Pub Date : 2025-12-09DOI: 10.1016/j.jadr.2025.101010
Yuehua Fei, Wei Yang, Yong Liu, Yanmei Yu, Tongcai Tan
Objective
Depressive symptoms are linked to increased all-cause mortality, but the biological mechanisms remain unclear. This study investigated whether systemic inflammatory markers—white blood cell count (WBC) and red cell distribution width (RDW)—mediate the association between depression and mortality in U.S. adults.
Methods
Data from 13,061 participants in the 2007–2018 National Health and Nutrition Examination Survey (NHANES) were analyzed. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). Cox proportional hazards models examined the association between depressive symptoms and all-cause mortality. Mediation analyses evaluated indirect effects of WBC and RDW.
Results
In fully adjusted models, severe depressive symptoms (PHQ-9 ≥15) were associated with higher mortality risk (HR = 2.18; 95 % CI: 1.17–4.09; p < 0.001). Depression scores were positively correlated with WBC (β = 0.33) and RDW (β = 0.21). Elevated WBC and RDW levels independently predicted increased mortality (WBC HR = 1.37; RDW HR = 2.53). Mediation analyses indicated WBC and RDW explained 12.2 % and 30.8 % of the total effect of depression on mortality, respectively.
Conclusions
Depressive symptoms are significantly associated with higher all-cause mortality, partially mediated by systemic inflammation. RDW, in particular, may reflect chronic inflammatory burden linked to depression. These findings highlight the value of monitoring inflammatory markers in depression management to mitigate long-term mortality risk.
{"title":"Inflammatory markers mediate the association between depression and all-cause mortality: Evidence from NHANES 2007–2018","authors":"Yuehua Fei, Wei Yang, Yong Liu, Yanmei Yu, Tongcai Tan","doi":"10.1016/j.jadr.2025.101010","DOIUrl":"10.1016/j.jadr.2025.101010","url":null,"abstract":"<div><h3>Objective</h3><div>Depressive symptoms are linked to increased all-cause mortality, but the biological mechanisms remain unclear. This study investigated whether systemic inflammatory markers—white blood cell count (WBC) and red cell distribution width (RDW)—mediate the association between depression and mortality in U.S. adults.</div></div><div><h3>Methods</h3><div>Data from 13,061 participants in the 2007–2018 National Health and Nutrition Examination Survey (NHANES) were analyzed. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). Cox proportional hazards models examined the association between depressive symptoms and all-cause mortality. Mediation analyses evaluated indirect effects of WBC and RDW.</div></div><div><h3>Results</h3><div>In fully adjusted models, severe depressive symptoms (PHQ-9 ≥15) were associated with higher mortality risk (HR = 2.18; 95 % CI: 1.17–4.09; <em>p</em> < 0.001). Depression scores were positively correlated with WBC (β = 0.33) and RDW (β = 0.21). Elevated WBC and RDW levels independently predicted increased mortality (WBC HR = 1.37; RDW HR = 2.53). Mediation analyses indicated WBC and RDW explained 12.2 % and 30.8 % of the total effect of depression on mortality, respectively.</div></div><div><h3>Conclusions</h3><div>Depressive symptoms are significantly associated with higher all-cause mortality, partially mediated by systemic inflammation. RDW, in particular, may reflect chronic inflammatory burden linked to depression. These findings highlight the value of monitoring inflammatory markers in depression management to mitigate long-term mortality risk.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"23 ","pages":"Article 101010"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-08DOI: 10.1016/j.jadr.2025.101004
Hailiang Guo , Xueqin Wang , Zhang Jin
Background
The COVID-19 pandemic has exposed critical gaps in mental health support systems for vulnerable populations. While prior studies have documented parental stress during acute pandemic phases, longitudinal patterns across pandemic stages remain unexplored. This large-scale study examines the trajectory of parental mental health in China through three distinct pandemic phases (containment, normalization, reopening), addressing the critical need for time-sensitive intervention strategies.
Methods
A total of 166,435 parents (81.9 % mothers) were administered self-assessment questionnaires concerning both the pandemic and their mental well-being, during three phases: initial outbreak (April 2020), sustained control (November 2020) and policy relaxation (November 2021). Exploratory factor analysis extracted six latent dimensions, which accounted for 44.8 % of the total variance. K-means clustering (k = 5 determined by elbow method) categorized participants into mental health profiles. Subsequently, changes in the proportions of different clusters across different time points were investigated.
Results
Mental health trajectories followed a U-shaped curve: the proportion of parents identified as optimists decreasing from 33.6 % during the initial lockdown to 23.2 % at the pandemic peak, followed by a rebound to 43.8 % in the post-restriction phase. Latent transition analysis revealed significantly higher volatility in mental health trajectories among younger parents (<30 years). Additionally, mothers reported higher levels of psychological distress compared to fathers.
Conclusion
Findings reveal parents’ complex emotional challenges during the pandemic, stressing the need for tailored support, especially for mothers. By emphasizing age and gender, the research deepens understanding of COVID-19′s psychological impacts and calls for refined mental health approaches in global crises.
