Depressive Symptomatology Research Articles

Procrastination, depressive symptomatology, and loneliness in later life

Objectives Procrastination is an almost universal behaviour and yet little research to date has focused on procrastination among older adults. The purpose of this study was to explore the potential association between age and procrastination, and the potential mediating roles of depressive symptomatology and loneliness. Method Structural equation modelling was applied to data from 1309 participants (aged 29–92) from two waves United States Health and Retirement Study (2016–2020). Within the model, sex, education, marital status, and job status were added as covariates. Results There was no statistically significant direct effect between age and procrastination (β = 0.06, p = 0.106). However, an indirect effect was present via depressive symptomatology (β = −0.40, p < 0.001). No mediating effect of loneliness was observed (β = − 0.01, p = 0.371). Subsequent analysis revealed that the symptoms, fatigue, loneliness, and lack of motivation significantly predicted procrastination. Conclusion While age was not directly associated with procrastination, increasing age was associated with a decreased likelihood of depressive symptomatology, which was in turn associated with an increased likelihood of procrastination. Such findings indicates that age demonstrates no association with procrastination because of the suppressing effect of depressive symptomatology.

Time-Varying Network Models for the Temporal Dynamics of Depressive Symptomatology in Patients With Depressive Disorders: Secondary Analysis of Longitudinal Observational Data.

As depression is highly heterogenous, an increasing number of studies investigate person-specific associations of depressive symptoms in longitudinal data. However, most studies in this area of research conceptualize symptom interrelations to be static and time invariant, which may lead to important temporal features of the disorder being missed. To reveal the dynamic nature of depression, we aimed to use a recently developed technique to investigate whether and how associations among depressive symptoms change over time. Using daily data (mean length 274, SD 82 d) of 20 participants with depression, we modeled idiographic associations among depressive symptoms, rumination, sleep, and quantity and quality of social contacts as dynamic networks using time-varying vector autoregressive models. The resulting models showed marked interindividual and intraindividual differences. For some participants, associations among variables changed in the span of some weeks, whereas they stayed stable over months for others. Our results further indicated nonstationarity in all participants. Idiographic symptom networks can provide insights into the temporal course of mental disorders and open new avenues of research for the study of the development and stability of psychopathological processes.

Relationship between Depressive Symptoms, Caregiver Strain, and Social Support with Dementia Grief in Family Caregivers.

Background and Objectives: Dementia grief in family caregivers of people with dementia refers to grieving prior to the death of the care recipient. It is related to psychosocial risk factors that may have a negative impact on the health of these family caregivers. This study aimed to describe the relationship between depressive symptoms, caregiver strain, and social support with dementia grief in family caregivers of people with dementia. Materials and Methods: A descriptive correlational cross-sectional study was conducted. A total of 250 family caregivers of people with dementia participated. Dementia grief was the main variable, and depressive symptoms, caregiver strain, and social support were assessed. Additionally, socio-demographic data were collected. Descriptive statistics were calculated, and a bivariate correlation analysis and a multiple linear regression analysis were performed for dementia grief. Results: Higher scores for dementia grief were found in women, in family caregivers of patients at advanced stages of dementia, and in family caregivers with a low level of education. High levels of depressive symptoms and caregiver strain and low levels of social support indicated greater intensity of dementia grief. Depressive symptomatology was the variable with the greatest influence on dementia grief. Caregiver strain and social support also related to dementia grief, but to a lesser extent. Conclusions: In family caregivers, depressive symptoms, caregiver strain, and social support are related to the intensity of dementia grief, with a greater influence of depressive symptoms. Moreover, being female, having a low level of education, and caring for a care recipient at an advanced stage of dementia are factors associated with increased dementia grief. Concerning study limitations, the sample was restricted, belonging to a specific region of Spain and to a Provincial Federation of associations. It is necessary to exercise caution in generalizing results due to the sociodemographic and geographical characteristics of the sample.

