Depressive Symptoms In Adults Research Articles

In the Words of Early Adolescents: A Novel Assessment of Positive Psychological Well-Being Predicts Young Adult Depressive Symptoms

PurposeGiven the burden of depression in young adulthood, identifying protective early life factors is important. Protective factors like positive psychological well-being may be challenging to assess via conventional methods if early adolescents lack personal insight or informants disagree. We investigated whether essays written by 11-year-olds could indicate the presence of positive psychological well-being and predict depressive symptom levels in young adulthood, beyond informant reports of problematic behaviors. MethodsData were from 4,599 individuals in the 1958 National Child Development Study who wrote an essay at age 11 about how they imagined their life at age 25. Coders rated essays for seven facets of positive psychological well-being, which were averaged together (α = 0.92). Participants self-reported depressive symptoms (yes/no) at age 23 on the 24-item Malaise Inventory. Depressive symptoms were modeled as a sum, both continuously (range = 0–24) and dichotomously (depressed: total scores ≥8). Linear and logistic regressions adjusted for relevant age 11 covariates including teacher-reported internalizing and externalizing behaviors. ResultsUnadjusted logistic regression showed a 1-SD higher positive psychological well-being score in early adolescence was associated with reduced odds of being depressed 12 years later (odds ratio = 0.83, 95% confidence interval [0.75, 0.93], p = .001). Associations remained when adjusting for all covariates (odds ratio = 0.87, 95% confidence interval [0.78, 0.98], p = .02); patterns were similar with continuous depressive symptoms. DiscussionA well-being measure derived from the words of 11-year-olds was associated with young adult depressive symptoms independent of teacher-reported internalizing and externalizing behaviors. Incorporating early adolescents' perspectives on positive functioning provides valuable information about current and future health beyond problem behaviors.

Factors Associated with Psychotic and Depressive Symptoms in Methamphetamine Users.

Objective: Methamphetamine use has been recognized as a prominent public health issue, which is associated with psychotic and depressive symptoms. This study aimed to assess factors that show a significant relation with psychotic and depressive symptoms in adults who use methamphetamine. Method : We assessed 95 patients who had used methamphetamine within the last month and were admitted to the outpatient treatment clinic. Evaluation of all patients was carried out through face-to-face interviews, and their symptoms were evaluated using different scales. The Scale for the Assessment of Positive Symptoms and the Scale for the Assessment of Negative Symptoms were employed to assess positive and negative symptoms of psychosis, respectively. Depressive symptoms were measured using the Montgomery-Asberg Depression Rating Scale, while illness severity was evaluated using the Clinical Global Impression- Severity Scale. Additionally, functioning status was assessed using the Functioning Assessment Short Test, and withdrawal severity was measured by employing the Amphetamine Cessation Symptom Assessment Scale. Craving severity was evaluated using the Stimulant Craving Questionnaire, anxiety severity using the Hamilton Anxiety Rating Scale, and insight status using the Schedule for Assessment of Insight Expanded. Results: Among the demographic variables, working with family was associated with lower positive symptoms scores (OR = 6.31, P < 0.05). Parole/probation related admissions were associated with lower positive and depressive symptoms scores (OR = 15.06, P = 0.03; OR = 9.87, P = 0.02). Having suicide attempts, number of suicide attempts, and amount of methamphetamine used were found to show association with higher positive (OR = 13.59, P < 0.01; OR = 2.52, P < 0.05; OR = 3.48, P < 0.05, respectively) and depressive symptoms scores (OR = 10.35, P < 0.001; OR = 2.23, P < 0.01; OR = 2.3, P < 0.05). After adjusting for all variables, clinical impression and insight scores remained significantly associated with positive symptoms scores (AOR = 6.74, P < 0.05; AOR = 2.63, P < 0.001, respectively), while anxiety, amphetamine cessation, and positive symptoms scores remained associated with depressive symptoms scores (AOR = 0.48, P < 0.001; AOR = 0.11, P = 0.003; AOR = 0.36, P = 0.02, respectively). Conclusion: This study appears to be the first to examine the associations between clinical variables and both positive symptoms and depressive symptoms in methamphetamine users. Increased attention should be paid to suicide history, anxiety level, amount of methamphetamine use and loss of insight to provide effective treatment in patients with methamphetamine use.

The application of target trials with longitudinal targeted maximum likelihood estimation to assess the effect of alcohol consumption in adolescence on depressive symptoms in adulthood.

