Elevated Depressive Symptoms Research Articles

Mental Health of Pediatric Patients with Cystic Fibrosis after 18 Months on Elexacaftor-Tezacaftor-Ivacaftor Therapy.

Research studies are conflicting regarding new highly effective modulators and the association with mental health symptoms for adults and adolescents with cystic fibrosis (CF). For younger children, small studies and case reports indicate a wide range of effects, ranging from improvement in mood to the development of neuropsychiatric symptoms. However, a large placebo-controlled study indicated no causal connection. This study evaluates the frequency and severity of mental health symptoms in children and adolescents while taking elexacaftor/tezacaftor/ivacaftor (ETI). The study includes 81 pediatric patients with CF followed at Nationwide Children's Hospital (NCH). Patient Reported Outcomes Measurement Information System (PROMIS)-Anxiety and Depression, Patient Health Questionnaire 8 (PHQ-8) and Generalized Anxiety Disorder Questionnaire (GAD-7) were used to screen for depression and anxiety. Age-appropriate questionnaires were completed over the first 18 months after initiating ETI. At baseline, majority of participants reported mental health symptoms within normal limits (WNL). For participants with elevated baseline measures, depressive and anxiety symptoms significantly decreased throughout the study period. Depending on the metric, patients experiencing depressive and anxiety symptoms dropped to 2-3% (n = 1, on each depressive measure) and 0% (n = 0, on either anxiety measures) respectively by 18 months. Most pediatric patients with CF did not endorse symptoms of depression or anxiety disorders at ETI initiation. Over the first 18 months of ETI usage, the percentage of patients with these symptoms decreased, suggesting that the percentage of patients experiencing severe symptoms of depression and anxiety may decrease with ongoing use of ETI.

Sequential Dual Mediating Effects of Smartphone Dependence and Aggression on the Relationship Between Negative Parenting Attitudes and Depressive Symptoms Among Adolescents

ABSTRACTThis study examined the sequential dual mediating effects of negative parenting attitudes, smartphone dependence and aggression on depressive symptoms among adolescents. Data were obtained from the 2018 Korean Children and Youth Panel Survey (KCYPS) conducted by the National Youth Policy Institute. Using a multistage stratified cluster sampling method, the 2018 KCYPS comprehensively examined various aspects of the growth and development of children and adolescents. The study sample included a nationally representative sample of 2541 adolescents. PROCESS macro Model 6 was used to examine the sequential dual mediating model that not only examines the effects of negative parenting attitudes on smartphone dependence and aggression but also establishes the sequential causal relationship between smartphone dependence and aggression, ultimately confirming the direct and indirect effects on depressive symptoms of adolescents. The significance of the mediation effect was verified by applying the bootstrapping method. The findings demonstrated that negative parenting attitudes increased smartphone dependence, which, in turn, elevated depressive symptoms among adolescents. Furthermore, negative parenting attitudes increased smartphone dependence, which heightened aggression, ultimately contributing to depressive symptoms among adolescents. Based on these findings, this study has practical and policy implications for preventing depressive symptoms among adolescents. Prioritizing efforts to reduce smartphone dependence and aggression among adolescents while promoting positive parenting attitudes can play a crucial role in addressing this issue.

QOL-31. RESULTS OF A TELEHEALTH-BASED PSYCHOLOGICAL INTERVENTION FOR CAREGIVERS OF PATIENTS WITH PRIMARY MALIGNANT BRAIN TUMORS: A MODERATION ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL

Abstract BACKGROUND In a recent randomized controlled trial, caregivers of patients with primary malignant brain tumors (PMBT) who received NeuroCARE—a six-session, telehealth-based psychological intervention—demonstrated improved anxiety and depression symptoms, coping, and self-efficacy at 11-weeks compared to usual care (UC) participants. We now explore how sociodemographic variables, disease-specific factors, and baseline mood symptoms moderate intervention effects on anxiety and depression symptoms. METHODS We examined data from 120 enrolled caregivers (Mage=53 years; 83% female, 92% White, 70% spouses/partners) of PMBT patients (84% glioblastoma). Eligible caregivers had elevated anxiety (Generalized Anxiety Disorder-7 ≥ 5). Participants were randomized 1:1 to NeuroCARE or UC and completed baseline sociodemographic questionnaires and the Hospital Anxiety and Depression Scale at baseline and 11-weeks. We used linear regression to evaluate whether selected sociodemographic characteristics (gender, age, relationship to patient), tumor characteristics (tumor location/laterality, IDH mutation status), and baseline mood symptoms moderated intervention effects on anxiety and depression symptoms. We report the group-by-moderator (b) effects, using a 0.20 significance level. RESULTS The beneficial effects of NeuroCARE on reducing 11-week anxiety symptoms were greater in women compared to men (b=-2.63, CI: -6.17, 0.91, p=0.14) and greater in caregivers who reported higher baseline anxiety symptoms (b=-0.43, CI: -0.78, -0.08, p=0.02) and depression symptoms (b=-0.56, CI: -0.96, -0.17, p=0.01). The beneficial effects of NeuroCARE on reducing 11-week depression symptoms were greater in caregivers of patients with IDH-wildtype tumors compared to caregivers of patients with IDH-mutant tumors (b=2.49, CI: -0.26, 5.24, p=0.08). Caregiver age, relationship to patient, and tumor location/laterality did not significantly moderate NeuroCARE effects on mood. CONCLUSIONS The positive effects of NeuroCARE were particularly salient for caregivers with elevated anxiety and/or depression symptoms and those caring for patients with IDH-wildtype tumors. Content may be further tailored to account for the unique needs of men and caregivers of patients with IDH-mutant tumors.

Changes to Positive Self-Schemas After a Positive Imagery Training are Predicted by Participant Characteristics in a Sample with Elevated Depressive Symptoms

Changes to Positive Self-Schemas After a Positive Imagery Training are Predicted by Participant Characteristics in a Sample with Elevated Depressive Symptoms

Coparenting conflict moderates the association between maternal prenatal depressive symptoms and infant regulatory capacity

AbstractAs a development‐enhancing or a risk‐promoting environment, coparenting may shape the association between maternal prenatal depressive symptoms and infant regulatory capacity. This study aimed to analyse the moderator role of coparenting cooperation and conflict in the association between maternal prenatal depressive symptoms and infant regulatory capacity at 3 months. The sample comprised 103 primiparous couples (N = 206 parents) and their 3‐month‐old infants (53.7% female). Mothers reported on depressive symptoms at the first trimester of pregnancy, and both parents reported on coparenting, and infant regulatory capacity at 2 weeks and 3 months postpartum. Higher levels of maternal prenatal depressive symptoms and higher levels of coparenting conflict reported by parents at 2 weeks postpartum were associated with lower infant regulatory capacity at 3 months. Coparenting conflict at 2 weeks postpartum accentuated the association between maternal prenatal depressive symptoms and infant regulatory capacity at 3 months. The results support a view of coparenting conflict as a risk‐promoting environment that can accentuate the association between maternal prenatal depressive symptoms and infant regulatory capacity. Infants in families with mothers with elevated prenatal depressive symptoms and with high levels of coparenting conflict may be at high risk of low regulatory capacity.

Symptoms of depression, but not PTSD, influence cognitive performance in healthy Army National Guard Soldiers.

Research suggests that comorbid depression and PTSD may contribute to cognitive impairment. However, few studies have explored this dynamic in military personnel who report only subclinical symptoms of PTSD and depression. Army National Guard Soldiers (ARNG; N = 1415) completed the Automated Neuropsychological Assessment Metrics (ANAM), the PTSD Checklist (PCL), and the Center for Epidemiological Studies Depression Scale (CES-D). The effects of PTSD and depression symptoms on ANAM performance were examined using multiple linear regression analyses. Exploratory factor analysis and regression models examined the relationship between symptom clusters and ANAM performance. Six factors were identified: avoidance/flashbacks, cognitive/social difficulty, depressed mood, positive mood, sleep difficulty, and hypervigilance. Elevated symptoms of depression (measured using factor scores) were associated with poorer attention (β range -0.19-0.18, p range < 0.01-0.04, f2 effect size range 0.02-0.94). Depression symptoms were associated with diminished attentional performance in a large sample of ARNG Soldiers who reported no clinical diagnosis. This study was limited in that unmeasured factors other than depression, PTSD, or demographics may explain much of the variance in cognitive performance. These findings highlight the importance of careful mental health screening and strategies to heighten awareness of the potential detrimental effects of depression and PTSD on health and performance.