Dispositional factors in the explanation of symptoms of depression, anxiety, health anxiety and COVID-19 Phobia.

Maladaptive personality, the motivational systems, and intolerance of uncertainty play important roles in the statistical explanation of depression and anxiety. Here, we notably examined for the first time whether symptoms of depression, anxiety, health anxiety, and fear of COVID-19 share similar associations (e.g., variance explained) with these important dispositional dimensions. For this cross-sectional study, data from 1001 participants recruited in Germany (50% women; mean age = 47.26) were collected. In separate models, we examined the cross-sectional associations of the symptoms of depression, anxiety, health anxiety, and fear of COVID-19 with the Personality Inventory for DSM Short Form Plus scales, the Behavioral Inhibition System / Flight-Fight-Freeze System / Behavioral Activation System scales, and Intolerance of Uncertainty scales. Relative weight analyses were used to determine the within-model importance of the different scales in the prediction of the symptoms. All in all, our study showed that maladaptive personality and intolerance of uncertainty dimensions are more important sets of predictors of the studied outcomes (with which depressive and anxious symptomatology feature very similar associations) than are the motivational system dimensions. Within predictor sets, the scales with the most important predictors were: Negative Affectivity, the Behavioral Inhibition System, and Burden due to Intolerance of Uncertainty. Our findings highlight the relevance of focusing behavioral targets of psychotherapy on these within-set traits and identify potential research priorities (maladaptive personality and intolerance of uncertainty) in relation to the symptoms of interest.

Bright light therapy versus physical exercise to prevent co-occurring depression in adolescents and young adults with attention-deficit/hyperactivity disorder: a multicentre, three-arm, randomised controlled, pilot phase-IIa trial

Abstract Depression is common in attention-deficit/hyperactivity disorder (ADHD), but preventive behavioural interventions are lacking. This randomised controlled, pilot phase-IIa trial aimed to study a physical exercise intervention (EI) and bright light therapy (BLT)—both implemented and monitored in an individual, naturalistic setting via a mobile health (m-health) system—for feasibility of trial design and interventions, and to estimate their effects on depressive symptoms in young people with ADHD. Two hundred seven participants aged 14–45 years were randomised to 10-week add-on intervention of either BLT (10,000 lx; daily 30-min sessions) (n = 70), EI (aerobic and muscle-strengthening activities 3 days/ week) (n = 69), or treatment-as-usual (TAU) (n = 68), of whom 165 (80%) were retained (BLT: n = 54; EI: n = 52; TAU: n = 59). Intervention adherence (i.e. ≥ 80% completed sessions) was very low for both BLT (n = 13, 22%) and EI (n = 4, 7%). Usability of the m-health system to conduct interventions was limited as indicated by objective and subjective data. Safety was high and comparable between groups. Changes in depressive symptoms (assessed via observer-blind ratings, Inventory of Depressive Symptomatology) between baseline and end of intervention were small (BLT: −0.124 [95% CI: −2.219, 1.971], EI: −2.646 [95% CI: −4.777, −0.515], TAU: −1.428 [95% CI: −3.381, 0.526]) with no group differences [F(2,153) = 1.45, p = 0.2384]. These findings suggest that the m-health approach did not achieve feasibility of EI and BLT in young people with ADHD. Prior to designing efficacy studies, strategies how to achieve high intervention adherence should be specifically investigated in this patient group. Trial registration ClinicalTrials.gov, NCT03371810, 13 December 2017.

