Cognitive Depressive Symptoms Research Articles

Short-physical performance battery: complete mediator of cognitive depressive symptoms and diabetes mellitus in hemodialysis patients

ObjectiveThis study aimed to examine the relationship between different dimensions of depressive symptoms and the presence of diabetes mellitus in hemodialysis patients. Additionally, the study sought to elucidate the mediating effect of physical performance on this association.MethodsThis was a cross-sectional multicenter study conducted between July 2020 and March 2023, involving 1024 patients from eight hemodialysis centers in Shanghai. Diabetes mellitus was based on a documented physician diagnosis and blood glucose tests. Physical performance and depressive symptoms were assessed using short-physical performance battery (SPPB) and the patient health questionnaire-9, respectively. Regression and mediation analysis were applied to statistical analysis.ResultsAmong the 1024 participants, 39.26% (n = 402) were found to have coexisting diabetes mellitus. Diminished SPPB scores (OR = 0.843, 95% CI = 0.792–0.897) and cognitive depressive symptoms (OR = 1.068, 95% CI = 1.011–1.129) exhibited significant associations with diabetes mellitus, while somatic depressive symptoms did not show a significant correlation. Notably, SPPB emerged as a complete mediator in the relationship between cognitive depressive symptoms and diabetes mellitus. The observed indirect effect of SPPB on this relationship was estimated at 0.038 (95% CI: 0.021–0.057).ConclusionThis study showed an association between diabetes mellitus and cognitive depressive symptoms in patients undergoing hemodialysis, with physical performance appearing to mediate the relationship between diabetes mellitus and depressive symptoms.

Patient perspectives on the Tailored intervention for Anxiety and Depression Management in COPD (TANDEM): a qualitative evaluation

BackgroundChronic obstructive pulmonary disease (COPD) is commonly associated with anxiety/depression which can affect self-management and quality of life. The TANDEM trial evaluated a cognitive behavioural approach intervention targeting COPD-related symptoms of anxiety and/or depression, comprising up to eight one-to-one sessions delivered by respiratory healthcare professionals prior to pulmonary rehabilitation (PR). The intervention showed no improvement in anxiety/depression or uptake/completion of PR. We present patient perspectives of the intervention to help understand these results.MethodSemi-structured individual interviews, using a semi-structured topic guide informed by Sekhon’s Theoretical Framework of Acceptability, were conducted with 19 patients between September 2019 and April 2020. The interviews were audio-recorded, transcribed verbatim and analysed thematically.ResultsThe following could have limited the impact of the intervention: (1) The lives of patients were complex and commonly affected by competing comorbidities or other external stressors which they managed through previously adopted long-standing coping strategies. (2) Some patients were reluctant to talk about their mood despite the Facilitators' training and person centred-skills which aimed to enable patients to talk freely about mood. (3) The intervention handouts and ‘home-practice’ were perceived as helpful for some, but not suitable for all. (4) Many patients perceived improvements in their physical and mental health, but this was not sustained due to a mix of personal and external factors, and some did not perceive any benefits. (5) PR non-attendance/non-completion was a result of personal and PR service-related reasons. (6) Discussing COPD and mental health with the Facilitator was a novel experience. Many patients felt that TANDEM could be of benefit if it was offered earlier on/at different time points in the COPD illness journey.ConclusionWe found the delivery of TANDEM prior to PR was not helpful for patients with advanced COPD often experiencing other comorbidities, and/or difficult personal/external events. These patients already utilised long-standing coping strategies to manage their COPD. Holistic interventions, that address the impact of COPD in relation to wider aspects of a patients’ life, may be more beneficial.Trial registrationISRCTN Registry 59,537,391. Registration date 20 March 2017.