{"title":"Exploring psychological changes of parents during different phases of COVID-19: A cross-sectional study using factor analysis and k-means clustering","authors":"Hailiang Guo , Xueqin Wang , Zhang Jin","doi":"10.1016/j.jadr.2025.101004","DOIUrl":"10.1016/j.jadr.2025.101004","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic has exposed critical gaps in mental health support systems for vulnerable populations. While prior studies have documented parental stress during acute pandemic phases, longitudinal patterns across pandemic stages remain unexplored. This large-scale study examines the trajectory of parental mental health in China through three distinct pandemic phases (containment, normalization, reopening), addressing the critical need for time-sensitive intervention strategies.</div></div><div><h3>Methods</h3><div>A total of 166,435 parents (81.9 % mothers) were administered self-assessment questionnaires concerning both the pandemic and their mental well-being, during three phases: initial outbreak (April 2020), sustained control (November 2020) and policy relaxation (November 2021). Exploratory factor analysis extracted six latent dimensions, which accounted for 44.8 % of the total variance. K-means clustering (<em>k</em> = 5 determined by elbow method) categorized participants into mental health profiles. Subsequently, changes in the proportions of different clusters across different time points were investigated.</div></div><div><h3>Results</h3><div>Mental health trajectories followed a U-shaped curve: the proportion of parents identified as optimists decreasing from 33.6 % during the initial lockdown to 23.2 % at the pandemic peak, followed by a rebound to 43.8 % in the post-restriction phase. Latent transition analysis revealed significantly higher volatility in mental health trajectories among younger parents (<30 years). Additionally, mothers reported higher levels of psychological distress compared to fathers.</div></div><div><h3>Conclusion</h3><div>Findings reveal parents’ complex emotional challenges during the pandemic, stressing the need for tailored support, especially for mothers. By emphasizing age and gender, the research deepens understanding of COVID-19′s psychological impacts and calls for refined mental health approaches in global crises.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"23 ","pages":"Article 101004"},"PeriodicalIF":0.0,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-08DOI: 10.1016/j.jadr.2025.101009
Katherine Séguin , Marie-Hélène Pennestri , Linda Booij , Raphaëlle Giac , Angélique Brun , Cathy Vaillancourt , Sarah Lippé , Catherine M. Herba , & the RESPPA team
Purpose
Pregnancy is a period of heightened vulnerability to mental illness. Research shows that poor sleep quality can predict mental health problems over time, although there is evidence of bidirectional associations. The objective was to study bidirectional links between maternal mental health, sleep quality and perceived parental impact over the perinatal period.
Methods
Pregnant individuals (Mage=31.13; SD=4.28) were recruited from October 2020-September 2022 for the Resilience and Perinatal Stress during the Pandemic (RESPPA) Study. Analyses (N= 1385) were conducted using cross-lagged panel models, with data collected from the third trimester of pregnancy (T1), at 3 months postpartum (T2) and 12 months postpartum (T3).
Results
Greater maternal anxiety symptoms at T1 were associated with poorer sleep quality at T2 (β=0.168, SE=0.035, p<.001), and with a lower sense of perceived parental impact at T2 (β=-0.141, SE=0.043, p=.001). Greater maternal depressive symptoms at T1 were associated with poorer sleep quality at T2 (β=0.151, SE=0.036, p<.001), and with a lower sense of perceived parental impact at T2 (β=-0.121, SE=0.044, p=.006). Greater maternal depressive symptoms at T2 were associated with a lower sense of perceived parental impact at T3 (β=-0.147, SE=0.039, p<.001). A lower sense of perceived parental impact at T2 was associated with greater maternal depressive symptoms at T3 (β=-0.102, SE=0.031, p=.001).
Conclusions
Results indicate associations between maternal mental health symptoms and subsequent perceived sleep quality, but not vice-versa. While anxiety and depressive symptoms were associated with subsequent perceived parental impact, perceived parental impact was also associated with subsequent depressive symptoms (but not anxiety symptoms).
{"title":"Clarifying longitudinal associations between maternal mental health, perceived sleep quality, and perceived parental impact: A cross-lagged panel model","authors":"Katherine Séguin , Marie-Hélène Pennestri , Linda Booij , Raphaëlle Giac , Angélique Brun , Cathy Vaillancourt , Sarah Lippé , Catherine M. Herba , & the RESPPA team","doi":"10.1016/j.jadr.2025.101009","DOIUrl":"10.1016/j.jadr.2025.101009","url":null,"abstract":"<div><h3>Purpose</h3><div>Pregnancy is a period of heightened vulnerability to mental illness. Research shows that poor sleep quality can predict mental health problems over time, although there is evidence of bidirectional associations. The objective was to study bidirectional links between maternal mental health, sleep quality and perceived parental impact over the perinatal period.</div></div><div><h3>Methods</h3><div>Pregnant individuals (<em>M<sub>age</sub></em>=31.13; <em>SD</em>=4.28) were recruited from October 2020-September 2022 for the Resilience and Perinatal Stress during the Pandemic (RESPPA) Study. Analyses (<em>N</em> <em>=</em> 1385) were conducted using cross-lagged panel models, with data collected from the third trimester of pregnancy (T1), at 3 months postpartum (T2) and 12 months postpartum (T3).</div></div><div><h3>Results</h3><div>Greater maternal anxiety symptoms at T1 were associated with poorer sleep quality at T2 (β=0.168, SE=0.035, <em>p</em><.001), and with a lower sense of perceived parental impact at T2 (β=-0.141, SE=0.043, <em>p</em>=.001). Greater maternal depressive symptoms at T1 were associated with poorer sleep quality at T2 (β=0.151, SE=0.036, <em>p</em><.001), and with a lower sense of perceived parental impact at T2 (β=-0.121, SE=0.044, <em>p</em>=.006). Greater maternal depressive symptoms at T2 were associated with a lower sense of perceived parental impact at T3 (β=-0.147, SE=0.039, <em>p</em><.001). A lower sense of perceived parental impact at T2 was associated with greater maternal depressive symptoms at T3 (β=-0.102, SE=0.031, <em>p</em>=.001).</div></div><div><h3>Conclusions</h3><div>Results indicate associations between maternal mental health symptoms and subsequent perceived sleep quality, but not vice-versa. While anxiety and depressive symptoms were associated with subsequent perceived parental impact, perceived parental impact was also associated with subsequent depressive symptoms (but not anxiety symptoms).</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"23 ","pages":"Article 101009"},"PeriodicalIF":0.0,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-08DOI: 10.1016/j.jadr.2025.101001
E.M. Hoogerwerf , H. Riese , P. Spinhoven , F. Lamers , R. Goekoop
Background
: This study aims to gain more insight into participants with anxiety disorders by conducting network analysis with experience sampling methodology data (i.e. data measured multiple times a day via smartphone), comparing group networks of participants diagnosed with an anxiety disorder and healthy controls. We expect the networks of participants with an anxiety disorder to be more connected and to reveal relationships between symptoms that may perpetuate problems.
