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Children and adolescents are more susceptible than adults to developing posttraumatic stress disorder (PTSD). Pediatric PTSD is characterized by functional alterations in brain fear circuitry, but little is known about the underlying microstructural changes; previous work has mainly focused on the corpus callosum. This study is aimed at investigating brain-wide microstructural abnormalities in pediatric PTSD, their relationship to age and sex, and their potential diagnostic value. The microstructure of major white matter tracts was assessed from diffusion tensor images acquired from 24 treatment-naive non-comorbid PTSD patients

Brain functional network abnormalities are reported in posttraumatic stress disorder (PTSD). Most resting-state functional magnetic resonance imaging (rs-fMRI) studies have assumed that the functional networks remain static during the scan. How these might change dynamically in PTSD remains unclear.Rs-fMRI data were collected from 71 noncomorbid treatment-naïve PTSD patients and 70 demographically-matched trauma-exposed non-PTSD (TENP) controls. Network switching rate was used to characterize dynamic changes of individual resting-state functional networks. Results were analyzed by comparing switching rates between PTSD and TENP, for diagnosis-by-sex interactions, and by correlation with individual PTSD symptom severity.At the global level, PTSD showed significantly lower network switching rates than TENP. These were observed mainly in the fronto-parietal, default-mode, and limbic networks at the subnetwork level, and in the frontal and temporal regions at the nodal level. These network switching rate alterations were correlated with PTSD symptom severity. There were no significant effects of sex.These disruptions of dynamic functional network stability, reflected by lower network switching rate in the resting state, are a feature of PTSD, and suggest that the fronto-parietal, default mode and limbic networks may play a critical role in the underlying neural mechanisms.

Studying the role of psychological resilience in self-perceived stress and mental disorders among family members of medical workers can help us understand its importance in mental health care and guide us to develop psychological intervention strategies for family members of medical workers.A total of 671 family members of medical workers were enrolled. Self-perceived stress, resilience, depression symptoms, anxiety symptoms, and post-traumatic stress disorder (PTSD) symptoms were measured in our research.The prevalence of anxiety, depression, and PTSD symptoms among relatives of medical workers were 49.0 %, 12.2 %, and 20.3 % respectively during the COVID-19 epidemic. According to the Multivariate regression model, compared with family members of doctor, family members of nurse and medical technologists were more likely to report anxiety symptoms. Female members of medical staff were more likely to have PTSD symptoms than male counterparts; and family members of medical technologist appeared to less likely have PTSD symptoms than family members of either doctor or nurse. The mediation analysis confirmed that mental resilience mediated the relationship between self-perceived stress and anxiety symptoms.Single cross-sectional study design without the follow-up comparative analysis, only self-reported measurements were adopted, and inadequate pre-set demographic variables.To the best of our knowledge, our study firstly demonstrated the risk of psychological distress present in the family members of medical providers during the COVID-19 epidemic. Meanwhile, our findings highlighted the importance of mental resilience in family members of frontline medical workers as it mediated the relationship between self-perceived stress and anxiety symptoms.

This study develops a fear-potentiated startle paradigm (FPS) and a machine learning approach to accurately predict PTSD symptoms using electrogram data. A three-phase fear-potentiated startle paradigm was designed to assess the conditioning, generalization, and extinction of fear. Electrooculogram and electrocardiogram signals were collected during the FPS. A total of 1107 Chinese firefighters participated in the study. The Chinese version PCL-C was administered to all subjects. A cutoff of 38 or higher is used to indicate PTSD symptoms. Electrogram features were extracted and selected to build a machine learning model to classify individuals. The machine learning model was 5-fold cross validated. The importance of the selected features was calculated. Classification performance metrics were evaluated for the machine learning model. The machine learning model can identify firefighters with a PCL-C score of 38 or above with sensitivity and specificity both above 0.85 when 5-fold cross validated on a 1107-person sample. The area under the receiver operating characteristic curve of the model is 0.93. Features related to fear generalization are found to be the most important. The proposed fear-potentiated startle paradigm and machine learning approach can accurately predict PTSD symptoms in Chinese firefighters, which can improve the screening and diagnosis of PTSD.

The G allele in retinoid-related orphan receptor alpha (RORA, rs8042149) gene is associated with post-traumatic stress disorder (PTSD) diagnosis and more severe symptoms, reported in the first genome-wide association study of PTSD and subsequent replication studies. Although recent MRI studies identified brain structural deficits in RORA rs8042149 risk G allele carriers, the neural mechanism underlying RORA-related brain structural changes in PTSD remains poorly understood.This study included 227 Han Chinese adults who lost their only child. Cortical thickness and subcortical volume were extracted using FreeSurfer, and PTSD severity was assessed using the Clinician-Administered PTSD Scale. Hierarchical linear regression was used to assess the interaction effect between RORA genotypes (T/T, G/T, and G/G) and PTSD severity on cortical and subcortical structures.Significant genotype × PTSD symptom severity interaction effects were found for bilateral transverse temporal gyrus thickness. For individuals with the homozygous T/T genotype, current PTSD symptom severity was positively associated with bilateral transverse temporal gyrus thickness. For individuals with heterozygous G/T genotype, current PTSD symptom severity was negatively associated with the left transverse temporal gyrus thickness. No significant main or interaction effects were found in any subcortical regions.Cross-sectional design of this study.These findings suggest that the non-risk T/T genotype - but not the risk G allele carriers - has a potentially protective or compensatory role on temporal gyrus thickness in adults who lost their only child. These results highlight the moderation effect of RORA polymorphism on the relationship between PTSD symptom severity and cortical structural changes.

