Coping behavior of Parkinson's disease (PD) patients undergoing subthalamic Deep Brain Stimulation (STN-DBS) is poorly understood. Identifying patients with ineffective coping could help prepare them better for surgery. To clarify coping of PD patients preoperatively and the relation with psychiatric symptoms, quality of life (QoL), and cognition. Scores of 158 STN-DBS candidates were retrospectively reviewed, including the Utrecht coping list (UCL), Symptom Checklist (SCL90-R), Beck Depression Inventory (BDI2NL), PD Questionnaire 39 Summary Index (PDQ39-SI) and the neuropsychological assessment. One-sample and independent-samples t-tests, and correlation coefficients were calculated. We found significant positive correlations between emotion-focused coping (palliative/passive reactions, avoidance, expression of emotions, reassuring thoughts and seeking social support) and anxiety, depressive symptoms, and general psychosomatic symptoms. Patients reporting more palliative and passive reactions reported lower QoL. Patients with executive function deficits/impairment reported less active problem-focused coping (-1.89, 95% CI -3.60; -0.17); those with deficits/impairments in memory and executive functions reported less problem-focused coping (-1.96, 95% CI -3.81; -0.10), palliative reactions (-2.12, 95% CI -3.72; 0.51), seeking social support (-2.68, 95% CI -4.07; -1.28) and reassuring thoughts (-1.41, 95% CI -2.52; -0.30) compared to cognitively unimpaired patients. Our data affirm the association of specific coping strategies with depression, anxiety, general physical and mental symptoms, and QoL in STN-DBS candidates. Patients with impaired cognition, especially poor executive functioning, used ineffective coping strategies more often. Characterizing coping is simple and helps identify patients who may benefit from additional support to reinforce effective strategies, possibly leading to a less burdensome pre-surgical trajectory.

Individual differences in the structure and function of the frontostriatal reward network have been related to depression. However, there is a strong need for prospective, longitudinal studies aiming to understand the role of frontostriatal networks in depression in a developmental context. We aimed to examine bidirectional associations between structural connectivity in the frontostriatal reward network and depressive symptoms in adolescent girls, as well as to determine to what extent the directionality and strength of these associations are dependent on age or pubertal stage. About 596 observations from 174 adolescent girls (up to 4 time points per person, ages 10-17) were included. Depressive symptoms were measured with the Center for Epidemiological Studies-Depression scale for Children and pubertal stage with the Pubertal Development Scale and the Tanner Stage Line Drawings. Probabilistic tractography was done on diffusion-weighted imaging scans to obtain average fractional anisotropy from ventral striatum to orbitofrontal cortex and ventral striatum to ventromedial prefrontal cortex tracts. Linear mixed-effects models showed that frontostriatal connectivity was not associated with subsequent change in depressive symptoms. Depressive symptoms were also not associated with subsequent change in frontostriatal connectivity. Depressive symptoms increased with age and pubertal stage, but the association with connectivity did not vary with age or pubertal stage. This suggests previously reported cross-sectional associations might not pertain to developmental effects in girls. Future research should examine prospective associations between frontostriatal functional connectivity and depression.

The aim of this study was to determine the prevalence of anxiety and depression symptoms in WLHIV in antiretroviral therapy and the associated factors. A cross-sectional study was conducted in Ceará, Brazil, with a sample of 387 WLHIV. Inclusion criteria were female individuals with HIV, over 18 years of age and on antiretroviral therapy. Data collection was carried out through interviews, using the Sociodemographic, Epidemiological, Behavioral and Clinical Form, Beck Anxiety Inventory and Beck Depression Inventory. Univariate and multivariate logistic regression analysis were performed. The odds ratio and 95% confidence interval were calculated. The prevalence of anxiety and depression symptoms were respectively 64.0% and 66.0%, in addition to concomitant symptoms (53.8%). The most commonly used contraceptive method was tubal ligation (41.3%). In the multivariate analysis, the factors associated with anxiety symptoms were age under 46 years (p < 0.001), unemployment (p = 0.025), retirement/leave (p = 0.007) and diagnosis of depression (p < 0.001). Physical exercise was a protective factor against anxiety (p = 0.015). The factors associated with depression were unemployment (p = 0.028), retirement/leave (p = 0.025) and having a diagnosis of anxiety (p < 0.001). More than half of the sample had symptoms of anxiety and depression, mainly associated with unemployment and retirement/leave. Physical exercise was a protective factor against anxiety.