Methods
224 participants, 141 diagnosed with an anxiety disorder (Group A) at baseline (T0) and 83 healthy controls (Group B), from the Netherlands Study of Depression and Anxiety participated in ESM monitoring at 9-year follow-up (T1). Anxiety disorder status was assessed at T1 as well and used to group participants into group A-1, anxiety disorder at T0 and T1, and A-2, anxiety disorder at T0 but not at T1. 6 ESM items were used to conduct network analysis. The permutation test mnet was used to inspect the networks for significant differences.
Results
The autoregression coefficients of ESM-items ‘worrying’ and ‘nervousness’ were larger in Group A compared to group B, as well as the temporal influence of worrying on tiredness. The autoregression coefficients of worrying and tiredness were larger in Group A-2 than in Group A-1, those of enthusiasm were larger in Group A-1. The influence of tiredness on apathy was greater in Group A-2.
Conclusions
It seems likely that participants with chronic mood- and anxiety disorders are not distinct from each other on a level of symptomatic interconnectedness, even if they differ in diagnostic categories 9 years after baseline. These findings confirm the existing information regarding the chronic course that anxiety disorders often take.
{"title":"Towards a better understanding of persistence of anxiety disorders: a network perspective","authors":"E.M. Hoogerwerf , H. Riese , P. Spinhoven , F. Lamers , R. Goekoop","doi":"10.1016/j.jadr.2025.101001","DOIUrl":"10.1016/j.jadr.2025.101001","url":null,"abstract":"<div><h3>Background</h3><div><em>:</em> This study aims to gain more insight into participants with anxiety disorders by conducting network analysis with experience sampling methodology data (i.e. data measured multiple times a day via smartphone), comparing group networks of participants diagnosed with an anxiety disorder and healthy controls. We expect the networks of participants with an anxiety disorder to be more connected and to reveal relationships between symptoms that may perpetuate problems.</div></div><div><h3>Methods</h3><div>224 participants, 141 diagnosed with an anxiety disorder (Group A) at baseline (T0) and 83 healthy controls (Group B), from the Netherlands Study of Depression and Anxiety participated in ESM monitoring at 9-year follow-up (T1). Anxiety disorder status was assessed at T1 as well and used to group participants into group A-1, anxiety disorder at T0 and T1, and A-2, anxiety disorder at T0 but not at T1. 6 ESM items were used to conduct network analysis. The permutation test <em>mnet</em> was used to inspect the networks for significant differences.</div></div><div><h3>Results</h3><div>The autoregression coefficients of ESM-items ‘worrying’ and ‘nervousness’ were larger in Group A compared to group B, as well as the temporal influence of worrying on tiredness. The autoregression coefficients of worrying and tiredness were larger in Group A-2 than in Group A-1, those of enthusiasm were larger in Group A-1. The influence of tiredness on apathy was greater in Group A-2.</div></div><div><h3>Conclusions</h3><div>It seems likely that participants with chronic mood- and anxiety disorders are not distinct from each other on a level of symptomatic interconnectedness, even if they differ in diagnostic categories 9 years after baseline. These findings confirm the existing information regarding the chronic course that anxiety disorders often take.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"23 ","pages":"Article 101001"},"PeriodicalIF":0.0,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-08DOI: 10.1016/j.jadr.2025.101006
Eunice H. Barnabas , Matiko Mwita , Rogatus M. Kabyemera , Emmanuela E. Ambrose
Background
Depression is an increasingly important public health concern among children, particularly those living with chronic illnesses, including sickle cell anemia. Due to a lack of routine screening in sickle cell clinics, depression often goes undiagnosed and untreated, making it crucial to assess its magnitude for appropriate intervention. Therefore, this study aimed to determine the prevalence and factors associated with positive depression screening among children with sickle cell anemia attending Bugando Medical Centre, a tertiary hospital in Mwanza, northwestern Tanzania.
