Depression Mood Disorders Research Articles

Cortisol and ACTH response to Dex/CRH Testing and 24-Hour Urine Free Cortisol Levels in Women with and without Premenstrual Dysphoric Disorder

HPA axis dysregulations are consistently reported in depression and other mood disorders, whereas previous studies examining HPA axis function in women with premenstrual dysphoric disorder (PMDD) have yielded inconsistent findings. In this study, we characterized the HPA axis in women with PMDD using the combined dexamethasone suppression and CRH stimulation (Dex/CRH) test and 24-hour urine free cortisol (UFC). A total of 26 women with prospectively confirmed PMDD and 25 asymptomatic controls (ACs) underwent Dex/CRH and UFC testing during both the mid-follicular and luteal phases of the menstrual cycle (MC). Primary outcomes were serial plasma cortisol and ACTH levels, their area-under-the-curve (AUC), and 24-hour UFC levels. Serial cortisol and ACTH levels were compared using a mixed model, while UFC levels and AUC of cortisol and ACTH were compared using Wilcoxon Signed Rank test. There were no significant diagnostic or menstrual cycle phase effects on plasma cortisol or ACTH levels (from time 0 to +75minutes), nor on the AUCs of plasma cortisol or ACTH (p > 0.05 for all comparisons). The PMDD group had significantly reduced 24-hour UFC levels compared to the AC group during both follicular and luteal phases (p=0.0004 and p=0.0007, respectively). Our study suggests that the pathophysiology of PMDD is distinct from that of major depression and is associated with neither exaggerated nor enhanced HPA axis activity or reactivity. Instead, we observed reduced overall HPA axis activity, which could reflect compensatory mechanisms downregulating HPA axis activity in response to chronic stress.

The challenge of a late diagnosis of Autism Spectrum Disorder: co-occurring trajectories and camouflage tendencies. a case report of a young Autistic female with Avoidant Restrictive Food Intake Disorder

IntroductionAutistic individuals may show several psychiatric co-occurrences, including Feeding and Eating Disorders (FEDs). Avoidant and Restrictive Food Intake Disorder (ARFID) consists of avoidance or restriction in food intake, leading to significant weight loss, nutritional deficiencies, and marked interference with psychosocial functioning. Both Autism Spectrum Disorder (ASD) and ARFID are characterized by the two main features of cognitive rigidity and sensory sensitivity, which may complicate differential diagnosis. There is a notable lack of information on the manifestation of ASD-ARFID co-occurrence, as well as tailored assessment tools and practice, and therapeutic approaches.Case descriptionThis report provides a detailed description of L., a young girl with a late diagnosis of ASD who also developed unspecific depressive mood disorder and ARFID in co-occurrence. After the diagnosis of ASD, L. underwent multiple evaluations to address emerging psychiatric co-occurrences and symptom exacerbation, and in order to develop the most effective integrated treatment.ConclusionThe case of L. expands the knowledge on the phenotype of Autistic females and exemplifies how delayed diagnosis may exacerbate functioning differences and increase the camouflage phenomenon. Additionally, it underscores the importance of improving tailored evaluation, combined treatment plans, with both cognitive-behavioral therapy and drugs, and monitoring the evolving patterns of Autistic manifestations and associated psychiatric co-occurrences.

In silico analysis of hub genes and regulatory networks implicates the putamen in non-motor Parkinson’s disease disorders

