Journal of affective disorders最新文献

Background: Emotional dysregulation (ED) represents a burden for individuals with ADHD. Physical activity (PA) is associated with improvements in emotion regulation, but knowledge is limited regarding its role in ED in the context of ADHD. This study aimed to increase understanding of the association between ADHD and ED and to explore the role of PA. Identifying modifiable risk factors could aid the design of future interventions.

Methods: Children from the Swedish Twin Registry were included. ADHD symptoms and PA intensity and frequency were measured using parent-reported questionnaires at age 9/age 12. ED was assessed through questionnaires at age 15. The association between ADHD and ED was assessed through linear GEE regression models. Interaction terms and stratified analyses by level of PA were used to explore the role of PA. Analyses were done separately for boys and girls.

Results: 12,094 children (52 % girls) were included. A positive association between ADHD symptoms and ED remained significant after adjusting for mental comorbidities and unmeasured family-shared confounders (β = 0.07, 95% CI 0.02-0.12 in boys; β = 0.09, 95% CI 0.02-0.16 in girls). The association was driven by inattention in boys but combined symptoms in girls. The association remained in all strata of PA. A significant interaction between PA frequency and ADHD symptoms was observed among boys (p = 0.02).

Limitations: Results were based on parent-reported PA; findings might differ with sensor-based measurements.

Conclusion: Higher ADHD symptoms in childhood were associated with greater ED in adolescence in all PA levels. Low PA frequency intensified the association among boys.

Background: BDD and OCD symptoms often co-occur, but the associations between specific symptoms remain unclear. Furthermore, current research suggests that the clinical presentation of emotional disorders can differ in individuals who self-report exposure to trauma, but it is unclear whether this extends to BDD and OCD. The current study aimed to: (a) investigate associations between individual OCD and BDD symptoms and (b) determine whether symptom networks differ in those with self-reported trauma compared to those without self-reported trauma.

Methods: Participants (N = 3127) were drawn from the Genetic Links to Anxiety and Depression (GLAD) Study and had completed validated self-reported questionnaires to assess BDD and OCD symptoms, and childhood and adulthood experiences of trauma. Network analysis was used to investigate associations between seven BDD symptoms and six OCD symptom domains. Networks of reporters and non-reporters of lifetime trauma were compared using the network comparison test.

Results: BDD and OCD symptoms clustered distinctively with some bridging associations between them. The strongest bridging edges highlighted an association between three core BDD symptoms and the OCD domain of obsessional thoughts. BDD and OCD networks of reporters and non-reporters of lifetime trauma did not differ.

Limitations: Cross-sectional design, meaning causality cannot be inferred.

Conclusions: The findings suggest that BDD and OCD symptoms cluster distinctively, with some bridging associations between core BDD symptoms and obsessional thoughts. Future research is needed to understand the mechanisms underpinning this relationship.

Background: Although meta-analyses suggest comparable efficacy of cognitive-behavioral therapy (CBT) in older adults compared to working-age adults, little is known about its effectiveness in naturalistic settings across different age groups. Hence, this study compared symptom change, attrition rates, and treatment duration in outpatient CBT between working-age adults (18-64 years), young-old adults (65-74 years), and old-old adults (≥ 75 years).

Methods: We analyzed a large naturalistic dataset comprising 9081 patients between 18 and 96 years receiving outpatient CBT in Germany. Using propensity score matching, we examined differences in treatment response, remission, attrition, and duration between comparable groups of working-age, young-old, and old-old adults.

Results: Response and remission rates did not differ between the three age groups in terms of the Brief Symptom Inventory (BSI-53) and patient- and clinician-rated subjective improvement (CGI-I). Young-old and old-old adults showed lower rates of response and remission on the Beck Depression Inventory (BDI-II). These differences were limited to items assessing somatization, which may be related to normal aging. Treatment duration was shorter in young-old and old-old adults compared to working-age adults. Attrition rates did not differ.

Limitations: The samples of older adults were relatively small and probably selective. Especially, home-bound, vulnerable older adults may be underrepresented. Further, the observational study design limits interpretability of findings.

Conclusions: Young-old and old-old adults seem to benefit from outpatient CBT to a similar extent as working-age adults. Potential bias in outcome measures due to age-related somatic complaints should be acknowledged in practice and future research.

Objective: Physical activity (PA) is suggested to reduce the risk of depression, and inflammation is believed to play an important role in this antidepressant effect. The current study aims to investigate the effect of neutrophils, one of the most important markers of inflammation, on the relationship between PA and depression.

Methods: We cross-sectionally analyzed 34,317 adults who participated in the National Health and Nutrition Examination Survey. The moderation and mediation effects of neutrophils on the relationship between PA and depression were assessed using a four-way decomposition approach. Additional Mendelian Randomization (MR) analysis was conducted to validate the potential causal mediation effect.

