Beck Depression Inventory-II Research Articles

Comparative cross-sectional study of comorbid depression in patients with irritable bowel syndrome and chronic gastritis at an urban outpatient clinic

This comparative cross-sectional study evaluates the prevalence of comorbid depression in patients with Irritable Bowel Syndrome (IBS) and chronic gastritis (CG) at an urban outpatient clinic. A total of 178 patients—89 diagnosed with IBS and 89 with CG—were assessed for depressive symptoms using the Beck Depression Inventory-II (BDI-II) and the 21-item Hamilton Depression Rating Scale (HDRS-21). Our findings indicate a significantly higher prevalence of depression in IBS patients, with 71.9% meeting criteria for depression based on the BDI-II and 70.8% based on the HDRS-21, compared to 10.1% in CG patients. The study highlights that retardation symptoms, including depressed mood and loss of interest, are central to depression and contribute to substantial impairment in daily activities and quality of life. Additionally, anxiety and somatization were prominent in the IBS cohort. This study emphasizes the need for integrated care approaches that address both gastrointestinal and psychological symptoms, fostering improved patient management and outcomes. Our results underscore the importance of regular psychological assessments in IBS patients, particularly those without overt depressive symptoms, to enhance their overall well-being.

Safety and efficacy of sertraline in depression among adults undergoing dialysis: A systematic review and meta-analysis

Background: Depression is prevalent among patients with end-stage renal disease (ESRD) undergoing dialysis, with significant implications for their quality of life and treatment compliance. Traditional treatments for depression, including various therapies and pharmacological interventions, have limitations due to their adverse effects. Sertraline, a selective serotonin re-uptake inhibitor (SSRI), offers a promising alternative, but its efficacy and safety in this population require thorough evaluation. Objective: This meta-analysis aims to assess the effectiveness and adverse effects of sertraline in treating depressive episodes in dialysis patients compared to placebo. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a comprehensive search of databases, including PubMed, Cochrane Library, and Science Direct, up to June 20, 2024. We included randomized controlled trials (RCTs) that compared sertraline with placebo in dialysis patients with depression. Two researchers independently performed data extraction and risk of bias assessment. Statistical analysis was conducted using ReviewManager 5.4.1, employing a random effects model. Results: Four RCTs involving 468 participants were included. Sertraline significantly reduced depressive symptoms, as measured by the Quick Inventory of Depressive Symptomatology (QIDS) and Beck Depression Inventory-II (BDI-II) scores, at 6 and 12 weeks compared to placebo. Improvements in kidney disease-specific quality of life (KDQOL-36) scores were also noted. However, sertraline was associated with a higher risk of adverse events compared to placebo. Conclusions: Sertraline effectively reduces depressive symptoms and improves the quality of life in dialysis patients with ESRD. Despite the increased risk of adverse events, the overall benefits make sertraline a viable treatment option for this population. Larger, more comprehensive studies are needed to confirm these findings and optimize sertraline use in clinical practice.

Semantic inhibition impairment in college students with depressive states as evidenced by EEG and pupillometry during the hayling task

In this study we tested whether depression is associated with impaired semantic inhibition, resulting in symptoms of rumination and anhedonia. For this purpose and using the Beck Depression Inventory II (BDI-II) college students with depressive states (DEP) and matched controls (CTL) performed a Hayling’s task, while EEG and pupillometry measures were recorded. Participants were asked to complete sentential contexts with either a highly associated word (initiation) or a non-related word (inhibition), in response to randomly presented trial-by-trial cues. The DEP group, compared to the CTL group, showed lower performance, and reduced frontal negativity (N450) in inhibition trials. Source analyses revealed greater activation for inhibition trials than for initiation trials in bilateral orbitofrontal cortex for the CTL group, but the difference was reduced and more left lateralized for the DEP group. In addition, the DEP group showed more pupil size reactivity to inhibition trials than the CTL group, indicating higher cognitive effort during semantic inhibition. Finally, self-reported rumination and anhedonia correlated with N450 in inhibition trials, and rumination correlated with pupil dilation. Overall, this research contributes to understanding the neural underpinnings of impaired semantic inhibition in individuals with depression, with potential clinical applications.

The Relationship between Erectile Dysfunction, Self-Esteem, and Depression in Post-Myocardial Infarction Patients.

