Depression among graduate students is a growing concern, according to the WHO. However, existing literature lacks multivariable analysis focused specifically on the graduate student populations. This study addresses this gap by investigating the factors contributing to depressive symptoms among science and technology graduate students.
Methods
A cross-sectional study was conducted after ethics committee approval among 387 consenting graduate students selected using stratified random sampling from all 13 departments at the Institute of Science and Technology (IOST), Tribhuvan University (TU), Nepal. The data were collected via a self-administered questionnaire, verifying the outcome variable depression by the Patient Health Questionnaire-9 (PHQ-9) scale (no/low depressive symptoms: 0–9 points; moderate/severe depressive symptoms: 10–27 points). Multivariable logistic regression was used to identify factors associated with moderate/severe depressive symptoms, calculating the adjusted odds ratio (OR) with 95% confidence interval (CI).
Results
The prevalence of moderate/severe depressive symptoms among graduate students was 23% (95% CI: 19–27). Statistically significant (p < 0.05) associated factors were financial stress (OR: 2.35, 95% CI: 1.30–4.26), relationship dissolution (OR: 2.22, 95% CI: 1.06–4.63), stressful assignments (OR: 5.09, 95% CI: 2.31–11.26), medium self-esteem (OR: 4.73, 95% CI: 2.43–9.18), and low self-esteem (OR: 10.21, 95% CI: 4.71–22.11).
Conclusion
The unique contributors to depressive symptoms identified in this study through multivariable analysis, adjusting for confounding, emphasize the need for targeted mental health support among science and technology graduate students.
{"title":"Factors Associated With Depressive Symptoms Among Graduate Students in Science and Technology: A Cross-Sectional Study With Multivariable Analysis","authors":"Saphal Chapagai, Ishwari Prasad Banjade, Shankar Prasad Khanal","doi":"10.1155/da/8886228","DOIUrl":"10.1155/da/8886228","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Depression among graduate students is a growing concern, according to the WHO. However, existing literature lacks multivariable analysis focused specifically on the graduate student populations. This study addresses this gap by investigating the factors contributing to depressive symptoms among science and technology graduate students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted after ethics committee approval among 387 consenting graduate students selected using stratified random sampling from all 13 departments at the Institute of Science and Technology (IOST), Tribhuvan University (TU), Nepal. The data were collected via a self-administered questionnaire, verifying the outcome variable depression by the Patient Health Questionnaire-9 (PHQ-9) scale (no/low depressive symptoms: 0–9 points; moderate/severe depressive symptoms: 10–27 points). Multivariable logistic regression was used to identify factors associated with moderate/severe depressive symptoms, calculating the adjusted odds ratio (OR) with 95% confidence interval (CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of moderate/severe depressive symptoms among graduate students was 23% (95% CI: 19–27). Statistically significant (<i>p</i> < 0.05) associated factors were financial stress (OR: 2.35, 95% CI: 1.30–4.26), relationship dissolution (OR: 2.22, 95% CI: 1.06–4.63), stressful assignments (OR: 5.09, 95% CI: 2.31–11.26), medium self-esteem (OR: 4.73, 95% CI: 2.43–9.18), and low self-esteem (OR: 10.21, 95% CI: 4.71–22.11).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The unique contributors to depressive symptoms identified in this study through multivariable analysis, adjusting for confounding, emphasize the need for targeted mental health support among science and technology graduate students.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2025 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12714082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jinwen Li, Minjie Zheng, Rong Bai, Dini Xue, Xia Liu
Purpose
Adolescents with depressive symptoms are particularly vulnerable and at higher risk for developing co-occurring mental health issues, such as non-suicidal self-injury (NSSI). This study focused on adolescents exhibiting persistent depressive symptoms across three time points and investigated how childhood maltreatment influences NSSI and its changes over time, along with the underlying mechanisms.
Methods
From a larger sample of 3981 students, 317 adolescents with persistent depressive symptoms (Mage = 13.20, SD = 0.82) were identified, and a control group of 317 non-depressed adolescents was selected via propensity score matching. Latent change score (LCS) modeling and longitudinal mediation models were employed to examine the mechanisms linking childhood maltreatment to NSSI and its changes.
Results
The univariate LCS model revealed an increasing trend in NSSI behaviors among adolescents with depressive symptoms over the measurement period. T1 childhood maltreatment indirectly influenced T2 NSSI through T2 self-esteem and T2 emotional reactivity. Additionally, T1 childhood maltreatment significantly predicted changes in NSSI through T2 emotional reactivity.
Conclusions
This study underscores the importance of addressing NSSI in adolescents with depressive symptoms and highlights the necessity of screening for childhood maltreatment histories in this population. The findings provide a foundation for future prevention and intervention efforts, suggesting that enhancing self-esteem and reducing emotional reactivity could mitigate the impact of childhood maltreatment on NSSI in depressed adolescents.
