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Background: Despite growing evidence linking loneliness and depressive symptoms, the underlying pathways remain unclear. This study aims to assess the impact of loneliness on depressive symptoms among Chinese adolescents and investigate the potential mediating role of sleep disturbance., Methods: A cross-sectional study was conducted between November and December 2021. Loneliness, depressive symptoms, and sleep disturbance were assessed using the UCLA Loneliness Scale, the 9-item Patient Health Questionnaire, and the Pittsburgh Sleep Quality Index questionnaire, respectively. Baron and Kenny's causal steps method and the Karlson-Holm-Breen method were applied to explore the mediating role of sleep disturbance. Subgroup analysis by gender was also conducted., Results: A total of 6838 adolescents were included, with 52.2 % boys and a mean age of 14.5 (SD = 1.6) years. Approximately 15.8 % of the adolescents reported depressive symptoms. Loneliness was positively associated with depressive symptoms after controlling for covariates (OR = 1.34, 95%CI = 1.31-1.36). After incorporating sleep disturbance into the model, the association was still significant (OR = 1.28, 95%CI = 1.25-1.31). Sleep disturbance partially mediated this association, contributing to 18.89 % of the total effects. The associations and mediation effects were consistent across both genders, with no moderating effect of gender observed., Limitations: The cross-sectional design limits the ability to establish causality., Conclusion: Loneliness was significantly associated with depressive symptoms in Chinese adolescents and this association was partially mediated by sleep disturbance. Interventions aimed at reducing loneliness and improving sleep quality may help lower the risk of depressive symptoms in Chinese adolescents, regardless of genders. Nevertheless, further randomized controlled trials are needed to confirm these findings., Competing Interests: Declaration of competing interest The authors declare that they had no conflict of interest during the preparation and publication of this study., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Depression is a common mental health disorder, and in recent years, the incidence of various forms of depression has been on the rise. Most medications for depression are highly dependency-inducing and can lead to relapse upon discontinuation. Therefore, novel treatment modalities and therapeutic targets are urgently required. Traditional Chinese medicine (TCM) offers advantages in the treatment of depression owing to its multi-target, multi-dimensional approach that addresses the root cause of depression by regulating organ functions and balancing Yin and Yang, with minimal side effects. Cynaroside (CNS), an extract from the traditional Chinese herb honeysuckle, is a flavonoid compound with antioxidant properties. In this study, network pharmacology identified 44 potential targets of CNS associated with depression and several highly correlated inflammatory signaling pathways. CNS alleviated LPS-induced M1 polarization and the release of inflammatory factors in BV-2 cells. Transcriptomic analysis and validation revealed that CNS reduced inflammatory polarization, lipid peroxidation, and ferroptosis via the IRF1/SLC7A11/GPX4 signaling pathway. In vivo experiments showed that CNS treatment had effects similar to those of fluoxetine (FLX). It effectively ameliorated anxiety-, despair-, and anhedonia-like states in chronic unpredictable mild stress (CUMS)-induced mice and reduced microglial activation in the hippocampus. Thus, we conclude that CNS exerts its therapeutic effect on depression by inhibiting microglial cells from polarizing into the M1 phenotype and reducing inflammation and ferroptosis levels. This study provides further evidence that CNS is a potential antidepressant, offering new avenues for the treatment of depression., Competing Interests: Declaration of Competing Interest The authors declare that there are no financial or other competing interests., (Copyright © 2024. Published by Elsevier Masson SAS.)

Background: Patients with cancer are vulnerable to depression or other depressive conditions. The aim of this paper was to evaluate the efficacy and safety of Chinese herbal medicine (CHM) for the treatment of depression or depressive symptoms in cancer patients., Methods: CENTRAL, MEDLINE, EMBASE, PsycINFO, CNKI, VIP, SinoMed, and online clinical trial registry websites were searched for relevant RCTs until May 2017. The methodological quality of each included study was assessed with the "risk of bias" tool. Review Manager 5.3.5 was used to analyze the data., Results: We identified 18 RCTs that included data from 1441 participants. Twelve different types of Chinese herbal preparations were investigated by these studies, and they showed a better therapeutic effect in most comparisons when measured in terms of depression rating scale scores, with SMDs (95% CI) of - 2.30 (- 3.54, - 1.05) (CHM versus no treatment), - 0.61 (- 1.03, - 0.18) (CHM versus antidepressants), and - 0.55 (- 1.07, - 0.02) (CHM plus psychological treatments versus psychological treatments), or when measured in terms of treatment response rate, with RRs (95% CI) of 1.65 (1.19, 2.29) (CHM versus no treatment), 1.15 (1.03, 1.28) (CHM versus psychological treatments), 1.32 (1.07, 1.63) (CHM plus antidepressants versus antidepressants), and 1.70 (1.02, 2.85) (CHM plus psychological treatments versus psychological treatments). Compared with antidepressants, these CHMs showed borderline superiority for improving the response rate, with an RR (95% CI) of 1.08 (0.93, 1.26). Subgroup analysis based on psychiatric diagnosis (depression versus depressive symptoms) did not modify the direction of these estimates and neither could it explain the high level of heterogeneity. Patients in the CHM group experienced fewer adverse events of cardiac toxicity (P = 0.02), functional gastrointestinal disorders (P = 0.008), sleep disturbances (P = 0.02), blurred vision (P = 0.02) and fatigue (P = 0.03) than the patients in the no treatment group or the antidepressants group., Conclusions: According to the investigation of the twelve herbal preparations, the CHM intervention appears to alleviate depressive symptoms in cancer patients, either alone or combined with antidepressants or psychological treatments. However, a high risk of bias and high heterogeneity made the mean estimates uncertain. Well-designed trials with comprehensive and transparent reporting are warranted in the future.

Depression is a common psychiatric disorder and a leading cause of disability worldwide. Traditional Chinese medicine is one of the commonly used complementary and alternative medicine therapies for depression. Clinical trials have been carried out to assess the efficacy and safety of Chinese herbal medicine currently. The exploration of herbal mechanisms of action used for the treatment of depression has also received great attention. This study is performed to summarize the frequently used formulae, patent drugs and single herbs in treating depression, review the literatures of clinical trials in treating depressive disorders, and to list the possible mechanisms involved during the treatment. Besides, we will analyze the limitations of present studies and the obstacles in the modernization of traditional Chinese medicine., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.)