History Of Depression Research Articles

Background: Hospital readmissions are costly, burdensome to patients, and are often preventable. Patients recovering from an acute myocardial infarction (AMI) face varying risks of readmission, which may be influenced by clinical, sociodemographic, and social determinants of health. There is a critical gap in evaluating social risk factors in modeling 30-day readmissions using electronic health record (EHR) data. A better understanding of these risk factors may help target specific interventions to mitigate disparate health outcomes. Objective: The objective of this study was to examine the relationship between demographic, clinical, and social characteristics and the risk of 30-day hospital readmission following AMI. Methods: Patients admitted with an AMI to Vanderbilt University Medical Center between 2007 and 2016 were identified from a retrospective cohort of EHR data. Encounters were limited to index admissions among patients who were discharged alive. The outcome was 30-day hospital readmission. Variables included demographics (age, race, ethnicity), clinical characteristics (vitals, labs, comorbidities), and social risk factors (living alone, depression, dementia) and those with >70% missingness were excluded, and remaining missing values were imputed with multiple imputation. Variable selection for the final model is illustrated in Figure 1. Results: A total of 6179 patients were included, and 646 experienced a 30-day readmission. The cohort included 4148 males, 1032 people of color, and the average age was 63.4 years. The top five statistically significant variables, based on magnitude of the odds ratio, included concurrent oncology care (OR: 4.92), medication non-compliance (OR: 4.67), sepsis in the 90 days before admission (OR: 4.46), length of stay of >= 5 days (OR: 3.169), and number of hospital admissions in the previous year (OR: 1.86). In addition, depression (OR: 1.32) or dementia (OR: 1.23) increased the risk for the outcome, while being Male (OR: 0.413) or non-Hispanic ethnicity (OR: 0.727) lowered the risk. Conclusions: Using a longitudinal cohort of EHR data, clinical, demographic, and social variables were found to influence the risk of 30-day readmission following an AMI. Patient populations with clinical comorbidities, prior utilization of inpatient resources, and social risk factors, including medication non-compliance, or history of depression and dementia, may be essential groups to target for readmission reduction interventions.

Introduction: Spontaneous coronary artery dissection (SCAD) is an infrequent but increasingly recognized cause of myocardial infarction that disproportionately affects women. SCAD is influenced by hormone fluctuations, arteriopathies, and physical&emotional stressors. We present a unique case of recurrent multivessel SCAD after severe emesis following GLP-1 receptor agonist (GLP-1RA) use. Case: A 58-year-old woman with past medical history of hypertension and depression presented to an emergency room (ER) with acute chest pain after intense running and was diagnosed with single vessel SCAD of the right coronary artery on coronary angiography. She was treated with dual antiplatelet therapy (DAPT) for 30 days and beta blockers without recurrent angina. One year later, she began taking a GLP-1RA (semaglutide 0.25 mg SQ once weekly) for weight loss, and developed extreme nausea and vomiting hours after her first dose. While retching, she experienced chest pain reminiscent of her prior SCAD episode and presented to the ER. Serial ECGs showed dynamic inferolateral ST depressions. Her initial high-sensitivity troponin I was 224 pg/mL and peaked at 15,492 pg/mL. Transthoracic echocardiogram showed normal function and no wall motion abnormalities. Coronary angiography revealed triple-vessel Type 2 SCAD involving the first obtuse marginal branch, distal left anterior descending artery, and posterior descending artery; each with TIMI 3 flow and not requiring percutaneous coronary intervention. Her chest pain was controlled with oral nitrates and beta blockers. She was prescribed DAPT with aspirin and clopidogrel for 6 months and discharged home with recommendation for outpatient fibromuscular dysplasia screening and cardiac rehabilitation. She was cautioned to discuss with her outpatient providers prior to reinitiation of GLP-1RAs. Discussion: This case illustrates a unique recurrence of SCAD occurring after semaglutide-induced vomiting, supporting a potential link between intense retching and SCAD in predisposed individuals. Although GLP-1RAs are not known to directly cause SCAD, their gastrointestinal side effects may act as precipitating physical stressors. With the anticipated exponential increase in GLP-1RA use, this case underscores the importance of exercising caution when initiating therapies with emetogenic potential in patients with a history of SCAD. Further studies are needed to understand this potential risk and guide safe therapeutic practices.