{"title":"Longitudinal Pathways From Childhood Maltreatment to NSSI in Middle School Students With Depressive Symptoms: A Latent Change Score Analysis","authors":"Jinwen Li, Minjie Zheng, Rong Bai, Dini Xue, Xia Liu","doi":"10.1155/da/6659147","DOIUrl":"10.1155/da/6659147","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Adolescents with depressive symptoms are particularly vulnerable and at higher risk for developing co-occurring mental health issues, such as non-suicidal self-injury (NSSI). This study focused on adolescents exhibiting persistent depressive symptoms across three time points and investigated how childhood maltreatment influences NSSI and its changes over time, along with the underlying mechanisms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From a larger sample of 3981 students, 317 adolescents with persistent depressive symptoms (<i>M</i><sub>age</sub> = 13.20, SD = 0.82) were identified, and a control group of 317 non-depressed adolescents was selected via propensity score matching. Latent change score (LCS) modeling and longitudinal mediation models were employed to examine the mechanisms linking childhood maltreatment to NSSI and its changes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The univariate LCS model revealed an increasing trend in NSSI behaviors among adolescents with depressive symptoms over the measurement period. T1 childhood maltreatment indirectly influenced T2 NSSI through T2 self-esteem and T2 emotional reactivity. Additionally, T1 childhood maltreatment significantly predicted changes in NSSI through T2 emotional reactivity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study underscores the importance of addressing NSSI in adolescents with depressive symptoms and highlights the necessity of screening for childhood maltreatment histories in this population. The findings provide a foundation for future prevention and intervention efforts, suggesting that enhancing self-esteem and reducing emotional reactivity could mitigate the impact of childhood maltreatment on NSSI in depressed adolescents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2025 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12714111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Workplace violence (WPV) against healthcare workers (HCWs) is a global public health concern. In China, HCWs face similar challenges; however, the impacts of WPV exposure on their mental health and occupational functioning remain unclear. This study aims to investigate the symptom network of anxiety, burnout, depression, and insomnia (ABDI) and adverse outcomes in Chinese HCWs exposed to WPV. From November 2023 to June 2024, 3361 HCWs with confirmed experiences of WPV were recruited across China through snowball sampling. WPV and ABDI were assessed using the Workplace Violence Scale, Generalized Anxiety Disorder Scale-7 (GAD-7), Oldenburg Burnout Inventory (OLBI), Patient Health Questionnaire-9 (PHQ-9), and Insomnia Severity Index (ISI), respectively. Data on adverse personal outcomes (low quality of life [QOL] and suicidal ideation [SI]) and occupational outcomes (turnover intention [TI]) were collected. We constructed and visualized networks, calculating strength and bridge strength (BS) indices to identify central and bridge symptoms. In the ABDI network of WPV-exposed HCWs, exhaustion (EX) emerged as the most central and bridge symptom. Uncontrollable worry (GAD2) and difficulty staying asleep (ISI2) were also central symptoms, while fatigue (PHQ4) and restlessness (GAD5) were identified as secondary bridge symptoms. Disengagement (DEM) strongly predicted TI; EX and sleep dissatisfaction (ISI4) predicted low QOL; and SI was most strongly linked to worthless (PHQ6), motor disturbance (PHQ8), and feeling afraid (GAD7). This study highlights that EX may serve as a priority target for preventing and intervening in psychological distress among WPV-exposed HCWs, as well as for improving their QOL. Burnout extends beyond workplace-related issues and is broadly associated with mental health problems and adverse outcomes. Implementing early detection and intervention measures is crucial for preventing and alleviating adverse effects in HCWs exposed to WPV.
