Depressed Participants Research Articles

A qualitative study exploring depressed participants' experiences of receiving Augmented Depression Therapy (ADepT).

The current study aimed to explore participants' views on the acceptability, impact and mechanisms of change of Augmented Depression Therapy (ADepT), a novel wellbeing-focused and recovery-oriented psychological therapy for depression. A semi-structured qualitative interview design was used, with data analysed using the framework approach. 20 participants with anhedonic depression who had received up to 20 sessions of ADepT, sampled from a pilot randomised controlled trial of ADepT versus Cognitive Behavioural Therapy (CBT). A primary care psychological therapy clinic in Devon, UK, with interviews occurring between May 2018 and February 2020. Participants found the wellbeing focus of ADepT acceptable. Helpful aspects of therapy were a positive therapeutic bond, the structure and flow of therapy scaffolding the learning journey, the tools and techniques of therapy helping building wellbeing and booster sessions supporting long-term recovery. Negative aspects for some participants were therapy feeling too intense and triggering feelings of failure. Participants reported significant positive impacts of treatment on wellbeing, functioning and hope. Perceived mechanisms of change were reorienting to the positive, engaging with valued goals, taking a proactive life stance, gaining confidence and motivation for change, breaking down tasks into small steps, cultivating self-care and self-compassion, enhancing help seeking and interpersonal effectiveness, changing the relationship to depression, and rediscovering the self beyond depression. Findings suggest that the wellbeing focus of ADepT is acceptable and leads to positive impacts, supports the logic model underpinning the intervention, and warrants continuation to a definitive trial. ISRCTN85278228.

Artificial Intelligence–Based Psychotherapeutic Intervention on Psychological Outcomes: A Meta‐Analysis and Meta‐Regression

Background: Artificial intelligence (AI)–based psychotherapeutic interventions may bring a new and viable approach to expanding psychiatric care. However, evidence of their effectiveness remains scarce. We evaluated the efficacy of AI‐based psychotherapeutic interventions on depressive, anxiety, and stress symptoms at postintervention and follow‐up assessments.Methods: A three‐step comprehensive search via nine electronic databases (PubMed, Embase, CINAHL, Cochrane Library, Scopus, IEEE Xplore, Web of Science, PsycINFO, and ProQuest Dissertations and Theses) was performed.Results: Thirty randomized controlled trials (RCTs) in 31 publications involving 6100 participants from nine countries were included. The majority (79.1%) of trials with intention‐to‐treat analysis but less than half (48.6%) of trials with perprotocol analysis were graded as low risk. Meta‐analyses showed that interventions significantly reduced depressive symptoms at the postintervention assessment (t = −4.40, p = 0.001) with medium effect size (g = −0.54, 95% CI: −0.79 to −0.29) and at 6–12 months of assessment (t = −3.14, p < 0.016) with small effect size (g = −0.23, 95% CI: −0.40 to −0.06) in comparison with comparators. Our subgroup analyses revealed that the depressed participants had a significantly larger effect size in reducing depressive symptoms than participants with stress and other conditions. At postintervention and follow‐up assessments, we discovered that AI‐based psychotherapeutic interventions did not significantly alter anxiety, stress, and the total scores of depressive, anxiety, and stress symptoms in comparison to comparators. The random‐effects univariate meta‐regression did not identify any significant covariates for depressive and anxiety symptoms at postintervention. The certainty of evidence ranged between moderate and very low.Conclusions: AI‐based psychotherapeutic interventions can be used in addition to usual treatments for reducing depressive symptoms. Well‐designed RCTs with long‐term follow‐up data are warranted.Trial Registration: CRD42022330228

Prosody-focused feedback enhances the efficacy of anti-depressive self-statements in depressed individuals - A randomized controlled trial.

