Depressed Mood Research Articles

Factors influencing the tendency of residual symptoms in patients with depressive disorders: a longitudinal study

BackgroundResidual symptoms of depressive disorders are serious health problems. However, the progression process is hardly predictable due to high heterogeneity of the disease. This study aims to: (1) classify the patterns of changes in residual symptoms based on homogeneous data, and (2) identify potential predictors for these patterns.MethodsIn this study, we conducted a data-driven Latent Class Growth Analysis (LCGA) to identify distinct tendencies of changes in residual symptoms, which were longitudinally quantified using the QIDS-SR16 at baseline and 1/3/6 months post-baseline for depressed patients. The association between baseline characteristics (e.g. clinical features and cognitive functions) and different progression tendencies were also identified.ResultsThe tendency of changes in residual symptoms was categorized into four classes: “light residual symptom decline (15.4%)”, “residual symptom disappears (39.3%)”, “steady residual symptom (6.3%)” and “severe residual symptom decline (39.0%)”. We observed that the second class displayed more favorable recuperation outcomes than the rest of patients. The severity, recurrence, polypharmacy, and medication adherence of symptoms are intricately linked to the duration of residual symptoms’ persistence. Additionally, clinical characteristics including sleep disturbances, depressive moods, alterations in appetite or weight, and difficulties with concentration have been identified as significant factors in the recovery process.ConclusionsOur research findings indicate that certain clinical characteristics in patients with depressive disorders are associated with poor recovery from residual symptoms following acute treatment. This revelation holds significant value in the targeted attention to specific patients and the development of early intervention strategies for residual symptoms accordingly.

Charles Bonnet Syndrome asssociated with glaucoma in a 95-year old female: A case report

Vision problems increase with age and evaluation of visual perception is important in geriatric practice. Visual hallucinations may occur in elderly individuals for various reasons. Hallucinations secondary to loss of severe visual acuity or visual field, also known as Charles Bonnet Syndrome(CBS), may be rarely seen. We reported a case of CBS secondary to glaucoma in a 95-year-old female patient. It is stated that this patient's visual hallucination has been developing for the last 3 years. The patient had simple hallucinations that were not related to dementia or psychotic disorder. The patient had accompanying depressive mood and fear of being alone. Visual hallucinations decreased after antidepressant treatment. The oldest known case of CBS is presented.

Effects and neural mechanisms of different physical activity on major depressive disorder based on cerebral multimodality monitoring: a narrative review.

Major depressive disorder (MDD) is currently the most common psychiatric disorder in the world. It characterized by a high incidence of disease with the symptoms like depressed mood, slowed thinking, and reduced cognitive function. Without timely intervention, there is a 20-30% risk of conversion to treatment-resistant depression (TRD) and a high burden for the patient, family and society. Numerous studies have shown that physical activity (PA) is a non-pharmacological treatment that can significantly improve the mental status of patients with MDD and has positive effects on cognitive function, sleep status, and brain plasticity. However, the physiological and psychological effects of different types of PA on individuals vary, and the dosage profile of PA in improving symptoms in patients with MDD has not been elucidated. In most current studies of MDD, PA can be categorized as continuous endurance training (ECT), explosive interval training (EIT), resistance strength training (RST), and mind-body training (MBT), and the effects on patients' depressive symptoms, cognitive function, and sleep varied. Therefore, the present study was based on a narrative review and included a large number of existing studies to investigate the characteristics and differences in the effects of different PA interventions on MDD. The study also investigated the characteristics and differences of different PA interventions in MDD, and explained the neural mechanisms through the results of multimodal brain function monitoring, including the intracranial environment and brain structure. It aims to provide exercise prescription and theoretical reference for future research in neuroscience and clinical intervention in MDD.

