Elevated Risk Of Depression Research Articles

The impact of oral health on depression: A systematic review.

As of 2020, about 21% of adults in the United States have a diagnosable mental health disorder, excluding substance use and developmental disorders. Depression, predicted by the WHO to be the leading cause of disease burden by 2030, is linked to various systemic conditions and has been associated with poor oral health. Both behavioral factors, like poor dental hygiene and irregular visits, and biological mechanisms, such as changes in salivary immunity, contribute to this connection, which impacts overall well-being and quality of life. This systematic review aims include: (1) Does tooth loss affect depression? (2) Does oral pain, such as that experienced during chewing and speaking, impact depression? (3) Does oral functionality, including chewing and speaking, influence depression? (4) Does overall oral health affect depression? We conducted a systematic search of PubMed, EBSCO host, Medline, and Google Scholar databases from January 2000 to June 2024 using relevant keywords. Studies examining the impact of oral health parameters (tooth loss, oral pain, oral functionality, overall oral health) on depression were included. Articles were included if (1) full text manuscripts in English were available, (2) the study described the association of oral health and depression, and (3) the independent value was an oral related factor and the dependent value was depression. The following were excluded from our analysis: (1) any articles where oral factors were not the independent value, (2) systematic reviews, (3) case reports, and (4) duplicate studies among our databases. Thirty-one studies met the inclusion criteria. Tooth loss, oral pain, and impaired oral functionality were consistently associated with increased depressive symptoms across the included studies. Greater tooth loss was linked to higher odds of both onset and progression of depression. Oral pain exacerbated depressive symptoms, while difficulties in chewing or speaking were associated with elevated risks of depression. There is a bidirectional relationship between oral health and depression, highlighting the urgent need for comprehensive public health initiatives. Integrating oral health assessments into routine medical care, and developing targeted interventions are crucial steps to mitigate the impact of poor oral health on mental health outcomes.

Chronic stress in adulthood results in microvascular dysfunction and subsequent depressive-like behavior

Depression is a prevalent mental disorder characterized by unknown pathogenesis and challenging treatment. Recent meta-analyses reveal an association between cardiovascular risk factors and an elevated risk of depression. Despite this, the precise role of vascular injury in depression development remains unclear. In this investigation, we assess vascular system function in three established animal models of depression— chronic unpredictable mild stress (CUMS), chronic social defeat stress (CSDS) and maternal separation (MS)—utilizing ultrasonography and laser Doppler measurement. All three model animals exhibit anhedonia and despair-like behavior. However, significant microvascular dysfunction (not macrovascular) is observed in animals subjected to CUMS and CSDS models, while such dysfunction is absent in the MS model. Statistical analysis further indicates that microcirculation dysfunction is not only associated with depression-like behavior but is also intricately involved in the development of depression in the CUMS and CSDS models. Furthermore, our study has proved for the first time that endothelial nitric oxide synthase-deficient (eNOS+/−) mice, which is a classic model of vascular endothelial injury, showed depression-like behavior which occurred two months later than microvascular dysfunction. Notably, the mitigation of microvascular dysfunction successfully reverses depression-like behavior in eNOS+/− mice by enhancing nitric oxide production. In conclusion, this study unveils the pivotal role of microvascular dysfunction in the onset of depression induced by chronic stress in adulthood and proposes that modulating microvascular function may serve as a potential intervention in the treatment of depression.

Association of dietary antioxidant intake with depression risk and all-cause mortality in people with prediabetes

People with diabetes has an elevated risk of depression, and depression contributes to a worse prognosis for people with diabetes. Dietary antioxidants have been shown to reduce the risk of depression in the general population. Therefore, we hypothesized that dietary antioxidants would also help to reduce the risk of depression and all-cause mortality in people with prediabetes. A total of 8789 participants aged 20 years and older from the 2005–2018 National Health and Nutrition Examination Surveys who met the diagnostic criteria for prediabetes were included in our study. The associations between six dietary antioxidant intakes and the composite dietary antioxidant index (CDAI) with depression risk and all-cause mortality were assessed using weighted logistic and Cox regression. Possible nonlinear associations were further explored using restricted cubic spline. To ensure the reliability of the findings, the multiple imputations by chained equation were applied to missing covariates to avoid potential bias. Our study found that moderate dietary antioxidant intake prevents depression and improves prognosis in people with prediabetes. Moreover, a CDAI score near three allows for maximum benefit. Our findings could provide clues for early intervention in people with diabetes.

