Simulation-based interprofessional education may increase confidence in postpartum depression management.

Development and evaluation of an evidence-based training and supervision program to enhance clinical competence management in perinatal depression management among rural maternal and child health workers: A pre-post study.

Screening, diagnosing, and managing perinatal depression: Review of SIX national guidelines.

Serotonin reuptake inhibition and intracerebral hemorrhage risk after ischemic stroke: A multicenter retrospective study.

Introduction: Depression is a complex mental health condition with multifactorial origins, including psychological, social, and biological factors. Recent evidence suggests that Vitamin D3 , a micronutrient traditionally associated with bone and calcium regulation, may also influence neurological functions and mood regulation. However, the role of Vitamin D in mental health remains underexplored, particularly in relation to depression severity. Aim: To explore perceptions and beliefs, among individuals with varying levels of depression and serum Vitamin D3 . Materials and Methods: The present qualitative study was conducted in Unique health Private hospital in Ernakulam, Kerala, India, between April and May 2025. A purposive sample of eleven adults (n=11), both males and females aged 20-45 years, was selected based on documented depression scores (moderate to severe) and serum Vitamin D3 levels. Data were collected through in-depth semi-structured interviews conducted in private settings using a pretested interview guide. The researcher, trained in qualitative methods with a background in psychology and public health, maintained reflexivity throughout the process. The study evaluated participants’ depression severity and Vitamin D3 status to explore perceptions and experiences related to mental health and nutrition. Data were analysed manually using Braun and Clarke’s six-phase thematic analysis framework, with Microsoft Excel 2021 used for organising codes and sociodemographic details. Results: Five major themes were identified: (1) Lack of awareness about the link between Vitamin D3 and mental health; (2) Patterns of deficiency among individuals with severe depression; and (3) Clinical neglect of Vitamin D3 screening in routine psychiatric assessments; (4) Emotional and social impacts of limited knowledge; and (5) Hopes for holistic and multidisciplinary care. Sub-themes revealed misconceptions about depression, inadequate nutritional education, and limited adoption of integrative care practices. Conclusion: The present study highlights limited awareness among study subjects about the role of Vitamin D3 in mental health and a lack of Vitamin D screening in clinical practice. Findings advocate for a holistic, interdisciplinary approach to depression management, bridging biological and psychosocial models. Broader public health initiatives are needed to increase awareness, reduce stigma, and improve clinical practices surrounding the role of micronutrients in mental health.

Suicidal ideation (SI) represents a manifestation of self-destructive thoughts and behaviors with significant public health implications. This study aimed to determine the prevalence of SI and identify associated risk factors among male and female university students in southern Bangladesh. Data were collected through simple random sampling between April and June 2022 from university students in southern Bangladesh, yielding a final sample of 584 participants (51.5% male, 48.5% female). SI was assessed as the primary outcome variable. Statistical analyses included frequency distributions, chi-square tests, and binary logistic regression to determine prevalence rates and identify associated risk factors. The prevalence of SI was substantially higher among female participants (31.4%) compared to their male counterparts (9.0%). Among female participants, significant risk factors included sleeping <7 hours per night (odds ratio (OR) = 7.670, P = .020), having a positive relationship with a partner (OR = 0.336, P = .018), experiencing mild (OR = 0.073, P < .01) or moderate depression (OR = 0.259, P = .014), and reporting no anxiety (OR = 0.031, P = .002). For male participants, significant associations were found with having no anxiety (OR = 0.014, P = .004) and experiencing moderate anxiety (OR = 0.043, P = .009). Female university students demonstrated a significantly higher risk of SI, underscoring the critical importance of gender-sensitive mental health interventions. Findings suggest that female students should be encouraged to maintain regular sleep patterns and cultivate healthy interpersonal relationships. Mental health screening and support services should be prioritized for both genders, with particular attention to depression and anxiety management.