Background: The interplay between the physical and mental health of patients recovering from myocardial infarction (MI) is crucial. Erectile dysfunction (ED) is a common sexual issue, particularly among patients who have had a myocardial infarction and arterial diseases, and it significantly affects self-esteem and overall psychological well-being. Despite significant advances in cardiac rehabilitation, the psychosocial aspects, especially those related to sexual health, remain underexplored. Objectives: The objective of this study was to examine the relationship between ED, self-esteem, and depression in male patients post-MI, and to assess how ED treatment affects patients' psychological health. Methods: This cross-sectional study involved 80 male patients with a confirmed MI within the last six months, aged between 35 and 77 years. The Beck Depression Inventory-II (BDI-II) and Rosenberg Self-Esteem Scale (SES) were used to assess psychological well-being, while the International Index of Erectile Function-5 (IIEF-5) was employed specifically to evaluate ED. Results: This study demonstrates a strong interdependence between mental and physical health in post-myocardial infarction (MI) patients, with ED being a key factor affecting self-esteem. There is a significant negative correlation between self-esteem and depression, highlighting the importance of psychological resilience in post-MI rehabilitation. Elevated self-esteem helps mitigate depressive symptoms, contributing to improved mental health and rehabilitation outcomes. Conclusions: Older patients tend to have lower self-esteem, likely due to the presence of multiple comorbidities and a longer, more challenging recovery period post-MI. Age was a significant factor in predicting lower self-esteem, but other demographic characteristics did not have a strong influence on self-esteem, depression, or ED.

Association between personal characteristics and anxiety and burnout in orthopedic residents: a cross-sectional cross-sectional study

ObjectiveBurnout is becoming a major problem in medicine, and some articles have pointed to the link between burnout and anxiety. Several factors can contribute to burnout and anxiety, and recognizing each can improve medical education environments. The purpose of this study is to determine the relationship between personal characteristics, anxiety and burnout of orthopedic residents.MethodIn this cross-sectional study, the anxiety rate, depression, and burnout were evaluated in 94 orthopedic residents above the second year and orthopedic fellowships in three hospitals. Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and Maslach Burnout Inventory—Human Services Survey (MBI-HSS) were used to measure the levels of depression, anxiety, and burnout, respectively. Multivariate logistic regression analysis was used to evaluate predictor variables for burnout.ResultsSevere anxiety and depression were reported in 17% and 12.77% of residents, respectively. The rate of burnout for Emotional Exhaustion (EE), Depersonalization (DP), and low sense of Personal Accomplishment (PA) subscales was 18.09%, 28.72%, and 43.62% of people with high levels of burnout, respectively. Multivariate analysis of logistic regression showed that Works > 60 h per week, Anxiety score > 28, Time spent in the hospital > 9 h per Day, Academic year and Experience being abused by the upstream, Balance between work and life, Feeling the need for support from nurses in the hospital were significantly associated with burnout.Conclusionstress and anxiety can be considered a severe factor in burnout; this issue can provide a clear perspective of the psychological cycle that ultimately leads to a decrease in the efficiency of the medical system and related services.

Psychometric properties of the revised internalized skin bias questionnaire.

The psychological impacts of skin disease are well documented, with patients reporting increased anxiety, depression and poorer quality of life. More recent studies suggest that adverse psychopathology is associated with re-direction of skin-disease-related social stigma towards oneself or internalized skin bias (ISB). To refine the Internalized Skin Bias Questionnaire (ISBQ) to reflect the construct of ISB with additional skin-specific biases as well as to evaluate its psychometric properties in a diverse sample of individuals with various skin conditions. Two-part observational design including consensus-building surveys among a dermatology expert group and a cross-sectional survey among participants with self-reported dermatological conditions to assess instrument psychometric properties. Eligible participants completed an online survey comprised of the revised ISBQ (ISBQ-R), the Questionnaire on Experiences with Skin Diseases-Short Form (QES-SF), the Dermatology Life Quality Index (DLQI), the Beck Depression Inventory-II (BDI-II) and the Burns Anxiety Inventory (BAI). Overall, 33 experts participated including 22 (66.7%) dermatologists or dermatology researchers and 11 (33.3%) patients. Except for three items in the first round, all items received high agreement for inclusion from the expert group. The revised survey was completed by 214 participants who identified mostly as female (n = 185; 86.9%), White (n = 182; 85.5%) and non-Hispanic/Latino (n = 200; 93.4%). Adding and modifying new items resulted in an instrument with stronger internal consistency (Cronbach's alpha = 0.92) and a stronger correlation with other existing stigma measures (QES-SF; ρ = 0.72). The ISBQ-R is a modified instrument with stronger internal consistency and a stronger correlation with other existing stigma measures. Additionally, the study further expanded upon previous research by exploring a two-factor structure, suggesting that the ISBQ-R could be used as a single- or a dual-factor instrument depending on investigator goals.

Effectiveness of a peer-to-peer, self-management intervention for young people with depression and anxiety in Denmark: an observational study and a propensity score-matched comparison.

