnia and hypochondriasis. Platelet distribution width (PDW) was positively correlated (P < 0.05) with HAMD scores for gastrointestinal and systemic symptoms as well as hopelessness. Higher CRP levels (P < 0.05) were found in the patients with depression than in the healthy control subjects. Furthermore, in the patients with depression, CRP levels were positively correlated (P < 0.05) with HAMD scores for guilt and the cognitive impairment factor.

Conclusion

Classical platelet parameters (PLT, MPV, PCT, PDW) and CRP were shown to be associated with specific depressive symptoms and cognitive impairment factors, including sleep, gastrointestinal symptoms, hypochondriasis, losing interest in work, and despair. These results suggest that both platelet parameters and CRP could be suitable biomarkers for predicting the occurrence and prognosis of depression, thus providing a new target for its treatment.

GABAA subunit single nucleotide polymorphisms show sex-specific association to alcohol consumption and mental distress in a Norwegian population-based sample

Little is known about genetic influences on the relationship between alcohol consumption and mental distress in the general population, where the majority report consumption and distress far below diagnostic thresholds. This study investigated single nucleotide polymorphisms (SNPs) from candidate gene studies on alcohol use disorder and depressive disorders, for association with alcohol consumption and with mental distress in a population-based sample from the Cohort of Norway (n = 1978, 49% women). The relationship between alcohol consumption and mental distress was further examined for genotype modification. There was a positive correlation between mental distress and alcohol consumption in men, as well as an association between SNPs and mental distress in men (GABRG1, GABRA2, DRD2, ANKK1, MTHFR) and women (CHRM2, MTHFR) and between SNPs and alcohol consumption in women (GABRA2, MTHFR). No modification by SNP genotype was found on the relationship between alcohol consumption and mental distress. The association between mental distress and GABRG1 in men remained significant after correcting for multiple comparisons. The results indicate that alcohol consumption and mental distress are associated in the general population even at levels below clinical thresholds and point to SNPs in genes related to GABAergic signalling for level of mental distress in men.

Expression Biomarkers of Pharmacological Treatment Outcomes in Women with Unipolar and Bipolar Depression

INTRODUCTION

This study aimed to find the expression biomarkers of pharmacological treatment response in a naturalistic hospital setting. Through gene expression profiling, we were able to find differentially-expressed genes (DEGs) in unipolar (UD) and bipolar (BD) depressed women.

METHODS

We performed gene expression profiling in hospitalized women with unipolar (n=24) and bipolar depression (n=32) who achieved clinical improvement after pharmacological treatment (without any restriction). To identify DEGs in peripheral blood mononuclear cells (PBMCs), we used the SurePrint G3 Microarray and GeneSpring software.

RESULTS

After pharmacological treatment, UD and BD varied in the number of regulated genes and ontological pathways. Also, the pathways of neurogenesis and synaptic transmission were significantly up-regulated. Our research focused on DEGs with a minimum fold change (FC) of more than 2. For both types of depression, 2 up-regulated genes, OPRM1 and CELF4 (p=0.013), were significantly associated with treatment response (defined as a 50% reduction on the Hamilton Depression Rating Scale [HDRS]). We also uncovered the SHANK3 (p=0.001) gene that is unique for UD and found that the RASGRF1 (p=0.010) gene may be a potential specific biomarker of treatment response for BD.

CONCLUSION

Based on transcriptomic profiling, we identified potential expression biomarkers of treatment outcomes for UD and BD. We also proved that the Ras-GEF pathway associated with long-term memory, female stress response, and treatment response modulation in animal studies impacts treatment efficacy in patients with BD. Further studies focused on the outlined genes may help provide predictive markers of treatment outcomes in UD and BD.

Prediction of Probable Major Depressive Disorder in the Taiwan Biobank: An Integrated Machine Learning and Genome-Wide Analysis Approach

In light of recent advancements in machine learning, personalized medicine using predictive algorithms serves as an essential paradigmatic methodology. Our goal was to explore an integrated machine learning and genome-wide analysis approach which targets the prediction of probable major depressive disorder (MDD) using 9828 individuals in the Taiwan Biobank. In our analysis, we reported a genome-wide significant association with probable MDD that has not been previously identified: FBN1 on chromosome 15. Furthermore, we pinpointed 17 single nucleotide polymorphisms (SNPs) which show evidence of both associations with probable MDD and potential roles as expression quantitative trait loci (eQTLs). To predict the status of probable MDD, we established prediction models with random undersampling and synthetic minority oversampling using 17 eQTL SNPs and eight clinical variables. We utilized five state-of-the-art models: logistic ridge regression, support vector machine, C4.5 decision tree, LogitBoost, and random forests. Our data revealed that random forests had the highest performance (area under curve = 0.8905 ± 0.0088; repeated 10-fold cross-validation) among the predictive algorithms to infer complex correlations between biomarkers and probable MDD. Our study suggests that an integrated machine learning and genome-wide analysis approach may offer an advantageous method to establish bioinformatics tools for discriminating MDD patients from healthy controls.