Journal of Affective Disorders Reports最新文献

Background

Burnout symptoms are highly prevalent among university students. The effort-reward imbalance (ERI) model is predictive for workers’ mental health. This study aims to investigate the associations of ERI and overcommitment with burnout symptoms among students.

Methods

An Italian version of the Oldenburg Burnout Inventory-Student (OLBI-S) and the Effort-Reward Imbalance-Student Questionnaire (ERI-SQ) were administered to assess burnout symptoms (range: 16–64), effort (range: 2–8), reward (range: 5–20) and overcommitment (range: 5–20) among 545 students twice with six months of follow-up. ERI (range: 0.25–4) was estimated multiplying the effort/reward ratio by a correction factor to account the difference in items investigating effort and reward. A between-within linear regression model was used to investigate whether ERI and overcommitment were associated with burnout symptoms (between individuals) and whether individual changes in ERI and overcommitment during the follow-up were associated with changes in burnout symptoms (within individuals).

Results

Higher levels of ERI (β: 10.13, 95 % CI: 9.21–11.05) and overcommitment (β: 1.09, 95 % CI: 0.95–1.23) were associated with higher levels of burnout symptoms. An increase in ERI (β: 4.93, 95 % CI: 3.02–6.84) and overcommitment (β: 0.92, 95 % CI: 0.59–1.26) within individuals was associated with an increase in burnout symptoms.

Discussion

This study supports the validity of the ERI model in the university setting. ERI and overcommitment may be determinants of burnout symptoms among university students. Interventions at individual and environmental level may aim to decrease ERI and overcommitment to tackle the burden of burnout among students. Future research may investigate the drivers of students’ ERI and overcommitment among students.

Background

Peripartum depression (PPD) is the most common peripartum mental health problem. However, none of the available questionnaires evaluates depressive symptoms according to the latest DSM-5-TR (APA, 2022). Peripartum Depression Scale (PDS) is a new measure of PPD developed according to DSM-5-TR full criteria and postpartum-specific symptoms described in the literature. The aim of this study was to validate a new scale to assess depression in pregnancy and postpartum.

Methods

In this online cross-sectional study, 513 pregnant women and 751 women within the 12 months postpartum completed a new PDS consisting of 43 items from Criterion A, rated on a four-point scale, and seven items on the remaining DSM-5-TR criteria. They also completed Edinburgh Postnatal Depression Scale (EPDS), Depression, Anxiety and Stress Scale (DASS), and General Data Questionnaire.

Results

Confirmatory factor analysis confirmed that the one-factor model had a poor fit, but the 9-factor with a second-order factor in postpartum sample and 10-factor model with a second-order factor in pregnant sample, on the same 42-item version of scale, had a good fit to the data. The reliability of McDonald's ω of .96 was very high in both pregnant and postpartum women. Convergent and known-groups validity was demonstrated; however, correlations with stress were high.

Limitations

Clinical interview was not administered.

Conclusion

Peripartum Depression Scale is a 42-item instrument which is shown to be a valid and reliable measure to assess depression symptoms both during pregnancy and the full postpartum year according to DSM-5-TR criteria and current literature on peripartum-specific symptoms.

Background

Both cognitive behavioral therapy (CBT) alone and combined with brief motivational interviewing (CBT + BMI) are associated with reductions in depression, alcohol-related problems (ARP), and heavy alcohol use among college students with co-occurring depression and heavy episodic drinking (HED). Little is known regarding how these interventions facilitate change and the temporal ordering of reductions. This study examined mediators of CBT alone versus CBT + BMI, including (1) emotion regulation constructs (cognitive reappraisal, expressive suppression, avoidance coping) and (2) drinking to cope motives. The temporal relationships between improvement in depression and reduction of ARP and HED were also examined.

Methods

Data from 94 college students with depression and HED randomized to either eight weeks of CBT alone or CBT + BMI collected during a previous trial were utilized. Multilevel structural equation models were adopted to investigate mediation models. A cross-lagged panel analysis examined temporal relationships between depression, ARP, and HED.

Results

Mediators associated with improvement did not differ between the two interventions. In both, depression amelioration was mediated by increased cognitive reappraisal and reduction of avoidance coping and drinking to cope. Reduction of drinking to cope mediated improvements in ARP.

Limitations

It is uncertain whether observed changes can be solely attributed to CBT, or if other factors may have played a role.

Conclusions

Treatment programs providing emotion regulation skills to cope with aversive affect, as an alternative to alcohol misuse, may lead to depression improvement.

Background

Depression and anxiety are prevalent among persons living with multiple sclerosis (plwMS) and are linked to negative prognostic outcomes. Cognitive theories posit that personality and cognitive factors confer risk for depression and anxiety. This meta-analytic review aimed to synthesise evidence on personality and cognitive factors related to depression and anxiety in MS and determine whether sociodemographic and clinical variables moderate factor-symptom relations.

