Depression and Anxiety最新文献

Aims: The present methodological study attempted to develop the Fear of Disasters Scale (FDS) and reveal its psychometric properties.

Methods: While explanatory factor analysis (EFA) was carried out on the data of 265 voluntary participants, the data of 75 participants were used to explore the test–retest reliability of the scale. Confirmatory factor analysis (CFA) was carried out on the data of 150 participants. All analyses were performed on the Statistical Package for the Social Sciences (SPSS) 25.0 and linear structural relations (LISRELs) programs.

Results: Cronbach’s α value was calculated to be 0.93. The test–retest reliability analysis resulted in a significant, very strong, and positive correlation (p < 0.001; r = 0.92). The CFA yielded the following fit indices for the scale: p > 0.05, χ²/df = 1.51, root mean square error of approximation (RMSEA) = 0.05, standardized root mean square residual (SRMR) = 0.02, goodness of fit index (GFI) = 0.96, normed fit index (NFI) = 0.97.

Conclusions: The findings revealed that the one-factor instrument with seven items is valid and reliable for measuring fear of disasters (FD) in the sample.

Background: The COVID-19 pandemic exposed a substantial portion of society to multiple stressors, while access to mental health care was limited. To address this, we introduced a digital stepped-care program rooted in cognitive–behavioral therapy (CBT) principles, aiming to alleviate mental health distress among the general public seeking help.

Methods: The program comprises a 4-week digital application using “Aury” the chatbot, followed by an optional 6-week online group session for those still symptomatic. A 4-week waiting period separated these steps. Participants entered based on self-identified mental health concerns. Interventions addressed prevalent pandemic mental health issues: sleep disturbances, anxiety, depression, worry/rumination, interpersonal issues, and resource mobilization. Outcomes focused on depressive, anxiety, and somatic symptoms, assessed by the Patient Health Questionnaire (PHQ).

Results: Of the 1261 initial participants, postchatbot results (N = 142) indicated small to medium effects (d = 0.412 to d = 0.523). Those finishing the entire program (N = 41) saw substantial symptom decline with medium to large effects (d = 0.757 to d = 0.818). No shifts were seen in the waiting phase. At follow-up 6 months after baseline, both groups—those who only used the chatbot (N = 60; d = 0.284 to d = 0.416) and those who completed the entire program (N = 27; d = 0.854 to d = 0.926)—showed sustained symptom reduction. Comparing groups that received no intervention, used the chatbot only, and completed the entire program, we observed a dose–response effect.

Conclusions: This resource-efficient and adaptable digital approach effectively reduced pandemic-induced mental health issues, indicating its potential in crisis periods with limited health resources. Randomized controlled trials are recommended for further validation.

Trial Registration: Clinical Trial Registry identifier: DRKS00023220.

Background: Suicidal ideation poses a significant risk for suicidal behavior among adolescents globally. While studies have highlighted the association between anxiety and suicidal ideation, little is known regarding these behaviors in the Chinese adolescent population, as well as possible contextual factors that may influence this relationship. This study explores the association between generalized anxiety disorder (GAD) and suicidal ideation in an urban Chinese in-school adolescent population and investigates the contextual influence of primary caregiver mental health, considering comorbid symptoms of depression, anxiety, and insomnia.

Methods: Data from the Students’ Mental Health Network (SMHN) project in Wuhan, China, involving 7967 adolescents and their primary caregivers, were analyzed. The study assessed adolescents’ and primary caregivers’ mental health, including depression, insomnia, and GAD. Suicidal ideation was measured using the 9th item of Patient Health Questionnaire-9 (PHQ-9). Multilevel ordinal logistic regression models were used to examine associations between GAD and suicidal ideation, adjusting for covariates. Contextual effects were explored to determine how the mental health of the primary caregiver influences suicidal ideation.