Cardiorespiratory fitness mediates the relationship between depressive symptomatology and cognition in older but not younger adults

Aging is commonly associated with emotional, physical, and cognitive changes, with the latter, particularly affecting executive functioning. Further, such changes may interact. For instance, depressive symptomatology is a known risk factor for developing cognitive deficits, especially at older ages. In contrast, an active lifestyle, reflected in high cardiorespiratory fitness (CRF) levels, has proven to protect against adverse effects on cognition across the adult lifespan. Hence, this study aimed to investigate the relationships between depressive symptomatology, CRF, and cognition during critical developmental stages, namely in young adults (YA), when cognitive abilities are at their peak, and in older adults (OA), when they may start to decline. Eighty-one OA with ages between 60 and 89 years (M = 70.46; SD = 7.18) and 77 YA with ages between 18 and 34 years (M = 22.54; SD = 3.72) went through (i) a sociodemographic interview, (ii) an emotional assessment, (iii) a battery of cognitive tests, and (iv) a physical evaluation assessing CRF levels, visceral fat and body-mass index. Results showed that OA exhibited lower general cognitive performance, inhibitory control, cognitive flexibility, memory, and CRF. Depressive symptoms and anxiety were not different among groups, with CRF mediating the relationship between depressive symptoms and cognition in the OA group. The present study provides valuable insights into the interplay between emotional, physical, and cognitive well-being. Additionally, it calls attention to how lifestyle factors can play a protective role against the adverse effects that depressive symptoms have on cognition, particularly at older ages.

The role of immuno-metabolic depression features in the effects of light therapy in patients with depression and type 2 diabetes mellitus: A randomized controlled trial

ObjectiveImmuno-metabolic depression (IMD) is proposed to be a form of depression encompassing atypical, energy-related symptoms (AES), low-grade inflammation and metabolic dysregulations. Light therapy may alleviate AES by modulating inflammatory and metabolic pathways. We investigated whether light therapy improves clinical and biological IMD features and whether effects of light therapy on AES or depressive symptom severity are moderated by baseline IMD features. Associations between changes in symptoms and biomarkers were explored. MethodsIn secondary analyses, clinical trial data was used from 77 individuals with depression and type 2 diabetes mellitus (T2DM) randomized to four weeks of light therapy or placebo. AES severity and depressive symptom severity were based on the Inventory of Depressive Symptomatology. Biomarkers included 73 metabolites (Nightingale) summarized in three principal components and CRP, IL-6, TNF-α, INF-γ. Linear regression analyses were performed. ResultsLight therapy had no effect on AES severity, inflammatory markers and metabolite principle components versus placebo. None of these baseline features moderated the effects of light therapy on AES severity. Only a principle component reflecting metabolites implicated in glucose homeostasis moderated the effects of light therapy on depressive symptom severity (βinteraction = 0.65, P = 0.001, FDR = 0.003). Changes in AES were not associated with changes in biomarkers. ConclusionFindings do not support the efficacy of light therapy in reducing IMD features in patients with depression and T2DM. We find limited evidence that light therapy is a more beneficial depression treatment among those with more IMD features. Changes in clinical and biological IMD features did not align over four-weeks' time.Trial registration: The Netherlands Trial Register (NTR) NTR4942.

Centering Agency: Examining the Relationship Between Acts of Resistance, Anxiety, and Depression Among Undocumented College Students

Research has established that legal vulnerability has detrimental consequences for the mental health of undocumented individuals. The purpose of our study is to consider how practicing agency is associated with mental health in the face of such structural marginalization. To meet this goal, we conceptualize actions taken to resist structural inequality as acts of resistance to center immigrants’ agency in navigating and contesting their marginalization. Drawing on survey data with California undocumented college students, we examine to what extent engaging in three acts of resistance is associated with depression and anxiety symptomatology. We find that students with higher rates of political engagement and critical consciousness raising report higher depression and anxiety symptomatology. Findings suggest that structural approaches to studying mental health must also consider immigrants’ agency and efforts to navigate, respond to, and challenge their marginalization.