IntroductionMajor depressive disorder (MDD) is associated with low-grade inflammation, and anti-inflammatory treatment can help improve depressive symptoms. A recent study found that fluvoxamine (FLV) can reduce Interleukin-6 (IL-6) production via sigma-1 receptor in inflammation models. However, the anti- IL-6 effect of FLV in treating patients with MDD and whether it can contribute to antidepressant effects remain unclear.MethodsA total of 65 patients with MDD and 34 healthy controls were recruited at baseline, and 50 patients completed the FLV treatment for 2 months. We assessed depression and anhedonia and collected plasma IL-6 levels at baseline, 1 month, and 2 months after baseline. This study evaluated the changes in clinical measures and IL-6 during treatment and analyzed their association. Further subgroup analyses were conducted in patients with MDD with high, medium, or low IL-6.ResultsDepression and anhedonia were significantly improved in patients with MDD, while the IL-6 did not significantly change after the FLV treatment. However, IL-6 significantly declined after the FLV treatment among patients with MDD with higher baseline IL-6. No significant associations were found between the changes in depressive symptoms and IL-6.ConclusionOur study provided preliminary evidence suggesting that the anti-IL-6 effect of FLV might not play a vital role in its antidepressant treatment, at least in patients with MDD with low inflammation. However, for patients with MDD with higher IL-6, FLV can help reduce IL-6 significantly in the antidepressant treatment, which may help guide the individual treatment of MDD with higher IL-6 levels.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/NCT04160377, identifier NCT04160377.

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.

Spot detection has attracted continuous attention for laser sensors with applications in communication, measurement, etc. The existing methods often directly perform binarization processing on the original spot image. They suffer from the interference of the background light. To reduce this kind of interference, we propose a novel method called annular convolution filtering (ACF). In our method, the region of interest (ROI) in the spot image is first searched by using the statistical properties of pixels. Then, the annular convolution strip is constructed based on the energy attenuation property of the laser and the convolution operation is performed in the ROI of the spot image. Finally, a feature similarity index is designed to estimate the parameters of the laser spot. Experiments on three datasets with different kinds of background light show the advantages of our ACF method, with comparison to the theoretical method based on international standard, the practical method used in the market products, and the recent benchmark methods AAMED and ALS.

Accumulating evidence suggests that the brain is highly dynamic; thus, investigation of brain dynamics especially in brain connectivity would provide crucial information that stationary functional connectivity could miss. This study investigated temporal expressions of spatial modes within the default mode network (DMN), salience network (SN) and cognitive control network (CCN) using a reliable data-driven co-activation pattern (CAP) analysis in two independent data sets. We found enhanced CAP-to-CAP transitions of the SN in patients with MDD. Results suggested enhanced flexibility of this network in the patients. By contrast, we also found reduced spatial consistency and persistence of the DMN in the patients, indicating reduced variability and stability in individuals with MDD. In addition, the patients were characterized by prominent activation of mPFC. Moreover, further correlation analysis revealed that persistence and transitions of RCCN were associated with the severity of depression. Our findings suggest that functional connectivity in the patients may not be simply attenuated or potentiated, but just alternating faster or slower among more complex patterns. The aberrant temporal-spatial complexity of intrinsic fluctuations reflects functional diaschisis of resting-state networks as characteristic of patients with MDD.

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 P P P 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.

BackgroundThe presence of heterogenous somatic symptoms frequently obscures the recognition of depression in primary care. We aimed to explore the association between somatic symptoms and subthreshold depression (SD) and Major Depressive Disorder (MDD), as well as to determine the predictive potential of somatic symptoms in identifying SD and MDD in primary care.MethodsData were derived from the Depression Cohort in China study (ChiCTR registry number: 1900022145). The Patient Health Questionnaire-9 (PHQ-9) was used to assess SD by trained general practitioners (GPs), and the Mini International Neuropsychiatric Interview depression module was used to diagnose MDD by professional psychiatrists. Somatic symptoms were assessed using the 28-item Somatic Symptoms Inventory (SSI).ResultsIn total of 4,139 participants aged 18–64 years recruited from 34 primary health care settings were included. The prevalence of all 28 somatic symptoms increased in a dose-dependent manner from non-depressed controls to SD, and to MDD (P for trend OR = 1.24, 95% CI, 1.18–1.31) and MDD (OR = 1.50, 95% CI, 1.41–1.60) The predictive performance of energy-related symptoms in identifying individuals with SD (AUC = 0.715, 95% CI, 0.697–0.732) and MDD (AUC = 0.941, 95% CI, 0.926–0.963) was superior to the performance of total SSI and the other two clusters (P < 0.05).ConclusionsSomatic symptoms were associated with the presence of SD and MDD. In addition, somatic symptoms, notably those related to energy, showed good predictive potential in identifying SD and MDD in primary care. The clinical implication of the present study is that GPs should consider the closely related somatic symptoms for early recognition for depression in practice.

Although observational studies have suggested associations between circulating antioxidants and many mental disorders, causal inferences have not been confirmed. Mendelian randomization (MR) analyses were conducted using summary-level statistics from genome-wide association studies (GWASs) to explore whether genetically determined absolute circulating antioxidants (i.e., ascorbate, retinol, β-carotene, and lycopene) and metabolites (i.e., α- and γ-tocopherol, ascorbate, and retinol) were causally associated with the risk of six major mental disorders, including anxiety disorders (AD), major depressive disorder (MDD), bipolar disorder (BIP), schizophrenia (SCZ), post-traumatic stress disorder (PTSD), and obsessive–compulsive disorder (OCD). MR analyses were performed per specific-outcome databases, including the largest GWAS published to date (from 9725 for OCD to 413,466 for BIP participants), UK Biobank (over 370,000 participants), and FinnGen (over 270,000 participants), followed by meta-analyses. We found no significant evidence that genetically determined diet-derived circulating antioxidants were significantly causally associated with the risk of the six above-mentioned major mental disorders. For absolute antioxidant levels, the odds ratios (ORs) ranged from 0.91 (95% CI, 0.67–1.23) for the effect of β-carotene on OCD to 1.18 (95% CI, 0.90–1.54) for the effect of ascorbate on OCD. Similarly, for antioxidant metabolites, ORs ranged from 0.87 (95% CI, 0.55–1.38) for the effect of ascorbate on MDD to 1.08 (95% CI, 0.88–1.33) for the effect of ascorbate on OCD. Our study does not support significant causal associations of genetically determined diet-derived circulating antioxidants with the risk of major mental disorders.

