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Depression is a pressing yet underdiagnosed issue in health management. Because depressed patients share their symptoms, life events, and treatments on digital platforms, information systems (IS) scholars resort to user-generated digital traces for depression detection. While they facilitate innovative information technology (IT) approaches to alleviate the social and economic burden of depression, most studies lack effective means to incorporate domain knowledge in depression detection systems or suffer from feature extraction difficulties. Following the design science research in IS, we propose a Deep-Knowledge-Aware Depression Detection system to detect social media users at risk of depression and explain the detection factors. We deploy extensive empirical analyses to evaluate our designed IT artifact, which shows domain knowledge greatly improves performance. Our work has significant implications for IS research in knowledge-aware machine learning, digital traces utilization, and generalizable design principles. Practically, the early detection and factor explanation from our IT artifact can assist depression management and enable large-scale assessment of the population's mental health. [ABSTRACT FROM AUTHOR]

Depression is a significant public health issue, closely associated with epilepsy and oxidative stress (OS). This study aims to explore the level of OS in patients with epilepsy and its relationship with moderate to severe depression (MSD). This cross-sectional study includes 10,819 participants aged 20–80 from the National Health and Nutrition Examination Survey (NHANES) database (2013–2020 pre-pandemic). Depression symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), and epilepsy was diagnosed based on antiepileptic drug use in the past 30 days. The oxidative balance score (OBS) was calculated from dietary recall and lifestyle habits over the previous 24 h. Compared to non-epileptic subjects, epileptic patients have a significantly higher prevalence of depression. Epileptic patients exhibit lower OBS and Dietary Oxidative Balance Scores (DOBS), while there is no significant difference in Lifestyle Oxidative Balance Scores (LOBS). Depressed patients show lower OBS, DOBS, and LOBS. The mediation model indicates that DOBS mediates 3.44 % of epilepsy-related MSD. Epileptic patients exhibit significantly higher levels of OS and consume more pro-oxidant foods compared to the general population. However, their lifestyle habits do not differ significantly from those of the control group. Additionally, epileptic patients are at a higher risk of developing MSD. Although a pro-oxidant diet may be associated with epilepsy-mediated MSD, its mediating effect is relatively weak. • Epileptic patients consume more pro-oxidant foods than non-epileptic patients, despite similar lifestyle habits. • The Dietary Oxidative Balance Score (DOBS) influences the relationship between epilepsy and depression. • DOBS mediates 3.44% of epilepsy-related moderate to severe depression (MSD). [ABSTRACT FROM AUTHOR]

The relationship between depression and gut microbiota remains unclear, but an important role of gut microbiota has been verified. The relationship between gut microbiota and antibiotic resistance genes (ARGs) may be a potential new explanatory pathway. We collected samples from 63 depressed patients and 30 healthy controls for metagenomic sequencing. The two groups' microbiota characteristics, functional characteristics, and ARG differences were analyzed. We obtained 30 differential KEGG orthologs (KOs) and their producers in 5 genera and 7 species by HUMAnN3. We found 6 KOs from Weissella_cibaria and Lactobacillus_plantaru are potentially coring functional mechanism of gut microbiota. Different metabolites including sphingolipids, pyrans, prenol lipids, and isoflavonoids also showed significance between MDD and HC. We detected 48 significantly different ARGs: 5 ARGs up-regulated and 43 ARGs down-regulated in MDD compared to HC. Based on Cox model results, Three ARGs significantly affected drug efficacy (ARG29, ARG105, and ARG111). Eggerthella, Weissella, and Lactobacillus were correlated with different core ARGs, which indicated different mechanisms in affecting MDD. The present study needs to be replicated in different ethnic groups. At the same time, a larger Chinese cohort study and detailed experimental verification are also the key to further discussion. Our findings suggest that ARGs play a role in the interplay between major depressive disorder and gut microbiota. The role of ARGs should be taken into account when understanding the relationship between depression and gut microbiota. • We detected 48 significantly different ARGs: 5 ARGs up-regulated and 43 ARGs down-regulated in MDD compared to HC. • Based on Cox model results, Three ARGs significantly affected drug efficacy (ARG29, ARG105, and ARG111). • Eggerthella, Weissella, and Lactobacillus were correlated with different core ARGs to affect MDD. [ABSTRACT FROM AUTHOR]

Major depressive disorder (MDD) and borderline personality disorder (BPD) often co-occur, with 20 % of adults with MDD meeting criteria for BPD. While MDD is typically diagnosed by symptoms persisting for several weeks, research suggests a dynamic pattern of symptom changes occurring over shorter durations. Given the diagnostic focus on affective states in MDD and BPD, with BPD characterized by instability, we expected heightened instability of MDD symptoms among depressed adults with BPD traits. The current study examined whether BPD symptoms predicted instability in depression symptoms, measured by ecological momentary assessments (EMAs). The sample included 207 adults with MDD (76 % White, 82 % women) recruited from across the United States. At the start of the study, participants completed a battery of mental health screens including BPD severity and neuroticism. Participants completed EMAs tracking their depression symptoms three times a day over a 90-day period. Using self-report scores assessing borderline personality disorder (BPD) traits along with neuroticism scores and sociodemographic data, Bayesian and frequentist linear regression models consistently indicated that BPD severity was not associated with depression symptom change through time. Diagnostic sensitivity and specificity may be restricted by use of a self-report screening tool for capturing BPD severity. Additionally, this clinical sample of depressed adults lacks a comparison group to determine whether subclinical depressive symptoms present differently among individuals with BPD only. The unexpected findings shed light on the interplay between these disorders, emphasizing the need for further research to understand their association. • Depression symptoms were measured through ecological momentary assessments (EMAs) three times a day over a ninety-day period. • Borderline personality disorder traits were not linked to instability of overall or individual depressive symptoms across time. • Findings diverged from expectations and highlight the need for further research on the relationship between BPD and MDD. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusions There is a “traditional belief” that antidepressant side effect complaints improve with medication persistence; however, support for this theory has remained inconclusive. We aimed to examine if side effect complaints improved over time by modeling the relationship between side effect complaints and time at dropout for patients receiving citalopram during the first level of acute treatment in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial.We categorized the 2833 patients into five patterns by week of dropout. We used pattern‐mixture modeling to model change in side effect complaints (frequency, intensity, and burden) over the 12‐week course of treatment, while accounting for attrition and depressive severity. Using post‐hoc linear contrasts, we compared the attrition patterns with the completers' pattern for severity of side effect complaints at each respective last visit prior to dropout as well as averaged side effect complaints across the duration of treatment. We also reported frequencies and tolerability of side effects for nine organ/function systems over the course of treatment.Patients who dropped out early exhibited worsening side effect burden and patients who dropped out later showed improvements in side effect frequency and intensity. Treatment completers improved in all side effect complaints over the course of treatment. Early attrition patterns had more severe side effect complaints for both tests of post‐hoc linear contrasts than later attrition patterns and completers.Side effect complaints from antidepressant treatment improve over time, but only for some types of patients. As a precaution for early dropout, clinicians should monitor patients who exhibit worsening and more severe side effect complaints—especially in the first 6 weeks of antidepressant treatment. In addition, clinicians may want to consider changing the type of treatment early on for these patients, rather than encouraging them to persist with their current medication. [ABSTRACT FROM AUTHOR]

• Abnormal functional connectivity was maintained throughout the whole sleep onset process in patients. • Depressed patients exhibited increased functional connectivity and inter-hemispheric long-range links. • Healthy controls showed more significant rates of change in EEG activity during sleep onset. Sleep disorders constitute a principal diagnostic criterion for depression, potentially reflecting the abnormal persistence of brain activity during the sleep onset (SO) transition. Here, we sought to explore the differences in the dynamic changes in the EEG activity and the EEG functional connectivity (FC) during the SO transition in depressed patients. Overnight polysomnography recordings were obtained from thirty-two depressed patients and thirty-three healthy controls. The multiscale permutation entropy (MSPE) and EEG relative power were extracted to characterize EEG activity, and weighted phase lag index (WPLI) was calculated to characterize EEG FC. The intergroup differences in EEG activity of relative power and MSPE were reversed near SO, which attributed to slower rates of change among depressed patients. Regarding the characteristics of the EEG FC network, depressed patients exhibited significantly higher inter-hemispheric and interregional WPLI values in both delta and alpha bands throughout the SO transition, concomitant with different dynamic properties in the delta band FC. During the process after SO, patients exhibited increased inter-hemispheric long-range links, whereas controls showed more intra-hemispheric ones. Finally, we found significant correlations in the dynamic changes between different EEG measures. Our research revealed that the abnormal changes during the SO transition in depressed patients were manifested in both homeostatic and dynamic aspects, which were reflected in EEG FC and EEG activity, respectively. These findings may elucidate the mechanism underlying sleep disorders in depression from the perspective of neural activity. [ABSTRACT FROM AUTHOR]