A Longitudinal Study of the Effect of Memory on the Quality of life of European Adults and Older Adults

Among studies conceptualizing quality of life (QoL) as the subjective measure of one’s well-being, evidence suggests a link between cognitive impairment and diminished quality of life. However, the direction of the association is not clear, and most studies have employed a global measure of cognition, which can mask subtle domain-specific declines. In this study, we aim at examining the longitudinal associations between memory and QoL in a representative sample of adults and older adults in Europe and Israel, employing data from the Survey of Health, Ageing and Retirement in Europe (SHARE). The sample was composed by 56,616 respondents aged 50 or older at the beginning of the study period. A Parallel-Process Latent Growth Model (PP LGM) of memory and QoL conditioned on the effects of age, gender, educational level, physical inactivity, depressive symptomatology and social activity participation, was tested. Results displayed a trajectory of decline for both memory and QoL, with higher initial levels of memory associated with higher initial levels of QoL, and steeper decline in memory associated with steeper decline in QoL. Moreover, a positive effect of initial memory onto QoL trend over time was found, indicating that better memory is associated to better QoL in the future, but the opposite did not occur. Results also provide evidence of gender differences. All in all, this work found evidence supporting the longitudinal effect of memory on QoL, which may have consequences for intervention implementation, given that actions for alleviating age-related memory impairment could also have a positive impact onto older adults’ QoL.

‘Does it matter how old I feel?’ The role of subjective age in a psychosocial intervention for improving depressive symptomatology among older adults in Brazil (PROACTIVE)

Objectives Depression is a prevalent mental health condition that also often affects older adults. The PROACTIVE psychosocial intervention was developed to reduce depressive symptomatology among older adults within primary care settings in Brazil. An important psychological marker that affects individuals’ aging experience relates to how old people feel. Known as subjective age, this marker has been shown to be a risk factor for experiencing greater depressive symptoms if individuals report feeling older than their (chronological) age. In this study, we perform secondary analyses of the PROACTIVE cluster-randomized controlled trial to examine the role of subjective age. Method The sample included 715 Brazilian older adults (74% female, M age 68.6, SD = 6.9, age range: 60–94 years) randomized to intervention (n = 360, 74% female, M age 68.4, SD = 6.6, age range: 60–89 years) or control (n = 355, 74% female, M age 68.9, SD = 7.2, age range: 60–94 years) arms. Here our primary outcome was depressive symptoms at the 8-month follow-up assessed with the 9-item Patient Health Questionnaire (PHQ-9) as a continuous variable. Our previous analyses demonstrated improved recovery from depression at follow-up in the intervention compared with the control arm. Results Relevant main effects and interactions in regression models for PHQ-9 presented here found that those reporting older subjective age had worse depressive symptoms at follow-up but that they benefitted more from the intervention when initial levels of depression were high. For participants who reported younger subjective ages the intervention showed positive effects that were independent of initial levels of depression. Conclusion Our findings emphasize the importance of investigating possible underlying mechanisms that can help clarify the impact of mental health interventions.

Association of performance in medical residency selection with a psychiatric diagnosis, and depressive and anxiety symptoms

Objective Few studies have focused on medical students and residents’ mental health impact on medical residency selection (MRS) performance. The authors evaluated the association of performance in MRS with depressive and anxiety symptoms and with a reported psychiatric diagnosis (rPD). Methods The authors enrolled candidates after the second round of MRS examinations at a Brazilian Medical School. Performance was assessed by final grade. Depressive and anxiety symptoms were assessed by the Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR) and the State-Trait Anxiety Inventory (STAI). The authors performed mediation analysis and multiple linear regression analysis to investigate the impact of rPD, state and trait anxiety, and depressive symptom severity on performance. Results 515 of the 643 MRS candidates (80.1%) participated in the study. Higher age, attending a preparatory course for MRS, rPD, and the number of MRS applications that year were associated with poorer performance. In mediation analysis, trait anxiety was associated with a direct effect on performance and an indirect effect mediated by rPD. Conclusion The data suggest that psychiatric diagnosis is associated with poorer performance on MRS, regardless of current symptoms of anxiety and depression. Additionally, increased levels of trait anxiety may negatively impact performance, directly and indirectly.

Psychedelics and the 'inner healer': Myth or mechanism?