Time-varying confounding is a common challenge for causal inference in observational studies with time-varying treatments, long follow-up periods, and participant dropout. Confounder adjustment using traditional approaches can be limited by data sparsity, weight instability, and computational issues. The Nicotine Dependence in Teens Study is a prospective cohort study, and we used data from 21 data collection cycles carried out from 1999 to 2008 among 1294 students recruited from 10 high schools in Montreal, Quebec, Canada, including follow-up into adulthood. Our aim in this study was to estimate associations of timing of alcohol initiation and cumulative duration of alcohol use with depression symptoms in adulthood. Based on the target trials framework, we defined intention-to-treat and as-treated parameters in a marginal structural model with sex as a potential effect-modifier. We then used the observational data to emulate the trials. For estimation, we used pooled longitudinal target maximum likelihood estimation, a plug-in estimator with double-robust and local efficiency properties. We describe strategies for dealing with high-dimensional potential drinking patterns and practical positivity violations due to a long follow-up time, including modifying the effect of interest by removing sparsely observed drinking patterns from the loss function and applying longitudinal modified treatment policies to represent the effect of discouraging drinking.

Association between residential greenness and depression symptoms in Chinese community-dwelling older adults

BackgroundStudies of residential greenness and depression symptoms among community-dwelling older adults in China are limited. However, understanding the role of greenness in depression symptoms among older adults can inform depression prevention and interventions. ObjectiveThis study explored the relationship between residential greenness and depression symptoms among community-dwelling older adults in China. MethodsA cluster random sampling method was used to survey 7512 community-dwelling adults aged 60 and above from three towns in Shanghai. Depression symptoms were assessed using the Geriatric Depression Scale (GDS30). Residential greenness was measured using the normalized difference vegetation index (NDVI) and the enhanced vegetation index (EVI). Long-term greenspace exposure was defined as the mean NDVI and EVI in the three years prior to the baseline survey. Controlling for the covariates, the relationship between greenness and depression symptoms was assessed using binomial logistic regression and mixed-effects linear regression. Interaction analysis was conducted to explore which covariates potentially alter the association. We also assessed the mediating role of physical activity. ResultsThe prevalence of depression symptoms among the participants was 13.72%. Higher residential greenness was associated with lower odds of depression symptoms, after adjusting for covariates. In the logistic regression analysis, the odds of depression symptoms decreased with increasing NDVI and EVI. In linear regression analysis, GDS30 scores decreased with increasing NDVI and EVI. Interaction analyses revealed that higher NDVI and EVI were more protective against depression among male individuals and older adults living with others than among female individuals and older adults living alone. Additionally, physical activity had a masking effect on residential greenness and depression symptoms. ConclusionHigher residential greenness is associated with lower odds of depression symptoms in community-dwelling Chinese older adults. Increasing urban and neighborhood green spaces may contribute to the prevention and intervention of depression symptoms in community-dwelling older adults.

The effects of childhood maltreatment on social support, inflammation, and depressive symptoms in adulthood

RationaleSocial Safety Theory (SST) suggests that social threats increase inflammation, exacerbating health risks, but that social support may decrease inflammatory signaling. One of the key health problems affected by both social forces and inflammation is major depression. ObjectiveThe present study sought to test aspects of the SST, to understand how social support and inflammation may mediate the effects of childhood maltreatment on depressive symptoms in adulthood. MethodsThis study utilized data from the national Midlife Development in the United States study (n = 1969; mean age 53; 77.2% White; 53.6% female) to model the effects of childhood maltreatment on depressive symptoms in adulthood and the potential serial mediating effects of social support and inflammation. Analyses were conducted via structural equation modeling, using the four subscales of the Center for Epidemiologic Studies Depression Scale to indicate depressive symptoms, the five subscales of the Childhood Trauma Questionnaire to indicate childhood maltreatment, and the Positive Relations Scale and a network level measure of support as indicators of social support. Inflammation was indexed using C-reactive protein (CRP). The model was estimated via maximum likelihood with robust standard errors and significance of indirect effects were assessed via a Sobel test. ResultsChildhood maltreatment was associated with increased depressive symptoms and CRP but decreased social support. Social support was associated with decreased depressive symptoms while CRP was associated with increased depressive symptoms. Assessing indirect effects yielded no serial mediation effect; however, a significant indirect effect from childhood maltreatment to depressive symptoms through social support was identified. ConclusionsAnalyses indicate mixed support for the SST with respect to depressive symptoms. Results highlight the role of social support in mitigating the effects depressive symptoms in adulthood; although, alternative strategies may be needed to decrease the effects of childhood maltreatment on inflammation as indexed by CRP.