This study was aimed to evaluate whether the efficacy of invoking anti-depressive self-statements to cope with depressed mood can be enhanced for depressed individuals by systematically guiding them to amplify the expression of conviction in their voice. Accordingly, we recruited N=144 participants (48 clinically depressed individuals, 48 sub-clinically depressed individuals, and 48 non-depressed individuals). Participants were randomly assigned to an experimental or control condition. Across study conditions, participants completed a mood induction procedure, then read aloud scripted anti-depressive self-statements designed to reduce depressed mood. Participants in the experimental condition received instructions to heighten the prosodic expression of conviction in their voice; participants in the control condition received no prosodic expression instructions. Results showed that depressed participants achieved a more pronounced decrease of depressed mood in the experimental condition than in the control condition. Further, the results indicated no effects in sub-clinically depressed and non-depressed individuals. Finally, heightened conviction expressed by participants in the experimental condition was associated with lower depressed mood and diminished depressive symptom severity. Overall, our findings suggest that fostering the prosodic expression of conviction in depressed persons' voices, while they vocalize anti-depressive self-statements, represents a promising method for augmenting the efficacy of cognitive interventions for depression.

Associations between attentional biases for emotional images and rumination in depression

ABSTRACT Rumination is a key feature of depression and contributes to its onset, maintenance, and recurrence. Researchers have proposed that biases in the attentional processing of emotional information may underlie rumination, and particularly, the brooding component. This investigation evaluated associations between attentional biases for emotional images and rumination, including both brooding and reflection, in currently and never depressed participants. In two separate studies, participants viewed sets of four emotional images (happy, sad, threatening, and neutral) for 8 s in a free-viewing eye-tracking paradigm. In both studies, currently depressed individuals attended to happy face images and happy naturalistic images significantly less than never depressed individuals. In Study 2, currently depressed individuals attended to sad naturalistic images significantly more than never depressed individuals. There were no statistically significant associations between attentional biases and any of the forms of rumination, independent of their shared relationship with depression symptoms. These findings call into question the robustness of the link between attentional biases and rumination.

Elevated brain pulsations in depression: insights from a pooled ultrasound cohort study.

Excessive brain tissue pulsations (BTP), measured by ultrasound, have been associated with depression and are hypothesized to contribute to brain damage in this population at risk for cerebrovascular lesions. However, previous research has been limited by small sample sizes. To address this issue, our study pooled data from three separate investigations, resulting in the largest cohort of depressed participants with BTP measurements to date. We analysed 123 participants (74 individuals with depression and 49 healthy controls) using ultrasound tissue pulsatility imaging (TPI) to assess resting BTP. Results showed that both MeanBTP and MaxBTP were significantly associated with depression, as determined by multiple linear regression models that included age, sex and blood pressure as covariates. Additionally, we found that age, sex and diastolic blood pressure were significant predictors of BTP. Specifically, BTP decreased with age, was higher in men, and was more strongly predicted by diastolic blood pressure than by systolic blood pressure. In this large cohort, we replicated the association between depression and increased BTP, supporting the notion that elevated BTP may be a potential mechanism underlying brain damage over time. Our findings suggest that TPI could serve as a valuable surrogate marker for brain health in clinical practice.

The Mediating Role of Social Participation in Depression and the Occurrence of Mild Cognitive Impairment among the Elderly in China: a prospective, case control, cross‐sectional study

The Mediating Role of Social Participation in Depression and the Occurrence of Mild Cognitive Impairment among the Elderly in China: a prospective, case control, cross‐sectional study

The Impact of Intravenous Ketamine on Attentional Bias: Probing Mechanisms of Rapid-Acting Antidepressant Effects Across Two Clinical Studies

BackgroundKetamine is known for its rapid antidepressant effect, but its impact on affective information processing (including attentional bias, a putative cognitive mechanism of depression), remains largely unexplored. We leveraged a novel measurement of attentional bias and sought to: (1) establish adequate test-retest reliability and validity among depressed participants prior to ketamine treatment; and (2) harness a single dose of ketamine to assess mechanistic shifts in attentional bias and their relation to antidepressant efficacy. MethodsA novel dual probe video task was used to index attentional bias toward sad film clips. In Study 1, treatment-seeking adults with moderate-to-severe depression (n=40) completed the task at 1) baseline, 2) 1-week retest, 3) 1-month retest, and, for a subset (n=15), 4) 24-hrs post-ketamine infusion (0.5mg/kg over 40min). In Study 2, participants (n=43) completed the task pre- and 24-hrs post-ketamine. ResultsIndices from the novel attentional bias task were stable prior to ketamine, demonstrating good one-week and one-month test-retest reliability. Participants in both studies exhibited a robust reduction in attentional bias from pre- to 24-hrs post-ketamine infusion. In Study 1, cross-sectional correlations were observed between attentional bias and clinician-rated depressive symptoms at each pre-treatment assessment. In Study 2, changes in attentional bias were correlated with improved symptoms from pre- to post-infusion. ConclusionsResults provide evidence for the validity of a novel, psychometrically robust measure of attentional bias among individuals with depression. Findings indicate that ketamine reliably and rapidly reduces attentional bias, offering insight into a replicable, potential cognitive mechanism involved in its antidepressant action.