Evaluation of low vagally-mediated heart rate variability as an early marker of depression risk

BackgroundBoth low vagally-mediated heart rate variability (HRV) and depression have been shown to be risk factors for cardiovascular disease (CVD). We recently identified an HRV cutpoint below which persons have an increased risk for several cardiometabolic disorders. However, no cutpoint exists to identify those at risk for depression. MethodsThe association between daytime HRV and diagnostically validated depression cutoffs using the five-item World Health Organization Well-being Index (WHO-5) was examined in adults from the Mannheim Industrial Cohort Study (n = 9973; Mage = 41.9[10.9]; 20 % women [n = 1934]). The aim was to identify HRV cutpoints for individuals who may have clinical depression. ResultsRegression adjusting for age, sex, and linear trend showed a significant quadratic association between depression, indexed by WHO-5 scores and HRV, indexed by the root mean square successive differences (RMSSD) in milliseconds (ms) (p < 0.001). Logistic regression models adjusting for age, sex, and heart period (i.e., inter-beat intervals) compared the clinically depressed (WHO-5 ≤ 28) and those with a screening diagnosis of depression (WHO-5 ≤ 50) to the rest of the population. Significant odds ratios suggested two RMSSD values 25 ± 2 ms (OR = 1.39 [1.17, 1.64]) and 35 ± 2 ms (OR = 1.17 [1.02, 1.34]) that may be used to identify those with an elevated risk for depression. LimitationsThe sample was primarily German men. Fitness and anti-depressant use were not available. ConclusionsAs HRV is a brief measure that can be used in clinical settings, our HRV cutpoints have implications for the early detection of those at risk for psychological and cardiometabolic disorders.

Regional gray matter changes in steatotic liver disease provide a neurobiological link to depression: A cross-sectional UK Biobank cohort study

BackgroundSteatotic liver disease (SLD) is characterized by excessive accumulation of lipids in the liver. It is associated with elevated risk of hepatic and cardiometabolic diseases, as well as mental disorders such as depression. Previous studies revealed global gray matter reduction in SLD. To investigate a possible shared neurobiology with depression, we examined liver fat-related regional gray matter alterations in SLD and its most significant clinical subgroup metabolic dysfunction-associated steatotic liver disease (MASLD). MethodsWe analyzed regional cortical thickness and area obtained from brain MRI in 29,051 participants in UK Biobank. Liver fat amount was computed as proton density fat fraction (PDFF) from liver MRI scans. We examined the relationship between brain structure and PDFF, adjusting for sociodemographic, physical, lifestyle, and environmental factors, as well as alcohol intake and a spectrum of cardiometabolic covariates. Finally, we compared patterns of brain alterations in SLD/MASLD and major depressive disorder (MDD) using previously published results. ResultsPDFF-related gray matter alterations were region-specific, involving both increases and decreases in cortical thickness, and increased cortical area. In several regions, PDFF effects on gray matter could also be attributed to cardiometabolic covariates. However, PDFF was consistently associated with lower cortical thickness in middle and superior temporal regions and higher cortical thickness in pericalcarine and right frontal pole regions. PDFF-related alterations for the SLD and the MASLD group correlated with those observed in MDD (Pearson r = 0.45–0.54, p < 0.01). ConclusionThese findings suggest the presence of shared biological mechanisms linking MDD to SLD and MASLD. They might explain the well-known elevated risk of depression in these groups and support early lifestyle interventions and treatment of metabolic risk factors for the successful management of the interconnected diseases depression and SLD/MASLD.

