Depression and Anxiety最新文献

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

Background: A nutritional supplement based on medicinal plants (saffron and ashwagandha), tryptophan, and vitamin B6 could contribute to alleviating/improving mood and associated disorders. The aim of this study was to evaluate the potential benefits of this combination supplement. During the study period, participants underwent a period of forced home confinement due to the COVID-19 pandemic, which represented an unexpected impact factor.

Methods: This open-label prospective trial enrolled a cohort of female employees who reported mild to moderate anxiety. The primary objective was to evaluate changes in the level of anxiety using the adapted Hamilton Anxiety Rating Scale (HARS) after 12 weeks of regular supplementation with Safromotive (two tablets daily, for 12 weeks). The secondary objectives were to evaluate health-related quality of life (HRQoL) and tolerability.

Results: In total, 46 women with a mean age of 45.0 (6.5) years were included. A statistically significant improvement in HARS was observed, with a 7.5-unit decrease from baseline to 12 weeks (p  < 0.0001) and from 4 to 12 weeks of supplement intake (p = 0.0058). However, no significant changes were found during the lockdown period (between weeks 8 and 12 of the study). No relationship was found between women’s sociodemographic characteristics and the HARS total score. A significant reduction in the HRQoL questionnaire score of 1.2 units was observed between baselines and 12 weeks of treatment (p = 0.0273). At the end of the study, 78.6% of the women reported consistency the supplement intake during the study course.

Conclusion: This nutritional supplement composed of saffron, ashwagandha, tryptophan, and vitamin B6 appears to improve anxiety and HRQoL, but confinement could have impacted the evolution of the outcome.

Objective: This study aims to explore the correlation between anxiety and serum thyroid hormone levels in patients with papillary thyroid carcinoma (PTC) who underwent microwave ablation (MWA).

Methods: A total of 107 PTC patients who underwent MWA were recruited. Three months after MWA, serum samples were collected from each participant to analyze their thyroid-related hormone levels, including free T3 (FT3), free T4 (FT4), T3, T4, and thyroid-stimulating hormone (TSH) levels. Additionally, the Self-Rating Anxiety Scale (SAS) was used to measure anxiety levels at the same time. Linear correlation analysis was used to determine the correlation between anxiety and serum thyroid hormone levels.

Results: SAS scores among the 107 PTC patients ranged from 27 to 58, with an average score of 38.19 ± 6.68. Seven patients (6.54%) met the criteria for anxiety; the mean SAS score among these patients was 51.57 ± 2.88. The remaining 100 patients (93.46%) did not meet the criteria for anxiety; the mean SAS score among these patients was 37.04 ± 5.49. Among all participants, TSH levels varied from 0.30 to 5.09, with an average of 2.08 ± 0.91. Nine participants exhibited slight fluctuations in FT3, FT4, T3, T4, and TSH levels; these hormone levels consistently remained within the normal range for the other 98 patients. Linear correlation analysis revealed a significant positive correlation between anxiety and TSH levels (p < 0.001).

Conclusion: The results demonstrated a significant positive correlation between anxiety and TSH levels in patients with PTC post-MWA, indicating that increased anxiety is associated with increased TSH levels.

Background: This study aims to elucidate characteristics of the symptom network of work–family conflict (WFC) and sleep disorders among Chinese correctional personnels while accounting for job burnout as a possible confounder.

Method: A total of 472 correctional personnel were included. Their WFC, sleep disorders, and job burnout were measured using a Chinese version of Work–Family Conflict Scale (WFCS), the Athens Insomnia Scale (AIS), and a revised Chinese version of Maslach Burnout Inventory-General Survey (MBI-GS), respectively. Central symptoms and bridge symptoms were respectively identified based on centrality indices and bridge centrality indices. Network stability was examined using the case-dropping procedure.

Results: Daytime condition (strength = 0.01) and strain-based work interference with family (WFCs, strength = 1.45) symptoms had the highest centrality values in the WFC-sleep disorder network structure, which were also identified as two bridge symptoms. Emotional exhaustion, daytime condition, and WFCs appeared to be potential bridge symptoms in the WFC–sleep disorder–burnout network structure.