Methods
A hospital-based cross-sectional study was conducted among children with sickle cell anemia attending the pediatric and medical outpatient clinics at Bugando Medical Centre. Structured questionnaires were used to collect data on sociodemographic and disease severity while likelihood of depression was determined using the Children's Depression Inventory tool. Participants were recruited using a systematic sampling technique between January 1st and March 31st 2024.
Results
A total of 200 participants were enrolled, with a median age of 11 [IQR 9–13] years and more than half of the participants were male, 104 (52.0 %). Elevated risk of depression was identified in 20 % of the children. Children in middle adolescence (AOR:3.1, 95 % CI:1.1–8.2, p = 0.036) and those with severe sickle cell anemia (AOR:5.0, 95 % CI:1.5–19.6, p = 0.010) had higher odds of positive depression screening.
Conclusion
One in five children with sickle cell anemia demonstrated symptoms of depression, highlighting a significant mental health burden and underscoring the urgent need for targeted mental health interventions, especially among sickle cell anemia patients in middle adolescence and those with severe sickle cell anemia.
抑郁症是儿童中日益重要的公共卫生问题，特别是那些患有慢性疾病的儿童，包括镰状细胞性贫血。由于镰状细胞诊所缺乏常规筛查，抑郁症经常未得到诊断和治疗，因此评估其严重程度以进行适当干预至关重要。因此，本研究旨在确定在坦桑尼亚西北部姆万扎的三级医院Bugando医疗中心就诊的镰状细胞性贫血儿童的患病率及其与积极抑郁筛查相关的因素。方法对在Bugando医疗中心儿科和门诊就诊的镰状细胞性贫血儿童进行了一项以医院为基础的横断面研究。使用结构化问卷收集社会人口学和疾病严重程度的数据，同时使用儿童抑郁症清单工具确定抑郁症的可能性。参与者在2024年1月1日至3月31日期间采用系统抽样技术招募。结果共纳入200例受试者，中位年龄为11岁[IQR 9-13]岁，男性104例（52.0%），超过半数。20%的儿童患抑郁症的风险升高。青春期中期儿童（AOR:3.1, 95% CI: 1.1-8.2, p = 0.036）和重度镰状细胞性贫血儿童（AOR:5.0, 95% CI: 1.5-19.6, p = 0.010）抑郁筛查阳性的几率更高。结论五分之一的镰状细胞性贫血患儿表现出抑郁症状，这突出了严重的心理健康负担，并强调了迫切需要有针对性的心理健康干预，特别是在青春期中期的镰状细胞性贫血患者和严重的镰状细胞性贫血患者中。
{"title":"Positive depression screening and associated factors among children with sickle cell anemia attending a tertiary hospital in Mwanza, Tanzania: A Cross-sectional study","authors":"Eunice H. Barnabas , Matiko Mwita , Rogatus M. Kabyemera , Emmanuela E. Ambrose","doi":"10.1016/j.jadr.2025.101006","DOIUrl":"10.1016/j.jadr.2025.101006","url":null,"abstract":"<div><h3>Background</h3><div>Depression is an increasingly important public health concern among children, particularly those living with chronic illnesses, including sickle cell anemia. Due to a lack of routine screening in sickle cell clinics, depression often goes undiagnosed and untreated, making it crucial to assess its magnitude for appropriate intervention. Therefore, this study aimed to determine the prevalence and factors associated with positive depression screening among children with sickle cell anemia attending Bugando Medical Centre, a tertiary hospital in Mwanza, northwestern Tanzania.</div></div><div><h3>Methods</h3><div>A hospital-based cross-sectional study was conducted among children with sickle cell anemia attending the pediatric and medical outpatient clinics at Bugando Medical Centre. Structured questionnaires were used to collect data on sociodemographic and disease severity while likelihood of depression was determined using the Children's Depression Inventory tool. Participants were recruited using a systematic sampling technique between January 1st and March 31st 2024.</div></div><div><h3>Results</h3><div>A total of 200 participants were enrolled, with a median age of 11 [IQR 9–13] years and more than half of the participants were male, 104 (52.0 %). Elevated risk of depression was identified in 20 % of the children. Children in middle adolescence (AOR:3.1, 95 % CI:1.1–8.2, <em>p</em> = 0.036) and those with severe sickle cell anemia (AOR:5.0, 95 % CI:1.5–19.6, <em>p</em> = 0.010) had higher odds of positive depression screening.</div></div><div><h3>Conclusion</h3><div>One in five children with sickle cell anemia demonstrated symptoms of depression, highlighting a significant mental health burden and underscoring the urgent need for targeted mental health interventions, especially among sickle cell anemia patients in middle adolescence and those with severe sickle cell anemia.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"23 ","pages":"Article 101006"},"PeriodicalIF":0.0,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-08DOI: 10.1016/j.jadr.2025.101007
Dale S. Mantey , Anna C. Holdiman , Alex Lao , R․Andrew Yockey
Introduction
Suicide is the second leading cause of death among youth in the US. Individuals who identify as sexual and gender minorities are at disproportionate risk of suicide. This study aims to quantify disparities in suicidal thoughts and behaviors (STBs) by sexual and gender identity in a nationally representative sample of high school students in the US.
Methods
We analyzed data from n = 15,073 US high school students via the 2023 Youth Risk Behavior Surveillance Survey (YRBSS). Four (4) multivariate logistic regressions compared STBs (hopelessness; suicidal ideations; planned attempts; past attempts) by sexual identity and by gender identity. A multivariate ordinal logistic regression examined a composite score (0–4) of STBs. Models controlled for sex, grade, race, ethnicity, and bullying victimization.
