Prevention Of Depression Research Articles

Outcome of Midwife-Led Debriefing on Postpartum Depression in Western Region, Kenya

ABSTRACT Context: Giving birth is a traumatic experience for women, and if unresolved, the emotions it causes can have a lasting negative impact on mental health, including depression in the postpartum period. Depression is a prevalent mental illness that can have major repercussions, particularly after giving birth. There is evidence of postpartum depression. However, many studies have concentrated on the prevalence of postpartum depression. In middle-income countries, including Kenya, very few studies have assessed the outcome of midwife-led debriefing for the prevention of postpartum depression. Aim: The study aimed to assess the outcome of a midwife-led debriefing on postpartum depression in the Western region of Kenya. Methods: The study was a quasi-experimental design with pre and post-test assessments. The study used the postnatal register as the sampling frame. Systematic random sampling was used to identify and allocate participants to the study's intervention and control groups. The target population was women of childbearing age. The study participants were women who gave birth during the study period, of which a sample of 212 participated in the study. The 165 participants were allocated to the intervention group, while 47 participants were in the control group, based on the 22% Prevalence of Postpartum Depression (PPD). Data was collected using a structured questionnaire on demographic characteristics and the Edinburg Postpartum Depression Scale (EPDS) for assessment of postpartum depression level. Results: The study results show that midwife-led debriefing significantly reduced the symptoms of postpartum depression (t=14.672, p-value=0.003). The Odds ratio (OR= 5.41) indicated an association between the intervention of midwife-led debriefing and the outcome (Reduced symptoms of depression) as compared with the standard care. The coefficient of β=0.871 shows a proportional shift in postpartum depression prevention of 0.871 units for every unit increase in midwife-led debriefing. At the 5% significance level, the null hypothesis was rejected (p=0.003), suggesting that postpartum depression could potentially be prevented using midwife-led debriefing. Conclusion: Midwife-led debriefing reduces postpartum depression symptoms. The study recommends that the national and county government health systems integrate midwife-led debriefing into the standard practice for postpartum care.

New Form of LPC-Omega-3 Beneficial for the Prevention and Treatment of Depression - A Novel Finding

New Form of LPC-Omega-3 Beneficial for the Prevention and Treatment of Depression - A Novel Finding

Prevention of Neuronal Damage in Brains of Chronic Stress-induced Male Wistar Rats Administering Centella asiatica (L) Urban

Introduction: Physiological and psychological response of an organism to repetitive stimulus leads to chronic stress which results in depression. This affects the neuro-endocrine axis causing hypersecretion of glucocorticoids which damages the hippocampal neurons in brain through oxidative stress. The body responds by producing Catalase (CAT) an antioxidant found on peroxisomes, which splits the hydrogen peroxide produced by oxidative stress into water and oxygen which are nontoxic, thus offering a protective effect. The synaptic function of the hippocampal neurons is dependent on acetylcholinesterase (AChE) and oxidative stress affects the levels of AChE. The available anti-depressants have the late onset of action and increased toxicity. Centella asiatica (CA), an herb with neuroprotective properties, is known as neuro-tonic and has less toxicity and has been used in ancient traditional medicines. This study aims to examine the neuroprotective effects of crude extract of CA on hippocampal neurons using Nissls stain and levels of AChE and expression of mRNA CAT in the brain tissues of chronic unpredictable mild stress (CUMS)-induced male Wistar rats. Materials and Methods: Thirty-six Male Wistar rats aged 8–10 weeks were held in six groups. One group assigned as control, whereas the other groups were administered CUMS by various stressors, namely restrain, forced swimming in cold water, overnight food and water deprivation, wet bedding, cage tilt at 45°, tail pinching, overcrowding the cages, and change of cage mates randomly for a period of 64 days. One of the stress-induced groups was retained as model group and others were administered crude extracts of CA at the doses of 200, 400, 800, and fluoxetine (Flx) 10 mg/kg body weight. At the end of 64 days, the rats were euthanized and the brain tissue was collected for Nissls staining of the hippocampus, measure levels of AChE using ELISA and expression of mRNA CAT levels using RT-PCR. Results: The rats of the model group exhibited reduced number of viable neurons in the hippocampus as observed in Nissls stain, reduced levels of AChE, and reduced expression of mRNA CAT in the brain tissue while the rat groups receiving CA showed increase in the number of viable neurons, increase in level of AChE, and increase in the expression of mRNA CAT in the brain tissues. The results were comparable to that of Flx. Conclusion: CA effectively attenuates CUMS-induced neuronal loss in the hippocampus of the rat’s brain, normalizes AChE levels, and also the expression of mRNA CAT antioxidant levels. CA could be used in the long-term prevention of chronic stress-induced depression.