BackgroundParkinson’s disease (PD) is a neurodegenerative condition marked by the gradual degeneration of dopaminergic neurons in the substantia nigra, leading to depletion of the dopaminergic neurons in the substantia nigra as well as degeneration as and decreased activity in the putamen. This study aims to identify the role of putamen in non-motor PD symptoms as well as potential therapeutic target in the putamen of PD.MethodsTranscriptome profiles of PD (dataset number: GSE205450, obtained from postmortem putamen and caudate samples from forty controls and thirty-five PD patients) were retrieved from the Gene Expression Omnibus (GEO) database. Specifically, we focused on putamen data for controls and PD patients. Differential gene expression analysis was carried out using with Limma, filtering for genes with |logFC|> 1 (fold change) and p < 0.05 (p-value). Protein–Protein Interaction networks were constructed using stringDB (combined score > 0.7) and analyzed in Cytoscape to identify hub genes based on various topological measures (EPC, MCC, MNC, Degree, and EcCentricity). Enrichment analysis of target genes was conducted using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG). Also, we constructed transcription factor (TF)-hub gene expression networks, miRNA-hub gene expression networks, and disease hub gene association networks using the JASPAR database, Tarbase database, and DisGeNET via NetworkAnalyst platform, respectively.ResultsSeven genes, namely SST, NPY, IL6, PVALB, ALB, NTS, and TH were identified as hub genes in PD putamen. Notable miRNAs included hsa-mir-34a-5p, hsa-mir-15a-5p, hsa-mir-424-5p, and hsa-mir-19b-3p, while key transcription factors include GATA2, CREB1, FOXC1, FOXL1, TID1, NFKB1, YY1, SPIB, GATA3, and STAT3.ConclusionsOur findings revealed close associations between the hub genes of PD putamen and non-motor symptoms of PD such as major depressive disorder, mood disorders and schizophrenia. These findings may provide a new direction for developing therapy for non-motor symptoms of PD and wet lab research is encouraged.

The place of school-based strategies for universal, selective, and indicated prevention for depression

Abstract In response to the question ‘what is the place of universal, selective and indicated prevention strategies for depression and other mood disorders’ posed by Hickie et al. (2024) we examine the role of school-based strategies for universal and targeted (including selective and indicated) prevention of depression. Schools represent a unique opportunity for systematic evidence-based depression prevention, targeting key developmental risk periods before peak depression onset. However, the realisation of this potential has been challenging particularly for universal approaches. We summarise the evidence for each of these tiers of prevention, including recent large-scale trials of universal prevention in high-income countries. Targeted approaches show more consistent preventive effects on depression however hold significant implementation challenges in the school context. We provide recommendations about next steps for the field including a continuum of support across all levels of prevention outlined above and broadening current strategies to focus on the school contexts and structural factors in which prevention programs are delivered, as well as teacher mental health.

Fluoxetine Mitigates Human Sperm Quality by Disrupting the Antioxidant Defense System and Altering the Expression of Apoptosis-Related Genes: An In Vitro Study.

Fluoxetine is used in the management of depression, anxiety and other mood disorders by increasing serotonin levels in the brain and can cause sexual side effects by changing the homeostasis of sex hormones and increasing oxidative stress. Since many men who take fluoxetine are of reproductive age and sperm are exposed to fluoxetine for a considerable time, this study aimed to examine the in vitro effects of fluoxetine on human sperm biochemical markers and sperm parameters. Semen samples from 30 fertile men were divided into three groups: a positive control group, a negative control group and a fluoxetine-treated group. We investigated sperm parameters, mitochondrial membrane potential (MMP), acrosome reaction, DNA fragmentation, chromatin integrity, and the expression of CASPASE8, CASPASE9, BAX, and BCL2 genes and proteins. Data were analyzed using repeated measures analysis. The results showed that the average percentage of motility, viability, MMP, acrosome and chromatin integrity, total antioxidant capacity (TAC) level, and BCL2 gene and protein expression in the fluoxetine group were significantly reduced compared to the positive and negative control groups. While the average percentage of non-progressive motility, sperm DNA fragmentation, malondialdehyde (MDA) level, reactive oxygen species (ROS), gene and proteins expression of CASPASE8, CASPASE9 and BAX increased significantly. This study suggests that fluoxetine may impair sperm quality by increasing the expression of apoptotic genes, proteins, and oxidative stress. Therefore, careful management of fluoxetine in treating depression is crucial, especially in men of reproductive age, due to its potential sexual side effects. HIGHLIGHTS: • Fluoxetine reduces the quality of human sperm by inducing oxidative stress. • Fluoxetine lowers the total antioxidant capacity in human sperm by increasing ROS. • Fluoxetine increases the expression of apoptosis genes in human sperm.