Reference to an intrinsic healing mechanism or an 'inner healer' is commonplace amongst psychedelic drug-using cultures. The 'inner healer' refers to the belief that psychedelic compounds, plants or concoctions have an intrinsically regenerative action on the mind and brain, analogous to intrinsic healing mechanisms within the physical body, for example, after sickness or injury. Here, we sought to test and critique this idea by devising a single subjective rating item pertaining to perceived 'inner healing' effects. The item was issued to 59 patients after a single high (25 mg, n = 30) or 'placebo' (1 mg, n = 29) dose of psilocybin in a double-blind randomised controlled trial of psilocybin for depression. Inner healer scores were higher after the high versus placebo dose of psilocybin (t = 3.88, p < 0.001). Within the high-dose sub-sample only, inner healer scores predicted improved depressive symptomatology at 2 weeks post-dosing. The principle of activating inner healing mechanisms via psychedelics is scientifically nascent; however, this study takes a positivist and pragmatic step forward, asking whether it warrants further examination.

Gender differences in the predictive effect of perceive emotional intelligence on depressive symptomatology in older adults

The aim of this study was to analyze the associations between emotional intelligence, gender, and depressive symptomatology in older adults. To test whether there were differences between groups in the Trait Meta-Mood Scale dimension, univariate and multivariate analysis of variance were carried out, and t tests were performed to find the differences between groups in the variables that had shown differences in the univariate analysis. Participants were 853 Spanish cognitively healthy older adults between 60 and 95 years of age, with a mean age of 71.7 (SD = 7.4), of whom 64.9% were women. Self-reports were administered to assess the different variables under study. Specifically, the Trait Meta-Mood Scale-24 was used to assess emotional intelligence, and the Centre for Epidemiologic Studies-Depression Scale to measure depressive symptomatology. The three dimensions of emotional intelligence showed differences as a function of gender and depression. Higher scores were found in the three dimensions of emotional intelligence in women. Moreover, people with higher levels of depressive symptomatology had higher scores on attention, and people with low depressive symptomatology had lower levels of clarity and repair. Women with depressive symptomatology showed high levels of attention, in contrast to men and women with low symptomatology. Considering the subjective perception of emotional intelligence, high attention to emotions and the female gender seem to be factors associated with depression in older adults, which allows us to outline a critical profile for depression that should receive special attention. Given the impact of depressive symptomatology in older adults, it is important to identify these profiles in order to detect possible risk factors for depression more effectively.

A Randomized Evaluation of MoodFX, a Patient-Centred e-Health Tool to Support Outcome Measurement for Depression: Une évaluation randomisée de MoodFX, un outil de santé en ligne centré sur le patient pour soutenir la mesure du résultat dans la dépression.

e-Health tools using validated questionnaires to assess outcomes may facilitate measurement-based care for psychiatric disorders. MoodFX was created as a free online symptom tracker to support patients for outcome measurement in their depression treatment. We conducted a pilot randomized evaluation to examine its usability, and clinical utility. Patients presenting with a major depressive episode (within a major depressive or bipolar disorder) were randomly assigned to receive either MoodFX or a health information website as the intervention and control condition, respectively, with follow-up assessment surveys conducted online at baseline, 8 weeks and 6 months. The primary usability outcomes included the percentage of patients with self-reported use of MoodFX 3 or more times during follow up (indicating minimally adequate usage) and usability measures based on the System Usability Scale (SUS). Secondary clinical outcomes included the Quick Inventory of Depressive Symptomatology, Self-Rated (QIDS-SR) and Patient Health Questionnaire (PHQ-9). Forty-nine participants were randomized (24 to MoodFX and 25 to the control condition). Of the 23 participants randomized to MoodFX who completed the user survey, 18 (78%) used MoodFX 3 or more times over the 6 months of the study. The mean SUS score of 72.7 (65th-69th percentile) represents good usability. Compared to the control group, the MoodFX group had significantly better improvement on QIDS-SR and PHQ-9 scores, with large effect sizes and higher response rates at 6 months. There were no differences between conditions on other secondary outcomes such as functioning and quality of life. MoodFX demonstrated good usability and was associated with reduction in depressive symptoms. This pilot study supports the use of digital tools in depression treatment.