Background The symptoms that patients with major depressive disorder (MDD) experience are the dominant contributing factors to its heavy disease burden. This study sought to identify key symptoms leading to disability in patients with MDD. Methods Subjects consisted of patients who had a 12-month MDD diagnosis based on the China Mental Health Survey (CMHS). World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was used to assess the degree of disability. The associations between depressive symptoms and disability were analyzed using a linear regression and logistic regression with a complex sampling design. Results Of the 32,552 community residents, 655 patients were diagnosed with 12-month MDD. The disability rate due to MDD was 1.06% (95% CI: 0.85%–1.28%) among adults in Chinese community and 50.7% (95% CI: 44.3%–57.1%) among MDD patients. Depression was associated with all functional losses measured by the WHODAS. Feelings of worthlessness in life or inappropriate guilt, and psychomotor agitation or retardation were the key symptoms related to disability. Economic status, co-morbidity of physical diseases or anxiety disorders were correlates of disability scores. Limitations The disability rate might be underestimated due to the exclusion of MDD patients living in hospitals. The effect of treatments on disability was excluded. Conclusions Psychological symptoms, not somatic symptoms, contribute to disability in MDD patients. Disability worsens when physical diseases or anxiety disorders are present. More attention could be paid to psychological symptoms, physical diseases, and anxiety disorders in MDD patients with disabilities.

Background Neuroimaging studies in posttraumatic stress disorder (PTSD) have identified various alterations in white matter (WM) microstructural organization. However, it remains unclear whether these are localized to specific regions of fiber tracts, and what diagnostic value they might have. This study set out to explore the spatial profile of WM abnormalities along defined fiber tracts in PTSD. Methods Diffusion tensor images were obtained from 77 treatment-naive noncomorbid patients with PTSD and 76 demographically matched trauma-exposed non-PTSD (TENP) controls. Using automated fiber quantification, tract profiles of fractional anisotropy, axial diffusivity, mean diffusivity, and radial diffusivity were calculated to evaluate WM microstructural organization. Results were analyzed by pointwise comparisons, by correlation with symptom severity, and for diagnosis-by-sex interactions. Support vector machine analyses assessed the ability of tract profiles to discriminate PTSD from TENP. Results Compared to TENP, PTSD showed lower fractional anisotropy accompanied by higher radial diffusivity and mean diffusivity in the left uncinate fasciculus, and lower fractional anisotropy accompanied by higher radial diffusivity in the right anterior thalamic radiation. Tract profile alterations were correlated with symptom severity, suggesting a pathophysiological relevance. There were no significant differences in diagnosis-by-sex interaction. Tract profiles allowed individual classification of PTSD versus TENP with significant accuracy, of potential diagnostic utility. Conclusions These findings add to the knowledge of the neuropathological basis of PTSD. WM alterations based on a tract-profile quantification approach are a potential biomarker for PTSD.

Summary Background In China, depressive disorders have been estimated to be the second leading cause of years lived with disability. However, nationally representative epidemiological data for depressive disorders, in particular use of mental health services by adults with these disorders, are unavailable in China. The present study, part of the China Mental Health Survey, 2012–15, aims to describe the socioeconomic characteristics and the use of mental health services in people with depressive disorders in China. Methods The China Mental Health Survey was a cross-sectional epidemiological survey of mental disorders in a multistage clustered-area probability sample of adults of Chinese nationality (≥18 years) from 157 nationwide representative population-based disease surveillance points in 31 provinces across China. Trained investigators interviewed the participants with the Composite International Diagnostic Interview 3.0 to ascertain the presence of lifetime and 12-month depressive disorders according to DSM-IV criteria, including major depressive disorder, dysthymic disorder, and depressive disorder not otherwise specified. Participants with 12-month depressive disorders were asked whether they received any treatment for their emotional problems during the past 12 months and, if so, the specific types of treatment providers. The Sheehan Disability Scale (SDS) was used to assess impairments associated with 12-month depressive symptoms. Data-quality control procedures included logic check by computers, sequential recording check, and phone-call check by the quality controllers, and reinterview check by the psychiatrists. Data were weighted according to the age–sex–residence distribution data from China's 2010 census population survey to adjust for differential probabilities of selection and differential response, as well as to post-stratify the sample to match the population distribution. Findings 28 140 respondents (12 537 [44·6%] men and 15 603 [55·4%] women) completed the survey between July 22, 2013, and March 5, 2015. Ethnicity data (Han or non-Han) were collected for only a subsample. Prevalence of any depressive disorders was higher in women than men (lifetime prevalence odds ratio [OR] 1·44 [95% CI 1·20–1·72] and 12-month prevalence OR 1·41 [1·12–1·78]), in unemployed people than employed people (lifetime OR 2·38 [95% CI 1·68–3·38] and 12-month OR 2·80 [95% CI 1·88–4·18]), and in people who were separated, widowed, or divorced compared with those who were married or cohabiting (lifetime OR 1·87 [95% CI 1·39–2·51] and 12-month OR 1·85 [95% CI 1·40–2·46]). Overall, 574 (weighted % 75·9%) of 744 people with 12-month depressive disorders had role impairment of any SDS domain: 439 (83·6%) of 534 respondents with major depressive disorder, 207 (79·8%) of 254 respondents with dysthymic disorder, and 122 (59·9%) of 189 respondents with depressive disorder not otherwise specified. Only an estimated 84 (weighted % 9·5%) of 1007 participants with 12-month depressive disorders were treated in any treatment sector: 38 (3·6%) in speciality mental health, 20 (1·5%) in general medical, two (0·3%) in human services, and 21 (2·7%) in complementary and alternative medicine. Only 12 (0·5%) of 1007 participants with depressive disorders were treated adequately. Interpretation Depressive disorders in China were more prevalent in women than men, unemployed people than employed, and those who were separated, widowed, or divorced than people who were married or cohabiting. Most people with depressive disorders reported social impairment. Treatment rates were very low, and few people received adequate treatment. National programmes are needed to remove barriers to availability, accessibility, and acceptability of care for depression in China. Funding National Health Commission and Ministry of Science and Technology of People's Republic of China. Translation For the Chinese translation of the abstract see Supplementary Materials section.

The efficacy of traditional treatment for post-traumatic stress disorder (PTSD) is still unsatisfactory. Repetitive transcranial magnetic stimulation (rTMS) has been widely used in the treatment of various types of mental disorders, including PTSD. Although rTMS has been demonstrated to be effective in many cases, there are still arguments regarding its mechanism and protocol. This review aims to summarize the origin, development, principle, and future direction of rTMS and introduce this neuro-stimulation therapy to relevant clinicians.