Exploring the Impact of the COVID-19 pandemic on depression in middle-aged and older Canadians with diabetes: Insights on incidence, recurrence, and risk factors from the Canadian longitudinal study on aging

PurposeIndividuals with diabetes have an elevated risk of depression. The occurrence of the COVID-19 pandemic may have further impacted the mental health of patients living with diabetes. This study aims to examine: 1) factors associated with the development of depression during the COVID-19 pandemic among individuals with diabetes without a history of depression; and 2) factors associated with the persistence or recurrence of depression during the pandemic among those with diabetes, and a pre-pandemic history of depression. MethodsSecondary analysis of four waves of the Canadian Longitudinal Study on Aging surveys. Canadian residents between the ages of 45–85 were recruited in 2012–2015 and subsequently completed three follow-up surveys. A total of 2,730 individuals with diabetes were included in this study. ResultsAmong those without a prior history of depression, the incidence of new depression was 12.9 % (95 % CI 11.3–14.4 %) during the pandemic. Among those with a history of depression, approximately half (48.5 %; 95 % CI 45.4–51.7 %) were depressed during the pandemic. Factors associated with increased risk of incident and recurrent depression during the pandemic among older adults with diabetes include being female, greater educational attainment, higher income/savings, functional limitations, loneliness/social isolation, chronic pain, family conflict, and difficulties accessing health care. ConclusionAmong Canadians living with diabetes, both the incidence and recurrence of depression increased during the pandemic. Continued efforts to support the psychological well-being of older adults with diabetes are needed.

Habitual Caffeine Use Is Associated With Heightened Cortisol Reactivity to Lab-Based Stress in Two Samples.

Habitual caffeine consumption protects against depression but through unclear mechanisms. Although habitual caffeine use predicts cortisol release in response to other acute stressors (e.g., exercise), this is less examined with lab-based psychosocial stress in healthy adults. Furthermore, caffeine-induced cortisol increases may mask theory-predicted cortisol blunting to robust stress in people with elevated depression risk. In two samples, we tested whether acute (same-day) and habitual caffeine use would predict greater cortisol reactivity to lab-based stress, and whether caffeine would "mask" the effect of a depression risk factor, trait rumination, on blunted cortisol reactivity. In sample 1, N = 128 emerging adults completed one of three Trier Social Stress Test conditions: nonevaluative control, ambiguously evaluative intermediate, or explicit negative evaluative. In sample 2, N = 148 emerging adults completed either a control or negative evaluative condition. In both samples, multilevel growth curve modeling indicated that habitual caffeine use ( t = -1.99, p = .048; t = -2.73, p = .007, samples 1 and 2, respectively) but not acute caffeine use predicted heightened cortisol reactivity as a function of condition. In sample 1, the relationship between condition, rumination, and blunted cortisol was evident only in caffeine nonusers, which differed from users ( t = 2.82, p = .005), but in sample 2, the predicted blunting pattern was evident regardless of caffeine use. The results provide evidence that habitual caffeine use is associated with greater cortisol release under psychosocial lab-based stress and may mask the influence of psychosocial variables; future research should examine whether habitual caffeine-induced cortisol release has behaviorally activating effects that protect against depression.

Sleep and mental health of current and retired athletes across playing status and level of competition

Sleep and mental health problems are common in athletic cohorts; however, our knowledge is limited to current, elite athletes. We attempted to compare the symptomology of sleep and mental health problems across different playing statuses and competition levels. An online survey was completed by 946 adults from 37 sports (52.3% women) in seven countries. Athletes were currently competing, retired from competition (&lt;20 years ago), or temporarily unable to play (i.e. injury/season postponed), from all competition levels. Retired athletes were at greater risk of sleep disordered breathing than current athletes (OR=2.30, 95% CI[1.66,3.20]) and those unable to play (OR=1.83, 95% CI[1.07,3.13]. Retired athletes (OR=1.54, 95% CI[1.11,2.15]) and those unable to play (OR=2.15, 95% CI[1.36,3.39]) were at greater risk of compromised wellbeing than current athletes. Sports institute/university/college level and semi-professional athletes were at greater risk of anxiety than professional athletes (OR=2.82, 95% CI[1.29, 6.17]; OR=2.38, 95% CI[1.10, 5.16]), respectively. Current and retired athletes had comparable risk of sleep difficulty, depression, and anxiety, while retired athletes were at the greatest risk for sleep apnoea, reflecting previous literature. Foreclosure of sport may explain reduced wellbeing in retired and temporarily unable to compete athletes. Emerging athletes were at elevated risk for depression and anxiety, with distinct barriers and stressors to elite athletes. The high risk prevalence observed has significant implications for the assessment and identification of sleep and mental health issues in athletic populations, highlighting the importance of intervention and prevention strategies. Findings underscore the necessity for longitudinal research, increased transparency from sporting organisations, and enhanced support during and beyond athletic careers.