Which polycystic ovary syndrome (PCOS)-related and general patient characteristics are associated with higher levels of anxiety and depressive symptoms, as well as with reduced body appreciation in women with PCOS? Anxiety was more common among participants with alopecia, obesity, younger age, and a history of anxiety or depression; depression was more common in participants with alopecia, unemployment, and a history of depression; and body appreciation scores were lower in participants with hirsutism, acne, alopecia, obesity, younger age, and a history of anxiety or depression. Women diagnosed with PCOS face over 30% likelihood of clinically relevant anxiety symptoms, over a 15% likelihood of clinically relevant depressive symptoms, and also experience reduced body appreciation. Evidence suggests that in women with PCOS, various factors may contribute to increased levels of anxiety and depression and reduced body appreciation. However, findings across studies are inconsistent, and the nature of these associations, as well as the potential influence of patient characteristics that have been less studied, are still not well understood. A cross-sectional online survey study was carried out from May 2021 to July 2023. Recruitment occurred through fertility clinics in the Netherlands, employing posters, leaflets with QR codes, and online platforms run by patient organizations. The participants were women with self-reported PCOS. They completed the Hospital Anxiety and Depression Scale (HADS) and the Body Appreciation Scale-2 (BAS-2). We assessed the association with mental health outcomes (symptoms of anxiety and depression, as well as body appreciation) with PCOS-related patient characteristics (hirsutism, acne, alopecia, obesity, and oligomenorrhea) and general characteristics (age, employment status, medical history, and medication use). Multivariable logistic and linear regression analyses were used, and adjusted odds ratios (aORs) or adjusted mean differences (aMDs) with 95% CI were calculated. We included 982 women, with 37.0% showing clinically relevant symptoms of anxiety (score ≥11) and 17.4% showing clinically relevant depressive symptoms (score ≥11). Risk factors associated with anxiety symptoms were alopecia (aOR: 1.79, 95% CI 1.35-2.38), obesity (aOR: 1.40, 95% CI 1.03-1.90), younger age (aOR per year older: 0.93, 95% CI: 0.91-0.96), and medical history of anxiety or depression (aOR: 2.63, 95% CI 1.82-3.79 and aOR: 1.60, 95% CI 1.13-2.28). Risk factors associated with symptoms of depression were alopecia (aOR: 1.74, 95% CI 1.21-2.50), unemployment (aOR: 2.59, 95% CI 1.56-4.31), and a medical history of depression (aOR: 1.89, 95% CI 1.25-2.85). Risk factors associated with reduced body appreciation were hirsutism (aMD: -2.29, 95% CI -3.41 to -1.16), acne (aMD: -1.14, 95% CI -2.11 to -0.17), alopecia (aMD: -1.93, 95% CI -2.89 to -0.97), obesity (aMD: -6.31, 95% CI -7.36 to -5.27), oligomenorrhea (aMD: -1.81, 95% CI -2.78 to -0.83), and younger age (aMD per year older: 0.13, 95% CI 0.04-0.23). A medical history of anxiety or depression disorder was also associated with reduced body appreciation (aMD: -1.80, 95% CI -3.10 to -0.50; aMD: -2.81, 95% CI -4.05 to -1.57, respectively). Results are based on self-reported PCOS diagnoses and may have been affected by sampling bias. It is crucial for healthcare providers to understand which characteristics in women with PCOS may influence the development of anxiety, depression, or reduced body appreciation. Such awareness helps them to be more alert and better recognize the different types of mental health concerns, enabling referrals and more targeted mental health support. This study was not funded by a specific grant. No conflicts of interest were reported in relation to the current research. Not applicable.

