Depressive Symptomatology Research Articles

Older caregivers’ depressive symptomatology over time: evidence from the Survey of Health, Ageing and Retirement in Europe

The prevalence of informal caregiving is increasing as populations across the world age. Caregiving has been found to be associated with poor mental health outcomes including depressive symptoms. The purpose of this study is to examine the mean trajectory of depressive symptomatology in older caregivers in a large European sample over an eight-year period, the effects of time-varying and time-invariant covariates on this trajectory, and the mean trajectory of depressive symptomatology according to pattern of caregiving. The results suggest that depressive symptoms in the full sample of caregivers follow a nonlinear trajectory characterized by an initial decrease which decelerates over time. Caregiver status and depressive symptoms were significantly associated such that depressive symptoms increased as a function of caregiver status. The trajectory in caregivers who report intermittent or consecutive occasions of caregiving remained stable over time. Significant associations were found between sociodemographic, health and caregiving characteristics and the initial levels and rates of change of these trajectories. While these results point to the resilience of caregivers, they also highlight the factors that are related to caregivers’ adaptation over time. This can help in identifying individuals who may require greater supports and, in turn, ensuring that caregivers preserve their well-being.

CURRENT STATE OF PSILOCYBIN-ASSISTED THERAPY IN MOOD DISORDERS.

Psychedelics are currently undergoing a scientific renaissance, with modern studies investigating therapeutic efficacy of psychedelic-assisted therapy in a range of psychiatric conditions. In particular, psilocybin-assisted therapy (PAT) has been suggested to have positive effects on patients suffering from depression and psychiatric distress associated with life-threatening disease - contexts with growing needs for alternative treatments - in a therapeutic setting involving fewer doses and less important adverse effect compared to that of classic psychotrope administration. Psychedelics are partial agonists of the serotonin 2A (5-HT2A) G protein-coupled receptors, whose activation likely mediates the acute psychoactive effects. Furthermore, psychedelics seem to induce a hyper-plastic state which allows for adaptation of inflexible pathological thinking patterns. Post-acutely, they are suggested to induce rapid, robust and sustained neuroplasticity. Eight clinical PAT trials have been conducted between January 1st 2001 and March 31st 2023 and are reviewed here. Five of them evaluate the effect on depressive symptomatology in an otherwise general population. The other three evaluate effect on depression and anxiety in patients suffering from somatic life-threatening disease. The studies reviewed here show that PAT is safe and feasible to administer in current clinical models. Preliminary efficacy shows significant improvements in depressive and anxious symptomatology which are immediate and partially sustained. One study comparing PAT to selective serotonergic reuptake inhibitors showed no significant difference of efficacy between the two treatments. Preliminary results regarding efficacy of PAT on mood disorders are promising, but further research is warranted for stronger inferences, with a particular focus on larger, multicentric studies, more diverse populations and a stronger control for expectancy and unblinding.

Identifying Person-Specific Drivers of Depression in Adolescents: Protocol for a Smartphone-Based Ecological Momentary Assessment and Passive Sensing Study.