Factors associated with high nutrition risk by 10-year age group: Data from the Canadian Longitudinal Study on Aging.

Nutrition at midlife and beyond influences how an individual ages. Nutrition risk, the risk of poor nutritional health, is highly prevalent in community-dwelling adults in these age groups. As the factors associated with nutrition risk may vary between different age groups, research is needed on the differences in nutrition risk between age groups. To examine the social, demographic, and health factors associated with high nutrition risk, determined using SCREEN-8, using data from the Canadian Longitudinal Study on Aging (CLSA), stratified by 10-year age groups. Using the baseline and first follow-up waves of the CLSA, bivariate multivariable logistic regression was conducted to examine the variables associated with high nutrition risk (SCREEN-8 score < 38) by 10-year age group. Higher levels of social support, higher social standing, more frequent participation in community activities, screening negative for depression, and higher levels of self-rated general health, healthy aging, and oral health were consistently associated with lower odds of being at high nutrition risk across all age groups at both baseline and follow-up. Individuals with low levels of social support, low social standing, infrequent participation in community activities, poor general health, poor healthy aging, poor oral health, or who screen positive for depression should be screened proactively for nutrition risk. Programs and policies designed to address social support, social standing, participation in community activities, depression, health, healthy aging, and oral health may also help reduce the prevalence of high nutrition risk.

Distinct prefrontal cortex alterations in confirmed and suspected depression individuals with different perceived stress during an emotional autobiographical memory task: One fNIRS investigation

BackgroundPrevious research showed that perceived stress was strongly linked to depression, little is known about the underlying neurological mechanism of different depression subtypes with different perceived stress, and there is currently no classification of stress-based subtypes of depression. This study aimed at using fNIRS to uncover the neuromechanism of confirmed and suspected depression with different perceived stress, hence providing neurobiological evidence for the classification of stress-based depression subtypes. It is a significant target for effective depression treatment. MethodThe study included 551 young adults: 256 healthy control individuals, 62 confirmed depression patients, and 233 suspected depression participants. A 53-channel fNIRS imaging system was used to gather the average oxyhemoglobin level in the PFC during EAMT. ResultsCompared with HC, confirmed and suspected depression group show significant lower hemodynamic activation in right frontal lobe of frame under high loss of control. Confirmed depression with high sense of tension had higher activation than with high loss of control in right dlPFC, while for suspected depression, the activation with high sense of tension was lower than with high loss of control in left broca's area (BA) and front polar cortex (FPC). ConclusionAll perceived stresses were not equal in their impacts on different depression types. The confirmed and suspected depression were two different depression subtypes sharing distinct activation pattern under different perceived stress in PFC, which may be an important target for stress-linked psychopathology. Depression can be further classified precisely based on stress. fNIRS can provide neuroimaging evidence for classification of stress-based depression subtypes.