Objective diagnostic approaches need to be tested to enhance the efficacy of depression detection. Non-invasive EEG-based identification represents a promising area. The present EEG study addresses two central questions: 1) whether inner or overt speech condition result in higher diagnositc accuracy of depression detection; and 2) does the affective nature of the presented emotion words count in such diagnostic approach. A matched case-control sample consisting of 10 depressed subjects and 10 healthy controls was assessed. An EEG headcap containing 64 electrodes measured neural responses to experimental cues presented in the form of 15 different words that belonged to three emotional categories: neutral, positive, and negative. 120 experimental cues was presented for every participant, each containing an "inner speech" and an "overt speech" segment. An EEGNet neural network was utilized. The highest diagnostic accuracy of the EEGNet model was observed in the case of the overt speech condition (i.e. 69.5%), while a an overall subject-wise accuracy of 80% was achieved by the model. Only a negligible difference in diagnostic accuracy could be found between aggregated emotion word categories, with the highest accuracy (i.e. 70.2%) associated with the presentation of positive emotion words. Model decision was primarily influenced by electrodes representing the regions of the left parietal, the left temporal lobe and the middle frontal areas. While the generalizability of our results is limited by the small sample size and potentially uncontrolled confounders, depression was associated with sensitive and presumably network-like aspects of these brain areas, potentially implying a higher level of emotion regulation that increases primarily in open communication. • Depression can be identified by EEG signals primarily in the overt speech condition. • The EEGNet model revealed network-like neural aspects underlying depression. • Depression is marked by increased emotion regulation to positive emotion words. • The findings may partly explain the tendency of depressed people to internalize. [ABSTRACT FROM AUTHOR]

• CRP and IL-6 are elevated in females with depression, but not in males. • No sex differences existed in the relation between TNF-α and depression. • The depression-inflammation link may depend on sex and symptom dimensions. • These findings could inform future sex-specific treatments. Major Depressive Disorder (MDD) is a heterogeneous disorder that affects twice as many women than men. Precluding advances in more tailored and efficacious treatments for depression is the lack of reliable biomarkers. While depression is linked to elevations in inflammatory immune system functioning, this relationship is not evident among all individuals with depression and may vary based on symptom subtypes and/or sex. This systematic review and meta-analysis examined whether inflammatory immune peripheral markers of depression are sex-specific. PRISMA guidelines were followed for the systematic review, and a comprehensive search strategy that identified studies from PubMed and PsycInfo was applied. Studies were included if they reported C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor (TNF)-α and/or IL-1β for males and/or females among depressed and healthy adults. We identified 23 studies that satisfied these inclusion criteria. Random-effects meta-analysis models were fit, and measures of association were summarized between levels of circulating markers of inflammation in depressed and healthy males and females. Sex-based analyses revealed elevated levels of CRP among females with depression (Cohen's d = 0.19) relative to their healthy counterparts (p = 0.02), an effect not apparent among males (Cohen's d = -0.01). Similarly, levels of IL-6 were increased among females with depression compared to healthy controls (Cohen's d = 0.51; p = 0.04), but once again this was not found among males (Cohen's d = 0.16). While TNF-α levels were elevated among individuals with depression compared to controls (p = 0.01), no statistically significant sex differences were found. The meta-analysis for IL-1β resulted in only three articles, and thus, results are presented in the supplemental section. This meta-analysis advances our understanding of the unique involvement of inflammatory biomarkers in depression among men and women, which may help inform more tailored sex-specific treatment approaches in the future. [ABSTRACT FROM AUTHOR]

Comparisons between bona fide psychological therapies generally report no effects or small effects favoring cognitive behavioral therapy (CBT), suggesting that differences between therapy modalities are of little importance. An observational, cohort study of patients (N = 11,116), drawn from the English Talking Therapies program. Patients presented with depression and were treated by CBT or person-centered experiential therapy (PCET), 67 % were female and the age range was 15–94. Multilevel modeling was used to identify variables associated with outcomes and CBT and PCET outcomes were compared dependent on the number of sessions patients attended and the severity of their depression at intake. Although overall a small effect size of 0.14 (0.10, 0.18) favored CBT, we found differing effect sizes depending on patient severity and the number of sessions they had attended at outcome. For non-clinical and moderately depressed patients no significant differences between therapies were found. For moderately-severe and severe patients there was a crossover in effectiveness with PCET more effective up to 5 or 6 sessions and CBT more effective thereafter. However, small effects in favour of PCET were unreliable. The largest effects were found for CBT for patients who were moderately-severe and had >10 sessions (d = 0.30, 0.12, 0.48) or were severe and had >12 sessions (d = 0.26 (0.02, 0.49). No data was available on therapy allocation decisions or therapists and the results may not be generalizable to non-NHS Talking Therapies services. Small effects can mask important contextual differences between therapies and their study can inform allocation decisions. • The benefits of longer therapy duration were moderated by therapy type • Little difference between PCET and CBT for non-clinical or moderately depressed patients • The therapy type*sessions interaction yielded a crossover in effectiveness in the full sample and the more severe subgroups • CBT especially effective with moderately-severe and severely depressed patients who had over 10 sessions • Small effects translate to large numbers of patients in large routine services [ABSTRACT FROM AUTHOR]

Disrupted cellular communication, inflammatory responses and mitochondrial dysfunction are consistently observed in late-life depression (LLD). Exosomes (EXs) mediate cellular communication by transporting molecules, including mitochondrial DNA (EX-mtDNA), playing critical role in immunoregulation alongside tumor necrosis factor (TNF). Changes in EX-mtDNA are indicators of impaired mitochondrial function and might increase vulnerability to adverse health outcomes. Our study examined EX-mtDNA levels and integrity, exploring their associations with levels of TNF receptors I and II (TNFRI and TNFRII), and clinical outcomes in LLD. Ninety older adults (50 LLD and 40 controls (HC)) participated in the study. Blood was collected and exosomes were isolated using size-exclusion chromatography. DNA was extracted and EX-mtDNA levels and deletion were assessed using qPCR. Plasma TNFRI and TNFRII levels were quantified by multiplex immunoassay. Correlation analysis explored relationships between EX-mtDNA, clinical outcomes, and inflammatory markers. Although no differences were observed in EX-mtDNA levels between groups, elevated levels correlated with poorer cognitive performance (r = −0.328, p = 0.002) and increased TNFRII levels (r = 0.367, p = 0.004). LLD exhibited higher deletion rates (F (83,1) = 4.402, p = 0.039), with a trend remaining after adjusting for covariates (p = 0.084). Deletion correlated with poorer cognitive performance (r = −0.335, p = 0.002). No other associations were found. Cross-sectional study with a small number of participants from a specialized geriatric psychiatry treatment center. Our findings suggest that EX-mtDNA holds promise as an indicator of cognitive outcomes in LLD. Additional research is needed to further comprehend the role of EX-mtDNA levels/integrity in LLD, paving the way for its clinical application in the future. • Depressed older adults exhibited higher estimated deletion rate in mitochondrial DNA within exosomes (EX-mtDNA). • EX-mtDNA instability, marker of impaired mitochondrial function, may heighten susceptibility to adverse health outcomes. • The EX-mtDNA instability holds potential as indicator of inflammation status and cognitive outcomes in late-life depression. [ABSTRACT FROM AUTHOR]

Background: Peripheral inflammation is often associated with depressive disorders, and immunological biomarkers of depression remain a focus of investigation. Methods: We performed RNA-seq analysis of RNA transcripts of human peripheral blood mononuclear cells from a case-control study including subjects with self-reported depression in the pre-symptomatic state of major depressive disorder and analyzed differentially expressed genes (DEGs) and the frequency of intron retention (IR) using rMATS. Results: Among the statistically significant DEGs identified, the 651 upregulated DEGs were particularly enriched in the term "bacterial infection and phagocytosis", whereas the 820 downregulated DEGs were enriched in the terms "antigen presentation" and "T-cell proliferation and maturation". We also analyzed 158 genes for which the IR was increased (IncIR) and 211 genes for which the IR was decreased (DecIR) in the depressed subjects. Although the Gene Ontology terms associated with IncIR and DecIR were very similar to those of the up- and downregulated genes, respectively, IR genes appeared to be particularly enriched in genes with sensor functions, with a preponderance of the term "ciliary assembly and function". The observation that IR genes specifically interact with innate immunity genes suggests that immune-related genes, as well as cilia-related genes, may be excellent markers of depression. Re-analysis of previously published RNA-seq data from patients with MDD showed that common IR genes, particularly our predicted immune- and cilia-related genes, are commonly detected in populations with different levels of depression, providing validity for using IR to detect depression. Conclusion: Depression was found to be associated with activation of the innate immune response and relative inactivation of T-cell signaling. The DEGs we identified reflect physiological demands that are controlled at the transcriptional level, whereas the IR results reflect a more direct mechanism for monitoring protein homeostasis. Accordingly, an alteration in IR, namely IncIR or DecIR, is a stress response, and intron-retained transcripts are sensors of the physiological state of the cytoplasm. The results demonstrate the potential of relative IR as a biomarker for the immunological stratification of depressed patients and the utility of IR for the discovery of novel pathways involved in recovery from depression. [ABSTRACT FROM AUTHOR]