Systematic Review Protocol: Anhedonia in Youth and the Role of Internet-Related Behavior

Background: Depression is a serious and debilitating condition with a rising prevalence. Anhedonia, a core symptom of depression, is notably significant and the second most weighted factor among the non-somatic concerns of depression, following depressed mood. The interaction between technology use, mood, emotions, depression, and anhedonia is a critical area of investigation. Aim: This study aims to develop a comprehensive Systematic Review Protocol to examine the emotional effects of Internet-related behavior in young people. Methods: A systematic review protocol was developed following PRISMA guidelines for systematic reviews. The research question was formulated according to the PICOS framework. The search was conducted using PubMed/Medline, Cochrane Library, Embase, Scopus, and PsycInfo, supplemented by gray literature sources via Google Scholar. The methodological quality and risk of bias was assessed using the Critical Appraisal Skills Programme (CASP) framework. This systematic review protocol was registered on the Open Science Framework with the registration DOI: 10.17605/OSF.IO/SHNJU. Conclusions: The findings of this systematic review are expected to provide new evidence on the correlations between depression, Internet addiction, and anhedonia, contributing to the development of targeted intervention strategies and improving the understanding of young peoples’ emotional well-being.

Efficacy of pentoxifylline for the treatment of bipolar I/II patients with treatment-resistant depression: A proof-of-concept, randomized, double-blind, placebo-controlled trial

BackgroundImmune dysregulation can play a role in depression pathophysiology, and immunological antagonists can improve depressive symptoms in treatment-resistant bipolar depression (TRD) patients according to studies. ObjectiveTo evaluate the anti-depressant effects of the anti-inflammatory drug, pentoxifylline (PTX) in TRD bipolar I/II adult subjects. MethodsThis 12-week, randomized, double-blind, placebo-controlled, parallel-group trial of 60 participants was conducted at Hawler Psychiatric Hospital and Private Clinic in Erbil, Iraq. Participants were confirmed as being qualified for bipolar I/II depression based on DSM-5 criteria. Data were analyzed using modified intent-to-treat analysis. ResultsThere were no significant differences between the two groups in Hamilton Rating Scale for Depression-17 (HAM-D-17) scores (χ2=1.9, P =.48) or a significant time × treatment interaction (χ2=7.1, P=.54). Nevertheless, a significant effect of time was observed with both groups’ reduction in HAM-D-17 scores from the start to the endpoint (χ2= 2.11, P=.002). Besides, a significant time × treatment × CRP interaction was found (χ2=3.1, P=0.016), where there was more reduction in HAM-D-17 score in PTX-treated subjects with CRP> 7.1 mg/L. The response rate difference between PTX and the placebo group did not reach a significance level (χ2=0.84, p=0.43). Furthermore, serum concentrations of TNF-α, CRP, and IL-6 significantly reduced at week 12 in the PTX group (P=.007,.04, and <.001, respectively). ConclusionThe current proof of concept study found that in terms of overall anti-depressant effectiveness in bipolar patients with TRD, PTX is not superior to placebo. However, it may improve depressive mood in a subpopulation of subjects with a higher pretreatment inflammatory profile.

Efficacy of Aromatherapy Against Behavioral and Psychological Disturbances in People With Dementia: A Meta-Analysis of Randomized Controlled Trials

ObjectivesBehavioral and psychological symptoms of dementia (BPSD) are common in people with dementia. Aromatherapy may reduce the frequency and severity of BPSD. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of aromatherapy in relieving BPSD and improving functional ability in people with dementia. DesignSystematic review and meta-analysis. Setting and ParticipantsPatients with dementia receiving aromatherapy. MethodsA literature search was conducted using PubMed, Embase, and Cochrane Library for RCTs published before March 2024 comparing aromatherapy with control treatments in patients with dementia. ResultsThere were 15 trials involving 821 patients. Overall, significant reduction in BPSD was observed after 1 month of aromatherapy treatment. Among 15 trials, 9 reported the Cohen-Mansfield Agitation Inventory (CMAI) score, and 7 evaluated the Neuropsychiatric Inventory (NPI) score. The meta-analysis showed significant improvement in CMAI score [weighted mean difference (WMD) −6.31, 95% CI −9.52 to −3.11] and NPI score (WMD −8.07, 95% CI −13.53 to −2.61) in patients receiving 3 to 4 weeks of aromatherapy compared with the control group. Four of the 15 trials reported improvement in depressive mood and 3 trials reported no significant improvement in functional ability. Conclusions and ImplicationsIn conclusion, aromatherapy is a safe and viable nonpharmacologic treatment to improve BPSD in people with dementia and its combination with massage showed higher efficacy.

