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Background: Persistent neurocognitive deficits are often associated with poor outcomes of major depressive disorder (MDD). Executive dysfunction is the most common cognitive deficit in MDD. However, it remains unclear which subcomponent of executive dysfunction is state-independent with distinct neural substrates.Methods: A comprehensive neurocognitive test battery was used to assess four subcomponents of executive function (working memory, inhibition, shifting, and verbal fluency) in 95 MDD patients and 111 matched healthy controls (HCs). After 6 months of paroxetine treatment, 56 patients achieved clinical remission (rMDD) and completed the second-time neurocognitive test. Network-based statistics analysis was utilized to explore the changes in functional connectivity (FC).Results: Compared with the HCs, all the four subcomponents of MDD patients were significantly impaired. After treatment, there was a significant improvement in working memory, inhibition, and verbal fluency in the rMDD group. And shifting and verbal fluency of the rMDD group remained impaired compared with the HCs. Fifteen functional connections were interrupted in the MDD group, and 11 connections remained in a disrupted state after treatment. Importantly, verbal fluency was negatively correlated with the disrupted FC between the right dorsal prefrontal cortex and the left inferior parietal lobule in patients with MDD and remitted MDD.Limitations: The correlation analysis of the association between cognitive impairment and connectivity alterations precluded us from making causal inferences.Conclusions: Verbal fluency is the potential state-independent cognitive deficit with distinct neural basis in patients with MDD. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) can place an immense psychological strain on the infected patient. The psychological distress can linger after the initial recovery from the infection. Objective: This study aimed to evaluate the prevalence and predictors of provisional post-traumatic stress disorder (PTSD) in patients with cured COVID-2019. Methods: The baseline survey was conducted from 10 to 25 February 2020 in patients with COVID-19 in a designated hospital. Demographic and clinical characteristics were acquired, and depression and anxiety levels were assessed, using the 9-item Patient Health Questionnaire and 7-item Generalized Anxiety Disorder scale, respectively. A follow-up survey was conducted 1 month post-discharge. PTSD symptoms were measured by the Impact of Event Scale-6 (IES-6) and patients' perception of supportive care during hospitalization was investigated using a self-developed questionnaire. Results: In total, 114 patients completed both the baseline and follow-up surveys. Of these, 41 (36.0%) met the cut-off score for provisional PTSD diagnosis according to the IES-6. Female gender [odds ratio (OR) = 4.69, 95% confidence interval (CI) 1.54–14.37], educational level of high school or below (OR = 15.49, 95% CI 1.13–212.71), higher anxiety levels (OR = 1.34, 95% CI 1.12–1.61) and lower perceptions of emotional support during hospitalization (OR = 0.41, 95% CI 0.17–0.96) predicted a higher risk for provisional PTSD. Conclusions: PTSD is commonly seen in patients with COVID-19 1 month post-discharge. Female patients, and patients with lower educational levels, higher anxiety levels and lower perceptions of emotional support during hospitalization may be more likely to develop PTSD in the near future. Enhancing emotional support during hospitalization could help to prevent PTSD in patients with COVID-19. More than one-third ofpatients met the diagnostic criteria of probable PTSD 1 month post-discharge. Providing timely emotional support during hospitaliza-tion may be one of the key measures for preventing PTSD in patients with COVID-19. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study includes: (1) using resting-state functional magnetic resonance imaging (rsfMRI) to explore the aberrant brain regional spontaneous brain activities in acute major depressive disorder (MDD) patients; (2) to determine whether the abnormalities could be restored after 6 months of antidepressant treatment; (3) to investigate whether the differences in regional spontaneous brain activities are associated with clinical variables in MDD.Method: RsfMRI scanning was performed in 149 MDD patients and 122 healthy control (HC) subjects at baseline. After 6 months of antidepressant treatment, rsfMRI scanning was reperformed in remitted MDD patients (MDD-R) (n=63). The characteristics of the amplitude of low-frequency fluctuations (ALFF), and the relationship between the fMRI representatives and clinical variables in the MDD group were analyzed.Results: (1) Compared to healthy controls, significantly decreased ALFF in the right precuneus/posterior cingulate cortex (PCUN/PCC) was detected in MDD. (2) The ALFF value of precuneus in MDD-R group did not change significantly after a 6-month antidepressant treatment and was still lower than the HC group when remission was achieved (P = 0.002). (3) No correlations were found between ALFF in the right PCUN/PCC and Hamilton Depression Rating Scale(HAMD) total score, illness duration, age of onset, and the number of episodes in the baseline MDD group. The ALFF change was not correlated with depressive symptom improvement in MDD-R group.Conclusions: The reduction of ALFF in the precuneus persisted in MDD who achieved clinical remission, suggesting that the decreased ALFF in PCUN/PCC may be a trait marker of MDD. [ABSTRACT FROM AUTHOR]