Results: PA was associated with lower odds of depression [Odds Ratio (OR): 0.67; 95 % Confidence Interval (CI): 0.56-0.79] and a lower level of neutrophils (OR: 0.83; 95 % CI: 0.77-0.90). Neutrophils were associated with higher odds of depression in a non-linear manner. While neutrophils did not modify the association between PA and depression, a significant mediating effect was observed. The influence of PA and neutrophils on depression was attributed to the controlled direct effect (96 % proportion) and the pure indirect effect (2 % proportion). MR analysis did not confirm a potential causal effect.

Conclusion: There is a close relationship between PA, neutrophils, and depression. The effect of PA on depression did not differ among participants with different levels of neutrophils. Although neutrophils mediated the association between PA and depression, this mediating effect was not causal. Other unknown factors closely related to neutrophils may be involved in this mediating process.

Background: Racial/ethnic disparities in health-related outcomes were exacerbated during the COVID-19 pandemic. Individuals from racial/ethnic minority groups or with a history of alcohol use disorder (AUD) may have greater medical mistrust. We examined racial/ethnic and AUD-related disparities in group-based medical mistrust during the pandemic and tested whether medical mistrust dimensions were associated with mental health symptoms.

Methods: Two hundred and fifty participants from the National Institute on Alcohol Abuse and Alcoholism COVID-19 Pandemic Impact on Alcohol Study completed an online survey between April and July of 2022. Exploratory factor analysis and path analysis were conducted.

Results: Group-based medical mistrust scores were elevated among participants who identified as Non-Hispanic Black and those with a history of AUD. Two medical mistrust dimensions were found: (1) Suspicion and Lack of Provider Support, and (2) Group Disparities in Health Care. Compared to Non-Hispanic White participants, Non-Hispanic Black participants reported higher scores on the Suspicion and Lack of Provider Support dimension of medical mistrust, which was associated with higher mental health symptoms. This medical mistrust dimension was also a significant mediator of the observed group differences in mental health symptoms.

Limitations: Cross-sectional data, aggregation of racial/ethnic groups with small sample sizes, and nonrepresentative sample.

Conclusions: Non-Hispanic Black individuals and individuals with AUD may be more vulnerable to mental health symptoms due to higher suspicion toward medical professionals and healthcare systems and lack of support from healthcare providers. Increased awareness among healthcare providers may help address medical mistrust, encourage help-seeking behaviors, and alleviate mental health symptoms.

Background: Caring for individuals with mental illness involves significant challenges from both the unique symptoms and societal stigma associated with these conditions, often leading to caregiver neglect despite the heightened risk of anxiety and depression among caregivers. This study was designed to quantify the prevalence of anxiety and depression among caregivers and to offer a detailed configurational analysis of their sociodemographic attributes.

Methods: Random-effects meta-analyses were conducted using generalized linear mixed models to calculate the prevalence rates for each study. We explored potential sources of heterogeneity through meta-regression and subgroup analyses. Qualitative Comparative Analysis (QCA) was utilized to identify sociodemographic configurations that contribute to anxiety and depression. The study was pre-registered in PROSPERO (CRDXXXXXXXXXX).

Results: A total of 52 studies involving 10,232 participants were included. The prevalence of depression was 43.91 % (95 % CI: 34.62 %-53.65 %), anxiety was 66.56 % (95 % CI: 48.45 %-80.82 %), and comorbidity was 37.24 % (95 % CI, 19.75 %-58.85 %). QCA identified four sociodemographic configurations contributing to depression and two contributing to anxiety. Key contributors to depression included younger, unmarried, highly educated female caregivers, as well as older, married caregivers caring for patients with schizophrenia. Anxiety was more prevalent among older, married caregivers of patients with schizophrenia and younger, highly educated female caregivers.

Limitations: Differences in the measurement tools used across studies may have impacted the results of this study.

Conclusions: The high prevalence of depression and anxiety among caregivers of individuals with mental illness underscores the need for targeted mental health services and policies.

Background: While prior research has linked the built environment to mental health, little attention has been given to how this relationship and its mechanisms differ at the intersection of gender and age. This study examines the direct and indirect associations between the perceived built environment and depressive symptoms, with neighborly relationships and community attachment as mediators. It also investigates how these associations vary across age-gender groups.

Methods: Drawing from nationally representative data from two waves of the China Family Panel Studies (n = 14,200), this study applied a moderated mediation model to analyze the mediating role of neighborly relationships and community attachment, as well as the moderating role of age-gender groups.

Results: The perceived built environment was negatively associated with depressive symptoms, and this relationship was mediated by both neighborly relationships and community attachment. Age-gender groups moderated both the direct and indirect associations, with middle-aged males exhibiting the strongest direct association, while middle-aged females demonstrated more pronounced indirect associations through social cohesion.

Limitations: This study relied on self-reported data to assess the built environment, and both neighborly relationships and community attachment were measured using single-item indicators, which may limit the depth of analysis. Furthermore, the observational design of the study precludes definitive causal inferences from the findings.

Conclusions: The study reveals varying associations between the perceived built environment and depressive symptoms across age-gender groups, with middle-aged males more affected by environmental stressors and middle-aged females benefiting from social cohesion. These findings provide insights for targeted interventions and policies.