Background: The pandemic of coronavirus disease 2019 lastingly affects public mental health. Many studies have described symptoms of anxiety and depression in pregnant women during the pandemic. However, limited study focuses on the prevalence and risk factors of mood symptoms among females and their partners during early pregnancy in the post-pandemic era in China, which was the aim of the study and could promote clinical attention and suggest possible directions for intervention. 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 the binominal logistic regression analysis. Results: 17.8% and 5.9% of first-trimester females had depressive and anxious symptoms, respectively. Among partners, 12.4% and 9.5% had depressive and anxious symptoms, respectively. In females, higher scores of FAD-GF (OR= 5.461 and 14.759; P< 0.05) and lower scores of Q-LES-Q-SF (OR= 0.830 and 0.715; P< 0.01) were related to the risk of depressive and anxious symptoms. A history of smoking and higher scores of FAD-GF were associated with the risk of depressive and anxious symptoms in partners (OR = 4.906 and 6.885; P< 0.05). Conclusions: This study prompted still prominent mood symptoms in the post-pandemic era. Family functioning, quality of life, or a smoking history increased risks of mood symptoms among early pregnant families, which might facilitate the updating of medical intervention. However, the current study did not further explore interventions based on these findings.

Background: Symptoms of depression and comorbid anxiety have been regarded as risk factors responsible for cognitive impairment in major depressive disorder (MDD). However, it remains unclear which dimension of the depressive and anxiety symptoms predicts cognitive impairment during a depressive episode. Methods: A comprehensive neurocognitive test battery was used to assess executive function, attention, processing speed, and memory in 162 medication-free patients with MDD and 142 matched healthy controls (HCs). The 24-item Hamilton Depression Rating Scale (HAM-D) was used to assess depressive symptoms (including 7 dimensions: retardation, cognitive disturbances, sleep disturbances, anxiety/somatization, weight loss, diurnal variation and hopelessness), and the 14-item Hamilton Anxiety Scale (HAM-A) was used to assess anxiety symptoms. Linear regression analyses and mediation analyses were conducted to evaluate the impact of depressive and anxiety symptoms, as well as their interactions, on cognitive impairments. Results: Among the depressive symptoms, sleep disturbances were associated with poorer executive function, lower processing speed, and memory impairments, and retardation was associated with lower processing speed in patients with MDD. Notably, retardation was found to mediate the impact of sleep disturbances on the processing speed. With regard to anxiety symptoms, psychic anxiety, rather than somatic anxiety, was associated with cognitive impairments of all the four aspects. Furthermore, sleep disturbances were found to mediate the impact of psychic anxiety on executive function and memory, while retardation was found to mediate the impact of psychic anxiety on processing speed. Conclusions: The present study provided preliminary evidence that sleep disturbances might be a significant predictor for poorer executive function, lower processing speed, and memory loss, while retardation might be a major factor for lower processing speed during a depressive episode.

Background Treatment non-response and recurrence are the main sources of disease burden in major depressive disorder (MDD). However, little is known about its neurobiological mechanism concerning the brain network changes accompanying pharmacotherapy. The present study investigated the changes in the intrinsic brain networks during 6-month antidepressant treatment phase associated with the treatment response and recurrence in MDD. Methods Resting-state functional magnetic resonance imaging was acquired from untreated patients with MDD and healthy controls at baseline. The patients' depressive symptoms were monitored by using the Hamilton Rating Scale for Depression (HAMD). After 6 months of antidepressant treatment, patients were re-scanned and followed up every 6 months over 2 years. Traditional statistical analysis as well as machine learning approaches were conducted to investigate the longitudinal changes in macro-scale resting-state functional network connectivity (rsFNC) strength and micro-scale resting-state functional connectivity (rsFC) associated with long-term treatment outcome in MDD. Results Repeated measures of the general linear model demonstrated a significant difference in the default mode network (DMN) rsFNC change before and after the 6-month antidepressant treatment between remitters and non-remitters. The difference in the rsFNC change over the 6-month antidepressant treatment between recurring and stable MDD was also specific to DMN. Machine learning analysis results revealed that only the DMN rsFC change successfully distinguished non-remitters from the remitters at 6 months and recurring from stable MDD during the 2-year follow-up. Conclusion Our findings demonstrated that the intrinsic DMN connectivity could be a unique and important target for treatment and recurrence prevention in MDD.

For children and adolescents, there is a high risk of developing post-traumatic stress disorder (PTSD) after suffering from catastrophic events. Previous studies have identified brain functionally and subcortical brain volumes structurally abnormalities in this population. However, up till now, researches exploring alterations of regional cortical thickness (CTh) and brain interregional structural covariance networks (SCNs) are scarce. In this cross-sectional study, CTh measures are derived from 3-Tesla Tl-weighted MRI imaging data in a well-characterized combined group of children and adolescents with PTSD after an earthquake (N = 35) and a traumatized healthy control group (N = 24). By using surface-based morphometry (SBM) techniques, the regional CTh analysis was conducted. To map interregional SCNs derived from CTh, twenty-five altered brain regions reported in the PTSD population were selected as seeds. Whole-brain SBM analysis discovered a significant thickness reduction in the left medial orbitofrontal cortex for the subjects with PTSD. Similarly, analysis of SCNs associated with “seed” regions primarily located in default mode network (DMN), midline cortex structures, motor cortex, auditory association cortex, limbic system, and visual cortex demonstrated that children and adolescents with PTSD are associated with altered structural covariance with six key regions. This study provides evidence for distinct CTh correlates of PTSD that are present across children and adolescents, suggesting that brain cortical abnormalities related to trauma exposure are present in this population, probably by driving specific symptom clusters associated with disrupted extinction recall mechanisms for fear, episodic memory network and visuospatial attention.