The intricate interplay between chronic psychological stress and periodontitis, mediated by oral microbiota and macrophage polarization, remains largely enigmatic. Here, we demonstrate that chronic restraint stress (CRS) exacerbates periodontitis by inducing oral microbial dysbiosis and a consequential shift in host metabolism. Clinical observations reveal a significant correlation between depressive symptoms and the severity of periodontitis, which is underpinned by a distinct oral microbiome. Crucially, fecal microbiota transplantation from CRS-exposed mice into germ-free mice was sufficient to transmit the heightened periodontitis phenotype, establishing a causal role for the stress-altered microbiota. Metabolomic profiling identified a depletion of eicosapentaenoic acid (EPA) in stressed, ligature-induced periodontitis mice. Mechanistically, supplementation with EPA ameliorates periodontitis by suppressing the NF-κB signaling pathway, thereby inhibiting the pro-inflammatory M1 polarization of macrophages. Our findings unveil a novel gut-oral axis mediated by microbiota and metabolites under stress, and position the omega-3 fatty acid EPA as a promising therapeutic agent for mitigating stress-aggravated inflammatory disorders.

Although anxiety symptoms and depressive symptoms are linked with increases in suicidal ideation, they leave much of the variance in suicidal ideation unexplained. Loneliness may mediate the links between anxiety symptoms and suicidal ideation as well as depressive symptoms and suicidal ideation. To analyze the mediating role of loneliness in the association between anxiety symptoms and suicidal ideation as well as in the association between depressive symptoms and suicidal ideation. This cross-sectional study used data collected between May 31, 2017, and October 1, 2023, from 62 685 US adults who completed the self-report mental health survey portion of the National Institutes of Health's All of Us Research Program. Self-report surveys estimated anxiety symptoms (using the 7-item Generalized Anxiety Disorder scale), depressive symptoms (using the first 8 items of the 9-item Patient Health Questionnaire [PHQ-9]), loneliness (using the UCLA Loneliness Scale), and suicidal ideation (using item 9 of the PHQ-9). Analyses were conducted in August of 2025. The analytic sample of 62 685 individuals had a mean (SD) age of 61.8 (16.1) years and included 40 749 women (65.0%). Anxiety symptoms (r = 0.33; P < .001), depressive symptoms (r = 0.39; P < .001), and loneliness (r = 0.31; P < .001) correlated with suicidal ideation. When controlling for gender and race and ethnicity, depressive symptoms (B = 0.017 [95% CI, 0.017-0.019]), anxiety symptoms (B = 0.004 [95% CI, 0.004-0.006]), and loneliness (B = 0.007 [95% CI, 0.007-0.008]) accounted for significant variability in suicidal ideation. Loneliness partially mediated the association between anxiety symptoms (average causal mediation effect = 0.01; proportion mediated, 0.25; total association, 0.03; P < .001) and suicidal ideation as well as depressive symptoms (average causal mediation effect = 0.003; proportion mediated, 0.10; total association, 0.02; P < .001) and suicidal ideation, indicating the associations of anxiety and depressive symptoms with suicidal ideation were in part mediated by loneliness. In this cross-sectional study of 62 685 participants from the All of Us Research Program, loneliness partially mediated the association between anxiety symptoms and suicidal ideation as well as depressive symptoms and suicidal ideation. Targeting and reducing loneliness may present a transdiagnostic approach to arrest the progression from anxiety and depressive symptoms toward suicidal ideation.