{"title":"Interrelationships of Anxiety, Burnout, Depression, and Insomnia Among Chinese Healthcare Workers Exposed to Workplace Violence: A Network Analysis","authors":"Huixue Xu, Zejun Li, Xin Wang, Min Wu, Tieqiao Liu, Qiuxia Wu","doi":"10.1155/da/9815503","DOIUrl":"10.1155/da/9815503","url":null,"abstract":"<p>Workplace violence (WPV) against healthcare workers (HCWs) is a global public health concern. In China, HCWs face similar challenges; however, the impacts of WPV exposure on their mental health and occupational functioning remain unclear. This study aims to investigate the symptom network of anxiety, burnout, depression, and insomnia (ABDI) and adverse outcomes in Chinese HCWs exposed to WPV. From November 2023 to June 2024, 3361 HCWs with confirmed experiences of WPV were recruited across China through snowball sampling. WPV and ABDI were assessed using the Workplace Violence Scale, Generalized Anxiety Disorder Scale-7 (GAD-7), Oldenburg Burnout Inventory (OLBI), Patient Health Questionnaire-9 (PHQ-9), and Insomnia Severity Index (ISI), respectively. Data on adverse personal outcomes (low quality of life [QOL] and suicidal ideation [SI]) and occupational outcomes (turnover intention [TI]) were collected. We constructed and visualized networks, calculating strength and bridge strength (BS) indices to identify central and bridge symptoms. In the ABDI network of WPV-exposed HCWs, exhaustion (EX) emerged as the most central and bridge symptom. Uncontrollable worry (GAD2) and difficulty staying asleep (ISI2) were also central symptoms, while fatigue (PHQ4) and restlessness (GAD5) were identified as secondary bridge symptoms. Disengagement (DEM) strongly predicted TI; EX and sleep dissatisfaction (ISI4) predicted low QOL; and SI was most strongly linked to worthless (PHQ6), motor disturbance (PHQ8), and feeling afraid (GAD7). This study highlights that EX may serve as a priority target for preventing and intervening in psychological distress among WPV-exposed HCWs, as well as for improving their QOL. Burnout extends beyond workplace-related issues and is broadly associated with mental health problems and adverse outcomes. Implementing early detection and intervention measures is crucial for preventing and alleviating adverse effects in HCWs exposed to WPV.</p>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2025 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12714119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Major depressive disorder (MDD) is a globally prevalent mental health condition with a complex pathogenesis and substantial disease burden. However, due to incomplete mechanistic understanding, existing therapeutic strategies frequently yield suboptimal outcomes. This review synthesizes evidence establishing neuroinflammation as a central pathogenic mechanism of MDD, involving elevated proinflammatory cytokines, microglial M1 polarization, blood–brain barrier (BBB) disruption, hypothalamic–pituitary–adrenal (HPA) axis dysregulation, and impaired neuroplasticity. Micro ribonucleic acid (miRNA) are identified as master molecular regulators bridging neuroinflammation and MDD pathology with details of how specific dysregulated miRNAs orchestrate MDD processes by targeting key inflammatory pathways, directing microglial polarization states, mediating intercellular communication via exosomes, and modulating BBB integrity. Crucially, these miRNAs may serve as novel diagnostic biomarkers and therapeutic targets for MDD. Building on this, we explore the potential of natural compounds as innovative miRNA-targeting therapeutics that can ameliorate neuroinflammation and restore neuroplasticity. Current challenges relating to clinical translation are discussed, including discordance between peripheral and brain miRNA profiles, species-specific miRNA functional variations, limited biomarker specificity across psychiatric disorders, the absence of standardized clinical reference ranges, and the need for more effective delivery systems. Overall, this review positions miRNA-mediated neuroinflammation regulation as a transformative frontier for MDD pathogenesis research and targeted treatment.
{"title":"MicroRNAs as Regulators of Neuroinflammation in Major Depressive Disorder","authors":"Qirui Li, Yuyan Ling, Ling Gu, Lei Li, Yutong Liu, Yuanyuan Ma, Ruiting Ma, Meijuan Chen","doi":"10.1155/da/9984291","DOIUrl":"https://doi.org/10.1155/da/9984291","url":null,"abstract":"<p>Major depressive disorder (MDD) is a globally prevalent mental health condition with a complex pathogenesis and substantial disease burden. However, due to incomplete mechanistic understanding, existing therapeutic strategies frequently yield suboptimal outcomes. This review synthesizes evidence establishing neuroinflammation as a central pathogenic mechanism of MDD, involving elevated proinflammatory cytokines, microglial M1 polarization, blood–brain barrier (BBB) disruption, hypothalamic–pituitary–adrenal (HPA) axis dysregulation, and impaired neuroplasticity. Micro ribonucleic acid (miRNA) are identified as master molecular regulators bridging neuroinflammation and MDD pathology with details of how specific dysregulated miRNAs orchestrate MDD processes by targeting key inflammatory pathways, directing microglial polarization states, mediating intercellular communication via exosomes, and modulating BBB integrity. Crucially, these miRNAs may serve as novel diagnostic biomarkers and therapeutic targets for MDD. Building on this, we explore the potential of natural compounds as innovative miRNA-targeting therapeutics that can ameliorate neuroinflammation and restore neuroplasticity. Current challenges relating to clinical translation are discussed, including discordance between peripheral and brain miRNA profiles, species-specific miRNA functional variations, limited biomarker specificity across psychiatric disorders, the absence of standardized clinical reference ranges, and the need for more effective delivery systems. Overall, this review positions miRNA-mediated neuroinflammation regulation as a transformative frontier for MDD pathogenesis research and targeted treatment.</p>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2025 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/da/9984291","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145751016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The underlying mechanism of pain-depression comorbidity is not well understood. This study aims to analyze the abnormal brain activity in adolescents with pain-depression comorbidity, and to provide imaging evidence for the understanding of brain neural mechanisms of pain-depression comorbidity.