Background Family functioning is associated with anxiety and depression. Perinatal depression and anxiety are common and influence the well-being of women, partners and their offspring. However, little is known about differences in associations between family functioning and mood symptoms in women and their partners in early pregnancy. Aims Investigating differences in associations between family functioning and anxious and depressive symptoms in women and their partners in early pregnancy. Method In total, 171 woman–partner pairs were enrolled. The Edinburgh Postnatal Depression Scale (EPDS), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-Item scale (GAD-7) and Family Assessment Device (FAD) were performed. Correlation analysis and multiple linear regression analysis were applied to investigate the associations. Results In pregnant women, all the subscale scores on the FAD were correlated with total scores on the EPDS and GAD-7 (all P < 0.05), whereas only the Roles subscale showed a predicting effect in regression models (P < 0.01). In partners, all the subscale scores on the FAD were related to total scores on the PHQ-9 (all P < 0.05), whereas only the Problem Solving subscale showed a predicting effect (P = 0.029). Conclusions Our findings indicate that family functioning in the domain of roles is associated with anxious and depressive symptoms in pregnant women and functioning in the domain of problem solving is associated with depressive symptoms in partners. Clinicians should pay special attention to roles and problem solving when assessing mood symptoms in pregnant women and their partners. This study also provides a basis for family health education in early pregnancy.

Background Medication adherence among patients with major depressive disorder (MDD) is a major and modifiable problem for health care systems. Childhood trauma is considered a vital factor that might be helpful to the early risk assessment of suboptimal adherence. We aimed to comprehensively explore the associations between different types of childhood trauma and medication adherence among patients with MDD, and to test whether measure of resilience has moderating effects on the foregoing associations. Methods Participants were from the Depression Cohort in China (ChiCTR registry number 1900022145), 282 patients with MDD completed the 12 weeks study. The diagnosis of MDD was assessed by trained psychiatrists using the Mini-International Neuropsychiatric Interview (M.I.N.I.). Childhood trauma was evaluated using the Childhood Trauma Questionnaire-28 item Short Form (CTQ-SF), resilience was evaluated using the Connor-Davidson Resilience Scale (CD-RISC). Demographic characteristics, depression symptoms, anxiety symptoms, suicidal ideation, suicidal attempt, insomnia symptoms, and painful somatic symptoms were also investigated. Participants were divided into groups of optimal and suboptimal adherence based on their scores on the Medication Adherence Rating Scale, and factors associated with medication adherence using univariate and multivariate logistic regression, and stratified analyses were evaluated. Results A total of 234 participants (83%) reported suboptimal medication adherence. After adjusting for covariates, CTQ total scores (AOR = 1.04, 95%CI = 1.01–1.06), CTQ measures of sexual abuse (AOR = 1.23, 95%CI = 1.07–1.42), and CTQ measures of physical neglect (AOR = 1.14, 95%CI = 1.04–1.12) were all associated with an increased likelihood of suboptimal adherence. There were significant moderating effects of resilience on the associations of childhood trauma (P = 0.039) and physical neglect (P = 0.034) with medication adherence. The stratification analyses showed that CTQ total scores and CTQ measures of physical neglect were independently associated with an increased risk of suboptimal adherence among patients with MDD with low-resilience or medium-resilience, while not significantly associated with suboptimal adherence in those with high-resilience. Conclusion Obtaining a history of childhood trauma and assessing resilience may help identify patients with suboptimal adherence when providing MDD pharmacotherapy. Psychiatrists may consider enhancing resilience to cope with the adverse effects of childhood trauma on medication adherence.

Background Suboptimal medication adherence is a major reason for failure in the management of major depressive disorder (MDD), childhood trauma might be an essential risk factor of suboptimal medication adherence. This study aimed to comprehensively explore the associations between different types of childhood trauma and medication adherence among patients with MDD, and to test whether resilience has moderating effects on the foregoing associations. Methods Participants were from the Depression Cohort in China (ChiCTR registry number 1900022145), 282 MDD patients with completed both baseline and 12-weeks follow-up investigations were included in this study. The diagnosis of MDD was assessed by trained psychiatrists using the Mini-International Neuropsychiatric Interview (M.I.N.I.). Childhood trauma was evaluated using the Childhood Trauma Questionnaire-28 item Short Form (CTQ-SF), and resilience was evaluated using the Connor-Davidson Resilience Scale (CD-RISC). Demographic characteristics, depression symptoms, anxiety symptoms, suicidal ideation, suicidal attempt, insomnia symptoms, and painful somatic symptoms were also investigated. Participants were divided into groups of optimal and suboptimal adherence based on their Medication Adherence Rating Scale scores. Logistic regression and stratified analyses were performed. Results A total of 234 participants (83%) reported suboptimal medication adherence. After adjusting for covariates, CTQ total scores (AOR = 1.03, 95%CI = 1.01–1.06), CTQ measures of sexual abuse (AOR = 1.17, 95%CI = 1.01–1.37), and CTQ measures of physical neglect (AOR = 1.12, 95%CI = 1.02–1.23) were all associated with an increased likelihood of suboptimal adherence. There were significant moderating effects of resilience on the associations of childhood trauma (P = 0.039) and physical neglect (P = 0.034) with medication adherence. The stratification analyses showed that CTQ total scores and CTQ measures of physical neglect were independently associated with an increased risk of suboptimal adherence among patients with MDD with low-resilience or moderate-resilience, while not significantly associated with suboptimal adherence in those with high-resilience. Conclusion Childhood trauma was a significant risk factor of suboptimal adherence among patients with MDD, and resilience moderated the foregoing association. Obtaining a history of childhood trauma and assessing resilience may help identify patients with suboptimal adherence when providing MDD pharmacotherapy. Psychiatrists may consider enhancing resilience to cope with the adverse effects of childhood trauma on medication adherence.

Background: Since the early clinical efficacy of antipsychotics has not yet been well perceived, this study sought to decide whether the efficacy of antipsychotics at week 2 can predict subsequent responses at week 6 and identify how such predictive capacities vary among different antipsychotics and psychotic symptoms. Methods: A total of 3010 patients with schizophrenia enrolled in a randomized controlled trial (RCT) and received a 6-week treatment with one antipsychotic drug randomly chosen from five atypical antipsychotics (risperidone 2-6 mg/d, olanzapine 5-20 mg/d, quetiapine 400-750 mg/d, aripiprazole 10-30 mg/d, and ziprasidone 80-160 mg/d) and two typical antipsychotics (perphenazine 20-60 mg/d and haloperidol 6-20 mg/d). Early efficacy was defined as the reduction rate using the Positive and Negative Syndrome Scale (PANSS) total score at week 2. With cut-offs at 50% reduction, logistic regression, receiver operating characteristic (ROC) and random forests were adopted. Results: The reduction rate of PANSS total score and improvement of psychotic symptoms at week 2 enabled subsequent responses to 7 antipsychotics to be predicted, in which improvements in delusions, lack of judgment and insight, unusual thought content, and suspiciousness/ persecution were endowed with the greatest weight. Conclusions: It is robust enough to clinically predict treatment responses to antipsychotics at week 6 using the reduction rate of PANSS total score and symptom relief at week 2. Psychiatric clinicians had better determine whether to switch the treatment plan by the first 2 weeks. Clinical Trial Registration Number: This RCT was registered at the Chinese Clinical Trials Registry Identifier: ChiCTR-TRC-10000934).