Antidepressants for moderate to severe major depressive disorder may be discontinued prematurely because the prescribed antidepressant is not always the most appropriate medication for an individual. Guidelines have recommended more precise targeting of antidepressant treatment. To evaluate the efficacy of a web-based tool to personalize antidepressant treatment. This multicenter, randomized clinical trial included persons between the ages of 18 and 74 years with major depressive disorder. The trial was conducted at 47 sites in 3 countries (Brazil, Canada, and the UK). The first participant was screened on November 29, 2022, and the last follow-up visit occurred on January 15, 2025. A total of 540 participants were randomized (1:1) to an evidence-based clinical decision-support system (PETRUSHKA tool; n = 271) or usual care (n = 269). The primary outcome was treatment discontinuation due to any cause at 8 weeks. The secondary outcomes included treatment discontinuation up to 24 weeks due to adverse events and changes in depressive symptoms (measured with the 9-item Patient Health Questionnaire [PHQ-9]; range, 0-27; higher scores indicate more severe depression) and anxiety symptoms (measured with the 7-item Generalized Anxiety Disorder [GAD-7] questionnaire; range, 0-21; higher scores indicate more severe symptoms). Of the 520 eligible participants, 493 were included in the primary analysis (median age, 35 [IQR, 25 to 48] years; 58% female; PHQ-9 mean score, 16.6 [SD, 5.1]; GAD-7 mean score, 11.5 [SD, 4.1]). At 8 weeks, 41 of 241 participants (17%) in the PETRUSHKA group discontinued the prescribed antidepressant due to any cause vs 69 of 252 (27%) in the usual care group (adjusted relative risk, 0.62 [95% CI, 0.44 to 0.88]; P = .007). At 8 weeks, 22 of 241 participants (9%) in the PETRUSHKA group discontinued the prescribed antidepressant due to adverse events vs 39 of 252 (16%) in the usual care group (adjusted relative risk, 0.59 [95% CI, 0.36 to 0.97]; P = .04). For the assessment of depressive symptoms at 24 weeks, the mean PHQ-9 score was 7.1 (SD, 5.4) in the PETRUSHKA group vs 9.2 (SD, 6.5) in the usual care group (n = 129 in each group; adjusted between-group mean difference, -1.92 [95% CI, -3.06 to -0.78]; P < .001). For the assessment of anxiety symptoms at 24 weeks, the mean GAD-7 score was 4.6 (SD, 4.1) in the PETRUSHKA group (n = 133) vs 5.8 (SD, 4.9) in the usual care group (n = 126) (adjusted between-group mean difference, -1.39 [95% CI, -2.26 to -0.52]; P = .002). Compared with usual care, use of the PETRUSHKA tool increased the number of patients still taking their antidepressant at 8 weeks and improved depressive and anxiety symptoms at 24 weeks. However, lack of a double-blind design and the large amount of missing data limit the validity of these results. ClinicalTrials.gov Identifier: NCT05608330.

Background: Obese Latino adolescents are at increased risk for stress and depressive symptomology, but interventions to target both physiological and mental health outcomes are scarce. This pilot randomized controlled trial assessed feasibility and preliminary efficacy for a home-based strength training (HBST) intervention on stress-related and mental health outcomes in obese Latino adolescent males. Methods: Fifty-two adolescents were randomized to HBST (n = 26) or control conditions (n = 26). Participants randomized to HBST completed a 16-week progressive resistance training intervention performed twice per week at home on non-consecutive days. Primary and secondary outcomes were assessed at baseline and immediately post-intervention and included measures of upper- and lower-body strength (1RM), body mass index (BMI), BMI percentile, BMI Z-score, salivary cortisol, depressive symptoms (CES-D), and perceived stress (PSS-14). Results are presented using completer-only analyses (n = 25) and mixed-design ANOVA models. An ANCOVA sensitivity analysis was conducted for depressive symptoms due to baseline imbalance, including baseline CES-D as a covariate in the model. Results: Recruitment goals were met, but retention was lower than expected (48% overall; HBST = 31%, control = 54%). Analyses revealed a significant Time × Group interaction for salivary cortisol (F(1, 20) = 5.70, p = 0.027, ηp2 = 0.222), such that cortisol decreased over time in HBST participants and increased in control participants. While all strength and anthropometric outcomes improved descriptively from baseline to follow-up in the intervention condition, no significant interactions were present between groups. Depressive symptoms also decreased descriptively in HBST participants, but this effect was no longer significant after adjusting for baseline CES-D using ANCOVA (F(1, 19) = 0.002, p = 0.968). There were no significant findings for perceived stress. Conclusions: Differential effects were observed on salivary cortisol, suggesting HBST may be feasible in obese Latino adolescents. However, results should be interpreted with caution given baseline imbalance, small sample size, high attrition, and limitations with measuring cortisol at one time point without adjustment for time of day or key psychosocial and physiological confounders. All psychological and anthropometric outcomes were exploratory and non-significant after adjustment. A larger, multisite trial using baseline-adjusted analytic procedures, repeated physiological sampling, objective measures of adherence, and extended follow-up is needed to determine whether HBST produces meaningful effects that are sustained over time.