Methods
Depression in adolescents with (n = 31) and without (n = 26) comorbid pain symptoms and 28 healthy controls matched for age, gender, and education level underwent resting-state functional magnetic resonance imaging (rs-fMRI) and completed the Hamilton depression scale and visual analog scale (VAS) of pain. The whole-brain amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) values were compared across groups. The brain regions with significant differences in ALFF values between groups were used as seed points for whole-brain functional connectivity.
Results
Compared with the depression group, the comorbidity group showed increased ALFF values in the right amygdala and right middle frontal gyrus, decreased ALFF values in the left middle occipital gyrus, right inferior temporal gyrus and right superior temporal gyrus, increased ReHo values in the right insula, and elevated functional connectivity between the right inferior temporal gyrus and right angular gyrus (Gaussian random field [GRF] corrected, p < 0.05).
Conclusion
Compared with adolescents with depression without pain, adolescents with pain-depression comorbidity have differences in neuronal activity and functional connectivity in the middle frontal gyrus, amygdala, insular lobe, temporoparietal and occipital lobes, suggesting that abnormal neuronal activity in these brain regions may be the neural basis of pain-depression comorbidity.
{"title":"Study on the Changes of Brain Function in Adolescents With Pain-Depression Comorbidity Based on rs-FMRI","authors":"Yu Tian, Wenyu Cai, Changjing He, Gaoqiang Xu, Ganjun Song, Kuntao Chen, Songjiang Liu","doi":"10.1155/da/7986150","DOIUrl":"https://doi.org/10.1155/da/7986150","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The underlying mechanism of pain-depression comorbidity is not well understood. This study aims to analyze the abnormal brain activity in adolescents with pain-depression comorbidity, and to provide imaging evidence for the understanding of brain neural mechanisms of pain-depression comorbidity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Depression in adolescents with (<i>n</i> = 31) and without (<i>n</i> = 26) comorbid pain symptoms and 28 healthy controls matched for age, gender, and education level underwent resting-state functional magnetic resonance imaging (rs-fMRI) and completed the Hamilton depression scale and visual analog scale (VAS) of pain. The whole-brain amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) values were compared across groups. The brain regions with significant differences in ALFF values between groups were used as seed points for whole-brain functional connectivity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared with the depression group, the comorbidity group showed increased ALFF values in the right amygdala and right middle frontal gyrus, decreased ALFF values in the left middle occipital gyrus, right inferior temporal gyrus and right superior temporal gyrus, increased ReHo values in the right insula, and elevated functional connectivity between the right inferior temporal gyrus and right angular gyrus (Gaussian random field [GRF] corrected, <i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Compared with adolescents with depression without pain, adolescents with pain-depression comorbidity have differences in neuronal activity and functional connectivity in the middle frontal gyrus, amygdala, insular lobe, temporoparietal and occipital lobes, suggesting that abnormal neuronal activity in these brain regions may be the neural basis of pain-depression comorbidity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2025 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/da/7986150","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kristian Tjelle, Bjarne Hansen, Stian Solem, Michael G. Wheaton, Gerd Kvale, Kristen Hagen
Background
Cognitive-behavioral therapy (CBT) with exposure and response prevention (ERP) is a recommended treatment for obsessive-compulsive disorder (OCD), although many patients who undergo this regimen do not achieve satisfactory symptom relief, and maintaining long-term remission is challenging. Concentrated exposure therapy (cET) has emerged as a potential treatment for treatment-resistant OCD. However, the role of insight as a predictor of treatment outcomes in this context remains underexplored.
Methods
We conducted a secondary analysis of a randomized controlled trial (RCT) including 163 adults diagnosed with treatment-resistant OCD. This study used linear regression models to evaluate whether pre-treatment levels of insight and changes in insight—measured by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) insight item—were associated with outcomes after 4 days of cET and whether insight levels changed post-treatment.
Results
Baseline insight did not predict OCD severity at post-treatment or 3-month follow-up but was associated with greater OCD severity at the 12-month follow-up. Insight scores improved significantly from pre- to post-treatment but worsened during the follow-up period. Notably, a change in insight during cET was a significant predictor of OCD symptom severity at all follow-up intervals.
Conclusions
Baseline insight was not a strong predictor of short-term treatment outcomes following cET but was related to long-term OCD severity. Improvements in insight during cET were associated with achieving and maintaining reduced symptoms over time. These results suggest that improvements in OCD and enhanced insight are associated.