Anxiety, depression, and fear of cancer recurrence in head and neck cancer.

Patients with head and neck cancer (HNC) report some of the highest levels of psychological distress amid managing their disease as well as debilitating and disfiguring treatment side effects. Fear of cancer recurrence (FCR) is a top unmet need and concern of patients with HNC. Prior research suggests elevated symptoms of anxiety and depression are potential antecedents to FCR, but findings have been limited in HNC populations. The aim of the present study was to examine the early level and change in symptoms of anxiety and depression in relation to later change in FCR among patients with HNC. The study is a secondary analysis of data collected from 2011 to 2014 through the Head and Neck 5000 Study in the United Kingdom. A sample of 4,891 patients completed self-report longitudinal assessments of anxiety and depression symptoms at baseline, 4, and 12 months and FCR at 4 and 12 months. Utilizing multiple indicator latent change score modeling, results revealed baseline anxiety and increases in anxiety from baseline to 4 months were both positively associated with increases in FCR from 4 to 12 months. Neither baseline depression nor change in depression from baseline to 4 months were significantly associated with FCR change. Findings indicate that early level and increases in symptoms of anxiety were markers of increased FCR in patients with HNC. Future research may consider anxiety as a unique antecedent and maintaining factor of FCR and targeting anxiety early in the cancer trajectory may have downstream effects on FCR development. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Psychometric properties of the Child Anxiety and Depression Life Interference Scale - Young Adult version.

A life interference measure specifically designed for young adults with anxiety and depressive symptoms does not currently exist. This paper describes the development and psychometric evaluation of a brief self-report measure of life interference associated with young adult anxiety and depression, the Child Anxiety and Depression Life Interference Scale - Young Adult version (CADLIS-YA). Cross-sectional, correlational and exploratory factor analysis (EFA). Five-hundred and thirty-two participants aged 18-24 years recruited from an undergraduate and community sample completed the CADLIS-YA. An EFA supported a three-factor model describing the impact of young adult anxiety and depression on social life, family and daily life interference. Test-retest reliability and internal consistency were good to excellent. Convergent validity was demonstrated, and the scale differentiated between young adults with and without elevated anxiety and depressive symptoms. Support for divergent validity was limited. The CADLIS-YA is a reliable and valid life interference measure for young adults with symptoms of anxiety and depression. It is potentially suitable for administration in low-resource research settings and it has promise for use in clinical settings; however, it needs validation in a clinical sample.

Transitioning to fatherhood: Prospective effects of wellbeing on future depression symptoms.