Background Individuals with generalized anxiety disorder (GAD) tend to worry exaggeratedly and uncontrollably about various daily routines. Previous studies have demonstrated that the GAD patients exhibited widespread alternations in both functional networks (FN) and structural networks (SN). However, the simultaneous alternations of the topological organization of FN, SN, as well as their couplings in GAD still remain unknown. Methods Using multimodal approach, we constructed FN from resting-state functional magnetic imaging (R-fMRI) data and SN from diffusion magnetic resonance imaging (dMRI) data of 32 adolescent GAD patients and 25 healthy controls (HC). Graph theory analysis was employed to investigate the topological properties of FN, SN, and FN-SN coupling. Results Compared to HC, the GAD patients showed disruptions in global (i.e., decreased clustering coefficient, global, and local efficiency) and subnetwork (i.e., reduced intermodular connections, rich club, and feeder connections) levels in FN. Abnormal global level properties (i.e., increased characteristic path length and reduced global efficiency) were also observed in SN. Altered FN-SN couplings in normalized characteristic path length and feeder connections were identified in the GAD patients. The identified network measures were correlated with anxiety severity in the GAD patients. Limitations The sample size of the current study is small and the cross-sectional nature can not infer causal relationship. Conclusions Our findings identified GAD-related topological alternations in both FN and SN, together with the couplings between FN and SN, providing us with a novel perspective for understanding the pathophysiological mechanisms of GAD.

BackgroundObservational studies have suggested associations between circulating antioxidant levels and many mental disorders, but evidence from randomized controlled trials (RCTs) is lacking and causal inferences have not been confirmed. The aim of this study was to explore whether genetically predicted diet-derived circulating antioxidants were causally associated with the risk of major mental disorders using Mendelian randomization (MR).Methods and findingsWe performed 2-sample MR analyses of summary-level genetic data to explore whether diet-derived circulating antioxidants [e.g., vitamins E (α- and γ-tocopherol), ascorbate, retinol, β-carotene, and lycopene], assessed by absolute circulating antioxidants and relative circulating antioxidant metabolites, were causally associated with the risk of six major mental disorders, including major depressive disorder (MDD), schizophrenia (SCZ), bipolar disorder (BIP), autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD). The inverse-variance weighted method was adopted as primary MR analyses and five additional MR methods (likelihood-based MR, MR-Egger, weighted median, penalized weighted median, and MR-PRESSO) and different outcome databases were used for sensitivity analyses. We found suggestive evidence that genetically predicted higher absolute circulating α-tocopherol levels marginally reduced the risk of SCZ, with the odds ratio (OR) per unit increase in log-transformed α-tocopherol values was 0.71 [95% confidence interval (CI) 0.54 to 0.94; P = 0.016]. However, after adjusting for multiple testing (threshold of P < 0.008), we found no significant evidence that genetically predicted higher diet-derived absolute circulating antioxidant levels and antioxidant metabolites concentrations were significantly causally associated with the six-foregoing major mental disorders.ConclusionsOverall, our study does not support significant causal associations of genetically predicted diet-derived circulating antioxidants with the risk of major mental disorders. Therefore, simply taking antioxidants to increase blood antioxidants levels is unlikely to have a significant protective effect on the prevention of most mental disorders.Author summaryWhy was this study done?Some observational studies have reported that diet-derived circulating antioxidants are associated with a reduced risk of major mental disorders; however, these studies are susceptible to uncertain temporal relationships, insufficient sample sizes, or potential confounding factors, and thus it remains unclear whether these associations are accurate.To our knowledge, there are no randomized clinical trials published to date on this topic. Since oxidative stress is closely related to the occurrence of mental diseases, if diet-derived circulating antioxidants can reduce the risk of major mental disorders, it will be an interesting target as primary prevention of mental disorders.What did the researchers do and find?We performed a Mendelian randomization study design to explore whether genetically predicted diet-derived circulating antioxidants [e.g., vitamins E (α- and γ-tocopherol), ascorbate, retinol, β-carotene, and lycopene], assessed by absolute circulating antioxidants and relative circulating antioxidant metabolites, were causally associated with the risk of six major mental disorders, including major depressive disorder, schizophrenia, bipolar disorder, autism spectrum disorder, attention- deficit/hyperactivity disorder, and post-traumatic stress disorder.Overall, our study provides suggestive evidence that genetically predicted higher absolute α-tocopherol levels may be causally associated with a reduced risk of schizophrenia. However, our study did not find genetically predicted significant causal associations of dietary antioxidants with major mental disorders after correction for multiple testing.What do these findings mean?Our findings suggest for healthy adults without nutritional deficiency, simply taking antioxidants to increase blood antioxidants levels is unlikely to have a significant protective effect on the prevention of most mental disorders.In the future, large-scale GWASs are needed to further validate our current findings, especially the suggestive protective effect of higher α-tocopherol levels on schizophrenia, by utilizing additional genetic variants and more samples.