Methods

This systematic review, meta-analysis and meta-regression was prospectively registered (CRD42020192253). Publications were identified through database searches (Medline, Embase, PsycInfo, WebofScience, Proquest) and considered if they included a sample of individuals with clinically definite MS (age ≥11 years) and a measure of depression or anxiety and a personality or cognitive factor. The Newcastle-Ottawa Scale was applied to assess methodological rigor.

Results

A total of 99 studies were included in the narrative synthesis (97 samples; N= 13,609; M_age= 44.20±7.26), with 77 contributing effects on 24 factors for random-effects meta-analyses. The most robust relationships were between depression and anxiety and higher neuroticism, lower extraversion, emotion dysregulation, and illness perceptions of serious MS consequences and a strong MS identity (r's=0.28–0.59). A set of factors exhibited specificity for depression, including psychological inflexibility (r= 0.62) and optimism (r= -0.43). Relationships varied as a function of age, gender, and MS-type.

Limitations

Limited data availability prevented evaluation of heterogeneity in all cases, and prospective conclusions. Exclusion criteria in the included studies reduced the generalisability findings.

Conclusions

Findings highlight shared and distinct factors implicated in depression and anxiety, offering insights for tailored interventions.

Background

Medical students are at high risk for mental disorders, and the COVID-19 pandemic might have exacerbated psychological distress. However, no data are available for the southern part of Italy. The SMS-ME (Sicilian Medical Students’ MEntal health) project aimed to estimate the prevalence of and predictors of depression, anxiety, stress, and suicidal ideation in a sample of Sicilian medical students.

Methods

A web-based cross-sectional survey was carried out from September 2022 to December 2022. The study protocol investigated sociodemographic factors and clinical data including Depression, Anxiety, Stress Scale-21 (DASS-21), and a specific question addressing suicidal ideation frequency over the last six months. Multivariate regression models were assessed to examine the association between symptoms and relevant predictors and then regressed their residuals with suicidal thought frequency.

Result

We collected 1,866 records (age=22.5, SD=3.4; 65.2 % females). One out of four students presented highly severe depression (25 %) and referred to the presence of some suicidal ideation in the six months preceding the interview (26.1 %). DASS-21 scores, especially depression (F(5, 1,828)=58.8, p = 6.59^–57), increasingly predicted the frequency of suicidal thoughts when above the sample's mean.

Limitations

The cross-sectional study design does not allow inferences on temporal relationships and the self-report strategy could be intrinsically biased by the person's feelings at the time of the interview.

Conclusions

High prevalence of anxiety and depressive symptoms and suicidal thoughts were observed among Sicilian medical students. The DASS-21 was a good predictor for suicidal ideation that Universities could use as a simple tool to assess the need for psychological healthcare in this population.

Introduction

Anhedonia is a core symptom in depressive episodes, predicting the occurrence of treatment resistance, suicidality, and poor responses to conventional treatments. Ketamine has shown potent antidepressant properties and appears to be a promising antianhedonic agent.

Methods

A systematic review and meta-analysis were performed for interventional studies published between 2013 and April 2023. Additionally, an active search was conducted on April 10, 2024. Sixteen studies, with an initial total sample of 1048 participants with treatment-resistant major depressive disorder (MDD) and bipolar depression (BD), were included in the meta-analysis. The ROBINS-I and ROB-2 tools assessed the risk of bias.

Results

Compared to baseline levels, ketamine showed a significant antianhedonic effect 24 h after the first infusion (MD -0.73, 95 % CI -0.93, -0.52, p < 0.01; Z= -7.07, Tau2= 0.0643, I²= 53 %, p = 0.02), for the general analysis considering the last infusion defined by each study protocol (MD -1.42, 95 % CI -1.79, -1.05, p < 0.01; Z= -7.46, Tau2= 0.6208, I² = 92 %, p < 0.01). Subanalysis revealed a significant effect for ketamine both in MDD patients (MD -1.13, 95 % CI -1.56, -0.70, p < 0.01; Z= -5.11, Tau2= 0.4116, I²= 88 %, p < 0.01) and those with BD (MD -1.21, 95 % CI -1.80, -0.62, p < 0.001; Z=-4.02, Tau2= 0.2142, I² = 66 %, p = 0.05).

Limitations

most included studies were non-randomized trials and post-hoc analyses. In addition, consistent heterogeneity was identified in the analysis.

Conclusion

The growing current evidence suggests that ketamine is a promising treatment for anhedonia.

Background

Current treatment of major depressive disorders still leave many patients with modest improvement. Attention Bias Modification (ABM) is an approach that may serve as an adjuvant therapy for subgroups of patients. We examined whether rumination, often found to be associated with a negative attentional bias, acts as a moderating variable in a computerized ABM procedure in participants with recurrent depression.

Methods

A total of 301 patients were randomized to receive either active - or sham ABM twice daily for 14 days. A regression-based moderator analysis was applied to evaluate whether baseline brooding, from the Rumination Response Scale (RRS-B), moderated the effect of ABM on Hamilton Depression Rating Scale (HDRS) and Beck Depression Inventory II (BDI-II).