Becoming a father is a critical period of life transition. Evidence suggests that lifetime history of mental health disorder/s and elevated depressive symptoms prior to conception increase risk for men's postnatal depression. Less is understood about the role of positive mental health, or wellbeing, as a protective factor for future depressive outcomes during the transition to fatherhood. The present study investigated whether men's post-natal depressive outcomes were associated with pre-conception levels of wellbeing and whether wellbeing during the post-natal period predicted depressive outcomes post-infancy. Secondary analysis of data from a national, longitudinal cohort study of men's health, namely, The Ten to Men Study (TTM), was conducted. Participants in the pre-conception sample were n = 350 men for whom data were available at both a pre-conception baseline and post-natal follow-up. The post-natal sample were n = 427 men with post-natal baseline data and post-infancy follow-up. Multivariate negative binomial regressions and logistic regression models were used to determine pre-conception and post-natal predictors of future depressive outcomes. Men's pre-conception depressive symptoms were the best predictor of post-natal depressive symptoms (IRR = 1.089, p < 0.001) and risk of moderate-severe depression (IRR = 1.193, p = 0.005) the latter of which was also predicted by a previous mental health diagnosis (IRR = 3.079, p = 0.029). Similarly, post-natal depressive symptoms were the best predictor of post-infancy depressive symptoms (IRR = 1.089, p < 0.001) and risk of moderate-severe depression (IRR = 1.193, p = 0.005) alongside lifetime prevalence of a mental health disorder (symptoms: IRR = 1.317, p = 0.011; moderate-severe depression: IRR = 2.606, p = 0.023). Preconception levels of wellbeing predicted lower post-natal depressive symptoms (IRR = 0.988, p < 0.001) and reduced risk of moderate-severe depression (IRR = 0.940, p = 0.002) after controlling for baseline symptoms and sociodemographic and behavioural confounds; however, wellbeing during the post-natal period did not predict either depressive outcome post-infancy. Fatherhood-specific risk factors for mental health outcomes (e.g., conception difficulties, maternal postnatal mental health) were not assessed in the present study, and only one aspect of wellbeing was captured. Screening for history of common mental health disorders and current symptoms is recommended to inform preventative approaches to paternal mental health care during early fatherhood. Inclusion of wellbeing in such screening procedures may be beneficial, however, further research is required to elucidate the prospective associations between wellbeing and depressive symptoms during the transition to fatherhood.

Depression Symptoms Moderate Associations between Daily Functioning and Neuropsychological Performance in Mexican American Adults.

The influence of depression on the relationship between cognition and daily living in aging Mexican American adults requires further investigation, given projected trends in general growth as well as prevalence of depression and Alzheimer's disease and related dementias (ADRD) in this population. In the present study, we examined the extent to which depression (assessed using the Geriatric Depression Scale - 15 item version) moderated the association between reported daily functioning (assessed using the Functional Activities Questionnaire [FAQ]) and objective neuropsychological performance in aging Mexican American adults in the National Alzheimer's Coordinating Center cohort. Worse reported daily functioning (higher FAQ scores) was associated with worse memory and language performance among participants without elevated depression symptoms (ps < .05), but no associations were observed among those with elevated symptoms (ps > .05). Moreover, depression did not moderate associations of reported daily functioning with performance in attention and working memory or executive functioning and processing speed (ps > .05). Aging Mexican American adults with elevated depression symptoms may have subjective informant reports of daily functioning that are discrepant from their objective performance on formal tests of memory and language. Within the context of neuropsychological evaluations for ADRD, failure to adequately assess mood to inform the nature of cognitive and/or functional changes could result in misdiagnosis and lead to delayed, premature, and/or improper intervention with this population.

Social factors that promote resilience in adolescents with depression: a systematic review

Abstract Background A socially protective environment matters. Social factors can protect against the development of depression among adolescents in community samples. There is however scant knowledge about their buffering role on the impact of depressive symptoms in adolescents in a clinical setting. Understanding these factors can help explaining why some children function well despite of their depression symptoms. In this review, we aimed to identify which social protective factors mitigate impairment from depression in adolescents. Methods We included peer-reviewed, cross-sectional and longitudinal studies using the following search strategy: Social protective factors AND depression or depression symptoms AND adolescents AND daily impairment, yielding 1737 hits. Included studies focused on social protective factors in relation to a depression diagnosis or depression symptoms severity, in adolescents age 11-24. Preliminary results We found 6 studies that examined the relationship between social protective factors and impairment or severity of depression symptoms in adolescents with a clinical depression or elevated symptoms. In these studies, higher rates of parental attachment, parental monitoring and school belonging moderated the relation between depression symptoms and daily impairment. Higher rates of family support and peer belonging were associated with the low depressed mood group. The rest of the studies tested the association of social protective factors on the development of depression symptoms in non-clinical populations. Conclusions There are limited studies on the buffering role of social protective factors in adolescents with clinical depression. Next, we will focus on non-clinical, longitudinal studies to explore which social protective factors moderate the development of depression over time. We aim to identify social factors that can mitigate the development of depression in community samples and are potentially important for clinical settings. Key messages • There is a scarcity of studies that explored the relation between social protective factors in adolescents with elevated depression symptoms or depression diagnosis. • The role of social protective factors that moderate the development of adolescent depression symptoms over time should be prioritized in the development of intervention programs.