Major depressive disorder (MDD) patients with anhedonia tend to have a poor prognosis. The underlying imaging basis for anhedonia in MDD remains largely unknown. The relationship between nodal properties and anhedonia in MDD patients need to be further investigated. Herein, this study aims to explore differences of cerebral functional node characteristics in MDD patients with severe anhedonia (MDD-SA) and MDD patients with mild anhedonia (MDD-MA) before and after the antidepressant treatment.Ninety participants with current MDD were recruited in this study. 24-Item Hamilton Depression Scale (HAMD-24) and Snaith-Hamilton Pleasure Scale (SHAPS) were used to assess the severity of depression and anhedonia at baseline and the end of 6-months treatment. The MDD patients who scored above the 25th percentile on the SHAPS were assigned to an MDD-SA group (Repeated measures 2-factor ANCOVA showed significant main effects on group on the eThere are obvious differences in nodal properties between the MDD-SA and the MDD-MA patients, such as the high e

Symptoms of subthreshold depression may differentially affect the illness transition. We examined the impact of cognitive-affective and somatic symptoms on different subthreshold depression transitions as well as risk factors influencing the aforementioned symptoms changes.Adults with subthreshold depression in the Depression Cohort in China were enrolled. Data collection was conducted at baseline, 6 and 12 months from 2019 to 2020. Cognitive-affective and somatic symptoms were assessed using the Patient Health Questionnaire-9. A total of 993 participants completed 12-month follow-up and were divided into persistent, intermittent and remission groups according to change in depressive symptoms. The longitudinal change of cognitive-affective and somatic symptoms in the three groups, as well as risk factors was analyzed using the generalized linear mixed-model.There were 24.07 %, 34.04 % and 41.89 % of participants proceeding into persistent, intermittent and remission subthreshold depression groups, respectively. Cognitive-affective symptoms were the core symptoms for predicting the deterioration in persistent subthreshold depression (t = 2.48, P = 0.013), whereas somatic symptoms improved over time (t = -2.82, P = 0.005). Anxiety symptoms were the primary risk factors for worsening cognitive-affective symptoms (P 0.001), following by insomnia symptoms, age, marital status, resilience and social functions. Somatic symptoms were affected by insomnia symptoms, anxiety symptoms and Body Mass Index successively.Major Depressive Episode was not explored in follow-up.Cognitive-affective symptoms in subthreshold depression are at greater risk of illness deterioration. Future studies should endeavor to identify specific risk factors in different symptoms to forestall the transition from subthreshold to Major Depressive Disorder.

Patients with major depressive disorder (MDD) exhibit concurrent deficits in both sensory and higher-order cognitive processing. Connectome studies have suggested a principal primary-to-transmodal gradient in functional brain networks, supporting the spectrum from sensation to cognition. However, whether this gradient structure is disrupted in patients with MDD and how this disruption associates with gene expression profiles and treatment outcome remain unknown. Using a large cohort of resting-state fMRI data from 2227 participants (1148 MDD patients and 1079 healthy controls) recruited at nine sites, we investigated MDD-related alterations in the principal connectome gradient. We further used Neurosynth, postmortem gene expression, and an 8-week antidepressant treatment (20 MDD patients) data to assess the meta-analytic cognitive functions, transcriptional profiles, and treatment outcomes related to MDD gradient alterations, respectively. Relative to the controls, MDD patients exhibited global topographic alterations in the principal primary-to-transmodal gradient, including reduced explanation ratio, gradient range, and gradient variation (Cohen's d = 0.16-0.21), and focal alterations mainly in the primary and transmodal systems (d = 0.18-0.25). These gradient alterations were significantly correlated with meta-analytic terms involving sensory processing and higher-order cognition. The transcriptional profiles explained 53.9% variance of the altered gradient pattern, with the most correlated genes enriched in transsynaptic signaling and calcium ion binding. The baseline gradient maps of patients significantly predicted symptomatic improvement after treatment. These results highlight the connectome gradient dysfunction in MDD and its linkage with gene expression profiles and clinical management, providing insight into the neurobiological underpinnings and potential biomarkers for treatment evaluation in this disorder.

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.

BackgroundLosing one's only child is a major traumatic life event that may lead to post-traumatic stress disorder (PTSD); however, the underlying mechanisms of its psychological consequences remain poorly understood. Here, we investigated subregional hippocampal functional connectivity (FC) networks based on resting-state functional magnetic resonance imaging and the deoxyribonucleic acid methylation of the human glucocorticoid receptor gene (NR3C1) in adults who had lost their only child.MethodsA total of 144 Han Chinese adults who had lost their only child (51 adults with PTSD and 93 non-PTSD adults [trauma-exposed controls]) and 50 controls without trauma exposure were included in this fMRI study (age: 40–67 years). FCs between hippocampal subdivisions (four regions in each hemisphere: cornu ammonis1 [CA1], CA2, CA3, and dentate gyrus [DG]) and methylation levels of the NR3C1 gene were compared among the three groups.ResultsTrauma-exposed adults, regardless of PTSD diagnosis, had weaker positive FC between the left hippocampal CA1, left DG, and the posterior cingulate cortex, and weaker negative FC between the right CA1, right DG, and several frontal gyri, relative to healthy controls. Compared to non-PTSD adults, PTSD adults showed decreased negative FC between the right CA1 region and the right middle/inferior frontal gyri (MFG/IFG), and decreased negative FC between the right DG and the right superior frontal gyrus and left MFG. Both trauma-exposed groups showed lower methylation levels of the NR3C1 gene.ConclusionsAdults who had lost their only child may experience disrupted hippocampal network connectivity and NR3C1 methylation status, regardless of whether they have developed PTSD.

Losing one’s only child is a major traumatic life event that may lead to posttraumatic stress disorder (PTSD); however, not all parents who experience this trauma develop PTSD. Genetic variants are associated with the risk of developing PTSD. Catechol-O-methyltransferase (COMT) rs4680 and brain-derived neurotrophic factor (BDNF) rs6265 are two most well-described single-nucleotide polymorphisms that relate to stress response; however, the neural mechanism underlying their effects on adults who lost an only child remains poorly understood. Two hundred and ten Han Chinese adults who had lost their only child (55 with PTSD and 155 without PTSD) were included in this imaging genetics study. Participants were divided into subgroups according to their COMT rs4680 and BDNF rs6265 genotypes. Degree Centrality (DC)—a resting-state fMRI index reflecting the brain network communication—was compared with a three-way (PTSD diagnosis, COMT, and BDNF polymorphisms) analysis of covariance. Diagnosis state had a significant effect on DC in bilateral inferior parietal lobules and right middle frontal gyrus (MFG), where PTSD adults showed weaker DC. BDNF × diagnosis interaction effect was found in the right MFG and hippocampus, and these two regions were reversely modulated. Also, there was a significant COMT × BDNF interaction effect in left cuneus, middle temporal gyrus, right inferior occipital gyrus, and bilateral putamen, independent of PTSD diagnosis. These findings suggest that the modulatory effect of BDNF polymorphism on the MFG and hippocampus may contribute to PTSD development in bereaved adults. Interactions of COMT × BDNF polymorphisms modulate some cortices and basal ganglia, irrespective of PTSD development.