Objective: Depression negatively affects interpersonal functioning and influences nonverbal behavior. Interpersonal theories of depression suggest that depressed individuals engage in behaviors that initially provoke others’ support and reassurance, but eventually lead to rejection that may also be expressed nonverbally. Methods: This study investigated movement synchrony as a nonverbal indicator of support and rejection and its association with depression severity in a sample of depressed and healthy individuals. Semi-standardized diagnostic interview segments with N = 114 dyads were video recorded. Body movement was analyzed using Motion Energy Analysis, synchrony intervalswere identified by computingwindowed cross-lagged correlation and a peak-picking-algorithm. Depression severity was assessed via both self-rating (BDI-II) and clinician rating (HAMD). Results: Both self-rated and clinician-rated depression severity were negatively correlated with patient-led, but not clinician-led movement synchrony measures. The more depressed patients were, the less they initiated movement synchrony with their clinicians. These correlations remained significant after controlling for gender, age, gross body movement, and psychopharmacological medication. Conclusion: Findings suggest that depression may negatively affect patients’ active initiative in interaction situations. Automatized methods as used in this study can add valuable information in the diagnosis of depression and the assessment of associated social impairments. [ABSTRACT FROM AUTHOR]

Background: Depression and tooth loss are associated with the occurrence of systemic disease or the progression of multi-factorial disease, and both are considered important public health issues by World Health Organization (WHO). Previous research just suggested that tooth loss can generate psychological stress, low self-esteem, anxiety and other emotional disturbances. However, the precise correlation and underlying mechanisms between depression and tooth loss remains poorly understood. ​Consequently, we aim to explore the association between depression and tooth loss through a cross-sectional study, as well as investigate potential pathways of influence. Methods: We analyzed data from the National Health and Nutrition Examination Survey (NHANES). Logistic regression models were employed to examine the relationship between depression and tooth loss, as well as the associations among healthy lifestyle, systemic immune-inflammation index (SII), depression and tooth loss. Through the mediating effect analysis by bootstrapping analysis, we evaluated the mediating effects of healthy lifestyle and SII between depression and tooth loss. Results: Depressed patients were more likely to be toothless, and at the same time showed a tendency to have more missing teeth, with odds ratio (OR) = 1.305 (1.098, 1.551), p = 0.003 for 1–7 missing teeth, OR = 1.557 (1.166, 2.079), p = 0.003 for 8–14 missing teeth, and OR = 1.960 (1.476, 2.603), p<0.001 for 15–28 missing teeth. Lower healthy lifestyle scores and higher SII were both associated with more tooth loss. Healthy lifestyle and SII played a partial mediating role in this relationship, with a mediating effect ratio of 41.691% and 3.289%, respectively. Conclusions: ​Depression was positively associated with more severe tooth loss, which was partly mediated by lifestyle and SII. Therefore, attention should also be paid to the effects of depression as a mental disorder on physical health, such as depression and tooth loss. Adopting a healthier lifestyle and controlling systemic inflammation may be potential ways to reduce the impact of depression and tooth loss. [ABSTRACT FROM AUTHOR]

Major Depressive Disorder, or depression, has been extensively linked to dysregulated HPA axis function, chronic inflammation and cardiovascular diseases. While the former two have been studied in depth, the mechanistic connection between depression and cardiovascular disease is unclear. As major mediators of vascular homeostasis, vascular pathology and immune activity, endothelial cells represent an important player connecting the diseases. Exaggerated inflammation and glucocorticoid function are important topics to explore in the endothelial response to MDD. Glucocorticoid resistance in several cell types strongly promotes inflammatory signaling and results in worsened severity in many diseases. However, endothelial health and inflammation in chronic stress and depression are rarely considered from the perspective of glucocorticoid signaling and resistance. In this review, we aim to discuss (1) endothelial dysfunction in depression, (2) inflammation in depression, (3) general glucocorticoid resistance in depression and (4) endothelial glucocorticoid resistance in depression co-morbid inflammatory diseases. We will first describe vascular pathology, inflammation and glucocorticoid resistance separately in depression and then describe their potential interactions with one another in depression-relevant diseases. Lastly, we will hypothesize potential mechanisms by which glucocorticoid resistance in endothelial cells may contribute to vascular disease states in depressed people. Overall, endothelial-glucocorticoid signaling may play an important role in connecting depression and vascular pathology and warrants further study. [ABSTRACT FROM AUTHOR]

Repetitive transcranial magnetic stimulation (rTMS) is a rapidly emerging treatment for depression, but outcome prediction is still a challenge. This study aimed to identify predictors of response to rTMS among baseline clinical factors and early symptomatic improvements. This cohort study comprised 136 patients with a unipolar or bipolar depressive episode referred for clinical intermittent theta-burst stimulation or right-sided 1 Hz rTMS at the Uppsala Brain Stimulation Unit. The co-primary outcomes used for logistic regression were response, defined as ≥50 % reduction of Montgomery and Åsberg Depression Rating Scale Self-assessment (MADRS-S) total score, and 1–2 points on the Clinical Global Impression Improvement (CGI-I) scale. Early improvement was defined as ≥20 % reduction in the MADRS-S total score, or ≥ 1 point reduction in each MADRS-S item, after two weeks of treatment. The response rates were 21 % for MADRS-S and 45 % for CGI-I. A depressive episode >24 months had lower odds for MADRS-S response compared to ≤12 months. Early improvement of the MADRS-S total score predicted CGI-I response (95 % CI = 1.35–9.47, p = 0.011), Initiative 6 predicted MADRS-S response (95 % CI = 1.08–9.05, p = 0.035), and Emotional involvement 7 predicted CGI-I response (95 % CI = 1.03–8.66, p = 0.044). No adjustment for concurrent medication. A depressive episode ≤12 months and early improvement in overall depressive symptoms, as well as the individual items, Initiative 6 and Emotional involvement 7 , predicted subsequent rTMS response in a naturalistic sample of depressed patients. This could facilitate the early identification of patients who will benefit from further rTMS sessions. • rTMS response rates are higher when rated by clinicians than patients (45 % vs 21 %). • The duration of a depressive episode is a predictor of patient rated rTMS response. • Early improvement in overall depressive symptoms predicts rTMS response. • Early improvement in initiative predicts patient rated rTMS response. • Early improvement in emotional involvement predicts clinician rated rTMS response. [ABSTRACT FROM AUTHOR]

Depressed people are susceptible to metabolic syndrome ression and metabolic syndrome in the Rafsanjan Youth Cohort Study in 2021. In this cross-sectional study, the data of 3005 young people aged 15–35 under the coverage of urban and rural health centers was investigated in the enrollment stage of the Rafsanjan Youth Cohort Study as a part of the prospective epidemiological research studies in IrAN (PERSIAN). Data was collected using face-to-face interview and electronic questionnaires of the Rafsanjan Youth Cohort Study. Age of the youth was 25.78 ± 6.06 years, 56 % (n = 1682) were female. The prevalence of metabolic syndrome (MetS) was 7.7 % (95 % CI: 6.8 %–8.8 %) and the prevalence of depression was 11.1 % (95 % CI: 10.0 %–12.3 %). Depression did not have a significant impact on the odds ratio of developing MetS in young people (P = 0.604). The odds ratio (OR) of MetS increases by 1.057 times with increasing age (95 % CI for OR: 1.020–1.094). This OR is also 1.715 times higher in married young people than in unmarried Youth (95 % CI for OR: 1.715–2.692) and 0.196 times lower in young people with medium and high MET index than in young people with low MET index (95 % CI for OR: 0.048–0.811). Inability to determine a causal relationship between MetS and depression. Due to the growing trend of components of MetS among the young population, this issue needs to be addressed in future policies and planning for prevention and control as a health priority. • Metabolic syndrome is considered as a new pandemic in the 21st century. • Depressed people are susceptible to metabolic syndrome. • We found that the overall prevalence of depression and metabolic syndrome in young people was 11.1 %, and 7.7 % respectively. • There was no significant relationship between metabolic syndrome and its criteria and depression. [ABSTRACT FROM AUTHOR]

A more in-depth understanding of the relationship between depressive symptoms, neurocognition and suicidal behavior could provide insights into the prognosis and treatment of major depressive disorder (MDD) and suicide. We conducted a network analysis among depressed patients examining associations between history of suicide attempt (HSA), core emotional major depression disorder, and key neurocognitive domains. Depressed patients (n = 120) aged 18–65 years were recruited from a larger randomized clinical trial conducted at the Douglas Institute in Montreal, Canada. They were randomly assigned to receive one of two antidepressant treatments (i.e., escitalopram or desvenlafaxine) for 8 weeks. Core emotional MDD and key neurocognitive domains were assessed pre-post treatment. At baseline, an association between history of suicide attempt (HSA) and phonemic verbal fluency (PVF) suggested that HSA patients reported lower levels of the latter. After 8 weeks of antidepressant treatment, HSA became conditionally independent from PVF. Similar results were found for both the HAM-D and the QIDS-SR core emotional MDD/neurocognitive networks. Network analysis revealed a pre-treatment relationship between a HSA and decreased phonemic VF among depressed patients, which was no longer present after 8 weeks of antidepressant treatment. • Core emotional MDD and key neurocognitive domains pre-post treatment associated with a history of suicide attempt. • Similar results for both the HAM-D and the QIDS-SR core emotional MDD/neurocognitive networks. • Network analysis revealed a pre-treatment relationship between a HSA and decreased phonemic VF among depressed patients. • Relationship between a HSA and decreased phonemic VF disappeared after 8 weeks of antidepressant treatment. [ABSTRACT FROM AUTHOR]

