Depression and Anxiety最新文献

Background. The global prevalence of depression and anxiety disorders underscores the need for a more profound comprehension of effective treatments. Mindfulness has shown promise in enhancing treatment outcomes and preventing relapse in these conditions, but the underlying mechanisms remain poorly understood. Methods. This study examined the role of emotion regulation as a mediator in the relationship between changes in mindfulness and the reduction of depression and anxiety symptoms during individual cognitive-behavioral therapy (CBT). We tracked longitudinal changes in mindfulness, emotion regulation, depression, and anxiety at baseline (pre), early treatment (session 5), midtreatment (session 15), and posttreatment (session 25) in 162 patients with depression and anxiety disorders. Further, we examined whether the effects of mindfulness on emotion regulation could be enhanced by introducing a brief mindfulness intervention at the beginning of each CBT session, as compared to progressive muscle relaxation and individual psychotherapy without any standardized session-introducing interventions. Results. Multilevel structural equation modeling indicated that decreases in rumination and increases in reappraisal and acceptance mediated the relationship between mindfulness and reductions in depressive symptoms. In contrast, reductions in avoidance explained the association between mindfulness and changes in anxiety symptoms. These links remained unchanged when adding a mindfulness intervention into individual CBT. Conclusion. Results support emotion regulatory properties of mindfulness and highlight distinct pathways of symptom reduction in depression and anxiety. These findings have important implications for understanding the mechanisms of mindfulness and tailoring treatment to individual patient needs. This trial is registered with NTC02270073.

Background. Heterogeneous findings among anxiety disorder studies have hindered elucidation of the underlying pathophysiology and the development of mechanism-based therapies. Purpose. To determine whether structural MRI findings in anxiety disorder studies converge on a common network with therapeutic significance. Materials and Methods. In this retrospective study, a systematic literature search of PubMed and Web of Science databases was performed to identify coordinates of gray matter atrophy in patients with anxiety disorder. Atrophy coordinates were then mapped to an anxiety network constructed from the resting-state functional MRI (rs-fMRI) data of 652 healthy participants using “coordinate network mapping” and validated by specificity tests. The causal association of this network to anxiety symptoms was tested in a cohort of patients with brain lesions and emergent anxiety symptoms. The potential therapeutic utility of this anxiety network was then assessed by examining the clinical efficacy of network-targeted repetitive transcranial magnetic stimulation (rTMS) among a separate anxiety disorder cohort. Statistical analyses of images were performed using nonparametric tests and corrected for family-wise error. Results. Sixteen studies comprising 453 patients with anxiety (245 females; mean age ± [SD], 31.4 ± 8.71 years) and 460 healthy controls (238 females; 31.7 ± 10.08 years) were included in the analysis. Atrophy coordinates were mapped to an anxiety network with a hub region situated primarily within the superficial amygdala. Lesions associated with emergent anxiety symptoms exhibited stronger connectivity within this anxiety network than lesions not associated with anxiety (t = 2.99; P = .004). Moreover, the connectivity strength of rTMS targets in the anxiety network was correlated with the improvements of anxiety symptom after treatment (r = .42, P = .02). Conclusions. Heterogeneous gray matter atrophy among patients with anxiety disorder localize to a common network that may serve as an effective therapeutic target.

Background. Depressive complications in chronic pain are detrimental to rehabilitation. This study was aimed at determining the influence of the presence of depressive symptoms on the efficacy of physical therapy among participants with chronic low back pain (CLBP). Methods. Data was collected from a randomized controlled trial on 113 participants with CLBP. Participants were reallocated into the depressed or nondepressed groups based on the 50-cutoff point of the self-rating depression scale. All patients received 60 min sessions of physical therapy twice a week for 12 weeks. The primary outcome was back-related disability. Secondary outcomes included pain ratings, sleep quality, life quality, other psychological outcomes, and minimal clinically important differences. These outcomes were collected at baseline, 12, 26, and 52 weeks. Results. 31 (27.4%) were accompanied by depressive symptoms. At 12 weeks, the initial depression score was only associated with anxiety score (β = 1.196 [0.531 to 1.860], P = 0.001) and depression score (β = 0.742 [0.200 to 1.284], P = 0.009) in the depressed group, but the initial depression score was associated with anxiety score (β = 0.409 [0.138 to 0.681], P = 0.004), depression score (β = 0.920 [0.658 to 1.184], P < 0.001), sleep quality (β = 0.108 [0.018 to 0.199], P = 0.020), and pain anxiety (β = 0.465 [0.034 to 0.897], P = 0.035) and negatively associated with life quality (β = −0.815 [−1.267 to −0.363], P = 0.001) in the nondepressed group. Conclusions. Physical therapy is effective to CLBP with depressive symptoms. A higher initial depression score may weaken the efficacy of physical therapy in the nondepressed group. Depressive complications may adversely influence intervention efficacy for CLBP. This trial is registered with ChiCTR1800016396.