Exploring the association between number of teeth, food intake, and cognitive function: A 9-year longitudinal study

ObjectivesThis study aimed to investigate the association between the number of teeth, food intake, and cognitive function in Japanese community-dwelling older adults. MethodsThis 9-year longitudinal study included a total of 293 analyzable participants who participated in baseline and follow-up surveys. Dental status (number of teeth and periodontal pocket depth), dietary assessment using the brief-type self-administered diet history questionnaire, cognitive function, and the following confounding factors were evaluated: educational level, financial satisfaction, living situation, smoking and drinking habits, history of chronic diseases, apolipoprotein E-ε4 carrier, body mass index, handgrip strength, instrumental activities of daily living, and depressive symptomatology. The Japanese version of the Montreal Cognitive Assessment was used to evaluate cognitive function. A multinomial logistic regression analysis for the intake level of each food categorized into three groups (low, moderate, high), and a generalized estimating equation (GEE) for cognitive function over nine years were performed. ResultsAfter controlling for confounding factors, the number of teeth was shown to be associated with the intake of green-yellow vegetables and meat. Furthermore, the GEE indicated that the lowest quartile of intake of green-yellow vegetables significantly associated with lower cognitive function (unstandardized regression coefficient [B] = -0.96, 95 % confidence interval [CI]: -1.72 to -0.20), and the lowest quartile of intake of meat significantly associated with lower cognitive function (B = -1.42, 95 % CI: -2.27 to -0.58). ConclusionsThe intake of green and yellow vegetables and meat, which is influenced by the number of teeth, was associated with cognitive function in Japanese community-dwelling older adults. Clinical SignificanceThere are few studies that have examined the association between oral health, food intake, and cognitive function. This 9-year longitudinal study suggests that it is important to maintain natural teeth to enable the functional means to consume green-yellow vegetables and meat, and thereby help maintain cognitive function.

Efficacy of Esketamine among patients with treatment resistant depression in a ‘real world' health-care setting in Israel

One in five people will likely suffer from major depressive disorder (MDD) during their life. Thirty percent of those with MDD will experience Treatment Resistant Depression (TRD), which is characterized by a failure to respond to two adequately administered trials of antidepressants. Esketamine is a rapidly acting intranasal antidepressant. Present-day Esketamine research has limited data in real-world populations. This study aimed to assess Esketamine treatment in a real-world community-based population.This naturalistic retrospective study included 94 individuals age 18 and above diagnosed with TRD, treated with Esketamine in an outpatient setting. The treatment was given in a single clinic, from January 2021 to January 2023, following approval of the Institutional Internal Review Board. The treatment included an acute phase (biweekly treatment, continuing 4–8 weeks), followed by a maintenance phase (once a week to once a month, for 6–12 months). Dosing ranged from 28 mg to 84 mg. Demographic and clinical data were retrospectively gathered. Depressive symptoms were assessed using the Quick Inventory of Depressive Symptomatology, at baseline and during each treatment phase.All patients completed the acute phase. About 60% completed the maintenance phase. Linear improvement of depressive symptoms was revealed in both phases. A sub-analysis of patients with comorbid personality disorder revealed a similar improvement pattern in the acute phase with milder improvement during the maintenance phase, compared to the other patients.This study supports the use of Esketamine for TRD, including patients with comorbid personality disorder and previous electroconvulsive therapy.