This study investigated the effectiveness of a 7-weeks peer-to-peer program for young people aged 15 to 25 years with depression or anxiety symptoms in Denmark. A total of 483 participants (72% women) participated in the program and the evaluation. The participants completed questionnaires at baseline, postintervention, and at 5-month follow-up to assess changes in depression symptoms (using Beck's Depression Inventory-II), anxiety symptoms (using Spielbergers State-Trait Anxiety Inventory for Adults) and self-efficacy in controlling or managing the illness (using the personal control subscale from the Illness Perception Questionnaire-Revised). Analyses were done using repeated measures mixed linear regression models. Moreover, a register-based matched comparison group was derived as a comparison to assess changes in being in education and employment at 8-month follow-up. Within the intervention group, both depression and anxiety scores declined across the 5-month follow-up compared to baseline (b = -9.6, 95% CI: -11.2, -8.1 for depression symptoms). The self-efficacy score increased from baseline to post-intervention (b = 1.4, 95% CI: 1.0, 1.8) and this level was maintained at follow-up. More than half of the participants were in education at baseline while 24% received social transfer payments. Compared with matched comparison group, a lower proportion of the intervention group remaining in education (71% vs. 80%). Among participants who were employed at baseline, a higher proportion of the intervention group were enrolled in education (27% vs. 19%) and were unemployed (14% vs. 4%) compared to the matched comparison group. This study supports the effectiveness of a peer-to-peer intervention for depression and anxiety symptoms, and self-efficacy in symptom control. However, mixed effects on education and employment were observed, indicating a negative impact on education among those initially enrolled and a higher proportion of employed participants starting education.

Accelerating depression intervention: identifying critical psychological factors using MCDM-MOORA technique for early therapy initiation

BackgroundA thorough psychosocial assessment is time-consuming, often requiring multiple sessions to uncover the psychological factors contributing to mental illness, such as depression. The duration varies depending on the severity of the patient’s condition and how effectively the psychotherapist can establish rapport. However, prolonged assessment periods pose a significant risk of patient deterioration.MethodsThe comprehensive psychosocial intervention, led by the Multi-Criteria Decision-Making (MCDM) approach utilizing the Multi-Objective Optimization by Ratio Analysis (MOORA) method, played a pivotal role in identifying the key psychological factors contributing to the depression of the client among the 21 factors specified by BDI-II analysis.ResultsThe integration of the MOORA strategy compared to traditional psychotherapy on 254 samples demonstrates a Jaccard similarity coefficient of 0.8, with a minimum error margin of 7% (vulnerability index = 0.57), indicating a significant agreement between the two approaches, both converging towards a similar solution. For patients with extreme depression, the number of sessions reduced from 18 ± 2 to 11 ± 2, showing a 33–35% reduction (χ2 = 6.94, p = 0.008). Severe depression patients experienced a reduction from 14 ± 2 to 8 ± 1 sessions i.e., 34–39% reduction (χ2 = 8.32, p = 0.004). Moderate depression patients saw sessions drop from 9 ± 1 to 5 ± 1, i.e., 37–43% reduction (χ2 = 0.29, p = 0.001). The accuracy for detecting dominant psychological factors improved to 82.88% for extreme, 86.74% for severe, and 90.34% for moderate depression, respectively. ConclusionThe implementation of MOORA facilitated the identification and prioritization of key psychosocial intervention strategies, making the process significantly faster compared to traditional methods. This acceleration greatly enhanced the precision and efficacy of the work. Additionally, critical vulnerable factors were identified through ordered statistics and correlation analysis [Pearson (r) = 0.8929 and Spearman’s rank (ρ) = 0.7551] on the Beck Depression Inventory-II model. These findings were supported by other MCDM schemes such as EDAS and TOPSIS, demonstrating high stability and robustness in dynamic decision-making environments, maintaining consistency across scenarios adapted by different psychotherapists. Overall, the combined application of MCDM (MOORA) and targeted psychological interventions yielded substantial positive outcomes in enhancing the well-being of individuals with psychological illnesses, such as depression, cognitive, affective, and somatic syndromes.