Background: Childhood trauma is an important early social risk factor for the development of the major depressive disorder (MDD). Both childhood trauma and depression are associated with dysfunctional attitudes and dysregulation in stress hormones. We aimed to clarify the path from childhood trauma to depression and identify potential predictors of antidepressant treatment outcomes.Objectives: One hundred and thirty-nine MDD patients and 112 healthy controls were included at baseline. Depressive symptoms were assessed with both self-reported and expert-rated scales. Childhood trauma and dysfunctional attitudes were evaluated and blood cortisol levels were assayed. Patients received an open-label antidepressant trial with paroxetine and their depressive symptoms were monitored by the Hamilton Depression Rating Scale (HAMD) during 6 months of treatment. After 6 months, 94 patients received the same assessments as the baseline.Results: At baseline, the influence of childhood trauma on depression diagnosis was mediated by dysfunctional attitudes. In patients with MDD, the influence of childhood trauma on depression severity was mediated by both dysfunctional attitudes and cortisol levels. Baseline childhood trauma predicted the antidepressant treatment outcome during early treatment phase and baseline cortisol levels predicted the antidepressant treatment outcome at later treatment phase. After 6-month antidepressant treatment, a significant remission by time effect was found on dysfunctional attitudes and depression severity but not on cortisol levels.Conclusion: Effect of childhood trauma on depression onset was mediated by dysfunctional attitudes. The relationship between childhood trauma and depressive symptoms was mediated by dysfunctional attitudes and cortisol levels in MDD patients. Baseline childhood trauma and cortisol levels may be moderators for antidepressant treatment response at different treatment phase. [ABSTRACT FROM AUTHOR]

Background: Major depressive disorder (MDD) is a debilitating mental illness with more than 50% of patients not achieving an adequate response using first-line treatments. Reliable models that predict antidepressant treatment outcome are needed to guide clinical decision making. We aimed to build predictive models of treatment improvement for MDD patients using machine learning approaches based on fMRI resting-state functional connectivity patterns.Methods: Resting-state fMRI data were acquired from 192 untreated MDD patients at recruitment, and their severity of depression was assessed by Hamilton Rating Scale for Depression (HAMD) at baseline. Patients were given medication after the initial MR scan and their symptoms were monitored through HAMD for a period of six months. Connectome-based predictive modeling (CPM) algorithms were implemented to predict the improvement in HAMD score at one month from resting-state connectivity at baseline. Additionally, by selectively combining the features from all leave-one-out iterations in the model building stage, we created a consensus model that could be generalized to predict improvement in HAMD score in samples of non-overlapping subjects at different time points.Results: Using baseline functional connectivity, CPM successfully predicted symptom improvement of depression at one month. In addition, a consensus 'MDD improvement model' could predict symptom improvement for novel individuals at the two-week, one-month, two-month and three-month time points after antidepressant treatment.Conclusions: Individual pre-treatment functional brain networks contain meaningful information that can be gleaned to build predictors of treatment outcome. The identified MDD improvement networks could be an appropriate biomarker for predicting individual therapeutic response of antidepressant treatment. Replication and validation using other large datasets will be a key next step before these models can be used in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Posttraumatic stress disorder (PTSD) is a debilitating mental illness that is thought to be associated with brain white matter (WM) alterations. Individual diffusion tensor imaging (DTI) studies to date have reported inconsistent alterations in FA across different brain regions in patients with PTSD. Here, we aimed to investigate FA in PTSD using both region-of-interest (ROI)-based and whole-brain-based meta-analytic approaches.Objectives: Individual ROI-based meta-analysis was carried out in each eligible white matter tract and seed-based D mapping (SDM) meta-analysis was conducted in the whole brain to identify the convergence of FA alterations in PTSD relative to controls.Results: Seventeen studies were included in ROI-based meta-analysis (≥ 3 studies were included for each ROI, NPTSD ≥ 80 and Ncontrol ≥ 103 per ROI). Fourteen studies with a total of 322 PTSD and 335 controls were included in whole-brain based meta-analysis. Both ROI and whole-brain meta-analyses showed that patients with PTSD have significantly higher FA in the inferior fronto-occipital fasciculus and lower FA in the genu of corpus callosum. Whole-brain meta-analyses also identified higher FA in the left inferior temporal gyrus and lower FA in the anterior cingulum and left corticospinal tract.Limitations: A small number of studies were included in some ROI tracts. Thus the results should be interpreted with caution.Conclusions: Our results suggest that PTSD patients have increased FA in areas related to visual processing, but decreased FA in anterior brain regions critical to cognition association and fear regulation. [ABSTRACT FROM AUTHOR]

Background: Dysfunctional attitudes, which are characterized by distorted self-cognitions, were considered to be linked to personality traits. It was found that certain personality traits may predict dysfunctional attitudes in patients with major depressive disorder (MDD). Nonetheless, the relationship between personality traits and dysfunctional attitudes remains under-researched. Aims: The aim of this study is to examine the relationship between specific domains of Sixteen Personality Factor (16PF) and dysfunctional attitudes in Chinese participants with or without MDD. In addition, the present study explores the associations between 16PF and eight subtypes of dysfunctional attitudes, based on the proposed eight-factor structure of the Chinese version of the Dysfunctional Attitude Scale-Form A (C-DAS-A). Methods: One hundred and sixty-eight participants with MDD and 130 healthy participants were included in the study (Trial Registration Number: ChiCTR1800014591). Personality was assessed using the 16PF Questionnaire. Dysfunctional attitudes were measured through the C-DAS-A. Results: The 16PF dimensions associated with dysfunctional attitudes and the eight subtypes were mainly concentrated in the four anxiety facets including factors C, L, O, and Q4, in both MDD and HC groups. There were significant differences in the 16 PF dimensions that would explain dysfunctional attitudes between the two groups, which were as follows: factors C, G, and O in the MDD group, and factors L and Q4 in the HC group. Conclusions: Personality traits, especially the anxiety-related personality traits, were distinctly associated with the development of dysfunctional attitudes in people with or without MDD. [ABSTRACT FROM AUTHOR]