Exploring the effects of mental health on bonding and caregiving among pregnant and postpartum persons with likely depression and/or PTSD in South Africa: A qualitative analysis.

Perinatal mental health disorders place a particularly high public health burden on South Africa (SA) via negative health outcomes for the birthing parent and adverse health outcomes for infants (e.g., low birth weight, preterm deliveries, malnourishment) as well as emotional and behavioral problems in children. Depression, posttraumatic stress disorder (PTSD), and other mental health disorders may also compromise engagement in HIV prevention behaviors during the perinatal period, when HIV acquisition risk increases. This is particularly important in SA, where almost a quarter of women between ages 15 to 49 have HIV. There is little research exploring the anticipated impacts mental health symptoms have on one's ability to emotionally connect or caregive after delivery; this critical information will enable providers to support women and their mental health during the transition from pregnancy to postpartum. HIV-negative pregnant persons were recruited from an antenatal clinic in Cape Town as a part of a larger study investigating mental health barriers to pre-exposure prophylaxis (PrEP) uptake during pregnancy. Participants qualified for an in-depth interview based on elevated symptoms of depression and/or PTSD. The interviews explored the likely impact of their mental health symptoms on their baby's wellbeing, their ability to bond with their baby, and their ability to meet their baby's needs. Following the principles of thematic analysis, we identified three main themes that described these relationships: (1) a strong perceived connection between maternal mental health and baby's wellbeing; (2) perceived strains on bonding with the baby; and (3) negative impact of mental health on likelihood of completing parenting tasks. This study will inform future mental health programming to prepare pregnant persons with mental health symptoms for a successful postpartum period with respect to bonding and caring for their infant.

Intergenerational transmission of depressive symptoms: Maternal socialization of infant positive affect as a mediator.

Parenting behaviors play an important role in the transmission of depressive symptoms from mothers to children. Although reduced positive affect is a central feature of depression, models of intergenerational transmission have neglected maternal socialization of positive affect as a mediating mechanism. This study investigated whether maternal responses to infant positive affect mediate the link between mothers' and toddlers' depressive symptoms. A community sample of 128 mothers (58% White) and their infants (Mage = 6.65 months, SD = 0.53 at first visit) participated in 3 assessments over a 1-year period. Assessments included self-reports of postpartum depressive symptoms, observational measures of maternal responses to infant positive affect and maternal sensitivity, and mother report of toddlers' depressive problems. Mediation analyses revealed that mothers with elevated postpartum depressive symptoms displayed fewer supportive responses to their infants' positive affect. In turn, infants who received fewer supportive responses had more depressive problems in toddlerhood. The indirect effect of postpartum depressive symptoms on toddlers' depressive problems via maternal supportive responses remained significant after controlling for maternal sensitivity. Findings suggest that maternal responses to infant positive affect play a unique role in the intergenerational transmission of depressive symptoms. The theoretical and practical implications of these findings are discussed.

Longitudinal association of homocysteine with depressive and anxiety symptoms among urban adults: healthy aging in neighborhoods of diversity across the life span study.