Augmented Depression Therapy for young adults: A mixed methods randomised multiple baseline case series evaluation

Augmented Depression Therapy (ADepT) is an individual psychotherapy for depression, which has been shown to be effective in the general adult population. A randomised multiple baseline case series evaluated the feasibility, acceptability, and effectiveness of ADepT in young adults (aged 20–24). Eleven depressed young adults were recruited from a UK university wellbeing service to receive ADepT during the COVID-19 pandemic, with outcomes evaluated relative to pre-specified continuation targets. All participants received a minimum adequate treatment dose (>60% target); 89% judged ADepT as acceptable and satisfactory and would recommend it to others (>60% target); only 9% showed reliable deterioration for depression or wellbeing (meeting <30% target); and there were no trial- or treatment-related serious adverse events. Qualitative interviews revealed most participants were satisfied with and experienced benefits from ADepT. At post-treatment, reliable improvement was shown by 33% of participants for depression and 67% of participants for wellbeing (not meeting target of both >60%), with medium effect size improvements for depression (g = 0.78) and large effect size improvement for wellbeing (g = 0.93; not meeting target of both >0.80). ADepT is feasible, acceptable, and safe in young adults but may require modification to maximise effectiveness. Further research outside of the COVID-19 pandemic is warranted.

Intensity dependence of auditory evoked potentials distinguish participants with unmedicated depression from non-depressed controls.

Depression is a heterogeneous syndrome that impacts an individual's emotional, social, cognitive and bodily functioning. Depression is associated with biases in emotional processing, but alterations in basic sensory processing have received less attention in depression research. Here, we measured event-related potentials (ERPs) in response to changes in the intensity of auditory stimuli and the location of somatosensory stimuli in participants with depression and in non-depressed control participants. We tested whether auditory mismatch negativity, P3a or N1 intensity dependence response or somatosensory mismatch response, P3a, P50 or N80 can dissociate depressed participants and non-depressed controls, and we also analysed the effects of depression medication and age in this sample. N1 intensity dependence response was increased in unmedicated depressed participants relative to non-depressed controls. When age was controlled for in the analysis, the effect of depression was only at a trend level. N1 intensity dependence response correlated with depression severity at the whole sample level. We did not observe any depression-related alterations in auditory mismatch negativity or P3a or somatosensory ERPs. Our results may reflect an association between the N1 intensity dependence response and altered neurotransmitter activity in depression, but this should be confirmed in future studies.

Association between social media use and depressive symptoms in middle-aged and older Chinese adults

The burden of depressive symptoms among middle-aged and older Chinese during the COVID-19 pandemic is unclear, and the contribution of social media use to depressive symptoms in this population has not been studied. To address the gaps, we analyzed data from the China Health and Retirement Longitudinal Study, nationally representative biannual surveys among adults aged ≥45 years. Social media use and depressive symptoms were measured in the 2018 and 2020 surveys. We tested longitudinal associations between baseline (2018) social media activities and risk of depressive symptoms in two years among 9121 participants without depressive symptoms. We also evaluated whether social media activity could reduce depressive symptoms during this period among 5302 individuals with depressive symptoms at baseline. Depressive symptoms affected 36·0% of this population in 2020. Women, individuals living in rural areas, and residents of western China provinces were particularly affected. Among participants without depressive symptoms, engaging in social media activities at baseline was associated with a 24.0% (95% confidence interval [CI]: 10–36%) lower likelihood of developing depressive symptoms over the next two years. Among depressed participants, compared to individuals not using social media, those initiating three or more social media activities during this period had 1.24 (95% CI: 1.05–1.46) times higher chance of becoming non-depressed, and those using social media all the time were 1·36 (95% CI: 1·09–1·72) times more likely to become non-depressed. In conclusion, middle-aged and older Chinese adults have a substantial burden of depressive symptoms, and social media activities may help to prevent and reduce the symptoms.

Depressive self-focus bias following failure: an eye-tracking study among individuals with clinical depression.

Depression is often characterized by a persistent sense of failure. Cognitive theories of depression suggest that depressed individuals may exhibit a maladaptive cognitive style, characterized by increased self-focus following personal failure. The validity of this proposition, however, is yet to be fully examined. This study aimed to identify the relation between symptoms in major depressive disorder and increased self-focus in failure situations. This clinical study involved a cohort of 30 patients diagnosed with and treated for depression. We used an eye-tracking paradigm to observe and analyze gaze direction - indicative of either self-focus or self-avoidance - after remembering a significant failure event. Contrary to the maladaptive cognitive style hypothesis, a majority of the depressed participants demonstrated an inclination towards self-avoidance following failure. Nevertheless, approximately 30% of the patient group - those with the highest scores of guilt, punishment, and self-blame - displayed a self-focused attentional bias post-failure. The presence of a maladaptive self-focusing style may be confined to severely depressed patients with high levels of guilt, punishment, and self-blame. These findings could have substantial clinical implications, as attention bias modification interventions could be particularly beneficial for this subgroup of patients.

