Journal of Affective Disorders Reports最新文献

Objectives

The purpose of this study is to longitudinally examine the change in depressive symptoms immediately following divorce among Korean women during the COVID-19 outbreak, as well as to verify the factors affecting the change in depressive symptoms.

Methods

A total of 401 women from the Korean Longitudinal Survey of Women & Families(KLoWF) were analyzed between 2012(4th wave) and 2020(8th wave). Latent Growth Modeling is utilized to assess the overall trajectory of depressive symptoms in women following divorce.

Results

In the immediate aftermath of divorce, the level of depressive symptoms in divorced women was high, but gradually decreased over time, only to reappear later on. The factors impacting the initial depressive symptom levels among women post-divorce revealed that lower educational attainment, lower subjective economic status, and poorer subjective health status were associated with higher depressive symptom levels. Among the factors influencing the rate of change in depressive symptoms, living alone emerged as the only statistically significant factor. The depressive symptom levels of women living alone declined gradually, whereas the depressive symptom levels of women living with someone decreased more rapidly.

Conclusion

As a result of this study, valuable data can be used to develop practical interventions aimed at enhancing the mental well-being of women post-divorce, particularly during challenging circumstances such as the COVID-19 outbreak.

Background

Passive suicidal ideation (i.e., the desire to be dead) may be an important, yet understudied, risk factor for suicidal behavior. Experiences of discrimination have been linked to greater severity of suicidal ideation though less work has examined factors that influence this relation. Though not explicitly tested, prior work suggests that problem orientation, defined as an individual's general beliefs about problems in daily life, may be an important moderator of this relation. In the present study, positive and negative problem orientation were hypothesized to moderate the relation between everyday discrimination and past month frequency of passive suicidal ideation.

Method

The study consisted of a diverse (62.4 % non-White; 21.4 % Latino/a/x; 27 % sexual minority) adult sample (N = 392; M_age = 20.24, SD = 2.49, 67.3 % female) recruited from a U.S. Mid-Atlantic college campus. Discrimination, problem orientation, past-month depressive symptoms, and past-month frequency of passive suicidal ideation were assessed using self-report measures. A single path model with Bayesian estimation was used to evaluate concurrent relations among study variables.

Results

After controlling for depressive symptoms, sex, sexual identity, and age, positive problem orientation buffered the impact of lifetime discrimination on past month passive suicidal ideation (b = -0.01, 95 % credibility interval [CI]: [-0.008, -0.001]). Negative problem orientation did not moderate this relation (b = 0.00, 95 % CI: [-0.002, 0.003]).

Limitations

Study design was cross-sectional in nature.

Conclusions

Results suggest that bolstering positive problem orientation in treatment with young adults who have experienced discrimination may help reduce suicide risk.

The purpose of this study is to investigate the trajectory of depression over time among all registered individuals with disability, including the period since the onset of COVID-19. In this study, we analyzed the results of the 12th-16th Korea Welfare Panel Study(KoWePS) which was conducted from 2017 to 2021. 793 individuals who were able to estimate the change in depression all period were selected for the final analysis. There was a significant increase in depression among people with disabilities occurs over time, and the level of depression rose gradually. Individuals being women, the lower the household income, the more severe the disability, and not having a physical disability was associated with the likelihood of higher depression. The health care system needs to be improved to be more disability-friendly to promote the health of people with disability, who are relatively more vulnerable during an infectious disease pandemic, such as COVID-19.

Background

Methylphenidate, a nervous system stimulant, is the active ingredient in the brand-name medication Ritalin. The non-medical consumption of this drug is on the rise worldwide, particularly among medical students who belong to an at-risk group. However, misusing this drug can have adverse effects such as depression. In this study, we sought to evaluate the relationship between arbitrary use of Ritalin and the incidence of depression and explore associated factors.

Methods

In this descriptive cross-sectional study, we examined 100 medical students enrolled at (XXX) Medical School (XXX) who reported taking at least one dose of Ritalin in the past month. We gathered participant data, including demographics such as age, education, residence status, history of psychiatric illness, and history of psychiatric medication use. Additionally, we collected information related to depression and anxiety using a questionnaire design based on the Hamilton scoring system in which a score range of 10–13 indicates mild depression, a score range of 14–17 signifies mild to moderate depression, and a score exceeding 17 indicates moderate to severe depression.

