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Christopher F Sharpley,1 Vicki Bitsika,1 Mary E McMillan,1 Emmanuel Jesulola,2 Linda L Agnew11Brain-Behaviour Research Group, University of New England, Armidale, NSW 2351, Australia; 2Emergency Department, Bathurst Base Hospital, Bathurst, NSW 2795, AustraliaCorrespondence: Christopher F SharpleyBrain-Behaviour Research Group, University of New England, Queen Elizabeth Drive, Armidale, NSW 2350, AustraliaTel +61 26 773 2596Email csharpl3@une.edu.auPurpose: Hormonal and inflammatory factors have been suggested as potentially influencing depressive state and depressive symptoms, but rarely compared for their relative contribution to these states and to specific depressive symptoms. This study examined cortisol:C-reactive protein (CRP) ratio, plus cortisol and CRP separately, as correlates of global depression and fatigue-related depression.Patients and methods: One hundred and twenty-six community volunteers from rural Australia provided saliva and serum samples, and also completed a depression inventory.Results: There was a significant correlation between cortisol:CRP ratio and depression-related fatigue, and this resolved to the effects of CRP rather than cortisol. Most of the variance in this association came from patients who were “depressed”, and there were no significant gender associations.Conclusion: Inflammation, rather than HPA-axis activity, was associated with depression-related fatigue, supporting a model that places inflammation as a contributor to one of the major symptoms and predictors of depression. Individualization of therapy for depression-related fatigue in chronically stressed or physically ill patients might benefit from future research into cytokine therapy.Keywords: depression, fatigue, CRP, cortisol

Christopher F Sharpley,1 Vicki Bitsika,2 Mary E McMillan,1 Emmanuel Jesulola,1 Linda L Agnew1 1Brain-Behaviour Research Group, University of New England, Armidale, NSW, Australia; 2Centre for Autism Spectrum Disorders, Bond University, Gold Coast, QLD, Australia Purpose: Depression remains difficult to treat in all cases, and further investigation of the role of genetic and environmental factors may be valuable. This study was designed to investigate the association between the short (s) versus non-short (non-s) 5HTTLPR variants, presence of childhood stressors and recent life stressors, and depression, and to do so at two levels that would expose the associations between total depression scores and also individual depression items.Materials and methods: Two hundred and forty-nine volunteers from one of the Australian Electoral Office electorates covering a large rural land area completed a series of questionnaires about childhood and recent life stress and depression, and provided a buccal cell sample for genotyping the 5-HTTLPR polymorphism into s versus non-s carriers.Results: Although there were no significant differences in the depression scores of the s-carriers versus the non-s carriers, each subtype of the 5-HTTLPR polymorphism showed different patterns of association between childhood stress and depression symptoms, and between recent life stress and depression symptoms.Conclusion: Individualization of therapy for depression may be achieved through consideration of the specific associations that patients exhibit between life stress, 5-HTTLPR polymorphism, and depression symptomatology. Keywords: genes, mental health, life experiences

Vicki Bitsika,1 Christopher F Sharpley2 1Centre for Autism Spectrum Disorder, Bond University, Robina, QLD, Australia; 2Brain-Behaviour Research Group, University of New England, Armidale, NSW, Australia Background: Although there have been suggestions that central coherence may be associated with eating disturbances (EBD) in children with autism spectrum disorder (ASD), relatively little attention has been given to specific aspects of IQ and EDB. Methods: The association between total IQ, perceptual and verbal composite scores and subtests was explored in a sample of 50 high-functioning girls with ASD (mean age = 9.7 years, SD = 2.4 years, range = 6 years to 14 years). Self-reports and mothers’ reports were collected about the girls’ EDB. Results: There were only isolated associations between mothers’ data and the girls’ IQ. Selected aspects of the girls’ self-reported EDB were significantly associated with matrix reasoning. Conclusion: The role of IQ, particularly matrix reasoning, in the assessment and treatment of EDB in girls with ASD, is highlighted by these findings. Keywords: autism, eating disturbance, IQ, global processing