WITHDRAWN: Associations Between Hypoglycemia Awareness, Hypoglycemia Beliefs, and Continuous Glucose Monitoring Glycemic Profiles and Anxiety and Depression Symptoms in Adults with Type 1 Diabetes Using Advanced Diabetes Technologies

WITHDRAWN: Associations Between Hypoglycemia Awareness, Hypoglycemia Beliefs, and Continuous Glucose Monitoring Glycemic Profiles and Anxiety and Depression Symptoms in Adults with Type 1 Diabetes Using Advanced Diabetes Technologies

Trajectories in Depressive Symptoms and Midlife Brain Health

AbstractBackgroundEvidence in older adults suggests that depressive symptoms may be part of prodromal mood changes in dementia, rather than a risk factor. However, it is unclear whether variations in depressive symptoms in adulthood exhibit distinct characteristics in brain structure and cognitive function in midlife.MethodsFrom the Coronary Artery Risk Development in Young Adults study, we identified 662 Black and White participants (age 23‐36 at baseline) who completed the Center for Epidemiological Studies Depression scale (CES‐D) at six time points over 20 years. 20 years after baseline, the participants underwent magnetic resonance imaging to characterize gray matter (GM) structures (total GM, temporal cortex, hippocampus, and entorhinal cortex) and white matter hyperintensities (WMHs). Participants also completed neuropsychological tests including the Digit Symbol Substitution Test (DSST), Rey‐Auditory Verbal Learning Test (RAVLT), Stroop Test, Montreal Cognitive Assessment (MoCA), and category and letter fluency tests, analyzed as z‐scores.ResultsUsing growth mixture modeling, we identified four trajectories of depressive symptoms (Figure 1): consistently low scorers (“steady low”; n = 509, 76.9%), a class with an early peak and decline in symptoms (“declining”; n = 63, 9.5%), a class with late increases in symptoms (“increasing”; n = 49, 7.4%), and consistently high scorers (“steady high”; n = 41, 6.2%). Compared to the steady low class, the steady high class had lower entorhinal cortex volume (β: ‐180.80, 95% CI: ‐336.69 to ‐24.91). The increasing class, had more WMHs (β: 0.55, 95% CI: 0.22 to 0.89) and less total brain volume (β: ‐9269.25, 95% CI: ‐17104.67 to ‐1444.82). Both the steady high and the increasing classes had poorer performance on the Stroop task (β: ‐0.40, 95% CI: ‐0.70 to ‐0.10; β: ‐0.39, 95% CI: ‐0.64 to ‐0.14, respectively), however the steady high also had poorer DSST performance (β: ‐0.40, 95% CI: ‐0.67 to ‐0.13), while the increasing class had poorer performance on the MoCA (β: ‐1.20, 95% CI: ‐2.04 to ‐0.37). The declining group was not significantly different from the steady low group on any brain or cognitive measures.ConclusionsOur findings suggest that trajectories in depressive symptoms in young to mid‐adulthood show different cognitive and brain phenotypes in midlife.

Sleep Duration and Insomnia with Comorbid Depression and Anxiety Symptoms in Chinese Adults: A Cross-Sectional Study.

Depression and anxiety are two highly prevalent mental disorders that commonly coexist. However, little is known about the association between sleep and comorbid depressive and anxiety symptoms (CDAS). Therefore, this study aims to explore the relationship between sleep duration, insomnia and CDAS. This is a cross-sectional study of 22,004 community adults who participated in the China Multi-Ethnic Cohort (CMEC) study. Chinese version of Patient Health Questionnaire-2 and Generalized Anxiety Disorder-2 were used to screen CDAS in community adults. A positive score on each scale was considered indicative of CDAS. All participants received face-to-face interviews, medical examinations, and biochemical examinations to assess sleep duration and insomnia and collect covariates. The self-reported sleep duration was divided into three groups: <7 hr, 7-9 hr and >9 hr groups. Logistic regression was used to analyze the association between sleep duration, insomnia and CDAS. A restricted cubic spline (RCS) was used to explore the dose-response relationship between sleep duration and CDAS. Stratified analysis based on gender and age was conducted. Overall, 2.8% (95% CI 2.6%~3.0%) of participants reported having CDAS. After adjusting the potential covariates, sleep duration <7 hr (OR=1.635, 95% CI=1.335~2.004) was significantly associated with CDAS, compared with sleep 7-9 hr. After RCS analysis, there was a nonlinear relationship between sleep duration and CDAS. The increase in the number of types of insomnia, the greater the likelihood of CDAS (p for trend<0.05). In sensitivity analysis, it was found that the results were consistent with those of the main analysis. After stratification by gender and age, the association between sleep duration and CDAS was only observed in female and young and middle-aged adults, not in men and older adults. Both insufficient sleep duration and insomnia are associated with a higher prevalence of CDAS in Chinese adults.