Quality of Life and Patient Satisfaction After the Provision of an Orthopedic Knee Scooter.

Partial or total avoidance of weight-bearing by a lower limb is regularly needed after trauma and surgery. There are approximately 200 such cases per 100 000 persons per year. Forearm crutches have mainly been used in Germany until now to keep these patients mobile. For those who lack the strength or co - ordination needed to use crutches, a wheelchair may become necessary, or they might find themselves forced to continue weightbearing on the affected limb, with possible impending adverse consequences and complications. The supplementary use of a new type of orthopedic scooter by patients who must avoid weight-bearing by a lower limb, wholly or in part, was studied in a multicenter randomized controlled trial involving 88 subjects. The endpoints were improvement in quality of life (EQ5D, SF36) and improved abilities in everyday life (retrospective registration: DRKS00032980). Patients who used orthopedic knee scooters (KS) reported a better overall state of health more frequently than those who used forearm crutches (UC) (SF-36 score: 67 [KS group], 95% CI [61; 73]; 59 [UC group], [53; 64]). They also reported less anxiety and depressed mood, greater mobility, and more independence than the patients who used crutches. In addition, they more frequently reported being able to transport themselves 4 x 500 meters in less than 20 minutes (n 30 [KS], 63.8% [48.5; 77.3]; n 6 [UC], 14.6% [5.6, 29.2]). The supplementary use of an orthopedic knee scooter can improve these patients' mobility and independence and prolong the distance over which they can transport themselves. For many patients, this form of treatment may well shorten the time of their total or partial inability to work and thus lower the socioeconomic costs of lower limb injuries and surgery.

Subclinical hypomanic experiences in young adults after sleep deprivation are independent of depressive disorders, chronotype or 5-HTTLPR polymorphism

Introduction The acute antidepressant effect of sleep deprivation (SD) in patients with depressive disorders has been studied for more than 60 years. However, hypomanic mood swings after partial or total SD have also been described in people without diagnosed mental disorders. Studying this phenomenon in the general population may yield insights about the mechanisms of therapeutic SD, mania and bipolar disorders. Methods A cross-sectional sample of young adults was recruited and classified into those who described having regularly occurring subclinical hypomanic experiences (ROHE) after SD and those who did not. History of psychiatric and physical illness, with screening for depression and mania, as well as alcohol or drug consumption, family history of depressive disorders or suicide, 5-HTTLPR polymorphism, and MEQ-SA chronotype were collected. Results A total of 251 participants were included; 39.0% indicated regularly having subclinical hypomanic experiences after SD. These experiences were not associated with depressive or mania screening, history of psychiatric illness, family history, 5-HTTLPR polymorphism, or MEQ-SA chronotype. Conclusions ROHE after non-therapeutic SD seem to be a relatively common phenomenon in young adults, independent of depressive mood state. Our results suggest that therapeutic SD may depend on a physiological phenomenon of subclinical affective disturbance after SD that affects a part of the general population, independent of psychiatric diagnosis. Further studies could elucidate associated factors and contribute to our understanding of (hypo-)manic mood states.

Timing and cortical region matter: theta power differences between teenagers affected by Major Depression and healthy controls

In adults affected by Major Depressive Disorder (MDD), most findings point to higher electroencephalographic (EEG) theta power during wake compared to healthy controls (HC) as a potential biomarker aiding the diagnostic process or subgrouping for stratified treatment. Besides these group differences, theta power is modulated by time of day, sleep/wake history, and age. Thus, we aimed at assessing if the time of recording alters theta power in teenagers affected by MDD or HC. Standardized wake EEG power was assessed with high-density EEG in 15 children and adolescents with MDD and in 15 age- and sex-matched HC in the evening and morning. Using a two-way ANOVA, group, time, and their interaction were tested. In patients, the current severity of depression was rated using the Children’s Depression Rating Scale. Broadband EEG power was lower in the morning after sleep, with a significant interaction (group x time) in central regions in the 4-6 Hz range. In MDD relative to HC, theta power was decreased over occipital areas in the evening and increased over frontal areas in the morning. A higher frontal theta power was correlated with more severe depressive mood in the morning but not in the evening. This was a cross-sectional study design, including patients on antidepressant medication. In conclusion, depending on time of recording, region-specific opposite differences of theta power were found between teenagers with MDD and HC. These findings stress the importance of the time of the recording when investigating theta power’s relationship to psychopathology.