Adolescence is marked by an increasing risk of depression and is an optimal window for prevention and early intervention. Personalizing interventions may be one way to maximize therapeutic benefit, especially given the marked heterogeneity in depressive presentations. However, empirical evidence that can guide personalized intervention for youth is lacking. Identifying person-specific symptom drivers during adolescence could improve outcomes by accounting for both developmental and individual differences. This study leverages adolescents' everyday smartphone use to investigate person-specific drivers of depression and validate smartphone-based mobile sensing data against established ambulatory methods. We describe the methods of this study and provide an update on its status. After data collection is completed, we will address three specific aims: (1) identify idiographic drivers of dynamic variability in depressive symptoms, (2) test the validity of mobile sensing against ecological momentary assessment (EMA) and actigraphy for identifying these drivers, and (3) explore adolescent baseline characteristics as predictors of these drivers. A total of 50 adolescents with elevated symptoms of depression will participate in 28 days of (1) smartphone-based EMA assessing depressive symptoms, processes, affect, and sleep; (2) mobile sensing of mobility, physical activity, sleep, natural language use in typed interpersonal communication, screen-on time, and call frequency and duration using the Effortless Assessment of Risk States smartphone app; and (3) wrist actigraphy of physical activity and sleep. Adolescents and caregivers will complete developmental and clinical measures at baseline, as well as user feedback interviews at follow-up. Idiographic, within-subject networks of EMA symptoms will be modeled to identify each adolescent's person-specific drivers of depression. Correlations among EMA, mobile sensor, and actigraph measures of sleep, physical, and social activity will be used to assess the validity of mobile sensing for identifying person-specific drivers. Data-driven analyses of mobile sensor variables predicting core depressive symptoms (self-reported mood and anhedonia) will also be used to assess the validity of mobile sensing for identifying drivers. Finally, between-subject baseline characteristics will be explored as predictors of person-specific drivers. As of October 2023, 84 families were screened as eligible, of whom 70% (n=59) provided informed consent and 46% (n=39) met all inclusion criteria after completing baseline assessment. Of the 39 included families, 85% (n=33) completed the 28-day smartphone and actigraph data collection period and follow-up study visit. This study leverages depressed adolescents' everyday smartphone use to identify person-specific drivers of adolescent depression and to assess the validity of mobile sensing for identifying these drivers. The findings are expected to offer novel insights into the structure and dynamics of depressive symptomatology during a sensitive period of development and to inform future development of a scalable, low-burden smartphone-based tool that can guide personalized treatment decisions for depressed adolescents. DERR1-10.2196/43931.

Relationship between anhedonia, biological rhythms, functioning and depression severity in patients with bipolar disorder.

The purpose of this study was to examine relationship between anhedonia, disruption of biological rhythms, functioning and depression severity in patients with bipolar disorder (BD). The sample included 58 patients with bipolar depression aged 18-65 years. The participants were assessed using the following scales: Dimensional Anhedonia Rating Scale (DARS), Snaith-Hamilton Pleasure Scale (SHAPS), Quick Inventory of Depressive Symptomatology- self-report (QIDS-SR), Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN), Functioning Assessment Short Test (FAST). Correlations between the variables were calculated. We built linear regression models with FAST or QIDS-SR as a dependent variable. Mediation analysis was performed. Statistically significant correlations were observed between the included variables. Biological rhythms dysregulation and anhedonia were independent predictors of the level of functioning or depression severity. Mediation analysis demonstrated statistically significant mediation of the relationship between anhedonia and depression severity/functioning by the BRIAN score. We demonstrated for the first time the interactions between anhedonia, dysregulation of biological rhythms and functioning/depression severity in patients with BD. Reward deficits by causing disruption of rhythm of daily activities and social contacts may result in more difficulties in functioning and higher intensity of depressive symptoms.

Treatment-emergent symptoms during short-term ketamine administration in treatment-resistant bipolar depression: A retrospective cross-sectional descriptive study

Symptoms that emerge during pharmacological treatment of bipolar depression are frequently observed, underscoring the necessity for comprehensive treatment monitoring. This observational study sought to observe the correlation of eight intravenous ketamine infusions with treatment-emergent depressive symptoms in treatment-resistant bipolar depression patients who maintained their baseline psychotropic and chronic somatic treatments. Depressive symptoms were evaluated using the Inventory of Depressive Symptomatology Self-Report 30 (IDS-SR30). Treatment-emergent symptoms TES were defined as symptoms absent at baseline but present at the conclusion of the study. The most common TES included decreased appetite, increased weight, hypersomnia, and diurnal mood variation. Conversely, feelings of sadness, altered perceptions of the future, decreased interest in sex, and physical discomfort were absent in all patients. Notably, 13.6 % of patients reported thoughts of death or suicide. Larger-scale studies, integrating clinician-rated and patient-reported outcome measures, are essential to deepen our understanding of treatment-emergent symptoms. Establishing regulatory or professional definitions for treatment-emergent symptoms is warranted to improve the robustness of future research endeavors.

