Depression and Anxiety最新文献

Background. Agency, a sense of control over one’s actions and outcomes, is crucial for recovery from depressive symptoms. However, the mechanisms that enhance agency in individuals with depressive symptoms remain poorly understood. This study endeavors to elucidate these fundamental processes. Materials and Methods. We recruited 52 participants exhibiting depressive symptoms to participate in a novel Judgment of Agency (JoA) task. This task was structured with a 3 (effort: high load, medium load, low load) × 2 (outcome: win, miss) within-subject design to assess the impact of effort and outcome valence on agency. Throughout the task, we utilized functional near-infrared spectroscopy (fNIRS) to explore the neural mechanisms underlying agency. Furthermore, we conducted a randomized, sham-controlled, pre–post-test trial involving intermittent theta-burst stimulation (iTBS) targeted at the left dorsolateral prefrontal cortex (DLPFC) to investigate its potential to enhance agency. Participants were randomly allocated to either an active iTBS group or a sham group, with each receiving a single session of stimulation (600 pulses). The JoA task was conducted both before and after the stimulation. Results. Effort significantly influenced agency in individuals with depressive symptoms, with this effect being moderated by the outcomes’ valences. Agency was positively correlated with self-efficacy (r = 0.28, P < 0.05) when goals were achieved with effort, and with anxiety severity (r = 0.29, P < 0.05) when goals were not achieved. Additionally, it was associated with the activation of several frontal brain regions (all P values < 0.01), including the left DLPFC, right premotor and supplementary motor areas, and the left inferior frontal gyrus (IFG). Application of iTBS over the left DLPFC significantly enhanced self-attributed agency, particularly when the outcomes were achieved under conditions of low-load effort. Conclusions. Our study highlights the critical role of effort in enhancing agency for individuals with depressive symptoms, with iTBS applied to the left DLPFC showing potential to enhance agency postgoal achievement. Moreover, the activation of the left IFG and the presence of anxiety are associated with maladaptive self-attributed agency, offering potential targets for therapeutic intervention.

Background. Individuals with mental health disorders face major barriers in accessing smoking cessation care, often due to the stigmas associated with mental disorders and addiction. Consequently, accessible population-based smoking cessation interventions are needed for this vulnerable group. Objective. This secondary analysis utilized data from a 12-month randomized trial to examine whether an acceptance and commitment therapy-based app (iCanQuit) demonstrated greater efficacy, engagement, and satisfaction compared to a United States (US) Clinical Practice Guidelines-based app (QuitGuide) in helping adults with mental health disorders quit smoking. Materials and Methods. Participants self-reported having bipolar disorder or schizophrenia, or screened positive for depression, generalized anxiety, panic disorder, posttraumatic stress disorder, or social anxiety. We compared the primary outcome of self-reported 30-day cigarette abstinence at 12 months between iCanQuit (n = 770) and QuitGuide (n = 785) using complete-case and multiple imputation analyses and compared engagement and satisfaction between arms. Mediation analyses were conducted to examine whether the intervention apps functioned by reinforcing hypothesized mechanisms of action, namely, acceptance of triggers to smoke and through app engagement. Results. Participants represented all 50 US states and had 30.2% non-White or Hispanic backgrounds. Among participants with any mental health disorder, iCanQuit demonstrated higher 30-day cigarette abstinence than QuitGuide at 12 months (complete-case: 24.4% vs. 20.4%, P = 0.04; multiple imputation: 24.6% vs. 20.4%, P = 0.04). A comparable effect size was observed in iCanQuit participants with bipolar disorder or schizophrenia compared to QuitGuide, albeit not statistically significant (multiple imputation: 27.1% vs. 20.9%; P = 0.06). iCanQuit’s cessation efficacy was mediated by acceptance of emotions triggering smoking (P < 0.001) and app engagement (P < 0.001). iCanQuit was more satisfying than QuitGuide (88.5% vs. 77.2%; P < 0.001). Conclusions. In the largest known study of ACT for smoking cessation among adults with mental health disorders, the smoking cessation, engagement, and satisfaction outcomes were all significantly greater with iCanQuit than QuitGuide. Acceptance of emotions triggering smoking and iCanQuit app engagement were important mechanisms of efficacy. This trial is registered with NCT02724462.