Bipolar depression is the most prevalent and disabling phase of bipolar disorder, yet its treatment is limited by modest efficacy, metabolic adverse effects, and the risk of mood destabilization. Lumateperone, a recently approved agent for bipolar depression, exhibits a distinctive multimodal pharmacological profile, modulating dopaminergic, serotonergic, and glutamatergic systems at relatively low receptor occupancy and targeting key neurobiological mechanisms implicated in depressive symptoms. This narrative review synthesizes mechanistic, translational, and clinical evidence from studies published between 2020 and 2025, drawing on data from pharmacodynamic investigations and randomized controlled trials. Lumateperone demonstrates an integrative mechanism involving presynaptic partial dopamine D₂ agonism, postsynaptic D₂ antagonism, potent 5-HT₂A antagonism, modest serotonin reuptake inhibition, and indirect enhancement of NMDA receptor–mediated glutamatergic signaling. Phase 3 trials show significant and early reductions in depressive symptoms in bipolar I and II disorder, with a favorable tolerability profile characterized by minimal metabolic, extrapyramidal, and prolactin-related adverse effects. While indirect comparisons suggest potential tolerability advantages over existing treatments, further long-term and comparative studies are required to establish its definitive role in bipolar depression management.

Mental health literacy (MHL) plays a key role in shaping attitudes and help-seeking approaches regarding mental health. Elite-level coaches who are well-informed about symptoms of mental ill-health and effective help-seeking can not only better support their own mental health needs but help reduce stigma and promote early intervention for athletes they coach. This study investigated attitudes toward mental health among elite-level coaches, including their ability to recognize symptoms of depression and burnout, views on appropriate sources and methods of support, and perceptions of mental health stigma among coaches and athletes. An online survey with four vignettes depicting coaches and athletes experiencing depression and burnout were presented. An international sample of elite coaches (n = 104 men & 39 women) were asked to identify whether anything was going wrong for the individual, how the individual could be best helped, to rate the appropriateness of various interventions (people/medicines/activities/treatments) and stigma-related questions. Analyses revealed that participants were better at identifying depression than burnout among both coaches and athletes. Participants largely perceived medical/psychological interventions (e.g. talking to a mental health professional) to be more helpful for coaches and athletes experiencing depression, while activity-based interventions (e.g. taking leave) were considered more helpful for burnout. Mental health stigma was also low within the sample. Considering burnout is a risk factor for mental ill-health, future MHL interventions should improve coaches’ knowledge of stressors and symptoms associated with burnout among athletes and coaches. Furthermore, appropriate clinical supports should be promoted for burnout, rather than advocating for time-off exclusively.

BackgroundPost-stroke depression is common yet frequently underdiagnosed, substantially hindering rehabilitation engagement and functional recovery. Understanding its impact from the clinician's perspective is critical to optimizing care.ObjectiveThis study aimed to explore how post-stroke depression affects patient autonomy and rehabilitation processes from the viewpoint of occupational, physical, and speech therapists.MethodsAn observational mixed-methods study was conducted via an online survey of 111 neurorehabilitation therapists. Quantitative data were analyzed descriptively; qualitative responses from open-ended questions underwent thematic analysis.ResultsTherapists reported that post-stroke depression profoundly influences rehabilitation through: (1) reduced patient motivation and collaboration; (2) the consequent need for adapted therapeutic strategies (e.g., modified goal-setting and relational approaches); (3) significant professional challenges in patient engagement; and (4) an increased emotional burden on therapists. Consequently, interventions are routinely modified, requiring more time, interdisciplinary coordination, and psychological support.ConclusionsThis study underscores that post-stroke depression necessitates a fundamentally adapted, team-based rehabilitation approach tailored to motivational deficits. The findings highlight the importance of early screening, therapist training in motivational and relational skills, and structured support for clinicians to improve both patient outcomes and therapist well-being.