Prevalence and factors associated with fatigue in patients with major depressive disorder or bipolar disorder

AimsTo study the prevalence of fatigue and factors associated with fatigue in patients with major depressive disorder (MDD) or bipolar disorder (BD). MethodsTwo hundred fifty-three outpatients with MDD or BD at the initial assessment were used to study the prevalence of fatigue and relationship between fatigue and other clinical correlates. The severity of fatigue was measured with Iowa Fatigue Scale (IFS), and depression and anxiety symptom-severity were measured with the QIDS-16-SR (the 16-item Quick Inventory of Depressive Symptomatology – Self-Report) and Zung-SAS (Zung Self-Rating Anxiety Scale). Correlation between IFS and QIDS-16-SR total scores, QIDS-16-SR item scores or Zung-SAS total scores, and independent factors associated with fatigue was assessed with simple or multiple linear regression analysis. ResultsOverall, 28.4 % of MDD and 29.8 % of BD patients did not have fatigue, but 41.2 % of MDD and 45.0 % of BD patients had fatigue, and 30.4 % of MDD and 25.2 % of BD patients had severe fatigue. Depression/anxiety severity was significantly correlated with fatigue. However, after controlling current psychiatric comorbidities, demographics, some social factors, and psychotropic use, only QIDS-16-SR scores were still significantly and positively correlated with IFS scores in both MDD and BD. Differential correlations between IFS scores and item scores of QIDS-16-SR in MDD and BD were observed. LimitationCross-sectional. ConclusionsIn this outpatient sample, fatigue was highly prevalent in patients with MDD or BD. The independent association of depressive severity with the severity of fatigue highlights the importance of complete resolution of depressive symptoms in treating MDD and BD.

Does Childcare Attendance Moderate the Associations Between Mother-Child Depressive Symptoms and Children’s Peer Victimization Experiences?

Peer victimization experiences is suggested to play a mediating role in the transmission of depression symptoms between mothers and children. Childcare attendance has been found to reduce the association between mother and child depressive symptoms. However, it is not clear whether this protective effect unfolds via a reduction of peer victimization experiences in middle childhood. The aims of this study were to test (1) whether peer victimization in middle childhood mediated the association between exposure to maternal depressive symptomatology in early childhood and child depressive symptoms in late childhood, (2) whether childcare attendance moderate the direct associations between maternal depressive symptoms and children’s peer victimization experiences in middle childhood as well as depressive symptoms in late childhood and (3) whether childcare attendance moderates this mediated association. Data come from the Avon Longitudinal Study of Children and Parents (N = 5526) where exposure to maternal depressive symptoms and intensity of childcare attendance were assessed repeatedly during early childhood. Children’s peer victimization and depressive symptoms were self-reported at eight and 10 years of age, respectively. We used weighted structural equation modeling and found that the association between mothers and children’s depression was partially mediated by peer victimization. Childcare attendance did not moderate the indirect effect of maternal depression on child depressive symptoms via peer victimization. However, we found that for children who attended childcare, maternal depression was no longer associated child depressive symptoms in late childhood. In conclusion, peer victimization experiences partly explain the intergenerational transmission of depressive symptoms, but this mechanism is not altered by children’s childcare attendance. Future research should examine potential socio-emotional and school readiness mechanisms that may break the cycle of depressive symptomatology from mothers to children.

Information and Counseling needs Regarding Parenthood Decisions: Are Existing Services Sufficient and what Role does Depression Play?

Support needs in parenting decisions and the associated desire for information and counseling services are insufficiently researched, especially in relation to groups of people with mental health burdens. The aim of this study was to assess information and counseling needs in parenting decisions. In addition, we investigated whether more severe depressive symptomatology is associated with increased needs. A sample of 187 individuals between the ages of 20 and 44 was surveyed in an online study. Not having enough information on the topic was expressed by 45% of participants, and the desire for information related to multiple topics. A larger offer of professional coun-seling was desired by 65% of the participants, 74% (rather) did not know where to get it. Existing counseling services were used infrequently in relation to needs and with predominantly moderate satisfaction. Greater depressive symptomatology was not associated with increased information or counseling needs. Findings suggest an expansion of support services on parenting decisions. Further research into the needs of different groups and barriers to using existing services is essential.