Depression and anxiety are highly prevalent among patients with breast cancer. We tested the capacity of personal resources (psychological resilience, social support, and process of recovery) for predicting depression, anxiety, and comorbid depression and anxiety (CDA) among such patients using machine learning (ML). We conducted a cross-sectional survey in Liaoning Province, China, including questions about demographics, COVID-19^′s impact, and personal resources (707 valid responses). In the training set, we used Lasso logistic regression to establish personal resource models. Subsequently, we used six ML methods and a tenfold cross-validation strategy to establish models combining personal resources, demographics, and COVID-19 impacts. Findings indicate that in total, 21.9%, 35.1%, and 14.7% of participants showed depression, anxiety, and CDA, respectively. Loneliness, vitality, mental health, bodily pain, and self-control predicted depression, anxiety, and CDA. Furthermore, general health predicted depression, and physical function predicted anxiety. Demographic and COVID-19 models were far less predictive than personal resource models (0.505–0.629 vs. 0.826–0.869). Among combined models, the support vector machine model achieved the best prediction (AUC: 0.832–0.873), which was slightly better than the personal resource models. Personal resources features with ML and personal resources can help predict depression, anxiety, and CDA in patients with breast cancer. Accordingly, interventions should target loneliness, bodily pain, vitality, mental health, and self-control.

Objective. Association between neuroticism and gastrointestinal tract (GIT) diseases may not be attributable to the genetic overlaps between neuroticism and psychiatric disorders. We aim to explore the genetic links and mechanisms of neuroticism and GIT diseases. Materials and Methods. We obtained European genome-wide association data of neuroticism (n = 390,278) or subclusters (depressed, n = 357,957; worry, n = 348,219) and six GIT diseases: gastroesophageal reflux disease (GERD, n = 456,327), inflammatory bowel disease (IBD, n = 456,327), peptic ulcer disease (PUD, n = 456,327), irritable bowel syndrome (IBS, n = 486,601), Crohn’s disease (CD, n = 20,883), and ulcerative colitis (UC, n = 21,895). We performed genetic correlation analysis (high-definition likelihood method and cross-trait linkage disequilibrium score regression), pairwise pleiotropic analysis, single nucleic acid polymorphism annotation, Bayesian colocalization, gene-level analysis, transcriptome-wide association analysis, and gene set enrichment analysis. Results. Neuroticism and its subclusters are associated with most GIT diseases (15 of 18 trait-pairs). GERD and PUD were highly correlated with depressed affect. We identified pleiotropic loci 11q23.2 (mapped gene: NCAM1/DRD2) and 18q12.2 (mapped gene: CELF4) in neuroticism and IBS/GERD, supporting the genetic overlap between neuroticism and depression. We found that 16q12.1 (mapped gene: NKD1/ZNF423/NOD2) and 2q37.1 (mapped gene: ATG16L1/SP140) are only highlighted in depressed/neuroticism CD, revealing pleiotropic loci with dissimilarities between neuroticism and different GIT diseases. MR analysis suggested that genetic liability to neuroticism is associated with increased risks of IBS, PUD, and GERD. Conclusion. Our findings document the genetic links between neuroticism and six GIT diseases, highlighting the genetic overlaps and heterogeneity between neuroticism and psychiatric disorders in the context of gastrointestinal disorders. Both the shared and unique pleiotropic loci identified between neuroticism and different GIT diseases could facilitate mechanistic understandings and may stimulate further translational implications.

Background. The term “incel” (involuntary celibate) refers to the members of an online subculture, mainly composed of heterosexual men. These individuals find it difficult or impossible to have a romantic and/or sexual partner, and they express extreme anger and resentment toward women, as they hold them accountable for their “inceldom.” In recent years, online and offline acts of violence have been perpetrated by incels, raising concern at social and political levels. This study aims to understand the personal, psychological, and psychopathological variables that may contribute to developing incel traits. Materials and Methods. A total of 800 Italian heterosexual cisgender men were recruited by a link to the survey forwarded on social networks. Participants have completed a sociodemographic questionnaire and a set of psychometric tests to assess incels’ personality traits, attachment patterns, paranoia, anxiety, and depression. Results. Positive correlations among incel personality traits and psychopathological symptoms and insecure attachment were found. Hierarchical regression analysis showed the significant role of paranoid thinking, insecure attachment, depression, and anxiety symptoms in the presence of incels’ personality traits. Conclusion. Therefore, the assessment of these psychopathological aspects could help clinicians, parents, and teachers to early identify young males that can be caught in the inceldom and to develop specific intervention programs to prevent violence.