Analysis of Demographics Characteristics on Depression in Perimenopausal Staff at a Central General Hospital in Medan, Indonesia

Introduction/Objective Perimenopause is a period where the ovary gradually starts to produce less estrogen. One of the impacts that could happen during perimenopause is the onset of depression arising from hormonal and metabolic disorders due to the significant decrease of ovarium function and secretion of endogenous estrogen. This study was conducted to assess the factors related to depression in perimenopausal women. Methods A multivariate linear regression analysis with a cross-sectional design was conducted at a Central General Hospital in Medan, Indonesia, from October 2023 to January 2024. Subjects were perimenopausal female staff at the hospital who met the inclusion and exclusion criteria. Symptoms of depression were assessed using the Beck Depression Inventory-II (BDI-II) score. Data analysis was conducted using bivariate and multivariate tests with linear regression. Results A total of 111 subjects were included in this study. The median age was 48 years, and the median Body Mass Index (BMI) was 25. The mean depression score based on BDI-II was 12.96±7.084. Bivariate analysis showed significance on age, years of education, total monthly income, BMI, and number of pregnancies. Multivariate analysis showed that total monthly income had the highest correlation amongst other variables, followed by age, while the number of pregnancies had the lowest correlation. Conclusion In conclusion, there was a significance between depression and age, income, and number of pregnancies in perimenopausal staff. On the other hand, there was no significance between depression and years of education, BMI, marital status, and chronic disease.

7945 Modelling the Factors Associated With Sexual and Mood Symptoms Within the First Year of Anabolic-Androgenic Steroid Cessation in Men

Abstract Disclosure: B. Grant: None. J. Kean: None. N.L. de Silva: None. O. Quinton: None. P. Bassett: None. J. McVeigh: None. A. Lingford-Hughes: None. S. Minhas: None. S. Bhasin: None. W.S. Dhillo: None. C.N. Jayasena: None. Context: Anabolic-androgenic steroids (AAS) are misused by millions of men worldwide to boost muscle size and physical performance. Recent studies have quantified the recovery of cardiovascular markers and testicular function following AAS cessation. Qualitative studies demonstrate that low mood, anxiety, suicidal ideation, and sexual dysfunction are also common following AAS cessation. However, no previous study has focused on quantifying symptoms within the first year of AAS cessation, nor investigated independently associated factors for these symptoms. Methods: Cross-sectional, observational study of 165 men in 3 groups; non-AAS (n=43); current-AAS (n=76); past-AAS ≤1 year (n=46). All participants completed questions on substance misuse, Beck Depression Inventory-II (BDI-II), International Index Erectile Function-15 (IIEF-15), General Anxiety Disorder (GAD-7), Quality-of-life (SF-36), and underwent fasting, morning blood sampling with urine toxicology. Results: As expected, current-AAS had lower gonadotropins and elevated serum total testosterone compared with past-AAS and non-AAS. Sexual function measured using IIEF-15 was impaired in men stopping AAS <1year (past-AAS) compared with current AAS users: (1) total: 69.0 [95% CI 64.0, 71.0], current-AAS; 61.0 [95% CI 56.0, 66.0], past-AAS; p=0.077; (2) erectile function: 30.0 [95% CI 29.0, 30.0], current-AAS; 28 [95% CI 21.0, 29.0], past-AAS; p=0.015; (3) sexual desire: 9.0 [95% CI 8.0, 10.0], current-AAS; 6.0 [95% CI 5.0, 8.0], past-AAS; p<0.0001; (4) overall satisfaction: 10.0 [95% CI 8.0, 10.0], current-AAS; 7.0 [95% CI 7.0, 8.0], past-AAS; p=0.002. Multivariable analysis suggested that psychiatric comorbidity (coefficient -6.5 [95% CI -13.0, -1.3] p=0.03) and AAS cessation (coefficient -10.8 [95% CI -5.6, -17.2]; p<0.001) were associated with lower total IIEF-15 scores.Depression scoring was worse in the past-AAS group compared with non-AAS: BDI-II 4.0 [95% CI 2.0, 7.0], non-AAS; 7.0 [95% CI 4.0, 16.0], past-AAS; p=0.0448. Multivariable analysis suggested that psychiatric comorbidity (OR 2.39 [95% CI 1.60, 3.57]; p<0.001) and lower serum total testosterone (OR 0.85 [95% CI 0.88, 0.94]; p=0.002) were associated with higher BDI-II scores.Energy and fatigue measured using SF-36 was lower in the past-AAS group compared with non-AAS: 70 [95% CI 65, 75], non-AAS; 60 [95% CI 50, 65], past-AAS; p=0.0498. No significant differences in anxiety scoring were detected. Discussion: We report the first, detailed quantification and modelling of symptoms in men currently misusing and stopped AAS within the previous year. These data reveal potentially treatable factors to improve symptoms of AAS cessation if proven within interventional studies. Presentation: 6/2/2024

7945 Modelling the Factors Associated With Sexual and Mood Symptoms Within the First Year of Anabolic-Androgenic Steroid Cessation in Men