Isotemporal substitution of sedentary behavior with physical activity and its influence on depressive symptoms among adults with overweight/obesity in the United States: A cross-sectional study

ObjectiveThis cross-sectional study examined the influence of sedentary behavior (SB) time substitution with physical activity (PA) on depressive symptoms among adults with overweight/obesity. SB time was replaced with equal amount of walking/bicycling or leisure-time moderate-to-vigorous PA (MVPA). MethodsData of the 18344 adults, who were overweight and obesity was obtained from the National Health and Nutrition Examination Survey 2006–2018. PA of participants was measured by the Global Physical Activity Questionnaire. Depressive symptoms, including overall, somatic, and cognitive depressive symptoms were assessed by the Patient Health Questionnaire-9 (PHQ-9). Isotemporal substitution model based on weighted multiple linear regression was used to assess the association of SB time substitution with PA on depressive symptoms. ResultsIndependent model analysis showed that 30 min/day SB time was significantly associated with higher PHQ-9 depressive symptoms, while engage in walking/bicycling or leisure-time MVPA for 30 min/day was associated with lower depressive symptoms. Isotemporal substitution analyses revealed that replacing 30 min/day SB time with equal amount of walking/bicycling or leisure-time MVPA was associated with significant lower PHQ-9 total scores (walking/bicycling: β = −0.088, 95%CI = −0.129, −0.047, P < 0.01; MVPA: β = −0.160, 95%CI = −0.185, −0.134, P < 0.01). Moreover, cognitive depressive symptoms (walking/bicycling: β = −0.035, 95%CI = −0.058, −0.013, P < 0.01; MVPA: β = −0.074, 95%CI = −0.088, −0.060, P < 0.01), and somatic depressive symptoms (walking/bicycling: β = −0.053, 95%CI = −0.075, −0.030, P < 0.01; MVPA: β = −0.085, 95%CI = −0.100, −0.071, P < 0.01) were also significantly lower after replacing SB time with either walking/bicycling or MVPA. However, replacing 30 min/day PA with SB time represented with higher depressive symptoms. ConclusionsReplacing SB time with walking/bicycling or MVPA is beneficial in lowering the depressive symptoms among overweight/obese adults. Owing to the benefits of PA on depression, strategies promoting PA participation, are necessary for better social/mental well-being and healthy society.

Associations Between Selected Micronutrient Deficiencies and Cognitive Function and Symptoms of Depression Among Non-pregnant Women of Reproductive Age in Punjab, India

Associations Between Selected Micronutrient Deficiencies and Cognitive Function and Symptoms of Depression Among Non-pregnant Women of Reproductive Age in Punjab, India

COGNITIVE BEHAVIORAL THERAPY MAY ALLEVIATE ANXIETY AND DEPRESSIVE SYMPTOMS IN ADVANCED CANCER PATIENTS

Tian L. Effects of cognitive behavioral therapy on anxiety and depressive symptoms in advanced cancer patients: A meta-analysis. Gen Hosp Psychiatry. 2024 Jan 20;87:20-32. doi:10.1016/j.genhosppsych.2024.01.006. Epub ahead of print. PMID: 38280276. This research was funded by the National College Students Innovation and Entrepreneurship Training Program (Grant No. 202310343044), and the Zhejiang University Student Science and Technology Innovation Activity Plan (Grant No. 2023R413038). The authors have no actual or potential conflicts of interest. Systematic review with meta-analysis of data.

Financial Hardship and Sleep Quality Among Black American Women With and Without Systemic Lupus Erythematosus.

To compare dimensions of financial hardship and self-reported sleep quality among Black women with versus without systemic lupus erythematosus (SLE). Participants were 402 Black women (50% with validated diagnosis of SLE) living in Georgia between 2017 and 2020. Black women with SLE were recruited from a population-based cohort established in Atlanta, and Black women without SLE were recruited to be of comparable age and from the same geographic areas as SLE women. Financial hardship was measured using three different scales: financial adjustments, financial setbacks, and financial strain. Sleep was assessed continuously using the Pittsburgh Sleep Quality Index (PSQI) scale. Each dimension of financial hardship was analyzed separately in SLE-stratified multivariable linear regression models and adjusted by sociodemographic and health status factors. Dimensions of financial hardship were similarly distributed across the two groups. Sleep quality was worse in Black women with, versus without, SLE (p < .001). Among Black women with SLE, financial adjustment was positively associated with a 0.40-unit increase in poor sleep quality (95% CI = 0.12-0.67, p = .005). When accounting for cognitive depressive symptoms, financial setbacks and strain were somewhat attenuated for Black women with SLE. Overall, no associations between financial hardships and sleep quality were observed for the women without SLE. Black women with SLE who experience financial hardships may be more at risk for poor sleep quality than Black women without SLE. Economic interventions targeting this population may help improve their overall health and quality of life.