Longitudinal associations of homocysteine (HCY) with depressive symptoms scores among urban adults remain under-studied, especially across sex, race and levels of anxiety. We examined longitudinal associations of homocysteine (HCY) with depressive symptoms scores among urban adults, before and after stratifying by sex, race and anxiety level, using data from 1460 Healthy Aging in Neighborhoods of Diversity across the Lifespan Study (HANDLS) participants aged 30-64 y at v1 (2004-2009), followed across 3 visits up to 2017. In addition to LnHcyv1, we used group-based trajectory models predicting z-transformed likelihood of greater LnHcy with age (Hcytraj). Total and domain-specific depression symptoms were scored using Center for Epidemiologic Studies Depression (CES-D) scale. Mixed-effects linear regression models and Cox proportional hazards models were utilized. A positive association was found between baseline LnHcyv1 and CES-D total scores in reduced socio-demographic- adjusted Model 1 (β (standard error [SE]) = + 2.337 (0.902), P = 0.010), a relationship slightly attenuated in fully adjusted Model 2 (Model 1 adjusting for lifestyle and health factors) with a β (SE) = + 1.825 (0.883), P = 0.039. Individuals with lower anxiety levels experienced faster CES-D domain 2 score annualized increase over time (interpersonal problems) with higher LnHcyv1 (β (SE) = 0.041 (0.018), P = 0.024). Hcytraj was linked to incident elevated depressive symptoms (CES-D total score ≥16) overall (fully adjusted model: HR = 1.09, 95% CI: 1.03-1.14, P = 0.001), particularly among women and those living in poverty. Baseline and "high trajectory" of LnHcy were positively associated with depressive symptoms and elevated depressive symptom incidence, in a sex-, race-, poverty status- and anxiety-level specific manner.

Managing Cancer and Living Meaningfully (CALM) in Adults with Brain Metastases: A NIH ORBIT Model Phase II Feasibility and Proof-of-Concept Trial

Abstract Background Managing Cancer and Living Meaningfully (CALM) is a brief, evidence-based psychotherapy designed to help patients with advanced cancer cope with the practical and profound challenges of their illness. However, no study has systematically examined CALM in adults with brain metastases, despite the well-documented incidence of distress in this growing population. The primary aim of this trial was to assess the feasibility and acceptability of CALM in adults with brain metastases. Methods Patients with brain metastases (N=13) and elevated symptoms of depression and/or death anxiety enrolled in this single-arm trial. CALM was administered in six biweekly sessions, with outcomes assessed at baseline and post-intervention. Feasibility was assessed based on established metrics including enrollment and retention rates. Acceptability was measured by post-session surveys and post-intervention interviews. Preliminary signal change on measures of psychological distress was explored. Results Of the 13 enrolled participants, 11 completed baseline assessments and initiated treatment: 73% female, Mage=58 years (SD=12.9; range=37-75). Nine completed the study (81% retention rate). Overall, participants reported high perceived benefit and would recommend the program to others. Baseline to post-intervention assessments indicated improvements in depression, death anxiety, generalized anxiety, post-traumatic stress, suicidal ideation, and spiritual well-being. Life quality, substance use, and fear of cancer recurrence remained relatively stable. Conclusions CALM is feasible and acceptable and may improve psychological distress in adults with brain metastases. The findings of this study align with our previous trial of patients with malignant glioma and support a future NIH ORBIT Phase II randomized pilot trial of CALM in neuro-oncology.

Specific depressive symptoms, body mass index and diabetes in middle-aged and older Chinese adults: Analysis of data from the China Health and Retirement Longitudinal Study (CHARLS)

BackgroundThis study examined the association between specific depressive symptoms and incident diabetes, and whether overweight or obesity mediates this relationship among middle-aged and older adults in China. MethodsIn a nationally representative prospective cohort study of 11,893 middle-aged and older Chinese adults without baseline diabetes, we used Cox models to assess the association between depressive symptoms and diabetes. The quantile g-computation (qgcomp) model evaluated the contribution of 10 specific depressive symptoms to diabetes risk, and a two-stage regression method explored the mediation effect of overweight or obesity. ResultsOver a median follow-up of 7.1 years, 1,314 cases of diabetes were identified. Elevated depressive symptoms were associated with increased diabetes risk (HR 1.23; 95 % CI 1.09–1.38). Eight out of 10 depressive symptoms were significantly associated to diabetes, with loneliness (weight = 18 %; HR 1.23; 95 % CI 1.10–1.39), restless sleep (weight = 17 %; HR 1.16; 95 % CI 1.04–1.29), and bother (weight = 15 %; HR 1.19; 95 % CI 1.07–1.33) being the primary contributors. Mediation analysis showed that overweight and obesity reduced the depression-diabetes risk association by 8.21 % and 12.61 %, respectively. LimitationsDiagnosis of diabetes was self-reported. ConclusionsEight out of ten specific depressive symptoms were associated to diabetes, overweight and obesity may partially mitigate the effect of depressive symptoms on diabetes among middle-aged and older adults in China. Clinical implicationsOur results highlight the importance of tailoring diabetes prevention and management strategies according to specific depressive symptoms among middle-aged and older adults in China.

