Depression and Anxiety最新文献

Purposes: This study aims to explore the association between brain structural connectivity and 1-year demoralization in patients with newly diagnosed breast cancer.

Methods: Patients were enrolled from a multicenter longitudinal program named as Be Resilient to Breast Cancer (BRBC) between 2017 and 2019. Brain structural connectivity was assessed with diffusion tensor imaging (DTI) at baseline and the demoralization scale II collected self-report data at baseline and 1 year later. A data-driven correlational tractography was performed to recognize significant neural pathways associated with the group membership (increased vs. nonincreased demoralization). The incremental prediction values of Quantitative Anisotropy (QA) extracted from the significant white matter tracts against the group membership were evaluated.

Results: 21.2% (N = 31) reported increased 1-year demoralization. Inferior fronto-occipital fasciculus (IFOF) was associated with 1-year demoralization in breast cancer. The incremental prediction values of QAs in net reclassification improvement (NRI) and integrated discrimination improvement (IDI) ranged from 8.11% to 46.89% and 9.12% to 23.95%, respectively, over the conventional tumor-nodal metatasis (TNM) staging model.

Conclusion: Anisotropy in IFOF is a potential prediction neuromarker to 1-year demoralization in patients with newly diagnosed breast cancer.

Trial Registration: ClinicalTrials.gov identifier: NCT03026374

Loneliness has long been a significant psychosocial problem for migrant children in urban China. In recent years, social changes and enhancements in social welfare equity have lessened the disadvantages faced by these migrant children. The current study investigated the time-trend of loneliness levels among migrant children from 2006 to 2019. A literature search was performed within major Chinese- and English-language databases, and studies that reported the means and standard deviations of Children’s Loneliness Scale (CLS) scores among Chinese migrant children were included in this cross-temporal meta-analysis. Weighted linear regression was conducted to examine the trend of mean CLS scores over the survey year, and Cohen’s d value was calculated to assess the magnitude of change. In total, 40 cross-sectional studies conducted between 2006 and 2019 (published by 2022), consisting of 47 cohorts of migrant children and a total sample size of 17,090, were included. Overall, there was a significant downward trend between the survey year and mean CLS score (unstandardized coefficient [β] = −0.342, P  < 0.001), and Cohen’s d value of this decline from 2006 to 2019 was 0.411. Similar declining time-trends were also observed among subgroups when broken down by sex, school type, and geographic regions (β = −0.182 to −0.589, P  < 0.001, d = 0.222–0.719). The loneliness levels of migrant children in urban China decreased from 2006 to 2019. Nevertheless, sustained measures and inclusive policies are still needed to mitigate the loneliness levels of Chinese migrant children.

Purpose: The 20-item Center for Epidemiological Studies Depression Scale for Children and Adolescents (CES-DC) is an instrument for screening of depression with good psychometric properties. This study aimed to examine the construct validity in terms of structural and convergent validity, the internal consistency, and the concurrent validity of a shorter 10-item version of this scale.

Methods: This was a cross-sectional validation study including 671 schoolchildren aged 9–11, from Cuenca, Spain. Depression was assessed using the 20-item CES-DC scale. We selected the 10 items with the highest factorial loading for a shorter version. Sociodemographic, anthropometric, fitness, and quality of life variables were considered to analyse convergent and discriminant validity.

Results: For the structural validity, confirmatory factor analyses revealed a three-factor latent structure for the 20-item CES-DC and a single factor in the 10-item version. Internal consistency measured by Cronbach’s α and ω statistic were 0.85 for 20-item CES-DC and 0.84 for 10-item CES-DC. Intraclass correlation coefficient between the two scales was 0.94. Convergent validity was tested through the correlation coefficients and regression models between both either CES-DC versions with body mass index, waist circumference, fitness, and quality of life measures, which were similar. For the concurrent validity, concordance analysis and the ROC curve showed an equivalent cut-off point for the 10-item CES-DC. The 20-item CES-DC classified a total of 33.1% of the sample as at risk of depression, while the 10-item CES-DC classified 30.4%.

Conclusion: This study indicates that both the 20-item and 10-item versions of the CES-DC have good internal consistency and structural validity in schoolchildren. Therefore, this short version can be used as a reliable and valid instrument for screening depression that is less time consuming and easy to use in clinical and scholarly contexts, potentially improving early detection and intervention for depression.

Trial Registration: ClinicalTrials.gov identifier: NCT03236337.