Introduction: In the present cross-sectional study, we investigated whether reasons for smartphone use are similar to those of social media use. Also, we explored links between reasons of smartphone use and mental health variables (problematic smartphone use, FOMO, depression symptoms, and life satisfaction) in Germany during the COVID-19 lockdown period. Methods: Overall, 571 smartphone users (Mage = 31.60, SDage = 12.73) provided their reasons for smartphone use. The reasons were assigned to six categories by an inductive qualitative content analysis. Results: Five of six reasons were similar to those of social media described by previous research. "Search for social interaction" goes along with less problematic smartphone use and depression symptoms and more life satisfaction. "Search for positive feelings" is associated with lower life satisfaction. More depressed people, those with problematic smartphone use tendencies, higher FOMO, and lower life satisfaction tend to "escape from negative emotions." Discussion: Our results help to understand the relationships between reasons for smartphone use and mental health variables. [ABSTRACT FROM AUTHOR]

Depression is a prevalent mental disorder, but the side effects of antidepressants also make depressed patients resistant. Effective and safe antidepressants should be developed from traditional herbs, with the aim of reducing the side effects of antidepressants and improving the efficacy of drugs. In this study, the new macamide compound‐4 (NMC‐4) was synthesized for the first time, addressing the problem of difficult extraction, isolation, and low content of natural macamide. NMC‐4 was characterized using mass spectrometry, nuclear magnetic resonance, and infrared spectroscopy. The protective effect of NMC‐4 against cell injury was demonstrated to be stronger than that of natural macamide (N‐benzylhexadecanamide, XA) using a PC12 cell injury model. The study explored the effects of NMC‐4 on chronic unpredictable mild stress (CUMS)‐induced depressive symptoms. NMC‐4 significantly improved depressive‐like behaviors. NMC‐4 ameliorated CUMS‐induced depressive‐like behaviors by mitigating neuroinflammation and modulating the NF‐κB/Nrf2 and BDNF/PI3K/Akt pathways. [ABSTRACT FROM AUTHOR]

Prospective memory (PM) is the ability to remember an intention in the future. Individuals with depression are candidates for PM failures, resulting in detrimental consequences, such as forgetting to take a medication or implement therapeutic techniques; inaccurate assessments of one's PM abilities can exacerbate these issues. The current study examined if appraisals about one's prospective memory (meta-PM) performance differs between healthy and depressed adults. Data were gathered from 137 adults and included self-reported depression, PM beliefs, objective PM, and assessment of executive functions (EFs). Participants were separated into depressed/healthy categories based on a self-report measure. There was a non-significant correlation between self-reported PM and objective PM for both depressed (r =.06, p =.61) and healthy (r =.08, p =.52) groups, suggesting both groups had inaccurate meta-PM. There were non-significant differences in meta-PM between these groups (Fisher's Z = −0.09, p =.93), but exploratory gender analyses revealed women's meta-PM was significantly less accurate than men's. Women had higher reports of depression and PM complaints compared to men. This study lends evidence that depression is not necessarily related to worse meta-PM accuracy, despite depression's association with memory complaints, and that women are at greater risk for inaccurate meta-PM. [ABSTRACT FROM AUTHOR]

Objective: The present study aims to demonstrate how assimilation processes indicated by formal aspects of in-session narratives change in the course of psychodynamic therapy and how this differs by therapy outcome. Method: Two sessions each from the initial, the middle, and the termination phase of six successful and six unsuccessful psychodynamic treatments were compared. All narratives were identified and coded for dramatic narrating and naming of emotions and mental verbs. Results: Good outcome cases peaked in the use of direct speech and naming negative emotions in the middle phase of treatment. Poorer treatment outcome was associated with a high amount of narrating and a tendency to more dramatic narrating in the termination phase and with a use of more narrative clauses throughout treatment. Conclusions: Emotional remembering and naming of emotional states in the middle phase could provide partial support for the role of assimilation processes in good outcome cases. Narrative characteristics of less successful treatments are discussed. [ABSTRACT FROM AUTHOR]

Comorbid anxiety and depression predict a poorer prognosis than either disorder occurring alone. It is unclear whether self-reported anxiety symptom scores identify patients with depression in need of more intensive mental health services. This study evaluated how anxiety symptoms predicted treatment receipt and outcomes among patients with new depression diagnoses in the Veterans Health Administration (VHA). Electronic medical record data from 128,917 VHA patients (71.6% assessed for anxiety, n = 92,237) with new diagnoses of depression were analyzed to examine how Generalized Anxiety Disorder-7 (GAD-7) scores predicted psychotropic medication prescriptions, psychotherapy receipt, acute care service utilization, and follow-up depression symptoms. Patients who reported severe symptoms of anxiety were significantly more likely to receive adequate acute phase and continuation phase antidepressant treatment, daytime anxiolytics/sedatives, nighttime sedative/hypnotics, and endorse more severe depression symptoms and suicidal ideation at follow-up. Patients who reported severe symptoms of anxiety at baseline were less likely to initiate psychotherapy. The GAD-7 may help identify depressed patients who have more severe disease burden and require additional mental health services. [ABSTRACT FROM AUTHOR]

Background: The effect of an intervention based on Mediterranean diet on reducing recurrence risk or subsyndromal depressive symptoms in recovered depressed patients has not been explored. Methods: The PREDIDEP study was a two-year randomized trial designed to assess the effect of the Mediterranean Diet enriched with extra virgin olive oil on depression recurrence. At baseline and at four, eight, 16, 20, and 24 months of follow-up, depressive symptoms were evaluated through the Beck Depression inventory. Cox regression analysis was fitted to assess the role of dietary intervention on the risk of depression recurrence. Mixed effects linear models were used to assess changes in depressive subsyndromal symptoms according to the intervention. Results: After two years of intervention, the dietary intervention group (n = 103) compared to the control group (n = 93) showed no differences regarding depression recurrence risk as main outcome. As secondary outcomes, an improvement of depressive symptoms was yielded at four (−2.15; 95% CI = −4.00 to −0.29) and eight months (−2.42; 95% CI = −4.17 to −0.67) in the intervention group, with no changes in control group. Moreover, at 20 months, significant differences were found between groups (−3.35; 95% CI = −6.08 to −0.61). Conclusions: An intervention with Mediterranean diet in patients with previous depressive episodes might contribute to the reduction of depressive subsyndromal symptoms. [ABSTRACT FROM AUTHOR]

Purpose: Depression is a major concern in maintenance hemodialysis. However, given the elusive nature of its risk factors and the redundant nature of existing assessment forms for judging depression, further research is necessary. Therefore, this study was devoted to exploring the risk factors for depression in maintenance hemodialysis patients and to developing and validating a predictive model for assessing depression in maintenance hemodialysis patients. Patients and Methods: This cross-sectional study was conducted from May 2022 to December 2022, and we recruited maintenance hemodialysis patients from a multicentre hemodialysis centre. Risk factors were identified by Lasso regression analysis and a Nomogram model was developed to predict depressed patients on maintenance hemodialysis. The predictive accuracy of the model was assessed by ROC curves, area under the ROC (AUC), consistency index (C-index), and calibration curves, and its applicability in clinical practice was evaluated using decision curves (DCA). Results: A total of 175 maintenance hemodialysis patients were included in this study, and cases were randomised into a training set of 148 and a validation set of 27 (split ratio 8.5:1.5), with a depression prevalence of 29.1%. Based on age, employment, albumin, and blood uric acid, a predictive map of depression was created, and in the training set, the nomogram had an AUC of 0.7918, a sensitivity of 61.9%, and a specificity of 89.2%. In the validation set, the nomogram had an AUC of 0.810, a sensitivity of 100%, and a specificity of 61.1%. The bootstrap-based internal validation showed a c-index of 0.792, while the calibration curve showed a strong correlation between actual and predicted depression risk. Decision curve analysis (DCA) results indicated that the predictive model was clinically useful. Conclusion: The nomogram constructed in this study can be used to identify depression conditions in vulnerable groups quickly, practically and reliably. [ABSTRACT FROM AUTHOR]

Among older adults, depression is a common, morbid, and costly disorder. Older adults with depression are overwhelmingly treated by primary care providers with poor rates of remission and treatment response, despite attempts to improve care delivery through behavioral health integration and care management models. Given one in 10 older adults in primary care settings meet criteria for depression, there is a pressing need to improve the efficacy of depression treatment among affected individuals. Measurement-based care (i.e., the incorporation of systematic measurement of patient outcomes into treatment) for depressed older adults in primary care has had poor uptake, which at least partly underlies the limited efficacy of depression treatments. In this perspective, we discuss the proposal that ecological momentary assessment (EMA) may increase uptake of measurement-based care for depression in primary care, enhance the quality of clinical depression data, and lead to improvements in treatment efficacy without adding to providers' burden. We describe key issues related to EMA implementation and application in routine settings for depressed older adults, along with potential pitfalls and future research directions. [ABSTRACT FROM AUTHOR]

