Depression and Anxiety最新文献

Despite the presence of individual differences in the depressive symptom change in adults during the COVID-19 pandemic, most studies have investigated population-level changes in depression during the first year of the pandemic. This longitudinal repeated-measurement study obtained 39,259 observations from 4,361 adults assessed nine times over a 24-month period in Norway (March 2020 to March 2022). Using a Latent Change Score Mixture Model to investigate differential change patterns in depressive symptoms, five profiles were identified. Most adults revealed a consistently resilient (42.52%) or predominantly resilient pattern differentiated by an initial shock in symptomatology (13.17%). Another group exhibited consistently high depressive adversities (8.5%). One group showed mild deterioration with small increases in depressive symptomatology compared to onset levels (29.04%), and a second strong deterioration group exhibited clinically severe levels of gained symptoms over time (6.77%). Both deteriorating depressive symptom change patterns predicted the presence of a psychiatric diagnosis and treatment seeking at the end of the study period. Together, the absence of a preexisting psychiatric diagnosis at the onset of the pandemic and severe symptom increases during, combined with reports of psychiatric treatment seeking and diagnosis at the end of the study period, indicated that the strongly deteriorating subgroup represents an additional and newly emerged group of adults struggling with depressive problems. Factors related to general adverse change (lower education levels, lone residence), initial shocks prior to recovery (frequent information seeking, financial and occupational concerns), and resilience and recovery (older age, being in a relationship, physical activity) were identified. Binge drinking and belonging to an ethnic minority were influential predictors of the strongly deteriorating group. All major change patterns in depressive symptoms occurred during the first 3 months of the pandemic, suggesting this period represents a window of sensitivity for the development of long-lasting depressive states versus patterns of recovery and resilience. These findings call for increased vigilance of psychiatric symptoms during the initial phases of infectious disease outbreaks and highlight a specific target period for the implementation of preventive measures.

Objective. To explore the psychological impact of gynecological cancers on middle-aged women in Southwest China and identify the risk factors for moderate to severe depressive symptoms. Methods. This cross-sectional study included 500 patients from Southwest China, divided into two groups: depression (n = 220) and no depression (n = 280). Data on demographics, clinical characteristics, and socioeconomic factors were collected. We developed a logistic regression model to predict depressive symptoms and assessed its accuracy using the area under the receiver operating characteristic curve (AUC). Results. The study cohort consisted of 500 middle-aged and young female cancer patients with a median age of 44 years. Significant predictors of depressive symptoms included younger age, higher economic stress levels, and out-of-pocket medical expenses. A comparative analysis showed that 220 patients exhibited depression symptoms, with these patients being generally younger (median age 41 years) compared to those without depression (median age 47 years, p < 0.001). Economic stress was consistently higher in the depression group across all cancer types. Patients with ovarian cancer had a reduced risk of depression compared to those with cervical cancer. The predictive model demonstrated high accuracy in identifying depression risk, with an AUC of 0.888. Internal validation yielded an average AUC of 0.885, and external validation produced an AUC of 0.872, underscoring the model’s robustness and reliability. These findings emphasize the complex interplay of demographic, socioeconomic, and clinical factors in the psychological well-being of gynecological cancer patients, highlighting the need for tailored psychological and financial support interventions. Conclusion. Gynecological cancer patients in Southwest China experience significant psychological challenges, particularly younger women and those facing economic stress. Our predictive model can aid in early identification of those at risk for depression, emphasizing the importance of holistic care. Interventions should focus on both psychological and financial support to improve patient outcomes.

There is an increased risk for depression and anxiety across the perinatal period (i.e., spanning pregnancy and the first year postpartum); however, limited research has examined elevations in core negative affectivity underlying internalizing disorders more broadly. The current study sought to characterize trajectories of core internalizing problems among both mothers and fathers across the perinatal period and explored whether modifiable risk and protective factors buffered risk for elevated symptoms during this key developmental transition. A community sample of mixed-sex couples (N = 159) completed assessments during pregnancy and at four postpartum timepoints. Using growth mixture modeling, we found that 21.2% of mothers demonstrated clinical elevations in core internalizing symptoms that persisted up to 2 years postpartum. In contrast, 7.8% of fathers demonstrated clinical elevations in core internalizing symptoms across this period, with an additional 29.0% of fathers demonstrating subthreshold symptom elevations. Concerns related to pregnancy and childbirth and paternal (partner) internalizing problems during pregnancy conferred risk for elevated symptoms in mothers, whereas psychological flexibility, emotional intimacy, and the quality of received support were identified as protective factors for fathers. Results highlight the importance of repeated screening for internalizing problems and suggest that promoting a strong interparental relationship is critical for emotional health and well-being across the perinatal period.