Multicultural adolescents experience higher levels of depressive symptoms than their non-multicultural counterparts. Although depressive symptoms vary by sex, few studies have examined sex-specific trajectories and their protective predictors, particularly among multicultural youth. Using nine annual waves of nationally representative longitudinal data from multicultural adolescents in South Korea (N = 1,500; 50.67% girls; Mage = 10.98, SD = 0.37), this study identified the sex-specific depressive symptom trajectories and their early intrapersonal and interpersonal predictors. Latent class growth models identified four trajectories for girls: low stable (30.43%), low increasing (36.12%), high-increasing then plateauing (19.29%), and high decreasing (14.16%). Three trajectories emerged for boys: low stable (46.76%), moderate increasing (43.21%), and high-increasing then plateauing (10.03%). After adjusting for age and socioeconomic status, multinomial logistic regression analyses showed that higher self-esteem significantly distinguished the resilient low stable group from the low increasing and high decreasing trajectories for girls, as well as the high-increasing then plateauing trajectory for boys. Furthermore, perceived family and friend support were associated with a lower likelihood of the high-increasing then plateauing trajectory in girls. For boys, teacher support predicted a lower risk of the moderate increasing trajectory. The findings underscore the importance of considering sex differences in understanding the progression of depressive symptoms and the key protective factors among multicultural adolescents, providing valuable insights for prevention and intervention efforts.

This study aimed to assess the prevalence of smoking, exposure to secondhand smoke, former smoking, and associated factors among older adults. Using data from the cross-sectional phase of the Ardakan Cohort Study on Aging (ACSA), self-reported information on smoking habits, secondhand smoke exposure, and childhood exposure to smoke was analyzed. Logistic regression was employed to evaluate factors influencing being a former smoker, while multinomial logistic regression compared nonsmokers, former smokers, and current smokers. A total of 4,981 individuals participated in the study, revealing that 22.23% of male participants were former smokers, 28.29% were current smokers, while only 0.19% of females were former smokers, and 0.08% were current smokers. The majority of smokers started smoking before the age of 18, with an average pack year of 26.27 and a smoking duration of 30.37 years (95% CI: 29.83 to 31.59). Exposure to secondhand smoke in homes was reported by 30.41% of women and 10.87% of men, while childhood exposure to cigarette smoke was reported by 30.37% of women and 43.29% of men. Smoking status was found to be associated with age, education, BMI, hypertension, hyperlipidemia, neurological disorders, depressive symptoms, and pack year history. The study highlights a high prevalence of both first- and secondhand smoking in the elderly population of Iran, emphasizing the need for targeted interventions. These findings may inform age- and context-appropriate public health strategies targeting older adults, particularly in regions where smoking remains socially embedded and cessation support is limited.

Third-wave psychotherapeutic approaches, which emphasise acceptance and mindfulness, have shown effectiveness in alleviating negative affect. This study examined the role of self-compassion in the relationship between resilience and negative affect, including symptoms of stress, anxiety, and depression. A cross-sectional design was employed with 494 adults from the general population. Participants completed the Depression Anxiety Stress Scale-21 (DASS-21), the Self-Compassion Scale (SCS), and the Brief Resilience Scale (BRS). Regression analyses indicated that higher resilience was associated with lower levels of negative affect and self-compassion was significantly correlated with both resilience and negative affect. Mediation analyses revealed a significant indirect effect, suggesting that self-compassion is associated with a portion of the variance in the relationship between resilience and negative affect. These findings highlight a notable association between self-compassion, resilience, and emotional distress, suggesting that self-compassion may be a relevant construct for interventions aimed at enhancing psychological wellbeing.