Differentiating anticipated and anticipatory emotions and their sensitivity to depressive symptoms.

Anticipated emotions are the feelings one expects if a hypothetical future event were to occur, whereas anticipatory emotions are those one experiences right now while imagining the event. There has been little direct comparison of these two forms of future-oriented emotion, and authors have typically focused on positive emotions (e.g., pleasure). Besides, their sensitivity to depressive symptoms-which may help to explain motivational problems in depression-has only recently been investigated (e.g., Anderson et al., 2023; Gamble et al., 2021). The present study (conducted September-November 2022) used innovative picture-and-text vignettes depicting everyday positive and negative future events, to which participants rated their anticipated and anticipatory responses on separate dimensions of valence (i.e., how positive or negative) and arousal (i.e., emotional intensity). Based on prior literature, anticipatory emotions were expected to be correlated with, yet weaker than, anticipated emotions, reflecting a conceptualization of anticipatory emotions as a "foretaste" of the affective response one expects in the future. We also predicted that high depressive symptoms would coincide with diminished emotion ratings overall and specifically for anticipatory emotions (tightly coupled with event expectations; Carrera et al., 2012). Results largely supported these preregistered predictions, yet anticipatory emotions (positive and negative) were only weaker in more highly depressed participants. Depressive symptoms may therefore affect how one currently feels about future possibilities without altering one's expectations of how such events would actually feel. Implications and future research objectives arising from this are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Impact of Androgen deprivation therapy on cognitive function of elderly men with Prostate Cancer

Abstract Background Prostate cancer affects millions of men worldwide. Androgen deprivation therapy (ADT) is the most prescribed medication for elderly men with prostatic cancer to slow and suppress the disease progression. ADT works on decreasing testosterone level and that can cause multiple side effects including potential cognitive affection, in the form of accelerating cognitive aging, and potentially increasing risk of dementia. Which in our elderly population requires careful consideration. Aim evaluation of the effect of androgen-deprivation therapy (ADT) on the cognitive function of elderly men recently diagnosed with prostate cancer (PC). Methods and Results The current research is a prospective cohort study conducted on 85 elderly recently diagnosed with prostate cancer and are about to start ADT within 2 weeks of the diagnosis. These patients were recruited from the Oncology and Geriatrics outpatient clinics of Ain Shams University hospitals and are expected to be followed up on ADT for at least 6 months. Cognitive and depression assessments were done using the Montreal cognitive assessment test (MoCA) and MoCA-basic according to their education and Geriatric Depression Scale (GDS) and the Patient Health Questionnaire-9 (PHQ-9). The cases were assessed at the start, after 2 months and after 6 months of ADT use. Cognitively impaired or depressed patients were excluded at the start of the study. This study showed that 57.6% of the studied participants had a lower MoCA score average after 6 months and indicating Mild cognitive impairment. Cognitive domains such as visuospatial, language, recall and attention were affected, 27.0 % were diagnosed with depression after 6 months of the ADT therapy. All of the depressed participants had cognitive impairment. Conclusion The use of androgen deprivation therapy caused cognitive decline, regression of some of the cognitive domains and depression in elderly patients with prostate cancer who received androgen deprivation therapy for a period of 6 months. It is recommended that the cognitive function and depression screening is to be assessed regularly to all cancer prostate patients receiving ADT and cognitive training must be advised and prescribed to preserve or improve the patients' cognitive abilities. Key words Prostate cancer, Androgen Deprivation Therapy, Cognitive decline, Elderly.

Effect of Masking Secondary to the COVID-19 Pandemic on Functional Capacity Improvement in Cardiac Rehabilitation.