Multiple surveys have revealed that China has an immense mental health care needs predominantly related to common mental disorders like anxiety and depressive disorders. China has provided different training pathways with an aim of increasing the number of psychiatrists working to address such growing mental health care needs. Although this strategy has successfully doubled the total number of psychiatrists over a couple of years, there remains the problem of harmonising the training standards across different training pathways and across different training units. There is also a pressing need to enhance psychiatric education among other health professionals as it is increasingly recognised that many people with common mental disorders do not have or want to have access to psychiatric care, and need to be taken care of by medical practitioners of other specialties or health professionals. Despite Hong Kong having a different training system from Mainland China, the problems faced with training psychiatrists and other health professionals in Hong Kong are strikingly similar to those encountered by their counterparts in China. Given their different historical origins and subsequent diverse development of training systems, Mainland China and Hong Kong have much to learn from one another.

Background Post-traumatic stress disorder (PTSD) is associated with disruption of the brain network topology; however, little is known about the topological changes and sex effects in PTSD patients following a unique trauma, the loss of an only child, in China. Methods Fifty-one lost-only-child parents with PTSD, 93 lost-only-child non-PTSD parents (NPTSD), and 50 healthy subjects underwent resting-state functional MRI. The whole-brain functional network was constructed by thresholding partial correlation matrices of 90 brain regions. Group differences in the topological properties, the diagnosis-by-sex interaction, and the relationships between topological metrics and clinical variables were investigated. Results Compared with healthy subjects, PTSD and NPTSD groups exhibited significantly shorter path lengths and higher nodal centralities in many brain regions across sexes; however, no significant difference was found between the PTSD and NPTSD groups. Additionally, the global topological metrics did not show any sex difference, whereas the nodal centralities in the left insula, right inferior frontal gyrus, and right posterior cingulate cortex differed significantly only in women, and the nodal centralities in the bilateral anterior cingulate cortices and left hippocampus were significantly different only in men. Furthermore, the nodal centralities of the right parahippocampus demonstrated significant diagnosis-by-sex interaction. Limitation Cross-sectional design of this study could not demonstrate the causality. Conclusions The parents who lost their only child exhibited a shift toward randomization and significant nodal topological alterations independent of PTSD effects. Additionally, sex differences were observed primarily in the topological properties at the nodal level, which may indicate a neurobiological contribution to the greater incidence of PTSD in females.

Background: Previous studies have shown that childhood maltreatment (CM) is closely associated with social support in the general population. However, little is known about the associations of different types of CM with social support in Chinese patients with major depressive disorder (MDD), which was the goal of the current study.Methods: One hundred and sixty-six patients with moderate-to-severe MDD were enrolled. Participants were assessed by the Childhood Trauma Questionnaire-28 item Short Form, Social Support Rating Scale (SSRS), the 24-item Hamilton rating scale for depression, and the 14-item Hamilton Anxiety Rating Scale. Correlation analysis and Hierarchical multiple linear regression analysis were adopted to investigate associations of types of CM with social support.Results: (1) Physical neglect (PN) and emotional neglect (EN) were the most commonly reported types of CM in patients with MDD. (2) EN was the only type of CM significant in the regression models of the SSRS total score, the score of subjective support, and the score of utilization of support.Limitations: The data of CM was collected retrospectively and recall bias may be introduced. Assessment of CM and social support were self-reported and could be influenced by the depression status.Conclusion: In Chinese patients with MDD, PN and EN are the most prevalent types of CM. EN is the only type of CM associated with low social support in regression models, calling for special attention in the assessment and intervention of EN.

Background Children exposed to natural disasters are vulnerable to developing posttraumatic stress disorder (PTSD). Previous studies using resting-state functional neuroimaging have revealed alterations in graph-based brain topological network metrics in pediatric PTSD patients relative to healthy controls (HC). Here we aimed to apply deep learning (DL) models to neuroimaging markers of classification which may be of assistance in diagnosis of pediatric PTSD. Methods We studied 33 pediatric PTSD and 53 matched HC. Functional connectivity between 90 brain regions from the automated anatomical labeling atlas was established using partial correlation coefficients, and the whole-brain functional connectome was constructed by applying a threshold to the resultant 90 * 90 partial correlation matrix. Graph theory analysis was used to examine the topological properties of the functional connectome. A DL algorithm then used this measure to classify pediatric PTSD vs HC. Results Graphic topological measures using DL provide a potentially clinically useful classifier for differentiating pediatric PTSD and HC (overall accuracy 71.2%). Frontoparietal areas (central executive network), cingulate cortex, and amygdala contributed the most to the DL model’s performance. Conclusions Graphic topological measures based on fMRI data could contribute to imaging models of clinical utility in distinguishing pediatric PTSD from HC. DL model may be a useful tool in the identification of brain mechanisms PTSD participants.

Background: Studies have shown a strong association between childhood maltreatment (CM) and major depressive disorder (MDD). Dysfunctional attitudes (DAs) play a crucial role in the development of MDD. In this study, we aimed to investigate whether (1) DAs are associated with CM, (2) specific CM types predict specific types of DAs, and (3) higher childhood trauma counts (CTCs) predict more DAs.Methods: One hundred seventy-one MDD participants and 156 healthy controls (HCs) were enrolled for the study. CM was assessed retrospectively with the Childhood Trauma Questionnaire. DAs were evaluated using the Chinese version of the Dysfunctional Attitude Scale–Form A (C-DAS-A). A series of analyses, including multiple analyses of covariance and hierarchical regression analyses, were used in this study to examine the hypotheses.Results: The proportion of CM was 60.2% in the MDD group and 44.2% in the HC group. The 2 × 2 analysis of covariance results showed no interaction effect between CM and MDD on C-DAS-A total score. When the factor scores replaced the C-DAS-A total score, a similar trend was observed. Within the MDD group, emotional abuse (EA) predicted two forms of DAs: self-determination type and overall DAs; physical neglect (PN) was predictive of attraction and repulsion-type DAs. Higher childhood trauma counts significantly predicted more types of DAs in the MDD group.Conclusion: DAs are a trait feature of CM. EA and PN predict specific types of DAs in MDD patients. Higher CTCs predict more DAs in MDD patients.

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