Background: Autism spectrum disorder (ASD) includes symptoms that vary in severity and frequency between children. Consequently, multiple psychometric assessment procedures are recommended to detect an ASD, including scales which asses the presence and nature of ASD-related behaviour. However, to date, few studies have examined the relative and specific contribution which such behaviourally oriented scales can make to the diagnosis of individual children with ASD. Method: Cluster analysis was used to explore the common characteristics of a group of 53 preschool and elementary school children with an ASD, based upon scores on tests of cognitive ability, adaptive behaviour and behavioural checklists designed to measure the presence of typical ASD. Results: Data confirmed the expected variability in intelligence test scores. In addition, measures of adaptive behaviour and data from a behaviourally based rating scale suggested that children with Asperger's Disorder and autism might be reclassified into subgroups according to the presence of particular ASD-specific behaviours. Conclusions: As well as confirming that children with ASD vary in their adaptive behaviour and cognitive levels, these data emphasise the limited contribution such assessment procedures make to an understanding of the child's day-to-day behaviour and functioning, thus arguing for the inclusion of behaviourally based rating scales to develop ideographic intervention plans.

Acute kidney injury (AKI) comprises several syndromes that are associated with a sudden decrease in renal function. AKI is a common condition especially among critically ill patients. It is typically multifactorial and of great prognostic significance. The incidence of AKI has increased while the associated mortality rate has remained unchanged over the last years. Recent definitions of AKI, namely the Risk, Injury, Failure, Loss of renal function and End-stage kidney disease (RIFLE) classifycation or the Acute Kidney Injury Network (AKIN) criteria, incorporate serum creatinine and urine output as the principal markers to define and detect AKI. However, elevated serum creatinine or oliguria were demonstrated to detect AKI at late stages of renal injury when preventive strategies may be less effective. Therefore, there has recently been a great scientific interest in obtainng valuable markers for early AKI detection. In the last 5 years numerous new markers such as neutrophil-gelatinase associated lipocalin, interleukin-18, cystatin C and kidney injury molecule 1 in the urine and/or serum have been studied and proposed as early detection markers of AKI. Persistently, these markers performed well in initial pilot trials. However, these promising results could often not be confirmed in later, larger multicentre trials and limitation of these biomarkers in the early diagnosis of renal injury were discovered. Furthermore, as AKI is multifactorial and heterogeneous in origin, it seems likely that not one single marker but a panel of biomarkers will be required to detect all subtypes of AKI early during their evolution. This has initiated proteomic studies to develop panels of biomarkers which may facilitate early detection of AKI. The present review will focus on the most important clinical studies evaluating the ability of single AKI biomarkers and on those in clinical proteomics that attempted to establish panels of biomarkers in urine for early and accurate AKI diagnosis and prognosis. [ABSTRACT FROM AUTHOR]

Objective: To psychometrically refine a standardized scale for identifying those lifestyle changes that were most likely to contribute to anxiety and depression among prostate cancer (PCa) patients.Methods: Three hundred and eighty-one PCa patients who had received their initial diagnosis between one and 96 months completed a survey of background variables, anxiety and depression inventories and the 36-item Effects of Prostate Cancer upon Lifestyle Questionnaire (EPCLQ).Results: Levels of anxiety (24%) and depression (26%) were similar to those previously reported for PCa patients. The EPCLQ was shown to have satisfactory psychometric properties and significantly predicted anxiety and depression scores and the presence of psychological clinicity among this sample. Factor analysis of the EPCLQ showed that adverse emotions and social withdrawal, plus loss of cognitive ability, were the most powerful predictors of fear, physiological arousal, discomfort and pain factors underlying anxiety; these factors also predicted pessimism and fatigue factors underlying depression.Conclusions: The EPCLQ was shown to be a reliably sound and valid instrument for assessing important lifestyle changes that predict anxiety and depression among PCa patients. In addition, links between receiving a diagnosis and treatment for PCa and development of psychosocial disturbance via emotional negativity, decreased cognitive performance and withdrawal from others appear to warrant further investigation. Copyright (c) 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

A survey of 219 parents of children with autism was administered on a confidential and anonymous basis. As well as tapping information about the nature of the child's disorder, parental well-being (anxiety, depression), parents' daily level of stress arising from parenting, their confidence in handling their child's major difficulty, and the frequency of being stretched beyond their limits were included as dependent variables. Independent variables were: gender of parents, age of child and age of onset, parental health, access to other family members, and level of understanding of those family members of the child's problems. Data indicated that, although social support has previously been posited as an alleviating factor for parental stress, this may be a result of the perceived expertise of the family member who provides respite care for the parents. Issues of self-efficacy, training in behaviour management, and provision of home-based care for parents are discussed. [ABSTRACT FROM AUTHOR]