Given the difficulty to perform exercise training wearing a mask, we examined differences in functional capacity improvement between masking during the coronavirus disease 2019 (COVID-19) pandemic and non-masking prior to the pandemic for patients undergoing cardiac rehabilitation (CR). Records of 660 patients who underwent and completed≥18 sessions of CR in 2018 (n=318, non-masking) and in 2022 (n=342, masking) at an academic health system were analyzed. The primary outcome was post-CR change in functional capacity in metabolic equivalents (MET) measured by exercise stress test. Sessions of CR participation and changes in depression, anxiety, and quality of life scores were secondary outcomes. We used multivariable linear regression to adjust for differences in baseline CR outcome measures, demographics, American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) risk, and comorbid conditions. Baseline age (64.6±0.46yr), sex (28% female), and racial distribution (85% white) were similar between the masking and non-masking groups. Non-masking patients were more likely to be classified in the AACVPR high risk category and had lower anxiety scores at baseline compared to masking patients. After CR, both groups had similar and significant improvements in depression, anxiety, and quality of life scores, but the improvement in functional capacity was lower in the masking group (-0.62±0.12MET, P <.001) compared to the non-masking group. Results remained significant after multivariable adjustment. Cardiac rehabilitation patients requiring masking during the COVID-19 pandemic had less improvement in functional capacity than patients who did not wear masks during CR prior to the pandemic. Interventions to mitigate the potential side effects of masking for CR patients may require further exploration.

Impact of Androgen Deprivation Therapy on Cognitive Function of Elderly Men With Prostate Cancer.

Background Prostate cancer affects millions of men worldwide. Androgen deprivation therapy is the most prescribed medication for elderly men with prostatic cancer to slow and suppress the disease progression. Androgen deprivation therapy works on decreasing testosterone levels, and that can cause multiple side effects, including potential cognitive affection in the form of accelerating cognitive aging and potentially increasing the risk of dementia. This study is aimed at evaluating the impact of androgen deprivation therapy on the cognitive function of elderly men recently diagnosed with prostate cancer. Methods The current research is a prospective cohort study conducted on 85 elderly patients recently diagnosed with prostate cancer who are about to start androgen deprivation therapy within two weeks of the diagnosis. These patients were recruited from the oncology and geriatrics outpatient clinics of Ain Shams University hospitals and were followed up on androgen deprivation therapy for at least six months. Cognitive and depression assessments were done using the Montreal Cognitive Assessment Test and Montreal Cognitive Assessment Test-Basic (according to their education) and the Patient Health Questionnaire-9. The cases were assessed at the start, after two months, and after six months of androgen deprivation therapy use. Cognitively impaired or depressed patients were excluded at the beginning of the study. Results This study showed that 49 out of 85 (57.6%) of the studied participants had a lower Montreal cognitive assessment test score average after six months, indicating mild cognitive impairment. Cognitive domains such as visuospatial, language, and attention were affected. About one-third of the participants were diagnosed with depression after six months of the androgen deprivation therapy. All the depressed participants had cognitive impairment. Conclusion The use of androgen deprivation therapy carries the risk of cognitive decline and regression of some of the cognitive domains such as language, visuospatial, attention, and depression in the elderly with recently diagnosed prostate cancer who received ADT for six months. Conversely, depression could not be linked to cognitive decline. Further research should continue exploring the relationship between cognitive decline and ADT and seek strategies to mitigate these effects, ensuring comprehensive patient care targetingcognitive and psychological well-being.

The association between ‘weekend warrior’, regular exercise, and cognitive function in elderly individuals with and without depressive symptoms: A cross-sectional analysis from NHANES 2011–2014