AMYPAD: Correlation of Amyloid PET results with anxiety and depressive symptoms in SCD+, MCI and dementia patients

AbstractBackgroundDepression and anxiety are two frequent neuropsychiatric symptoms in Alzheimer’s disease (AD). Moreover, depressive symptoms and anxiety are frequently associated with greater amyloid deposition and risk of Alzheimer’s dementia. The aim of the present study is to assess the association between anxiety and depression and amyloid burden.MethodIn the AMPYAD study, participants with subjective cognitive decline (SCD+, n = 244), mild cognitive impairment (MCI, n = 341) and dementia (n = 255) were enrolled in eight European memory clinics between 2018 and 2020. They underwent three study visits (baseline, six months, thirteen months) with collection of cognitive data and symptoms of depression and anxiety (Hospital Anxiety and Depression Scale, HADS) as well as measures of quality of life and coping strategies. Amyloid burden was obtained as the standardized centiloid values (CL). Correlation analyses were carried out for HADS‐Scores and CL. We analyzed the progression of depressive and anxiety symptoms over time between patients with and without presence of amyloid (CL≥21) using mixed‐model‐ANOVA. All analyses were corrected for time of PET result disclosure.ResultA total of 840 patients (46.2% female; mean age of 70.9 (SD = 7.8)) were included. Among SCD+ patients, CL values were positively correlated with baseline anxiety scores (r(216) = .14, p = .038). In contrast, MCI and dementia patients showed a negative correlation between CL and depressive symptoms (r(296) = ‐.16, p = .005; r(209) = ‐.23, p&lt;.001). In SCD+, there was no significant interaction between time and CL status for anxiety (p = .512), but a significant main effect of time (F(2,302) = 3.4, p = .036, η² = .02), indicating a decline in anxiety symptoms over time. A trend indicated higher anxiety for amyloid positive participants, but the effect missed statistical significance (p = .068). For depressive symptoms, we found no main effects and no significant interaction of time and CL status.ConclusionThe AMYPAD study contains a large amyloid‐PET data set of patients from eight European memory clinics. We observed an association of increased anxiety scores with amyloid load in SCD+, but reduced symptoms of depression with higher amyloid load in the MCI and dementia group. These findings and their longitudinal development over time will be put into a broader context of patient characteristics.

Relationship for co‐trajectories of cognitive decline and late‐life depression with postmortem neuropathology

AbstractBackgroundThe etiopathological relationship between late‐life cognitive decline and symptoms of depression remains unclear. Existing longitudinal studies have mostly grouped participants into distinct groups based on clinical diagnoses, and very few have analyzed postmortem neuropathology. Here we identified trajectories of both cognition and depressive symptoms in an elderly cohort over up to 27 years using growth mixture modeling (GMM), identifying co‐trajectory subgroups, and characterizing them with respect to postmortem neuropathologies.MethodWe analyzed 3,010 participants enrolled without dementia (mean age = 78) from the Religious Orders Study and Rush Memory and Aging Project (ROS/MAP). All included participants were evaluated for at least three annual visits for both depressive symptoms (using a modified Center for Epidemiologic Studies Depression Scale) and 19 cognitive tasks (yielding a global cognitive function summary score). A subset of 1,732 participants had complete postmortem neuropathological assessment data available. Latent trajectory subgroups were identified independently for global cognition and depressive symptoms using GMM with non‐linear time effects. Interaction effects of cognitive and depressive trajectory subgroups on neuropathologies were assessed using linear models.ResultThree trajectory subgroups (Figure 1) were identified for both cognitive decline (minimal (n = 1,232), slow (n = 1,325) and fast (n = 302)) and depressive symptoms (sustained low (n = 1,815), moderately increasing (n = 762) and consistently elevated (n = 433)). These subgroups showed significant overlap (chi‐square p = 0.0001), and their intersections defined nine co‐trajectories. A significant interaction effect (p = 0.0062) was identified between cognitive decline and depressive symptom trajectory subgroups for brain‐wide levels of paired helical filament tau; among only individuals experiencing fast cognitive decline, sustained lower depressive symptoms were associated with higher levels of tau (Figure 2).ConclusionLongitudinal cognitive decline and depressive symptom trajectories in late‐life are not independent. Intriguingly, we observed the highest tau burden in those individuals with both sustained low depressive symptoms and fast rates of cognitive decline. Given that use of antidepressants may lower tau levels (Dafsari &amp; Jessen, 2020), future models of neuropathology in trajectory‐based analyses will incorporate patterns of medication status.