P29: Prolonged Intermittent Theta-Burst Stimulation of the Left Dorsolateral Prefrontal Cortex for Older Adults with Treatment-Resistant Depression: Effectiveness and Safety

Objective:Treatment-resistant depression (TRD) is not uncommon in older people. Brain stimulation, such as 4-6 weeks of repetitive transcranial magnetic stimulation (rTMS) or theta burst stimulation (TBS) targeting the left dorsolateral prefrontal cortex, has been evidenced as an essential intervention for adult TRD and also documented in the current international treatment guideline. In 2018, Taiwan Food and Drug Administration cleared the rTMS as a treatment option for TRD and now rTMS is still a treatment at their own expense in Taiwan. Additionally, prolonged intermittent TBS (piTBS) protocol has been proven its similar antidepressant efficacy as standard 4-6 weeks rTMS/iTBS in adult TRD, but in a shorter treatment course of 2 weeks. For older adults with depression, 4-6 weeks of treatment course may burden their caregiver due to their limited ambulation and transportation ability. However, hitherto there was no study to investigate the antidepressant efficacy of left-sided prefrontal piTBS in treating older TRD.Methods:A chart review was performed at a single Taiwan hospital from 2018 to 2020. 17-items Hamilton Depression Rating Scale (HDRS-17) was measured before and after the piTBS intervention. Maudsley Staging Method was used for the depression treatment refractoriness.Results:We identified 23 old adults with TRD (mean [SD] age, 66.0[5.2]; 78% female) who underwent 10-20 sessions of daily piTBS (1800 pulses/session; 10sessions, n=18, 15sessions,n=4, 20session,n=1). On continuous outcomes, mean(SD) HDRS-17 total scores improved from 20.5(6.62) to 11.8(7.7) after receiving piTBS intervention. The mean percent improvement of HDRS-17 was 46.0%±29.4%. Dichotomous outcomes showed response rate of 43.5% and remission rate of 34.8%. No seizures or other serious adverse events were noted, and no premature discontinuation was noted.Conclusion:This study is the largest study demonstrating the piTBS protocol provides a comparable reduction in depression symptoms in older adults with TRD, similar to the effectiveness in adult TRD and the efficacy of standard sequential bilateral rTMS/iTBS in older TRD in the FOUR-D trial. Regarding desirable efficiency and effectiveness, piTBS may be an optimal form of rTMS in treating older adults with TRD. Further large comparative effectiveness trials with standard iTBS or high-frequency rTMS in this population are warranted.

Lifestyle behaviors and their association with depression symptoms in older adults during Coronavirus pandemic

Objetivo: Identificar la asociación entre las conductas del estilo de vida y síntomas de depresión en personas adultas mayores entre septiembre de 2021 y marzo de 2022 en Mexicali, Baja California (México). Materiales y métodos: Diseño de tipo transversal. Participaron 103 personas adultas mayores seleccionadas por un muestreo no probabilístico. Se aplicaron instrumentos para evaluar síntomas de depresión, el estado nutricional, actividad física, consumo de tabaco, consumo de alcohol y la presencia de problemas para dormir. Para el análisis de datos se empleó estadística descriptiva e inferencial. Se construyó un modelo con las conductas del estilo de vida. La investigación se desarrolló con base en la reglamentación vigente. Resultados: El 34 % presenta riesgo de desnutrición; 92.2 % tiene baja actividad física; 9.7 % consume tabaco; 15 % consume alcohol; 38.8 % reportó presentar problemas para dormir, y 31.1 % presentó síntomas de depresión. Respecto a las conductas del estilo de vida, se encontró que las personas adultas mayores con riesgo de malnutrición o malnutrición tienen 3.182 (p ? .5) más riesgo de desarrollar síntomas de depresión en comparación con quienes tienen un estado de peso adecuado. Conclusiones: El riesgo de malnutrición o malnutrición, así como el resto de conductas del estilo de vida, son factores modificables que pueden ser intervenidos por los profesionales de la salud a través de intervenciones multicomponentes, en las que se sumen esfuerzos para establecer programas de atención que apoyen a mejorar la salud física y mental de las personas adultas mayores.