Background. Although highly efficacious psychological treatments for posttraumatic stress disorder (PTSD) exist, there is evidence that first-line psychological treatment approaches leave a substantial subgroup of patients still suffering from clinically relevant PTSD symptoms posttreatment. Aims. We aimed to meta-analytically establish the prevalence and predictors of nonresponse to first-line guideline-recommended psychological treatments for PTSD. Materials and Methods. This meta-analysis was preregistered (CRD42023368766). We searched the PTSD Trials Standardized Data Repository, Embase, Medline, PsychINFO, and PTSDpubs. We included randomized controlled trials (RCT), reporting data on nonresponse operationalized by (lack of) symptom reduction in PTSD symptoms at posttreatment of first-line guideline-recommended PTSD treatments for adult patients meeting criteria for a PTSD diagnosis. All studies published by October 10, 2023, were included. Data were extracted by two independent reviewers. We estimated the pooled average nonresponse rates and ORs. Subgroup and metaregression analyses targeting the nonresponse rates served to identify significant predictors. All analyses were conducted using three-level multilevel models. Study quality was assessed using Cochrane’s RoB 2 tool. Results. Eighty six studies with 117 active treatment conditions and 7,894 participants were included in the meta-analysis. The weighted average nonresponse rate was 39.23%, 95% CI (35.08%, 43.53%). Nonresponse was less frequent in the treatment condition compared to the control condition (OR = 0.22). Subgroup analyses and metaregression revealed the type of analysis, population, type of intervention, treatment format, year of publication, age, sex, PTSD symptom severity, comorbid depression, and baseline depression score as significant predictors. The heterogeneity between studies was substantial to considerable (I² = 83.12%). Half of the studies had a high risk of bias. Conclusions. This meta-analysis found that a substantial subgroup of patients suffering from PTSD still showed clinically significant symptoms after having received treatment. Treatment modifications should be considered for specific subgroups of PTSD patients based on predictors found to be associated with nonresponse.

Object. Sex differences in suicide attempts in first-episode and drug-naïve (FEDN) patients with major depression disorder remain unclear. This study is aimed to examine sex differences in the prevalence and clinical correlates of suicide attempts in FEDN patients with MDD. Materials and Methods. A cross-sectional study was conducted on the FEDN patients with MDD, and 1,718 patients’ demography information and clinical data were collected. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS) were used to evaluate symptoms of depression, anxiety, and psychotic symptoms, respectively. Thyroid hormones, lipid profile, and fasting blood glucose (FBG) were measured. A history of suicide attempt was verified based on medical records and interviews with patients and their families. A 2 × 2 ANOVA was used to compare the clinical parameters of MDD patients in the suicide attempts subgroup and the sex subgroup, as well as whether there is an interaction between these two subgroups. Univariate analysis and multivariate binary logistic regression analyses were used to assess factors associated with suicide attempts. Results. There was no sex difference in rates of suicide attempt among FEND patients with MDD (male: 19.0% vs. female: 20.7%, χ² = 0.663, p = 0.416). Compared to males and females without suicide attempts, those with suicide attempts had higher levels of LDL-C and lower levels of HDL-C. There was a statistically significant difference in the course of disease, educational level, and TG in the female group but not in the male group. In both male and female patients, Lg (TPOAb) and severe anxiety symptoms were found to be positively correlated with suicide attempts. In addition, in male patients, suicide attempts were positively correlated with TC and FBG, while negatively correlated with body mass index. In female patients, there was a positive correlation between the severity of depression and elevated systolic blood pressure with suicide attempts (all p < 0.05). Conclusion. Our study showed that there is no sex difference in the prevalence of suicide attempts in FEDN patients with MDD and there are differences in factors related to suicide attempts between male and female MDD patients.