{"title":"Concentrated ERP for Patients With Difficult-to-Treat OCD: Insight as a Predictor of Acute and Long-Term Outcomes","authors":"Kristian Tjelle, Bjarne Hansen, Stian Solem, Michael G. Wheaton, Gerd Kvale, Kristen Hagen","doi":"10.1155/da/8960147","DOIUrl":"https://doi.org/10.1155/da/8960147","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cognitive-behavioral therapy (CBT) with exposure and response prevention (ERP) is a recommended treatment for obsessive-compulsive disorder (OCD), although many patients who undergo this regimen do not achieve satisfactory symptom relief, and maintaining long-term remission is challenging. Concentrated exposure therapy (cET) has emerged as a potential treatment for treatment-resistant OCD. However, the role of insight as a predictor of treatment outcomes in this context remains underexplored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a secondary analysis of a randomized controlled trial (RCT) including 163 adults diagnosed with treatment-resistant OCD. This study used linear regression models to evaluate whether pre-treatment levels of insight and changes in insight—measured by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) insight item—were associated with outcomes after 4 days of cET and whether insight levels changed post-treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline insight did not predict OCD severity at post-treatment or 3-month follow-up but was associated with greater OCD severity at the 12-month follow-up. Insight scores improved significantly from pre- to post-treatment but worsened during the follow-up period. Notably, a change in insight during cET was a significant predictor of OCD symptom severity at all follow-up intervals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Baseline insight was not a strong predictor of short-term treatment outcomes following cET but was related to long-term OCD severity. Improvements in insight during cET were associated with achieving and maintaining reduced symptoms over time. These results suggest that improvements in OCD and enhanced insight are associated.</p>\u0000 \u0000 <p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT02656342.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2025 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/da/8960147","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Suicidality is the most severe sign of major depressive disorder (MDD). However, network-wide structural dynamics alterations and transcriptional patterns in MDD patients with suicidality remain unclear. A total of 124 participants were recruited, including 31 MDD patients without suicidal ideation (MDDNSI), 34 MDD patients with suicidal ideation (MDDSI), 22 MDD patients with suicidal behavior (MDDSB), and 37 healthy controls (HCs). All participants completed diffusion tensor imaging scans and suicidal assessment. Network-based statistics (NBSs) were used to compare differences in structural connectivity, while average network controllability (ANC) reflecting brain state dynamics was measured based on suicidality-based circuits. Weighted gene coexpression network analysis (WGCNA) identified gene modules associated with neuroimaging phenotypes. Gene functions and cellular types in MDD patients were determined with enrichment analysis and cell-type-specific expression analysis. The results showed that in the suicidal ideation (SI) circuit, MDDSI patients represented decreased ANC compared to MDDNSI patients, with upregulated genes related to neuronal bundles and downregulated genes related to ribosomes. In the suicidal behavior (SB) circuit, MDDSB patients exhibited reduced ANC compared to MDDNSB patients, with upregulated genes associated with cytoplasmic pathways and positive regulation of signaling and downregulated genes related to synaptic signal transmission. Importantly, genes in both the SI circuit and SB circuit were enriched in gamma-aminobutyric acid (GABA) neurons. The study highlights that the differential ANC of the SI network and the SB network exerts a distinctive influence on brain state trajectories in MDD patients and identifies the specific transcriptional pattern and cell types associated with brain regions related to SI or SB in depression.
{"title":"Brain Network Controllability and Its Regional Gene Expression Profile Associated With Suicidal Tendencies in Major Depressive Disorder Patients","authors":"Xinyi Liu, Cancan He, Dandan Fan, Sangni Liu, Haisan Zhang, Zhijun Zhang, Hongxing Zhang, Chunming Xie, Xianxian Zhang","doi":"10.1155/da/6529148","DOIUrl":"https://doi.org/10.1155/da/6529148","url":null,"abstract":"<p>Suicidality is the most severe sign of major depressive disorder (MDD). However, network-wide structural dynamics alterations and transcriptional patterns in MDD patients with suicidality remain unclear. A total of 124 participants were recruited, including 31 MDD patients without suicidal ideation (MDDNSI), 34 MDD patients with suicidal ideation (MDDSI), 22 MDD patients with suicidal behavior (MDDSB), and 37 healthy controls (HCs). All participants completed diffusion tensor imaging scans and suicidal assessment. Network-based statistics (NBSs) were used to compare differences in structural connectivity, while average network controllability (ANC) reflecting brain state dynamics was measured based on suicidality-based circuits. Weighted gene coexpression network analysis (WGCNA) identified gene modules associated with neuroimaging phenotypes. Gene functions and cellular types in MDD patients were determined with enrichment analysis and cell-type-specific expression analysis. The results showed that in the suicidal ideation (SI) circuit, MDDSI patients represented decreased ANC compared to MDDNSI patients, with upregulated genes related to neuronal bundles and downregulated genes related to ribosomes. In the suicidal behavior (SB) circuit, MDDSB patients exhibited reduced ANC compared to MDDNSB patients, with upregulated genes associated with cytoplasmic pathways and positive regulation of signaling and downregulated genes related to synaptic signal transmission. Importantly, genes in both the SI circuit and SB circuit were enriched in gamma-aminobutyric acid (GABA) neurons. The study highlights that the differential ANC of the SI network and the SB network exerts a distinctive influence on brain state trajectories in MDD patients and identifies the specific transcriptional pattern and cell types associated with brain regions related to SI or SB in depression.</p>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2025 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/da/6529148","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145686328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xinxin Ye, Zhuzhu Qin, Huanju Liu, Yining Tao, Wan Ye, Yanxia Zhong, Li Shu, Ruizhe Jiang, Cong Huang
Objective
To investigate the associations between meeting the new Canadian 24-h movement guidelines and symptoms of depression, anxiety, and stress among Chinese medical students, thus providing empirical and theoretical support for targeted mental health interventions.