Abstract Disclosure: B. Grant: None. J. Kean: None. N.L. de Silva: None. O. Quinton: None. P. Bassett: None. J. McVeigh: None. A. Lingford-Hughes: None. S. Minhas: None. S. Bhasin: None. W.S. Dhillo: None. C.N. Jayasena: None. Context: Anabolic-androgenic steroids (AAS) are misused by millions of men worldwide to boost muscle size and physical performance. Recent studies have quantified the recovery of cardiovascular markers and testicular function following AAS cessation. Qualitative studies demonstrate that low mood, anxiety, suicidal ideation, and sexual dysfunction are also common following AAS cessation. However, no previous study has focused on quantifying symptoms within the first year of AAS cessation, nor investigated independently associated factors for these symptoms. Methods: Cross-sectional, observational study of 165 men in 3 groups; non-AAS (n=43); current-AAS (n=76); past-AAS ≤1 year (n=46). All participants completed questions on substance misuse, Beck Depression Inventory-II (BDI-II), International Index Erectile Function-15 (IIEF-15), General Anxiety Disorder (GAD-7), Quality-of-life (SF-36), and underwent fasting, morning blood sampling with urine toxicology. Results: As expected, current-AAS had lower gonadotropins and elevated serum total testosterone compared with past-AAS and non-AAS. Sexual function measured using IIEF-15 was impaired in men stopping AAS <1year (past-AAS) compared with current AAS users: (1) total: 69.0 [95% CI 64.0, 71.0], current-AAS; 61.0 [95% CI 56.0, 66.0], past-AAS; p=0.077; (2) erectile function: 30.0 [95% CI 29.0, 30.0], current-AAS; 28 [95% CI 21.0, 29.0], past-AAS; p=0.015; (3) sexual desire: 9.0 [95% CI 8.0, 10.0], current-AAS; 6.0 [95% CI 5.0, 8.0], past-AAS; p<0.0001; (4) overall satisfaction: 10.0 [95% CI 8.0, 10.0], current-AAS; 7.0 [95% CI 7.0, 8.0], past-AAS; p=0.002. Multivariable analysis suggested that psychiatric comorbidity (coefficient -6.5 [95% CI -13.0, -1.3] p=0.03) and AAS cessation (coefficient -10.8 [95% CI -5.6, -17.2]; p<0.001) were associated with lower total IIEF-15 scores.Depression scoring was worse in the past-AAS group compared with non-AAS: BDI-II 4.0 [95% CI 2.0, 7.0], non-AAS; 7.0 [95% CI 4.0, 16.0], past-AAS; p=0.0448. Multivariable analysis suggested that psychiatric comorbidity (OR 2.39 [95% CI 1.60, 3.57]; p<0.001) and lower serum total testosterone (OR 0.85 [95% CI 0.88, 0.94]; p=0.002) were associated with higher BDI-II scores. Energy and fatigue measured using SF-36 was lower in the past-AAS group compared with non-AAS: 70 [95% CI 65, 75], non-AAS; 60 [95% CI 50, 65], past-AAS; p=0.0498. No significant differences in anxiety scoring were detected. Discussion: We report the first, detailed quantification and modelling of symptoms in men currently misusing and stopped AAS within the previous year. These data reveal potentially treatable factors to improve symptoms of AAS cessation if proven within interventional studies. Presentation: 6/2/2024

Depressive Symptoms in Multiple Sclerosis: Links to Body Composition, Physical Activity, and Functional Ability.

BACKGROUND In patients with multiple sclerosis, depression and its associated symptoms are factors that reduce the health-related quality of life can affect the course of the disease and the patient's compliance with therapeutic recommendations, or may even increase the risk of suicide. This study aimed to determine the relationship between body composition, motor function of limbs, physical activity, and the occurrence of depressive symptoms in patients with multiple sclerosis. MATERIAL AND METHODS The study group included 110 patients - 84 women (76.4%) and 26 men (23.6%) - with multiple sclerosis and with or without depression. Disability status was assessed using the EDSS scale. Depressive symptoms were recognized based on the Beck Depression Inventory-II, while motor function was determined with the 9-Hole Peg Test and Timed 25-Foot Walk test. Accelerometers were used to evaluate physical activity of patients. Statistical analysis of collected data was performed using logistic regression. RESULTS Depressive symptoms (BDI-II score ≥14) were observed in 24.55% of the participants. MS patients with and without depression symptoms differed significantly in terms of fat mass, T25-FW, and 9-HPT-dominant hand. Multivariate regression analyses demonstrated that increased adiposity (OR=1.09; 95% CI=1.02-1.16; P=.008; and decreased motor ability of the upper limb, both dominant (OR=1.07; 95% CI=1.01-1.15; P=.043) and non-dominant one (OR=1.10 95% CI 1.01-1.18; P=.025) were associated with a higher risk of depression. The differences in physical activity and T25-FW between groups were statistically insignificant. CONCLUSIONS The severity of depression symptoms was related to higher body mass and decreased functional ability of the upper limbs in patients with MS. Thus, a detailed evaluation of the patient's upper-limb function should constitute an integral part of motor function assessment of patients with MS.