Background and Purpose. The number of older adults and the occurrence of concomitant health issues continue to grow. One of the most prevalent mental health issues in this population is depression. Physical exercise (PE) is widely acknowledged as a method to alleviate the associated health burdens of aging, including depression; however, there is no collated evidence regarding the effectiveness of specific types of exercise on a range of health outcomes. To address this, we conducted a systematic review to evaluate exercise benefits for this specific subgroup. Methods. An electronic search of five databases was used to retrieve controlled studies investigating health-related outcomes associated with any type of PE, in adults over 65 years with depression. Where possible, data were analyzed in meta-analyses or else reported narratively. Results and Discussion. Fifteen studies were included in the review. All 15 studies had data available for meta-analysis, yet heterogeneity in exercise types and outcome measures limited synthesis. When data for all types of exercise were pooled together, significant improvements were found in depression (SMD = 0.52; CI = 0.07, 0.97; p = 0.02), physical health and function (SMD = 0.44, CI = 0.14, 0.74; p = 0.004), anxiety (SMD = 0.23; CI = 0.04, 0.42; p = 0.02), and self-efficacy (SMD = 0.97; CI = 0.32, 1.61; p = 0.003). When data were pooled according to exercise type, positive effects were demonstrated for aerobic exercise on depression (SMD = 0.49; CI = −0.16, 0.8; p = 0.003), tai chi/qigong on depression (SMD = 0.89; CI = −0.14, 1.63; p = 0.02), and self-efficacy (SMD = 6.70; CI = −0.90, 12.50; p = 0.02) and multicomponent exercise demonstrated positive effects on physical function (SMD = 0.49; CI = 0.12, 0.87; p = 0.009) and the physical health component of quality of life (SMD = 0.88; CI = 0.10, 1.65; p = 0.03). No health-related benefits were revealed from the combined findings of the two studies investigating strengthening exercises. Conclusion. Lack of consistency regarding exercise types, dosage, and outcomes presents challenges in the evidence. In general, exercise is beneficial across a range of health-related variables. Multicomponent, aerobic, and tai chi forms of exercise appear most likely to reap benefits in depressed older adults; however, the type of benefit is determined by the type of exercise and should be considered when recommending a regime. This trial is registered with CRD42020173465.

Introduction. Depression is the most common mental health disorder worldwide with a lifetime prevalence of approximately 10% in the general population. Our objective was to assess the knowledge, attitudes, and practices among healthcare workers (HCWs) regarding depression care. Methods. We conducted a cross-sectional study among consenting healthcare workers in two medium-sized hospitals in Kenya. Data on demographic characteristics, knowledge, attitude, and practice of depression were collected through a self-administered structured questionnaire. The Revised Depression Attitude Questionnaire was incorporated into the questionnaire. Knowledge and attitude scores were computed, where higher scores suggested higher knowledge or more positive attitudes. Descriptive and regression analyses were used to assess associations, and a p value of < 0.05 was considered significant. Results. Among the 316 HCWs approached, 303 (95.9%) consented and were enrolled. Almost two-thirds (64.0%) of the respondents were female, and 58.4% were between 18 and 29 years old. HCWs were categorised into three: nurses, clinicians (doctors/clinical officers), and nonclinicians (other healthcare workers). The median knowledge score among respondents was 9 out of 10. Nonclinicians scored significantly lower (β = −0.5, p < 0.011) on the knowledge score compared to clinicians. Only 9.3% of the respondents strongly agreed or agreed that they were confident in assessing the risk of suicide in patients with depression. The median attitude score among respondents was 65 out of 110. The attitude score was positively associated with the knowledge score (β = 0.78, p = 0.001), and respondents with professional experience of 5-14 years had higher attitude scores compared (β = 1.7, p = 0.023) to those with fewer than 5 years. Among clinicians and nurses, 40.3% reported that they rarely or have never been screened for depression. Conclusions. HCWs demonstrated good knowledge of depression’s symptoms and causes but lacked confidence in pharmacological management, with gaps in regular screening and comprehensive care practices, particularly among nonclinicians and less experienced staff. Focused training for these groups could enhance the early detection and treatment of depressed patients.