Spatial demonstratives are highly frequent linguistic universals, with at least two contrastive expressions (proximal (“this”) vs. distal (“that”)) indicating physical, social, or functional proximity of the speaker to the referent object. Recent evidence based on the Demonstrative Choice Task (DCT), in which participants couple words with a spatial demonstrative with no context provided, suggests that demonstrative use is also indicative of experienced or emotional proximity to the self in an imagined mental space. As depression is characterized by increased and maladaptive focus on the self, the DCT may be a simple and reliable way to elicit behaviors that enable inference on the presence of severe depressive states and allow descriptions of the semantic characteristics of individual differences in such states. In two independent cross-sectional studies, including 775 and 879 participants, respectively, we showed that DCT-based classification models reliably capture semantic characteristics of experiential states that are predictive of self-reported depression symptom severity, as measured by PHQ-9. In both samples, DCT classifiers outperformed baseline models and replicated semantic patterns of negative affect previously observed to be associated with depression. This indicates that the paradigm captures semantic characteristics of the experiential states underlying depression symptoms and may be used to map individuals along a broad semantic space, potentially providing novel insights into individual differences in depressive states.

Objective. Posttraumatic stress disorder (PTSD) is linked with impaired intimate relationships in postpartum women, yet less is known about couple-level manifestations of posttraumatic psychopathology and potential associations with relationship functioning for mothers and fathers during this critical time. Method. In a predominately low-to-middle income sample of 867 mother-father couple dyads assessed six months following the birth of a child, two analytic methods—a data-driven dyadic latent profile analysis and hypothesis-driven a priori categorization approach—evaluated whether discrete subgroups of couples could be identified based on both partners’ PTSD symptoms. Structural equation models then tested associations between identified subgroups with (1) self-reported relationship quality and (2) interviewer-rated relationship stress. Results. Three couple-level PTSD symptom groupings were common to both methods: both low, mother low-father high, and mother high-father low. Dyad-level PTSD symptom patterns were differentially related to relationship dysfunction for mothers and fathers, although mixed findings emerged across methods regarding the relevance of which partner had elevated symptoms for relationship functioning in PTSD symptom-discordant couples. Individuals in dyads characterized by at least one partner with elevated PTSD symptoms consistently exhibited greater relationship dysfunction—indexed both subjectively and objectively—compared to dyads where both partners had low symptoms. Conclusions. Couple-level typologies of PTSD symptoms can be identified using data- and hypothesis-driven approaches, with generally concordant results. Dyadic patterns of PTSD symptoms are relevant to relationship functioning for both mothers and fathers during the postpartum period and may help to inform more targeted intervention efforts to support couples who are parenting.

Background. Despite the growing prevalence of internet usage among young people, the relationships between internet addiction, online social anxiety, fear of missing out (FoMO), and interpersonal sensitivity remain uncertain, intricate, and multifaceted. To gain insight into the underlying psychological mechanisms, we employed network analysis to explore the interconnections between them. This endeavor may provide fresh opportunities for intervention and treatment. Methods. In this study, 470 participants were assessed at age from 18 to 22 (M = 20.18 years, SD = 1.861) years. Network analysis was used to examine the connections between symptoms, and statistical measures were applied to assess the stability of the network model. Results. Online social anxiety and interpersonal sensitivity had the strongest associations with other symptoms in the network, with “Evaluation anxiety” having the highest expected influence centrality, followed by “Privacy concern anxiety,” “Need for approval,” “Suspicion,” and “vulnerability.” The FoMO symptom, “Fear of missing information,” had the strongest direct relation to internet addiction. “Evaluation anxiety” and “Fear of missing information” played a key role in bridging internet addiction and interpersonal sensitivity. Additionally, the structure distribution of edge weights had a significant difference between gender. Conclusions. Our findings indicated that FoMO, interpersonal sensitivity, and online social anxiety likely play a significant role in the development and continuation of internet addiction. Interpersonal sensitivity seems to contribute to increased online social anxiety, FoMO, and the development of internet addiction, indicating that targeting these symptoms may help reduce negative online behavior and psychological burden.