Patient-Reported Postoperative Neuropsychological Deterioration After Heart Valve Replacement and Coronary Artery Bypass Grafting

BackgroundPostoperative cognitive decline (POCD) after cardiosurgical interventions are well described through objective psychometric tests. However, a patient’s subjective perception is essential to clinical assessment and quality of life. This study systematically evaluated patient-reported POCD between subjects undergoing coronary artery bypass grafting and heart valve replacement. MethodsThis study was a multicentre, prospective questionnaire survey conducted at the cardiac surgery departments at the Kerckhoff Clinic in Bad Nauheim and the University Hospital in Giessen, Germany. We included patients undergoing elective coronary artery bypass grafting (CABG), aortic valve replacement (AVR), mitral valve replacement or reconstruction (MVR), and combined surgery (CABG + valve replacement [VR]) with extracorporeal circulation. The Hospital Anxiety and Depression Scale, the Cognitive Failures Questionnaire (CFQ) for Self-assessment (CFQ-S), and the external assessment (CFQ-foreign [F]) were completed preoperatively, as well as at 3 and 12 months postoperatively. ResultsA total of 491 patients were available for analyses (CABG = 182, AVR = 134, MVR = 93, CABG + VR = 82). POCD and postoperative depression increase (PODI) were observed for each surgical procedure. (At the 3-month follow-up: CFQ-S [CABG = 7.1%, AVR = 3.7%, MVR = 9.7%, CABG + VR = 9.8%]; CFQ-F [CABG = 9.9%, AVR = 9.7%, MVR = 9.7%, CABG + VR = 15.9%]; PODI [CABG = 7.7%, AVR = 9.7%, MVR = 6.5%, CABG + VR = 8.5%]. At the 12-month follow-up: CFQ-S [CABG = 6.6%, AVR = 7.5%, MVR = 15.1%, CABG + VR = 7.3%]; CFQ-F [CABG = 7.1%, AVR = 14.9%, MVR = 10.8%, CABG + VR = 9.8%]; PODI [CABG = 10.4%, AVR = 11.2%, MVR = 6.5%, CABG + VR = 4.9%]). No significant between-group effects were observed for the CFQ-S, CFQ-F, or the Hospital Anxiety and Depression Scale. ConclusionsFor clinicians, paying attention to patients' self-reported experiences of reduced cognitive function and symptoms of depression following cardiac surgery is important. Such reporting is an indication that interventions such as cognitive training or psychotherapy should be considered.

94 Physical Activity, Emotional Functioning, and Cognitive Concerns During the COVID-19 Pandemic Among Older Adults in the US

Objective:Physical inactivity is associated with a greater risk of frailty, neuropsychiatric symptoms, worse quality of life, and increased risk for Alzheimer’s disease. Little is known about how physical activity engagement of older adults during the COVID-19 pandemic relates to subjective cognitive concerns and management of emotional distress. This study aimed to examine whether there were changes in physical activity during the pandemic in older adults at baseline and 3 months compared to before the pandemic and whether these changes varied based on age, sex, income level, and employment status. Further, we examined whether individuals who reported engaging in less physical activity experienced greater subjective cognitive difficulties and symptoms of depression and anxiety than those who maintained or increased their physical activity levels.Participants and Methods:301 participants (73% non-Hispanic whites) completed an online survey in either English or Spanish between May and October 2020 and 3 months later. The Everyday Cognition Scale was used to measure subjective cognitive decline, the CES-D-R-10 scale to measure depressive symptoms, and the GAD-7 scale to measure anxiety symptoms. Changes in physical activity were measured with the question “Since the coronavirus disease pandemic began, what has changed for you or your family in regard to physical activity or exercise levels?” with options “less physical activity,” “increase in physical activity,” or “same activity level.” Income was self-reported as high, middle, or low. Analyses of chi-squared tests were used to examine differences in physical activity maintenance by age, income level, sex, and employment status.Results:Most individuals (60%) reported having decreased their physical activity levels during the pandemic, at baseline and 3-month followup. There were differences in physical activity levels based on income and age: participants with a high income reported engaging in more physical activity than those with low income (X^2=4.78, p =.029). At the 3-month follow-up, middle-income participants reported being less active than the high-income earners (X^2=8.92, p=.003), and younger participants (55-65 years, approximately) reported being less active than older participants (X^2=5.28, p =.022). Those who reported an increase in their physical activity levels had fewer cognitive concerns compared to those who were less active at baseline, but this difference was not seen in the 3-month follow-up. Participants of all ages who reported having maintained or increased their physical activity levels had fewer depressive symptoms than those who were less active (p &lt; 0.0001). Those who reported maintaining their physical activity levels exhibited fewer anxiety symptoms than those who were less active (p &lt; 0.01).Conclusions:Older adults reported changes in physical activity levels during the pandemic and some of these changes varied by sociodemographic factors. Further, maintaining physical activity levels was associated with lower symptoms of depression, anxiety, and cognitive concerns. Encouraging individuals and providing resources for increasing physical activity may be an effective way to mitigate some of the pandemic’s adverse effects on psychological wellbeing and may potentially help reduce the risk for cognitive decline. Alternately, it is possible that improving emotional distress could lead to an increase in physical activity levels and cognitive health.