Conclusions: In this study, among Chinese correctional personnel, daytime conditions, and WFCs were found to be central symptoms in the WFC–sleep disorder network structure, with emotional exhaustion as the bridge symptom in the WFC–sleep disorder–burnout network structure. We encourage relevant organizations to provide timely and effective education and guidance for regulatory personnel regarding these bridge symptoms. Subsequent research should follow up to assess the impact of relevant interventions on symptoms in the WFC–sleep disorder–burnout network, thereby advocating for the mental and physical health of correctional personnel.

The heterogeneity of posttraumatic stress disorder (PTSD) is an obstacle to both understanding and therapy, and this has prompted a search for internally homogeneous neuroradiological subgroups within the broad clinical diagnosis. We set out to do this using the individual differential structural covariance network (IDSCN). We constructed cortical thickness-based IDSCN using T1-weighted images of 89 individuals with PTSD (mean age 42.8 years, 60 female) and 89 demographically matched trauma-exposed non-PTSD (TENP) controls (mean age 43.1 years, 63 female). The IDSCN metric quantifies how the structural covariance edges in a patient differ from those in the controls. We examined the structural diversity of PTSD and variation among subtypes using a hierarchical clustering analysis. PTSD patients exhibited notable diversity in distinct structural covariance edges but mainly affecting three networks: default mode, ventral attention, and sensorimotor. These changes predicted individual PTSD symptom severity. We identified two neuroanatomical subtypes: the one with higher PTSD symptom severity showed lower structural covariance edges in the frontal cortex and between frontal, parietal, and occipital cortex—regions that are functionally implicated in selective attention, response selection, and learning tasks. Thus, deviations in structural covariance in large-scale networks are common in PTSD but fall into two subtypes. This work sheds light on the neurobiological mechanisms underlying the clinical heterogeneity and may aid in personalized diagnosis and therapeutic interventions.

Depression and obesity are two diseases that have a profound impact on global health. The relationship between obesity and depression is strongly comorbid, tending to exacerbate metabolic and depressive symptoms. Research also shows that there are complex interactions between obesity, depression symptoms, and food addiction (FA). The aim of the study was to investigate the relationship between body mass index (BMI), self-rated depression, and FA. The study sample consisted of 735 subjects (90.2% female, M_BMI = 27.58 kg/m², standard deviation (SD)_BMI = 6.58 kg/m²) aged 18–70 years (M = 39.01, SD = 14.07). The prevalence of FA symptoms was measured using the Yale Food Addiction Scale 2.0 and self-rated depression was assessed using the Zung Self-Rating Depression Scale. The prevalence of FA in the group was 41% and self-rated depression was present in 34.1% of the participants. It was found that the higher the BMI of the subjects, the higher the severity of FA, but the BMI was not significantly correlated with the severity of depression. In addition, the greater the severity of self-rated depression, the greater the severity of FA. This correlation was stronger for men than for women in the 18–30 and 31–45 age groups. The severity of self-rated depression and FA was significantly higher in people with an eating disorders. This study adds to the growing body of evidence suggesting that the presence and severity of FA are associated with the severity of self-rated depression, particularly in younger adults. In addition, people with a high BMI, indicating obesity, are more likely to have FA, especially severe FA.

Importance: While the prevalence and impact of depression have been widely described in sickle cell disease, its relationship with precariousness has never been studied.

Objective: This study aimed to describe the prevalence of depression and its relationship with clinical and demographic factors including social precariousness in children with sickle cell disease in French Guiana.

Methods: We included children aged 12–18 years with sickle cell disease from the Sickle Cell Reference Center in French Guiana. A simple depression questionnaire “Child depression inventory 2” was proposed and completed by a clinical examination and consultation by a psychologist. Using the known assessment of health inequalities and poverty in health screening centres (EPICES) score, we developed a composite precariousness score that uses five items (each item is scored from 0 to 2). According to the chosen items, precariousness was defined as a score ≥5.

Results: The prevalence of depression was 42.5% [95% CI: 31.5–54]. The median age was 15 years [95% CI: 13–17]. The age distribution peaked at 14 years in patients with depression. There were 76% of precarious patients in the depressed group and 18% in the control group (p  < 0.0001). In multivariate analysis, genotype SC (OR = 7.66, [1.17; 50.13], p = 0.0338) and precariousness (OR = 15.68, [4.73; 51.94], p  < 0.0001) were associated with higher rates of depression. Baseline hemoglobin levels (OR = 0.48, [0.27; 0.88], p = 0.0173) were also associated with lower rates of depression.

Conclusions and Relevance: Despite free healthcare, precariousness is an independent risk factor for depression.