Children in Mental Health Crisis: Pediatric Primary Care Providers' Role in Bridging Treatment Following Higher Levels of Care.

The current study examines the role of pediatric PCPs in bridging treatment for youth who have experienced mental health crises and the characteristics of these patients for whom PCPs sought psychiatric consultation and referral support from a child psychiatry access program, Maryland Behavioral Health Integration in Pediatric Primary Care. Psychiatric consultation and referral calls between 2012 and 2021 were included if a) the patient was recently seen in a higher level of care and b) the PCP was bridging treatment following the patient's discharge; 208 calls met criteria. The most common mental health concerns included depressed mood, suicidal thoughts/gestures, and anxiety. Acute concerns of aggression, suicide attempts, and hallucinations were also reported. Over half of the patients had two or more mental health diagnoses. At the time of the call, only one quarter of these patients had outpatient therapy services while about half were receiving medication treatment. Most of these patients were discharged from the higher level of care without a care plan. Pediatric PCPs are managing their patients' complex mental health concerns following receipt of higher levels of care. Improvements in collaboration and care coordination between pediatric PCPs and emergency department providers are needed.

Role of serum estradiol and C-telopeptide on musculoskeletal pain in menopausal women.

Musculoskeletal pain is one of the common symptoms of menopause syndrome throughout the world. Estradiol is the most potent and abundant derivative of estrogen and is associated with musculoskeletal pain, stiffness, and depressed mood during the menopausal transition. C-telopeptide is a molecule released during osteoclastic bone resorption and degradation of type I collagen, which is reported to have higher levels in individuals with musculoskeletal pain. An observational analytical study with a cross-sectional design was used in this research. Estradiol and C-telopeptide levels were measured in this study using enzyme-linked immunosorbent assay (ELISA). Musculoskeletal pain was assessed using the Nordic Musculoskeletal Questionnaire (NMQ) and the Menopause Quality of Life Questionnaire (MENQOL). Musculoskeletal pain was determined if the participant answered "yes" on questions number 12, 14 and 25 on the MENQOL. Data analysis was performed using the independent Student t-test for normally distributed data and the Mann-Whitney test for non-normally distributed data. A correlation test was performed using the Pearson correlation test for normally distributed data and the Spearman correlation test for non-normally distributed data. The results showed a non-significant relationship between estradiol and C-telopeptide levels with musculoskeletal pain assessed using the NMQ or MENQOL questionnaires. The correlation test also showed no correlation between estradiol and C-telopeptide levels in women with and without musculoskeletal pain.

Stimulant medications in the management of bulimia nervosa and anorexia nervosa in patients with and without comorbid attention deficit hyperactivity disorder: A systematic review.

People with attentional problems are at increased risk of eating disorders. This paper aimed to systematically review and synthesize the existing evidence on stimulant medication in the management of patients with bulimia nervosa (BN) or anorexia nervosa (AN) with or without comorbid attention deficit hyperactivity disorder (ADHD). A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A protocol for the review was registered with Open Science Framework (OSF) Registry and critical appraisal of the literature was conducted using Joanna Briggs Institute (JBI) Critical Appraisal Tools. Thirteen articles met inclusion criteria including two quasi-experimental studies, one randomized controlled trial, four case series, and six case reports. 26 cases were included from studies and 32 from case series/reports. Only two cases from a single case report had a diagnosis of AN, while the remainder had BN. Stimulants included methylamphetamine, lisdexamfetamine, methylphenidate, dextroamphetamine sulphate and mixed amphetamine salt. In nearly all cases of BN there were reported reductions in eating disorder symptoms. The rates of adverse effects were high and included weight loss, decreased appetite, tachycardia, dry mouth, fatigue, insomnia, restlessness, nausea, bruxism, headache, palpitations, blood pressure changes, irritability, anxiety, depressed mood, and diaphoresis. There is currently insufficient evidence to support the use of stimulant medications to treat symptoms of BN or AN. The authors recommend considering screening patients with BN for ADHD.