A disruption of the kynurenine (KYN) pathway may exist in major depressive disorder (MDD). However, the changing pattern of the KYN pathway across the different disease states in MDD is unclear. Herein, we performed a meta-analysis to examine the differences in KYN metabolites between patients in the current episode of MDD (cMDD) and patients in remission (rMDD), as well as the changes after treatments. Literature was systematically searched from electronic databases, from inception up to September 2022. Random-effect models were used to quantify the differences in KYN metabolites between patients with MDD across acute depressive episode and remission phases, as well as the changes after treatments. Fifty-one studies involving 7056 participants were included. Tryptophan (TRP), KYN, kynurenic acid (KYNA), KYNA/quinolinic acid (QA), KYNA/3-hydroxykynurenine (3-HK), and KYNA/KYN were significantly lower, while KYN/TRP was significantly higher in patients with cMDD. Moreover, these effect sizes were generally larger in medication-free patients. No significant differences were found between patients with rMDD and HCs. Additionally, KYNA was found negatively correlated with depression severity and significantly increased after treatments, while the alteration was not found in QA. The number of included studies of patients with rMDD and longitudinal studies investigating the change of the KYN metabolites after treatment with antidepressants was limited. In addition, the heterogeneity across included studies was relatively high. These findings showed a comprehensive image of the unique dysfunction pattern of the KYN pathway across different MDD states and highlighted KYNA as a potentially sensitive biomarker of MDD. • The dysfunction of the KYN pathway in patients with cMDD was present mainly in the neuroprotective KYNA branch. • No significant difference was found in the metabolites of KYN pathway between patients with rMDD and HCs. • The dysfunction of the KYN pathway across the disease course of MDD might be a disease state related alteration. • KYNA was found significantly increased after the treatments and may serve as a sensitive biomarker for MDD patients. • QA showed no significant changes both under different disease states and across the pre- and post-treatment states [ABSTRACT FROM AUTHOR]

Background: Depressive symptoms, which are continuously changing, are an essential manifestation of depression and can increase the risk of mental disorders and other diseases. Because the causes and cures for depression have not yet been identified, finding the characteristics, and risk factors of depressive symptom trajectories can help us identify at-risk populations early and reduce the related public disease burden. Aims: Herein we aimed to figure out the specific manifestations of depressive symptom trajectories among Chinese adults, explore the risk profiles of trajectory groups with higher depression burdens, and test the longitudinal associations between blood biomarkers with depressive symptoms. Methods: Trajectories of participants' depressive symptoms measured by the Center for Epidemiologic Studies Depression scores were modeled with growth mixture models from 2011 to 2018. Multinomial logistic models tested associations of baseline covariates with trajectories. Generalized estimating equations were used to explore the longitudinal associations between blood data and depressive symptoms in two waves from 2011 to 2015. Results: Among the sample of 5,641 individuals aged 40 or over, four heterogeneous depressive symptom trajectories were defined: stable-low, high-decrease, stable-high, and low-increase. At baseline, demographic factors and health statuses such as gender, education, income, and self-reported health status were associated with trajectories. A significant association was found between high-density lipoprotein and depressive symptoms. Conclusions: These findings provide clues for predicting and identifying adults with elevated depression burdens in middle and late life and may facilitate the development of targeted preventive strategies for this population. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) is a pervasive neurodevelopmental disorder characterized by abnormalities in structure and function of the brain. However, how ASD affects the relationship between fiber-bundle microstructures and functional connectivity (FC) remains unclear. Here, we analyzed structural and functional images of 26 high-functioning adult males with ASD, alongside 26 age-, gender-, and full-scale IQ-matched typically developing controls (TDCs) from the BNI dataset in the ABIDE database. We utilized fixel-based analysis to extract microstructural information from fiber tracts, which was then used to predict FC using a multilinear model. Our results revealed that the structure–function relationships in both ASD and TDC cohorts were strongly aligned in the primary cortex but decoupled in the high-order cortex, and the ASD patients exhibited reduced structure–function relationships throughout the cortex compared to the TDCs. Furthermore, we observed that the disrupted relationships in ASD were primarily driven by alterations in FC rather than fiber-bundle microstructures. The structure–function relationships in the left superior parietal cortex, right precentral and inferior temporal cortices, and bilateral insula could predict individual differences in clinical symptoms of ASD patients. These findings underscore the significance of altered relationships between fiber-bundle microstructures and FC in the etiology of ASD. [ABSTRACT FROM AUTHOR]