Abstract Background Patients with depression often exhibit persistent low mood, anhedonia, and social withdrawal, accompanied by reduced physical activity and impaired social functioning. These factors interact to further exacerbate symptom maintenance and relapse risk. Although pharmacotherapy and psychotherapy play a central role in clinical care, some patients still face challenges such as insufficient motivation, low social engagement, and reliance on single-intervention pathways during rehabilitation, which limit the overall nursing outcomes. In recent years, multidimensional intervention strategies integrating physical activity, structured education, and social interaction have gained increasing attention. Physical education can improve bodily arousal and emotional regulation, while social activities help alleviate feelings of isolation and enhance a sense of support. However, systematic nursing research on the synergistic effects of these two approaches remains limited. To address this, the study employs a multidimensional intervention framework, using randomization and multi-time watch evaluations to investigate the therapeutic effects and underlying mechanisms of nursing interventions combining physical education and social activities for depression patients. Methods The study enrolled 342 patients meeting the diagnostic criteria for depressive disorder who completed baseline assessments and were randomly assigned to one of three 12-week nursing interventions: (1) an integrated physical education and social activities intervention group (n = 116), which included structured exercise guidance, health education, and group social activities; (2) a standalone physical education nursing group (n = 112); and (3) a conventional nursing control group (n = 114). Key outcome measures included severity of depressive symptoms, emotional regulation ability, social functioning level, and subjective sense of support. These indicators were evaluated at baseline, intervention completion, and 3-month follow-up. Statistical analysis employed a mixed-effects model to compare the efficacy of different nursing strategies and used regression analysis to examine the predictive role of changes in emotional regulation and social support in symptom improvement. Results The experimental results demonstrated that, compared to the single physical education group and the conventional nursing group, the multidimensional intervention group exhibited a significant reduction in depressive symptoms at the end of the intervention (p&amp;lt;.001, d = 0.53), with sustained improvement maintained during the follow-up phase (p=.003). Mechanistic indicators revealed that the multidimensional intervention group showed a significant enhancement in emotional regulation capacity (p=.005, d = 0.44), along with concurrent improvements in social functioning and subjective sense of support (p=.008, d = 0.40). Further analysis revealed that enhanced emotional regulation capacity (p=.02) and increased sense of social support (p=.01) could significantly predict lower levels of depressive symptoms during the follow-up phase. This indicates that emotional regulation and social support may serve as important mediating pathways for the long-term efficacy of multidimensional nursing interventions. Discussion Multidimensional nursing interventions based on physical education and social activities can significantly improve the emotional state of patients with depression, demonstrating favorable sustained effects during follow-up. Studies indicate that multidimensional integrated interventions help compensate for the limitations of single-nursing models, serving as an important supplement to long-term care and rehabilitation management for depression. Future research could further optimize the combination ratios of different intervention elements and explore their application value in community and primary care systems.

Abstract Background Patients with depressive disorder (DD) often exhibit persistent low mood, impaired emotional regulation, and diminished self-efficacy. These psychological deficits not only exacerbate symptoms but also compromise treatment adherence and rehabilitation outcomes. In recent years, art-based interventions have gained increasing attention. Craft Art Creation (CAC), which emphasizes tactile engagement with materials, aesthetic experiences, and participatory processes, is considered potentially effective in promoting emotional relief and restoration of self-worth. However, systematic evidence regarding CAC’s therapeutic effects on DD remains limited, particularly concerning how it influences emotional regulation mechanisms, alters self-efficacy, and whether these factors interact to improve symptoms. This study aims to evaluate the impact of CAC on emotional regulation and self-efficacy in DD patients, while exploring the underlying mechanisms through which these factors contribute to symptom improvement. Methods This study enrolled 198 patients with depression (DD) who had received professional diagnosis, randomly assigned to either the CAC intervention group (n = 128) or the conventional psychoeducation control group (n = 70). The CAC program, conducted twice weekly over 10 weeks, involved tasks guided by professional art therapists, including material selection, texture exploration, design creation, and artwork presentation. Assessments included the Emotion Regulation Ability Score (ERAS), Self-Efficacy Level (SEL), and depression symptom scores. Measurements were taken before intervention, at the intervention conclusion, and during a 6-week follow-up. A mixed-effects model was used to analyze group differences, with path analysis examining the mediating effects of emotion regulation and self-efficacy. Results Experimental results demonstrated that the Enhanced Recovery After Surgery (ERAS) score in the CAC intervention group increased by approximately 39% at the end of the intervention period compared to baseline, significantly higher than the 14% improvement observed in the conventional psychological education control group (p=.003). The Self-Efficacy Level (SEL) in the CAC group rose by 36%, while the control group showed only a 11% increase, with statistically significant differences (p=.005). Depression symptom scores decreased by 41% in the CAC group and 18% in the control group (p&amp;lt;.001). Follow-up data revealed that the 34% symptom reduction in the CAC group persisted for 6 weeks, compared to only 10% in the control group (p=.006). Path analysis indicated that self-efficacy enhancement played a primary mediating role in depression symptom improvement (path coefficient: -0.52, p=.01), while improved emotional regulation also demonstrated significant predictive value (path coefficient: -0.44, p=.02). Additionally, participants with higher work completion rates exhibited more stable emotional states and greater psychological engagement during follow-up, suggesting that creative participation enhanced intervention effectiveness (p=.02). Discussion Crafts-based interventions provide an effective pathway for depression management, demonstrating significant effects in enhancing emotional regulation, boosting self-efficacy, and alleviating depressive symptoms. This efficacy may stem from the positive psychological effects generated by the synergistic interaction of aesthetic engagement, tactile experiences, and creative mastery. Future studies could integrate extended-term creative interventions with multimodal emotional assessment techniques to further validate the long-term benefits and mechanistic stability of arts and crafts in depression rehabilitation.