Results

Several noteworthy findings emerged from our study. We observed that the average age of female (26.45 ± 4.55, n = 39) participants was significantly higher than that of their male (24.26 ± 3.71, n = 61) counterparts (p = 0.01). Moreover, the average final depression score for students was determined to be 18.19, with a median score of 16. The data analysis revealed that 45% of students exhibited moderate to severe depression, whereas 55% experienced either no depression or only mild symptoms.

Conclusions

Our study indicates that depression is indeed a significant side effect of Ritalin use among medical students.

Background

Treatment resistant depression (TRD; failure to respond to ≥2 treatments in the same major depressive episode) affects 10–30 % of patients with major depressive disorder. In Portugal, the disease burden is estimated to exceed that of heart failure, highlighting the critical unmet needs of these patients.

Methods

A non-interventional cohort study of patients with TRD collected real-world data from several European countries. All patients started a new antidepressant treatment at baseline. We present a sub-analysis of baseline characteristics and Month 6 treatment outcomes in Portuguese patients.

Results

Among 411 patients enrolled, 37 were Portuguese. At baseline, 45.9 % of Portuguese patients had severe depression versus 32.6 % of the total study population. Portuguese patients had numerically greater impairments in work and productivity, measured by the Work Productivity and Activity Impairment questionnaire and the Sheehan Disability Scale. There was considerable heterogeneity in treatments used in the Portuguese subgroup, with 31 different treatment strategies reported. At Month 6, a greater proportion of Portuguese patients (n = 27) achieved either response or remission (40.7 %) compared with the total study population (n = 306; 26.5 %).

Limitation

Small patient numbers in the Portuguese subgroup.

Conclusions

The higher baseline disease severity and productivity impairment in the Portuguese subgroup relative to the total study population suggests notable societal disease burden, whilst the heterogeneity of treatments used indicates a lack of clinical consensus. Despite Portuguese patients reporting higher rates of response and remission than the overall study population, most patients failed to respond to treatment, highlighting an unmet need for TRD in Portugal.

Background

Problematic sexual behaviours are controversial phenomena, lacking diagnostic consensus, yet they are significant and warrant in-depth scientific research due to their clinically significant consequences. Therefore, this study aimed to explore the association between potential risk factors of sex addiction and problematic online pornography use, with a specific focus on the role of attachment and dissociation.

Method

A sample of 375 participants (M_age = 30 years; SD = 12.441) was involved in the research. The collected data were analysed by implementing a path analysis model.

Results

Significant and positive total effects in the relationships between fearful/preoccupied attachment patterns and both sex addiction and problematic online pornography use were shown. Furthermore, these associations were significantly mediated by dissociation. Finally, sex addiction and problematic online pornography use were significantly associated with daily thoughts about sex and weekly online pornography use, respectively.

Limitations

The cross-sectional design and the use of only self-report measures in an online survey should be kept in mind while interpreting the results.

Conclusions

Such data provide useful insight into the complex interplay of attachment, dissociation, and problematic sexual behaviours, providing information that may inform and guide targeted clinical interventions.

Background

Self-injurious thoughts and behaviors (SITBs) are a major problem worldwide and continue to be a serious public health concern. Research investigating risk factors for suicide has shown that reward processes, such as the inability to feel pleasure, may confer risk for SITBs. However, less work has examined how different dimensions of trait reward relate to SITBs. Accordingly, the present study investigated the unique and interactive effects of trait anticipatory and consummatory reward for explaining SITBs.

Methods

260 community adults ages 18–55 (M/SD = 32.79/10.54, females = 49.6 %, males = 50.4 %) completed an interview, neuropsychological tests, and questionnaires. We used hierarchical multivariate multiple regression analysis to assess cross-sectional associations between trait anticipatory and consummatory reward and different types of SITBs [self-injurious thoughts, nonsuicidal self-injury (NSSI), and suicide attempts] from the Risky, Impulsive, and Self-destructive Behavior Questionnaire.

Results

The unique variance associated with anticipatory and consummatory reward were differentially related to self-injurious thoughts but unrelated to self-injurious behaviors (NSSI/suicide attempts). The interaction of anticipatory and consummatory reward was associated with self-injurious behavior, such that the inability to experience both anticipatory and consummatory reward was associated with higher frequency of NSSI.

Limitations

Limitations of the study include its cross-sectional nature and reliance on self-reported measures.