Introduction: Acute iron poisoning is a potentially life-threatening condition that primarily affects the gastrointestinal, hepatic and cardiovascular systems. While it most often occurs accidentally in children, intentional overdoses in adolescents and adults remain an important clinical concern. Case description: We report the case of a 14-year-old male patient with a history of depression who intentionally ingested 100 ferrous sulfate tablets (equivalent to 118 mg/kg of elemental iron). The patient was admitted to the emergency department three hours after ingestion. He presented with vomiting tablet remnants, headache, and mild abdominal pain. Supportive measures included intestinal irrigation with polyethylene glycol (PEG), gastric protection, and N-acetylcysteine intravenous administration. The iron chelator therapy with deferoxamine was not possible because the medication was unavailable, so treatment with the oral iron chelator (deferasirox) was initiated. The iron levels gradually decreased, with no evidence of liver or cardiovascular involvement. The patient was discharged on day 20 post-ingestion with outpatient psychiatric follow-up. Discussion: This case highlights the importance of early initiation of gastrointestinal decontamination with PEG to limit systemic iron absorption. The use of deferasirox as an alternative chelating agent in the absence of deferoxamine has been associated with a favorable response. Conclusions: The rational use of oral chelators, gastrointestinal decontamination, and hepatoprotective therapies in acute iron poisoning might prevent major complications and improve prognosis. Alternative therapies can be valuable when an antidote is not immediately available; however, further clinical research is required before making a recommendation.

Parental expressed emotion, family conflict, and symptom severity in adolescent offspring of parents with mood disorders.

Concurrent and prospective associations between sleep duration and timing and postpartum anxiety symptoms.

ABSTRACTIntroductionAnxiety and depression can affect immune function, yet little is known about their impact on immune checkpoint inhibitor (ICI) therapy outcomes. We investigated associations between an existing anxiety or depression diagnosis and ICI outcomes.MethodsIn this secondary analysis, multicenter retrospective real‐world data were abstracted from medical charts. Patients included received ≥ 1 dose of anti‐PD‐1 or anti‐PD‐L1 monotherapy. Key variables abstracted were anxiety/depression diagnosis at treatment initiation, ICI therapy outcomes (immune‐related adverse events, irAEs; overall survival, OS; time to treatment failure, TTF), and other sociodemographic and clinical factors.ResultsOf the 913 patients, 11% and 12% had an existing anxiety or depression diagnosis, respectively. Rates of any grade irAEs were 32% overall, and 44% and 37% among those with anxiety or depression history, respectively. In the multivariable analysis, patients with an anxiety diagnosis had a greater likelihood of experiencing irAEs (OR = 1.80; 95% CI = 1.16–2.79, p = 0.009) and better OS (HR = 0.74; 95% CI = 0.54–1.00, p = 0.048) compared to those without an anxiety diagnosis. Depression diagnosis was not significantly associated with irAEs, OS, or TTF. In multivariable sensitivity analyses restricted to patients with non‐small cell lung cancer (NSCLC, n = 417), those with an anxiety diagnosis had a trend toward better OS (HR = 0.66; 95% CI = 0.43–1.01; p = 0.056) and longer TTF (HR = 0.71; 95% CI = 0.50–1.02; p = 0.063) than those without an anxiety diagnosis, while irAEs did not vary significantly by anxiety.ConclusionPre‐existing anxiety diagnosis may impact clinical outcomes for patients receiving anti‐PD‐1 or anti‐PD‐L1 treatments. Links between psychosocial factors and ICI outcomes should be further examined in translational and prospective studies.

Various forms of pregnancy losses and risks of depression and anxiety in later life.

Wish to hasten death in older adults living in nursing homes in the Spanish population: A descriptive study

Prevalence, risk factors and family dynamics of antenatal depression in couples: A multicenter cross-sectional study.

Association between hyperemesis gravidarum and depression: a national register-based controlled study in Finland.

Paraquat is a highly toxic herbicide that can cause fatal pulmonary fibrosis even with small ingestions. We report a 35-year-old male with a history of depression and previous suicide attempt who presented with gastrointestinal symptoms after ingesting 20 mL of concentrated Paraquat. Despite intensive care measures including hemodialysis, corticosteroids, and supportive therapy, he developed progressive respiratory failure due to worsening pulmonary fibrosis and died on hospital day 51. This case underscores the severity of Paraquat poisoning and the limited effectiveness of available treatments, highlighting the importance of early recognition, the need for novel biomarkers denoting severity, and the combination of supportive care with extracorporeal detoxification modalities in managing such cases.

Associations of plasma omega-3 fatty acid levels and reported fish oil supplement use with depression and anxiety: A cross-sectional analysis from the UK Biobank.