Results
Youth who identified as transgender had greater odds of reporting hopelessness (aOR: 3.50), suicidal ideations (aOR: 4.23), planned attempt (aOR: 2.96), and past attempts (aOR: 2.96), relative to those who identified as cisgender; similar estimates were observed for youth who reported being unsure of their gender identity. Youth who identified as gay/lesbian (aOR: 3.02), bisexual (aOR: 4.11), questioning (aOR: 3.12), and other (aOR: 5.06) had significantly higher odds of reporting more severe symptoms of STBs relative to heterosexual youth.
Conclusion
Youth who identified as transgender had 3 to 4 times greater odds of STBs in a national sample; sexual identity was similarly associated with STBs. Interventions that expand prevention resources and improve social support for youth who identify as sexual and gender minorities are critically needed.
Implications and Contribution
Transgender and sexual minority youth are more likely to report each type of STB and to report more severe symptoms of suicidality. These data suggest the need for multifaceted, suicide prevention programs tailored preventing and reduce STBs among youth, particularly transgender and sexual minority youth.
{"title":"Disparities in suicidal thoughts and behaviors by sexual and gender identity: A national study of high school students in the US, 2023","authors":"Dale S. Mantey , Anna C. Holdiman , Alex Lao , R․Andrew Yockey","doi":"10.1016/j.jadr.2025.101007","DOIUrl":"10.1016/j.jadr.2025.101007","url":null,"abstract":"<div><h3>Introduction</h3><div>Suicide is the second leading cause of death among youth in the US. Individuals who identify as sexual and gender minorities are at disproportionate risk of suicide. This study aims to quantify disparities in suicidal thoughts and behaviors (STBs) by sexual and gender identity in a nationally representative sample of high school students in the US.</div></div><div><h3>Methods</h3><div>We analyzed data from <em>n</em> = 15,073 US high school students via the 2023 Youth Risk Behavior Surveillance Survey (YRBSS). Four (4) multivariate logistic regressions compared STBs (hopelessness; suicidal ideations; planned attempts; past attempts) by sexual identity and by gender identity. A multivariate ordinal logistic regression examined a composite score (0–4) of STBs. Models controlled for sex, grade, race, ethnicity, and bullying victimization.</div></div><div><h3>Results</h3><div>Youth who identified as transgender had greater odds of reporting hopelessness (aOR: 3.50), suicidal ideations (aOR: 4.23), planned attempt (aOR: 2.96), and past attempts (aOR: 2.96), relative to those who identified as cisgender; similar estimates were observed for youth who reported being unsure of their gender identity. Youth who identified as gay/lesbian (aOR: 3.02), bisexual (aOR: 4.11), questioning (aOR: 3.12), and other (aOR: 5.06) had significantly higher odds of reporting more severe symptoms of STBs relative to heterosexual youth.</div></div><div><h3>Conclusion</h3><div>Youth who identified as transgender had 3 to 4 times greater odds of STBs in a national sample; sexual identity was similarly associated with STBs. Interventions that expand prevention resources and improve social support for youth who identify as sexual and gender minorities are critically needed.</div></div><div><h3>Implications and Contribution</h3><div>Transgender and sexual minority youth are more likely to report each type of STB and to report more severe symptoms of suicidality. These data suggest the need for multifaceted, suicide prevention programs tailored preventing and reduce STBs among youth, particularly transgender and sexual minority youth.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"23 ","pages":"Article 101007"},"PeriodicalIF":0.0,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-08DOI: 10.1016/j.jadr.2025.101011
Azza Amin , Duaa A. Alsmany , Abubaker Mohamed , Al hissen Abubaker , Thurya Almahi , Zainab Hashim , Ahmed Osman , Yousif B. Hamdalneel , Mohamed Elmustafa , Alhumaira Wedaa
Millions of Sudanese people have been forced to flee their homes since war erupted in April 2023. Subsequently, an alarmingly high prevalence of Post-traumatic stress disorder (PTSD) among internally displaced people has been described. This war has resulted in the displacement, loss of shelter, suspension of study, destruction of personal property, and other war-related traumatic events for the majority of pharmacy students in the country. Therefore, this study aimed to estimate the prevalence of PTSD among pharmacy students at Wad Medani College of Medical Sciences and Technology, and to explore the association between socio-demographic data, traumatic events, and PTSD prevalence. This was a cross-sectional study using an online questionnaire that collected data about socio-demographics, encountered traumatic events, and the PTSD checklist for DSM-5 (PCL-5). For associations, the chi-square test and binary logistic regression were used. Overall, 45.6 % of the 456 participating pharmacy students met the criteria for PTSD. The war in Wad Medani, Sudan, led to the displacement of 94.3 % of the pharmacy students. More than half of them sought refuge in neighbouring countries. Economic status had a statistically significant association with PTSD prevalence (OR=1.497, CI (1.108 - 2.021)). All Traumatic events, such as lack of shelter (OR=2.113, CI (1.142- 3.913)), and being forced to hide (OR=2.078, CI (1.323- 3.265)) were significantly associated with PTSD. A large proportion of pharmacy students in this study may potentially be suffering from PTSD, indicating a pressing need for more research and targeted mental health services in settings affected by this conflict.