Possible effect of exercise with anti-fatigue nutrition on ROS-induced depression and suicide risk: a review.

Epidemiological evidence shows that physical activity, including continuous stimulus changes and appropriate exercise programs, improves brain degeneration in the hippocampus, prefrontal cortex (PFC), and anterior cingulate cortex (ACC). Therefore, we investigated the possible synergistic effects of physical activity and nutrition in controlling chronic fatigue and reducing oxidative stress in patients at risk for depression and suicide. We systematically reviewed the literature on various systemic factors related to the effects of 1) suppressing oxidative stress and 2) improving depression through exercise and nutrition. To conduct this review, we searched the PubMed database for papers published until May 1, 2024, using the terms "physical activity OR exercise" and "fatigue" OR "anti-fatigue," "oxidative stress" and "depression" and "suicide." We then reviewed the resulting list of articles related to antioxidant mechanisms. Appropriate physical activity and natural product intake can substantially change whole-body homeostasis and provide a way to overcome the threat of depression and suicide by regulating metabolites, scavenging free radicals, and neurotransmitters. Suicide and depression prevention play crucial roles in improving patients' quality of life. Our review provides evidence supporting the idea that exercise and antioxidant nutrition diminish oxidative stress and fatigue by improving the degeneration of the hippocampus, PFC, and ACC.

Family and job microsystems as mediators between social integration and depression among rural-to-urban migrant workers in China: does having sons make a difference?

Rural-to-urban migrant workers are a vulnerable group at risk of developing depression. Based on the social-ecological systems theory, this study investigates the impact of the lack of social integration on depression, considering the mediating roles of migrant workers' microsystems (family happiness and job burnout). Additionally, the study explores whether having sons influences these associations. The sample of 4,618 rural-to-urban migrant workers was obtained from the 2018 wave of the China Labor Force Dynamics Survey (CLDS). All the measures in the survey exhibited good reliability, including the Center for Epidemiological Research Depression Scale (CES-D), family happiness, job burnout, and social integration. The data were primarily analyzed using a structural equation model. Social integration had a direct impact on depression among migrant workers. Additionally, it indirectly affected depression through the mediating roles of family happiness not job burnout. The moderating effect of having sons mainly occurred on the path from social integration to family happiness. The cross-sectional design impeded the ability to draw causal inferences. This finding highlights the potential benefits of social integration and family happiness in promoting early prevention of depression among migrant workers. It indicates that the inclination toward having sons among migrant workers continues to impact their mental health.

A secondary analysis of three types of social support in relation to self-efficacy, disease impact, and depression in fibromyalgia

ObjectiveFibromyalgia (FM) is a chronic pain condition associated with depression. However, self-efficacy (belief in own ability to manage symptoms) and social support may be protective. This study tested three types of social support (emotional, tangible, and instrumental) for moderation of the mediating effect of self-efficacy on the relationship between FM impact and depression over time. MethodsSix hundred participants with FM were randomly assigned to no intervention, social support group, or combined self-management and social support. The Fibromyalgia Impact Questionnaire, Norbeck Social Support Questionnaire, FM-modified Arthritis Self-Efficacy Scale, and Center for Epidemiological Studies-Depression surveys were administered at baseline, 6, 12, and 18 months. There were no significant intervention effects on the variables of interest, however, participants' scores were used to assess four longitudinal models. ResultsSelf-efficacy showed mediation both between (b = 0.104, p < .001, 95% CI = [0.071, 0.137]) and within (b = 0.89, p < .001, 95% CI = [0.073, 0.106]) individuals. Only tangible support demonstrated moderation of the relationship between FM impact and self-efficacy, and only between individuals (b = 0.154, p = .022, 95% CI = [0.022, 0.287]). ConclusionThe results indicated that self-efficacy attenuated a portion of the effect of FM impact on depression over time. Additionally, higher levels of tangible support (the belief that your social network can provide you with assistance) were related to weaker influence of FM impact on self-efficacy over time. These factors may be important targets for the prevention of depression in people with FM.