Abstract Background Although it is well established that prostate cancer (PCa) patients are more likely to experience clinical depression than their age-matched non-prostate cancer peers, and that such depression can have negative effects upon survival, little is known about the underlying nature of the depressive symptomatology that these men experience. In particular, the incidence of melancholic symptoms of depression, which are signs of increased risk of suicide and resistance to treatment, has not previously been reported in PCa patients. The present study aimed to measure the incidence and nature of Melancholia in PCa depression. Method A sample of 507 PCa patients in Queensland, Australia, completed anonymous and confidential questionnaires about their background, treatment status, and depression. Data were analysed to select depressive symptoms that were part of the definition of Melancholia vs those which were not. Regression was used to determine the links between Melancholia and overall depressive status, and factor analysis revealed the underlying components of Melancholia, which were mapped over time since diagnosis for 3 years. Results Psychometric data were satisfactory. Melancholia significantly predicted depressive status for the most depressed subset of patients, but not for the total sample. Melancholia was factored into its components of Anhedonia and Agitation, and the first of these was more powerful in predicting Melancholia. Variability over the 3 years following diagnosis was noted for each of these two components of Melancholia. Conclusions The strong presence of Melancholia in the depressive symptomatology of this sample of PCa patients suggests that some forms of treatment for depression may be more likely to succeed than others. The dominance of Anhedonia and Agitation over other symptoms of Melancholia also holds implications for treatment options when assisting these men to cope with their depression.

Abstract Depression is one of the major contributors to the Total Disease Burden and afflicts about one-sixth of Western populations. One of the most effective treatments for depression focuses upon analysis of causal chains in overt behaviour, but does not include brain-related phenomena as steps along these causal pathways. Recent research findings regarding the neurobiological concomitants of depressive behaviour suggest a sequence of structural and functional alterations to the brain which may also produce a beneficial outcome for the depressed individual--that of adaptive withdrawal from uncontrollable aversive stressors. Linking these brain-based explanations to models of observable contingencies for depressive behaviour can provide a comprehensive explanation of how depressive behaviour occurs and why it persists in many patients.

Relatively little attention has been given to mixed anxiety and depression in autistic youth, particularly how this differs between males and females. This study investigated sex-based differences in the prevalence and correlates of mixed anxiety and depression in a sample of 51 autistic males ( M age = 10.16 yr, SD = 2.81 yr, and range = 6 yr to 17 yr) and 51 autistic females (M age = - 10.07 yr, SD = 2.76 yr, and range = 6 yr to 17 yr), matched for age, IQ, and autism severity. Self-reports on generalised anxiety disorder and major depressive disorder, morning salivary cortisol, ADOS-2 scores, and WASI-II full-scale scores were collected from these autistic youth, and data on the ASD-related symptoms of these youth were collected from their parents. The data were analysed for total anxiety-depression score levels, for the underlying components of this scale, and for the individual items used in the scale. The results indicate no significant sex differences for the prevalence of mixed anxiety and depression total scores or the underlying components of anxiety and depression or for the individual items of the mixed anxiety-depression scale. There were sex differences in the significant correlates of mixed anxiety and depression: morning cortisol and ASD-related difficulties in social interaction for females, and ASD-related behaviour for males. Males' feelings of being restless or edgy were correlated with their social interaction and repetitive and restricted behaviour. Females' difficulties in social interaction were correlated with their concerns about their abilities and their sleeping problems. Females' sleeping problems, their tendency to talk about dying, and feeling worthless, were correlated with their morning cortisol. These findings suggest that, while mixed anxiety and depression is experienced similarly by autistic males and females at the global, component, and individual item levels, specific aspects of the symptomatology of mixed anxiety and depression are differently associated with aspects of their ASD-related symptomatology and their levels of chronic physiological stress for males and females., Competing Interests: Conflicts of InterestNone of the authors have any conflicts of interest to declare., (© 2024 by the authors.)

Psychological resilience (PR) is known to be inversely associated with depression. While there is a growing body of research examining how depression alters activity across multiple functional neural networks, how differences in PR affect these networks is largely unexplored. This study examines the relationship between PR and functional connectivity in the alpha and beta bands within (and between) eighteen established cortical nodes in the default mode network, the central executive network, and the salience network. Resting-state EEG data from 99 adult participants (32 depressed, 67 non-depressed) were used to measure the correlation between the five factors of PR sourced from the Connor-Davidson Resilience Scale and eLORETA-based measures of coherence and phase synchronisation. Distinct functional connectivity patterns were seen across each resilience factor, with a notable absence of overlapping positive results across the depressed and non-depressed samples. These results indicate that depression may modulate how resilience is expressed in terms of fundamental neural activity.