Methods
A total of 3679 medical students were recruited through multicenter convenience sampling in November 2022. A self-administered standardized questionnaire assessed three 24-h movement behaviors—moderate-to-vigorous physical activity (MVPA), sedentary time, and sleep—as well as symptoms of depression, anxiety, and stress. Logistic regression models were applied to analyze the association between meeting new 24-h movement guidelines and symptoms of depression, anxiety, and stress.
Results
A total of 3228 valid responses were obtained. The proportions of students who met all 24-h movement behavior recommendations were low, at 4.01% among clinical students and 7.14% among nursing students. The overall prevalence of negative emotional symptoms was 60.9% in clinical students and 46.7% in nursing students. A clear dose–response relationship was evident between the number of recommendations met and a lower risk of depression, anxiety, and stress. Medical students who fully met all recommendations had a significantly lower risk of negative emotional symptoms compared with those who met none (stress odds ratio [OR] = 0.239, 95% confidence interval [CI]: 0.101–0.568, p = 0.001; anxiety OR = 0.601, 95% CI: 0.407–0.889, p = 0.011; depression OR = 0.450, 95% CI: 0.290–0.700, p < 0.001). Similar protective associations were found in both clinical and nursing subgroups. All associations remained generally consistent after false discovery rate (FDR) correction, supporting the robustness of the results. A significant three-way interaction among MVPA, sedentary behavior, and sleep was observed for stress.
Conclusion
Adherence to the 24-h movement behavior recommendations was suboptimal among Chinese medical students. However, greater adherence was associated with a lower risk of symptoms of depression, anxiety, and stress, highlighting the need for integrated lifestyle interventions targeting physical activity, sedentary time, and sleep balance.
目的探讨符合加拿大新24小时运动指南与中国医学生抑郁、焦虑和压力症状的关系，为有针对性的心理健康干预提供实证和理论支持。方法采用多中心方便抽样法，于2022年11月对3679名医学生进行调查。一份自我管理的标准化问卷评估了三种24小时运动行为——中度到剧烈的身体活动（MVPA）、久坐时间和睡眠——以及抑郁、焦虑和压力的症状。采用Logistic回归模型分析符合新的24小时运动指南与抑郁、焦虑和压力症状之间的关系。结果共获得有效问卷3228份。符合所有24小时运动行为建议的学生比例较低，临床专业学生为4.01%，护理专业学生为7.14%。临床生负性情绪症状总体患病率为60.9%，护理生为46.7%。明确的剂量-反应关系明显存在于建议摄入量与抑郁、焦虑和压力风险降低之间。完全符合所有建议的医学生出现负面情绪症状的风险明显低于未达到建议的医学生（压力优势比[OR] = 0.239, 95%可信区间[CI]: 0.101-0.568, p = 0.001；焦虑优势比[OR] = 0.601, 95% CI: 0.407-0.889, p = 0.011；抑郁优势比[OR] = 0.450, 95% CI: 0.290-0.700, p < 0.001）。在临床和护理亚组中都发现了类似的保护性关联。在错误发现率（FDR）校正后，所有关联大体上保持一致，支持结果的稳健性。MVPA、久坐行为和睡眠对压力有显著的三方交互作用。结论中国医学生对24小时运动行为建议的依从性不佳。然而，更强的依从性与抑郁、焦虑和压力症状的风险较低相关，这突出了针对身体活动、久坐时间和睡眠平衡的综合生活方式干预的必要性。
{"title":"Assessing the Association Between Meeting New 24-h Movement Guidelines and Symptoms of Depression, Anxiety, and Stress Among Chinese Medical Students: A Multicenter Study","authors":"Xinxin Ye, Zhuzhu Qin, Huanju Liu, Yining Tao, Wan Ye, Yanxia Zhong, Li Shu, Ruizhe Jiang, Cong Huang","doi":"10.1155/da/8848293","DOIUrl":"https://doi.org/10.1155/da/8848293","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the associations between meeting the new Canadian 24-h movement guidelines and symptoms of depression, anxiety, and stress among Chinese medical students, thus providing empirical and theoretical support for targeted mental health interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 3679 medical students were recruited through multicenter convenience sampling in November 2022. A self-administered standardized questionnaire assessed three 24-h movement behaviors—moderate-to-vigorous physical activity (MVPA), sedentary time, and sleep—as well as symptoms of depression, anxiety, and stress. Logistic regression models were applied to analyze the association between meeting new 24-h movement guidelines and symptoms of depression, anxiety, and stress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 3228 valid responses were obtained. The proportions of students who met all 24-h movement behavior recommendations were low, at 4.01% among clinical students and 7.14% among nursing students. The overall prevalence of negative emotional symptoms was 60.9% in clinical students and 46.7% in nursing students. A clear dose–response relationship was evident between the number of recommendations met and a lower risk of depression, anxiety, and stress. Medical students who fully met all recommendations had a significantly lower risk of negative emotional symptoms compared with those who met none (stress odds ratio [OR] = 0.239, 95% confidence interval [CI]: 0.101–0.568, <i>p</i> = 0.001; anxiety OR = 0.601, 95% CI: 0.407–0.889, <i>p</i> = 0.011; depression OR = 0.450, 95% CI: 0.290–0.700, <i>p</i> < 0.001). Similar protective associations were found in both clinical and nursing subgroups. All associations remained generally consistent after false discovery rate (FDR) correction, supporting the robustness of the results. A significant three-way interaction among MVPA, sedentary behavior, and sleep was observed for stress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Adherence to the 24-h movement behavior recommendations was suboptimal among Chinese medical students. However, greater adherence was associated with a lower risk of symptoms of depression, anxiety, and stress, highlighting the need for integrated lifestyle interventions targeting physical activity, sedentary time, and sleep balance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2025 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/da/8848293","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145694987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiaoxia Duan, Yujie Tao, Mingjing Situ, Xinyi Yu, Di Jing, Pei Liu, Zhaozhi Yang, Yi Huang