Blood DNA methylation of CRF and its association with amygdala volume and mood in Cushing’s syndrome

ObjectiveThe impact of chronic exposure to stress or glucocorticoids on psychiatric symptoms has been exemplified by cases of iatrogenic or endogenous hypercortisolism such as Cushing’s syndrome (CS). The amygdala plays an important role in mediating both stress and affective responses, and one of the key factors that link stress response and psychiatric symptoms is the corticotropin-releasing factor (CRF). Epigenetic changes, especially those occurring on CpG dinucleotides in DNA of glucocorticoid target genes in blood, have been previously implicated as potential predictors of glucocorticoid-related events in the central nervous system (CNS). In this study, we examined amygdala volume and mood symptoms in CS patients and aimed at evaluating whether these parameters were associated with blood DNA methylation of CRF.MethodsIn this cross-sectional study, 32 CS patients and 32 healthy controls matched for age, sex, and years of education underwent an MRI scan, a Beck Depression Inventory-II, and a State-Trait Anxiety Inventory. Genomic DNA extracted from total leukocytes were used for DNA methylation analysis of several CpG dinucleotides at the CRF promoter region.ResultsSignificant associations between CRF methylation vs. amygdala volume (CpG-1, P = 0.006) and depression scores (CpG-2, P = 0.01) were found. To assess whether the promoter CpG methylation has functional consequences, we examined RNA and DNA extracted from non-CS, postmortem amygdala tissues. A significant association between CpG methylation and gene expression (CpG-1, P = 0.004) was observed.ConclusionThese results demonstrate that methylation levels of the CRF promoter CpGs are associated with amygdala volume in CS and related mood symptoms. Methylation levels may also be associated with CRF expression. This finding supports the feasibility of using epigenetic patterns in blood as a surrogate for assessing GC-related pathologies in the brain.

Lithium Aspartate for Long COVID Fatigue and Cognitive Dysfunction

Neurologic post-COVID-19 condition (PCC), or long COVID, symptoms of fatigue and cognitive dysfunction continue to affect millions of people who have been infected with SARS-CoV-2. There currently are no effective evidence-based therapies available for treating neurologic PCC. To assess the effects of lithium aspartate therapy on PCC fatigue and cognitive dysfunction. A randomized, double-blind, placebo-controlled trial (RCT) enrolling participants in a neurology clinic from November 28, 2022, to June 29, 2023, with 3 weeks of follow-up, was conducted. Subsequently, an open-label lithium dose-finding study with 6 weeks of follow-up was performed among the same participants enrolled in the RCT. Eligible individuals needed to report new, bothersome fatigue or cognitive dysfunction persisting for more than 4 weeks after a self-reported positive test for COVID-19, Fatigue Severity Scale-7 (FSS-7) or Brain Fog Severity Scale (BFSS) score of 28 or greater, Beck Depression Inventory-II score less than 24, and no history of a condition known to cause fatigue or cognitive dysfunction. All participants in the RCT were eligible for the dose-finding study, except for those who responded to the placebo. Intention-to-treat analysis was used. Lithium aspartate, 10 to 15 mg/d, or identically appearing placebo for 3 weeks followed by open-label lithium aspartate, 10 to 15 mg/d, for 2 weeks. In the subsequent dose-finding study, open-label lithium aspartate dosages up to 45 mg/d for 6 weeks were given. Change in sum of FSS-7 and BFSS scores. The scores for each measure range from 7 to 49, with higher scores indicating more severe symptoms. Secondary outcomes included changes from baseline in the scores of additional questionnaires. Fifty-two participants were enrolled (30 [58%] males; mean [SD] age, 58.54 [14.34] years) and 26 were randomized to treatment with lithium aspartate (10 females) and 26 to placebo (12 female). Two participants assigned to lithium aspartate were lost to follow-up and none withdrew. No adverse events were attributable to lithium therapy. There were no significant intergroup differences for the primary outcome (-3.6; 95% CI, -16.6 to 9.5; P = .59) or any secondary outcomes. Among 3 patients completing a subsequent dose-finding study, open-label lithium aspartate, 40 to 45 mg/d, was associated with numerically greater reductions in fatigue and cognitive dysfunction scores than 15 mg/d, particularly in 2 patients with serum lithium levels of 0.18 and 0.49 mEq/L compared with 1 patient with a level of 0.10 mEq/L. In this RCT, therapy with lithium aspartate, 10 to 15 mg/d, was ineffective for neurologic PCC fatigue and cognitive dysfunction. Another RCT is required to assess the potential benefits of higher lithium dosages for treating neurologic PCC. ClinicalTrials.gov Identifier: NCT05618587 and NCT06108297.