Natural Language Processing Accurately Differentiates Cancer Symptom Information in Electronic Health Record Narratives.

Identifying cancer symptoms in electronic health record (EHR) narratives is feasible with natural language processing (NLP). However, more efficient NLP systems are needed to detect various symptoms and distinguish observed symptoms from negated symptoms and medication-related side effects. We evaluated the accuracy of NLP in (1) detecting 14 symptom groups (ie, pain, fatigue, swelling, depressed mood, anxiety, nausea/vomiting, pruritus, headache, shortness of breath, constipation, numbness/tingling, decreased appetite, impaired memory, disturbed sleep) and (2) distinguishing observed symptoms in EHR narratives among patients with cancer. We extracted 902,508 notes for 11,784 unique patients diagnosed with cancer and developed a gold standard corpus of 1,112 notes labeled for presence or absence of 14 symptom groups. We trained an embeddings-augmented NLP system integrating human and machine intelligence and conventional machine learning algorithms. NLP metrics were calculated on a gold standard corpus subset for testing. The interannotator agreement for labeling the gold standard corpus was excellent at 92%. The embeddings-augmented NLP model achieved the best performance (F1 score = 0.877). The highest NLP accuracy was observed in pruritus (F1 score = 0.937) while the lowest accuracy was in swelling (F1 score = 0.787). After classifying the entire data set with embeddings-augmented NLP, we found that 41% of the notes included symptom documentation. Pain was the most documented symptom (29% of all notes) while impaired memory was the least documented (0.7% of all notes). We illustrated the feasibility of detecting 14 symptom groups in EHR narratives and showed that an embeddings-augmented NLP system outperforms conventional machine learning algorithms in detecting symptom information and differentiating observed symptoms from negated symptoms and medication-related side effects.

Quality of Life Among Breast Cancer Patients in Mures County, Romania: A Cross-Sectional Study.

Background and aim Psychiatric pathology does not always start on its own but may be conditioned or triggered by a comorbidity with a high impact on the human psyche. When there are comorbidities, psychiatric pathology can occur due to the high diagnostic burden. Our study aims to find out if there is a correlation between the diagnosis of breast cancer and its severity,and psychiatric symptoms such as depressive mood, atypical anxiety, or even autolytic ideation that directly influence the quality of life of patients. Materials and methods The study is a prospective, cross-sectional, single-center study carried out between December 2023 and June 2024 at the Mureș County Clinical Hospital in Romania. The sample population had to be at least 18 years old and had to bediagnosed with breast cancer recently.We applied two tests, WHODAS 2 (World Health Organization's Disability Assessment Schedule 2.0) and level 1 (level 1 of cross-sectional measurements of symptoms), to be able to measure and aid assessment of mental health domains that are important across psychiatric diagnoses and also the degree of disability triggered by breast cancer. The statistical analysis included descriptive statistics and interferential statistics. Statistical tests, such as Shapiro-Wilk, Kruskal-Wallis, and Mann-Whitney U tests with Bonferroni correctiontests, were used.The p-value was set to 0.05 with a confidence interval (CI) of 95%. Results The study included 120 women diagnosed with breast cancer, with a mean age of 56.64 ± 9.46 years. Regarding the severity of the diagnosis, 44 women (36.66%) had non-invasive cancer, 58 (48.33%) had invasive cancer, and 18 (15%) had metastases.There was a statistically significant difference between three of the five selected level 1 domains across cancer types.The WHODAS 2.0 disability scores showed a significant difference between groups (p < 0.001). Subjects with non-invasive cancer had the lowest WHODAS 2.0 score, followed by the invasive group, while metastases had the highest score. Conclusions Following the application of the two tests, level 1 and WHODAS 2.0, to our group of subjects, statistically significant differences were observed between the three categories of subjects. The degree of disability and the occurrence of psychological symptoms differed according to the severity of breast cancer. Adapting to the status of an oncological patient entails multiple changes from a psycho-emotional, social, occupational, and professional point of view. Although the most recent medications prolong survival, a holistic approach that considers psychological aspects can improve patients' long-term results.