Unlocking Joy: Investigating the Impact of Parent-Child Communication on Happiness among Gen Z Filipinos

Generation Z, brought up in the era of pervasive technology and often labeled the “social media generation,” confronts elevated risks of depression, anxiety, and tragically, suicide (Abror et al., 2020). This study aimed to investigate the influence of parent-child communication on the happiness levels of Filipino individuals belonging to Generation Z, employing a sequential explanatory mixed-method approach. The quantitative phase involved 109 Filipino Gen Z participants, with an average age of 20 years old. Subsequently, in the qualitative phase, six Gen Z participants and their parents engaged in answering qualitative inquiries. Regression analysis revealed a significant association between parent-child communication and happiness levels. Additionally, qualitative findings highlighted the role of effective parent-child communication in nurturing positive development and enhancing overall happiness among youth. Importantly, the research emphasized the necessity for parents to gain deeper insights into the psychosocial challenges encountered by Generation Z, while also underscoring the youth’s preference for open, non-judgmental conversations with their parents. These insights prompt considerations regarding the most effective parenting styles within the Filipino context for fostering the well-being of Generation Z. The implications extend to counseling and psychological intervention practices, advocating for interventions that foster constructive communication between parent and child.

The impact of educational attainment on mental health: A Causal Assessment from the UKB and FinnGen Cohorts.

Observational studies report inverse associations between educational attainment and depression/anxiety risks, but confounding hinders causal inference. This study aimed to assess potential causal relationships using Mendelian randomization (MR). Two-sample MR analysis was conducted using genetic instruments for education, smoking, body mass index, and physical activity from published genome-wide association studies. Depression and anxiety data came from the UK Biobank ([UKB] 117,782 individuals) and FinnGen (215,644 individuals) cohorts. Inverse variance weighted regression determined associations between exposures and mental health outcomes. Increased educational attainment was causally associated with reduced risks of depression (odds ratio [OR] = 0.99 per year, 95% confidence interval [CI]: 0.990-0.996, P < .001) and anxiety (OR = 0.99, CI: 0.98-0.991, P < .001) in both cohorts. Smoking initiation conferred higher risks of depression (UKB OR = 1.05, CI: 1.03-1.06, P < .001; FinnGen OR = 1.20, CI: 1.10-1.32, P < .001) and anxiety (FinnGen only, OR = 1.10, CI: 1.01-1.21, P < .05). Likewise, maternal smoking history associated with greater depression (UKB OR = 1.15, CI: 1.10-1.35, P = .027) and anxiety susceptibility (FinnGen OR = 3.02, CI: 1.67-5.46, P = .011). Higher body mass index elevated depression risk in both cohorts. Physical activity showed no clear associations. This MR study provides evidence that education may causally reduce mental health disorder risk. Smoking, obesity, and low activity appear detrimentally linked to depression and anxiety. Improving access to education could offer effective strategies for lowering population psychiatric burden.

Suicide Risk Among Medical Students Associated With Loneliness, Burnout, and Depressive Symptoms.