Cognitive Behavioral Program for the Prevention of Depression in At-Risk Adolescents: Isolating the Effects of Dose.

The current study estimated effects of intervention dose (attendance) of a cognitive behavioral prevention (CBP) program on depression-free days (DFD) in adolescent offspring of parents with a history of depression. As part of secondary analyses of a multi-site randomized controlled trial, we analyzed the complete intention-to-treat sample of 316 at-risk adolescents ages 13-17. Youth were randomly assigned to the CBP program plus usual care (n=159) or to usual care alone (n=157). The CBP program involved 8 weekly acute sessions and 6 monthly continuation sessions. Results showed that higher CBP program dose predicted more DFDs, with a key threshold of approximately 75% of a full dose in analyses employing instrumental variable methodology to control multiple channels of bias. Specifically, attending at more than 75% of acute phase sessions led to 45.3 more DFDs over the 9-month period post randomization, which accounted for over 12% of the total follow-up days. Instrument sets were informed by study variables and external data including weather and travel burden. In contrast, conventional analysis methods failed to find a significant dose-outcome relation. Application of the instrumental variable approach, which better controls the influence of confounding, demonstrated that higher CBP program dose resulted in more DFDs.

Selenium Intake and Postnatal Depression-A Short Review.

Postnatal depression is a common and severe complication of childbirth. It is an important public health problem with significant implications for both mothers and children. The exact mechanisms underlying and the factors influencing the occurrence of postnatal depression remain unclear. The literature suggests that certain dietary deficiencies during pregnancy and the postnatal period may contribute to a greater risk of maternal depression. This review focuses on the role of selenium in postnatal depression. It collects evidence from published interventional and observational studies investigating the relationship between selenium intake during the antenatal and postnatal periods and the mental status of postpartum women and summarises information about biological mechanisms that may underlie the association between selenium status and postnatal depression. The review includes studies identified through electronic searches of Medline (via PubMed) and Google Scholar databases until December 2023. Despite the small number of relevant studies and their potential methodological limitations, the findings suggest that optimizing selenium status may support the prevention and treatment of postnatal depression. Further longitudinal and interventional studies are necessary to confirm the clinical significance of these effects.

Early Detection of 5 Neurodevelopmental Disorders of Children and Prevention of Postnatal Depression With a Mobile Health App: Observational Cross-Sectional Study.

Delay in the diagnosis of neurodevelopmental disorders (NDDs) in toddlers and postnatal depression (PND) is a major public health issue. In both cases, early intervention is crucial but too rarely implemented in practice. Our goal was to determine if a dedicated mobile app can improve screening of 5 NDDs (autism spectrum disorder [ASD], language delay, dyspraxia, dyslexia, and attention-deficit/hyperactivity disorder [ADHD]) and reduce PND incidence. We performed an observational, cross-sectional, data-based study in a population of young parents in France with at least 1 child aged <10 years at the time of inclusion and regularly using Malo, an "all-in-one" multidomain digital health record electronic patient-reported outcome (PRO) app for smartphones. We included the first 50,000 users matching the criteria and agreeing to participate between May 1, 2022, and February 8, 2024. Parents received periodic questionnaires assessing skills in neurodevelopment domains via the app. Mothers accessed a support program to prevent PND and were requested to answer regular PND questionnaires. When any PROs matched predefined criteria, an in-app recommendation was sent to book an appointment with a family physician or pediatrician. The main outcomes were the median age of the infant at the time of notification for possible NDD and the incidence of PND detection after childbirth. One secondary outcome was the relevance of the NDD notification by consultation as assessed by health professionals. Among 55,618 children median age 4 months (IQR 9), 439 (0.8%) had at least 1 disorder for which consultation was critically necessary. The median ages of notification for probable ASD, language delay, dyspraxia, dyslexia, and ADHD were 32.5 (IQR 12.8), 16 (IQR 13), 36 (IQR 22.5), 80 (IQR 5), and 61 (IQR 15.5) months, respectively. The rate of probable ADHD, ASD, dyslexia, language delay, and dyspraxia in the population of children of the age included between the detection limits of each alert was 1.48%, 0.21%, 1.52%, 0.91%, and 0.37%, respectively. Sensitivity of alert notifications for suspected NDDs as assessed by the physicians was 78.6% and specificity was 98.2%. Among 8243 mothers who completed a PND questionnaire, highly probable PND was detected in 938 (11.4%), corresponding to a reduction of -31% versus our previous study without a support program. Suspected PND was detected a median 96 days (IQR 86) after childbirth. Among 130 users who filled in the satisfaction survey, 99.2% (129/130) found the app easy to use and 70% (91/130) reported that the app improved follow-up of their child. The app was rated 4.8/5 on Apple's App Store. Algorithm-based early alerts suggesting NDDs were highly specific with good sensitivity as assessed by real-life practitioners. Early detection of 5 NDDs and PNDs was efficient and led to a possible 31% reduction in PND incidence. ClinicalTrials.gov NCT06301087; https://www.clinicaltrials.gov/study/NCT06301087.