Adults with severe mental illness (SMI) face a 10- to 20-year reduction in life expectancy, largely due to heightened cardiometabolic diseases. Low levels of physical activity (PA) and prolonged sedentary behavior (SB) are modifiable risk factors that contribute to this mortality gap. Although strong evidence demonstrates that PA is safe and effective in improving psychiatric and physical outcomes, systematic integration into clinical practice remains limited. Individuals with SMI are among the most physically inactive groups in society, often spending more than 10 hours per day sedentary and rarely meeting recommended PA recommendations. Low PA and high SB exacerbate neuroinflammatory, neuroendocrine, and cardiometabolic pathways implicated in psychiatric morbidity. Recent meta-analyses show that structured PA, that is, exercise, produces moderate to large reductions in depressive and psychotic symptoms, as well as benefits for cognition, quality of life, and cardiometabolic health. Evidence also suggests that mentally passive SB, such as prolonged television viewing, are associated with poorer mental health outcomes. Physical activity should be individualized to each person's capabilities and preferences, emphasizing forms they find enjoyable. Two sessions of strength training weekly are advised, and greater mental health benefits typically arise from leisure or active travel PA. To guide translation into care, the 5A framework (Ask, Assess, Advise, Assist, Arrange) provides a structured, pragmatic approach: clinicians can screen for PA and SB, assess readiness and safety, provide tailored advice, support motivation and goal setting, and arrange follow-up, referral, and community support. PA should be considered a core component of psychiatric care. By systematically promoting PA and reducing prolonged SB through structured clinical frameworks, psychiatrists and other mental health professionals can improve symptoms, enhance physical and cognitive health, and help narrow the life expectancy gap experienced by people with SMI.

Social media is one form of technological advancement that has become an integral part of students’ lives, including university students. Its use is not limited to communication and information sharing, but it may also generate psychological effects that influence both physical and mental health. The purpose of this review is to identify and explain the psychological impacts of social media use through appropriate theoretical approaches, which serve as a foundation for discussing the research findings. This study employs a literature review method by examining various academic books and relevant scientific articles. The findings indicate that excessive use of social media has the potential to cause psychological problems among university students, such as social comparison behavior, cyberbullying, decreased sleep quality, and reduced learning productivity. These issues are influenced by several factors, including the intensity of social media use, the type of content accessed, and individuals’ ability to manage emotions and time. Furthermore, uncontrolled social media use may lead to difficulties in social relationships, increased procrastination, poor time management, and reduced self-control in using social networking platforms. Therefore, students are encouraged to develop healthier patterns of social media use to reduce the risk of psychological disturbances. This review is also expected to assist healthcare professionals in understanding the relationship between the intensity of social media use and the occurrence of depressive symptoms among university students.

The convergence of climate change and population ageing poses a global health challenge, especially in LMICs, where older adults face unique vulnerabilities. Evidence on mental/cognitive impacts is fragmented and geographically skewed, hindering policy. We systematically synthesised quantitative evidence on these impacts in older adults. Following PRISMA/PROSPERO guidelines, we searched Scopus, EBSCOHost, ScienceDirect, and Web of Science (Jan 2000-June 2025) for studies linking climate exposures (e.g. thermal stress, disasters) to mental/cognitive outcomes in older adults (>60 years). Two reviewers extracted data and assessed bias. Findings were narratively synthesised due to heterogeneity. We included 28 quantitative studies. Thermal stress (heat/cold) was robustly linked to increased depressive symptoms. Acute disasters were consistently associated with higher psychological distress, anxiety, and PTSD. An emerging link between heat exposure and cognitive impairment has been identified, although some studies suggest that older adults exhibit greater psychological resilience post-disaster than younger cohorts. Key pathways (physical health, sleep, social support) were identified. Critically, the evidence is profoundly concentrated in East Asia (primarily China), with significant data gaps in Africa and South Asia. Climate change poses a significant threat to older adults' mental and cognitive health. The severe geographic research imbalance, neglecting low- and middle-income settings-especially sub-Saharan Africa and South Asia-represents a major global health failure. Future research and funding must prioritise these high-risk, low-evidence regions and shift towards the development and testing of interventions.