Results: The study found that GAD is independently associated with suicidal ideation among adolescents after accounting for other mental health covariates. Specifically, adolescents with more severe GAD symptoms, particularly subtype symptoms of “Restlessness” and “Irritability,” had a higher likelihood of experiencing suicidal ideation. There were significant contextual effects on adolescent suicidal ideation at the caregiver mental health level. Adolescents with caregivers experiencing depression and anxiety symptoms had an increased risk of suicidal ideation.

Conclusions: This research highlights the importance of recognizing GAD as an independent risk factor for suicidal ideation among Chinese adolescents. It also emphasizes the role of caregiver mental health as a contextual factor. The findings suggest a need for holistic interventions addressing both adolescents’ and caregivers’ mental well-being, ultimately enhancing suicide prevention efforts.

Background: Mindfulness-based cognitive therapy (MBCT) is effective in reducing depressive symptoms in patients with major depressive disorder (MDD). Understanding for whom and how MBCT works may allow for improvements in treatment allocation and effectiveness. In this study, our aim was to investigate depressive rumination, content-independent perseverative thinking, mindfulness skills, and self-compassion as potential moderators and mediators of MBCT.

Methods: In this non-randomized controlled trial, patients with persistent (n = 53) or recurrent MDD with (n = 31) or without (n = 51) a current depressive episode were assigned to an intervention (MBCT plus treatment as usual [TAU], n = 94) or control group (TAU only, n = 40) based on the time between the date of inclusion and the start of MBCT. Assessments were carried out before, halfway, and after 8 weeks of MBCT + TAU or TAU. Latent growth models were employed to examine moderation, while cross-lagged structural equation models were used to assess the mediating effects of several possible mediators of MBCT-induced change in depressive symptoms and overall functional impairment.

Results: MBCT + TAU was more effective in reducing depressive symptoms (and overall functional impairment than TAU with a medium [d = −0.54] and small [d = 0.44] effect size, respectively). Higher baseline levels of rumination and perseverative thinking and lower levels of self-compassion moderated the effect of MBCT on depressive symptoms and overall functional impairment. Task-based negative intrusive thoughts moderated the effects of MBCT on overall functional impairment. No mediators were established, particularly due to a lack of effect of MBCT on all assessed mediators at mid-treatment. For interpretative purposes, a sample split (based on Johnson–Newman values) showed moderate-to-large effects in depressive symptom reduction for those with high rumination, high perseverative thinking, and low self-compassion, while negative-to-small nonsignificant effects were found for the opposite traits.

Conclusion: In the future, MBCT allocation based on levels of rumination and self-compassion might lead to a more efficient reduction in depressive symptoms. Directions for mediation analysis within the context of MBCT for depression are discussed.

Preregistration: This study was initially preregistered in the Dutch National Trial Register (NL7842). However, due to the NTR no longer being available since June 2022, the trial was reregistered at ClinicalTrials.gov (NCT05802966, dd 09-Apr-2023). The statistical analysis plan was adjusted after the start of the trial but before the finalization of data collection (NCT05802966; ClinicalTrials.gov).

Police officers and staff who investigate child sexual abuse material (CSAM) may be at elevated risk for mental health problems, which may be mitigated or exacerbated by institutional and interpersonal factors. The current work examined mental health in a large sample of UK CSAM investigators (N = 661). Results suggest substantially elevated rates of depression and anxiety but not posttraumatic stress disorder (PTSD). Feeling successful and supported powerfully buffered against negative outcomes, whereas moral injury—particularly feelings of institutional betrayal—predicted worse outcomes. Although exposure to CSAM and contact with victims predicted worse outcomes, these effects were much smaller. Regarding coping styles, self-blame, rumination, catastrophizing, withdrawal, ignoring, and negative religious coping predicted worse outcomes, whereas positive refocusing, seeking distraction, and social support were effective. These results held controlling for demographics. These results suggest that UK CSAM police officers and staff experience elevated depression and anxiety, but institutional and interpersonal support can buffer outcomes.

Background: Sleep problems are known as risk factors for depression and anxiety, but research on this subject with commercial pilots is limited. This study aimed to explore the effects of sleep problems on depressive and anxiety symptoms among Chinese commercial pilots.