BackgroundWhile previous studies have suggested that both ‘Weekend Warrior’ (WW) and Regular Exercise (RE) patterns confer health benefits, the relationship between different types of physical activity (PA) and cognitive function (CF) in elderly individuals with and without depressive symptoms remains unclear. MethodsOur study leveraged the NHANES 2011–2014 dataset, focusing on older adults. We explore the relationship between PA and CF, stratifying by depressive status. Our statistical approach included multivariable regression analysis to identify relationships between PA levels and cognitive outcomes, along with advanced techniques such as smoothed curve fitting and threshold effect analysis to examine potential nonlinear associations and identify optimal PA pattern for cognitive health. ResultsAnalysis revealed a positive correlation between PA time and CF across all participants (β-depressive symptoms = 0.03, 95 % CI: 0.01–0.05; β-non-depressive symptoms = 0.01, 95%CI: 0.00–0.02). When comparing against the inactive, non-depressed participants partaking in WW showed improved cognitive scores (β-WW = 0.22, 95 % CI: 0.05–0.39), similar to those engaging in RE (β-RE = 0.15, 95 % CI: 0.09–0.21). However, among the depressed participants, significant cognitive improvements were observed in the RE (β-RE = 0.15, 95 % CI: 0.04–0.25), with the WW showing less definitive results (β-WW = 0.22, 95 % CI: −0.02-0.47). LimitationThe cross-sectional nature limits causal inferences. ConclusionOur findings affirm the potential role of PA in enhancing CF among older subjects without depressive symptoms. However, only RE was associated with improved CF in those with depressive symptoms. These results are critical for crafting personalized PA guidelines to enhance cognitive health in the aging population.

FC5: Predicting adherence to psychotherapy with mHealth data using deep learning

Objectives: Effectiveness of psychotherapy depends on patients’ adherence to between-session homework (HW) to practice therapeutic skills. mHealth apps can offer continuing reminders, although frequent reminders overwhelm or burden patients and therefore are ineffective. Predicting likelihood of completing daily HW and sending contextual reminders has the potential to improve HW adherence and therefore improvesymptoms.Methods: Depressed older participants (N = 51) undergoing psychotherapy provided daily active ratings on mood, anhedonia, stress and pain via an mHealth app. Data on activity, mobilization, sociability and sleep passively were also recorded via device sensors (e.g., microphone, accelerometer, GPS etc.). Using active and passive mHealth data, we developed predictive models of daily home-work completion status using a naïve semi-supervised deep learning algorithm. Prediction accuracy was determined via time-dependent cross-validation.Results: Study participants had a mean (SD) age of 71.4 (7.76) years, mean (SD) of 14.9 (2.93) years of education, mean (SD) BIS/BAS total of 22.6 (3.36), mean (SD) MADRS total score of20.4 (6.04) and 88.2% were of female gender, 29.4% were single, 83.8% were of non-Hispanic ethnicity, 58.8% belonged to Caucasian race and 38.2% practiced Catholic religion. With 4700 person-days HW completion response, our models show an AUC of 84.7% (sensitivity = 76.2%; specificity = 80%) estimated by cross-validation.Conclusions: This paper demonstrates the feasibility of predicting adherence to psychotherapy in depressed older adults using actively and passively collected mHealth data. Digital interventions based on such predictive models can potentially increase adherence to psychotherapy and thereby improve its effectiveness without increasing the user notification burden.

Impaired Emotional Processing in Major Depressive Disorder. Accuracy versus Processing Speed

Depression is one of the most frequent conditions within the general population, ranking among the most burdensome in terms of public health expenses, productivity loss and social costs. The condition has been linked with cognitive deficits that may even continue in remission phases, social cognition being one potentially affected cognitive function. In our study, the Penn’s Emotional Acuity Test included in the CogtestTM battery was used to assess emotion recognition accuracy and processing speed. The Structured Clinical Interview for the Montgomery-Asberg Depression Rating Scale was used to assess the intensity of the symptomatology. A total of 48 depressed individual individuals (65% females), with a mean age of 49.8 ± 10.4 years, and 40 healthy controls (75% females), with a mean age of 35.2 ± 6.9 years were included. As compared to controls, depressive participants recorded significantly less correct answers (9.3 ± 3.8 vs. 11.2 ± 3.6, p = 0.019 – Student’s t test) and slower processing speeds (6795 ± 3366 vs. 4042 ± 1623, p 0.001 – Mann-Whitney U test) in emotion processing. Furthermore, symptom severity significantly influences only processing speed and not accuracy in emotion recognition tasks. Thus, we conclude that depressive individuals have a significant deficit in processing speed and accuracy when identifying the intensity of other peoples’ emotions.