Abstract Background Depression among college students has become a major global public health concern, with a detection rate of 23.8% in higher education. Among treated students, relapse rates reach 40–60%. Traditional interventions focus on acute symptom control but often neglect rehabilitation and functional recovery, leaving persistent impairments in social functioning. Rehabilitation management, as a systematic intervention, emphasizes multi-dimensional promotion of functional recovery and relapse prevention, showing good outcomes in chronic mental disorders. This study aimed to develop a structured rehabilitation management model for depressed college students and assess its effect on mental health. By examining multi-level indicators, the study also explored the underlying mechanisms, providing guidance for improving full-course management, reducing relapse, and promoting functional recovery. Methods A randomized controlled trial recruited 300 college students from five universities who had partially remitted symptoms after acute treatment, with Hamilton Depression Rating Scale-17 (HAMD-17) scores of 8–17. Participants were randomly assigned to a rehabilitation management group (n = 150) or a control group (n = 150). The rehabilitation group received a 24-week comprehensive intervention including: (1) Case management: biweekly assessments; (2) Functional rehabilitation training: twice-weekly cognitive training and weekly social skills training; (3) Lifestyle management: guidance on sleep, exercise, and nutrition; (4) Academic adaptation support; (5) Mobile app monitoring and real-time alerts. The control group received standard follow-up care. Primary outcomes were 24-week relapse rate and functional recovery rate. Secondary outcomes included HAMD-17, Montreal Cognitive Assessment (MoCA), General Self-Efficacy Scale (GSES), and Social Support Rating Scale (SSRS). Assessments were conducted at baseline, week 12 and 24. Results Baseline characteristics did not differ significantly between groups (p&amp;gt;.05). At 24 weeks, the rehabilitation group had a significantly lower relapse rate than controls (12.7% vs. 31.3%, p&amp;lt;.001) and higher functional recovery (68.7% vs. 42.0%, p&amp;lt;.001). HAMD-17 scores decreased to 5.8 ± 3.2 in the intervention group, significantly lower than 9.4 ± 4.6 in controls (p&amp;lt;.001, d = 0.91), with complete remission at 76.0%. MoCA scores rose from 24.3 ± 2.8 to 28.1 ± 1.6 (p&amp;lt;.001), GSES improved by 34.2% (p&amp;lt;.001), and SSRS increased by 28.6% (p&amp;lt;.001). Mediation analysis indicated that improvements in cognitive function, social support, and self-efficacy explained 32.6%, 28.4%, and 24.1% of the total effect, respectively, with a combined mediation of 63.8%. Program completion rate was 87.3%, and satisfaction averaged 8.6 ± 1.2. Discussion The study confirmed that comprehensive rehabilitation management significantly reduces relapse risk and promotes functional recovery in depressed college students. Improvements stemmed from biological effects, including reduced inflammation and enhanced neural plasticity, alongside psychological benefits such as better cognitive function, increased self-efficacy, and strengthened social support. These multi-level effects jointly contributed to the intervention’s efficacy. The findings support shifting depression management from focusing solely on symptom control to emphasizing functional recovery through a full-course service integrating acute treatment, rehabilitation, and relapse prevention. Rehabilitation management should be standardized in campus mental health services, particularly for students at risk of persistent functional impairment. Future research should expand sample size, extend follow-up to evaluate long-term effects, and explore tailored interventions for different depression subtypes to refine precision rehabilitation strategies for college populations. Funding No. 2024XLZX41.