Objective: Maintenance hemodialysis (MHD) patients suffer from enormous physical, mental stress and poor quality of life, so an increasing number of patients are in a long-term state of depression. A prominent feature of MHD patients is chronic persistent inflammation, which is also an important mechanism for the onset of depression. Therefore, finding economically convenient inflammatory markers to predict and diagnose the onset of depression in MHD patients is of great value. As a novel inflammatory marker, systemic immune inflammation index (SII) can more comprehensively reflect the inflammation and immunity level of patients. This study aims to explore the relationship between SII and depressive symptoms in MHD patients. Methods: A cross-sectional studywas conducted on 206MHD patients fromthree dialysis centers. Based on the Hospital Anxiety and Depression Scale (HADS) scores, patients were divided into non-depression and depression groups. Inter group comparison and multivariate logistic regression analysis were performed to determinewhether SII is an independent risk factor for depression inMHD patients. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of SII on depression symptoms in MHD patients. Results: According to the HADS scale score, 38.83% of the included patients were in a state of depression. After adjusting for all confounding factors, MHD patients with SII>963.93 had a 4.709 times higher risk of depression than those with SII = 478.32 (OR=4.709, 95% CI 1.821-12.178, P<0.01). ROC analysis showed that SII>685.11 was the best cutoff value for MHD depression patients, and the area under the curve (AUC) was 0.681. Conclusions: High SII is an independent risk factor for depressed MHD patients and an ideal inflammatory marker for predicting and identifying depression in MHD patients as assessed by the HADS scale. [ABSTRACT FROM AUTHOR]

Objective: Recurrent depressive episodes are preceded by changing mean levels of repeatedly assessed emotions (e.g., feeling restless), which can be detected in real time using statistical process control (SPC). This study investigated whether monitoring changes in the standard deviation (SD) of emotions and negative thinking improves the early detection of recurrent depression. Method: Formerly depressed adults (N = 41) monitored their emotions five times a day for 4 consecutive months. During the study, 22 individuals experienced recurrent depression. We used SPC to detect warning signs (i.e., changing means and SDs) of four emotions (positive and negative affect with high or low arousal) and negative thinking. Results: SD-based warning signs only preceded 23%–36% of recurrences, but almost never reflected a false alarm (0%–16%). Correspondingly, SD-based warnings had a high specificity (at the cost of sensitivity), while mean-based warnings had a higher sensitivity (but lower specificity). There was little overlap in mean- and SD-based warning signs. For the majority of emotions, monitoring for high SDs alongside monitoring changes in mean levels improved the detection of depression (p <.015) compared to when only monitoring for changing mean levels. Conclusions: Warning signs for depression manifest not only in changing mean levels of emotions and cognitions but also in increasing SDs. These warnings could eventually be used to detect not just who is at increased risk for depression but also when risk is rising. Further research is needed to evaluate the clinical utility of depression SPC. What is the public health significance of this article?: Changes in the mean levels of self-reported emotions precede recurrent depressive episodes and are therefore considered warning signals. This study shows that the early detection of recurrent depression improves when warning signals are not only tracked in the mean but also in the variability of emotions. Thus, monitoring for both changes in emotional intensity and variability may aid the early detection, and possibly the prevention, of depression. [ABSTRACT FROM AUTHOR]

Background and Objectives: Depression is associated with problems in social interaction and communication. Most of the research conducted in this field uses non-interactive tasks. The theory of economic games as a branch of behavioral economics can provide a new tool for investigating interactions and social decisions in interactive and dynamic conditions and help to better understand neuropsychiatric disorders. In this research, the decision making of depressed people in interactive situations is investigated with a systematic review of economic game theory articles. Methods: By systematic review method, 45 related articles from 2010 to 2023 were extracted from Scopus and Web of Science databases. After removing the duplicate articles and checking the exclusion criteria, finally, 23 articles that analyzed the decision-making process of patients with depression symptoms in economic games were analyzed. Results: The findings showed that the performance of depression sufferers in economic games is different from the healthy group. These differences can be discussed in two groups of cognitive and social components. The cognitive component was classified into the subcomponents of theory of mind, negative cognitive schema, bias in perception, and limited cognitive processing, and the social component was classified into the subcomponents of social avoidance, social comparison and competition, and interpersonal trust. Conclusion: Economic games may help identify suboptimal and maladaptive choices associated with depressive disorder and thus provide a powerful tool for discovering candidate cognitive and social markers of depressive disorder. [ABSTRACT FROM AUTHOR]

Background: Habenula, a hub brain region controlling monoaminergic brain center, has been implicated in major depressive disorder (MDD) and as a possible target of antidepressant response. Nevertheless, the effect of antidepressant drug treatment on habenular volumes remains unknown. The objective of the present research was to study habenular volume change after antidepressant treatment in patients with MDD, and assess whether it is associated with clinical improvement. Methods: Fifty patients with a current major depressive episode (MDE) in the context of MDD, and antidepressant‐free for at least 1 month, were assessed for habenula volume (3T MRI with manual segmentation) before and after a 3 months sequence of venlafaxine antidepressant treatment. Results: A 2.3% significant increase in total habenular volume (absolute volume: P = 0.0013; relative volume: P = 0.0055) and a 3.3% significant increase in left habenular volume (absolute volume: P = 0.00080; relative volume: P = 0.0028) were observed. A significant greater variation was observed in male patients (4.8%) compared to female patients. No association was observed between habenular volume changes and response and remission. Some habenula volume changes were associated with improvement of olfactory pleasantness. Conclusion: Habenular volumes increased after 3 months of venlafaxine treatment in depressed patients. Further studies should assess whether cell proliferation and density or dendritic structure variations are implied in these volume changes. [ABSTRACT FROM AUTHOR]

Background and Objectives: Caregiving for geriatric patients is essential for ensuring the well-being and quality of life of older adults. Family caregivers play a crucial role, but they often face a significant burden that can lead to adverse mental health outcomes, including depression. This study aimed to estimate the prevalence of depression among caregivers of geriatric patients in Jeddah, Saudi Arabia, and to analyze its association with caregiver burden and various socio-demographic and caregiving parameters. Methods: A cross-sectional study was conducted in Jeddah, Saudi Arabia, between January and March 2024. Adult caregivers of geriatric patients were recruited through various social media platforms. Data were collected via an electronic questionnaire that included demographic information, caregiving parameters, the Patient Health Questionnaire-9 (PHQ-9) for depression screening, and the Zarit Burden Interview (ZBI-12) for caregiver burden assessment. Data were analyzed using descriptive statistics, chi-square tests, and multivariate logistic regression. Results: Of the 269 participants, the average age was 32 years, and the gender distribution was nearly balanced. The prevalence of depression (PHQ-9 score ≥ 10) among caregivers was 45.4% (95% CI: 39.3, 51.5%). Significant factors associated with higher depression scores included younger age, female gender, single status, being a student, low income, and caregiving burden. In the multivariate analysis, female gender (OR 2.50, 95% CI 1.30–4.80) and caregiving burden (mild-to-moderate burden: OR 6.18, 95% CI 2.94–13.00; high burden: OR 22.75, 95% CI 8.75–59.13) were independent predictors of depression. Conclusions: The study highlights the high prevalence of depression among caregivers of geriatric patients in Jeddah and underscores the significant impact of caregiving burden on mental health. These findings emphasize the need for targeted interventions, such as mental health support, respite care programs, and culturally sensitive educational training, to mitigate caregiver burden and enhance the well-being of caregivers. [ABSTRACT FROM AUTHOR]

Suicidal behavior necessitates prompt diagnosis due to its severe consequences. C-reactive protein (CRP) levels may offer insights into its pathophysiology and aid in risk assessment, potentially enhancing preventive interventions and treatment strategies. The aim of this study is to assess the CRP levels in depressed patients with and without suicidal behavior. Our systematic review was registered in Prospero (#CRD42024518477). We searched five databases (PubMed, Scopus, PsycINFO, Web of Science, and CINAHL Complete) for records in English from inception to February 2024. We included observational studies that measured CRP in depressed patients with and without suicidal behavior. We used the Newcastle–Ottawa Scale (NOS) to assess the quality of the included studies. We employed a random-effects model, and the statistical analysis was conducted using Stata software version 17. Initial 632 articles narrowed to 15 for systematic review. Fifteen studies with 3652 participants included. Fourteen studies involving 3387 depressed patients, 1269 with suicidal behavior, analyzed CRP levels. Suicidal patients exhibited higher CRP levels (SMD: 0.80 [0.37, 1.23]). Analysis of seven studies with 465 participants, including 200 depressed patients with suicidal behavior and 265 healthy controls, showed higher CRP levels in depressed patients (SMD: 1.58 [0.97, 2.19]). In summary, our systematic review and meta-analysis of CRP levels in suicidal patients revealed that those with suicidal behavior exhibited higher CRP levels, suggesting possible implications for treatment approaches. • 14 studies covering 3,387 depressed patients and 1,269 with suicidal behavior found elevated CRP levels. • Suicidal patients had significantly higher CRP levels than non-suicidal depressed patients (SMD: 0.80 [0.37, 1.23]). • Depressed patients with suicidal behavior have higher CRP levels than healthy controls (SMD: 1.58 [0.97, 2.19]). [ABSTRACT FROM AUTHOR]