Background/Objectives: Diagnosis of Autism Spectrum Disorder (ASD) relies on the observation of difficulties in social communication and interaction, plus the presence of repetitive and restrictive behaviors. The identification of neurological correlates of these symptoms remains a high priority for clinical research, and has the potential to increase the validity of diagnosis of ASD as well as provide greater understanding of how the autistic brain functions. This study focused on two neurological phenomena that have been previously associated with psychiatric disorders (alpha- and theta-wave asymmetry across the frontal region of the brain), and tested for their association with the major diagnostic criteria for ASD. Methods: A total of 41 male autistic youth underwent assessment with the Autism Diagnostic Observation Schedule (ADOS-2) and 3 min of eyes-closed resting EEG to collect alpha- and theta-wave data from right and left frontal brain sites. Results: Different associations were found for theta versus alpha asymmetry and the ADOS-2 subscales, across different brain regions responsible for a varying range of cognitive functions. In general, theta asymmetry was associated with conversation with others, sharing of enjoyment, and making social overtures, whereas alpha asymmetry was linked with making eye contact, reporting events to others, and engaging in reciprocal social communication. Specific brain regions involved are identified, as well as implications for clinical practice. Conclusions: Specific autism symptoms may be associated with selected brain region activity, providing a neurological basis for diagnosis and treatment.

Melancholia is a major and severe subtype of depression, with only limited data regarding its association with neurological phenomena. To extend the current understanding of how particular aspects of melancholia are correlated with brain activity, electroencephalographic data were collected from 100 adults (44 males and 56 females, all aged 18 y or more) and investigated for the association between symptoms of melancholia and the ratios of alpha/beta activity and theta/beta activity at parietal-occipital EEG sites PO1 and PO2. The results indicate differences in these associations according to the depressive status of participants and the particular symptom of melancholia. Depressed participants exhibited meaningfully direct correlations between alpha/beta and theta/beta activity and the feeling that "Others would be better off if I was dead" at PO1, whereas non-depressed participants had significant inverse correlations between theta/beta activity and "Feeling useless and not needed" and "I find it hard to make decisions" at PO1. The results are discussed in terms of the relative levels of fast-wave (beta) versus slow-wave (alpha, theta) activity exhibited by depressed and non-depressed participants in the parietal-occipital region and the cognitive activities that are relevant to that region.

Purpose: A high incidence of psychosocial problems in prostate cancer patients has been reported including anxiety, depression and distress. These can add to the patients' disease burden and have been associated with unfavorable cancer treatment outcomes. Interventions designed to address them have found limited success, but psychological resilience (PR) training has never been formally tested. The measurement of PR in prostate cancer patients has been described and has been associated with more favorable psychosocial outcomes in these patients but it has never been systematically reviewed. The aim of this study was to conduct the first systematic review of those studies that have measured it using standardized scales and to determine the potential for resilience training to help overcome the significant psychosocial problems faced by prostate cancer patients., Materials and Methods: We searched the literature to identify articles that measured PR among prostate cancer patients., Results: Of 384 articles identified by the search criteria, there were 19 studies suitable for inclusion regarding 5,417 patients. The most commonly-used scale was the original Connor-Davidson Resilience Scale, or an abbreviated version of it. Possible scores range from 0 to 100, mean scores from these studies ranged from 72.9 to 87.1 (standard deviations varied between 13.2 and 16.3). PR was consistently associated with improved psychological outcomes including depression, anxiety and distress, although these were measured with a wide variety of methods making it difficult to quantify the effects. There was also evidence of PR mediating the physical effects of prostate cancer and treatment including urinary symptoms, fatigue and insomnia., Conclusions: As resilience training has been successful in other cancer settings, it seems likely that it could improve the significant adverse psychosocial outcomes that have been reported in prostate cancer patients and trials designed to objectively test it should be encouraged., Competing Interests: The authors have no nothing to disclose., (Copyright © 2024 Korean Society for Sexual Medicine and Andrology.)