Background. This study aims to explore whether helping behavior is always beneficial for alleviating depression or if there is a “moderation is the key” effect. Materials and Methods. This study focused on a sample of 7,436 participants from the China Health and Retirement Longitudinal Study (CHARLS). The 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) was used to identify the presence of depression. Linear mixed model and Quasi-Bayesian estimation methods were used to explore the mediating role of life satisfaction in the relationship between helping behavior and depression, as well as the moderating effects of the instrumental activity of daily living (IADL). Additionally, we employed the Johnson–Neyman technique to visualize the moderating effect of IADL. Results. Helping behavior shows a negative correlation with depression (B = −0.170, p = 0.020), where life satisfaction fully mediates this relationship (effect = −0.055, 95% confidence interval = −0.088 to −0.022). Moreover, the association between helping behavior and life satisfaction is moderated by IADL (B = −0.047, p < 0.001). Specifically, when IADL is below 0.56, helping behavior positively impacts life satisfaction. In contrast, when IADL exceeds 1.99, helping behavior has a detrimental effect on life satisfaction. Conclusions. This study highlights the significant positive impact of helping behavior on depression alleviation, which is achieved by increasing life satisfaction. Notably, although helping behavior has positive effects on individuals, not everyone can benefit directly from it. Only those without functional limitations are more likely to experience the benefits of such behavior. Therefore, when policymakers and researchers develop strategies to encourage individuals in helping behavior to combat depression, they should consider two key approaches. First, life satisfaction should be used as an important indicator in the treatment of depression, allowing for timely adjustments to ensure the effectiveness and individualization of treatment plans. Second, the principle of “moderation is the key” should be prioritized, ensuring that helping behavior can maximize its benefits and help individuals emerge from the shadows of depression.

Introduction. No specific instruments are available to detect the risk of suicide in women during the perinatal period. Suicide in perinatal women is little studied despite being one of the main causes of maternal mortality. Its prevalence has increased by 100% in the United States in a decade. Moreover, it has consequences for the mother and the newborn. Objective. To validate the Paykel Suicide Scale and the Plutchik Suicide Risk Scale in Spanish women during the perinatal period. Materials and Methods. Cross-sectional study with Spanish women who were pregnant or who had given birth less than 18 months ago. Information was collected on sociodemographic variables, obstetric variables, and the newborn. A questionnaire that included both suicide scales and the Edinburgh Postnatal Depression Scale (EDPS) was used. An exploratory factor analysis (EFA), convergent and criterion validation, as well as internal consistency analysis, were performed. Results. In total, 237 women participated. The EFA determined that in the Plutchik Suicide Risk Scale 4 components explained 54.8% of the variance, while in the Paykel Scale, a single component explained 53.0% of the variance. In the convergent validity, the risk of suicide or suicidal ideation was related to the Plutchik Suicide Risk Scale and the Paykel Suicide Scale, respectively, with the variables: perception of low social support, risk of intimate partner violence, level of anxiety, history of mental pathology, and having experienced a stressful event in the last year, among others (p  < 0.05). The area under the receiver operating characteristic curve for the Plutchik Suicide Risk Scale scores was 0.88 (95% CI: 0.82–0.93), and for the Paykel Scale, it was 0.90 (95% CI: 0.85–0.95). The value of Cronbach’s alpha (α) was placed for the Plutchik Suicide Risk Scale at 0.806 and for the Paykel Suicide Scale at 0.766. Conclusion. Both scales presented adequate psychometric characteristics to be used as a screening instrument for suicide risk in Spanish women in the perinatal period.

This study investigated the efficacy of combining binaural beat music (BBM) with rhythmical photic stimulation at the α frequency in alleviating anxiety among daycare staff and explored its impacts on daycare staff with different anxiety levels. A quasi-experimental research design was adopted, which included three interventions: BBM, BBM integrated with rhythmical photic stimulation, and relaxation music (control group). Participants completed a questionnaire prior to the first intervention, which included personal demographic information and the Beck Anxiety Inventory. The effects of these interventions on anxiety relief among daycare staff were evaluated through heart rate variability (HRV), brain waves, and blood pressure before and after the interventions. Statistical analysis primarily employed the Friedman test to analyze the differences in changes in HRV, brain waves, and blood pressure before and after the interventions. A total of 40 individuals participated in this study (16 males and 24 females), with an average age of 31.73 ± 8.83 years. The results showed that, compared to BBM alone, BBM integrated with rhythmical photic stimulation significantly reduced the normalized low/high frequency (nLF/nHF) ratio in participants with moderate anxiety (p < 0.05). The results suggest that BBM integrated with rhythmical photic stimulation may serve as an intervention for the prevention and relief of anxiety by regulating an individual’s autonomic nervous system. However, further research is required to confirm these findings.