Childhood trauma as a mediator between autistic traits and depression: evidence from the ALSPAC birth cohort.

Autism and autistic traits have been associated with greater risk of childhood trauma and adulthood psychopathology. However, the role that childhood trauma plays in the association between autism, autistic traits and depression in adulthood is poorly understood. We used a UK-based birth cohort with phenotype and genotype data on autism, autistic traits, childhood trauma and depression in up to 9,659 individuals prospectively followed up from birth until age 28 years. Using mixed-effects growth-curve models, we assessed trajectories of depression symptoms over time according to the presence or absence of autism/ autistic traits and explored whether these differed by trauma exposure. We further investigated the association between autism/ autistic traits and depression in adulthood using confounder-adjusted logistic regression models and undertook mediation analyses to investigate the relationship with childhood trauma. All autism variables demonstrated increased depressive symptom trajectories between ages 10-28 years. Social communication difficulties (SCDs) were the most strongly associated with a depression diagnosis in adulthood (age 24 OR= 2.15; 95%CIs: 1.22-3.76). Trauma and autistic traits combined to further increase depression symptom scores. Mediation analyses provided evidence for direct pathways between autistic traits and increased risk of depression alongside indirect pathways through increased risk of trauma. Autism/ autistic traits increase the odds of experiencing childhood trauma and of being diagnosed with depression at age 18 and 24. Depressive symptom trajectories emergent in childhood persist into adulthood. The combined effect of SCDs and childhood trauma is greater than the individual exposures, suggesting worse depression symptomatology following trauma in individuals with SCDs.

Stress, Anxiety and Depression in First-year Medical Undergraduates and Coping Strategies Employed during COVID-19-induced Online Learning: A Cross-sectional Study from North India

Abstract Background: The COVID-19 pandemic, due to its rising uncertainties, was expected to negatively impact the overall psychological functioning of students undergoing first year of medical professional education with changing teaching styles and environmental restraints. Objective: The objective was to assess the impact of this stressful period on the first-year Bachelor of Medicine and Bachelor of Surgery (MBBS) students at an Institute of National importance in North India, by measuring their various emotional states such as stress, anxiety, depression and coping strategies. Methods: This was a descriptive cross-sectional study undertaken in first-year MBBS students who were admitted in February 2021 due to delay in the admission process. Their physical classes were suspended due to the onset of second wave of COVID-19 and underwent a significant shift from conventional classes to a hybrid teaching module involving online classes, minimal face-to-face contact with teachers and almost no practical exposure which is in contrast to the conventional teaching practices. Data collection was done during and in the aftermath of second wave of COVID-19 using the Depression, Anxiety and Stress Scale (DASS-21) to assess emotional state and the Brief-Coping Orientation to Problems Experienced Inventory to measure the coping strategies employed. Results: One hundred and twenty-five students were approached and 80 consented to participate. The 80 students were analysed. Elevated depressive symptomatology scores were found in 46% of students, of which 14% had scores falling in severe category. More than 62% had elevated anxiety scores, of which 26% had severe range of scores, and 37% students had elevated stress scores, of which more than 10% had severe range of scores. Venting, humour and self-blame were found to be the predominant facets of coping styles employed and they had a significant statistical correlation with all three subscales of DASS-21. Conclusion: The study found a significant prevalence of depressive, anxiety and stress symptomatology. These findings emphasise the need for mental health interventions and support programmes for medical college MBBS students to help them cope with the psychological impact of academic and personal stressors.

Resilience as a protective factor against depression in informal caregivers.

Although previous research has demonstrated that resilience can be protective against various mental health conditions such as depression, existing studies examining the relationship between resilience and depression have limitations. To our knowledge, the moderators of the relationship have not been examined. The aim of this study was to determine whether resilience acts as a protective factor against depression in informal caregivers and to examine potential moderators of the relationship between these variables. In this cross-sectional study, 554 randomly selected informal caregivers participated (86.8% women, average age = 55.3 years). Major depressive episode, depressive symptomatology, resilience, positive environmental reward, negative automatic thoughts, self-efficacy, and personality were assessed. A total of 16.1% of informal caregivers met criteria for a depressive episode and 57.4% were at risk of developing depression. The average resilience score was 26.3 (SD = 7.6); 62.6% of participants were in the lower quartile of the resilience scale. The gender of the informal caregiver and self-efficacy acted as moderating variables in the relationship between resilience and depression. The impact of resilience on depressive symptoms was more pronounced in female informal caregivers, and increased as self-efficacy increased. Based on these findings, programs aimed at preventing depression in informal caregivers should focus on promoting resilience, especially in women, and introduce strategies to enhance self-efficacy to increase their impact.