The Role of Water-Soluble Vitamins and Vitamin D in Prevention and Treatment of Depression and Seasonal Affective Disorder in Adults.

Depression is a major global health concern expected to worsen by 2030. In 2019, 28 million individuals were affected by depressive disorders. Dietary and supplemental vitamins show overall favorable preventative and therapeutic effects on depression. B vitamins are crucial for neurological function and mood regulation. Deficiencies in these vitamins are linked to depression. Studies on individual B vitamins show promise in improving depressive symptoms, particularly thiamin, riboflavin, niacin, and folate. Vitamin C deficiency may heighten depressive symptoms, but its exact role is not fully understood. Seasonal Affective Disorder (SAD) is associated with insufficient sunlight exposure and vitamin D deficiency. Vitamin D supplementation for SAD shows inconsistent results due to methodological variations. Further investigation is needed to understand the mechanisms of vitamins in depression treatment. Moreover, more research on SAD and light therapy's efficacy and underlying mechanisms involving photoreceptors, enzymes, and immune markers is needed. Although dietary and supplemental vitamins show overall favorable preventative and therapeutic effects on depression, dietitians treating psychiatric disorders face challenges due to diverse study designs, making direct comparisons difficult. Therefore, this article reviews the current literature to assess the role of dietary and supplemental vitamins in the prevention and treatment of depression. This review found that, although evidence supports the role of B vitamins and vitamins C and D in preventing and treating depression, further research is needed to clarify their mechanisms of action and determine the most effective intervention strategies.

Effects of Different Anesthesia Applications on Mood, Depression, and Anxiety Levels in Burn Patients.

Adequate and effective pain management and prevention of depression are essential in patients with burns. This study aims to explore the effects of ketamine sedation in patients with burns in terms of mood disorders, depression, anxiety, and suicidality during postoperative follow-up in the intensive care unit. This study targeted subjects aged 18-65 years, in the ASA I-II class, with basic communication skills, no history of diagnosed mental illness, and no history of neuropsychiatric or cognitive disorders or related treatment. The study was conducted on 67 patients. After preoxygenation, anesthesia induction was practiced with 2 mg/kg intravenous (IV) propofol and 1 mcg/kg IV fentanyl in the general anesthesia group. Anesthesia was continued with a mixture of 0.3-0.5 mcg/kg/min remifentanil, 2% sevoflurane, 50% air, and 50% oxygen. In the sedation group, 1 mcg/kg IV fentanyl and 1 mg/kg IV ketamine were administered at induction; anesthesia was maintained by adding 30-50 mg IV propofol if necessary. The Montgomery-Asberg Depression Rating Scale (MADRS), Hamilton Anxiety Rating Scale (HAM-A), and Beck Scale for Suicidal Ideation (BSSI) have been administered via way of means of a psychiatrist preoperatively and on the primary postoperative day. In intragroup evaluations, MADRS values for the sedation anesthesia group decreased statistically significantly after the anesthesia (11.63 ± 5.49) compared to the preanesthesia period (14.44 ± 7.22) (P < .001). HAM-A scores of both anesthesia groups decreased statistically significantly after anesthesia. No patient was found to have suicidal ideation in all evaluations in which BSSI was used. Patients with burns may have a high potential for depression, anxiety disorders, and suicidal tendencies due to the trauma they have experienced. In these patients, sedation anesthesia with ketamine may reduce negative mood, depression, anxiety, and suicidal tendencies in the postoperative period.