Background. The efficacy and safety of esketamine nasal spray (ESK) were established in registration trials in patients with treatment-resistant depression (TRD). This French real-world study aimed to describe the treatment patterns, effectiveness, and safety of ESK in TRD patients over a 12-month follow-up. Materials and Methods. This study used secondary data from patient files of hospital-based psychiatrists and started during the first French patient early access to ESK. The response and remission rates with ESK were analyzed using the total score of the Montgomery–Åsberg Depression Rating Scale (MADRS). The time to first treatment response and work resumption were described (Kaplan–Meier method). Adverse events (AEs) were analyzed. Results. Prior to ESK initiation, the 157 analyzed patients (age ≤ 65 years, 82.8%; female, 66.2%) had depression for 10.5 years (median, IQR, 4.2–21.2) and received a median of 6 (3–8) previous treatment lines. At ESK initiation, the mean ± SD total MADRS score was 32.1 ± 7.7. At that time, ESK was combined with antidepressants (93.6% of patients; SNRI, 65.0%; SSRI, 57.3%) and/or other potentiation strategy (63.1%; atypical antipsychotics, 36.3%; lithium, 25.6%; antiepileptics, 21.7%). During the 12-month follow-up, 125 patients (79.6%) discontinued ESK. The median duration of ESK treatment was 19.4 weeks (IQR, 4.4–40.1). At 1 month after ESK initiation, 40.2% of still treated patients met criteria for clinical response and 19.7% for remission (median time to response, 5.7 weeks; 95% CI (4.1–8.4)). 82.6% of active patients were on sick leave at ESK initiation; the work resumption rate was 24% (13%–40%) 12 weeks later. AEs were reported in 68.6% of patients, serious AEs in 17.2%, and AEs leading to ESK discontinuation in 14.6%. Conclusion. These real-world effectiveness and safety data were consistent with findings from previous clinical trials, describing the real-life clinical experience of patients receiving ESK and confirming that ESK has its place in therapy for the treatment of TRD.

Background. Major depressive disorder (MDD) and anxiety disorders (AD) have high degrees of comorbidity and show great overlap in symptoms. The analysis of covarying depressive- and anxiety symptoms in longitudinal, sparse data panels has received limited attention. Dynamic time warping (DTW) analysis may help to provide new insights into symptom network properties based on diagnostic- and disease-state stability criteria. Materials and Methods. In the Netherlands Study of Depression and Anxiety depressive-, anxiety-, and worry symptoms were assessed four or five times over the course of 9 years using self-report questionnaires. The sample included 1,649 participants at baseline, comprising controls (n = 360), AD patients (n = 158), MDD patients (n = 265), and comorbid AD–MDD patients (n = 866). With DTW, 1,649 distance matrices were calculated, which yielded symptom networks and enabling comparison of network densities among subgroups. Results. The mean age of the sample was 41.5 years (standard deviations, 13.2), of whom 66.4% were female. The largest distance was between worry symptoms and physiological arousal symptoms, implicating the most dissimilar dynamics over time. The network density in the groups, from lowest to highest, followed the order: controls, AD, MDD, and comorbid AD–MDD. The comorbid group showed strongly connected mood and cognitive symptoms, which contrasted with the more strongly connected somatic and arousal symptoms in the AD and MDD groups. Groups that showed more transitions in disease states over follow-up, regardless of the diagnoses, had the highest network density compared to more stable states of health or disease (beta for quadratic term = −0.095; P  < 0.001). Conclusions. Symptom networks over time can be visualized by applying DTW methods on sparse panel data. Network density was highest in patients with comorbid anxiety and depressive disorders and those with more instability in disease states, suggesting that a stronger internal connectivity may facilitate “critical transitions” within the complex systems framework.