Abstract Targeted electrical approaches to the treatment for Parkinson’s disease (PD) include deep brain stimulation (DBS), which is effective for core motor symptoms, such as essential tremor. Interestingly, treating comorbid depressive symptoms in PD, using electroconvulsive therapy (ECT), also appears to help motor disability. But it is unclear whether such electrical strategies have any impact on the underlying disease processes of PD. Since aggregation of misfolded alpha-synuclein fibrils is a pathological hallmark of PD, this may be an important therapeutic target. To this end, we presently assessed whether direct current stimulation (DCS) of cortical neurons that were seeded with wild-type or A53T alpha-synuclein mutant pre-formed fibrils (PFFs) would reduce their aggregation. We found that both wild-type and A53T alpha-synuclein PFFs readily induced alpha-synuclein aggregation in primary cortical neurons and this effect was more pronounced at embryonic day 17 (E17), compared to less mature E14 derived neurons. We did find that DCS time-dependently reduced alpha-synuclein accumulation (phosphorylated and aggregate forms) within neurons and increased neuronal viability. Increased extracellular alpha-synuclein levels suggest that the DCS induced an increase in neuronal activity causing the clearance of the intra-cellular alpha-synuclein. These data have implications for non-invasive neuromodulation strategies to lower alpha-synuclein burden and possibly correct aberrant neuronal firing in PD and other alpha-synucleopathies.

ABSTRACT Previous literature links emotional dysregulation (ED) to HIV acquisition risk and intimate partner violence (IPV) perpetration. This study assessed the relationship between ED, HIV acquisition risk, and IPV perpetration cross-sectionally and longitudinally among men (18–30 years) in urban informal settlements and rural areas in KwaZulu-Natal, South Africa. Data were drawn from 163 young men enrolled in a pilot randomized controlled trial of Stepping Stones and Creating Futures Plus (SSCF+). Regression models were used to examine baseline and longitudinal associations. Informed by previous findings that SSCF+ reduced ED among men with elevated depressive symptoms, we assessed whether the intervention modified ED – HIV/IPV associations in this subgroup using ED × intervention interaction terms among participants with elevated depressive symptoms (n = 56). Cross-sectionally, ED was associated with multiple sexual partners, alcohol use and drug use. Longitudinally, only alcohol abuse remained significantly associated with ED (adjusted odds ratio [aOR] 1.06, 95% CI 1.02–1.11). ED increased the risk of emotional and combined IPV perpetration cross-sectionally, and longitudinally ED was associated with physical (aOR 1.07, 95% CI 1.02–1.13), emotional (aOR 1.06, 95% CI 1.02–1.11), sexual (aOR 1.05, 95% CI 1.01–1.10), and combined IPV perpetration (adjusted beta coefficient [aβ] 0.16, 95% CI 0.03–0.34). Among men with elevated depressive symptoms, combined IPV perpetration increased with ED in the control group but remained relatively flat in the intervention group. Addressing ED within IPV and HIV prevention programming may be an important strategy for reducing men’s IPV perpetration and HIV risk.

Negative Problem Orientation, Future Orientation, and Pessimism Matter for Multigroup Latinx Adults Living in the US: Identifying Robust Expectancy Predictors of Depressive Symptoms and Psychological Pain Among the Invisible

Research reports on the relationship between cardiometabolic index (CMI) and depressive symptoms are limited. This study aimed to evaluate the possible relationship between CMI and depressive symptoms. We conducted a cross-sectional analysis of adults from the National Health and Nutrition Examination Survey (NHANES). Participants aged ≥ 18years with complete data on CMI and depressive symptoms from the 2007-2018 cycles were included (n = 7965). Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) with a score ≥ 10 as the cut-off. Multivariable logistic regression models were used to assess the association. Restricted cubic splines (RCS) and logistic regression were employed to explore nonlinearity and identify inflection points. Subgroup analyses were performed to examine effect modification. Of 7965 individuals, 637 (8%) had depressive symptoms, while hypertension and stroke are present in 3039 (38.15%) and 216 (2.71%), respectively. A multivariable logistic regression model observed that When LnCMI is employed as a classification variable, no significant association between them can be observed. A dose-response fitting curve find that there is a nonlinear J-shaped association between LnCMI and depressive symptoms. A two-piecewise logistic regression model to analyze their relationship, which we observed that CMI on the left side of the cut-off point was not associated with depressive symptoms prevalence. However, among patients with LnCMI ≥ -2, there was a positive association between LnCMI and depressive symptoms prevalence (OR 1.92; 95% CI 1.40-2.64). Subgroup analysis revealed that only BMI had a moderating effect on the association between CMI and depressive symptoms (OR:2.37,95% CI 1.53-3.67; P for interaction = 0.017). Our research findings suggest a strong association between higher CMI levels and increased prevalence of depressive symptoms, particularly among American adults with BMI ≥ 25kg/m2. We further revealed a turning point by threshold effect analysis.