Medical students face elevated risks of depression and suicide due to rigorous training demands. However, comparative research between medical and non-medical students is limited, hindering understanding of specific risks. This study compared 337 students (89 medical) on suicide risk, depression, perfectionism, burnout, loneliness, and internet addiction. Medical students showed significantly higher suicide risk, depression, perfectionism, burnout, and loneliness. Regression analysis identified medical student status, depressive symptoms, and loneliness as significant predictors of suicide risk. Mediation analysis revealed loneliness and depressive symptoms mediating the relationship between medical student status and suicide risk. Strategies to address mental health risks among medical students are crucial, including early screening and interventions. However, this study's limitations include self-report measures and a predominantly non-medical student sample. Further research is needed to explore causal relationships and interventions effectively.

The effects of family support and smartphone-derived homestay on daily mood and depression among sexual and gender minority adolescents.

Sexual and gender minority (SGM) adolescents are at elevated risk for depression. This risk is especially pronounced among adolescents whose home environment is unsupportive or nonaffirming, as these adolescents may face familial rejection due to their identity. Therefore, it is critical to better understand the mechanisms underlying this risk by probing temporally sensitive associations between negative mood and time spent in potentially hostile home environments. The current study included adolescents (N = 141; 43% SGM; 13-18 years old), oversampled for depression history, who completed clinical interviews assessing lifetime psychiatric history and depression severity as well as self-report measures of social support. Participants also installed an app on their personal smartphones, which assessed their daily mood and geolocation-determined mobility patterns over a 6-month follow-up period. Over the 6-month follow-up period, SGM adolescents reported elevated depression severity and lower daily mood relative to non-SGM youth. Interestingly, SGM adolescents who reported low family support experienced lower daily mood than non-SGM adolescents, particularly on days when they spent more time at home. Current findings reinforce evidence for disparities in depression severity among SGM adolescents and highlight family support as a key factor. Specifically, more time spent in home environments with low family support was associated with worse mood among SGM adolescents. These results underscore the need for clinical interventions to support SGM youth, particularly interventions that focus on familial relationships and social support within the home environment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prevalence and risk factors of depression and anxiety symptoms in intensive care unit patients with cardiovascular disease: A cross-sectional study.

To investigate the prevalence of anxiety and depression symptoms in intensive care unit (ICU) patients with cardiovascular disease (CVD) and to explore which elements are risk factors for the development of anxiety and depression symptoms. A cross-sectional study. A total of 1028 ICU patients with CVD were enrolled in this cross-sectional study. Logistic regression was used to assess risk factors and associations between anxiety and depression symptoms, and mediation analysis was used to explore the effect of risk factors on the association between anxiety and depression symptoms. Reporting of the study followed the STROBE checklist. The results showed that among ICU patients with CVD, 38.1% had anxiety symptoms, 28.7% had depression symptoms and 19.3% had both anxiety and depression symptoms, and there was a significant association between anxiety and depression symptoms. We also identified female gender, hypertension, hyperlipidemia and cardiac function class IV as independent risk factors for anxiety and depression symptoms. Importantly, these factors also mediated the association between anxiety and depression symptoms, emphasising their role in the psychological well-being of this patient group. ICU patients with CVD were prone to anxiety and depression symptoms. Female gender, hypertension, hyperlipidemia and cardiac function class IV were identified as independent risk factors that also served as mediators in the relationship between anxiety and depression symptoms. Especially, cardiac function class IV emerged as a critical factor in this association. It is imperative for critical care professionals to recognize the elevated risk of depression and anxiety among ICU patients with severe CVD, especially those with cardiac function class IV, hypertension, hyperlipidemia and females. Proactive and supportive measures are essential for this vulnerable group during their ICU stay to safeguard their mental health and prevent negative outcomes. No Patient or Public Contribution.