Personality traits are considered potential risk or protective factors for learning and psychological adjustment. This is a concern in higher education settings, which comprise mostly youth in emerging adulthood. The purpose of this study is to apply a person-centered approach to identify personality profiles of university students based on their character traits and then evaluate whether some clusters predict differences in emotional distress and coping strategies. We conducted a cross-sectional web-based survey with 467 southern Italian undergraduate university students (M = 21.8, SD = 3.69). Students completed an anonymous online survey and self-report questionnaires measuring sociodemographic characteristics, personality traits (Personality Inventory for DSM-5), emotional distress (General Anxiety Disorders-7, Patient Health Questionnaire-9), and coping strategies (Brief-COPE). Two distinct clusters were identified, differing in relation to maladaptive personality traits. One was characterized by high maladaptive personality traits, comprising 45.6% of the sample population. This high-risk profile evidenced higher levels of negative affect, detachment, psychoticism, antagonism, and disinhibition. A second cluster, with low maladaptive personality traits, represented the remainder of the sample. Participants featuring high maladaptive personality traits reported lower functioning in terms of avoidant coping strategies in comparison to the second low-risk cluster. Generating profiles of latent traits, such as in cluster analysis, can enhance a more profound theoretical understanding of underlying patterns within personality traits. This can enable higher education settings to meet variations in student needs by adapting their support services and interventions. Students can be trained to use coping strategies more effectively and efficiently.

Aim. To determine serum concentrations of leptin and ghrelin in patients with major depressive disorder (MDD) before and after vitamin D3 supplementation. Methods. A total of 72 participants were recruited in this study (40 MDD patients and 32 healthy controls). MDD was diagnosed by using Beck’s Depression Inventory (BDI) scale. Blood samples were collected from all participants at the beginning of the study to determine baseline serum 25(OH)D3, leptin, and ghrelin concentrations. Patients were then treated weekly with vitamin D3 (50,000 IU) for 3 months, and blood samples were collected again by the end of the study. Results. At baseline, serum leptin concentrations were significantly higher in MDD patients than in healthy controls. In contrast, serum ghrelin concentrations were significantly lower compared to those in healthy controls. After supplementation with vitamin D3 for three months, MDD patients showed improvements characterized by a decrease in their BDI’s scores and an increase in their serum vitamin D and ghrelin concentrations. No effects of vitamin D3 supplementation were seen on serum leptin concentration. Conclusions. The antidepressant effects of vitamin D3 supplementation could be mediated by ghrelin but not leptin.

Working memory updating plays a critical role in executive function. Few studies explored the working memory updating in socially anxious individuals. In this study, we wanted to explore the working memory updating in socially anxious individuals. We studied this issue by instructing participants to perform an emotional 2-back task, and recording their response time and accuracy. We found that high socially anxious individuals showed significant longer response time in positive word condition than that of negative and neutral words. But there was no significant difference in word type in low socially anxious group. In accuracy, we did not observe any significant difference in group, word type, and their interaction. These results indicate that socially anxious individuals have deficits in positive content updating, which have an important implication for developing method to reduce social anxiety.

The objectives of this study were to investigate the interaction of mitochondrial DNA (mtDNA) and lifestyle factors in the development of psychiatric disorders and to gain greater insight into their pathogenesis and comorbidity. We analyzed data from approximately 150,000 individuals from the UK Biobank. Mitochondrial gene-by-environment interaction studies (mtGEIS) were performed to assess the relationships between mtDNA and psychiatric disorders, such as anxiety, depression, and self-harm. These disorders were defined using diagnostic and severity indicators derived from the General Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9). Smoking and drinking behaviors were characterized based on UK Biobank criteria. For the mtGEIS, logistic and linear regression models from PLINK 2.0 were employed, accounting for covariates like age, sex, PC1-10, Townsend Deprivation Index (TDI), and educational attainment. We also conducted sex-stratified analyses to detect any gender-specific effects. Our findings highlighted significant associations between mtDNA and three psychiatric disorders. Moreover, the interplay between mtDNA and lifestyle factors showed significant associations with psychiatric disorders (all P values < 0.05). Specifically, two mutant loci, T5004C (B_{Anx_self} = −0.0026, B_{Dep_self} = −0.0024, B_Self−harm = −0.0018) and G9123A (B_{Anx_self} = −0.0030, B_{Dep_self} = −0.0024, B_Self−harm = −0.0017), were found to reduce the risk of three disorders after interacting with alcohol. Sex-specific differences were also observed. In summary, the expression of mitochondrial genes could be modulated by lifestyle factors like smoking and drinking, potentially affecting psychiatric disorders. These habits might influence mitochondrial respiratory chain activity and the replication and transcriptional regulation of mitochondrial genes, culminating in changes in mitochondrial functionality and subsequently psychiatric disorders.