Abnormal emotional perception may contribute to emotional dysfunction in individuals with anxiety. This study explored the progression of impaired emotional perception with the deepening of anxiety in individuals with nonclinical trait anxiety, by measuring the motor cortical excitability associated with emotional perception. In total, 87 participants were assigned to a high trait anxiety (n = 27), moderate trait anxiety (n = 30), or low trait anxiety (n = 30) group. Transcranial magnetic stimulation was applied to the right primary motor cortex at 150 ms or 300 ms after the onset of positive, negative, or neutral images, while participants performed an emotion recognition task, and motor-evoked potentials (MEPs) were collected. For participants with low trait anxiety, MEP amplitudes were significantly higher for both negative and positive stimuli than for neutral stimuli. Participants with moderate trait anxiety showed significantly higher MEP amplitudes only for negative stimuli. Participants with high trait anxiety showed no significant difference in MEP amplitudes for positive, negative, and neutral stimuli. Trait anxiety score was negatively correlated with MEP amplitude: For higher trait anxiety scores, MEP amplitudes were correlated with lower emotional perception of positive and negative stimuli. Findings suggest that anxiety impairs emotional perception–related motor cortical excitability, starting with decreased motor cortical excitability responses to positive information and progressing to negative information as anxiety levels increase.

Objective: In the early stage of COVID-19 pandemic from December 2019 to March 2020, COVID-19 patients endured huge mental stress combined with constant physiological suffering. We aimed to summarize the emotional experiences of patients with COVID-19 during the early stages of the Wuhan crisis and present the coping strategies they used during the extreme time.

Methods: We did a qualitative study using an empirical phenomenology approach. COVID-19 patients with recovery and near discharge were recruited from the Dawu County Hospital of Traditional Chinese Medicine in Hubei province using purposive sampling. Semistructured face-to-face interviews were conducted by frontline medical staff and recorded by video and audio, then transcribed by two researchers separately. The Haase adapted version of the Colaizzi method was used to analyze the transcriptional data.

Results: We included 18 adult survivors of COVID-19 (33% female, 67% male) within the age range of 27–83 (mean age 48), and the average duration of isolation was 31.17 days. In conjunction with clinical data, we meticulously delved into the emotional trajectory of each survivor, spanning from the onset of illness through the phases of decline, improvement, and eventual recovery. Three theme categories were obtained from data analysis, including negative emotions and sources, coping strategies, and positive emotions and sources. COVID-19 patients adopted self-management strategies and received support from different roles when confronting high level of negative emotions.

Conclusions: Early survivors of COVID-19 experienced both negative and positive emotional experiences. Anxiety and other negative emotions were originated from both collective and individual concerns. The influence of the emotion sources differed at each stage of the disease. Patients coped with these stressors using external supports and self-adjustment. Still, comprehensive and targeted psychological services are needed.

Depressive symptoms and stress exposure fluctuate over time in community-dwelling older adults, but they are frequently assessed using one-time retrospective self-report measures. Social support viewed as a multifaceted construct can play diverse moderating roles in this association although it is typically gauged through the measure of perceived social support. This study aims to explore the relationships between stress, social support, and depressive symptoms among older adults by utilizing the longitudinal data collected through a smartphone application and supplemented by annual face-to-face interviews conducted over a 2-year period. Using longitudinal multilevel analysis, we analyzed the data on PHQ-9, stress exposure, and four distinct measures of social support collected from 354 community-dwelling older adults in South Korea. The results demonstrated that 59% of the variability in depressive symptoms was attributable to differences between individuals. Stress exposure was a strong predictor (γ = 3.01 ^∗∗∗, 95% CI = 2.34–3.67). As expected, positive functional social support alleviated the effects of stress on depression (γ = −1.12 ^∗∗, 95% CI = −1.92 ~ −0.32) while negative functional social support (γ = 2.36 ^∗∗∗, 95% CI = 1.29–3.44) and negative structural social support (γ = 3.22 ^∗, 95% CI = 0.79–5.64) worsened the effects of stress on depression. A notable finding is that stress-amplifying effects from the negative functional and structural social support, in addition to well-known stress-buffering effects from positive functional social support, should be regarded as indispensable components in safeguarding the mental health of older adults. Considering the decline in social interactions and the lower probability of older adults establishing new social connections, it is essential to consider approaches that prevent a lack of functional and structural social support and foster a high-quality of functional and structural social support, particularly for those facing greater stressors, as a preventative method against depressive symptoms.

Background: Perinatal depression (PND) in low-resource areas is a significant concern that imposes a substantial burden on both families and societies. Although many studies have explored rural PND, there is a lack of systematic synthesis of the existing research. This study aimed to estimate the global prevalence of PND among rural women and to summarize its determinants.

Methods: Comprehensively electronic searches were performed across eight English databases. Two reviewers independently assessed the eligibility of the study and extracted the relevant data. Any inconsistencies were resolved through discussion with a third reviewer. Prevalence estimates were calculated using a random-effects meta-analysis model. Subgroup analysis, sensitivity analysis, and meta-regression were employed to examine the source of heterogeneity. In addition, a narrative synthesis of the influence factors reported in the included studies was provided.

Results: The search identified 17,810 studies, of which 86 were included in the analyses. The pooled prevalence of PND in rural areas was 22.1% (95% CI 19.0%–25.3%, p < 0.001, I² = 99.2%). Subgroup analyses indicated higher PND prevalence in low-income (24.5%) and lower middle-income countries (22.8%). Additionally, PND prevalence was greater when assessed using self-reported screening instruments (22.8%) compared to diagnostic interviews (17.6%). Major risk factors included violence, antenatal psychiatric disorder, low family income, male-child preference, and food insecurity, while positive social support and higher levels of education were protective factors.