Heterogeneity in the co-occurrence of depression and anxiety among adolescents: Results of latent profile analysis

BackgroundDepression and anxiety co-occur frequently and there is heterogeneity in the co-occurrence of such symptoms; however, few previous studies investigated the heterogeneity based on person-centered perspectives in adolescents. The primary aim of our study was to explore it using latent profile analysis (LPA), a person-centered statistical approach. MethodThe Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were used to examine depression and anxiety symptoms in 7422 Chinese adolescents from 23 primary and secondary schools. To investigate latent profiles and assess profile validity, we employed Latent Profile Analysis (LPA), multinomial logistic regression, and analysis of variance. ResultsA three-profile model was suggested as the optimum: low (69.9 %), moderate (21.6 %), and high depression/anxiety (8.5 %). Female with higher negative cognitive bias and higher emotional regulation difficulty are more likely to be categorized in the high depression/anxiety group. Internet addiction, academic “Lying flat” and involution are significantly and positively linked with the severity of anxiety and depression. LimitationsReliance on self-reported measures may lead to response bias; the cross-sectional design limits our ability to study how symptom profiles and category membership change over time. ConclusionsThree latent profiles of the co-occurrence of depression and anxiety presented a parallel pattern, which serves as a poignant reminder of the imperative need to identify Chinese adolescents who may be at elevated risk for depression and/or anxiety, and promoting intervention that are meticulously tailored to address the unique symptom presentations of each individual.

Building Equitable Mental Health Care for Latino Children: Perspectives from Providers and Communities.

The current pediatric mental health crisis has disproportionately impacted Latino youth in the United States (US), as demonstrated by their elevated risks of depression, substance use disorder, and anxiety. Despite this, research suggests Latino youth receive inequitable mental health services. To understand best practices, challenges, and priorities in providing accessible and equitable mental health care for Latino youth from the perspectives of front-line mental health providers and Latino community members. A bicultural, bilingual researcher conducted semi-structured interviews with 20 participants with expertise in Latino mental health. Topics included barriers and facilitators to mental health care access and cultural tailoring of treatment for Latino youth. Rapid qualitative analysis was used to identify themes. Four themes were identified: (1) Navigating immigration concerns and acculturation, practitioners should consider immigration-related concerns and be trained to address acculturation-related stressors respectfully; (2) Adapting to the cultural needs and strengths of the communities, cultural humility education can allow providers to engage with both the strengths and needs of Latino families; (3) Engaging Latino caregivers as partners, it is critical to engage with Latino caregivers' cultural perspectives on parenting and mental health collaboratively; and (4) Addressing systemic barriers to promote access, providers must recognize and attempt to alleviate the systemic barriers that limit families from seeking care. Participants identified several practical strategies to improve the provision of mental health services for Latino children. Future directions, policy and practice implications, and limitations are discussed.

The role of loneliness in the association between sexual orientation and depressive symptoms among older adults: A prospective cohort study

BackgroundThis study aims to understand the mechanisms contributing to the elevated risk of depression among sexual minority older adults compared to heterosexuals. Specifically, the role of loneliness as a potential mediator is investigated to inform targeted interventions for preventing depression in sexual minority populations. MethodsData from the English Longitudinal Study of Ageing, focusing on adults aged over 50, were analysed. Sexual orientation (sexual minority or heterosexual) and loneliness scores (UCLA scale) were assessed at wave six (2010−2011), while depressive symptoms (CESD) were assessed at wave seven (2013–14). Linear regression models and mediation analyses, using g-computation formula and adjusted for confounders, were conducted. ResultsThe sample included 6794 participants, with 478 (7.0 %) identifying as sexual minorities. After adjustments, sexual minorities scored higher on depressive symptoms at wave seven (mean difference): 0.23, 95 % CI 0.07 to 0.39) and loneliness at wave six (MD: 0.27, 95 % CI 0.08 to 0.46). Loneliness was positively associated with depressive symptoms (coefficient: 0.27, 95 % CI 0.26 to 0.29). In mediation analyses, loneliness explained 15 % of the association between sexual orientation and subsequent depressive symptoms. LimitationsThe dataset used sexual behaviour rather than desire and identity, potentially skewing representation of sexual minorities. Additionally, transgender older adults were not included due to limited gender diversity reported within the ELSA dataset. ConclusionsLoneliness appears to be a significant modifiable mechanism contributing to the heightened risk of depressive symptoms in sexual minority older adults compared with their heterosexual counterparts.