Background Psychological and cognitive disorders have been reported in acromegaly, yet with limited and heterogeneous data, especially concerning long-term cognitive functioning. Methods We conducted a cross-sectional study enrolling 44 acromegalic patients and 40 healthy controls. We systematically assessed anxiety and depressive symptoms through the State–trait Anxiety Inventory and the Beck Depression Inventory, respectively. We investigated their cognitive functioning thorough a wide battery of 16 tests addressing verbal and visuo-spatial memory, attention, verbal fluencies, executive functions and constructional praxis. Moreover, we performed a prospective evaluation in a 10-year time-span of a small subgroup of patients. Results Clinically significant depressive and anxiety symptoms were registered in 23 and 35% of patients respectively, mostly in the group with active disease at evaluation. Concerning cognition, patients scored worse than controls in all cognitive domains explored, with a significant difference registered in almost all tests administered. Moreover, hypopituitarism and IGF-1 levels seem to be related to a worse cognitive performance, especially in the group of tests exploring the memory domain. In the prospective group, with the limitation of a really small sample size, we observed a global improvement over time in all domains evaluated. Conclusion Acromegaly is characterized by higher levels of psychological distress and poorer neurocognitive functioning, with a possible association with activity of disease.

Adolescent mental health has worsened, and prevention efforts have become increasingly important. The purpose of this study was to examine longitudinal symptom trajectories of depression and anxiety throughout adolescence, in a contemporary sample. The stress-diathesis model was used to inform potential vulnerability factors and stressors associated with these trajectories. Symptoms of depression and generalized anxiety were assessed in a school-based population sample of N=6102 adolescents (aged 13-14 at baseline). Growth mixture models across four time points were used to model longitudinal trajectories of symptoms. Multinomial regression was used to examine factors associated with each trajectory class. Of the full sample, 49.5% were female, 45.9% were male, and 4.6% were gender diverse. Four discrete classes for both depression and anxiety trajectories were identified, which comprised consistently low symptoms ('low'; 72.5% depression; 66.9% anxiety), consistently high symptoms ('high'; 11.5% depression; 18.4% anxiety), elevated symptoms that reduced over time ('decreasing'; 8.3% depression; 6.9% anxiety), and low-moderate symptoms that increased over time ('increasing'; 7.7% depression; 7.8% anxiety). Factors associated with poorer trajectories were being female or gender diverse, lower socioeconomic status, higher levels of neuroticism and lower levels of conscientiousness, greater adverse childhood experiences, higher levels of peer problems, bullying victimization, and negative family interactions. A range of background vulnerabilities and specific stressors were associated with poorer depression and anxiety trajectories over a 3-year period. Prevention approaches may require policy and practice changes that promote more supportive family, school, and societal environments from childhood to adolescence.

The present study investigated the prevalence of exposure to traumatic events, and the relationship between trauma, acculturative stress, and protective social and cultural factors on mental health outcomes among aging Latino and Hispanic immigrants. In this cross-sectional study, 80 middle-aged and older (M = 54 years, SD = 7) Latino or Hispanic immigrants (51% male) living in the United States completed a series of questionnaires in Spanish. We performed multiple regression analyses to examine risk and protective factors for mental health outcomes. The results indicated that 86% of our participants reported experiencing at least one traumatic event in their lifetime (M = 5, SD = 6). Higher acculturative stress was associated with greater symptoms of depression, anxiety, and posttraumatic stress disorder. Greater levels of family support were found to be linked with lower symptoms of psychological distress, depression, and posttraumatic stress disorder symptoms. The cumulative exposure to traumatic events and acculturative stress across the lifespan impacts the mental health of aging Latino immigrants. Family support is an important protective factor for researchers, clinicians, and policy makers to consider in the development of effective and culturally appropriate interventions for middle-aged and older Latino/Hispanic immigrants.