Melatonin Aids in Treating Mood and Sleep Problems Resulting from Hormonal Therapy in Breast Cancer Patients: A Randomized, Double-Blinded, Placebo-Controlled Trial

Background: Hormone therapy is commonly used to treat breast cancer but can cause mood disorders and sleep disturbances, negatively impacting patients' well-being. Objectives: This trial aimed to evaluate the effects of melatonin on sleep problems and mood changes in breast cancer patients undergoing hormone therapy. Methods: The study was conducted at Omid Hospital in Isfahan, Iran, using a randomized, double-blinded, placebo-controlled design. Participants were assessed using the Hospital Anxiety and Depression Scale (HADS) and were randomly assigned to receive either 6 mg of melatonin or a placebo daily for 4 weeks. Sleep quality, depression levels, and mood states were measured using the Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiological Studies-Depression Scale (CES-D), and the Profile of Mood States (POMS) Questionnaires at the beginning and end of the 4-week follow-ups. Results: Sixty participants (34 in the melatonin group and 26 in the placebo group) completed the study. Melatonin administration significantly improved sleep quality, latency, duration, and reduced the use of sleep-promoting medication, according to the PSQI scores. However, there were no significant improvements in depression severity or mood disorders, as assessed by the CES-D and POMS questionnaires, in either group following the 4-week melatonin supplementation period. Conclusions: Melatonin supplementation effectively alleviated sleep disturbances caused by hormone therapy in breast cancer patients. However, the study did not find substantial evidence supporting the use of melatonin for improving mood disorders or depression in this specific context.

Acupuncture treatment of restless legs syndrome: a randomized clinical controlled study protocol based on PET-CT and fMRI.

Restless legs syndrome (RLS) is a sensorimotor disorder of the nervous system that is mainly characterized by nighttime leg discomfort and can be accompanied by significant anxiety, depression, and other mood disorders. RLS seriously affects the quality of life. Clinical studies have confirmed that acupuncture can alleviate the clinical symptoms of RLS. This randomized controlled trial (RCT) aims to investigate the efficacy of acupuncture in the treatment of RLS and further explore the central response mechanism of acupuncture in the treatment of RLS. In this RCT, a total of 124 eligible patients in Shanghai will be randomly assigned to one of the following two groups: treatment group (acupuncture) and control group (sham acupuncture). Treatment will be given three times per week for 4 consecutive weeks. The primary outcome is the International Restless Legs severity rating scale (IRLSS). The secondary outcomes are the RLS-Quality of Life (RLSQoL), the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), the Hamilton Depression Scale (HAMD), and the Hamilton Anxiety Scale (HAMA). The objective evaluation tools will be polysomnography, positron emission tomography-computed tomography (PET-CT), and functional magnetic resonance imaging (fMRI) of the brain. All adverse effects will be assessed by the Treatment Emergent Symptom Scale. Outcomes will be evaluated at baseline (1 week before the first intervention), during the intervention (the second week of the intervention), after the intervention (at the end of the intervention), at 1-month follow-up, and at 3-month follow-up. The trial has been approved by the Ethics Committee of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine (no. 2022-061). Written informed consent will be obtained from all participants. The results of this study will be published in peer-reviewed journals or presented at academic conferences. https://www.chictr.org.cn/, identifier ChiCTR2000037287.

Leptin and leptin receptor gene polymorphisms and depression treatment response.

Associations between leptin (LEP) and leptin receptor (LEPR) gene polymorphisms and mood disorders have been found but not yet confirmed in multiple studies. The aim of our study was to study the associations between LEP and LEPR single nucleotide polymorphisms (SNPs) and treatment response of depression. Associations between leptin levels and depression severity were also investigated. The data included 242 depressed patients in secondary psychiatric care. Symptoms of depression were assessed with the Montgomery–Åsberg Depression Rating Scale (MADRS). Previously found LEP and LEPR SNPs associated with depression and other mood disorders were studied. Furthermore, all available LEP and LEPR SNPs were clumped using proxy SNPs to represent gene areas in r2 > 0.2 linkage disequilibrium and their association with treatment response was analysed with logistic regression. Two proxy SNPs of LEPR gene, rs12564738 and rs12029311, were associated with MADRS response at 6 weeks (p adjusted = 0.024, p adjusted = 0.024). SNPs from previous studies were not associated with MADRS response, but LEPR rs12145690 from a previous study was strongly associated with rs12564738 (r2 = 0.94). The positive association between leptin levels and MADRS score at baseline after adjusting with age, sex, body mass index (BMI), Alcohol Use Disorders Identification Test score, and smoking was found (p = 0.011). Our findings suggest that LEPR polymorphisms are associated with depression treatment response. We also found associations between leptin levels and depression independently of BMI. Further studies and meta-analyses are needed to confirm the significance of found SNPs and the role of leptin in depression.