Background: Postpartum depression (PPD) is a significant yet underrecognized public health issue that adversely affects maternal mental health and child development. The interplay of psychosocial, biological, and environmental factors contributes to its onset, particularly in resource-constrained settings like South Punjab. Objective: To analyze key psychosocial, biological, and environmental factors contributing to postpartum depression among women in urban and rural communities of South Punjab, and to identify preventive strategies for improving maternal mental health outcomes. Methods: A descriptive study was conducted over eight months among 384 postpartum women within six months of delivery in South Punjab. Participants were selected using multistage sampling. Data were collected through structured interviews using a pretested questionnaire and the Edinburgh Postnatal Depression Scale (EPDS). Statistical analysis was performed using SPSS version 26. Data were normally distributed; thus, t-tests, chi-square tests, and multivariate logistic regression were applied to explore associations and predictors. Results: The prevalence of probable postpartum depression (EPDS ≥13) was 41.6%. Higher rates were observed among women with a history of depression (74.2%), low social support (68.5%), unemployment (63.3%), and rural residence (59.6%). Mean EPDS scores were significantly higher in rural women (12.4 ± 4.8) and those with low social support (13.7 ± 5.1). Multivariate analysis confirmed these factors as significant predictors. Conclusion: Postpartum depression is highly prevalent among mothers in South Punjab, especially in rural areas and among socially unsupported women. Addressing these factors through targeted interventions is essential for improving maternal mental health and overall family well-being.

Total hip replacement (THR) is the definitive treatment for degenerative conditions of the hip with an excellent track record for success. However, there is emerging evidence that patients with musculoskeletal conditions suffering from concomitant psychological and/or mental health ailments may be predisposed to suboptimal outcomes after surgery. Determining whether psychological and mental health influence outcomes following Total Hip Replacement (THR)—and to what extent—has important prognostic, preventive, and therapeutic implications. In this study, we evaluated the influence of pre-operative pain catastrophizing, depression, and/or mental health on post-operative clinical outcomes following THR. We evaluated outcomes as part of a secondary analysis in a prospective cohort observational study of patients undergoing THR. We employed a multivariable mixed model regression analysis to determine whether pain catastrophizing, depression, or mental health was associated with persistent pain, decreased function, and/or higher risk of revision surgery pre-operatively and up to 5 years post-operatively. A Pain Catastrophizing Scale (PCS) score of 30 or above was pre-defined as the threshold for clinically important pain catastrophizing. Depression and mental health were reported and analyzed as binary categorical variables. We used the ICOAP to measure constant and intermittent hip pain and the WOMAC Physical Function measure to measure physical function. A p value of less than 0.05 was considered as statistically significant. The study cohort consisted of 576 patients who underwent THR (49.3% male; 50.7% female), divided into 189 who screened positive for a psychological, mental health, or pain catastrophizing and 387 who did not. All patients improved substantially following THR, with large significant and clinically important improvements between pre-operative and all post-operative follow up time points for both groups. After adjustment, constant pain scores (ICOAP Constant) were 1.35 (SE 0.18) higher in those with a PCS score >= 30 (p = 30. Female sex was also significantly associated with higher pain scores. Physical function scores (WOMAC PF) were 4.61 (SE 0.53) higher (i.e. worse) in those with PCS > = 30. Younger age at surgery and female sex were also associated with higher WOMAC PF scores (i.e. worse function). History of depression or mental health disorder were not significant in the model. Patients with high levels of pain catastrophizing show large improvements in pain and function following THR. However, these patients have higher levels of pre-operative and post-operative pain and lower physical function following THR. Although the differences are small, pain catastrophizing may be used as one element of a risk stratification model to estimate risk of poor post-operative outcome following THR. Whether targeted interventions to address pain catastrophizing can improve surgical outcome remains to be investigated.