To synthesise meta-analytic outcomes from randomised controlled trials examining exercise effects on depression and anxiety across all population groups, including children and adults with both clinically diagnosed and subclinical symptoms, excluding those with pre-existing chronic physiological conditions. Meta-meta-analysis (Preferred Reporting Items for Overviews of Reviews (PRIOR) framework). Five electronic databases were searched for eligible meta-analyses published from inception to 31 July 2025. Meta-analyses of randomised controlled trials examining exercise interventions for the management of depression and anxiety symptoms were included. To avoid contamination effects, meta-analyses exclusively focused on populations in which chronic physiological conditions were excluded. Study selection was undertaken in duplicate by two independent reviewers. 63 studies (81 meta-analyses, 1079 component studies and 79 551 participants) were included. Exercise reduced depression (standardised mean difference (SMD)=-0.61, 95% CI -0.69 to -0.54) and anxiety (SMD=-0.47, 95% CI -0.59 to -0.36) symptoms, with aerobic exercise demonstrating the most substantial impact on both depression and anxiety symptoms. The greatest benefits by population group for depression were seen in emerging adults aged 18-30 and postnatal women. Greater reductions in depression were associated with exercise in group and supervised settings. Exercise of shorter duration and at lower intensity was most strongly associated with anxiety reduction. The findings of the study support that exercise based interventions, in all formats and parameters, can help mitigate depression and anxiety symptoms across all population categories. These results can help health professionals provide targeted, cost effective, evidence based support that aligns with individual profiles and preferences. PROSPERO CRD42020210651.

BackgroundThe benefits of physical activity (PA) for both physical and mental health, including major depressive disorder (MDD), are well established. Mobile devices, such as smartphones, offer a scalable way to monitor PA and its relationship with depressive symptoms in daily life.ObjectiveThis study aimed to investigate the association between passive smartphone-recorded step counts and current depressive symptoms in individuals with and without a lifetime diagnosis of MDD, using a naturalistic bring-your-own-device approach.MethodsWe used the Remote Monitoring Application in Psychiatry (ReMAP) to collect passive step count data from participants’ personal smartphones. The sample included 181 individuals with a lifetime MDD diagnosis, assessed via the structured clinical interview for the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition; DSM-IV), and 195 healthy controls (HCs). Current depressive symptoms were assessed using the Beck Depression Inventory. PA was operationalized as daily and weekly step counts, passively recorded via smartphone sensors. Hierarchical models were applied to examine the association between PA and depression severity.ResultsPatients with MDD exhibited significantly lower daily step counts (mean 3454, SD 2683) compared to HCs (mean 4699, SD 3175; P<.001) and showed reduced diurnal variability (β=–0.36; P=.003). Higher daily step counts were associated with lower Beck Depression Inventory scores across the full sample (β=–0.06, 95% CI –0.09 to –0.02; P=.002), with similar trends in both MDD and HC groups. Weekly step counts also significantly predicted lower concurrent depressive symptoms (β=–0.29, 95% CI –0.43 to –0.14; P<.001), while patients with MDD displayed less variability in weekly activity levels than HCs (β=–0.75; P=.001).ConclusionsThese findings underscore the potential of mobile devices to be used as effective tools for monitoring PA in patients with MDD, supporting more customized and adaptive approaches to prevention and treatment. They also emphasize the importance of incorporating PA into the clinical management of depression.

