Depression and Anxiety最新文献

Obsessive-compulsive disorder (OCD) is a psychiatric condition that varies considerably in severity and resistance to treatment. The aim of this study was to identify error detection abnormalities in OCD patients using evoked potential recordings and to determine whether links could be established between individual patients' error detection processes and their severity and resistance to treatment. To answer this question, the potentials evoked by participants' responses to a flanker task, i.e., the error-related negativity (ERN/CRN component) and subsequent positivity (Pe/Pc component), were recorded. Twenty-six OCD patients with a wide range of pathology severity and treatment resistance and 26 control participants matched for gender, age, and education level with the patients were included in the study. The amplitude of the error-related negativity (ERN) evoked by false responses was positively correlated with the severity of patients' pathology, while the lower the amplitude of the negativity evoked by correct responses (CRN), the more resistant patients were to treatment. The ERN/CRN components could therefore be used as markers of the severity and treatment resistance of OCD patients' pathology. Furthermore, under the present experimental conditions, the positive Pe/Pc component, supposed to reflect patients' awareness of the correctness of their responses, was virtually absent compared to control participants. This suggests a major deficit in the patients' monitoring of the consequences of their actions. The discovery of this disappearance of action feedback signals in patients leads to proposing an original neurodevelopmental model for the onset of pathology in childhood or adolescence.

Introduction: Anxiety and depression significantly impair quality of life (QoL) in primary care (PC) patients. While transdiagnostic cognitive behavioural therapy (TD-CBT) is effective, the mechanisms underlying its long-term impact on QoL remain unclear. This study examined whether changes in anxiety and depressive symptoms mediate the effect of TD-CBT on QoL at 12-month follow-up.

Methods: Data were used from the "Psychology in Primary Care" trial (PsicAP, from its Spanish acronym), which included 1061 PC patients with anxiety and depression, randomised to TD-CBT plus treatment-as-usual (TAU) or TAU alone. Anxiety and depression were assessed at baseline, post-treatment and 6-month follow-up. QoL was measured at baseline and 12-month follow-up. Path analyses using structural equation modelling (SEM) were used to study direct and indirect effects, controlling for baseline scores and gender.

Results: TD-CBT significantly reduced anxiety and depression immediately post-treatment compared to TAU. The only significant indirect effect on 12-month QoL across all dimensions operated sequentially through sustained reductions in depressive symptoms. No significant mediation was found via anxiety symptoms. No specific temporal sequence of symptom improvement mediating QoL was identified.

Discussion: TD-CBT improves anxiety and depressive symptoms at post-treatment; nevertheless, long-term QoL improvement occurs primarily through sustained reduction in depressive symptoms and through the direct effects of treatment itself. These findings support the implementation of TD-CBT in PC to achieve lasting functional recovery, highlighting the crucial role of addressing and sustaining improvements in depression.

Anxiety disorders and depression are the most frequently diagnosed mental illnesses and are highly comorbid. Both have been linked to memory impairments, albeit the relationship between them remains unclear and understudied. Our review aims to investigate behavioral pattern separation performance in individuals with varying levels of anxiety and depression. We included studies where mnemonic discrimination performance is measured using mnemonic discrimination tasks designed to directly measure behavioral pattern separation, while symptoms of anxiety and/or depression are assessed using any validated and recognized scales or inventories. We only included quantitative studies. Fixed scientific databases and artificial intelligence were systematically searched, identifying nine studies on anxiety and 14 on depression. Anxiety studies presented conflicting evidence, but a trend showed optimal mnemonic discrimination with threat-based encoding and safe retrieval. Conversely, depression studies consistently suggested a negative relationship between symptom severity and pattern separation performance. Additionally, pattern separation appeared enhanced for negative stimuli and impaired for neutral stimuli in individuals with higher levels of depression. However, no clear differences were observed between clinically diagnosed groups and healthy controls. Methodological inconsistencies in anxiety studies present challenges for interpretation. Similarly, the effects of medication and the heterogeneity of clinical groups pose limitations to depression studies. Trends were identified, but further investigation with unified methodologies and clinical groups is needed to understand the relationship between anxiety, depression, and mnemonic discrimination performance.

[This corrects the article DOI: 10.1155/da/3698331.].

Background: Family dysfunction and insecure attachment are established risk factors for adolescent depressive symptoms, yet individual differences in sensory processing may influence vulnerability to these environmental stressors.

Objective: To explore the mediating role of insecure attachment and the moderating effect of sensory processing sensitivity (SPS) in the relationship between family functioning and adolescent depressive symptoms.

Methods: This study employed a cross-sectional design, with 503 adolescents recruited via convenience sampling in October 2023. Participants completed self-report questionnaires assessing family functioning, insecure attachment, SPS, and depressive symptoms. SPSS 26.0 was used to conduct moderated mediation analyses to examine the complex interactions among these variables.

Results: The results showed that family functioning was directly associated with adolescent depressive symptoms and also was indirectly associated with depressive symptoms through insecure attachment. Additionally, SPS was found to statistically moderate both the direct and indirect pathways. Specifically, the negative association between poor family functioning and depressive symptoms and the statistical mediating pathway through insecure attachment were more pronounced in adolescents with higher SPS.

Conclusion: Impaired family functioning and insecure attachment were associated with higher levels of depressive symptoms in adolescents. SPS appeared to strengthen these associations, highlighting the importance of considering individual differences in sensory sensitivity when addressing adolescent mental health. Tailoring interventions to strengthen family support and attachment security, especially for adolescents with heightened SPS, may help mitigate the risk of depressive symptoms. This study emphasizes the need for family-centered interventions to foster resilience against adolescent depressive symptoms.

Anxiety and depression affect over 500 million people globally. Despite the availability of effective low-cost treatments, like those provided by NHS talking therapies (TT), over half of patients relapse within a year, highlighting the need to co-develop solutions to maintain wellbeing and optimise healthcare. This study used a multiphase participatory design to synthesise evidence on relapse prevention and collaboratively develop evidence-informed strategies for sustained mental health following low-intensity treatment. The three-phase project began by synthesising evidence from diverse sources. Phase 2 involved two patient and two NHS professional/key stakeholder co-design workshops, using the RAND/UCLA appropriateness method. A sustained patient and public involvement (PPI) group reviewed and refined findings, co-designing content for phase 3, which involved a mixed-stakeholder online meeting to finalise key recommendations and priorities. Phase 1 identified 41 evidence-based solutions for rating during phase 2. Across the four phase 2 workshops (n = 18), 24 solutions were rated as appropriate and necessary and ranked for priorities. These were refined with the PPI group into 13 core recommendations. These recommendations were incorporated into a relapse prevention model during the final workshop, forming a foundation to enhance post-treatment support and inform clinical practice, service design, workforce training and policy. Preventing relapse and supporting wellbeing are essential for improving patient outcomes and reducing health inequalities. Identifying priorities across multiple levels lays the groundwork for a robust relapse prevention model that promotes sustained recovery. Future research should implement and evaluate the feasibility and impact of these recommendations in routine care.