ABSTRACT Migraine significantly impacts social, family, and work activities, affecting quality of life (QoL), productivity, and financial strain. This study aimed to assess the QoL and well-being among King Khalid University (KKU) students who had migraine during the 2023–2024 academic year. Using Propensity score matching, a comparative cross-sectional study was conducted among 600 students (300 with migraine and 300 without). An anonymous self-administered questionnaire, including the World Health Organization (WHO) Quality of Life (WHO QOL)-BREF and WHO-5 Well-Being Index, was collected through face-to-face interviews using convenience and snowball sampling. The majority of participants were single (96.4%), non-smokers (93.8%), urban residents (86.7%), with a mean age of 21.3 years, and 66.0% were females. There was a significant difference between groups in all QoL domains except the psychological domain. Good QoL and well-being were reported by 23.0% and 35.7% among migraine students, respectively, compared to 33.3% and 50.7% among non-migraine students. The domains of QoL correlated positively with well-being. Low family income negatively impacted QoL and well-being, while a history of depression also significantly affected the scores. Marriage positively influenced well-being and QoL. This study emphasizes the significant impact of migraine on students’ QoL and well-being, especially for those with low family income and depression. Universities should establish support frameworks to address these challenges.

Illness Perceptions and Emotional Experiences in Heart Failure: Qualitative Insights to Inform Personalized Psychosocial Care.

Disclosure: B. Chow: None. A. Rajpal: None.Introduction: Gender affirming hormone therapy (GAHT) is an essential part of male to female transgender care. In 2022, prevalence of self-reported transgender individuals increased by 0.5% in adults. Consequently, one study estimated that 44 per 100,000 people had an underling prolactinoma, but the prevalence in transgender patients is unknown. Prior to initiation of GAHT, baseline hormone labs are not routinely obtained to assess for pre-existing prolactinomas which can have significant clinical implications. We report a case of macroprolactinoma in a transgender female several years after initiation of high dose GAHT. Case Description: 48-year-old transgender female with a history of depression on high dose estradiol (8 mg/day), progesterone (200 mg/day), and spironolactone (400 mg/day) for the last 10 years was found to have an elevated prolactin (PRL) levels on routine evaluation. The patient was asymptomatic but given an elevated PRL level of 370 ng/ml, she underwent MRI Sella which showed a 1.1 cm pituitary adenoma abutting the right cavernous sinus. Her estradiol and progesterone supplementation were discontinued, resulting in a decline in her psychological well-being. Over next 6 months her PRL level trended down to 163 ng/ml. She was evaluated by neurosurgery and surgical intervention was deferred. Cabergoline was initiated (gradually up titrated to 0.25 mg three times weekly) and her repeat MRI 6 months after initial presentation showed interval decrease of the prolactinoma to 0.6 cm. Repeat PRL levels 2 months after cabergoline therapy were undetectable. Thereafter the patient was restarted on estradiol 2 mg daily with plans to closely monitor her PRL levels and possible repeat MRI 6-9 months afterwards. Discussion: Prolactinomas in transgender women on GAHT can often be masked as symptoms are commonly attributed to reduced testosterone levels. This case highlights the importance of timely biochemical monitoring prior to initiation of GAHT, as elevated PRL levels may indicate an underlying pituitary pathology. The mainstay of prolactinoma treatment involves cessation of hormone supplementation and medical management with dopamine agonists, which reduces tumor size in 80% of patients. However, this response may differ for transgender women on GAHT, particularly with estrogen therapy. As high doses of estrogen have shown to cause stimulation in prolactin secretion and possible growth induction of prolactinomas, the management becomes further challenging in transgender individuals. Additionally, discontinuation of hormone supplementation in transgender women may exacerbate underlying mood disorders; optimization of non-pharmacologic treatments should be pursued after discontinuation of hormone therapy. With the growing transgender population, further discussions on early identification and management of prolactinomas in this group are essential. Presentation: Monday, July 14, 2025