Antenatal depression may result in adverse outcomes for both the mother and the offspring. However, few studies have focused on the screening of pregnant women at a higher risk for antenatal depression in the first trimester. The present study aimed to assess the effect of lifestyle and family relationships on antenatal depression in the first trimester in a large Chinese population. Cross-sectional population data were obtained from a real-world cross-sectional survey conducted in Shenzhen, China from 2020 to 2024. The data on sociodemographic characteristics, lifestyle, and family relationships were obtained using self-reported questionnaires. Antenatal depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS), with a score of ≥13 indicating the presence of probable antenatal depression. A binary logistic regression model was used to identify the risk factors of antenatal depression. A total of 42,363 pregnant women in the first trimester were recruited in the cross-sectional survey, among whom 3107 (7.3 %) had probable antenatal depression. We found (1) age < 25 years, (2) low or moderate economic status, (3) smoking, (4) partner smoking, (5) alcohol use, (6) lack of physical exercise, (7) poor or moderate living environment, (8) low or moderate marital happiness, and (9) never talking about problems were associated with antenatal depression. However, level of education, employment status, partner alcohol use, and living alone were not significantly related to antenatal depression in the first trimester. The cross-sectional design and the use of self-report measures must be considered while interpreting the results. This study suggested that the prevalence of antenatal depression in the first trimester was 7.3 %. Public health prevention efforts aimed at reducing the prevalence of antenatal depression are recommended. Early identification of women at a higher risk in early pregnancy is necessary for preventing antenatal depression and improving quality of life. [Display omitted] • The prevalence of self-reported antenatal depression in the first trimester was 7.3% in a developed district in South China. • Several lifestyle and family relationships were identified as risk factors for antenatal depression. • Early and evidence-based prenatal support is essential to prevent antenatal depression and improve the mental well-being of this high-risk population. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the impact of isolation form on the recovery of psychological distress in patients with coronavirus disease 2019 (COVID-19) after being discharged from hospital.Methods: Baseline survey was conducted from February 10, 2020 to February 25, 2020 in patients with COVID-19 in a designated hospital on the discharge day. After discharge, patients were free to choose whether isolate in a centralized isolation site (i.e. designated hotel) or their own home for another two weeks. A follow-up survey was conducted at the end of the 2-week post-discharge isolation. Depression, anxiety as well as self-rated health were assessed at both time points using the 9-item patient health questionnaire, 7-item generalized anxiety disorder scale and self-rated health scores, respectively.Results: Fifty centrally isolated and 45 home isolated patients completed both the baseline and the follow-up assessments. Significant effects of time and time by isolation form were found on depression and anxiety levels, with a significant decrease in depression and anxiety shown in home isolated but not in centrally isolated patients. Besides, a significant time effect was identified on self-rated health with significant improvement found in home isolated but not in centrally isolated patients.Conclusions: Home isolation is superior to centralized isolation in the recovery of COVID-19-associated depression, anxiety as well as self-rated health. More attention needs to be paid to the psychological well-being of centrally isolated patients. A sustained and integrated rehabilitation plan is warranted for patients with COVID-19 to achieve both physical and psychological recovery. [ABSTRACT FROM AUTHOR]

The continued spread of the coronavirus disease 2019 (COVID-19) has a serious impact on everyone across the globe, both physically and psychologically. In addition to proactive measures addressing physical survival needs and health protection, China has launched a mental health support system to cope with the widespread psychological stress during the pandemic and its aftermath. In this debate, the authors attempted to depict and reflect upon the overall framework of China's mental health support, with particular reference to the psychological intervention in response to COVID-19 over the last few months. Although a lot of effort has been made to meet the mental health needs, the accessibility, acceptability and effectiveness of the support system still have much room for improvement. Therefore, it is very important to re-think the predicament and challenge on ways of enhancing public mental health emergency responses in China. The concepts of universality, timeliness and scientific rigour were proposed as a possible reform in preparation for large-scale natural or man-made disasters in the coming future. [ABSTRACT FROM AUTHOR]

Recent studies have evidenced the negative psychological consequences of the COVID-19 pandemic and sociodemographic vulnerability among the general population, while limited information was available on which factors make the greatest contribution to psychological distress when these factors were considered concurrently. Herein, we aimed to investigate the pathways that underlie psychological distress in the context of retracting dynamic zero-COVID policy. We employed the mixed graphical model to construct the network of depression (PHQ-9), anxiety (GAD-7), and pandemic-related factors in a general population sample (N = 1610). Then, we re-examined the network by adding sociodemographic variables to further explore the influence of sociodemographic factors. Additionally, we repeated the analyses in the second sample (N = 620) collected in the same period to assess the replicability. The relationships between the pandemic factors and anxiety and depressive symptoms exhibited a tendency to decrease after adding demographic variables, and income became the most important node and shared edge weights with all anxiety and depressive symptoms. These findings were replicable with the second sample. No significant difference in the network properties was detected between the two samples. The cross-sectional design limits the ability to observe longitudinal changes in these risk factors and their relationship with psychological distress. Income level, rather than the pandemic-related factors, acted as a vital role in the psychological distress of the general population, implying that livelihood issues may be the critical intervention targets for mental health during the post-pandemic period. • COVID-19 pandemic factors were differently associated with specific depressive and anxiety symptoms. • The association between pandemic factors and depressive-anxiety symptoms decreased after adding demographic variables. • Income is the most important node in activating depression and anxiety networks. • Livelihood issues are vital for post-pandemic mental health intervention. [ABSTRACT FROM AUTHOR]