{"title":"Prevalence of post-traumatic stress disorder (PTSD) among pharmacy students at Wad Medani College of Medical Sciences and Technology during wartime in Sudan","authors":"Azza Amin , Duaa A. Alsmany , Abubaker Mohamed , Al hissen Abubaker , Thurya Almahi , Zainab Hashim , Ahmed Osman , Yousif B. Hamdalneel , Mohamed Elmustafa , Alhumaira Wedaa","doi":"10.1016/j.jadr.2025.101011","DOIUrl":"10.1016/j.jadr.2025.101011","url":null,"abstract":"<div><div>Millions of Sudanese people have been forced to flee their homes since war erupted in April 2023. Subsequently, an alarmingly high prevalence of Post-traumatic stress disorder (PTSD) among internally displaced people has been described. This war has resulted in the displacement, loss of shelter, suspension of study, destruction of personal property, and other war-related traumatic events for the majority of pharmacy students in the country. Therefore, this study aimed to estimate the prevalence of PTSD among pharmacy students at Wad Medani College of Medical Sciences and Technology, and to explore the association between socio-demographic data, traumatic events, and PTSD prevalence. This was a cross-sectional study using an online questionnaire that collected data about socio-demographics, encountered traumatic events, and the PTSD checklist for DSM-5 (PCL-5). For associations, the chi-square test and binary logistic regression were used. Overall, 45.6 % of the 456 participating pharmacy students met the criteria for PTSD. The war in Wad Medani, Sudan, led to the displacement of 94.3 % of the pharmacy students. More than half of them sought refuge in neighbouring countries. Economic status had a statistically significant association with PTSD prevalence (OR=1.497, CI (1.108 - 2.021)). All Traumatic events, such as lack of shelter (OR=2.113, CI (1.142- 3.913)), and being forced to hide (OR=2.078, CI (1.323- 3.265)) were significantly associated with PTSD. A large proportion of pharmacy students in this study may potentially be suffering from PTSD, indicating a pressing need for more research and targeted mental health services in settings affected by this conflict.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"23 ","pages":"Article 101011"},"PeriodicalIF":0.0,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-20DOI: 10.1016/j.jadr.2025.100998
Eling D. de Bruin , Nadine Buffat , Emanuel Brunner , Davy Vancampfort , Stefan Büchi , Josef Jenewein , Patrick Eggenberger
Background
A diagnosis of depression is traditionally made based on clinical criteria, including current symptomatology and history. This process relies on subjective interpretation only. Identification of objective depression-associated factors using appropriate statistical methods can help formulate prevention and refine treatment programs and policies aimed at reducing depression burden. The purpose of this study was to test whether physical and neurobiological markers might be important depression-associated factors.
Methods
Ninety adults (mean age (SD) 45.7 (10.8) years, 55 females) were categorized as depressed or non-depressed. All were assessed for executive functions, heart rate variability (HRV), gait, and prefrontal cortex oxygenation during walking (measured with functional near-infrared spectroscopy, fNIRS). Least Absolute Shrinkage and Selection Operator (LASSO) regression and planned contrasts were performed to determine independent associations with a diagnosis of depression and assess differences between groups.
Results
LASSO regression analysis resulted in variable selection from gait, executive functions, HRV, and fNIRS measures. The resulting multiparametric model displayed very high predictive power to distinguish non-depressed individuals from those with depression (area under the curve, AUC = 0.946). Planned contrasts revealed that depression significantly differs from non-depression regarding selected single measures of executive functioning (e.g., r = 0.16, p ˂ 0.009), HRV (e.g., r = 0.14, p= 0.05), gait (e.g., r = 0.19, p ˂ 0.001), and fNIRS (e.g., r = 0.16, p = 0.04).
Conclusions
The identified depression-associated factors can possibly be combinedly used to raise awareness of modifiable factors associated with depression. Our findings warrant further investigations into the causality of the associations to determine their possible utility as modifiable risk factors and to identify their relevance within novel treatments in individuals with depression.