Conclusions

Low anticipatory reward and high consummatory reward may confer risk for self-injurious thoughts. Low levels of both trait anticipatory and consummatory reward may confer risk for NSSI. Findings suggest reward sensitivity may be an understudied risk factor for a range of SITBs.

Background

This systematic review and meta-analysis aimed to synthesize the evidence of efficacy and tolerability of adjunctive topiramate treatment for patients with obsessive-compulsive disorder.

Methods

A systematic search was conducted on MEDLINE, Cochrane Central Register of Controlled Trials, and OpenGrey to identify randomized controlled trials assigning participants with OCD to pharmacological intervention with topiramate. Study inclusion and data extraction were undertaken by two reviewers independently. The primary outcome was the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scale score, as a continuous variable within-subject OCD illness severity before and after treatment. The weighted mean difference (WMD) with 95 % confidence interval was calculated between the topiramate group and the control group.

Results

Five studies were selected for inclusion in the systematic review, 4 of which were also included in the quantitative synthesis of data. The WMD in the Y-BOCS score between topiramate and placebo subjects was -0.49 (-2.28, 1.30) (p = 0.00); The results show a trend towards an effect of topiramate, but the estimate was not significant. Subgroup analysis revealed a significant effect at 12 weeks but not at 16 weeks (p = 0.00).

Limitations

Low quality of the studies included and small sample size.

Conclusion

There is a small positive signal for an anti-obsessive/compulsive effect in OCD patients which should encourage further research with larger, randomized, and placebo-controlled trials to assess topiramate's potential role in OCD treatment comprehensively.

Background

Treatment-Resistant Depression (TRD) is a poorly understood but prevalent clinical phenomenon that lacks a widely accepted definition, explanatory model, or set of practice recommendations. It involves a chronic form of unipolar Major Depressive Disorder (MDD) that fails to respond to at least two first-line clinical treatments. TRD affects as many as 70 % of patients who fail to respond to their first trial of antidepressant medication and 60 % of patients who fail to respond to their first phase of psychotherapy.

Purpose

This qualitative study aims to develop a model for understanding the phenomenon of unipolar TRD and the practices involved in its effective treatment.

Methods

This study involved a grounded theory analysis of interviews with four adult-American patients with unipolar TRD and five American providers who routinely treat such patients.

Results

A model of unipolar TRD was developed, explaining common etiological and maintaining factors of unipolar TRD and offering recommendations for guiding effective treatment.

Limitations

This study had a small sample size (N = 9) with limited sociodemographic diversity (all Americans; only two females; one racial/ethnic minority; no sexual minorities), which may limit its generalizability.

Conclusions

Nevertheless, its emergent theory underscores the importance of TRD patients cultivating positive views of medication and psychotherapy while collaborating with their providers to obtain psychoeducation, build mindfulness/coping skills, enhance social support, and re-engage with pleasurable activities. It recommends that mental health providers focus on processing TRD patients’ subjective experiences, validating patients’ frustrations, and monitoring and calibrating patients’ expectations.

Background

Depression is a condition which affects the individuals’ entire existence. The difficulty in emotionally tuning in to the environment and the resulting sensation of loneliness have frequently been described as salient points of depressive experience. To our knowledge there are no studies that phenomenologically analyze how depressed people feel perceived by others.

Methods

Aiming to fill this gap, this study builds on a previous work, which carried out a literature screening and a thematic analysis on the subjective experience of depression. The narratives collected in this way were analyzed using a bottom-up qualitative method (Consensual Quality Research).

Results

Four main categories of experience related to perceived social apprehension of depression have been identified: (1) feeling guilty about not meeting others' expectations, (2) feeling socially misunderstood, (3) bringing to light an inconvenient truth that others do not want to see, and (4) hiding from exposure to the judgement of others.

Limitations

A broader and more specific data collection on the topic is missing.

Conclusions

Depressed patients often feel misunderstood by their social environment, which belittles or dramatizes their condition or doesn't realize how otherwise normal requests can instead cost a lot of effort, generating feelings of guilt and inability. This frequently pushes depressed individuals to try to hide their condition by isolating themselves or wearing a social mask. The difficulty in emotional attunement already present in depression can only worsen in the face of this feeling of incomprehension, generating a vicious circle of non-recognition that ends up maintaining the depressive state.