Social Media Addiction Predicts Compromised Mental Health as well as Perceived and Objective Social Isolation in Denmark: A Longitudinal Analysis of a Nationwide Survey Linked to Register Data

AbstractSocial media addiction has previously been linked to compromised mental health and social isolation; however, most studies are cross-sectional or based on convenience samples. The objective of the current study was to assess the extent to which social media addiction predicts compromised mental health and social isolation (including bi-directionality) in a large prospective sample of Danish adults. Data stem from a nationwide longitudinal Danish survey of 1958 adults (aged 16+) conducted in 2020 and 2021. The Bergen Social Media Addiction Scale (BSMAS) was used. Validated scales were used to assess depression, mental wellbeing, and loneliness. A total of 2.3% screened positive for social media addiction. As compared to no symptoms, social media addiction was associated with an elevated risk for depression (OR = 2.71; 95% CI 1.08, 6.83) and negatively with mental wellbeing (coef = −1.29; 95% CI −2.41, −0.16). Similarly, social media addiction was associated with an elevated risk of loneliness (OR = 4.40; 95% CI 1.20, 16.19), and negatively with social network size (coef = −0.46; 95% CI −0.86, −0.06). There is a need for preventive actions against addictive social media use, as this poses significant risk to mental health and social functioning in the working age population.

Threats to social safety and neuro-inflammatory mechanisms underlying sexual orientation disparities in depression symptom severity: A prospective cohort study of young adults

Sexual minority individuals have a markedly elevated risk of depression compared to heterosexuals. We examined early threats to social safety and chronically elevated inflammation as mechanisms contributing to this disparity in depression symptoms, and compared the relative strength of the co-occurrence between chronic inflammation and depression symptoms for sexual minorities versus heterosexuals. To do so, we analyzed data from a prospective cohort of sexual minority and heterosexual young adults (n = 595), recruited from a nationally representative sample, that included assessments of early threats to social safety in the form of adverse childhood interpersonal events, three biomarkers of inflammation (i.e., CRP, IL-6, TNF-α) measured at two time points, and depression symptoms over four years. In pre-registered analyses, we found that sexual minorities experienced more adverse childhood interpersonal events, were more likely to display chronically elevated inflammation, and reported more severe depression symptoms than heterosexuals. Adverse childhood interpersonal events and chronically elevated inflammation explained approximately 23 % of the total effect of the association between sexual orientation and depression symptom severity. Further, there was an increased coupling of chronically elevated inflammation and depression symptoms among sexual minorities compared to heterosexuals. These results provide novel longitudinal, population-based evidence for the role of chronically elevated inflammation in linking threats to social safety during childhood with depression symptom severity in young adulthood, consistent with the primary tenets of the social signal transduction theory of depression. Our study extends this theory to the population level by finding that members of a stigmatized population (i.e., sexual minorities) experience a greater risk of depression because of their greater exposure to adverse childhood interpersonal events and the subsequent link to chronic inflammation, highlighting potential biopsychosocial intervention targets.

Accelerated biological aging as potential mediator mediates the relationship between pro-inflammatory diets and the risk of depression and anxiety: A prospective analysis from the UK biobank