Conclusions: Our findings suggest that the prevalence of PND is higher in rural areas compared to global data, particularly in low-income and lower middle-income countries. To improve rural maternal mental health, it is essential to develop measures targeting modifiable risk factors for PND, including promoting gender equality, implementing antiviolence initiatives, and strengthening economic support systems. Addressing these factors can help reduce the burden of PND and enhance the well-being of mothers in rural communities.

Background: Depressive symptoms commonly co-occur with cognitive decline in older adults. However, prospective interrelationships between different cognitive function domains and depressive symptoms are not well understood. This study evaluated prospective interrelationships between depressive symptoms and cognitive functioning components among individuals aged 50 years or older from a perspective of network analysis.

Method: Longitudinal data from the English Longitudinal Study of Aging were analyzed. Depressive symptoms were measured with the eight-item Center for Epidemiologic Studies Short–Depression Scale. Cognitive functions assessed included memory, orientation, and executive function. Contemporaneous network analyses were conducted using mixed graphical model, while a temporal network model was assessed using cross-lagged panel network model. To identify important predictors and outcomes, centrality indices, including expected influence, out-expected influence, and in-expected influence, were calculated.

Results: A total of 6,433 older adults were included in the network analysis. Baseline “Not enjoy life” (CESD-6) was negatively associated with executive function at the follow-up assessment. Moreover, improvements in “Everything was an effort” (CESD-2) and “Loneliness” (CESD-5) were related to less future decline of executive function and memory ability. Furthermore, analyses suggested targeting “Lack of happiness” (CESD-4) could be useful in reducing the co-occurrence of depression and cognitive decline among older adults.

Conclusions: This network analysis study highlighted dynamic interrelationships between depressive symptoms and cognitive decline in older adults. Findings suggest that interventions targeting specific depressive symptoms may have the potential to alleviate declines in executive function and memory for this population.

Background: Elevated homocysteine levels and late-life depression are risk factors for cognitive decline: a comparative study highlighted the association of late-onset depression (LOD) with more significant cognitive deficits and brain pathology than early-onset depression (EOD). Limited research has explored the possible interaction between homocysteine levels and their correlation with cognitive performance in patients with EOD and LOD.

Methods: Fifty-seven individuals with EOD, 56 with LOD, and 89 matched healthy controls (HC) were recruited. Global cognition, memory, execution, language, attention, visuospatial skills, and plasma homocysteine levels were examined.

Results: Compared with HC and patients with EOD, patients with LOD had higher plasma homocysteine levels (p < 0.05), with no significant difference between HC and patients with EOD (p > 0.05). Furthermore, homocysteine levels and diagnosis groups showed significant main effects on depression and cognition, with no significant interaction effects being observed. Additionally, plasma homocysteine levels were negatively correlated with global cognition, attention, visuospatial skills, and executive function in patients with LOD (p < 0.05).

Conclusions: Compared with HC and patients with EOD, elevated homocysteine levels in patients with LOD were independently associated with cognitive performance. The potential therapeutic efficacy of homocysteine-lowering B-vitamin supplementation could be explored as a viable intervention to mitigate the documented debilitating effects of cognitive deficits in this population.

Background: OnabotulinumtoxinA (OnaA) injection in glabella area appears to be a promising treatment for major depression. However, one major concern of placebo-controlled studies on botulinum toxin injections is to ensure adequate blinding.

Patients and Methods: In this context, all subjects of this trial received the active product (OnaA). After randomization, 58 patients with resistant major depressive disorder (MDD) received OnaA either in the glabella area (N = 29) or in the crow’s feet area (N = 29). Subjects were blinded to the supposedly effective area against resistant depression and the examiner was not aware of the injected area. The primary outcome measure was the proportion of responders (50% or greater decrease in MADRS [Montgomery and Asberg Depression Rating Scale] score from baseline) in glabella group versus crow’s feet group at week 6 after the OnaA injection.

Results: The number of responders was significantly higher in the glabella group than in the crow’s feet group with 13 responders out of 29 patients (44.8%) in the glabella group and five out of 28 patients (17.9%) in the crow’s feet group (p = 0.029). The rate of psychomotor agitation as measured by item 9 of the Hamilton Depression Rating Scale (HAM-D), associated with a shorter span of psychiatric disorder, was a potent positive predictive factor of positive response to treatment.

Conclusion: We conclude that OnaA injected in the glabella muscles is an effective and well-tolerated treatment for MDD. We suggest that patients with a high score at item 9 of the HAM-D might be a subgroup of best responders. We assume that OnaA may act as a modulator of the activity of the primary sensorimotor cortex and then of the amygdala.

Trial Registration: ClinicalTrials.gov identifier: NCT03484754