Cognitive behavioral therapy-enhanced through videoconferencing for night eating syndrome, binge-eating disorder and comorbid insomnia: a Case Report

BackgroundBoth night-eating syndrome and binge-eating disorder are characterized by episodes of excessive food consumption, significant distress, and functional impairment related to maladaptive eating behaviors. Both types of eating disorders are associated with poorer sleep quality. Cognitive behavioral therapy has demonstrated good outcomes for binge-eating disorder; however, it is unknown if it is effective for night-eating syndrome and comorbid insomnia.Case presentationThe current paper presents a case report of a Dutch woman in her 40’s receiving cognitive behavioral therapy-enhanced for night-eating syndrome, as well as binge-eating disorder. However, to tailor the intervention to her specific needs, throughout the course of treatment, cognitive behavioral therapy-insomnia interventions were also implemented. Her comorbid complaints were insomnia, childhood trauma, a depressive mood disorder, and cluster B and C personality traits. She had a history of bariatric surgery, as well as alcohol addiction, and received various treatments in the past, aiming to become abstinent from binge eating.ConclusionsPost-treatment, she was abstinent from binge eating and, her scores of various eating disorder measures were below clinical cut-points. However, it is unclear if she would show earlier symptom reduction if she received cognitive behavioral therapy-insomnia, prior to cognitive behavioral therapy-enhanced. In addition, the patient reported an increase in her depressive mood and commenced schema therapy after cognitive behavioral therapy- enhanced. Although common, the underlying cause of symptom shifts in patients with an eating disorder remains largely unknown.

Abstract B148: Prevalence of Multimorbidity Among Patients with Newly Diagnosed Cancer at a Safety-Net Health System

Abstract Background: Multimorbidity (MM) presents challenges for cancer care and may require coordination between oncologists and primary or specialty care providers. Nevertheless, U.S.-based studies of MM among cancer patients have mostly been conducted in non-Hispanic White and insured populations, which limits understanding of strategic care planning and resource allocation among more diverse populations. Therefore, we aimed to assess the prevalence of MM among adults with newly diagnosed cancer at a large, racial/ethnically diverse safety-net health system. Methods: We used electronic health record and cancer registry data from JPS Health Network, an urban safety-net health system in North Texas. Our eligible population included patients ≥18 years of age diagnosed with first primary cancer in 2016 – 2020 (excluding in situ cases), whose diagnosis or first-course cancer treatment was received at JPS. Our outcomes of interest were MM (≥2 chronic conditions) and severe MM (≥3 chronic conditions) based on 30 chronic conditions defined by the Centers for Medicare &amp; Medicaid Services with up to a 2-year lookback period before cancer diagnosis. We assessed overall and sub-group specific (age group, sex, and race/ethnicity) prevalence of MM and severe MM. We estimated prevalence differences (PD) and 95% confidence intervals between groups using pairwise comparisons with Bonferroni correction. Results: Our study population comprised 5,019 newly diagnosed adult cancer patients. The median age was 58 years and the majority were females (51%), racial/ethnic minorities (59%), uninsured (51%), and overweight or obese (69%). The most common cancer types were breast (13%), lung (12%), and colorectal (11%). Nearly half (45%) were diagnosed with advanced stage cancer. A high proportion of cancer patients had MM (79%) and severe MM (62%). The most common conditions were hypertension (55%), anemia (36%), hyperlipidemia (31%), diabetes (27%), and depressive mood disorders (22%). MM increased by age: 56% among patients aged 18 – 39 years, 78% among patients aged 40 – 64 years, and 91% among patients aged ≥65 years. A higher proportion of males had MM (PD: 6.0% [95% CI: 3.8%, 8.3%]) and severe MM (PD: 7.5% [95% CI: 4.9%, 10%]) compared with females. By race/ethnicity, Non-Hispanic Black patients had the highest prevalence of MM (PD: 8.1% [95% CI: 4.3%, 12%]) and severe MM (PD: 11% [95% CI: 6.7%, 16%]) compared with the lowest prevalences among Hispanic patients. Conclusions: We observed a high prevalence of MM and severe MM among adult cancer patients, particularly among patients aged ≥45 years and non-Hispanic Black patients. Our estimates were &amp;gt;15% higher than prior studies that included mostly non-Hispanic White adult cancer survivors with higher socioeconomic status. Our findings provide insight about the burden of MM among racially diverse cancer patients with low socioeconomic status, which may inform resource allocation and care coordination initiatives to manage MM. Citation Format: Anand B. Singh, Yan Lu, Aaron W Gehr, Kalyani Narra, Bhavna Tanna, Jolonda Bullock, Rachel J. Meadows. Prevalence of Multimorbidity Among Patients with Newly Diagnosed Cancer at a Safety-Net Health System [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B148.