Association between changes in depressive symptoms and risk of anemia: from the China Health and Retirement longitudinal study

BackgroundPrevious studies have reported that anemia was associated with depression, but the association between changes in depressive symptoms and the risk of anemia was unclear. This study aimed to explore whether changes in depressive symptoms were associated with anemia among the middle-aged and elderly adults.MethodsA total of 6112 patients aged 45 years and older from the China Health and Retirement Longitudinal Study (CHARLS) were included in this analysis. Elevated Depression Symptoms (EDS) was defined as the Center for Epidemiological Studies Depression Scale-10 score ≥ 10. Depression status was defined as no depressive symptom [no EDS at Wave 1 (2011–2012) and Wave 2 (2013–2014)], decreasing depressive symptoms (EDS at Wave 1, no EDS at Wave 2), increasing depressive symptoms (no EDS at Wave 1, EDS at Wave 2), persistent depressive symptoms (EDS at Wave 1 and Wave 2). Multivariable logistic regression analyses were conducted to estimate the relationships between depressive symptoms and the changes and risk of anemia.ResultsDuring the follow-up of Wave 1 and Wave 3 (2015–2016), 906 participants (14.82%) developed anemia, the multivariable-adjusted odds ratio for the depressive symptom compared with the no depressive symptom was 1.24 (95% CI, 1.12–1.58) for anemia. From Wave 2 to Wave 3, there were 828 participants (14.62%) diagnosed with anemia. Compared to participants with no depressive symptom, those with persistent depressive symptoms during Wave 1 and Wave 2 had the significantly elevated risk of anemia (odds ratio 1.44, 95% CI 1.21–1.84).ConclusionsThe present study demonstrated that baseline depressive symptoms and changes in depressive symptoms were associated with increased risks of anemia.

Feasibility, acceptability, and fidelity of remote-delivered abbreviated mindfulness-based cognitive therapy interventions for patients with migraine and depressive symptoms.

This study was an open-label single-arm clinical trial evaluating the fidelity, feasibility, acceptability, and clinical signal of abbreviated mindfulness-based cognitive therapy (MBCT-brief) delivered either via telephone (MBCT-T) or by video conferencing (MBCT-V) for people with migraine and comorbid depressive symptoms. Migraine is commonly comorbid with elevated depressive symptoms. MBCT reduces depressive symptoms and shows promise to reduce migraine-related disability. An abbreviated and remotely delivered version of MBCT could increase access to care. People with migraine and elevated depressive symptoms were recruited from a large urban health system. Participants were assigned in blocks of eight to receive an evidence-based MBCT-brief treatment, including eight weekly group classes and home practice delivered via telephone (MBCT-T) or video (MBCT-V); MBCT-T was randomly selected for the first block. Sessions were recorded and coded for treatment fidelity. Feasibility was assessed via session attendance (primary), homework completion, recruitment rate, and survey completion rate. Acceptability was assessed via the eight-item Client Satisfaction Questionnaire (CSQ-8; primary), the Credibility/Expectancy Questionnaire (CEQ), the System Usability Scale (SUS), and items assessing survey acceptability. Participants completed the Headache Disability Inventory (HDI) and Quick Inventory of Depressive Symptomatology-Self Report 16-item (QIDS-SR16) at baseline, mid-treatment, and post-treatment. Feasibility and acceptability rates were compared to a priori benchmarks. Participants (n = 16) were all female with a mean (standard deviation [SD]) age of 45 (13) years, the majority of whom identified as White (13/16, 81%) and non-Hispanic (14/16, 88%). The intervention met the a priori criteria set for therapist fidelity to treatment protocol (mean [SD] MBCT-Treatment Acceptability and Competence Scale Adherence score 2.9 [0.2]), feasibility (mean [SD] session attendance was 7.9/8 [0.3]), and acceptability (mean [SD] CSQ-8 score 28.8 [3.3]) for the entire sample and for each treatment arm. The usability of the remote-delivery system was high across study participants (mean [SD] SUS score 84.8 [11.0]). Survey procedures were broadly deemed acceptable, with at least 80% participants either endorsing "Agree" or "Strongly Agree" across all items. Using Wilcoxon tests, we observed significant reductions in both the HDI (pre-treatment median [interquartile range] score 63 [40, 70] vs. post-treatment 36 [26, 54], p = 0.004) and the QIDS-SR16 (pre-treatment median [interquartile range] score 8 [5, 13] vs. post-treatment 4 [3, 6], p = 0.003). We found that remotely delivered MBCT-brief for migraine and depressive symptoms was feasible and acceptable to patients in both the telephone and video modalities. Intervention was associated with significant post-treatment reductions in headache-related disability and depressive symptomatology, findings that must be interpreted cautiously in the absence of a control group.