Background: Parenting styles and the associated proximal psychological factors are suggested to increase suicidal risks in adolescents. However, how the two factors interact and confer risks on the emergence of adolescent suicidal thoughts remains unclear. Herein, we used a network approach to investigate their interrelationship and explore whether the network properties predict adolescent suicidal thoughts. Methods: Self-report questionnaires were completed by 1171 students aged 12–16. Network analyses were performed by Gaussian graphical models estimating the adolescent psychosocial network structure of parenting styles and psychological variables including depression, anxiety, affective lability, rumination, and resilience. Furthermore, we re-examined the network by adding a variable measuring active suicidal thoughts. Moreover, we conducted linear regressions to examine the predictive utility of bridge symptoms for adolescent suicidal thoughts. Results: Resilience, Afraid, Rumination, Concentration, and affective lability (Anger) had the highest bridge strengths in the adolescent psychosocial network. Among the identified bridge symptoms, Resilience was negatively correlated with active suicidal thoughts (regularized edge weights = -0.181, bootstrapped 95% CIs: [-0.043, -0.155]), whereas affective lability (from Anxiety to Depression, Anger), Rumination, and Afraid were positively correlated with active suicidal thoughts, with edge weights (bootstrapped 95% CIs) ranging from 0.057 (0.001, 0.112) to 0.081(0.026, 0.136). Regression analysis showed that bridge strength was significantly correlated with active suicidal thoughts (R2 = 0.432, P = 0.001). Conclusion: Negative parenting styles may drive and maintain suicidal thoughts by modifying the key proximal psychological variables. Our findings highlight the important role of bridge symptoms, which may serve as vital targets for triggering adolescent suicide. [ABSTRACT FROM AUTHOR]

Background: Previous studies suggested that childhood maltreatment is associated with poor health outcomes. While not everyone who experiences abuse as a child goes on to experience poor mental health, some traumatized people are grown to be more resilient than others. Few studies have examined the association between childhood maltreatment and adult resilience. This study aimed to determine different relationships between specific types and features of childhood maltreatment with adult resilience among Chinese with Major Depressive Disorder (MDD) and healthy controls (HCs). Methods: A total of 101 patients with MDD and 116 participants in the healthy control (HC) group from Zhumadian Psychiatric Hospital and its nearby communities were included in this analysis. Childhood maltreatment was assessed retrospectively using Childhood Trauma Questionnaire (CTQ). Adults' resilience was assessed by the Connor-Davidson Resilience Scale (CD-RISC). Generalized linear models were applied between childhood maltreatment (specific types and features) and resilience adjusting for covariates. Results: The total score of CD-RISC and factor scores of strength, optimism, and tenacity in the HC group were higher than those in the MDD group. CTQ total score had a negative association with optimism score among participants in MDD (β=-0.087, P < 0.001) and HC (β=-0.074, P = 0.023) groups. Higher emotional neglect (EN) score (β=-0.169, P = 0.001) and physical neglect (PN) score (β=-0.153, P = 0.043) were related to a worse optimism score in MDD group. Emotional abuse (EA) score was associated with a worse tenacity score (β=-0.674, P = 0.031) in MDD group. For participants in HC group, higher EN and PN scores were related to worse resilience scores (tenacity, strength, and optimism). Conclusions: Patients with MDD showed lower optimism than HCs. Childhood maltreatment, especially childhood negect, independently contributed to optimism, with more severe childhood maltreatment predictive of worse performance of optimism. EA in childhood was also linked to worse tenacity in adult patients with MDD. [ABSTRACT FROM AUTHOR]

This study aimed to elucidate the contribution of childhood maltreatment (CM) and the disease of major depressive disorder (MDD) on cognitive function in medication-free patients in a current depressive episode, and to examine the effect of CM on the improvement of cognitive function after treatment with antidepressants. One hundred and fifty-three unmedicated patients with MDD and 142 healthy controls (HCs) underwent clinical interviews. CM assessment was performed using the Childhood Trauma Questionnaire (CTQ), and a battery of comprehensive neurocognitive tests was used to assess the participants' executive function, processing speed, attention, and memory. After 6 months of treatment with antidepressants, the neurocognitive tests were reperformed in patients with MDD and HCs. There was a significant main effect of MDD on all four cognitive domains, while the main effect of CM was only significant on memory. No significant interactive effect was found between MDD and CM on any of the cognitive domains. In the MDD group, higher CTQ total score was predictive of poorer memory performance. After treatment, significant main effects of treatment and MDD were found on all four cognitive domains in remitted patients with MDD. No significant main effect of CM or three-way interaction effect of treatment × MDD × CM was found on any of the cognitive domains. The disease of MDD contributed to impairments in all four cognitive domains. CM independently contributed to memory impairment in patients in a current depressive episode, with higher severity of CM predictive of poorer memory performance. [ABSTRACT FROM AUTHOR]