Validation of Machine Learning-Based Assessment of Major Depressive Disorder from Paralinguistic Speech Characteristics in Routine Care

New developments in machine learning-based analysis of speech can be hypothesized to facilitate the long-term monitoring of major depressive disorder (MDD) during and after treatment. To test this hypothesis, we collected 550 speech samples from telephone-based clinical interviews with 267 individuals in routine care. With this data, we trained and evaluated a machine learning system to identify the absence/presence of a MDD diagnosis (as assessed with the Structured Clinical Interview for DSM-IV) from paralinguistic speech characteristics. Our system classified diagnostic status of MDD with an accuracy of 66% (sensitivity: 70%, specificity: 62%). Permutation tests indicated that the machine learning system classified MDD significantly better than chance. However, deriving diagnoses from cut-off scores of common depression scales was superior to the machine learning system with an accuracy of 73% for the Hamilton Rating Scale for Depression (HRSD), 74% for the Quick Inventory of Depressive Symptomatology–Clinician version (QIDS-C), and 73% for the depression module of the Patient Health Questionnaire (PHQ-9). Moreover, training a machine learning system that incorporated both speech analysis and depression scales resulted in accuracies between 73 and 76%. Thus, while findings of the present study demonstrate that automated speech analysis shows the potential of identifying patterns of depressed speech, it does not substantially improve the validity of classifications from common depression scales. In conclusion, speech analysis may not yet be able to replace common depression scales in clinical practice, since it cannot yet provide the necessary accuracy in depression detection. This trial is registered with DRKS00023670.

Sociodemographic, clinical and treatment characteristics of current rapid-cycling bipolar disorder: a multicenter Chinese study

BackgroundRapid cycling bipolar disorder (RCBD), characterized by four or more episodes per year, is a complex subtype of bipolar disorder (BD) with poorly understood characteristics.MethodThis multicenter, observational, longitudinal cohort study enrolled 520 BD patients across seven psychiatric institutions in China from January 2013 to January 2014. Participants were divided into RCBD and non-RCBD (NRCBD) groups based on the frequency of mood episodes in the preceding year. Data collection utilized a standardized form, supplemented by a medical record review, focusing on sociodemographic, clinical, and treatment characteristics. Statistical analysis involved independent samples t-tests, Kruskal–Wallis H tests, Chi-square or Fisher's exact tests, with Bonferroni correction applied to account for multiple comparisons, and multivariable logistic regression to identify characteristics associated with RCBD.ResultsAmong the BD cohort, 9.4% were identified as current RCBD. Compared to NRCBD, RCBD patients had a shorter duration from the first psychiatric consultation to the diagnosis of BD, a reduced duration of their longest period of euthymia, a lower proportion of lifetime hospitalization history due to BD, and less use of electroconvulsive therapy (ECT) within the last 12 months. Additionally, they presented higher baseline scores on the Mood Disorder Questionnaire (MDQ) and the Brief 16-item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16). However, after applying the Bonferroni correction, these differences were not statistically significant. Multivariable logistic regression analysis identified three factors that were independently associated with RCBD: time from first psychiatric consultation to BD diagnosis (Odds Ratio [OR] = 0.512, P = 0.0416), lifetime hospitalization history due to BD (OR = 0.516, P = 0.0476), and ECT treatment within the past 12 months (OR = 0.293, P = 0.0472).ConclusionThis study revealed that the duration from first psychiatric consultation to BD diagnosis, lifetime hospitalization history due to BD, and ECT treatment in the past year were associated with RCBD. Recognizing these factors could contribute to enhance the early identification and clinical outcomes of RCBD.Trial Registration Number Registry ClinicalTrials.gov NCT01770704. Date of Registration: First posted on January 18, 2013.

Towards precision in the diagnostic profiling of patients: leveraging symptom dynamics as a clinical characterisation dimension in the assessment of major depressive disorder.