传统上，抑郁症的诊断是基于临床标准，包括当前的症状和病史。这个过程只依赖于主观的解释。使用适当的统计方法识别客观的抑郁相关因素可以帮助制定预防和完善旨在减轻抑郁负担的治疗方案和政策。本研究的目的是测试生理和神经生物学标记是否可能是抑郁症相关的重要因素。方法90例成人（平均年龄45.7（10.8）岁，女性55例）分为抑郁症和非抑郁症。评估所有患者的执行功能、心率变异性（HRV）、步态和行走时前额皮质氧合（用功能性近红外光谱（fNIRS）测量）。进行最小绝对收缩和选择算子（LASSO）回归和计划对比，以确定与抑郁症诊断的独立关联，并评估组间差异。结果采用slasso回归分析，从步态、执行功能、HRV和fNIRS测量中选择变量。所得的多参数模型在区分非抑郁个体和抑郁个体方面显示出很高的预测能力（曲线下面积，AUC = 0.946）。计划对比显示，抑郁症与非抑郁症在执行功能（例如，r = 0.16， p小于0.009）、HRV（例如，r = 0.14, p = 0.05）、步态（例如，r = 0.19， p小于0.001）和近红外光谱（例如，r = 0.16, p = 0.04）的选择单一测量方面有显著差异。结论已确定的抑郁症相关因素可联合应用，提高对抑郁症相关可变因素的认识。我们的发现保证了对这些关联的因果关系进行进一步的调查，以确定它们作为可改变的风险因素的可能效用，并确定它们与抑郁症患者的新治疗方法的相关性。
{"title":"Physical and neurobiological depression-associated factors: A cross-sectional study","authors":"Eling D. de Bruin , Nadine Buffat , Emanuel Brunner , Davy Vancampfort , Stefan Büchi , Josef Jenewein , Patrick Eggenberger","doi":"10.1016/j.jadr.2025.100998","DOIUrl":"10.1016/j.jadr.2025.100998","url":null,"abstract":"<div><h3>Background</h3><div>A diagnosis of depression is traditionally made based on clinical criteria, including current symptomatology and history. This process relies on subjective interpretation only. Identification of objective depression-associated factors using appropriate statistical methods can help formulate prevention and refine treatment programs and policies aimed at reducing depression burden. The purpose of this study was to test whether physical and neurobiological markers might be important depression-associated factors.</div></div><div><h3>Methods</h3><div>Ninety adults (mean age (SD) 45.7 (10.8) years, 55 females) were categorized as depressed or non-depressed. All were assessed for executive functions, heart rate variability (HRV), gait, and prefrontal cortex oxygenation during walking (measured with functional near-infrared spectroscopy, fNIRS). Least Absolute Shrinkage and Selection Operator (LASSO) regression and planned contrasts were performed to determine independent associations with a diagnosis of depression and assess differences between groups.</div></div><div><h3>Results</h3><div>LASSO regression analysis resulted in variable selection from gait, executive functions, HRV, and fNIRS measures. The resulting multiparametric model displayed very high predictive power to distinguish non-depressed individuals from those with depression (area under the curve, AUC = 0.946). Planned contrasts revealed that depression significantly differs from non-depression regarding selected single measures of executive functioning (e.g., <em>r</em> = 0.16, <em>p</em> ˂ 0.009), HRV (e.g., <em>r</em> = 0.14, <em>p</em> <em>=</em> 0.05), gait (e.g., <em>r</em> = 0.19, <em>p</em> ˂ 0.001), and fNIRS (e.g., <em>r</em> = 0.<em>16, p</em> = 0.04).</div></div><div><h3>Conclusions</h3><div>The identified depression-associated factors can possibly be combinedly used to raise awareness of modifiable factors associated with depression. Our findings warrant further investigations into the causality of the associations to determine their possible utility as modifiable risk factors and to identify their relevance within novel treatments in individuals with depression.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"23 ","pages":"Article 100998"},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-19DOI: 10.1016/j.jadr.2025.100997
Reinhard Maß , Kerstin Backhaus , Bodo Karsten Unkelbach
Patients’ expectations concerning the effectiveness of treatment play a significant role in shaping clinical outcomes. These expectations are, in part, influenced by the explanatory models patients hold regarding the etiology of their illness. In the case of depression, both psychotherapeutic and pharmacological treatment options are available, each associated with distinct etiological models—psychological and biomedical, respectively.
Our study aimed to examine the significance of pre-treatment expectations regarding the helpfulness of medication or psychotherapy for treatment outcomes in depression.
A total of 635 inpatients diagnosed with major depressive disorder were included. Upon admission, all patients were asked to rate two statements assessing their expectations regarding the potential benefits of medication and psychotherapy. Depressive symptom severity was evaluated using the revised Beck Depression Inventory (BDI-II). Additionally, a subsample of 290 patients was queried about their beliefs concerning the etiology of their depression, including ongoing stress, metabolic imbalances in the brain, adverse childhood experiences, and genetic predisposition.
Mean BDI-II scores decreased substantially from admission to discharge. Expectations of receiving help through medication were more strongly associated with biomedical explanatory models, whereas expectations of benefiting from psychotherapy were more closely linked to psychological explanations. Regression analysis revealed that the reduction in depressive symptoms was attenuated by high expectations of benefit from medication, while optimistic expectations regarding psychotherapy were associated with greater symptom improvement.
Our findings suggest that fostering patients’ confidence in psychotherapy is important. Moreover, biomedical explanations for depression should not be promoted, particularly given the limited scientific evidence supporting them.