School-based strategies to prevent depression in adolescents: An integrative review

Background: Adolescents are vulnerable to psychological disorders due to rapid physical, cognitive, and psychosocial changes. Depression affects 20% of adolescents worldwide, making it a leading cause of disability. Schools are the ideal places for preventative strategies for school-aged children.Aim: To provide a synthesis of effective school-based strategies to prevent depression in adolescents in Qatar.Methods: The integrative review framework developed by Whittemore and Knafl was utilized to guide this review. The CINAHL, MEDLINE, and Academic Search Complete databases were systematically searched for peer-reviewed primary studies published between 2016 and 2022. Ten articles were included after considering inclusion and exclusion criteria. The quality of the included studies was assessed using the Mixed-Methods Appraisal Tool (MMAT). The Population Health Promotion Model guided the data analysis and presentation of results.Results: The implementation of school-based strategies at individual and family levels is effective in preventing depression in adolescents. At the individual level, the focus is on creating a supportive environment and developing personal skills (social, behavioural regulation, emotional regulation, cognitive regulation, resilience, and coping). At the family level, the focus is on creating a supportive environment and developing personal skills (parental and social).Conclusion: Prevention of depression in adolescents requires multidisciplinary school-based strategies that must focus on creating a supportive environment and developing the personal skills of students and their families. National and organizational policies should be developed in support of multidisciplinary school-based strategies to prevent depression in adolescents.

Exploring the relationship between sleep patterns and depression among Chinese middle school students: a focus on sleep quality vs. sleep duration.

This study aims to explore the relationship between sleep patterns and depressive symptoms among adolescents, examining variations in depressive symptoms across different sleep qualities, durations, and habits. A cross-sectional survey was conducted, gathering data from 8,775 Chinese adolescents on their demographics, lifestyle habits, sleep quality and duration, and depressive symptoms. The association between sleep parameters and depressive symptoms was analyzed using multivariate logistic regression. The findings reveal a significant correlation between sleep quality/duration and depressive symptoms. Specifically, adolescents with poor sleep quality had higher depressive scores (mean score = 14.62, standard deviation = 5.71), significantly exceeding those with better sleep quality (mean score = 11.54, standard deviation = 4.69). Adolescents with shorter sleep duration also showed significantly higher depressive scores than those with moderate sleep duration. Importantly, adolescents experiencing both poor sleep quality and shorter sleep duration were at a significantly increased risk of depressive symptoms (OR = 4.04, 95% CI: 3.53-4.62, P < 0.001). Further analysis indicated that older age and lower family economic status were independent predictors of a higher risk of adolescent depression (OR = 1.22, 95% CI: 1.08-1.38, P = 0.001), whereas factors such as gender, ethnicity, residence, being an only child, and parental education levels were not statistically significant. Among Chinese adolescents, poor sleep quality and shorter sleep duration are independent predictors of higher depressive symptom scores. Adolescents experiencing both of these conditions simultaneously have a significantly increased risk of depressive symptoms. Furthermore, older age and lower family economic status are also significantly related to an increased risk of depression in adolescents. These findings emphasize the importance of improving sleep quality and optimizing sleep duration for the prevention of adolescent depression. They also suggest the need for a comprehensive approach that addresses the multifaceted factors influencing adolescent mental health, including sleep patterns and socioeconomic disparities.

A Mendelian randomization study of the effect of mental disorders on cardiovascular disease.