Methods: Adults who participated in the baseline assessment of the Civil Aviation Health Cohort of China between December 2022 and March 2023 formed the study sample. Depressive and anxiety symptoms and sleep quality were assessed using standardized scales. Sleep duration was measured with standardized questions. Logistic regression and restricted cubic splines (RCSs) were used to analyze the association between sleep problems and depression/anxiety symptoms.

Results: A total of 7055 pilots were included in this study. The overall prevalence of depression and anxiety among pilots was 23.3% (n = 1642; 95% confidence interval [CI] = 22.3%–24.3%) and 17.0% (n = 1196; 95% CI = 16.1–17.8%), respectively. Logistic regression analyses revealed that short sleep duration (<7 h) was significantly associated with a higher risk of depression (odds ratio [OR] = 2.491; p  < 0.001) and anxiety (OR = 2.555; p  < 0.001), while poor sleep quality was also associated with a higher risk of depression (OR = 7.297; p  < 0.001) and anxiety (OR = 7.469; p  < 0.001). After adjusting for confounders, there was an inverse, J-shaped nonlinear relationship between sleep duration and both depression (inflection point: 7.64 h) and anxiety (inflection point: 7.48 h). Similarly, a J-shaped nonlinear relationship was found between sleep quality and depression/anxiety with an inflection point of Pittsburgh Sleep Quality Index (PSQI) = 4 points for both. The major limitation of the study was that causal relationships between variables could not be inferred due to the cross-sectional study design.

Conclusion: This study found that depression and anxiety were common among Chinese commercial pilots. Insufficient length and poor quality of sleep were associated with an increased risk of depression and anxiety. Implementing targeted strategies to improve sleep patterns is crucial for reducing the risk of depression and anxiety in this population.

Aims: It is unknown whether bullying exposure is independently associated with suicide attempts incidence. This study aims to investigate the association between traditional bullying, cyberbullying, and subsequent risk of suicide attempts among Chinese adolescents.

Methods: In this prospective cohort study, 1162 participants (mean age, 12.59, 54.5% male) were recruited from November 2020 to December 2020 in Changsha Hunan Province. In total, 782 of them completed the follow-up in May and June 2021 and were included in the final analysis. Logistic regression was utilized to calculate the odds ratio (OR) with 95% confidence intervals (95% CIs). Gender differences in these associations were further explored by stratified analysis.

Results: Adolescents who engaged in bullying perpetration (BP) and experienced cyberbullying victimization (CV) were significantly associated with an increased risk of suicide attempts in the 6-month follow-up even after adjusting for age, ethnicity, single child, depression, anxiety, and stress in the baseline (BP: adjusted OR [aOR] = 3.337, 95% CI: 1.463–7.611, p = 0.004; CV: aOR = 3.338, 95% CI: 1.468–7.590, p = 0.004). Furthermore, the association between BP and suicide attempts was found to be statistically significant only among male adolescents (aOR = 6.692, 95% CI: 1.566–28.601, p = 0.01), while CV was significantly associated with a heightened risk of suicide attempts among female adolescents (aOR = 4.452, 95% CI: 1.684–11.771, p = 0.003).

Conclusions: BP and CV were longitudinally associated with an increased risk of suicide attempts in Chinese youth, and these associations vary across genders.

Background: More than two-thirds of patients with functional gastrointestinal disorders (FGIDs) experience various degrees of mental health issues. Although studies indicate that FGIDs are related to depressive symptoms, sleep disorders, and somatic symptoms, the underlying mechanism between these variables remains unknown. Our objective was to establish a model that outlines the interactions between these psychological dimensions in FGIDs and, thus, provide valuable insights into how to enhance the well-being of affected individuals.

Methods: This study used the convenient sampling method to enroll patients who visited the digestive internal medicine department. A total of 238 patients were investigated using the Rome IV criteria (irritable bowel syndrome used Rome Ⅲ criteria). A questionnaire including the Hospital Anxiety and Depressive Symptoms Scale, the Pittsburgh Sleep Quality Index, and the Patient Health Questionnaire-12 was used. The chain mediating roles of sleep disorders and somatic symptoms in the relationship between depressive symptoms and FGIDs were examined by the bootstrap method.