Disclosure: U.B. Zakia: None. M. Aiad: None. G. Smith: None. M. Wilson: None.Background: Adrenal insufficiency (AI) is a significant endocrine toxicity caused by immunotherapy (3,4). Immune checkpoint inhibitors may result in primary (n=11), secondary (n=191), or mixed types (n=4) of adrenal insufficiency. Clinical Case: Our patient, a 60-year-old Caucasian male with a history of smoking (9 pack years), anxiety, depression, and right lower lobe adenocarcinoma of the lung, underwent resection for the primary tumor but experienced recurrence in the lymph nodes and right pleural effusion. He received 5 cycles of chemotherapy, including carboplatin, pemetrexed, and pembrolizumab over three months. Upon admission, he presented with nausea, vomiting, weakness, significant weight loss, diarrhea, and orthostatic dizziness. He was afebrile with stable vital signs, but lab results showed hyponatremia (sodium 133 mmol/L) and low bicarbonate (16 mmol/L). CT scans indicated possible cystitis and moderate pleural effusion, with a normal head CT. The following day, the patient began experiencing visual hallucinations, including seeing lions on the TV screen. His cortisol levels were low (1.2 and 1.6 ug/dL), and ACTH was also low (3.3 pg/mL), confirming secondary adrenal insufficiency induced by pembrolizumab. Hydrocortisone was started, and endocrinology was consulted for management. The patient improved and was discharged on oral hydrocortisone with follow-up appointments. At his oncology follow-up, pembrolizumab was discontinued, and his symptoms continued to improve with steroid therapy. The patient’s non-small cell lung cancer tested positive for PD-L1, which enhances pembrolizumab efficacy. Approximately 21% of immunotherapy patients develop endocrinopathies, often due to immune-related hypophysitis, causing low ACTH and secondary adrenal insufficiency. Symptoms include weakness, nausea, vomiting, anorexia, hypotension, and psychosis. Theories suggest that hyponatremia may cause cerebral edema and confusion, or low glucocorticoids could impair memory and executive function, contributing to psychosis. Additionally, reduced glucocorticoids may increase endorphin levels, leading to hallucinations. Psychosis typically improves with hydrocortisone, but steroids can also cause psychiatric symptoms. In this case, visual hallucinations occurred before steroid treatment. After ruling out alcohol withdrawal, anesthesia effects, and delirium, steroid therapy successfully resolved the patient’s symptoms. Timely diagnosis and treatment of adrenal insufficiency are critical for managing this potentially life-threatening condition. Conclusion: In patients undergoing Pembrolizumab treatment, endocrine toxicities should be regularly assessed through laboratory tests with high clinical suspicion.Presentation: Saturday, July 12, 2025

Abstract Disclosure: E. Braybrook: None. K. Natasha: None. D. Grammatopoulos: None. Depressive symptoms experienced either during pregnancy or postpartum, collectively termed perinatal depression (PND) affects around 17% of women globally, with significant impact to both the mother and child’s health. The underpinning mechanisms are not yet fully understood, however dysregulation of the HPA axis is believed to be central, with impairment of neurotransmitter function also linked to inflammation. Additionally, the occurrence of depression antenatally is shown to be a significant risk factor in the development of postpartum depression. Clinicians currently use questionnaires as the primary tool to identify risk of depression, however their performance is inadequate and only one fifth of women who experience PND actively seek help. Biomarker-based screening strategies might offer an additional tool for earlier identification, stratification and development of targeted therapies. Plasma proteomics is emerging as a powerful tool, enabling both improved understanding of key biological processes through the generation of molecular profiles, and the identification of novel biomarkers for disease prediction. This study analysed serum samples from 260 women between 24-28 weeks gestation, with risk of depression assessed through the Edinburgh Postnatal Depression Questionnaire. To capture depressive symptoms either during pregnancy or postpartum, scores were obtained between 24-29 weeks gestation and again 6-10 weeks postpartum, with a cut-off score of 10 used to indicate increased risk. 92 inflammatory markers were analysed in the serum samples using Olink Proseek Multiplex Inflammation I panel, utilising a proximity extension assay. Differential expression analysis revealed distinct profiles between the antenatal and postnatal depression groups. Machine learning models (e.g. Random Forrest, Classification and Regression Tree and Pearsons Chi-square Statistic) were applied to the data using SPSS Modeler, with similarities across the outputs in key proteins identified (STAMPB, SIRT2, AXIN1, LAP TGF-beta-1, IL-10, MMP-10 and IL17C). In addition, differing psychosocial variables were highlighted as contributing factors across the two groups (history of anxiety or depression in antenatal and family history of PND in postnatal). Functional enrichment analyses further explored the biological functions of key proteins. This work highlights the value of targeted proteomics approaches coupled with machine learning in uncovering biomarker signatures that add to our understanding of the underlying biological mechanisms of PND. Alterations in inflammatory protein networks suggest distinct mechanisms between antenatal and postnatal depression. Application of biomarker tools, incorporating key proteins alongside patient history, could pave the way for personalised PND diagnosis and development of novel therapies. Presentation: Saturday, July 12, 2025