BackgroundThe relationship between inflammatory dietary patterns and the risk of depression/anxiety has not been clearly established due to differences in study populations, geographic regions, sex, and methods of calculating the inflammatory index. MethodsWe drew upon a prospective cohort in the UK Biobank and calculated the energy-adjusted dietary inflammatory index (E-DII). The follow-up time was defined from the date of completing the last dietary survey questionnaire to the date of diagnosis of depression, anxiety, phobic anxiety, other types of anxiety, death, loss to follow-up, or the respective censoring dates for England (September 30, 2021), Scotland (July 31, 2021), and Wales (February 28, 2018). The final follow-up times end on September 30, 2021, July 31, 2021, and February 28, 2018, for England, Scotland, and Wales, respectively. During the follow-up process, if a participant develops the condition, dies, or is lost to follow-up, the follow-up is terminated. We used Cox regression to evaluate the connection between E-DII and depression/anxiety. We employed restricted cubic spline curves for nonlinear relationships. We also conducted mediation analyses to explore whether biological age mediated the relationship between E-DII and depression. Additionally, we investigated whether genetic susceptibility modified the relationship between E-DII and depression through interaction modeling. ResultsIn the final analysis, we included a total of 151,295, 159,695, 165,649, and 160,097 participants for the analysis of depression, all types of anxiety, specific phobia anxiety, and other types of anxiety, respectively. For every one-unit increase in E-DII, the risk of experiencing depression and anxiety increased by 5 % and 4 %, respectively. We identified a “J”-shaped nonlinear relationship (P for nonlinear = 0.003) for both depression and anxiety. A significant association with an elevated risk of depression was observed when E-DII exceeded 0.440, and an increased risk of anxiety was noted when E-DII was more than −0.196. Mediation analysis demonstrated that PhenoAge age acceleration (AA) (For depression, proportion of mediation = 9.6 %; For anxiety, proportion of mediation = 10.1 %) and Klemera-Doubal method Biological Age (KDM AA) (For depression, proportion of mediation = 2.9 %; For anxiety, proportion of mediation = 5.1 %) acted as mediators between E-DII and the development of depression and anxiety (P < 0.05). ConclusionsDiets with pro-inflammatory characteristics are associated with a heightened risk of depression and anxiety. Furthermore, the association of pro-inflammatory diets and depression is mediated by biological age.

Mental Health Conditions in Partners and Adult Children of Stroke Survivors

Family caregiving after critical illness has been associated with several adverse health outcomes, including various aspects of mental health, but research focusing specifically on family members of stroke survivors is limited. To examine the associations of stroke in a partner or parent with the risk of depression, substance use disorders, anxiety disorders, and self-harm or suicide. This nationwide, population-based cohort study used data from Danish nationwide administrative and clinical registries (2004-2021). Participants included partners and adult children of survivors of stroke. Data analysis was performed from March to December 2023. Having a partner or parent who survived stroke. The Aalen-Johansen estimator was used to compute propensity score-weighted 3-year absolute risks, risk differences, and risk ratios for depression, substance use disorders, anxiety disorders, and self-harm or suicide among partners or children of survivors of stroke compared with partners or children of survivors of myocardial infarction (MI) and matched individuals from the general population. The study included a total of 1 923 732 individuals: 70 917 partners of stroke survivors (median [IQR] age, 68 [59-76] years; 46 369 women [65%]), 70 664 partners of MI survivors (median [IQR] age, 65 [55-73] years; 51 849 women [73%]), 354 570 partners of individuals from the general population (median [IQR] age, 68 [59-76] years; 231 833 women [65%]), 207 386 adult children of stroke survivors (median [IQR] age, 45 [36-52] years; 99 382 women [48%]), 183 309 adult children of MI survivors (median [IQR] age, 42 [33-49] years; 88 078 women [48%]), and 1 036 886 adult children of individuals from the general population (median [IQR] age, 45 [36-52] years; 496 875 women [48%]). Baseline characteristics were well balanced across cohorts after propensity score weighting. Among partners of stroke survivors, the 3-year absolute risk was 1.0% for depression, 0.7% for substance use disorders, 0.3% for anxiety disorders, and 0.04% for self-harm or suicide. Risk ratio point estimates for the assessed outcomes ranged from 1.14 to 1.42 compared with the general population and from 1.04 to 1.09 compared with partners of MI survivors. The elevated risk of depression in partners of stroke survivors was more pronounced after severe or moderate stroke than after mild stroke. Among adult children of stroke survivors, the 3-year absolute risk was 0.6% for depression, 0.6% for substance use disorders, 0.2% for anxiety disorders, and 0.05% for self-harm or suicide. Both absolute risks and risk ratios for adult children of stroke survivors were smaller than those reported in the partner analyses. In this cohort study of partners and adult children of stroke survivors, risks of several mental health conditions and self-harm or suicide were moderately higher compared with the general population and, to a lesser extent, partners and adult children of MI survivors. These findings highlight the potential consequences of stroke among family members, particularly partners, and its findings may possibly serve as a quantitative foundation for the development of future stroke rehabilitation services.