Cognitive impairments (CI) are prevalent and persistent in patients with major depressive disorder (MDD). There is a lack of longitudinal studies exploring the changes of the percentage of CI among MDD patients before and after a long-term antidepressant treatment and the risk factors that predict the residual CI. A neurocognitive battery was performed to assess four domains of cognitive function, including executive function, processing speed, attention, and memory. CI was set as cognitive performance scoring 1.5 SDs lower than the mean scores of healthy controls (HCs). Logistic regression models were conducted to examine the risk factors for the after-treatment residual CI. Over 50 % of patients showed at least one kind of CI. After the antidepressant treatment, the overall cognitive performance among remitted MDD patients was identical to HCs, however, there were still 24 % of the remitted MDD patients had at least one type of CI, especially in executive function and attention. Additionally, the percentage of CI among non-remitted MDD patients was still significantly different from HCs. Our regression analysis further identified that except for the non-remission of MDD, CI at baseline could also predict the residual CI in MDD patients. A relatively high drop-out rate at follow-ups. Cognitive impairment in executive function and attention is persistent even in remitted patients with MDD, and baseline cognitive performance can predict the post-treatment cognitive performance. Our findings emphasize the integral role of early cognitive intervention in MDD treatment. • The first longitudinal follow-up study on the percentage of cognitive impairment (CI) in patients with MDD. • 24 % of the patients with remitted MDD had at least one type of CI, especially in the executive function and attention. • Non-remission of MDD is a key predictor for the residual CI in the domain of processing speed. • Among the remitted patients, baseline CI at the acute-onset episode can predict the post-treatment residual CI. [ABSTRACT FROM AUTHOR]

Background: The mechanism by which antidepressants normalizing aberrant resting-state functional connectivity (rsFC) in patients with major depressive disorder (MDD) is still a matter of debate. The current study aimed to investigate aberrant rsFC and whether antidepressants would restore the aberrant rsFC in patients with MDD. Methods: A total of 196 patients with MDD and 143 healthy controls (HCs) received the resting-state functional magnetic resonance imaging and clinical assessments at baseline. Patients with MDD received antidepressant treatment after baseline assessment and were re-scanned at the 6-month follow-up. Network-based statistics were employed to identify aberrant rsFC and rsFC changes in patients with MDD and to compare the rsFC differences between remitters and non-remitters. Results: We identified a significantly decreased sub-network and a significantly increased sub-network in MDD at baseline. Approximately half of the aberrant rsFC remained significantly different from HCs after 6-month treatment. Significant overlaps were found between baseline reduced sub-network and follow-up increased sub-network, and between baseline increased sub-network and follow-up decreased sub-network. Besides, rsFC at baseline and rsFC changes between baseline and follow-up in remitters were not different from non-remitters. Conclusions: Most aberrant rsFC in patients with MDD showed state-independence. Although antidepressants may modulate aberrant rsFC, they may not specifically target these aberrations to achieve therapeutic effects, with only a few having been directly linked to treatment efficacy. [ABSTRACT FROM AUTHOR]

Background: The pandemic of coronavirus disease 2019 lastingly affects public mental health. Many studies have described symptoms of anxiety and depression in pregnant women before the pandemic. However, the limited study focuses on the prevalence and risk factors of mood symptoms among first-trimester females and their partners during the pandemic in China, which was the aim of the study. Methods: One hundred and sixty-nine first-trimester couples were enrolled. The Edinburgh Postnatal Depression Scale, Patient Health Questionnaire-9, Generalized Anxiety Disorder 7-Item, Family Assessment Device-General Functioning (FAD-GF), and Quality of Life Enjoyment and Satisfaction Questionnaire, Short Form (Q-LES-Q-SF) were applied. Data were mainly analyzed through logistic regression analysis. Results: 17.75% and 5.92% of first-trimester females had depressive and anxious symptoms, respectively. Among partners, 11.83% and 9.47% had depressive and anxious symptoms, respectively. In females, higher scores of FAD-GF (OR = 5.46 and 13.09; P < 0.05) and lower scores of Q-LES-Q-SF (OR = 0.83 and 0.70; P < 0.01) were related to the risk of depressive and anxious symptoms. Higher scores of FAD-GF were associated with the risk of depressive and anxious symptoms in partners (OR = 3.95 and 6.89; P < 0.05). A history of smoking was also related to males' depressive symptoms (OR = 4.49; P < 0.05). Conclusion: This study prompted prominent mood symptoms during the pandemic. Family functioning, quality of life, and smoking history increased risks of mood symptoms among early pregnant families, which facilitated the updating of medical intervention. However, the current study did not explore interventions based on these findings. [ABSTRACT FROM AUTHOR]

