Depression and Anxiety最新文献

Background: Major depressive disorder (MDD) is a complex condition characterized by persistent depressed mood, loss of interest or pleasure, loss of energy or fatigue, and, in severe case, recurrent thoughts of death. Despite its prevalence, reliable diagnostic biomarkers for MDD remain elusive. Identifying peripheral biomarkers for MDD is crucial for early diagnosis, timely intervention, and ultimately reducing the risk of suicide. Metabolic changes in peripheral blood mononuclear cells (PBMCs) have been observed in animal models of depression, suggesting that PBMC could serve as a valuable matrix for exploring potential peripheral biomarkers in MDD.

Methods: We performed a transcriptomic analysis of PBMCs from patients with MDD and age- and sex-matched healthy controls (n = 20 per group).

Results: Our analysis identified 270 differentially expressed genes in PBMCs from MDD patients compared to controls, which correlated with the Hamilton Depression Rating Scale scores. These genes are involved in several KEGG pathways, including the herpes simplex virus 1 infection pathway, NOD-like receptor signaling pathway, antigen processing and presentation, and glycerophospholipid metabolism—all of which are linked to various aspects of the immune response. Further machine learning analysis and quantitative real-time PCR (qPCR) validation identified three key genes—TRPV2, ZNF713, and CTSL—that effectively distinguish MDD patients from healthy controls.

Conclusions: The immune dysregulation observed in PBMCs is closely related to the pathogenesis of MDD. The candidate biomarkers TRPV2, ZNF713, and CTSL, identified and validated through machine learning and qPCR, hold promise for the objective diagnosis of MDD.

Trial Registration: Clinical Trial Registry identifier: ChiCTR2300076589

Background: Postpartum depression (PPD) significantly affects the welfare of mothers, infants, families, and communities. Mothers in rural areas often face low incomes, poor social security, low education levels, and inadequate medical services. These specific cultural, social, and economic aspects have led to a worsening of PPD in rural areas. However, the current situation of PPD among women in rural areas of China is still insufficiently explored.

Aim: This study aims to explore the prevalence and risk factors of PPD among women in low-income developing rural areas of China.

Methods: A cross-sectional design was used in this study. Edinburgh Postnatal Depression Scale (EPDS) was applied to evaluate PPD symptoms. General demographic questionnaire, obstetrics-/pediatrics-related questionnaire, and psychosocial-related questionnaire were adopted. Abuse Assessment Screen (AAS) was utilized to assess experienced intimate partner violence during pregnancy and postpartum. Social Support Rating Scale (SSRS) was utilized to measure their levels of social support.

Results: Of the 467 participants, the overall prevalence of PPD among women in rural areas of China was 16.5%, and the average EPDS score was 8.35 (SD = 4.50). PPD occurred most frequently at 7–9 months postpartum (33.8%). Six factors associated with PPD were whether the sex of the baby was in line with the family’s expectations, monthly income of partners, social support, IPV during pregnancy and childbirth, and negative life events in the last 1 year, as well as physical and mental exhaustion from caring for a baby.

Conclusions: This study sheds light on the prevalence and various risk factors associated with PPD among women residing in low-income developing rural areas of China. The findings highlighted the need for targeted interventions and support systems designed to address the specific socioeconomic and cultural difficulties encountered by rural mothers.

Background. The global presence of high blood pressure and depression poses a significant public health threat, particularly in emerging nations. High blood pressure and depression are inevitable among the working population of Ghana, and it is crucial to recognize the potential influence of these conditions on the working-age population.

Materials and Methods. The study analyzed the risk factors associated with high blood pressure and depression among the working population of Ghana. The data in this study were drawn from Wave 1 data of the Study on Global Ageing and Adult Health (SAGE) survey, which was conducted by World Health Organization (WHO) in Ghana from January 2007 to December 2008. A longitudinal survey under the banner of SAGE was conducted. The study used 2681 participants aged 18–60 years. We modeled high blood pressure using logistic regression and depression with the proportional odds model of ordinal logistic regression.

Results. The study revealed that the prevalence of depression among the working-age population was 42.5%, whereas that of high blood pressure was 48.7%. The result also showed that males have a lower risk of developing high blood pressure and depression (OR = 0.851 and OR = 0.658, respectively) compared with females. Also, older adults (40–60 years) have a higher risk of developing high blood pressure and depression (OR = 1.992 and OR = 2.334, respectively) compared with younger adults. Other risk factors associated with high blood pressure include diabetes (2.107), depression, and weight. Last, alcohol intake (1.502), tobacco intake (1.279), and high blood pressure were found to be other risk factors associated with depression.

Conclusion. The prevalence of depression and high blood pressure is high among the working population of Ghana. There is therefore the need to incorporate health awareness programs on these topics.

Background: Patients with type 2 diabetes mellitus (T2DM) face an increased risk of developing depression and metabolic dysregulation, which can lead to a higher risk of cardiovascular disease (CVD). However, the relationship between the severity of depression and metabolic dysregulation in patients with T2DM remains unclear. This study aimed to investigate this association using data from the ACCORD-health-related quality of life study.

Methods and Results: Patient Health Questionnaire-9 (PHQ-9) scores and medication regimens were assessed at baseline, 1, 3, and 4 years, and HbA1c, blood pressure, and lipid levels were monitored every 4 months over a 4-year period. The severity of depressive symptoms was categorized as none (0–4 points), mild (5–9 points), or moderate–severe (10–24 points) based on PHQ-9 scores. Among the participants, 62% developed depressive symptoms at some point during the 4-year follow-up period, with 21% experiencing persistent depressive symptoms. Participants with moderate-to-severe depression exhibited 0.18% (0.12, 0.24) higher levels of HbA1c, 1.11 mmHg (95% CI, 0.04, 2.15) of SBP, 0.90 mmHg (95% CI, 0.22,1.58) of DBP, and 2.12(95% CI, −0.03, 4.27) mg/dL of LDL, and 0.97 (95% CI, 0.38, 1.56) mg/dL lower levels of HDL compared to their counterparts without depressive symptoms. Moreover, as the severity of depressive symptoms increased, variability in HbA1c and blood pressure levels also increased. Furthermore, patients with more severe depressive symptoms demonstrated suboptimal adherence to medication regimens.

Conclusion: Our study found a significant association between depressive symptoms severity and metabolic control in T2DM patients. Greater depressive severity correlated with poorer glycemic, blood pressure, and lipid control, alongside increased variability in these parameters. Additionally, patients with severe depressive symptoms showed suboptimal medication adherence. Addressing mental health in T2DM management is crucial to improve metabolic control and reduce CVD risks.

Trial Registration: ClinicalTrials.gov identifier: NCT00000620

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.