Metformin reprograms tryptophan metabolism via gut microbiome-derived bile acid metabolites to ameliorate depression-Like behaviors in mice

As an adjunct therapy, metformin enhances the efficacy of conventional antidepressant medications. However, its mode of action remains unclear. Here, metformin was found to ameliorate depression-like behaviors in mice exposed to chronic restraint stress (CRS) by normalizing the dysbiotic gut microbiome. Fecal transplants from metformin-treated mice ameliorated depressive behaviors in stressed mice. Microbiome profiling revealed that Akkermansia muciniphila (A. muciniphila), in particular, was markedly increased in the gut by metformin and that oral administration of this species alone was sufficient to reverse CRS-induced depressive behaviors and normalize aberrant stress-induced 5-hydroxytryptamine (5-HT) metabolism in the brain and gut. Untargeted metabolomic profiling further identified the bile acid metabolites taurocholate and deoxycholic acid as direct A. muciniphila-derived molecules that are, individually, sufficient to rescue the CRS-induced impaired 5-HT metabolism and depression-like behaviors. Thus, we report metformin reprograms 5-HT metabolism via microbiome-brain interactions to mitigate depressive syndromes, providing novel insights into gut microbiota-derived bile acids as potential therapeutic candidates for depressive mood disorders from bench to bedside.

Relationship between Psychosomatic Factors and Functional Dyspepsia and Progress in Treatment

Objective: To investigate the relationship between psychosomatic factors and functional indigestion, to provide relevant treatment methods and measures according to the actual situation as a clinical reference. Methods: This pilot study was conducted in the hospital from August 2023 to August 2024, and 100 patients who were diagnosed with functional dyspepsia were selected for the study. In this study, the anxiety self-rating scale and depression self-rating scale were applied to assess the psychological conditions of the patients and analyze the relationship between psychological conditions and functional dyspepsia. Subsequently, the patients were divided into two groups, in which one group was given conventional glutamine and other treatments, as the control group, and the other group was given comprehensive treatment, as the experimental group, to compare and analyze the differences in the treatment effects of the patients in the two groups. Results: Among the 100 patients in this study, 34 of them were accompanied by anxiety mood disorder, 22 patients were accompanied by depression mood disorder, and 44 patients were accompanied by anxiety and depression mood disorder. The psychosomatic factors were significantly associated with functional dyspepsia. After treatment, both groups of patients have high treatment efficiency of 98.00% and 84.00% respectively, but the difference in data comparison is statistically significant (P &lt; 0.05), in which the experimental group has the higher efficiency. At the same time, before treatment, both groups of patients were accompanied by bad mood (SAS and SDS scores are higher than the standard score), and the comparison of data between groups is not significant (P &gt; 0.05). After the treatment, the effect was significant, the patients’ scores (SAS and SDS) were reduced, meaning the patients in the experimental group had a greater degree of reduction, and the difference between the experimental group and the control group increased (P &lt; 0.05), and the improvement of bad mood was better. Conclusion: The human body’s mental psychological factors usually functional dyspepsia accompanied by correlation, the occurrence of adverse mental psychological problems can lead to functional dyspepsia. Based on this, it is of positive significance to give patients comprehensive treatment, adopt measures such as acid suppression and gastric protection, and at the same time give patients psychological treatment, which is more conducive to improving patients’ bad mood and digestive function and promoting patients’ recovery.