Cognitive deficits such as difficulties with attention, memory, and executive functions are frequently reported during remission from depression and relates to adverse functioning in daily life and risk of relapse. There is therefore a need for interventions targeting cognitive deficits after depression. However, few randomized controlled trials have investigated the efficacy of interventions targeting subjective residual cognitive deficits in adults remitted from depression. This randomized crossover trial aimed to investigate the efficacy of an internet-delivered cognitive enhancement intervention on subjective residual cognitive deficits. Forty-four formerly depressed adults (89 % female;mean age = 39 years) were included. Twenty-three participants received the intervention, and 21 participants were assigned to a waitlist control group. The waitlist control group received the intervention after seven weeks. Analyses of follow-up assessment after six months were conducted for the combined sample. Significant differences were found between the intervention and waitlist control group in subjective cognitive functioning (d = 1.83) and rumination (d = 1.65). There was a difference in symptoms of depression between the groups (d = 1.22), whereas symptoms of depression increased in the waitlist control, but not in the intervention group. Fewer participants in the waitlist control group (43 %), compared to the intervention group (78 %) showed reliable improvement in self-reported cognitive deficits after receiving the intervention. Findings should be interpreted with caution due to the small sample, and lack of an active control group. Internet-delivered cognitive enhancement interventions may improve subjective cognitive deficits. Waiting time to receive cognitive enhancement interventions may worsen symptoms and treatment response. • The intervention was associated with improvement of self-reported residual cognitive deficits and rumination. • Symptoms of depression increased in the waitlist control group but were unchanged in the intervention group. • Fewer participants from the waitlist control group showed reliable improvement compared to the intervention group. [ABSTRACT FROM AUTHOR]

The burden of major depressive disorder is compounded by a limited understanding of its risk factors, the limited efficacy of treatments, and the lack of precision approaches to guide treatment selection. The Texas Resilience Against Depression (T-RAD) study was designed to explore the etiology of depression by collecting comprehensive socio-demographic, clinical, behavioral, neurophysiological/neuroimaging, and biological data from depressed individuals (D2K) and youth at risk for depression (RAD). This report details the baseline sociodemographic, clinical, and functional features from the initial cohort (D2K N = 1040, RAD N = 365). Of the total T-RAD sample, n = 1078 (76.73 %) attended ≥2 in-person visits, and n = 845 (60.14 %) attended ≥4 in-person visits. Most D2K (84.82 %) had a primary diagnosis of any depressive disorder, with a bipolar disorder diagnosis being prevalent (13.49 %). RAD participants (75.89 %) did not have a psychiatric diagnosis, but other non-depressive diagnoses were present. D2K participants had 9-item Patient Health Questionnaire scores at or near the moderate range (10.58 ± 6.42 > 24 yrs.; 9.73 ± 6.12 10–24 yrs). RAD participants were in the non-depressed range (2.19 ± 2.65). While the age ranges in D2K and RAD differ, the potential to conduct analyses that compare at-risk and depressed youth is a strength of the study. The opportunity to examine the trajectory of depressive symptoms in the D2K cohort over the lifespan is unique. As a longitudinal study, missing data were common. T-RAD will allow data to be collected from multiple modalities on a clinically well-characterized sample. These data will drive important discoveries on diagnosis, treatment, and prevention of depression. • Heterogeneity in symptoms and treatment response hinders treatment of depression. • Longitudinal clinical and biological data are needed for Precision Psychiatry. • Texas Resilience Against Depression is a naturalistic observational cohort study. • The study is gathering longitudinal data in depressed adults and at-risk youth. • Data collected include self-report measures, EEG, MRI, blood, and stool samples. [ABSTRACT FROM AUTHOR]

Major depressive disorder is a well-established risk factor for cardiac events in patients with coronary heart disease, but clinical trials have produced little evidence that treating depression reliably improves cardiac event-free survival in these patients. In this review, we offer evidence that certain symptoms that commonly remain after otherwise successful treatment of depression—insomnia, fatigue, and anhedonia—independently predict cardiac events. This may help to explain the failure of previous depression treatment trials to improve cardiac event-free survival even when other symptoms of depression improve. We thus propose that adverse cardiovascular effects that have long been attributed to syndromal depression may be instead caused by persistent fatigue, insomnia, and anhedonia, regardless of whether other symptoms of depression are present. We also identify interventions for these symptoms and call for more research to evaluate their effectiveness in depressed patients with coronary heart disease. • Although depression is a known cardiac risk factor, treating depression does not reliably improve cardiac event-free survival in CHD. • We present a novel hypothesis that may explain the failure of depression treatment to improve cardiac event-free survival, and propose an alternative treatment paradigm that warrants testing in future studies. • Our hypothesis concerns insomnia, fatigue, and anhedonia, symptoms that commonly remain after depression treatment and that are independent predictors of cardiac events. [ABSTRACT FROM AUTHOR]

Dopaminergic transmission impairment has been identified as one of the main neurobiological correlates of both depression and clinical symptoms commonly associated with its spectrum such as anhedonia and psychomotor retardation. We examined the relationship between dopaminergic deficit in the striatum, as measured by 123I-FP-CIT SPECT imaging, and specific psychopathological dimensions in patients with major depressive disorder. To our knowledge this is the first study with a sample of >120 subjects. After check for inclusion and exclusion criteria, 121 (67 females, 54 males) patients were chosen retrospectively from an extensive 1106 patients database of 123I-FP-CIT SPECT scans obtained at the Nuclear Medicine Unit of Fondazione Policlinico Universitario Agostino Gemelli IRCCS in Rome. These individuals had undergone striatal dopamine transporter (DAT) assessments based on the recommendation of their referring clinicians, who were either neurologists or psychiatrists. At the time of SPECT imaging, each participant underwent psychiatric and psychometric evaluations. We used the following psychometric scales: Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Snaith Hamilton Pleasure Scale, and Depression Retardation Rating Scale. We found a negative correlation between levels of depression (p = 0.007), anxiety (p = 0.035), anhedonia (p = 0.028) and psychomotor retardation (p = 0.014) and DAT availability in the left putamen. We further stratified the sample and found that DAT availability in the left putamen was lower in seriously depressed patients (p = 0.027) and in patients with significant psychomotor retardation (p = 0.048). To our knowledge this is the first study to have such a high number of sample. Our study reveals a pivotal role of dopaminergic dysfunction in patients with major depressive disorder. Elevated levels of depression, anxiety, anhedonia, and psychomotor retardation appear to be associated with reduced DAT availability specifically in the left putamen. • We conducted single-photon emission computed tomography (SPECT) evaluation to study dopamine transporter (DAT) availability in the striatum and psychometric scales to assess the psychopathology of patients with major depressive disorder (MDD) and related clinical symptoms (anxiety, anhedonia, and psychomotor retardation). • We found a negative correlation between levels of depression (p = 0.007), anxiety (p = 0.035), anhedonia (p = 0.028) and psychomotor retardation (p = 0.014) and DAT availability in the left putamen. • Furthermore, we found that DAT availability in the left putamen was lower in seriously depressed patients (p= 0.027) and in patients with significant psychomotor retardation (p = 0.048). • To our best knowledge this is the first study, among those investigating dopamine levels in the striatum through SPECT, involving such a high number of patients (121 patients with MDD). [ABSTRACT FROM AUTHOR]

Hypnosis has been applied in healing procedures since the earliest of recorded history and today it is implemented in a wholesome concept Hypnotherapy (HT1). On a neurophysiological level, hypnosis has been associated with parts of the Default Mode Network (DMN2), but its effects on this network when induced in a treatment setting of a widespread disorder, namely depression, have never been investigated. Depression is associated with abnormal functional connectivity (FC3) of the DMN. Cognitive Behavioral Therapy (CBT4) has proven itself to be an effective treatment for depression; effects of CBT on DMN-related regions are heterogeneous. In the past years, HT was found to be a promising alternative or helpful adjunction. Yet, its underlying mechanisms remain to be unclear. In this original study 75 depressed patients receiving either CBT or HT were included and measured during resting-state before and after therapy with functional near-infrared-spectroscopy (fNIRS5). On symptom level, results show a significant reduction in both groups. On a neurophysiological level, first exploratory analyses hint toward treatment effects in two components of the DMN. However, these effects do not withstand correction for multiple testing. Still, our study is a first stepstone in the investigation of neural mechanisms of HT and offers first ideas about possible implications. [ABSTRACT FROM AUTHOR]

Background: The present longitudinal investigation had two major goals. First, we intended to clarify whether depressed patients are characterized by impairments of emotional awareness for the self and the other during acute illness and whether these impairments diminish in the course of an inpatient psychiatric treatment program. Previous research based on the performance measure Levels of Emotional Awareness Scale (LEAS) provided inconsistent findings concerning emotional self-awareness in clinical depression. Second, we investigated whether cognitive and affective empathic abilities change from acute illness to recovery in depressed patients. Methods: Fifty-eight depressed patients were tested on admission and after 6–8 weeks of inpatient psychiatric treatment. A sample of fifty-three healthy individuals were also examined twice at an interval of 6–8 weeks. The LEAS and the Interpersonal Reactivity Index (IRI) were administered to assess emotional awareness and empathic abilities. Written texts were digitalized and then analyzed using the electronic scoring program geLEAS, the German electronic Levels of Emotional Awareness Scale. Results: Depressed patients reported more depressive symptoms than healthy controls and less severe depressive symptomatology at time 2 compared to time 1. Independent of time, depressed individuals tended to show lower geLEAS self scores and had lower geLEAS other scores than healthy individuals. Depressed patients showed higher personal distress scores than healthy individuals at both measurement times. No group differences were observed for the cognitive empathy scales of the IRI (perspective taking and fantasy) and empathic concern, but empathic concern decreased significantly in depressed patients from time 1 to time 2. Empathic abilities as assessed by the IRI were not significantly correlated with emotional awareness for others, neither in the whole sample, nor in the patient and control subsample. Conclusions: Depressed patients seem to be characterized by impairments in emotional awareness of others during acute illness and recovery, but they also tend to show deficits in emotional self-awareness compared to healthy individuals. Self-reported cognitive empathic abilities seem to be at normal levels in depressed patients, but their heightened self-focused affective empathy may represent a vulnerability factor for depressive disorders. [ABSTRACT FROM AUTHOR]