Objectives: Prostate cancer (PCa) patients often experience depression. One possible buffer against stress-related depression is psychological resilience (PR), which has been described as heterogeneous in structure, like major depressive disorder (MDD). Although both of these constructs are central to understanding and assisting distressed PCa patients, no data have been reported on how they connect via network arrays at a component and symptom level. Such information has the potential to inform clinical practice with depressed PCa patients., Methods: Using a cross-sectional design, 555 PCa patients completed the Patient Health Questionnaire-9 (PHQ-9) and the Connor-Davison Resilience Scale (CDRISC). Data were analysed via network analysis., Results: Network analysis indicated that various CDRISC factors interacted with different PHQ-9 symptoms. For example, trust in one's instincts, tolerance of negative affect, and strengthening effects of stress (CDRISC) was associated with concentration problems and suicidal ideation (PHQ-9); positive acceptance of change, and secure relationships (CDRISC) was linked to low self-worth, anhedonia, fatigue/lethargy, motor problems, depressed mood, and concentration and appetite problems (PHQ-9). Similarly heterogeneous associations were found between individual CDRISC items and PHQ-9 symptoms. Network analytic figures depict both these sets of associations., Conclusions: As well as confirming the heterogeneous nature of PR and MDD in PCa patients, these findings argue for the further development of 'individualised' medicine approaches when working with PCa patients and their experiences of depression., (© 2023 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.)

Depression is associated with frontal alpha asymmetry (FAA) and Psychological Resilience (PR), although in different ways. Only cursory attention has been given to how these three constructs interact despite the possible clinical and research implications of those associations. One limitation of recent research into these associations has been conceptualising PR as a unitary construct, whereas it has been shown to be multi-component. This study investigated the underlying components of PR, their correlations with FAA, and the effect that participants' depressive status had upon those correlations in a community sample of 54 males and 46 females aged between 18 yr and 75 years. Results confirmed the overall inverse association between total PR and depression for four of the original five PR components and for one of the two components found in this sample. Similarly, there were differences between the ways that FAA and PR components were associated, depending upon the depressive status of participants. Source localisation data indicated that the PR components were not uniformly correlated with alpha activity in the same brain regions. These findings of content, efficacy, and neurophysiological differences between the five components of PR and their associations with FAA argue against consideration of PR as a unitary construct.

Alpha wave asymmetry inconsistently correlates with Major Depressive Disorder (MDD). One possible reason for this inconsistency is the heterogeneity of MDD, leading to study of depressive 'subtypes', one of which is Melancholia. To investigate the correlation between Melancholia and alpha-wave asymmetry, 100 community participants (44 males, 56 females; aged at least 18 yr) completed the Zung self-rated Depression Scale, and underwent 3 min of eyes closed EEG recording from 24 scalp sites. There was no significant correlation between EEG data and Melancholia total score for the entire sample, but there was for those participants who had clinically significant depression (n = 33). When examined at the level of individual Melancholia scale items, significant EEG data correlations were found for some of the items but not for others. Factor analysis revealed a two-factor structure for the Melancholia scale, only one of which exhibited significant correlations with EEG AA data. Further exploration of those data identified two subcomponents of that Melancholia factor, one which was inversely correlated with frontal alpha asymmetry, and another which was directly correlated with parietal-occipital alpha wave asymmetry. These findings suggest that Melancholia may itself be heterogeneous, similarly to MDD, and rely upon different aspects of cognitive function., Competing Interests: Declaration of Competing Interest None of the authors has any conflict of interest to declare., (Copyright © 2023. Published by Elsevier B.V.)

Introduction: Although depression is widespread carries a major disease burden, current treatments remain non-universally effective, arguably due to the heterogeneity of depression, and leading to the consideration of depressive "subtypes" or "depressive behavior subtypes." One such model of depressive behavior (DB) subtypes was investigated for its associations with frontal lobe asymmetry (FLA), using a different data analytic procedure than in previous research in this field., Methods: 100 community volunteers (54 males, 46 females) aged between 18 yr. and 75 years ( M  = 32.53 yr., SD = 14.13 yr) completed the Zung Self-rating Depression Scale (SDS) and underwent 15 min of eyes closed EEG resting data collection across 10 frontal lobe sites. DB subtypes were defined on the basis of previous research using the SDS, and alpha-wave (8-13 Hz) data produced an index of FLA. Data were examined via network analysis., Results: Several network analyses were conducted, producing two models of the association between DB subtypes and FLA, confirming unique neurophysiological profiles for each of the four DB subtypes., Discussion: As well as providing a firm basis for using these DB subtypes in clinical settings, these findings provide a reasonable explanation for the inconsistency in previous FLA-depression research., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Sharpley, Bitsika, Arnold, Shadli, Jesulola and Agnew.)