Astrogliosis marker [11C]SL25.1188 After COVID-19 With Ongoing Depressive and Cognitive Symptoms

After acute COVID-19, five percent of people experience persistent depressive symptoms and reduced cognitive function (COVID-DC). Theoretical models propose that astrogliosis is important in long COVID but measures primarily indicative of astrogliosis have not been studied in the brain of long COVID or COVID-DC. The objective is to measure [11C]SL25.1188 total distribution volume ([11C]SL25.1188 VT), index of monoamine oxidase B (MAO-B) density and marker of astrogliosis with PET in COVID-DC and compare to healthy controls. In 21 COVID-DC cases and 21 healthy controls, [11C]SL25.1188 VT was measured in prefrontal cortex, anterior cingulate cortex, hippocampus, dorsal putamen, and ventral striatum. Depressive symptoms were measured with the Beck Depression Inventory-II and cognitive symptoms were measured with neuropsychological tests. [11C]SL25.1188 VT was higher in COVID-DC in prefrontal cortex, anterior cingulate cortex, hippocampus, dorsal putamen, and ventral striatum compared to healthy controls. Depressive symptom severity correlated negatively with [11C]SL25.1188 VT across prioritized brain regions. More recent acute COVID-19 correlated positively with [11C]SL25.1188 VT, reflecting higher values since predominance of the omicron variant. Exploratory analyses found greater [11C]SL25.1188 VT in hippocampus, dorsal putamen, and ventral striatum compared to major depressive episode controls with no history of COVID-19; and no relationship to cognitive testing in prioritized regions. Results strongly support the presence of MAO-B labelled astrogliosis in COVID-DC throughout the regions assessed although the association of greater astrogliosis with less symptoms raises the possibility of a protective role. Magnitude of astrogliosis in COVID-DC is greater since emergence of omicron variant.

Standardized weighted low-resolution electromagnetic tomography study of the amygdala activity in patients with comorbid major depressive disorder and anxiety symptoms

Major depressive disorder (MDD) often coexists with anxiety disorders or symptoms, as identified by previous functional magnetic resonance imaging (fMRI) studies. These studies have found abnormal amplitudes of low-frequency fluctuations (ALFF) in the amygdala, which serve as traits and state markers of MDD. This study used standardized weighted low-resolution electromagnetic tomography (swLORETA) technology to explore amygdala markers in patients with comorbid MDD and anxiety. Participants included patients with MDD comorbid with anxiety symptoms (MDD group) and healthy controls (HC group) who completed the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI). EEG data collected under resting state, happiness recall, and depressive recall tasks were converted into current-source density (CSD) values using swLORETA to assess amygdala activation. The results indicated higher beta2, beta3, and high beta levels in both the left and right amygdalae during the resting state in the MDD group than in the HC group. Similarly, elevated levels of beta2, beta3, and high beta were observed in the left and right amygdalae of the MDD group during happiness and depressive recall tasks. These findings support the presence of hyperactivity in the amygdala under resting state and emotional tasks in patients with comorbid MDD and anxiety symptoms.

The mediation effect of the inferior-parietal cortex and globus pallidus on the relationship between family conflict and major depressive disorder

ObjectiveFamily conflict is an important risk factor for major depressive disorder (MDD) and is associated with structural alterations in the brain. However, it is unclear whether structural alterations associated with family conflict would contribute to depression. This study aims to investigate the neuroimaging characteristics that connect family conflict with depression. MethodsThis study included 54 healthy controls and 53 antidepressant-free patients with MDD. Both groups completed the Beck Depression Inventory-II, the simplified Chinese version of the Family Environment Scale, and the Childhood Trauma Questionnaire. Structural Magnetic Resonance Imaging data was collected to measure cortical thickness and regional gray matter volumes. ResultsFamily conflict has a significant effect on depression diagnosis. Higher levels of family conflict were positively associated with symptoms of sadness, guilty feelings, and punishment feelings in patients, as well as with cortical thickness in the right inferior-parietal cluster and the volumes of the left globus pallidus in all participants. In the patient group, cortical thickness in the right inferior-parietal cluster and volume of the left globus pallidus were negatively related to symptoms of sadness and guilty feelings, respectively. The structural alteration in the right inferior-parietal cluster mediated the relationship of family conflict and sadness, whereas changes in the globus pallidus mediated the associations between family conflict and both depression and guilty feelings in patients. ConclusionFindings revealed the relationships between family conflict and depression, including both depression diagnosis and specific symptoms. Cortical thickness in the right inferior-parietal cortex and the volume of the left globus pallidus played mediating roles in these relationships, indicating the important contributions of these brain regions to the effect of family conflict on depression.