Previous studies report low self-concept clarity in depression, but they are limited to nonclinical samples and self-report questionnaires. To comprehensively understand the relationship between self-concept clarity and depression, this study expanded the range of depression to include clinical samples and explored self-concept clarity through a behavioral task. In Study 1, the self-concept clarity scale was administered to 48 nonclinical and 53 clinical participants, and the quadratic model best explained the relationship. In Study 2, 24 undergraduates and 21 depressed patients completed the me/not-me task. Shorter reaction time and greater internal consistency of negative self-descriptive words were associated with higher depression severity. The results suggest that a certain and consistent negative self-view relates to more severe depression. [ABSTRACT FROM AUTHOR]

Objectives: This study was designed and conducted to compare the neurological and neuropsychological functions of depressed patients with and without suicidal thoughts. Methods: This research is a case-comparative study. A group of depressed patients visited NAJA Imam Sajjad Hospital between early August and late October 2016. According to the Morgan table, 66 individuals (33 with suicidal thoughts and 33 without) were selected for comparison with controlled variables in this examination. The Beck Depression Inventory (BDI), Neurological Evaluation Scale, and Wechsler Memory Scale (for neuropsychological function) were administered to all the participants. Data were analyzed using one-way analysis of variance (ANOVA), Scheffe follow-up test, and SPSS version 22 software. Results: The findings indicated that the group of depressed patients with suicidal thoughts showed poorer scores in neurological functions compared to the control group (P = 0.01). Furthermore, the control group scored higher than the depressed group with suicidal thoughts on the Wechsler Memory Scale (P = 0.05). Conclusions: The results suggest that depressed patients with suicidal thoughts exhibit worse performance in both neurological and neuropsychological functions compared to the non-suicidal group. [ABSTRACT FROM AUTHOR]

To determine how depression state impacts postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) scores and achievement of minimum clinically important difference (MCID) following lumbar fusion. Depression has been shown to negatively impact outcomes following numerous orthopedic surgeries. Situational and major clinical depression can differentially affect postoperative outcomes. Adult patients undergoing elective 1–3 level lumbar fusion were reviewed. Patients with a formal diagnosis of major depression were classified as "clinically depressed" whereas patients with at least "mild" PROMIS Depression scores in the absence of formal depression diagnosis were deemed "situationally depressed." analysis of variance testing was used to assess differences within and between groups. Multivariate regression was used to identify features associated with the achievement of MCID. Two hundred patients were included. The average age was 65.9 ± 12.2 years. 75 patients (37.5%) were nondepressed, 66 patients (33.0%) were clinically depressed, and 59 patients (29.5%) were situationally depressed. Situationally depressed patients had worse preoperative physical function (PF) and pain interference (PI) scores and were more likely to have severe symptoms (P = 0.001, P = 0.001). All groups improved significantly from preoperative baseline scores. All groups met MCID PF at different rates, with highest proportion of situationally depressed reaching this metric (P = 0.03). Rates of achieving MCID PI were not significantly different between groups (P = 0.47). Situational depression was predictive of achieving MCID PF (P = 0.002) but not MCID PI. Our study investigated the relationship between depression and postoperative PROMIS scores and identified situationally depressed patients as having the worst preoperative impairment. Despite this, the situationally depressed cohort had the highest likelihood of achieving MCID PF, suggestive of a bidirectional relationship between lumbar degenerative disease and subclinical, situational depression. These findings may help guide preoperative counseling on expectations, and patient selection. [ABSTRACT FROM AUTHOR]

The prevalence of depressive disorder is increasing due to a variety of factors, which brings a huge strain on individuals, families and society. This study aims to investigate whether there is Frontal Theta Asymmetry (FTA) in depressed patients, and whether FTAs are related to depression severity and cognitive function changes in depressed patients. Participants who met the inclusion criteria were enrolled in this study. Socio-demographic data of each participant were recorded. Zung's self-rating Depression Scale was used to assess the depression status of participants. P300 was used to evaluate the cognitive function of participants. EEG data from participants were collected by the NeuroScan SynAmps RT EEG system. t -test, Wilcoxon rank-sum test and Chi-square test were used to detect the differences of different variables between the two groups. Multiple linear regression analysis and multiple logistic regression analysis were used to analyze relationships between FTAs in different regions and participants' depression status and cognitive function. A total of 66 depressed participants and 47 healthy control participants were included in this study. The theta spectral power of the left frontal lobe was slightly stronger than that of the right frontal lobe in the depression group, while the opposite was true in the healthy control group. The FTA in F3/F4 had certain effects on the emergence of depression in participants, the emergence of depression in participants and Changes in cognitive function. FTAs are helpful to assess the severity of depression and early identify cognitive impairment in patients with depression. • Depressed participants had changes in cognitive function. • FTAs occur in depressed patients. • FTAs were negatively correlated with the emergence of depression in participants and participants' depression severity. • FTAs were negatively correlated with participants' cognitive function. [ABSTRACT FROM AUTHOR]

Systemic low-grade inflammation may be a pathophysiological mechanism in a subtype of depression. In this study we investigate a novel candidate mechanism of inflammatory depression - Selective Glomerular Hypofiltration Syndromes (SGHS) - which are characterized by a reduced estimated glomerular filtration rate (eGFR) based on cystatin C (cysC) relative to eGFR based on creatinine (crea). SGHS have been associated with increased blood levels of pro-inflammatory markers, but have never been investigated in a sample of depressed individuals. The prevalence of SGHS was compared between 313 patients with difficult-to-treat depression and 73 controls. Since there is no single established eGFR cysC /eGFR crea -ratio cut-off to define SGHS, several cut-offs were investigated in relation to a depression diagnosis, inflammation, and symptom severity. Plasma inflammatory markers tumor necrosis factor alpha (TNF-α), interferon gamma (IFN-γ), interleukin (IL)-6, IL-8, and IL-10 were available from 276 depressed patients. We examined mediation effects of IL-6 on the relationship between SGHS and depression. Depressed patients were more likely to have SGHS compared to controls defining SGHS as either eGFR cysC /eGFR crea -ratio < 0.9 (33.2 % vs 20.5 %, p = 0.035) or < 0.8 (15.7 % vs 5.5 %, p = 0.023). Lower eGFR cysC /eGFR crea -ratio was associated with higher levels of inflammatory markers in depressed patients. IL-6 partly mediated the relationship between SGHS and depression. This is the first study to demonstrate a link between SGHS and inflammatory depression. If replicated in independent and longitudinal cohorts, this may prove to be a relevant pathophysiological mechanism in some cases of depression that could be targeted in future intervention and prevention studies. • SGHS is a recently identified group of kidney disorders that has been linked to inflammation. • SGHS was more common in patients with difficult-to-treat depression compared to controls. • SGHS was associated with low-grade inflammation in depression. • Pro-inflammatory cytokine IL-6 mediated part of the relationship between SGHS and depression. [ABSTRACT FROM AUTHOR]

Depression is a prevalent psychiatric disease with the characteristic of persistently gloomy mood. The treatment of depression with traditional therapeutic medications suffers from low efficacy and adverse side effects due to the extremely unpredictable courses and uneven responses to treatment. The goal of this paper was to investigate the preparation of selenium‐enriched fermented goat milk and the potential mechanism of its intervention on the chronic unpredictable stress‐induced depression mice model. The results showed that Se‐Lactobacillus paracasei 20241 (Se‐20241) significantly alleviated depressive behavior, reversed the upregulation of inflammatory factors, and attenuated glucocorticoid resistance. Meanwhile, the results showed a modulatory function on oxidative stress dysfunction in the liver, hippocampus, and prefrontal cortex. The change in abundance of Ileibacterium, Muribaculaceae, Turicibacter, Dubosiella, and Bifidobacterium was also modified. These results provided the theoretical groundwork for the development of psychoactive probiotic supplements for depressed patients and clarified the probable mechanism of Se‐20241 for antidepressant impact on the CUMS model. [ABSTRACT FROM AUTHOR]

Background and Aim: Despite decades of research on co-occurring smoking and depression, cessation rates remain consistently lower for depressed smokers than for smokers in the general population, highlighting the need for theory-driven models of smoking and depression. This paper provides a systematic review with a particular focus on psychological states that disproportionately motivate smoking in depression, and frame an incentive learning theory account of smoking-depression co-occurrence. The objective of the study was to estimate the sociodemographic correlates of tobacco consumption and its association with depression. Methodology: This is a cross sectional study. Over a period of one year around 120 depressed and tobacco dependent patients of age group 15 to 80 years were sampled from a tertiary care hospital in this study. Data on tobacco consumption and pattern was elicited from patients and household informants. Prevalence and sociodemographic profile of tobacco dependent depressed patients were used as outcome measures. Association between level of nicotine dependence and severity of depression was also assessed. Results: It was observed that such patients were more associated with the male gender (Females; N=5