The Accuracy Properties of the Reflective Thinking Index in Polish Language Narratives

The assessment of the Reflective Thinking Index in narratives is considered as an insights indicator of the person constructing a story. The aim of this study was to verify the index validity. 553 adults took part in the study. The respondents wrote a story about their close relationship and filled in questionnaires measuring the state and trait anxiety, depression, and personality disorder traits. In the narratives, all the phrases constituting the Reflective Thinking Index components were counted using a computerized method. Then, a cluster analysis was performed using the k-means method to distinguish types of people with specific index values. Next, it was checked whether the identified subtypes of the index allow differentiating people with an optimistic vision of the situation, high vs low levels of anxiety state/trait, high vs low levels of depressive mood, and various personality disorder traits. To demonstrate index sensitivity, specificity, and precision, ROC curves were analyzed. The results indicate that the Reflective Thinking Index varies depending on the level of state/trait anxiety, optimistic vision of the situation, depressiveness, and education level. High Reflective Thinking is associated with average sensitivity, low specificity, and average precision in the prediction of an optimistic situation vision. The low Reflective Thinking Index is characterized by average sensitivity, low specificity, and average precision in the prediction of state/trait anxiety. The obtained accuracy properties of the Reflective Thinking Index suggest some caution in its application and interpretation.

Cognitive and depressive disorders in older hypertensive patients

Arterial hypertension is a main risk factor for cardiovascular and cerebrovascular events and death, as well as cognitive and mood disorders. The purpose of this research was to assess the frequency of cognitive decline and depressive disorders in older hypertensive patients. 117 patients aged 50 - 89 were investigated using the MMSE, Mini-Cog tests, and the Geriatric Depressives scale. Cognitive dysfunction was registered in 24% and 30% of older hypertensive patients explored by MMSE and Mini-Cog, respectively. Mild cognitive decline prevailed. The frequency of cognitive impairments increased with age mostly in men. Depressive disorders were frequent (nearly 34 %) among older hypertensive patients. Mild mood disorders were 3 times more common than moderate. Female gender was associated with depression severity. The multimorbidity level correlated with the Geriatric Depression Scale score (r = 0.22, P &lt; 0.05). There was a correlation between MMSE and the Geriatric Depression Scale score (r = 0.255, P = 0.006) Given the multimorbidity, not only the age and hypertension itself but also concomitant pathology should be considered as a significant factor for cognitive decline and depressive mood disorders as well as their association. _________________________________________________________________________________________ Keywords: older patients, arterial hypertension, geriatric screening, cognitive decline, depressive mood

Repetitive Transcranial Magnetic Stimulation (rTMS) Therapy in Mood Disorders and Generalized Anxiety Disorder (GAD)

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neurostimulation technique increasingly investigated for its therapeutic potential in mood disorders and related brain conditions. This paper using content analysis reviewed literatures and summarized current research on the efficacy and safety of rTMS in treating mood disorders, including major depressive disorder (MDD), bipolar disorder (BD), and Generalized Anxiety Disorders (GAD). Studies suggest that rTMS may offer significant improvements in depressive symptoms and mood regulation, particularly in individuals who have not responded to traditional treatments. Mechanisms of action involve modulation of cortical excitability and neural circuitry implicated in mood regulation. While rTMS demonstrates promise as a well-tolerated intervention with minimal side effects, further research is needed to optimize treatment protocols, identify patient-specific predictors of response, and elucidate long-term outcomes. Understanding the role of rTMS in mood disorder management holds potential for advancing personalized treatment approaches and improving overall patient outcomes. The paper concludes that rTMS is a promising intervention for individuals with major depressive disorder (MDD), and generalized anxiety disorder (GAD). Finally, it was recommended that further studies should be conducted on the efficacy or rTMS on mood disorders generally.