Because of the distinctive vertical climate and topography gradients in the alpine region, the snow cover of the Tienshan Mountains possesses complex spatiotemporal heterogeneity, particularly during the melting process. Quantifying the environmental factors is therefore crucial to understanding the melting process and for predicting and managing snowmelt runoff. Herein, the snow cover area, grain size, and contamination extent were determined to characterize the detailed melting status based on surface reflectance data of MOD09A1 in the central Tienshan Mountains from 2013 to 2017. The environmental factors collected include relief (elevation, slope, and aspect); meteorology (surface air temperature, land surface temperature, solar radiation, and wind speed); and land surface vegetation. Analysis of the geodetector results indicated the following. (1) Patterns of changes in the overall dominant environmental variables were consistent for the pre-, mid-, and post-melting periods defined according to the decline of snow cover area over five years. (2) The overall major environmental factors were wind speed and radiation (pre-period), land surface temperature and elevation (mid-period), and elevation and land surface types (post-period), respectively. (3) Regional distinctions were detected of the dominant environmental factors. In the pre-melting period, the effects of solar radiation and wind speed were noticeable in the north and south regions, respectively. The effects of elevation, land surface temperature, and land cover types became more prominent in all regions during the mid- and post-melting periods. (4) Interaction between the major environmental factors was significantly enhanced on both the overall and regional scales, thus affecting the snow-melting process. Finally, the energy distribution mismatch resulted in the snowmelt. Multiple environmental factors substantially affect heat redistribution at different spatiotemporal scales, resulting in the snowmelt as a complex manifestation of the factors and their interactions. The findings highlight regional differences in various environmental factors of the melting process and offer a theoretical foundation for the melting process at various scales over multiple years. [ABSTRACT FROM AUTHOR]

Background: Major depressive disorder (MDD) patients with comorbid anxiety symptoms showed obvious cognitive deficits. However, it remains unclear whether comorbid anxiety symptoms will make a specific contribution to cognitive deficits in MDD.Methods: Executive function, processing speed, attention and memory were assessed in 162 MDD patients, and 142 healthy controls (HCs) by a comprehensive neuropsychological battery. 14-item Hamilton Anxiety Rating Scale (HAM-A) was used for anxiety symptoms and MDD patients with HAM-A total score >14 were classified into MDD with comorbid anxiety (MDDA) group. A multivariate analysis of covariance and regression models was conducted to evaluate the effects of anxiety symptoms on cognitive deficits.Results: There were no significantly differences in all 4 cognitive domains between MDD alone and MDDA patients (all p < 0.05). In MDDA subgroup, HAM-A total score contributed to executive function and memory (both p < 0.05), while HAM-A psychic symptoms contributed to all 4 domains (all p < 0.05). Moreover, after controlling for the severity of depression, either anxiety symptoms shown as HAMA total score or psychic anxiety symptoms only contributed significantly to the executive function performance.Limitations: The cross-sectional design made it hard to acquire a cognitive performance trajectory accompanied by the fluctuations in anxiety symptoms.Conclusion: Our findings suggest that there is no significant difference in cognitive performance between MDD alone and MDDA patients. However, comorbid anxiety, especially psychic anxiety may contribute to extensive cognitive deficits in MDDA patients. Notably, anxiety symptoms only independently triggered executive dysfunction when eliminating effect of the severity of depression. [ABSTRACT FROM AUTHOR]

• First study to explore cognitive subtypes in medication-free patients with MDD. • Two cognitive subgroups were found during the acute episode phase and after 6 months of treatment. • 80% of the patients stayed in their original subgroup after 6 months of treatment. • The cognitive impairment subgroup in 6 months can be predicted by disease status and cognitive impairment at baseline. This study aimed to investigate whether there are different cognitive subtypes in patients with major depressive disorder (MDD) and the change pattern of cognitive clusters across the course of MDD. A battery of comprehensive cognitive tests was used to assess the executive function, processing speed, attention, and memory of 153 medication-free patients and 142 healthy controls (HCs). After 6 months of treatment with antidepressants, 87 patients completed cognitive tests again. K-means cluster analysis was performed to determine the cognitive subtypes. A preserved cognition cluster and an impaired cognition cluster were identified in the acute episode phase and the 6-month follow-up phase. 80.5% of the patients remained in their original subgroup after 6 months of treatment. The impaired cognition cluster during the 6-month follow-up period could be predicted by impaired cognition during the episode phase, disease state (remission or non-remission), current illness duration, and education level. This study supporting the heterogeneity of cognitive performance across the course of disease in patients with MDD using cluster analysis. It was found that cognitive impairment during depressive episodes was predictive of poorer cognitive performance even after treatment with antidepressants. Therefore, interventions targeting cognitive function from the early stages of MDD is essential. [ABSTRACT FROM AUTHOR]

• This is the first study to examine the network structure of posttraumatic stress symptoms (PTSS) during four waves of COVID-19 in China. • The PTSS symptoms in HCWs become intensified and the symptom structures become more strongly connected throughout four COVID-19 outbreaks. • COVID-19 pandemic had varying effects on the PTSS of different professions over time, with nurses showing a greater increase in PTSS. • There was an increased role of the avoidant thoughts and depressive symptoms during the four waves, reflecting a dynamic change of symptoms profiles over time. • Hyperactive emotions, avoidance, startle response, hypervigilance, and depression were important targets for HCWs' PTSS. Posttraumatic stress symptoms of healthcare workers have become a significant public concern in the healthcare system that have long COVID-19. It is less known how the pandemic impacts the HCWs' PTSS longitudinally and long-term risk factors for it. Four consecutive surveys were conducted among healthcare workers in China from 2019 to 2023 COVID-19 outbreaks. Multilevel mixed-effect models were used to examine longitudinal changes and risk factors. Network analysis was utilized to explore network centrality changes in PTSS symptoms. HCWs' PTSS symptoms were increased over time during the COVID-19 pandemic. Being female, being nurse, working in the emergency department, working longer hours, less frequently going back home and having COVID-19 infection are risk factors of PTSS for HCWs; unmarried is the protective factor. Significant interaction between symptom changes and profession exists. PTSS networks showed that Avoidance of thoughts, Emotional-cue activity, Exaggerated startle response and Hypervigilance were the central symptoms during four waves. The global strength of the PTSS network grows over time, and nodal strength of Avoidance of thoughts, Loss of interest and Negative beliefs increased by COVID-19. The pandemic's impacts on healthcare workers vary by professions. PTSS symptoms exacerbate, reinforce each other, and persists with recurring waves. [ABSTRACT FROM AUTHOR]