IntroductioneHealth has the potential for managing depression and enhancing quality of life. Identifying end user needs and employing participatory methodologies that actively engage all stakeholders can improve user experience, usability and effectiveness.Materials and MethodsSix face-to-face empathy workshops were conducted in three Spanish autonomous communities (Catalonia, Andalusia and Canary Islands) using design thinking methodologies, involving individuals with depression and mental health professionals. Data were analyzed using an iterative and inductive analysis approach.ObjectiveTo explore the perspectives of people diagnosed with depression and healthcare professionals involved in its management, using a design thinking methodology.ResultsThirteen individuals with depression (10 women, average age 49.15, SD: 18.10) and 17 mental health professionals (11 women, average age 40.21, SD: 12.15) participated in empathy workshops. Three key themes emerged: the daily experience of depression, the potential of technology in managing depression, and emerging challenges to address.DiscussionThe intensity and daily experience of depressive episodes were influenced by various factors. Technologies, when used as a complement to face-to-face care, showed potential for managing depression. However, there were associated risks and challenges that need to be addressed.ConclusionIt is essential to identify and understand the needs of end users and incorporate the perspectives of all stakeholders in the design and development of digital health interventions.

Major depressive disorder (MDD) remains a highly heterogeneous condition, presenting significant challenges for effective diagnosis and treatment. Traditional diagnostic systems often fail to capture the diverse clinical and biological phenotypes of MDD, limiting the efficacy and predictability of therapeutic interventions. The advent of wearable technology has enabled the continuous collection of real-time, objective data. By leveraging advanced artificial intelligence (AI) methodologies, these data streams can be transformed into dynamic digital phenotypes that may correlate with the complex psychopathological manifestations of depression. This integration offers a novel, data-driven approach to augment traditional subjective assessments, paving the way for more precise classification and personalized treatment strategies. This review explores the potential of AI-enhanced digital phenotyping to revolutionize depression diagnosis and management, advocating for a paradigm shift toward a more personalized, precision-based approach in psychiatric practice.

A Practical Primer on How to Detect and Treat Depression in CKD.

Primary-care-focused interpretable machine learning model for depression screening in geriatrics: A comparative study of multiple algorithms.

The clinical management of depression presents significant challenges. While acupuncture has shown efficacy in alleviating depressive symptoms, the underlying mechanisms through which it exerts its antidepressant effects remain incompletely understood. Recent research has underscored the crucial role of glial cells in the pathophysiology of depression. This discovery opens a novel and promising avenue for investigating the mechanisms underlying acupuncture's antidepressant actions. Based on clinical evidence supporting the use of acupuncture in treating depression, this article reviews recent studies on how acupuncture influences the glial cell network. This is the first review of studies examining the effects of acupuncture on glial cells in depression. The review encompasses several key aspects, including microglial polarization and associated inflammatory signaling pathways, the role of astrocytes in maintaining metabolic homeostasis, the processes of oligodendrocyte differentiation and myelin repair, as well as the intricate interactions among these three types of glial cells. However, this paper also has certain limitations, such as the majority of mechanistic evidence deriving from animal models, and due to the heterogeneity of acupuncture protocols and the lack of human causal data.

Delivering therapeutics for neurodegenerative disorders is a complex process as there is involvement of blood brain barrier which prevents the entry of unwanted substances in the brain. Various therapeutic regimens are available showing effectiveness in mental health management but they show adverse effects and hence the conjugation of nanotechnology-based approaches with medicinal plants or phytomedicine have gained interest as phytochemicals are naturally abundant, and show lesser adverse effects than pharmacological regimens, also provide promising targeted delivery to the brain. Researchers have used nanotechnology approaches to encapsulate the herbal or phytomedicine so that the stability and bioavailability can be increased. Nanotechnology-based phytomedicine approaches have shown efficacy in crossing the blood brain barrier easily and increasing the concentration of therapeutics in the brain. This chapter provides a detailed overview on the role of nano phytomedicine in the management of neurodegenerative diseases such as depression and anxiety along with various phytochemicals showing neuroprotective properties and various challenges faced with implementing those in mental health management.