The effect of mental disorders (MD) on cardiovascular disease (CVD) remains controversial, and this study aims to analyze the causal relationship between eight MD and CVD by Mendelian randomization (MR). Single nucleotide polymorphisms of attention-deficit/hyperactivity disorder (ADHD), anorexia nervosa (AN), anxiety disorder (ANX), autism spectrum disorder (ASD), bipolar disorder (BD), depression, obsessive-compulsive disorder (OCD), schizophrenia (SCZ), and CVD were obtained from UK Biobank and FinnGen. Exposure-outcome causality was tested using inverse variance weighted (IVW), MR-Egger, and weighted median. Horizontal pleiotropy and heterogeneity were assessed by MR-Egger intercept and Cochran's Q, respectively, while stability of results was assessed by leave-one-out sensitivity analysis. MR analysis showed that ANX (IVW [odds ratio (OR) 1.11, 95% confidence intervals (CI) 1.07-1.15, p < 0.001]; MR-Egger [OR 1.03, 95% CI 0.92-1.14, p = 0.652]; weighted median [OR 1.09, 95% CI 1.03-1.14, p = 0.001]), ASD (IVW [OR 1.05, 95% CI 1.00-1.09, p = 0.039]; MR-Egger [OR 0.95, 95% CI 0.84-1.07, p = 0.411]; weighted median [OR 1.01, 95% CI 0.96-1.06, p = 0.805]), depression (IVW [OR 1.15, 95% CI 1.10-1.19, p < 0.001]; MR-Egger [OR 1.10, 95% CI 0.96-1.26, p = 0.169]; weighted median [OR 1.13, 95% CI 1.08-1.19, p < 0.001]) were significantly associated with increased risk of CVD, whereas ADHD, AN, BD, OCD, and SCZ were not significantly associated with CVD (p > 0.05). Intercept analysis showed no horizontal pleiotropy (p > 0.05). Cochran's Q showed no heterogeneity except for BD (p = 0.035). Sensitivity analysis suggested that these results were robust. ANX, ASD, and depression are associated with an increased risk of CVD, whereas AN, ADHD, BD, OCD, and SCZ are not causally associated with CVD. Active prevention and treatment of ANX, ASD, and depression may help reduce the risk of CVD.

Attachment Style Modifies the Effect of Spousal Support on Postpartum Depression in Women.

This study aims to examine the impact of spousal support on postpartum depression in women with different attachment styles and assessing if attachment style influences this effect. From March to May 2022, 96 couples with late-stage pregnant women were randomly selected from tertiary maternity hospitals in Shandong and Guangdong provinces for a prepartum survey. Psychological assessments were conducted using the Adult Attachment Scale, Dyadic Coping Inventory, and the Patient Health Questionnaire-9 (PHQ-9) Depression Scale. To examine the relationship between each variable and postpartum depression, univariate and multiple logistic regression analyses were employed. Additionally, interaction analysis was used to analyze the interplay between different attachment styles and how spousal support influences women's postpartum depression. The findings revealed that even after accounting for confounding variables, prepartum spousal support was an independent predictor of postpartum depression (adjusted odds ratio (OR) = 0.82, 95% CI: 0.69-0.96, P = .015). Women with a secure attachment style showed a significantly lower incidence of postpartum depression compared to those with insecure attachment styles (24.2% vs. 46%, P = .037). In the secure attachment group, spousal support had a protective effect against postpartum depression (adjusted OR = 0.57, 95% CI: 0.36-0.91, P = .018), and attachment style emerged as a potential interactive factor influencing the impact of spousal support on postpartum depression (P for interaction = .029). The provision of spousal support, especially to individuals with secure attachment styles, plays a preventive role in postpartum depression. This underscores the importance of considering attachment styles in interventions targeting postpartum depression prevention.

Factors Influencing Health-related Quality of Life in Adult Women

Objectives: The present study investigates the association between the health-related quality of life of Korean adult women and their socio-demographics, health behavior, and psychological characteristics. Methods: The analysis was carried out using the 8th Korea National Health and Nutrition Examination Survey data (KNHNES) in the second year (2020), and the subjects consisted of 2,181 adult women between the ages of 19-64. A multivariate linear regression analysis was performed, employing three models to identify factors related to health-related quality of life as the dependent variable. In Model 1, socio-demographic characteristics were considered. While Model 2 includes both socio-demographics and health behavior characteristics. In Model 3, psychological characteristics as well as socio-demographic and health behavior characteristics were considered. Results: The health-related quality of life of adult women in late adulthood, post-menopause, low household income, and poor subjective health status were found to be low in the analysis of socio-demographic characteristics. For the health behavior characteristics, the health-related quality of life showed significant differences with respect to smoking, drinking, sleeping, and physical activity but these variables were not identified as the affecting factors. For the psychological characteristics, depression and perceived stress were found to be factors lowering the health-related quality of life. Conclusions: To enhance the health-related quality of life of adult women, prevention and proper management of depression and stress for those with poor health behavior are needed with special care and support for post-menopause women with low household income and poor subjective health status.