Introduction: Few studies have examined the relationship between anxiety and response to repetitive transcranial magnetic stimulation (rTMS) in patients with unipolar depressive disorder (UDD) and bipolar depressive disorder (BDD). The primary aim of this study was to investigate the correlation between anxiety symptoms and the response to rTMS in individuals with comorbid anxiety, in both UDD and BDD patients. The secondary aim was to evaluate the efficacy of rTMS in reducing depressive symptoms, anxiety, and different subtypes of anxiety disorder.

Methods: A total of 379 outpatients (214 UDD, 165 BDD) underwent 20 sessions of either right unilateral low-frequency rTMS or sequential bilateral rTMS targeting the dorsolateral prefrontal cortex (DLPFC). Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI-II) were used for assessment.

Results: Binary logistic regression analysis indicated that pre-treatment physical anxiety scores showed a negative correlation with rTMS response, while subjective anxiety scores were positively associated. Distinct and overlapping response profiles for UDD and BDD patients with comorbid anxiety were identified based on anxiety symptoms. Predictive values for the BDD group were more reliable than those for the UDD group (PPV: 75 %, NPV: 77 %). Moreover, both unilateral and bilateral rTMS significantly reduced depressive symptoms as well as physical, subjective, and panic-related anxiety symptoms.

Conclusion: The findings suggest that in both UDD and BDD, physical anxiety symptoms are linked to less response to rTMS, whereas subjective anxiety symptoms are associated with more response. Future prospective studies are required to confirm the predictive value of anxiety symptoms in UDD and BDD patients who suffer from comorbid anxiety.

Background: Shorter weeknight sleep duration has not been assessed as a mediating mechanism linking earlier pubertal timing to a greater burden of adolescent depression symptoms.

Methods: Among 1138 participants (48.6 % female) from Project Viva, a pre-birth longitudinal cohort, we examined relationships among pubertal timing measures, actigraphy-captured and self-reported weeknight sleep duration across mid-adolescence, and depression symptoms in late adolescence. We assessed pubertal timing using age at peak height velocity, self-reported adrenarche (Tanner pubic hair stage) and parent-reported Pubertal Development Scale scores in early adolescence. Relationships were adjusted for age, sex, mid-childhood BMI, and socioeconomic status; effect modification by sex was considered throughout. The mediational g-formula estimated the indirect effect of pubertal timing on depression symptoms via weeknight sleep duration.

Results: All measures of earlier pubertal timing predicted shorter actigraphy-measured sleep duration; self-reported adrenarche predicted self-reported sleep duration and depression symptoms. No effect modification by sex was found. In both sexes, a 1-stage advance in adrenarche was associated with less (-0.14 h (95 % CI -0.23,-0.05)) self-reported sleep on weeknights across the mid-adolescent years. The relationship between earlier adrenarche and depression symptoms was mediated by self-reported weeknight sleep duration - a decrease in sleep duration in mid-adolescent years attributable to a 1-stage advance in adrenarche increased depression symptoms by 0.22 points (95 % CI 0.08,0.40).

Limitations: The geographic specificity and attrition in Project Viva limit the generalizability of our findings.

Conclusions: Maintaining adequate weeknight sleep across adolescent years may mitigate the impact of earlier adrenarche on depressed mood in late adolescence.

Background: The relationship between age-related eye diseases and the subsequent risk of dementia and depressive disorders remains inconsistent. Furthermore, the effects on anxiety disorders and sleep disorders have been underexplored. This study aims to comprehensively examine the impact of age-related eye diseases on common mental disorders in older adults, thereby enhancing our understanding of the mental health implications in these conditions.

Methods: The electronic health records of 1,522,036 patients aged over 60 from ten institutions in South Korea were analyzed. Patients with and without age-related eye diseases were identified, and 1:4 propensity score matching (PSM) was implemented. A 10-year longitudinal analysis was conducted using the Cox proportional hazards model to calculate the hazard ratios (HR). A meta-analysis was performed to combine the results from different institutions. Subgroup analyses were conducted to explore the impact of specific age-related eye diseases (cataract, glaucoma, age-related macular degeneration) on mental disorders.

Results: A total of 41,637 patients with age-related eye disease were matched with 134,908 patients without such conditions. Patients with age-related eye disease showed a significantly higher risk of mental disorders (dementia, HR: 1.21 [95 % CI: 1.14-1.27]; depressive disorders, HR: 1.28 [95 % CI: 1.20-1.36]; anxiety disorders, HR: 1.31 [95 % CI: 1.22-1.41]; sleep disorders, HR: 1.29 [95 % CI: 1.22-1.37]). In subgroup analyses, each of the three age-related eye diseases was significantly associated with an increased risk of mental disorders. (cataract, HR: 1.25-1.33; glaucoma, HR: 1.15-1.49; age-related macular degeneration, HR: 1.18-1.37).

Conclusion: Age-related eye diseases increase the risk of developing mental disorders in older adults, highlighting the need for a multidisciplinary approach to patient care in these conditions.