Exploring the influence of learning modality preferences and COVID-19 infection experiences on depressive mood in Chinese students

The COVID-19 pandemic has significantly impacted the mental health of children and adolescents worldwide. While various factors contributing to this phenomenon have been explored, the role of learning style preferences remains underexamined. This cross-sectional study, conducted between October and November 2020, involved over 20,000 participants, including students from junior high school, senior high school, and undergraduate levels. Significant differences in depressive mood levels were observed among individuals with different learning modality preferences upon the return to traditional, in-person learning. Students with in-person learning preferences exhibited lower depression levels, while students with no preference for either learning style outperformed devotees of remote learning. The highest depression occurred among those endorsing neither learning mode. Importantly, the impact of these preferences on depressive moods was found to be moderated by COVID-19 infection experiences. The findings highlight the nuanced relationship between learning style preferences, COVID-19 infection experiences, and mental health outcomes among students. Acknowledging the moderating effect of infection experiences is crucial for developing targeted interventions and adapting pedagogical approaches post-pandemic. This study contributes valuable insights into the complex relationships shaping the mental well-being of students amidst educational disruptions caused by the pandemic.

From mood to use: Using ecological momentary assessments to examine how anhedonia and depressed mood impact cannabis use in a depressed sample

Anhedonia and depressed mood are two cardinal symptoms of major depressive disorder (MDD). Prior work has demonstrated that cannabis consumers often endorse anhedonia and depressed mood, which may contribute to greater cannabis use (CU) over time. However, it is unclear (1) how the unique influence of anhedonia and depressed mood affect CU and (2) how these symptoms predict CU over more proximal periods of time, including the next day or week (rather than proceeding weeks or months). The current study used data collected from ecological momentary assessment (EMA) in a sample with MDD (N = 55) and employed mixed effects models to detect and predict weekly and daily CU from anhedonia and depressed mood over 90 days. Results indicated that anhedonia and depressed mood were significantly associated with CU, yet varied at daily and weekly scales. Moreover, these associations varied in both strength and directionality. In weekly models, less anhedonia and greater depressed mood were associated with greater CU, and directionality of associations were reversed in the models looking at any CU (compared to none). Findings provide evidence that anhedonia and depressed mood demonstrate complex associations with CU and emphasize leveraging EMA-based studies to understand these associations with more fine-grained detail.

Parasympathetic nervous system: A key role in control and mood disorders in patients with asthma

BackgroundPatients with severe asthma often have uncontrolled disease and experience mood disorders, particularly anxiety and depression. The autonomic nervous system (ANS) plays an important role in asthma, mainly through the parasympathetic ANS system (PANS), which favors bronchoconstriction and mental health status. ObjectiveTo evaluate the role of the activation of the PANS in uncontrolled asthma and related mood disorders. MethodsThis was a proof-of-concept cross-sectional study that analyzed demographic and clinical variables reflecting asthma severity and control, lung function, inflammation (from induced sputum), evaluation of quality of life, and the risk for anxiety and depression according to validated questionnaires. The PANS analysis was conducted based on heart rate variability: SD of the difference between consecutive normal-to-normal (NN) intervals (SDNN), root mean square of the successive differences (RMSSD), percentage of consecutive NN intervals (pNN50), total power (TP), and respiratory-related power (Pr). ResultsA total of 30 patients with asthma were grouped according to asthma control and the risk for anxiety and depression; 10 patients with uncontrolled asthma compared with the patients with controlled asthma showed significant differences (P < .05) in SDNN (26.5 [8.2] vs 42.7 [29.7]), RMSSD (14.1 [6.5] vs 24 [20]), pNN50 (0.6 [1.5] vs 6.2 [11.8]), TP (0.0005 [0.00046] vs 0.0014 [0.00085]), and Pr (0.0003 [0.00025] vs 0.0007 [0.00060]) respectively. A total of 13 patients at risk for anxiety and depression compared with the patients without showed reduced values (P < .05) for SDNN (26.5 [7.9] vs 45.6 [31.3]), pNN50 (0.75 [1.4] to 7.12 [12.6]), TP (0.0005 [0.00048] to 0.0012 [0.0008]), and Pr (0.0003 [0.00027] to 0.0008 [0.00062]). ConclusionOur results suggest that PANS activity is depressed in patients with uncontrolled asthma and common mood disorders such as depression and anxiety, and the evaluation of heart rate variability may be a useful means for follow-up of asthma control and related mood disorders.