Prevalence of Anxiety, Depression, and Perceived Stress Among Family Caregivers of Patients Diagnosed With Oral Cancer in a Tertiary Care Hospital in Central India: A Cross-Sectional Study.

Background and objectives Oral cancer is a significant health issue in India, with one of the highest incidence rates globally. Family caregivers play a crucial role in the care of oral cancer patients, but their mental health often faces challenges. This study aimed to assess the prevalence of anxiety, depression, and perceived stress among family caregivers of oral cancer patients in a tertiary care hospital in central India and explore the associated psychosocial factors. Population and method The study was carried out between March 2023 and August 2023 in a tertiary care hospital in Wardha, Maharashtra. Family caregivers (N=82, mean age = 36.1 (SD 10.5) years) of patients with clinically diagnosed oral cancer were subjected first tostructured psychiatric clinical interviews to screen for psychiatric diagnoses and then were given self-reporting questionnaires for socio-demographic data, Beck Depression Inventory (BDI-II) for measuring the emotional, cognitive, and motivational symptoms of depression, Manifest Anxiety Scale (MAS) to assess the degree of anxiety and Perceived Stress Scale-10 (PSS-10) to assess stress level. Data was analysed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States). Chi-square test and logistic regression analyses were conducted wherever appropriate in order to explore predictive factors of depressive, anxious, or stress symptoms. Result In the studied population, the majority experienced symptoms of depression (65.1%), anxiety (69.5%), and perceived stress (74.7%). Caregivers of patients with advanced oral cancer were found to have a higher likelihood of experiencing depression (χ2 (1) = 16.76, p < .001) and anxiety related to unemployment (χ2 (1) = 10.12, p = .001) or insufficient earnings (χ2 (1) = 28.63, p < .001). Additionally, participants with no or little formal education (χ2 (1) = 4.63, p = 0.031) and lower income (χ2 (1) = 28.63, p < .0001) were significantly more likely to experience distress compared to those with higher levels of education. Conclusion This study highlights the need for comprehensive support systems for family caregivers of oral cancer patients. Educational programs, financial assistance, and mental health services should be tailored to caregivers' specific needs. Early identification and intervention strategies can help mitigate the psychological impact of caregiving. Further research is essential to develop targeted interventions that enhance the well-being of caregivers and improve the quality of life for both patients and caregivers.

Effect of vortioxetine versus venlafaxine on cognitive functions in adults with major depressive disorder: A randomized-controlled trial.

Vortioxetine and venlafaxine are antidepressants which have shown established efficacy to treat major depressive disorder (MDD). There are no studies that compared them for their efficacy in cognitive symptoms of depression. The study aimed to compare the effect of vortioxetine and venlafaxine on the change in cognitive scores in adults with MDD. The present study was an open-label, active-controlled parallel design randomized clinical trial. After randomization, baseline clinical evaluations by Montgomery-Asberg Depression Rating Scale (MADRS) and Social and Occupational Functioning Assessment Scale (SOFAS) were done and coding (subset of WAIS-IV), WCST, TMT, Stroop test, PGI memory were used to assess cognition in 100 unmedicated MDD patients. They were reassessed after eight weeks of monotherapy with vortioxetine or venlafaxine. Primary cognitive measure (coding score) was found to be significantly higher (Mean Difference = 0.680; 95% CI:.202 to 1.158; P = 0.006) in vortioxetine in comparison with venlafaxine. Stroop test scores (word score, color score, color-word score) were also found to be significantly higher with vortioxetine. In other cognitive measures (WCST scores: total trials, total errors score, total perseverative responses score, total perseverative errors scores; TMT-A and B scores), a significant decrease in scores with vortioxetine in comparison with venlafaxine were observed. A significant decrease in MADRS and increase in SOFAS scores were observed with vortioxetine in comparison with venlafaxine. Both the drugs alleviated the symptoms of depression but vortioxetine was better tolerated. Our study findings suggest that improvement in cognitive scores is significantly higher with vortioxetine than venlafaxine over the eight weeks of monotherapy. CTRI/2020/07/026819 (Registered with Clinical Trials Registry- India).