Results

There was no significant interaction effect of ABM and RRS-B on HDRS or BDI-II at post-intervention or at 1 month follow-up. In addition, no correlation was found for pre-training attention bias and RRS-B.

Limitations

: Generalizability is limited to individuals with non-clinical symptom scores.

Conclusions

There was no moderator effect of brooding rumination on clinical depression scales in the largest clinical study on ABM to date.

Background

Emotion regulation (ER) plays an important role for mental health. However, there is limited research involving ER variability as a prerequisite for adaptive ER. The present study assessed the relations between two indicators of ER variability (between- and within-strategy), depressive symptoms, perceived ER effort and success, and age.

Methods

We implemented a three-week ambulatory assessment study during a nationwide lockdown in Germany during the Covid-19 pandemic (April 2020). The sample comprised 322 participants aged between 15 and 82 years (M = 28.8 years, SD = 14.0, 74.5 % female). Participants reported their daily use of ER strategies in the evening. The data were analysed with stepwise regression analyses.

Results

We found significant positive associations between within-strategy variability and depressive symptoms. Perceived ER effort was positively correlated to depressive symptoms, while perceived ER success was negatively associated with depressive symptoms. Between-strategy variability did not show a significant connection to depressive symptoms. Age was negatively associated with within-strategy variability.

Conclusions

The findings support that day-to-day ER variability, particularly within-strategy variability, is a significant correlate of depressive symptoms across a wide age range. Our results underscore the importance of considering situational context information when analyzing the adaptiveness of specific ER patterns.

Post-traumatic stress disorder (PTSD) is a mental disorder linked to neurochemical, hypothalamic-pituitary-adrenal (HPA)-axis dysregulations, inflammatory and pro-oxidant challenges in response to traumatic events. It is one of the leading causes of neurocognitive declines, hence prompting the need for a pharmacological intervention. However, the impact of diosgenin, a naturally occurring steroidal saponin with adaptogenic-like action, on PTSD-induced neuropsychiatric disturbances and its underlying mechanisms are unknown. In this study, we investigated the outcome of diosgenin treatment in a multimodal traumatic, single prolonged stress (SPS)-induced PTSD in mice. Following the SPS-induced 7 days of PTSD, mice (n = 9) were thereafter treated with diosgenin (25 and 50 mg/kg) or fluoxetine (10 mg/kg) orally from days 8–20 (14 days). Locomotory, cognitive-, depressive- and anxiety-like behaviors were investigated. We assayed for changes in adrenal weight, serum glucose and corticosterone concentrations. Neurochemical, inflammatory, oxido-nitrergic dysfunctions and monoamine oxidase-B and acetylcholinesterase activities, were measured in the striatum, prefrontal-cortex and hippocampus. The results revealed that the SPS challenge inhibited locomotor, spatial/non-spatial memory functions, increased anxiety and depressive-like features, which were reversed by diosgenin. Diosgenin reduced SPS-induced increased monoamine oxidase-B, acetylcholinesterase activities, TNF-α, IL-6, malondialdehyde and nitrite levels in the striatum, prefrontal-cortex and hippocampus. Antioxidants such as glutathione, superoxide-dismutase, and catalase levels in SPS-mice brains were increased by diosgenin. Moreover, diosgenin attenuated SPS-induced hyper-HPA-axis mediation of PTSD by decreasing serum corticosterone, glucose levels and adrenal gland hypertrophy. Herewith, we suggest that diosgenin convenes adaptogenic-like protection against mice exposed to PTSD by enhancing antioxidant machinery, neurochemical modulations, and inhibition of oxido-nitrergic, inflammatory, and HPA-axis dysfunctions.

Background

Individuals with major depressive disorder (MDD) hospitalized for a suicide attempt are at high risk for a repeated suicide attempt. Previous studies have identified immune alterations in MDD, but not the prospective association between immunological abnormalities and subsequent suicide behavior.

Methods

We enrolled 69 adults with MDD following hospitalization for a suicide attempt. Participants were assessed for co-occurring immunological disorders and on clinical measures. Participants had a blood sample drawn from which were measured cytokines, antibodies, and other markers of inflammation. Following hospital discharge, participants were assessed for six months. Cox proportional hazard models examined the relationships between baseline variables and a repeated suicide attempt.

Results

A total of 15 (24 %) of the 62 participants with at least one post-hospital visit had a suicide attempt in the follow-up period. These individuals had a significant alteration in a combined immune marker consisting of the cytokines, IL-1β, TNF-α, and IFN‐γ as well as IgG antibodies to Epstein Barr Virus (HR= 8.03, 95 % CI 1.73, 37.08, p=.008). A diagnosis of asthma was also associated with a repeated suicide attempt (HR= 3.10, 95 % CI 1.10, 8.79, p=.033). Suicidal intent, stressful events, and aspects of psychiatric history also predicted this outcome.

Limitations

The sample was relatively small limiting statistical power. Also, we focused on one specific high-risk group.

Conclusions

Persons with MDD and immunological abnormalities have an increased rate of repeated suicide attempts. Immunological measurements combined with clinical information may identify high risk individuals who would benefit from personalized interventions.