Allostatic load (AL) is the cumulative wear and tear on the body due to the chronic adverse physical or psychosocial situations. The acute stress response activates the primary mediators of AL, which include cortisol, epinephrine (EPI), norepinephrine (NE), and dehydroepiandrosterone sulfate (DHEA-S). Secondary outcomes, such as metabolic syndrome (MetS), cardiovascular, and immune system changes, can result from long-term stress responses. Given these complex reactions to an acute stressor, a multidimensional stress assessment is required when investigating individual stress reactivity in an experimental setting. This study is aimed at examining the association between the primary mediators of AL and MetS in major depressive disorder (MDD) patients. MDD patients (n = 164, age = 18–65 years old) with MetS+ (n = 46, weight = 93.10 ± 16.43 kg) and without MetS- (n = 118, weight = 73.08 ± 15.22 kg) were analyzed cross-sectionally. Stepwise binary regression and Welch’s t-test were used to find the associations and differences between the two groups. The regression analysis was fully adjusted for age, sex, and the Beck Depression Inventory-II score. In unadjusted model, cortisol (b = −0.003, p = 0.034) was inversely associated with MetS. In fully adjusted model, EPI (b = −0.006, p = 0.007) was inversely associated with MetS. However, significant differences (p = 0.005) were observed for cortisol between MDD patients without MetS- (410.13 ± 144.63 nmol/l) and MDD patients with MetS+ (340.90 ± 132.98 nmol/l) with a small effect size (Cohen’s d of 0.489). Significant differences (p = 0.001) were observed for EPI between MDD patients without MetS- (185.67 ± 124.44 pg/ml) and MDD patients with MetS+ (124.95 ± 84.38 pg/ml) with a moderate effect size (Cohen’s d of 0.530). These observations are of clinical importance for the management of MDD patients.

Background. The neuropathology of anxiety disorders, including specific phobias, social phobias, and generalized anxiety disorders (GAD), has been believed to be rooted in a reduced inhibition of limbic areas by the dorsolateral prefrontal cortex (DLPFC). Trait anxiety has been linked to insufficient recruitment of DLPFC mechanisms for attentional control. Despite limited research on individuals with anxiety disorders, our study utilized transcranial magnetic stimulation to assess DLPFC cortical activity and emotional states using the N100 as an indicator of GABA-B-mediated cortical inhibition. Additionally, we aimed to correlate trait anxiety scores with cortical activity. Methods. A total of 20 subjects with social phobia and GAD and 21 subjects with specific phobia were compared to 24 control subjects regarding their inhibitory N100 in the DLPFC. Therefore, TMS was applied on the left and right DLPFC during an emotional task with fearful, angry, and neutral faces and a rest condition. Results. Smaller N100 amplitudes after DLPFC stimulation were found in subjects with social phobia, GAD, and social phobias compared to the control group. Furthermore, a correlation between trait anxiety scores and smaller N100 amplitudes, independent of group effects, was found. Conclusion. There appears to be a decrease in GABA-B-mediated cortical inhibition in the DLPFC in subjects with anxiety disorders. The correlation between trait anxiety and N100 amplitudes suggests a trait-related modulation of cortical inhibition.

Background. Suicide is one of the global burdens of morbidity and mortality in all reproductive-age women population groups across the world. It is one of the most significant contributors to the global burden of illness and a cause of morbidity. This study is aimed at finding out how it occurred and what risk factors were related to suicidal ideation and attempts among women in the reproductive-age group. Methods. A community-based cross-sectional study design was conducted using a multistage cluster sampling technique to get a total of 590 study participants from March to April 2021. Data were entered into EpiData version 3.1 and analyzed in bivariate and multivariable logistic regression models using Statistical Package for Social Science (SPSS) version 20. Variables with a p value <0.05 were declared to be associated risk factors with the outcome variable. Results. A total of 590 of the 598 sampled women participated, with a response rate of 98.7%. A one-month prevalence of suicidal ideation and attempt was 2.9% (95% CI: 1.5%, 4.4%) and 2.5% (95% CI: 1.4%, 3.7%), respectively. Intimate partner violence (AOR = 4.69, 95% CI: 1.53, 14.45), depression (AOR = 3.11, 95% CI: 1.11, 9.85), and history of mental illness (AOR = 5.18, 95% CI: 1.55, 17.32) were associated risk factors for suicide ideation. Anxiety (AOR = 3.55, 95% CI: 1.17, 10.81), being unmarried (AOR = 4.39, 95% CI: 1.49, 12.87), and history of mental illness (AOR = 7.95, 95% CI: 2.42, 26.15) were associated risk factors for suicide attempts. Conclusion. SI and SA are prevalent in reproductive-age women. Intimate partner violence, depression, anxiety, a history of mental illness, and being single were associated factors. This implies that providing relevant information, education, and continuing support is very crucial for reproductive-age group women to decrease the incidence and risk factors of suicide.