54264 Association of Anxiety, Depression and Other Mood Disorders in Patients with Anogenital Pruritus

54264 Association of Anxiety, Depression and Other Mood Disorders in Patients with Anogenital Pruritus

The Role of Spiritual Well-Being and Religious Coping in Psychiatric Morbidities Associated with Breast Cancer Patients: A Cross-Sectional Analysis

Background: Spirituality and religious resources support and enhance both overall and emotional well-being during adversity such as diagnosis of breast cancer. Breast cancer patients are at higher risk of developing severe anxiety, depression, and potential mood disorders. Aim: The aim is to assess, compare, and correlate spiritual well-being and religious coping in patients with breast cancer with and without psychiatric disorders (anxiety and depression). Materials and Methodology: Recently diagnosed 90 treatment-naïve breast cancer patients were selected in adherence to the inclusion and exclusion criteria. Hospital Anxiety and Depression Scale (HADS), Spiritual Assessment Scale, and Brief Religious Coping Scale were applied to the sample population. The study population was divided into two groups depending on scores of HADS, those having psychiatric disorders, and those who did not have. The data were analyzed using Mann‒Whitney test and Pearson’s correlation coefficient in the SPSS version 21. Results: More than half (61.1%) of the females suffered from psychiatric disorders after diagnosis of breast cancer. About 50% and 38.9% of the study population developed significant emotional distress, leading to the diagnosis of cases of anxiety and depression, respectively. Females suffering from psychiatric disorders have significantly lower spirituality, positive religious coping, and significantly higher negative religious coping than females without any psychiatric disorder. Total spirituality score (P = 0.034) is making a significant contribution toward predicting depression. Negative religious coping is making a significant contribution toward predicting both anxiety (P = 0.008) and depression (P = 0.045). Conclusion: The study suggests that spirituality and religion-based coping facilitates adaptive psychological adjustment to cancer and decreases the prevalence of anxiety and depression.

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

Behavioral skill practice as a predictor of mood and family functioning in adolescents with bipolar and depressive mood disorders: Results of a 6-month randomized trial of family-focused therapy.

Behavioral interventions require considerable practice of treatment skills in between therapy sessions. The effects of these treatments may vary with the degree to which patients are able to implement these practices. In offspring of parents with bipolar and major depressive disorders, we examined whether youth who frequently practiced communication and problem-solving skills between family-focused therapy (FFT) sessions had less severe mood symptoms and better psychosocial functioning over 6 months than youth who practiced less frequently. We randomly assigned offspring (ages 12-19) of parents with mood disorders to 12 sessions of FFT plus a mobile app that encouraged the practice of communication, problem-solving and mood management skills (FFT-MyCoachConnect [MCC] condition) or 12 sessions of FFT with an app that only allowed for tracking of symptoms and stress (FFT-Track condition). Independent evaluators assessed youths' mood and psychosocial functioning at 9-week intervals over 27 weeks. Clinicians rated participants' between-session skill practice at each FFT session. FFT-MCC was associated with more frequent skill practice than FFT-Track over 18 weeks of treatment. Skill practice was associated with reductions in youths' mood instability and perceptions of family conflict over 27 weeks in both app conditions. Skill practice mediated the effects of app condition on youths' mood instability and family functioning. Mobile applications as adjuncts to family therapy for youth with mood disorders can help increase skill practice. These findings provide preliminary causal evidence for behavioral skill practice improving mood symptoms and family functioning among youth with mood disorders.

Spectrum of psychiatric adverse reactions to cyclin-dependent kinases 4/6 inhibitors: A pharmacovigilance analysis of the FDA adverse event reporting system.