Aesthetic chills modulate reward learning in anhedonic depression

ObjectiveThis study aimed to examine the potential of experiencing aesthetic chills to enhance reward learning in individuals with elevated depressive symptoms, specifically anhedonia, by investigating the effect of chills on participants' ability to modulate behavior as a function of rewards. MethodsA total of 103 participants with elevated depressive symptoms took part in the experiment. Among them, 59 participants had depressive symptoms (BDI ≥ 20), with 26 classified as “High Anhedonic” (HA) and 33 as “Low Anhedonic” (LA). Additionally, 39 participants without elevated depressive symptoms (BDI < 20 and SHAPs <32) were included as the control group. We utilized ChillsDB, an open-source database of validated audiovisual stimuli known to elicit chills in the US population. ResultsAnhedonic participants who experienced chills demonstrated a significant increase in response bias (p = .004) towards rewards compared to those who did not experience chills. Highlighting specificity, no significant difference in reward bias was observed among LA participants. ConclusionsThese findings suggest that the experience of chills has the potential to impact reward learning in anhedonic individuals, aligning with the known neurobiology of this phenomenon. These results highlight the potential of aesthetic chills as a novel approach to elicit and enhance positive affect in depressed populations.

The effects of deep TMS on purpose in life, quantitative EEG and event-related potentials in major depressive disorder

Background: Perceived purpose in life (PIL) is linked with many vital health outcomes, including Major Depressive Disorder (MDD). Methods: In this study, biomarkers associated with depression and PIL were investigated using Brain Network Activation (BNA) based quantitative electroencephalography (QEEG) and event-related potential (ERP) measures in a sample of individuals with MDD. Data were analyzed before and after a 36-session, Deep transcranial magnetic stimulation (TMS) program. Results: At baseline, the study observed that increased slow-frequency resting-state activity in the frontal and temporal regions correlated with higher levels of depression and reduced PIL. Additionally, a reduced P3b amplitude was found to predict elevated depressive symptoms. However, with the application of Deep TMS treatment notable improvements were observed in both depression (p < .001. d = 2.15) and PIL (p < .001, d = 1.59) levels. The treatment also successfully regulated resting-state QEEG (delta/beta) and ERP characteristics (P200 latency), bringing them closer to healthy levels. Conclusions: This attenuation of brain activity patterns relating to depression is encouraging as it suggests that effects were robust and are more likely to be sustained over time. This study represents the first exploration of the effects of Deep TMS on PIL and relevant QEEG and ERP biomarkers. The initial evidence suggests that Deep TMS holds promise in enhancing both PIL and neurophysiological health. Future investigations should continue exploring the utility of Deep TMS in targeting a wide range of neuropsychological and physical health conditions, leveraging objective biomarkers such as QEEG and ERP.