Relationship of Hoarding and Depression Symptoms in Older Adults

Hoarding disorder (HD) is a debilitating neuropsychiatric condition that affects 2%–6% of the population and increases in incidence with age. Major depressive disorder (MDD) co-occurs with HD in approximately 50% of cases and leads to increased functional impairment and disability. However, only one study to date has examined the rate and trajectory of hoarding symptoms in older individuals with a lifetime history of MDD, including those with current active depression (late-life depression; LLD). We therefore sought to characterize this potentially distinct phenotype. We determined the incidence of HD in two separate cohorts of participants with LLD (n = 73) or lifetime history of MDD (n = 580) and examined the reliability and stability of hoarding symptoms using the Saving Inventory-Revised (SI-R) and Hoarding Rating Scale-Self Report (HRS), as well as the co-variance of hoarding and depression scores over time. HD was present in 12% to 33% of participants with MDD, with higher rates found in those with active depressive symptoms. Hoarding severity was stable across timepoints in both samples (all correlations >0.75), and fewer than 30% of participants in each sample experienced significant changes in severity between any two timepoints. Change in depression symptoms over time did not co-vary with change in hoarding symptoms. These findings indicate that hoarding is a more common comorbidity in LLD than previously suggested, and should be considered in screening and management of LLD. Future studies should further characterize the interaction of these conditions and their impact on outcomes, particularly functional impairment in this vulnerable population.

Higher anthocyanin intake is associated with lower depressive symptoms in adults with and without major depressive disorder.

Major depressive disorder (MDD) is a significant cause of disability globally and an emerging body of evidence suggests that dietary components, including flavonoids, may impact depression-related biochemical pathways. Further research that characterizes dietary intake of flavonoids in diverse population groups, including people with MDD and explores the relationship between flavonoid intake and depression is needed. This study aimed to determine dietary flavonoid and subclass intake and assess the association with depressive symptomatology in a sample of adults with and without MDD. Participants with and without MDD (determined using DSM 5) completed the Depression, Anxiety, and Stress Scale-21 (DASS-21). Diet history interviews were analyzed using PhenolExplorer to quantify flavonoid subclasses (flavan-3-ols, flavonols, anthocyanins, flavones, flavanones, isoflavones), and total flavonoid intake. Independent t-tests and linear regression, adjusting for age, sex, and BMI were performed. Participants (n = 93; 75% female) had a mean age of 26.0 ± 8.2 years. Participants with MDD had significantly higher DASS-depression scores (n = 44; DASS-depression 27.3 ± 9.8) compared to participants without MDD (n = 49; DASS-depression 3.1 ± 4.4; p < .001). Intakes of total flavonoids and subclasses were similar between groups, except for anthocyanins where participants with MDD reported lower intakes of anthocyanins compared to participants without MDD (median intake: 0.08 mg/day and 11.6 mg/day, respectively; p = .02). In the total sample, higher anthocyanin intake was associated with lower DASS-depression score (B = -4.1; SE = 1.8; 95% CI [-7.7, -0.4]; p = .029). Intake of total flavonoids and most subclasses were similar between people with and without MDD. However, a dietary deficit of anthocyanins (found in purple/red fruits and vegetables) was evident in participants with MDD, and higher anthocyanin intake was associated with lower depressive symptomatology in the total sample. Further research in larger samples is warranted to explore if the documented association is independent of MDD status.