Somatic Symptoms of Depression Lose Association with Mortality upon Adjustment for Frailty: Analysis from the Fitness Haemodialysis Cohort.

The somatic symptom component of depression is associated with increased hospitalisation and mortality and poorer health-related quality of life (HRQOL). However, the relationship of subsets of depression symptoms with frailty and outcomes is not known. This study aimed to (1) explore the relationship between the Clinical Frailty Scale (CFS) and components of depression and (2) their association with mortality, hospitalisation, and HRQOL in haemodialysis recipients. We conducted a prospective cohort study of prevalent haemodialysis recipients, with deep bio-clinical phenotyping including CFS and PHQ-9 somatic (fatigue, poor appetite, and poor sleep) and cognitive component scores. EuroQol EQ-5D summary index assessed HRQOL at the baseline. Electronic linkage to English national administration datasets ensured robust follow-up data for hospitalisation and mortality events. Findings. Somatic (β = 0.067; 95% C.I. 0.029 to 0.104; P < 0.001) and cognitive (β = 0.062; 95% C.I. 0.034 to 0.089; P<0.001) components were associated with increased CFS scores. Both somatic (β = -0.062; 95% C.I. -0.104 to -0.021; P<0.001) and cognitive (β = 0.052; 95% C.I. -0.081 to -0.024; P < 0.001) scores were associated with lower HRQOL. Somatic scores lost mortality association on addition of CFS to the multivariable model (HR1.06; 95% C.I. 0.977 to 1.14; P=0.173). Cognitive symptoms were not associated with mortality. Neither the component score was associated with hospitalisation on multivariable analyses. Both somatic and cognitive depression symptoms are associated with frailty and poorer HRQOL in haemodialysis recipients but were not associated with mortality or hospitalisation when adjusted for frailty. The risk profile of depression somatic scores may be related to overlap with symptoms of frailty.

64-LB: Cognitive and Somatic Symptoms of Depression Are Uniquely Related to HbA1c and Suicide Attempt History

Screening for depression and suicide risk is an essential part of care for adolescents and young adults (AYA) with type 1 diabetes (T1D), as increased depression symptoms and suicide attempt history are independently associated with elevated Hba1c. As symptoms of depression and prolonged hyperglycemia may coexist, further insight may be gained from an understanding of how somatic versus cognitive symptoms may uniquely relate to clinical outcomes in AYA with T1D. This study examined the independent relationships between HbA1c and suicide attempt history with cognitive and somatic symptoms on the Patient Health Questionnaire-9 Adolescent Version (PHQ-9) for AYA with T1D. The PHQ-9 was electronically administered (n = 2,491) at routine outpatient medical visits, and PHQ-9 scores, relevant background variables (age, sex, race, ethnicity, diabetes duration), and HbA1c values were obtained via chart review. AYA with T1D were 15.7 years old and had diabetes for 6.2 years, on average. After adjusting for covariates, somatic (B = .08, p &amp;lt;0.001), but not cognitive symptoms (B = .02, p = 0.3), predicted HbA1c levels. Follow up analyses showed this relationship varied by sex, with somatic symptoms and HbA1c related in females (B = .10, p = .002) but not males (B = .05, p = .14), and by race, with somatic symptoms and HbA1c related in those who identify as African American (B = .13, p = .009) but not White (B = .03, p = .32). Logistic regression analyses controlling for relevant background variables showed cognitive symptoms (B = .46, p &amp;lt; 0.001), but not somatic symptoms (B = .06, p = 0.39), were related to suicide attempt history. Findings demonstrate the value of independently monitoring cognitive and somatic symptoms of depression for AYA with T1D. Somatic symptoms are more strongly related to glycemic control, particularly for AYA with T1D who are female and identify as African American, respectively, whereas cognitive symptoms are significantly related to suicide attempt history. Disclosure J. M. Gettings: None. E. J. Pantesco: None. N. Andorko: None. S. M. Willi: Advisory Panel; Boehringer Ingelheim International GmbH, Medtronic.