Internalized homonegativity and mental health among sexual minority couples and parents

This study examined the indirect effect of relationship and parental status on mental health through internalized homonegativity among lesbian, gay, and bisexual (LGB) individuals. Prior research suggested that being in a relationship and becoming a parent may improve the mental health of LGB individuals, acting as protective factors against stigma and discrimination. However, the role of internalized homonegativity in mental health disparities between LGB individuals in relationships/parents and those who are not remains unclear. Therefore, we surveyed 491 LGB cisgender Israelis aged 18–64 years (M = 33.51, SD = 9.09) assessing relationship status, parental status, internalized homonegativity, depressive symptomatology, and life satisfaction. Indirect effects were explored using the PROCESS macro. Results showed that LGB individuals in romantic relationships reported lower depressive symptomatology and higher life satisfaction compared to those not in relationships. Similarly, LGB individuals who were parents reported lower depressive symptomatology and higher life satisfaction compared to non-parents. Significant indirect effect was found for couplehood/parenthood on depressive symptomatology/life satisfaction through internalized homonegativity. This study deepens the understanding of the interplay between couplehood, parenthood, and internalized homonegativity and their contribution to mental health of LGB individuals. It provides valuable insights for researchers and practitioners, highlighting the potential role of couplehood and parenthood in the mental health of sexual minority groups facing legal restrictions on marriage and parenting.

Baseline circulating biomarkers, their changes, and subsequent suicidal ideation and depression severity at 6 months: A prospective analysis in patients with mood disorders

BackgroundIdentifying circulating biomarkers associated with prospective suicidal ideation (SI) and depression could help better understand the dynamics of these phenomena and identify people in need of intense care. In this study, we investigated the associations between baseline peripheral biomarkers implicated in neuroplasticity, vascular homeostasis and inflammation, and prospective SI and depression severity during 6 months of follow-up in patients with mood disorders. Methods149 patients underwent a psychiatric evaluation and gave blood to measure 32 plasma soluble proteins. At follow-up, SI incidence over six months was measured with the Columbia Suicide Severity Rating Scale, and depressive symptoms were assessed with the Inventory for Depressive Symptomatology. Ninety-six patients provided repeated blood samples. Statistical analyses included Spearman partial correlation and Elastic Net regression, followed by the covariate-adjusted regression models. Results51.4 % (N = 71) of patients reported SI during follow-up. After adjustment for covariates, higher baseline levels of interferon-γ were associated with SI occurrence during follow-up. Higher baseline interferon-γ and lower orexin-A were associated with increased depression severity, and atypical and anxious, but not melancholic, symptoms. There was also a tendency for associations of elevated baseline levels of interferon-γ, interleukin-1β, and lower plasma serotonin levels with SI at the six-month follow-up time point. Meanwhile, reduction in transforming growth factor- β1 (TGF-β1) plasma concentration correlated with atypical symptoms reduction. ConclusionWe identified interferon-γ and orexin-A as potential predictive biomarkers of SI and depression, whereas TGF-β1 was identified as a possible target of atypical symptoms.

The Association Between Depressive Symptoms and the Weekly Duration of Physical Activity Subset by Intensity and Domain: Population-Based, Cross-Sectional Analysis of the National Health and Nutrition Examination Survey From 2007 to 2018.