Relationship between depressive disorder and autonomic nervous system has been already discussed. Reduced emotional regulation is supposed to be associated with prefrontal hypofunction and subcortical hyperactivity. The aim of this study was to determine the effect of vortioxetine on heart rate variability (HRV), a parameter of cardiac autonomic regulation, in depressed hospitalized paediatric patients and assess the clinical effectiveness of the drug in this population. We performed repeated polysomnography analyses at admission and after a short treatment in hospital (15.2 days on average) and measured various HRV parameters (RRi, pNN50, RMSSD, LF-HRV, HF-HRV) during wakefulness, N3 and REM sleep stages. Out of 27 study subjects, 67% have improved depression symptoms as well as anxiety and subjective sleep quality after short vortioxetine treatment. We have found a significant decrease in parasympathetic parameters pNN50, RMSSD and HF-HRV during N3 sleep phase, though not exclusively among vortioxetine responders. The anticipated increase in cardiovagal regulation after vortioxetine treatment was not demonstrated in this pilot study, possibly due to the drug's multimodal mechanism and impact on the nucleus tractus solitarii, particularly its antagonism on 5HT-3 receptors. Application of selective drugs could further explain the effect of vortioxetine on HRV in depressed patients. [ABSTRACT FROM AUTHOR]

Background and Purpose. The number of older adults and the occurrence of concomitant health issues continue to grow. One of the most prevalent mental health issues in this population is depression. Physical exercise (PE) is widely acknowledged as a method to alleviate the associated health burdens of aging, including depression; however, there is no collated evidence regarding the effectiveness of specific types of exercise on a range of health outcomes. To address this, we conducted a systematic review to evaluate exercise benefits for this specific subgroup. Methods. An electronic search of five databases was used to retrieve controlled studies investigating health‐related outcomes associated with any type of PE, in adults over 65 years with depression. Where possible, data were analyzed in meta‐analyses or else reported narratively. Results and Discussion. Fifteen studies were included in the review. All 15 studies had data available for meta‐analysis, yet heterogeneity in exercise types and outcome measures limited synthesis. When data for all types of exercise were pooled together, significant improvements were found in depression (SMD = 0.52; CI = 0.07, 0.97; p = 0.02), physical health and function (SMD = 0.44, CI = 0.14, 0.74; p = 0.004), anxiety (SMD = 0.23; CI = 0.04, 0.42; p = 0.02), and self‐efficacy (SMD = 0.97; CI = 0.32, 1.61; p = 0.003). When data were pooled according to exercise type, positive effects were demonstrated for aerobic exercise on depression (SMD = 0.49; CI = −0.16, 0.8; p = 0.003), tai chi/qigong on depression (SMD = 0.89; CI = −0.14, 1.63; p = 0.02), and self‐efficacy (SMD = 6.70; CI = −0.90, 12.50; p = 0.02) and multicomponent exercise demonstrated positive effects on physical function (SMD = 0.49; CI = 0.12, 0.87; p = 0.009) and the physical health component of quality of life (SMD = 0.88; CI = 0.10, 1.65; p = 0.03). No health‐related benefits were revealed from the combined findings of the two studies investigating strengthening exercises. Conclusion. Lack of consistency regarding exercise types, dosage, and outcomes presents challenges in the evidence. In general, exercise is beneficial across a range of health‐related variables. Multicomponent, aerobic, and tai chi forms of exercise appear most likely to reap benefits in depressed older adults; however, the type of benefit is determined by the type of exercise and should be considered when recommending a regime. This trial is registered with CRD42020173465. [ABSTRACT FROM AUTHOR]

A significant decrease in estrogen levels puts menopausal women at high risk for major depression, which remains difficult to cure despite its relatively clear etiology. With the discovery of abnormally elevated inflammation in menopausal depressed women, immune imbalance has become a novel focus in the study of menopausal depression. In this paper, we examined the characteristics and possible mechanisms of immune imbalance caused by decreased estrogen levels during menopause and found that estrogen deficiency disrupted immune homeostasis, especially the levels of inflammatory cytokines through the ERα/ERβ/GPER-associated NLRP3/NF-κB signaling pathways. We also analyzed the destruction of the blood-brain barrier, dysfunction of neurotransmitters, blockade of BDNF synthesis, and attenuation of neuroplasticity caused by inflammatory cytokine activity, and investigated estrogen-immuno-neuromodulation disorders in menopausal depression. Current research suggests that drugs targeting inflammatory cytokines and NLRP3/NF-κB signaling molecules are promising for restoring homeostasis of the estrogen-immuno-neuromodulation system and may play a positive role in the intervention and treatment of menopausal depression. [ABSTRACT FROM AUTHOR]

Objective: To explore the insight, treatment attitude, and related influencing factors of hospitalized elderly patients suffering from major depression. Methods: A total of 141 hospitalized elderly patients with depression were selected as the research objects. Insight was evaluated by the total score of the Insight and Treatment Attitude questionnaire (ITAQ). The data collected included sociodemographic characteristics, psychiatric symptoms, delirium status, social functioning, social support, suicide risk, and cognitive function. Results: The sample included 74.5% of female patients, and the mean age was 67.53 (sd=7.19) years. The influencing factors of inpatients with depression included alcohol consumption, length of hospitalization, admission types, and the main caregivers (P<0.05). The various factors were further analyzed by linear regression, revealing that the insight and treatment attitude of elderly depressed hospitalized patients were mainly related to the Mini-Mental State Examination (MMSE) (β= 0.225, 95% CI 0.055-0.395, P=0.01), dependent on a caregiver (β=-5.810, 95% CI -8.086~-3.535, P<0.001), the type of admission (involuntary admission) (β=-3.365, 95% CI -5.448~-1.283, P=0.002), Functional Activities Questionnaire (FAQ) (β=-0.156, 95% CI -0.303~-0.010, P=0.037), and length of stay (=28 days) (β=2.272, 95% CI 0.055~-4.489, P=0.045). Conclusion: The level of insight was affected by cognitive function, involuntary admission, dependent on a caregiver, social function and length of stay. Future studies should focus on cognitive function recovery, observation of admission mode, and self-care ability in elderly patients with depression. [ABSTRACT FROM AUTHOR]

Depressive symptoms seem to be interrelated in a complex and self-reinforcing way. To gain a better understanding of this complexity, the inclusion of theoretically relevant constructs (such as risk and protective factors) offers a comprehensive view into the complex mechanisms underlying depression. Cross-sectional data from individuals diagnosed with a major depressive disorder (N = 986) and healthy controls (N = 1049) were analyzed. Participants self-reported their depressive symptoms, as well as several risk factors and protective factors. Regularized partial correlation networks were estimated for each group and compared using a network comparison test. Symptoms of depression were more strongly connected in the network of depressed patients than in healthy controls. Among the risk factors, perceived stress, the experience of negative life events, emotional neglect, and emotional abuse were the most centrally embedded in both networks. However, the centrality of risk factors did not significantly differ between the two groups. Among the protective factors, social support, personal competence, and acceptance were the most central in both networks, where the latter was significantly more strongly associated with the symptom of self-hate in depressed patients. The network analysis revealed that key symptoms of depression were more strongly connected for depressed patients than for healthy controls, and that risk and protective factors play an important role, particularly perceived stress in both groups and an accepting attitude for depressed patients. However, the purpose of this study is hypothesis generating and assisting in the potential selection of non-symptom nodes for future research. • Symptoms of depression are interrelated in a complex and self-reinforcing way. • The inclusion of risk and protective factors offers a more comprehensive view into depression. • Key symptoms of depression were indecisiveness and lack of satisfaction. • Perceived stress plays an important role in healthy controls and depressed patients. • An accepting attitude seems especially beneficial for depressed patients. [ABSTRACT FROM AUTHOR]

Patients with major depression often suffer from excessive interpersonal sensitivity, although it is not typically measured in antidepressant clinical trials. Preliminary evidence suggests selective serotonin reuptake inhibitors have the capacity to reduce interpersonal sensitivity. This was a pooled analysis of data from 1709 patients in three randomized, double-blind, placebo-controlled trials of fluoxetine and paroxetine for acute major depressive disorder. Depressive symptoms were assessed with the Hamilton Depression Rating Scale. A factor from the Symptom Checklist was used to assess interpersonal sensitivity. Our outcome of interest was change from baseline scores at the last assessment (up to 8 or 12 weeks, depending on the trial). Both medications produced significantly greater reductions in interpersonal sensitivity relative to placebo. The effect of medication remained significant after controlling for depression improvement, which explained 18.5% of the variation in interpersonal sensitivity improvement among those treated with active medication. The effect of medication on depressive symptoms, relative to placebo, was not influenced by baseline interpersonal sensitivity. The outcome measured interpersonal sensitivity over the last week, and the results do not necessarily reflect changes in long-standing, trait-like patterns of interpersonal sensitivity. Only two medications were studied. Selective serotonin reuptake inhibitors are effective at treating interpersonal sensitivity in acutely depressed patients. This appears to be a unique drug effect that is not only the result of depression improvement. Future clinical trials might benefit from assessing interpersonal sensitivity more routinely. • Paroxetine and fluoxetine reduced interpersonal sensitivity more than placebo. • This effect could not be fully explained by concurrent depression improvement. • Baseline interpersonal sensitivity did not moderate the depression treatment effect. [ABSTRACT FROM AUTHOR]