{"title":"The impact of expectations on treatment outcomes following intensive psychotherapy in inpatients with major depression","authors":"Reinhard Maß , Kerstin Backhaus , Bodo Karsten Unkelbach","doi":"10.1016/j.jadr.2025.100997","DOIUrl":"10.1016/j.jadr.2025.100997","url":null,"abstract":"<div><div>Patients’ expectations concerning the effectiveness of treatment play a significant role in shaping clinical outcomes. These expectations are, in part, influenced by the explanatory models patients hold regarding the etiology of their illness. In the case of depression, both psychotherapeutic and pharmacological treatment options are available, each associated with distinct etiological models—psychological and biomedical, respectively.</div><div>Our study aimed to examine the significance of pre-treatment expectations regarding the helpfulness of medication or psychotherapy for treatment outcomes in depression.</div><div>A total of 635 inpatients diagnosed with major depressive disorder were included. Upon admission, all patients were asked to rate two statements assessing their expectations regarding the potential benefits of medication and psychotherapy. Depressive symptom severity was evaluated using the revised Beck Depression Inventory (BDI-II). Additionally, a subsample of 290 patients was queried about their beliefs concerning the etiology of their depression, including ongoing stress, metabolic imbalances in the brain, adverse childhood experiences, and genetic predisposition.</div><div>Mean BDI-II scores decreased substantially from admission to discharge. Expectations of receiving help through medication were more strongly associated with biomedical explanatory models, whereas expectations of benefiting from psychotherapy were more closely linked to psychological explanations. Regression analysis revealed that the reduction in depressive symptoms was attenuated by high expectations of benefit from medication, while optimistic expectations regarding psychotherapy were associated with greater symptom improvement.</div><div>Our findings suggest that fostering patients’ confidence in psychotherapy is important. Moreover, biomedical explanations for depression should not be promoted, particularly given the limited scientific evidence supporting them.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"23 ","pages":"Article 100997"},"PeriodicalIF":0.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-19DOI: 10.1016/j.jadr.2025.101000
Javier Díaz Esteban-Herreros , Miriam Garrido-Miguel , Vicente Martínez-Vizcaíno , Ana Isabel Torres-Costoso , Asunción Ferri-Morales , Juan Moreno-Garcia , Elizabeth Bravo Esteban-Herreros
This study aims to evaluate the associations between psychological resilience and various health-related factors, including diet, smoking, alcohol use, and physical self-perception, in a sample of university students. The primary objective is to identify factors that are most significantly related to resilience and to determine their ability to predict an individual’s resilience level. A total of 360 university students participated in this cross-sectional study. Data were collected via validated questionnaires, such as the CD-RISC (Connor and Davidson, 2003) for psychological resilience, the PREDIMED (Guasch-Ferré et al., 2017) for the Mediterranean diet, the AUDIT (Kuitunen-Paul and Roerecke, 2018) for alcohol consumption risk, and the SCOFF (Morgan et al., 1999) for disordered eating behaviors. Additionally, questionnaires designed by researchers were used to assess smoking status and body image. Advanced machine learning models, specifically Random Forest (Breiman, 2001) (Breiman, 2001) and TabNet (Arik and Pfister, 2021) were applied to predict the resilience levels. To address class imbalance, the SMOTE technique was used. The model performance was measured via the macro F1-score, a metric suitable for imbalanced datasets. Additionally, the importance values of the predictor variables were calculated to provide interpretability. A clustering analysis was also conducted to segment the population on the basis of their characteristics. Our predictive models achieved moderate accuracy but successfully identified the most influential variables for resilience. Perceived health and body image emerged as key predictors of psychological resilience. A positive association was also found between adherence to a healthy diet and increased resilience. Clustering analysis revealed two distinct resilience groups, with the lower resilience group showing a greater risk of alcohol dependence. Finally, our findings confirm the associations between psychological resilience and various health habits and self-perceptions. The study provides a novel applications of machine learning to a psychological construct, identifying key predictors and demonstrating the complexity of these relationships. While this research provides valuable insights, future studies should consider larger sample sizes and a longitudinal design to further explore these dynamics and incorporate a broader range of sociocultural and familial factors.
{"title":"Machine learning prediction of psychological resilience: An analysis of health and self-perception variables","authors":"Javier Díaz Esteban-Herreros , Miriam Garrido-Miguel , Vicente Martínez-Vizcaíno , Ana Isabel Torres-Costoso , Asunción Ferri-Morales , Juan Moreno-Garcia , Elizabeth Bravo Esteban-Herreros","doi":"10.1016/j.jadr.2025.101000","DOIUrl":"10.1016/j.jadr.2025.101000","url":null,"abstract":"<div><div>This study aims to evaluate the associations between psychological resilience and various health-related factors, including diet, smoking, alcohol use, and physical self-perception, in a sample of university students. The primary objective is to identify factors that are most significantly related to resilience and to determine their ability to predict an individual’s resilience level. A total of 360 university students participated in this cross-sectional study. Data were collected via validated questionnaires, such as the CD-RISC (Connor and Davidson, 2003) for psychological resilience, the PREDIMED (Guasch-Ferré et al., 2017) for the Mediterranean diet, the AUDIT (Kuitunen-Paul and Roerecke, 2018) for alcohol consumption risk, and the SCOFF (Morgan et al., 1999) for disordered eating behaviors. Additionally, questionnaires designed by researchers were used to assess smoking status and body image. Advanced machine learning models, specifically Random Forest (Breiman, 2001) (<span><span>Breiman, 2001</span></span>) and TabNet (Arik and Pfister, 2021) were applied to predict the resilience levels. To address class imbalance, the SMOTE technique was used. The model performance was measured via the macro F1-score, a metric suitable for imbalanced datasets. Additionally, the importance values of the predictor variables were calculated to provide interpretability. A clustering analysis was also conducted to segment the population on the basis of their characteristics. Our predictive models achieved moderate accuracy but successfully identified the most influential variables for resilience. Perceived health and body image emerged as key predictors of psychological resilience. A positive association was also found between adherence to a healthy diet and increased resilience. Clustering analysis revealed two distinct resilience groups, with the lower resilience group showing a greater risk of alcohol dependence. Finally, our findings confirm the associations between psychological resilience and various health habits and self-perceptions. The study provides a novel applications of machine learning to a psychological construct, identifying key predictors and demonstrating the complexity of these relationships. While this research provides valuable insights, future studies should consider larger sample sizes and a longitudinal design to further explore these dynamics and incorporate a broader range of sociocultural and familial factors.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"23 ","pages":"Article 101000"},"PeriodicalIF":0.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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