Prior literature suggests a dose-response relationship between physical activity (PA) and depressive symptoms. The intensity and domain of PA are suggested to be critical to its protective effect against depression; however, existing literature has shown mixed results. The purpose of this population-based study is to examine the associations between depressive symptoms and weekly duration of (1) total PA and (2) PA subset by intensity, domain, or both. A cross-sectional analysis of National Health and Nutrition Examination Survey data from 2007 to 2018 was conducted using multivariable logistic and linear regression models and survey weights. Participants (N=29,730) were 20 years and older and completed the Physical Activity Questionnaire and Depression Screener. The primary outcome was the presence of depressive symptoms, and the secondary outcomes were cognitive-affective and somatic symptoms of depression. Participants (N=29,730) had a weighted mean age of 47.62 (SD 16.99) years, and 15,133 (51.34%) were female. On average, participants without depressive symptoms engaged in 10.87 hours of total PA per week, whereas participants with depressive symptoms engaged in 8.82 hours (P<.001). No significant associations were seen between the weekly duration of total PA and depressive symptom odds, somatic, or cognitive-affective symptoms (all P>.05). Participants with an increased weekly duration of recreational PA had decreases in depressive symptom odds (adjusted odds ratio [aOR] 0.965, 95% CI 0.944-0.986) and in somatic (adjusted coefficient [aβ]=-0.016, 95% CI -0.022 to -0.009) and cognitive-affective (aβ=-0.015, 95% CI -0.023 to -0.007) symptoms. When recreational PA was subset by intensity, participants with an increased weekly duration of vigorous-intensity recreational PA had decreases in depressive symptom odds (aOR 0.926, 95% CI 0.883-0.972) and in somatic (aβ=-0.021, 95% CI -0.032 to -0.010) and cognitive-affective (aβ=-0.022, 95% CI -0.035 to -0.009) symptoms. However, significant associations were not seen for the weekly duration of work-related, moderate- or vigorous-intensity PAs (all P>.05). Findings suggest that recreational, not work-related PA is associated with reduced symptoms of depression. Future studies should explore the impact of the different types and contexts of PA on depressive symptomatology.

Bayesian Networks for Prescreening in Depression: Algorithm Development and Validation.

Identifying individuals with depressive symptomatology (DS) promptly and effectively is of paramount importance for providing timely treatment. Machine learning models have shown promise in this area; however, studies often fall short in demonstrating the practical benefits of using these models and fail to provide tangible real-world applications. This study aims to establish a novel methodology for identifying individuals likely to exhibit DS, identify the most influential features in a more explainable way via probabilistic measures, and propose tools that can be used in real-world applications. The study used 3 data sets: PROACTIVE, the Brazilian National Health Survey (PesquisaNacionalde Saúde [PNS]) 2013, and PNS 2019, comprising sociodemographic and health-related features. A Bayesian network was used for feature selection. Selected features were then used to train machine learning models to predict DS, operationalized as a score of ≥10 on the 9-item Patient Health Questionnaire. The study also analyzed the impact of varying sensitivity rates on the reduction of screening interviews compared to a random approach. The methodology allows the users to make an informed trade-off among sensitivity, specificity, and a reduction in the number of interviews. At the thresholds of 0.444, 0.412, and 0.472, determined by maximizing the Youden index, the models achieved sensitivities of 0.717, 0.741, and 0.718, and specificities of 0.644, 0.737, and 0.766 for PROACTIVE, PNS 2013, and PNS 2019, respectively. The area under the receiver operating characteristic curve was 0.736, 0.801, and 0.809 for these 3 data sets, respectively. For the PROACTIVE data set, the most influential features identified were postural balance, shortness of breath, and how old people feel they are. In the PNS 2013 data set, the features were the ability to do usual activities, chest pain, sleep problems, and chronic back problems. The PNS 2019 data set shared 3 of the most influential features with the PNS 2013 data set. However, the difference was the replacement of chronic back problems with verbal abuse. It is important to note that the features contained in the PNS data sets differ from those found in the PROACTIVE data set. An empirical analysis demonstrated that using the proposed model led to a potential reduction in screening interviews of up to 52% while maintaining a sensitivity of 0.80. This study developed a novel methodology for identifying individuals with DS, demonstrating the utility of using Bayesian networks to identify the most significant features. Moreover, this approach has the potential to substantially reduce the number of screening interviews while maintaining high sensitivity, thereby facilitating improved early identification and intervention strategies for individuals experiencing DS.