International guidelines present overall symptom severity as the key dimension for clinical characterisation of major depressive disorder (MDD). However, differences may reside within severity levels related to how symptoms interact in an individual patient, called symptom dynamics. To investigate these individual differences by estimating the proportion of patients that display differences in their symptom dynamics while sharing the same overall symptom severity. Participants with MDD (n = 73; mean age 34.6 years, s.d. = 13.1; 56.2% female) rated their baseline symptom severity using the Inventory for Depressive Symptomatology Self-Report (IDS-SR). Momentary indicators for depressive symptoms were then collected through ecological momentary assessments five times per day for 28 days; 8395 observations were conducted (average per person: 115; s.d. = 16.8). Each participant's symptom dynamics were estimated using person-specific dynamic network models. Individual differences in these symptom relationship patterns in groups of participants sharing the same symptom severity levels were estimated using individual network invariance tests. Subsequently, the overall proportion of participants that displayed differential symptom dynamics while sharing the same symptom severity was calculated. A supplementary simulation study was conducted to investigate the accuracy of our methodology against false-positive results. Differential symptom dynamics were identified across 63.0% (95% bootstrapped CI 41.0-82.1) of participants within the same severity group. The average false detection of individual differences was 2.2%. The majority of participants within the same depressive symptom severity group displayed differential symptom dynamics. Examining symptom dynamics provides information about person-specific psychopathological expression beyond severity levels by revealing how symptoms aggravate each other over time. These results suggest that symptom dynamics may be a promising new dimension for clinical characterisation, warranting replication in independent samples. To inform personalised treatment planning, a next step concerns linking different symptom relationship patterns to treatment response and clinical course, including patterns related to spontaneous recovery and forms of disorder progression.

Abstract LB138: Quality of life impact on cancer screening in Black subgroups

Abstract Introduction Blacks have the poorest cancer outcomes with the highest incidence and mortality. Preliminary studies led by the African Caribbean Consortium (AC3) show that Blacks are diverse with distinct cancer risks and outcomes. It is clear that cancer screening is critical to prevention, and population patterns of screening are dictated by complex and multilevel factors including cost, access and health system as well as personal factors. These personal characteristics, especially considering Black diversity, are particularly understudied. Hence, this study seeks to describe cancer screening patterns in Black subgroups, especially considering the influence of quality of life (QOL). Methods This study drew data from the community-engaged AC3-Cancer Prevention Project (CAP3) targeting diverse Blacks. Specifically, we sought to identify associations between QOL measured by CDC Physical and Mental Health; Perceived Stress, and self-reported cancer screenings breast, prostate, cervical and colon cancers. Cancer screening rates were stratified by African Americans (AfA) and African (AfI) and African-Caribbean (AfC) immigrants. Descriptive analyses and Fisher’s Exact test were conducted. Results There were 263 AfA, 103 AfI, and 174 AfC. Overall, cancer screening rates were consistently above 50%. Distinct QOL variables were associated with cancer screening patterns with some variability by Black sub-group. Better Mental Health e.g., wellbeing (p=0.01) and energy (p=0.04) are related to mammogram uptake for all subgroups. Better energy (p=0.03) and lower life-burden (p=0.01) showed significant associations with mammogram for AfAs. For AfCs, Mental Health- depressive symptomatology was significantly related to breast- (p=0.04), prostate- (p=0.03), and colorectal- cancer screening (p=0.03). For AfI, Stress was significantly related to colorectal cancer screening (p=0.01). Discussion Results demonstrated QOL variables, especially those related to mental health e.g., depressive symptomatology and lack of life control influenced cancer screening among AfC and AfI, respectively than other subgroups. While among AfA screening patterns were more heavily influenced by mental health aspects on the empowerment domain e.g., energy and burden. This novel, discovery science study suggests the importance of interaction between QOL, in particular mental wellbeing, self-and health efficacy and life-burden, and cancer screening. Findings highlight Black heterogeneity–encompassing diverse ethnic and cultural subgroups–with distinct influencers of cancer screening patterns; all requiring urgent scientific attention and research prioritization to address pressing Black cancer vulnerability and disparities, particularly qualitative exploration of these relationships among the Black diasporas. Citation Format: Camille Ragin, Kimlin T. Ashing, Gaole Song, Elizabeth Blackman, Denise Gibbs, Zhongxuan He, Sharon Harrison, Jomel Meeko Manzano, Olivia Theard, Marshall Tulloch-Reid. Quality of life impact on cancer screening in Black subgroups [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB138.