Purpose: Caring for an autistic child is associated with elevated stress, anxiety and depression. Although some data suggest that 'child' or 'carer' factors may moderate the severity of carer distress, relatively few international comparisons have been made, limiting the generalizability of previous findings. This study aimed to address this issue., Method: A survey-based comparison was made of carers from three nations (Australia, Denmark, Greece), and the effects of demographic, child, and carer variables upon carer anxiety and depression were investigated., Results: Only limited cross-nation consistency was found for nation, child, or carer variables and their effects upon carer anxiety or depression., Conclusion: The application of universal treatment models for carer anxiety and depression may be of differing value across nations., Competing Interests: No potential conflict of interest was reported by the authors., (© The British Society of Developmental Disabilities 2023.)

To investigate possible contributors to the inconsistent association between frontal lobe asymmetry (FLA) and depression, EEG data were collected across five frontal sites, and examined for their associations with four subtypes of depression (Depressed mood, Anhedonia, Cognitive depression, Somatic depression). One hundred community volunteers (54 males, 46 females) aged at least 18 yr completed standardized scales for depression and anxiety, and gave EEG data under Eyes Open and Eyes Closed conditions. Results indicated that, although there was no significant correlation between the differences in EEG power across each of the five pairs of frontal sites and total depression scores, there were several meaningful correlations (accounting for at least 10% of the variance) between specific EEG site differences data and each of the four depression subtypes. There were also different patterns of association between FLA and the depression subtypes according to sex, and total depression severity. These findings help to explain the apparent inconsistency in previous FLA-depression results, and argue for a more nuanced approach to this hypothesis., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Objectives: Many prostate cancer patients also suffer from depression, which can decrease their life satisfaction and also impede recovery from their cancer. This study described the network structure of depressive symptomatology in prostate cancer patients, with a view to providing suggestions for clinical interventions for depressed patients., Methods: Using a cross-sectional design, 555 prostate cancer patients completed the Patient Health Questionnaire-9 (PHQ-9)., Results: Network analysis and multidimensional scaling indicated that anhedonia was the most central symptom for these men, and that several sets of depression symptoms were closely associated with each other. These included anhedonia-depressed mood; sleeping problems-fatigue/lethargy; and suicidal ideation-low self-worth-depressed mood. Other depression symptoms such as appetite problems, concentration problems, and motor problems, were less well-related with the remainder of the network. Patients receiving treatment for reocurring prostate cancer (PCa) had significantly higher PHQ9 scores than patients undergoing their initial treatment, but no major differences in their network structures. Implications for clinical practice were derived from the relationships between individual depression symptoms and the overall depression network by examining node predictability., Conclusions: The use of total depression scores on an inventory does not reflect the underlying network structure of depression in PCa patients. Identification and treatment of the central symptom of anhedonia in PCa patients suggests the need to adopt specific therapies that are focussed upon this symptom., (© 2022 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.)

This study aimed to investigate the moderating effect of psychological resilience on sleep-deterioration-related depression among patients with prostate cancer, in terms of the total score and individual symptoms. From a survey of 96 patients with prostate cancer, 55 who reported a deterioration in their sleep quality since diagnosis and treatment completed the Zung Self-Rating Depression Scale, Connor-Davidson Resilience Scale, and the Insomnia Severity Index. Moderation analysis was conducted for the scale total scores and for the 'core' symptoms of each scale within this sample, based on data analysis. Interaction analysis was used to identify key associations. The moderation analysis suggested that psychological resilience moderated the depressive effect of sleep deterioration that patients reported occurred after their diagnosis and treatment and did so at the total and 'core' symptom levels of being able to see the humorous side of things and to think clearly when under pressure, but there was an interaction between this moderating effect, the strength of psychological resilience, and severity of sleep deterioration. Although it appears to be a successful moderator of depression arising from sleep deterioration that was reported by patients with prostate cancer, the effectiveness of psychological resilience is conditional upon the severity of patients' sleep difficulties and the strength of their psychological resilience. Implications for the application of resilience training and concomitant therapies for patients with prostate cancer with sleep difficulties and depression are discussed.