Emotional awareness for self and others and empathic abilities in clinical depression during acute illness and recovery

BackgroundThe present longitudinal investigation had two major goals. First, we intended to clarify whether depressed patients are characterized by impairments of emotional awareness for the self and the other during acute illness and whether these impairments diminish in the course of an inpatient psychiatric treatment program. Previous research based on the performance measure Levels of Emotional Awareness Scale (LEAS) provided inconsistent findings concerning emotional self-awareness in clinical depression. Second, we investigated whether cognitive and affective empathic abilities change from acute illness to recovery in depressed patients.MethodsFifty-eight depressed patients were tested on admission and after 6–8 weeks of inpatient psychiatric treatment. A sample of fifty-three healthy individuals were also examined twice at an interval of 6–8 weeks. The LEAS and the Interpersonal Reactivity Index (IRI) were administered to assess emotional awareness and empathic abilities. Written texts were digitalized and then analyzed using the electronic scoring program geLEAS, the German electronic Levels of Emotional Awareness Scale.ResultsDepressed patients reported more depressive symptoms than healthy controls and less severe depressive symptomatology at time 2 compared to time 1. Independent of time, depressed individuals tended to show lower geLEAS self scores and had lower geLEAS other scores than healthy individuals. Depressed patients showed higher personal distress scores than healthy individuals at both measurement times. No group differences were observed for the cognitive empathy scales of the IRI (perspective taking and fantasy) and empathic concern, but empathic concern decreased significantly in depressed patients from time 1 to time 2. Empathic abilities as assessed by the IRI were not significantly correlated with emotional awareness for others, neither in the whole sample, nor in the patient and control subsample.ConclusionsDepressed patients seem to be characterized by impairments in emotional awareness of others during acute illness and recovery, but they also tend to show deficits in emotional self-awareness compared to healthy individuals. Self-reported cognitive empathic abilities seem to be at normal levels in depressed patients, but their heightened self-focused affective empathy may represent a vulnerability factor for depressive disorders.

Eveningness is associated with more severe depressive symptoms independently of sleep quality and fatigue level only in first-episode but not recurrent depression in major depressive disorder

ABSTRACT People with an evening chronotype have an increased risk of experiencing a major depressive disorder (MDD). It is unclear if this effect is predominantly related to the initial development of MDD or also present in recurrent episodes. The current study aimed to investigate if the association between chronotype and depressive severity in MDD patients is comparable in MDD patients with first and recurrent episodes. 386 MDD patients, 70.7% females and aged between 16 and 64, participated in the study. The Morningness – Eveningness Questionnaire (MEQ), Pittsburgh Sleep Quality Index (PSQI), Multidimensional Fatigue Inventory (MFI20), and Quick Inventory of Depressive Symptomatology (QIDS-SR16) were administered to participants to determine chronotype, sleep quality, fatigue level, and depressive severity, respectively. Multivariate regression models were utilized to analyze how chronotype influences depressive severity. The study showed that chronotype, sleep quality, and fatigue level were all associated with depressive severity. Eveningness significantly predicted an increase in depressive severity independently of sleep quality and fatigue level only in patients with the first episode (−0.068, p = 0.010), but not in patients with recurrent episodes (0.013, p = 0.594). Circadian-focused treatment should be considered in first-episode depression only.

Subjective cognitive concerns not related to objective impairment in patients with somatic symptom and related disorders