<div> <section> <h3> Background</h3> <p>Although the link between psychopathological and behavioral issues and suicidality is well-established, existing studies often focus on static timepoints, neglecting their dynamic nature and sex differences. This study investigates the trajectories of these symptoms from late childhood to early adolescence and their association with suicidality, while also examining variations by sex.</p> </section> <section> <h3> Methods</h3> <p>We included 7849 unrelated children from the Adolescent Brain Cognitive Development (ABCD) cohort, with assessments conducted over a 3-year follow-up period. Caregiver-reported psychopathological and behavioral symptoms were assessed using the Child Behavior Checklist (CBCL) at baseline (ages 9–10) and during three subsequent annual follow-ups. Youth-reported suicidality was assessed at both baseline and the 3-year follow-up (ages 12–13) using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS).</p> </section> <section> <h3> Results</h3> <p>Latent class growth analysis (LCGA) identified three trajectory groups for total problems, internalizing, and externalizing behaviors, and two trajectory groups for each dimension. All high symptom trajectory groups had a higher risk of suicidality compared to low symptom trajectory groups, with adjusted odds ratios (ORs) ranging from 1.35 to 3.15 (all <i>p</i> < 0.05). Persistent high anxious/depressed symptoms showed the strongest association with suicidal ideation (SI; adjusted OR = 1.96, <i>p</i> < 0.001), while persistent high attention problem was most strongly associated with suicide attempts (adjusted OR = 2.87, <i>p</i> < 0.001). Persistently high anxious/depressed symptoms most strongly predicted suicide-related outcomes in girls (OR = 2.17, 95% confidence interval [CI]: 1.73–2.71), whereas high-increasing withdrawn/depressed symptoms showed the strongest association in boys (OR = 2.00, 95% CI: 1.53–2.60). Persistently high attention problems consistently and most strongly predicted suicide attempts in both sexes (boys: OR = 3.41, 95% CI: 1.52–7.65; girls: OR = 2.98, 95% CI: 1.72–5.14).</p> </section> <section> <h3> Conclusions</h3> <p>Trajectories of psychopathological and behavioral symptoms from late childhood to early adolescence are modestly associated with suicidality during this critical transition. Withdrawn/depressed symptoms strongest predicted risk in boys, whereas anxious/depressed symptoms were most salient in girls. Attention problems consistently predicted suicide attempts across both sexes. These finding
{"title":"Sex Differences in Behavioral and Psychopathological Trajectories From Late Childhood to Early Adolescence: Implications for Suicidality Risk","authors":"Xiaoxia Duan, Yujie Tao, Mingjing Situ, Xinyi Yu, Di Jing, Pei Liu, Zhaozhi Yang, Yi Huang","doi":"10.1155/da/9546609","DOIUrl":"https://doi.org/10.1155/da/9546609","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although the link between psychopathological and behavioral issues and suicidality is well-established, existing studies often focus on static timepoints, neglecting their dynamic nature and sex differences. This study investigates the trajectories of these symptoms from late childhood to early adolescence and their association with suicidality, while also examining variations by sex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included 7849 unrelated children from the Adolescent Brain Cognitive Development (ABCD) cohort, with assessments conducted over a 3-year follow-up period. Caregiver-reported psychopathological and behavioral symptoms were assessed using the Child Behavior Checklist (CBCL) at baseline (ages 9–10) and during three subsequent annual follow-ups. Youth-reported suicidality was assessed at both baseline and the 3-year follow-up (ages 12–13) using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Latent class growth analysis (LCGA) identified three trajectory groups for total problems, internalizing, and externalizing behaviors, and two trajectory groups for each dimension. All high symptom trajectory groups had a higher risk of suicidality compared to low symptom trajectory groups, with adjusted odds ratios (ORs) ranging from 1.35 to 3.15 (all <i>p</i> < 0.05). Persistent high anxious/depressed symptoms showed the strongest association with suicidal ideation (SI; adjusted OR = 1.96, <i>p</i> < 0.001), while persistent high attention problem was most strongly associated with suicide attempts (adjusted OR = 2.87, <i>p</i> < 0.001). Persistently high anxious/depressed symptoms most strongly predicted suicide-related outcomes in girls (OR = 2.17, 95% confidence interval [CI]: 1.73–2.71), whereas high-increasing withdrawn/depressed symptoms showed the strongest association in boys (OR = 2.00, 95% CI: 1.53–2.60). Persistently high attention problems consistently and most strongly predicted suicide attempts in both sexes (boys: OR = 3.41, 95% CI: 1.52–7.65; girls: OR = 2.98, 95% CI: 1.72–5.14).