Female sexual dysfunctions in multiple sclerosis patients with lower urinary tract symptoms: an Italian case-control study.

Multiple sclerosis (MS) is a recurrent, autoimmune, and inflammatory demyelinating chronic disease that typically manifests in young adulthood and exerts adverse effects on sexual functions. The study evaluated the prevalence of sexual dysfunctions (SDs) and the relationship with neurological disability, depression, and lower urinary tract symptoms (LUTS) in a cohort of MS female patients, comparing these results with those of healthy women. From January 2023 to January 2024, consecutive premenopausal female patients with MS, were recruited and the examination included urinalysis, ultrasonography and a urodynamic test according to the International Continence Society standard. Descriptive statistics were reported as mean and standard deviation for continuous variables (analyzed by independent samples Mann-Whitney U test and independent samples Kruskal-Wallis test) while categorical variables were reported as frequency and percentage (analyzed by chi-square test with Fisher's exact test). Female Sexual Function Index (FSFI) total score and all FSFI subscales scores were significantly lower in patients with MS vs healthy control subjects (P < .001); FSFI total scores and all FSFI subscale scores were statistically significantly lower in patients with MS with an International Prostate Symptom Score ≥20 (P < .001) and considering a cutoff for Beck Depression Inventory-II score ≥17, depression was present in 61% (n = 47 of 77) of patients with MS and completely absent in the control group. The knowledge that SDs are a common problem in MS and in other chronic illnesses can alleviate the feeling of stigma and talking openly of sexual problems can be helpful for the patients and so the doctor-patient relationship can be reinforced. The sample was drawn from a single center, and larger multicenter studies that include both genders are needed to obtain strong results. Our findings confirm the idea of a polygenic and multifactorial etiology of female SDs in MS. Therefore, women with MS should be evaluated in terms of SDs during follow-ups.

Exploring the efficacy of memory specificity training on depression among Iranian adolescents: a comparative analysis of online vs. in-person delivery

Depression in adolescence is common worldwide, with the burden being highest in low- and middle-income countries. This study assessed the efficacy of in-person Memory Specificity Training (MeST) and computerized MeST (c-MeST) as cognitive training programs aimed at addressing depression among Iranian adolescents. A secondary aim was to evaluate the efficacy of MeST and c-MeST on autobiographical memory specificity, emotion regulation and cognitive control. Ninety Iranian male adolescents (aged 13–18 years) with depression were randomly assigned to three groups; MeST group (n = 30), c-MeST group (n = 30) and the non-active control group (n = 30). Participants completed the Beck Depression Inventory-II, Autobiographical Memory Test, Cognitive Emotion Regulation Questionnaire, Wisconsin Card Sorting Test and Stroop Color and Word Test. The groups underwent either MeST and c-MeST. All the assessments were re-conducted after the intervention (post-intervention) and at 1-month post-intervention (follow-up). The in-person MeST group exhibited significantly higher autobiographical memory specificity at post-intervention and follow-up compared to the c-MeST group. Both groups demonstrated significantly lower levels of depression at post-intervention and follow-up. Both groups showed improvements in emotion regulation and cognitive control, which were found to mediate improvements in depression symptomatology. c-MeST and MeST appear promising brief interventions for the treatment of depression among adolescents in Iran.

Quality of Life and Depression in Premenstrual Dysphoric Disorder and Premenstrual Syndrome Among College Students

The symptoms before a woman’s period, Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) involve physical and emotional aspects. PMS and PMDD differ in symptom severity. Thus, the psychological effects are considerable and affect the individual’s physical state. The present study aims to investigate the quality of life and depression among college students with PMS and PMDD. Forty clinically diagnosed females with Premenstrual Dysphoric Disorder and 40 females with Premenstrual syndromes were sampled through purposive sampling method, the age range of 16 to 21 (Mean age 18.37, SD 1.63) years from Kapurthala, Punjab. WHO Quality of Life -BREF Hindi and Beck Depression Inventory-II were individually administered to both groups. The statistical analysis of descriptive and t-tests revealed that premenstrual dysphoric disorder exhibits a significantly low level of quality of life as compared to premenstrual syndrome. Premenstrual dysphoric disorder revealed significantly higher levels of depression as compared to premenstrual syndrome. The significant finding of the study is that adolescents with Premenstrual dysphoric disorder suffer from poor quality of life and Well-being. Study supporting female adolescents, especially those with severe Premenstrual dysphoric disorder, can enhance their quality of life and well-being through counseling, education, and lifestyle changes.