The emergence of cyclin-dependent kinases 4/6 inhibitors (CDK4/6i) represented a major breakthrough in the treatment of breast cancer over the past decade. In both clinical trials and real-world settings, it was observed that patients using CDK4/6i might experience psychiatric adverse events (PAEs). Herein, we conducted a pharmacovigilance study to comprehensively assess the correlation between CDK4/6i and PAEs. We obtained individual case safety reports submitted to the FDA Adverse Events Reporting System (FAERS) during the period from January 2015 to December 2023. In disproportionality analysis, the reporting odds ratio (ROR) and information component (IC) values were calculated for each adverse event-drug combination. Univariate logistic regression analysis was utilized to explore factors associated with PAEs following CDK4/6i treatment. A total of 95,591 reports related to CDK4/6i were identified, with 6.72% reporting PAEs, and this proportion exhibited an annual upward trend. Based on the ROR and IC values, 17 categories of PAEs were defined as CDK4/6i-related PAEs. Among these PAEs, insomnia, stress, eating disorder, depressed mood, and sleep disorder were very common, each accounting for over 10% of CDK4/6i reports. Ribociclib showed the highest risk signal of CDK4/6i-related PAEs (ROR = 1.89[1.75-2.04], IC025 = 0.79), followed by palbociclib (ROR = 1.47[1.41-1.53], IC025 = 0.49), while abemaciclib did not exhibit a significant signal (ROR = 0.52[0.44-0.62], IC025 = -1.13). Female sex, younger age and weight exceeding 80 kg were significant risk factors for the incidence of CDK4/6i-related PAEs. Using data from a real-world, large-scale spontaneous reporting system for adverse drug reactions, our study delineated the spectrum of PAEs to CDK4/6i. This potentially offered valuable insights for healthcare professionals to manage the risk of PAEs in patients receiving CDK4/6i treatment, particularly those with psychiatric disorders.

Microbiome Dysbiosis in Depression: A Narrative Review

The comprehensive exploration of the microbial composition of the gut and its role in depression underscores a complex interplay involving alterations in gut microbiome, immune pathways, and inflammatory control. Studies reveal potential biomarkers and therapeutic targets linked to depression, with particular bacterial genera correlated with the severity of depressive symptoms. The dysregulation extends to disruptions in metabolic pathways and functions of bacterial proteins within the gut, contributing to intestinal barrier dysfunction and increased gut permeability. Notably, alterations in microbial composition are observed in various depressive conditions, including major depressive disorder (MDD), post-stroke depression (PSD), and depression during neoadjuvant cancer treatment. The influence of the gut microbiome on the central nervous system and the bidirectional relationship between depression and microbial changes are highlighted. Regulatory interventions, including antidepressants and probiotics, show promise in modulating the gut microbiome and alleviating depressive symptoms. The combination of probiotics with antidepressants emerges as a potential strategy for inducing a balanced microbiome. However, a lack of consensus exists regarding specific bacterial taxa associated with depression, emphasizing the need for further research to refine the therapeutic approaches for managing depression and related mood disorders. This review aims to explore the relationship between microbiome dysbiosis and depression, highlighting the role of dysbiosis as a potential contributing factor to depressive symptoms.

Therapeutical Potential of 5-HT6 of Receptor Modulation in Neurological and Psychiatric Conditions

This review examines the pharmacological effects of targeting 5-HT6 receptors, a subtype of serotonin receptors found primarily in the hippocampus. These receptors are essential for synaptic function, functional plasticity and various cognitive functions such as learning and memory. The review synthesizes the existing literature to investigate the potential therapeutic use of drugs targeting 5-HT6 receptors in neurological and psychiatric conditions, including Alzheimer's disease, schizophrenia, depression, anxiety, neurodegenerative diseases and pregnancy mood disorders. Although some preclinical studies suggest positive precognitive effects, these results have often conflicted with clinical research; therefore more work needs to be done on drug classification and therapeutic effect as well as dosage considerations.

How to Solve Clinical Challenges in Mood Disorders; Machine Learning Approaches Using Electrophysiological Markers.

Differentiating between the diagnoses of mood disorders and other psychiatric disorders, and predicting treatment response in depression has long been a concern for clinicians. Machine learning (ML) is one part of artificial intelligence that focuses on instructing computers to mimic the cognitive abilities of the human brain through training. This study will review the research on the use of ML techniques to differentiate diagnoses and predict treatment responses in mood disorders based on electroencephalography (EEG) data. There have been several attempts to differentiate between the diagnoses of bipolar disorder and major depressive disorder , mood disorders, and other psychiatric disorders using ML techniques found on EEG markers. Previous studies have shown that accuracy varies depending on which EEG markers are used, the sample size, and the ML technique. Also, precise and improved ML approaches can be developed by adapting the various feature selection and validation methods that reflect each disease's characteristics. Although ML faces some limitations and challenges in solving for consistent and improved accuracy in the diagnosis and treatment of mood disorders, it has a great potential to understand mood disorders better and provide valuable tools to personalize both identification and treatment.