The influence of childhood emotional maltreatment on cognitive symptoms, rumination, and hopelessness in adulthood depression.

Childhood emotional maltreatment (CEM) is a risk factor for the pathogenesis of depressive disorders. However, it is not clear whether CEM is more strongly related to specific symptoms of depression and whether specific traits or cognitive states may mediate the association between CEM and depressive symptoms. In our cross-sectional study, including 72 patients with a current depressive episode, we investigated if CEM is specifically related to cognitive symptoms of depression. In addition, we evaluated whether CEM also influences the extent of rumination and hopelessness in adult depression. Using multiple regression analyses, we tested if CEM and rumination could predict cognitive symptoms and hopelessness. A structural equation model (SEM) was used to examine if rumination mediates the relationship between CEM and cognitive symptoms. Correlational analyses revealed that CEM was related to cognitive symptoms, rumination, and hopelessness. The regression analyses showed that only rumination was a significant predictor for cognitive symptoms and hopelessness, whereas CEM could not significantly predict the two constructs. SEM revealed that the association between CEM and cognitive symptoms in adult depression was mediated by rumination. Our results thereby suggest that CEM is a risk factor particularly for the development of cognitive symptoms as well as rumination and hopelessness in adult depression. However, the influence on cognitive symptomatology seems to be indirectly regulated by rumination. These findings may contribute to a better understanding of processes that promote depression, as well as provide guidance for more targeted treatment options.

A study protocol on teaching english to people with mild cognitive impairment with the use of songs

AbstractBackgroundPeople with Mild Cognitive Impairment (MCI) need to improve their cognitive functions in order to avoid the deterioration of their condition. Cognitive abilities can be improved by learning a foreign language. Due to the cognitive deficits of MCI people, conventional methods that teaching English cannot have significant results. The use of songs in teaching English is proved to be a promising method for more effective acquisition of the language while also improving cognitive functions and symptoms of depression and anxiety.MethodThis learning method had been designed by combining elements from four methodologies in language learning “Communicative Language Teaching”, “Natural Approach”, “(De) suggestopedia” and “Neurolinguistic Programming (NLP)”. The intervention of this study involves a randomized controlled trial design with two arms (an intervention arm and a control group) over a nine‐month period and will be provided twice a week. Participants will be people with MCI aged 60‐85 years, of both genders. A sample size of 90 participants is targeted based on expected neuropsychological test performance, and drop‐out rates. Interventions will be provided by trained staff with a control group not receiving any intervention but continuing life as usual. Assessments will be done at baseline, and nine months, and include neuropsychological tests to measure for changes in cognition. Secondary outcome measures will include mood changes in anxiety, depression and quality of life. All efficacy statistical analysis will be carried out on an intention to treat basis. Primary and secondary outcomes will be modeled using the linear mixed model for repeated measurements and further analysis will be undertaken.ResultThis study protocol is implementing by Greek Association of ALzheimer Disease and Related Disorders and the final results will be announced soon.ConclusionThis will be the first study to implement and assess this intervention in a randomized controlled trial. We expect that this study protocol could prevent cognitive decline, decrease symptoms of depression and anxiety and significantly impact quality of life and the wellbeing of people with MCI.

Changes in affective and cognitive distortion symptoms of depression are reciprocally related during cognitive behavior therapy

We tested the predictions from Beck's cognitive theory that change in cognitive distortions precedes and predicts change in affective symptoms of depression, and his secondary prediction that change in affective symptoms precedes and predicts change in cognitive distortions during the course of cognitive behavior therapy (CBT; Beck, 1963). We used bivariate latent difference score modeling to examine change in affective and cognitive distortion symptoms of depression over time in a sample of 1402 outpatients who received naturalistic CBT in a private practice setting. Patients completed the Beck Depression Inventory (BDI) at each therapy session to monitor their progress in treatment. We selected items from the BDI to create measures of affective and cognitive distortion symptoms that allowed us to assess change in those phenomena over the course of treatment. We examined BDI data from up to 12 sessions of treatment for each patient. As predicted by Beck's theory, we found that change in cognitive distortion symptoms preceded and predicted change in affective symptoms of depression, and that change in affective symptoms preceded and predicted change in cognitive distortion symptoms. Both effects were small in size. These findings support the notion that change in affective and cognitive distortion symptoms of depression each precedes and predicts the other – that is, they are reciprocal in nature during cognitive behavior therapy. We discuss implications of our findings for the nature of the change process in CBT.