Results: Correlation analysis revealed that depressive symptoms were positively related to sleep disorders, somatic symptoms, and FGIDs. Sleep disorders were positively related to somatic symptoms and FGIDs. Somatic symptoms were positively related to FGIDs. Chain mediating effect analysis showed that depressive symptoms can not only affect FGIDs but also through three indirect paths, as follows: the mediating role of sleep disorders and somatic symptoms, the chain mediating roles of sleep disorders and somatic symptoms, and the mediating effect size accounted for 7.2%, 7.7%, and 2.5% of the total effect, respectively.

Conclusions: This study is conducive to understanding the internal mechanism underlying the relationship between depressive symptoms and FGIDs. It reminds us that when treating FGIDs patients, we should not only provide adequate psychological support to improve but also pay attention to improvements in their sleep quality and somatic symptoms.

Background: Moderate-to-severe anxiety symptoms are severe and common in patients with major depressive disorder (MDD) and have a significant impact on MDD patients and their families. The main objective of this study was to develop a risk prediction model for moderate-to-severe anxiety in MDD patients to make the detection more accurate and effective.

Methods: We conducted a cross-sectional survey and tested biochemical indicators in 1718 first-episode and drug naïve (FEDN) patients with MDD. Using machine learning, we developed a risk prediction model for moderate-to-severe anxiety in these FEDN patients with MDD.

Results: Four predictors were identified from a total of 21 variables studied by least absolute shrinkage and selection operator (LASSO) regression analysis, namely psychotic symptoms, suicide attempts, thyroid stimulating hormone (TSH), and Hamilton Depression Scale (HAMD) total score. The model built from the four predictors showed good predictive power, with an area under the receiver operating characteristic (ROC) curve of 0.903 for the training set and 0.896 for the validation set. The decision curve analysis (DCA) curve indicated that the nomogram could be applied to clinical practice if the risk thresholds were between 13% and 40%. In the external validation, the risk threshold was between 14% and 40%.

Conclusion: The inclusion of psychotic symptoms, suicide attempts, TSH, and HAMD in the risk nomogram may improve its utility in identifying patients with MDD at risk of moderate-to-severe anxiety. It may be helpful in clinical decision-making or for conferring with patients, especially in risk-based interventions.

Purposes: To evaluate the association between psychological resilience, depression disorder (DD), and brain functional–structural hybrid connectome in patients with breast cancer before treatment (T0) and at 1 year.

Methods: Between February 2017 and October 2019, 172 patients were longitudinally enrolled from a multicenter trial named as Be Resilient to Breast Cancer (BRBC) and completed resting-state functional magnetic resonance imaging (rs-fMRI) and diffusion tensor imaging (DTI) before the T0. Data-driven multivoxel pattern analysis (MVPA) and correlational tractography (CT) were performed to identify distinct functional-structural hybrid connectome. DD was diagnosed by psychiatry physicians according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Psychological resilience was collected by Resilience Scale Specific to Cancer (RS-SC) and tested as the mediation variable between hybrid connectome and DD.

Results: Of the total sample of 172, 14.5% (N = 25) were diagnosed with DD. High psychological resilience was associated with a lower risk of DD (hazard ratio (HR) = 0.37, 95% confidence interval (CI), 0.17–0.82, p = 0.0368). Frontal pole right (88.0%) in rs-fMRI and arcuate fasciculus_L (75.2%) in DTI were identified as main significant brain areas. Psychological resilience accounted for 10.01%–12.14% of direct effect between brain functional–structural hybrid connectome and 1-year DD.

Conclusion: Psychological resilience predicts DD at 1 year and mediates the association between brain functional–structural hybrid connectome and DD at 1 year in patients diagnosed with breast cancer.

Trial Registration: ClinicalTrials.gov identifier: NCT03026374