ABSTRACT Objectives Patients with Somatic Symptom and Related Disorders (SSRD) report subjective cognitive concerns, and research indicates that they show objective cognitive impairment. This study explored the value of subjective concerns flagging objective impairment. Furthermore, we investigated whether coping moderated this relationship, and the role of depressive symptomatology. Method In a cross-sectional design, objective impairment was measured with an extensive neuropsychological assessment; subjective concerns with the Cognitive Failure Questionnaire; coping styles with the Coping Inventory of Stressful Situations; and symptoms of depression with the Patient Health Questionnaire- 9. Results The results show that subjective concerns are of limited value in signaling objective impairment in patients with SSRD. Regression analyses performed on data from 225 patients showed that symptoms of depression (β = .32) were the main predictor of subjective concerns, which were unrelated to objective impairment. Coping was not a moderator, but patients with emotion-oriented coping styles had more subjective concerns (β=.40), and conversely, patients with avoidance- and/or task-oriented coping styles had less (respectively, β=-.27 and β=-.24). Conclusions These results align with the Somatosensory Amplification Theory; patients with SSRD may amplify benign cognitive failures and experience them as intrusive, noxious, and more intense. In patients with SSRD, subjective cognitive concerns are more related to psychological constructs (symptoms of depression and coping styles) than to objective impairment.

Impact of pre-existing depression and food insecurity on the trajectory of depressive symptomatology during the COVID-19 pandemic outbreak in South Africa: A panel analysis of nationally representative South African data

We investigated the trajectory of depressive symptoms (“depression”) from the start of the COVID-19 pandemic in South Africa (March 2020) until 2021, between individuals with and without pre-pandemic depression, specifically regarding the role of food security. Our investigation used publicly available panel data (N = 6,930) from the South African National Income Dynamics Study Coronavirus Rapid Mobile Survey (SA-NIDS-CRAM from 2020–2021) on those who had also participated in the pre-pandemic South African National Income Dynamics Study (SA-NIDS, 2017) depression interview. We investigated trends in depressive symptomatology (based on a 2-item Patient Health Questionnaire) at SA-NIDS-CRAM Wave 2 (July 2020), Wave 3 (February 2021) and Wave 5 (May 2021). Generalized estimating equations (GEE) with post-estimation linear combinations of estimators were fitted to investigate the roles of pre-pandemic depression (based on 2017 SA-NIDS data) and food insecurity during the pandemic on depressive symptomatology. During the pandemic, the highest levels of depression were observed consistently among those with pre-pandemic depression and food insecurity; and were lowest among those without pre-pandemic depression and food security. Depressive symptomatology rose in nearly equal magnitude during the early phases of the pandemic in two groups: those without pre-pandemic depression but food insecure during the pandemic; as well as those with pre-pandemic depression but food secure during the pandemic. However, this dynamic changed later in the pandemic, when higher depressive symptomatology was observed in the group with both pre-pandemic depression and food insecurity, widening the gap between them from Wave 3 (adj β = 0.63, p < 0.01) to Wave 5 (adj β = 0.79, p < 0.01). Our results highlight the importance of addressing both population mental health and food insecurity, particularly at the early stages of a crisis/disaster. As we showed that mental health impact is linked to food insecurity during a pandemic, strengthening social protection measures, especially around food and nutrition, would help build resilience to crises in the long term.

Effectiveness of internet-delivered psychological treatments for children and adolescents with anxiety and/or depressive disorders: Systematic review and network meta-analysis

BackgroundAnxiety and depression symptomatology has increased in the child and adolescent population. Internet-delivered psychological treatments (IDPT) can help to reduce this symptomatology, attending to the largest possible population. AimTo conduct a systematic review and network meta-analysis of IDPT to reduce anxiety and depression symptoms in children and adolescents. MethodsThe search for studies was conducted in SCOPUS, PsycINFO, PSICODOC, PsycARTICLES and Medline, between 2000 and 2022, in December 2022. Studies were selected if they were conducted with a sample of children and/or adolescents with previous symptoms of anxiety and depression, had applied IDPT, and included at least two comparative groups with pretest-posttest measures. Network meta-analyses were separately performed for anxiety and depression outcomes. Publication bias was analyzed using Egger's test and funnel plots, and mixed-effects meta-regression models were applied to account for heterogeneity. Results37 studies were included in the meta-analysis, providing a total of 74 comparative groups. IDPT exhibited low-to-moderate, statistically significant average effect sizes when compared to both inactive and active controls. No statistical significance was found when IDPT was compared with other types of interventions. DiscussionIDPT is recommended to reduce anxiety and depression symptomatology in children and adolescents, but more studies are needed which compare treatments with other types of interventions, such as face-to-face therapy.