Whole blood cadmium levels and depressive symptoms in Chinese young adults: A prospective cohort study combing metabolomics

ObjectivesTo investigate the association between Cd exposure and depressive symptoms in Chinese young adults. And to investigate the potential metabolic changes associated with high blood Cd concentrations. MethodsWe conducted a cohort study in 2019 and 2021. Blood Cd and depressive symptoms were collected during baseline and follow-up. The nine-item Patient Health Questionnaire (PHQ-9) scores were used to assess depressive symptoms. We used the generalized linear mixed model to estimate the association between blood Cd levels and depressive symptoms. A metabolomic and lipidomic analysis based on liquid chromatography-mass spectrometry was conducted on a total of 679 blood samples. The metabolomic data were analyzed using variance analysis and linear mixed effects models. ResultsBlood Cd concentrations were significantly associated with increased severity of depression symptoms [odds ratio (OR) 2.07, 95% confidence interval (CI) 1.04–4.11]. Metabolomics analysis found 93 metabolites with significant statistical differences between the lowest blood Cd level group and the highest Cd level group. Among the 93 differential metabolites, 17 were enriched in 7 differential metabolic pathways. ConclusionsBlood Cd was associated with increased severity of depression symptoms in Chinese young adults. Cd exposure may affect depressive symptoms by inducing oxidative stress, inflammation, and disrupting amino acid metabolism.

Prevalence of Depression Among Adults With Diabetes Mellitus and the Relationship Between Improvement in Depressive Symptoms and Glycemic Control.

Depression is one of many comorbid conditions associated with diabetes.The rationale for this study is to examine the prevalence of depressive symptoms in adults with diabetes mellitus type II.Furthermore, the association between depressive symptoms and glycemic control will also be analyzed. A chart review of 59 diabetes mellitus type II patients from a family practice clinic in San Juan, Texas was performed.These patients were screened for depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9) during their annual physical exam.Since many of these patients have been treated in this clinic for many years for their multiple comorbidities, it is possible to evaluate their responses to the PHQ-9 over consecutive years and compare them with their glycemic control using a HbA1c level.Data was evaluated by using biological parameters, such as age and gender, and the clinical parameter of a HbA1c level.Inferential statistics, such as prevalence, frequency, correlation, and p-value,were also used in analyzing the data. Depressive symptoms were analyzed using the PHQ-9.In 2016, 2017, and 2018, female diabetics were found to have a higher prevalence of depressive symptoms.When comparing diabetes and age, in 2016, those who were between the ages of 65 and 74 and 75 and olderhad a higher incidence of depressive symptoms.Furthermore, in 2017 and 2018, patients 75 and older also had a higher frequency of depressive symptoms.The controlled diabetic population was also found to have a greater rate of depressive symptoms.However, after careful analyzation, there was no significant relationship between glycemic control and depressive symptoms. Many diabetics have comorbid depressive symptoms.Even though this study showed no relationship between depressive symptoms and glycemic control, the treatment of depressive symptoms in diabetics may help to prevent the multiple life altering complications that diabetes can cause.

68 Interactive Effects of Sleep Apnea and Depression Symptoms on Cognition in Older Adults

Objective:Sleep deprivation and depressive symptoms have been shown to negatively impact cognitive function within older adult populations (Gilley, 2022; Donovan et al., 2016). However, there is minimal research on interactions between sleep disturbance and depressive symptoms in relation to their shared impact on cognitive impairment. The purpose of this study is to examine possible interactions between sleep disorders and depression and their relationship with cognition among relatively good functioning and healthy older adults.Participants and Methods:The sample was obtained from the Memory and Aging Project (Rush Alzheimer's Disease Center, Rush University, 2019) and consisted of 3,345 community dwelling older adults. The study analyzed data from 2552 women (76.3%) and 1093 men (23.7%). The average age of participants was 80 years and ranged from 45 to 98 years old. Measures used included the Berlin Questionnaire (risk for sleep apnea), Center for Epidemiological Studies Depression Scale (CES-D; depression), and a neuropsychological battery (visuospatial ability/perceptual reasoning and processing speed).Results:ANOVA analyses exhibited a significant main effect of depression on visuospatial ability/perceptual reasoning (p &lt;.001), processing speed (p &lt;.001), and semantic memory (p &lt;.001). No significant main effect was found for sleep apnea on these cognitive domains. However, when sleep apnea was analyzed between those with any depressive symptoms versus those without, significant interactions were found for visuospatial ability/perceptual reasoning (p =.027), processing speed (p &lt;.001), and semantic memory (p =.016). Sleep apnea symptoms had a greater detrimental effect on visuospatial skills and perceptual reasoning (F=4.90; p=.027) only when any depression symptom is present. In contrast, there was a steeper decline of processing speed when only depressive symptoms were present apart from sleep apnea symptoms (F=10.34; p =.001) Similarly, depressive symptoms had a greater negative effect on semantic memory for older adults who reported no sleep apnea symptoms compare to those who did (F=5.83, p=.016).Conclusions:The current study indicated that while sleep apnea was negatively related to several cognitive domains, the impact became greater with the presence of depression on visuospatial skills and perceptual reasoning among older adults. However, the detrimental impact of sleep apnea was somewhat less with the presence of depression for processing speed and semantic memory. This may be due to likely higher endorsements of depressive symptoms compared to sleep apnea symptoms within the study sample. These findings suggest that there are differential interactive effects of sleep impairment and depressive symptoms on cognitive domains among older adults. Considering the relationship that exists between depression and increased disease burden among older adults, it is crucial for clinicians to also take sleep behaviors into account when examining and treating their patients. Clinicians should be mindful of their older patient's sleep health and depression measures when cognitive declines are suspected. They also suggest that cognitive performance may be improved with treating any symptoms of sleep apnea and depression in older adults.