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Trajectories of psychopathological and behavioral symptoms from late childhood to early adolescence are modestly associated with suicidality during this critical transition. Withdrawn/depressed symptoms strongest predicted risk in boys, whereas anxious/depressed symptoms were most salient in girls. Attention problems consistently predicted suicide attempts across both sexes. These finding","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2025 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/da/9546609","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145686278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dan-Lin Li, Su-Tong Yu, Li-Jun Zhang, Xiao-Feng Zhang, Chen-Wei Pan
Background
Myopia and mental disorders share common environmental and behavioral risk factors. Previous studies have been inconsistent regarding the association between them, this systematic review and meta-analysis aims to explore the association between myopia and mental disorders.
Methods
Databases, including PubMed, Web of Science, Wiley online library, and Cochrane Library were searched for eligible publications from January 2000 to July 2024. Studies assessing the relationship between myopia and any one of the mental disorders were identified. Pooled odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs) were estimated using random-effects models.
Results
We identified 15 articles (two cohort studies and 13 cross-sectional studies) examining the impact of myopia on mental disorders, involving 2,841,653 participants from seven countries. Pooled results indicated that myopia was significantly associated with an increased risk of mental disorders (OR = 1.41, 95% CI: 1.23, 1.59). Besides, a significant relationship was observed between the mental disorders and myopia (OR = 1.15, 95% CI: 1.01, 1.29) based on eight articles, including 1,942,855 participants from five countries. Subgroup analyses showed that the association of myopia with both anxiety and depression was significant, with ORs of 1.49 and 1.33, respectively.
Conclusions
Myopia and mental disorders may influence each other, with each condition potentially exacerbating the risk of the other. These findings help to explore the possible interplay between mental disorders and myopia.
{"title":"Bidirectional Relationship Between Myopia and Mental Disorders","authors":"Dan-Lin Li, Su-Tong Yu, Li-Jun Zhang, Xiao-Feng Zhang, Chen-Wei Pan","doi":"10.1155/da/3543589","DOIUrl":"https://doi.org/10.1155/da/3543589","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Myopia and mental disorders share common environmental and behavioral risk factors. Previous studies have been inconsistent regarding the association between them, this systematic review and meta-analysis aims to explore the association between myopia and mental disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Databases, including PubMed, Web of Science, Wiley online library, and Cochrane Library were searched for eligible publications from January 2000 to July 2024. Studies assessing the relationship between myopia and any one of the mental disorders were identified. Pooled odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs) were estimated using random-effects models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 15 articles (two cohort studies and 13 cross-sectional studies) examining the impact of myopia on mental disorders, involving 2,841,653 participants from seven countries. Pooled results indicated that myopia was significantly associated with an increased risk of mental disorders (OR = 1.41, 95% CI: 1.23, 1.59). Besides, a significant relationship was observed between the mental disorders and myopia (OR = 1.15, 95% CI: 1.01, 1.29) based on eight articles, including 1,942,855 participants from five countries. Subgroup analyses showed that the association of myopia with both anxiety and depression was significant, with ORs of 1.49 and 1.33, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Myopia and mental disorders may influence each other, with each condition potentially exacerbating the risk of the other. These findings help to explore the possible interplay between mental disorders and myopia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2025 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/da/3543589","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145686303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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