Effectiveness of an Online Dementia Prevention Program on Cognitive Function and Depression in Community-Dwelling Older Adults during the COVID-19 Pandemic in Korea.

(1) Background: Continuous participation in a comprehensive dementia prevention program is important for community-dwelling older adults during the coronavirus disease (COVID-19) pandemic, as limitations on their communities and social participation have increased and participation in daily tasks has decreased. These factors can negatively affect their cognitive function and symptoms of depression. This study aimed to introduce an evidence-based online dementia prevention program in the South Korean context and to identify its effect on cognitive function and symptoms of depression in community-dwelling older adults during the COVID-19 pandemic. (2) Methods: One hundred and one community-dwelling older adults without dementia participated in twelve sessions of an online dementia prevention program designed by occupational therapists. Cognitive function and symptoms of depression were assessed before and after the program. Cognitive function was tested using the Cognitive Impairment Screening Test and symptoms of depression were assessed using the Korean version of the Short Geriatric Depression Scale. The participants' opinions were gathered using open-ended questions. (3) Results: After the program, according to the raw score, orientation was maintained and attention, visuospatial function, executive function, memory, and language function increased. The memory and total cognitive score was improved significantly. Symptoms of depression significantly decreased. The program's benefits according to the participants were participation in new activities, boredom reduction, online communication, and reminiscence. (4) Conclusions: An online dementia prevention program is effective in maintaining and increasing cognitive function and preventing depression in community-dwelling older adults. An online dementia prevention program is a useful method in providing opportunities to participate in cognitive training and continuous daily activities during the COVID-19 pandemic.

Depressed patients who do not believe they deserve to get better: Prevalence, clinical characteristics, and treatment outcomes.

The aim of the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project was to examine the demographic and clinical features that distinguished depressed patients who did and did not indicate they deserved to feel better. A total of 490 depressed patients completed a clinical history questionnaire that included a question about whether the patient thought they deserved to feel better, as well as a self-report questionnaire assessing symptoms, positive mental health, coping ability, functioning, and well-being. Approximately 20% of patients indicated they were unsure or undeserving of feeling better. Patients who did not believe they deserved to get better reported more cognitive symptoms of depression, were more likely to drop out of treatment due to nonattendance, more pessimistic about outcomes upon treatment initiation, more frequently reported suicidal ideation, more frequently reported a history of multiple suicide attempts, and experienced less improvement in their depressive symptoms during treatment. A meaningful number of depressed patients seeking treatment did not assert that they deserved to feel better. Efforts to treat individuals who do not believe they deserve to feel better may be less productive if this perspective is not addressed.

Depressive Symptoms are Positively Linked to Malevolent Creativity: A Novel Perspective on the Maladaptive Nature of Revenge Ideation

ABSTRACTDepressed mood has attracted little attention in creativity research. By comparison, psychotherapeutic studies have repeatedly associated depressive symptomatology with increased revenge ideation. Combining creativity and retaliatory ideation, the present study examined whether self‐reported subclinical depressive symptoms are linked to malevolent creativity – creativity used for the purpose of damaging others – in a psychometric test. In a sample of n = 259 participants, overall depressive symptoms were positively associated with malevolent creativity. Sensitivity analyses confirmed this link for motivational and interactional symptoms, but not cognitive symptoms of depression. As a gender‐specific finding, malevolent creativity was positively linked to emotional symptoms of depression in women, but not men. Our findings hint at the possibility that mood impairments through depressive symptoms may facilitate malevolent creative ideation through increased impulsivity, reduced self‐regulation, and protracted anger rumination. Following recommendations regarding more focused investigations into the vast research complex of psychopathology and creativity, this study emphasizes negative mood as a risk factor for the occurrence of harmful creative ideation, and thus, presents a novel perspective on the intricate link between internalizing and externalizing symptomatology.