Exploring gender differences in the relationships among childhood maltreatment, PTSD, and depression in young adults through network analysis

Background and objectivesCollege students who have experienced childhood maltreatment commonly exhibit adverse psychological consequences such as post-traumatic stress disorder (PTSD) and depression. The aim of this study is to use network analysis to investigate the gender differences in complex connections among various types of childhood maltreatment, PTSD, and depression. MethodsThis study involved 481 participants (M = 19.25 years, 54.5 % female) who were selected from a larger sample of 5231 college students. These participants had experienced childhood maltreatment and exhibited significant clinical symptoms of PTSD and depression. The participants completed validated measures that assessed childhood trauma, PTSD, and depression. ResultsThe network analysis performed on the entire sample revealed robust connections among various types of childhood maltreatment, symptom clusters of PTSD, and depression. The most central symptom that emerged was negative alterations in cognitions and mood (NACM), with emotional abuse displaying the highest centrality measure among the various types of childhood maltreatment. Upon comparing the subnetworks, the centrality analysis identified significant gender differences in nodes such as sexual abuse, physical neglect, emotional neglect, and avoidance. ConclusionsThe study's findings confirm that various forms of childhood abuse have intricate and multifaceted connections with depression and PTSD symptoms in adulthood. The study suggests that NACM could be the most significant symptom, and emotional abuse may play a vital role in adverse psychological outcomes. Furthermore, notable gender discrepancies were identified in the relationship between various forms of maltreatment and psychopathological symptoms.

Recognition of masked and unmasked facial expressions in males and females and relations with mental wellness.

While the effects of mask wearing/facial occlusion are known to impair facial expression recognition, little is known about the role of mental wellness on facial expression recognition, as well as the influence of sex on misattribution errors (i.e., confusions between emotions). In this large study, we aimed to address the relation between facial expression recognition and loneliness, perceived stress, anxiety, and depression symptoms in male and female adults. We assessed the influence of mask-wearing on facial expression recognition [i.e., accuracy and response time (RT)] via an online study in N = 469 adult males and females across Canada. Expectedly, recognition was impaired under masked conditions (i.e., lower accuracy, longer RTs, more misattribution errors). Females were faster and more accurate than males, with less misattribution errors. A novel finding was that people with higher perceived stress were less accurate at identifying masked fearful faces. Perceived stress influenced the relation between sex and RT to masked happy faces; males with high stress scores were slower to recognize masked happy faces, the opposite was true for females. Finally, this study was among the first to show that higher loneliness predicted shorter RT to unmasked faces. Our results show that facial expression recognition is impaired by mask-wearing, and that sex and mental health features are important predictors of performance. Such insight could be detrimental in certain sectors of the population (e.g., health care or education), and inform policies being adopted in future pandemics.

A Link between Prenatal Stage of Life during the Great Chinese Famine and Subsequent Depressive Symptoms among Middle-Aged and Older Adults

Prenatal malnutrition may increase the risk of depressive symptoms in adulthood. This study investigated the association between prenatal exposure to malnutrition with risk of depressive symptoms in middle-aged and older adults using the Chinese Great Famine of 1959–1961 as a natural experiment. Data were obtained from the China Health and Retirement Longitudinal Study baseline survey (2011). A total of 5391 individuals born from 1956 to 1965 were included in the study. Depressive symptoms were ascertained via the Center for Epidemiological Studies Depression Scale short form. Famine severity was measured using the cohort size shrinkage index. Difference-in-differences models were used to explore the association between prenatal famine exposure and later-life depressive symptoms. Compared with the post-famine cohort (1963–1965), famine cohorts (1959–1962) were 4.74 times (95% CI = 1.28–8.20) as likely to develop depressive symptoms. The stratified analysis found that prenatal exposure to famine was associated with depressive symptoms in rural residents but not those living in urban areas. In rural females, prenatal malnutrition was associated with a higher risk of depressive symptoms. However, there was no significant association between prenatal malnutrition and depressive symptoms in rural males. Our results indicated that prenatal malnutrition may contribute to a higher risk for depressive symptoms in later life among female rural residents.