Background: The concept "psychobiotics" claims potential beneficial effect of probiotics on anxiety, whereas findings from clinical trials are inconsistent. Thus, a meta-analysis is needed to clarify the effect of probiotics on anxiety.Methods: Randomized controlled trials (RCTs) assessing the effect of probiotics on anxiety were systematically retrieved from online databases and manually screened for references of relevant published literature through September 1, 2017. Standardized mean difference in change from baseline of anxiety rating scales between probiotics groups and placebo groups was selected as the main effect index. Subgroup analyses were conducted with respect to overall health status of the sample, existence of gastrointestinal symptoms, strains of flora, trial duration, and risk of bias assessment. Publication bias was evaluated by funnel plot and Egger's test. The reliability of the result was assessed by leave-one-out sensitivity analysis.Results: Twelve studies with 1,551 subjects (871 in probiotics group and 680 in control group) were included. All the studies were rated as low or moderate risk of bias. The meta-analysis and subgroup analyses all showed no significant difference between probiotics and placebo in alleviating anxiety symptoms. The Egger's test revealed no evidence of significant publication bias. Sensitivity analysis showed that leaving out one study would result in marginal significance.Conclusions: The evidence for the efficacy of probiotics in alleviating anxiety, as presented in currently published RCTs, is insufficient. More reliable evidence from clinical trials is needed before a case can be made for promoting the use of probiotics for alleviating anxiety. [ABSTRACT FROM AUTHOR]

• Nitrous oxide displays pro-cognitive effect on executive function for treatment-resistant depression. • The pro-cognitive effect of nitrous oxide might be independent from improvements in depressive symptoms. • No pro-cognitive effects of nitrous oxide in subjective cognitive function, processing speed, and attention. Nitrous oxide (N 2 O) has demonstrated an antidepressant effect for treatment-resistant depression (TRD), but no studies investigated the effects of N 2 O on different cognition domains. This study aimed to test whether N 2 O would display pro-cognitive effects. We conducted a double-blinded, placebo-controlled, randomized controlled trial, 44 patients with TRD were randomized to N 2 O group (one-hour inhalation of 50% N 2 O/50% oxygen) or placebo group (50% air/50% oxygen). Thirty-four patients completed cognitive tests at the pre-treatment phase, 1-week, and 2 weeks post-treatment including subjective cognitive function, processing speed, attention, and executive function. Although the antidepressant effect of N 2 O was not significant at 1 week, patients still showed better performance of executive function at 1 week after receiving N 2 O compared with the placebo. Moreover, this significant improvement still existed at 1 week after controlling for the change in depressive symptoms over-time. Additionally, no significant difference was observed in subjective cognitive function, processing speed, and attention between these two groups across the 2-week follow-up period. As the first study investigating the treatment effects of N 2 O on improving cognitive function in TRD patients, the current study indicated that N 2 O has a potential pro-cognitive effect on executive function and this effect might be independent from improvements in depressive symptoms. [ABSTRACT FROM AUTHOR]

• A single inhalation of 50% nitrous oxide has an antidepressant effect for treatment-resistant depression. • The antidepressant effect of 50% nitrous oxide lasts for no more than one week. • Nitrous oxide is safe for patients with treatment-resistant depression. Nitrous oxide (N 2 O), an N-methyl-D-aspartate glutamate receptor antagonist, has demonstrated a rapid-onset antidepressant effect for treatment-resistant depression (TRD) preliminarily in the United States. This study aimed to test the efficacy and safety of N 2 O for TRD patients in China. In this double-blinded, placebo-controlled trial, 44 patients with TRD were randomized to receive a one-hour inhalation of a mixture of either 50% N 2 O/50% oxygen (N 2 O group) or 50% air/50% oxygen (placebo group). The primary outcome was the change on the 17-item Hamilton Depression Rating Scale (HDRS-17) over a course of two weeks. Using modified intention-to-treat analysis, the between group difference was found in the HDRS-17 score at two hours and 24 h after inhalation treatment, while no significant difference was found in week one and week two. Patients receiving N 2 O reported a significantly higher number of adverse events. All the adverse events lasted for no more than 24 h. No serious adverse events were reported. A single inhalation of 50% N 2 O effectively alleviates depression in patients with TRD in China. The efficacy lasts for no more than one week. N 2 O is safe for patients with TRD. [ABSTRACT FROM AUTHOR]