Clustered health risk behaviors with comorbid symptoms of anxiety and depression in young adults: Moderating role of inflammatory cytokines

BackgroundPeople with multiple health risk behaviors (HRBs) are at higher risk for psychological problems, and vice versa. However, the mechanisms underlying this association remain unknown. MethodWe collected questionnaire and blood sample data from 2 universities in Anhui and Jiangxi Provinces. Demographic information, HRBs and blood samples were collected at baseline. Depression/anxiety symptoms were collected using questionnaires at follow-up. Latent class analysis was used to explore clustered HRBs pattern, and logistic regression analysis was used to examine the association between clustered HRBs quantity, pattern and anxiety-depression symptoms comorbidity. The Mplus software was used to analyze the moderating effects of inflammatory cytokines. ResultsCompared to the HRB low-risk group, the substance dependence group (OR: 1.89, 95%CI: 1.11–3.21) and sedentary group (OR: 2.98, 95%CI: 1.48–6.02) had a higher risk of anxiety-depression comorbid symptoms. Compared to participants with no clustered HRBs, participants with 2 HRBs (OR: 2.16 95%CI: 1.17–4.00) and >3 HRBs (OR: 3.55, 95%CI: 1.68–7.48) were more likely to suffer from comorbid symptoms of anxiety and depression. Moreover, IL-6, IL-1β, IL-10 had negative moderating effects between clustered HRBs pattern and comorbid symptoms of anxiety and depression. LimitationsRecall bias may exist for anxiety / depression symptoms, and cannot exclude unmeasured confounders or the effect of residual confounding. ConclusionsThis study finds clustered HRBs have a significant impact on mental health among young adults, and inflammatory cytokine evidence supports a negative moderating effect on the relationship. Interventions that decrease clustered HRBs may support mental health development in adolescence.

Educational attainment and symptoms of anxiety and depression in young adulthood

Abstract Background Young adulthood is a life phase when mental health problems are common. Although education is known to exert an influence on health, increased knowledge about the links between educational attainment and mental health problems in young adults is needed. The aim of this study was to analyse if educational attainment at the end of upper secondary (U.S.) school (i.e. age 19) predicted self-reported anxiety and depression symptoms two years later. Methods Data was derived from the Swedish population-based cohort study Futura01 (n = 3247; 56% women). Anxiety and depression were measured by self-reports in 2022 (age 21) through the Patient Health Questionnaire (PHQ-4). Educational attainment was measured through linked registry information from 2020 (age 19). Linear regression analysis was used. Covariates included parental country of birth, parental education and family type. Results Co-occurring symptoms of anxiety and depression were more common among young adults with a compulsory than a U.S. academic degree (women: b = 0.79, 95% CI 0.49, 1.09; men: b = 0.77, 95% CI 0.37, 1.17). Symptoms of depression only were more common among women with a compulsory degree (b = 0.60, 95% CI 0.20, 1.00), and among participants with a U.S. vocational degree (women: b = 0.51, 95% CI 0.09, 0.94; men: b = 0.50, 95% CI 0.08, 0.91), compared to those with a U.S. academic degree. Symptoms of anxiety only were, in contrast, less common among men and women with a compulsory degree compared to those with a U.S. academic degree, although statistically significant only among women (b=-0.50, 95% CI -0.88, -0.12). Conclusions Educational level in young adulthood was clearly associated with subsequent symptoms of anxiety and depression but the social patterning varied between symptoms. Lower educational level was linked to a higher reporting of co-occurring anxiety and depression and of depression only, while a higher educational level was linked to a higher reporting of anxiety only. Key messages • Young adult educational attainment was negatively associated with symptoms of co-occurring anxiety and depression and of depression only, but positively associated with symptoms of anxiety only. • In young adulthood educational level is associated with anxiety and depression in complex ways. Efforts to improve educational attainment and/or mental health need to consider this complexity.