Mapping 15-year depressive symptom transitions in late life: population-based cohort study.

The longitudinal course of late-life depression remains under-studied. To describe transitions along the depression continuum in old age and to identify factors associated with specific transition patterns. We analysed 15-year longitudinal data on 2745 dementia-free persons aged 60+ from the population-based Swedish National Study on Aging and Care in Kungsholmen. Depression (minor and major) was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision; subsyndromal depression (SSD) was operationalised as the presence of ≥2 symptoms without depression. Multistate survival models were used to map depression transitions, including death, and to examine the association of psychosocial (social network, connection and support), lifestyle (smoking, alcohol consumption and physical activity) and clinical (somatic disease count) factors with transition patterns. Over the follow-up, 19.1% had ≥1 transitions across depressive states, while 6.5% had ≥2. Each additional somatic disease was associated with a higher hazard of progression from no depression (No Dep) to SSD (hazard ratio 1.09; 1.07-1.10) and depression (Dep) (hazard ratio 1.06; 1.04-1.08), but also with a lower recovery (HRSSD-No Dep 0.95; 0.93-0.97 [where 'HR' refers to 'hazard ratio']; HRDep-No Dep 0.96; 0.93-0.99). Physical activity was associated with an increased hazard of recovery to no depression from SSD (hazard ratio 1.49; 1.28-1.73) and depression (hazard ratio 1.20; 1.00-1.44), while a richer social network was associated with both higher recovery from (HRSSD-No Dep 1.44; 1.26-1.66; HRDep-No Dep 1.51; 1.34-1.71) and lower progression hazards to a worse depressive state (HRNo Dep-SSD 0.81; 0.70-0.94; HRNo Dep-Dep 0.58; 0.46-0.73; HRSSD-Dep 0.66; 0.44-0.98). Older people may present with heterogeneous depressive trajectories. Targeting the accumulation of somatic diseases and enhancing social interactions may be appropriate for both depression prevention and burden reduction, while promoting physical activity may primarily benefit recovery from depressive disorders.

Impact of childhood socioeconomic status on depression among postdoctoral researchers in universities: The chain mediating role of current subjective socioeconomic status and perceived stress.

Postdoctoral researchers in Chinese universities commonly face a high risk of mental health issues, such as depression, yet the underlying causes and mechanisms remain unclear. This study aims to explore the influence of childhood socioeconomic status (SES) on depression among postdoctoral researchers and the mediating roles of current subjective SES and perceived stress in this process. An online survey was conducted among postdoctoral researchers at a university. The survey included a general information questionnaire, the Childhood Socioeconomic Status Scale, the Subjective Socioeconomic Status Scale, the Perceived Stress Scale, and the Patient Health Questionnaire. A total of 505 valid responses were collected. Pearson correlation analysis was used to analyze the data, and the PROCESS macro was employed for chain mediation analysis. Childhood SES was significantly positively correlated with current subjective SES (P<0.05) and significantly negatively correlated with postdoctoral tenure, perceived stress, and depression (all P<0.05). Current subjective SES was significantly negatively correlated with perceived stress and depression (both P<0.05), while perceived stress was significantly positively correlated with depression (P<0.05). The chain mediation effect of childhood SES → current subjective SES → perceived stress → depression was significant (P<0.05). Childhood socioeconomic status can influence depression among postdoctoral researchers through the mediating roles of current subjective socioeconomic status and perceived stress. These findings provide a target for the prevention and intervention of depression in postdoctoral populations and offer a reference for the development of mental health promotion strategies for young university faculty.

Acute neural effects of the mood stabiliser lamotrigine on emotional processing in healthy volunteers: a randomised control trial.

Lamotrigine is an effective mood stabiliser, largely used for the management and prevention of depression in bipolar disorder. The neuropsychological mechanisms by which lamotrigine acts to relieve symptoms as well as its neural effects on emotional processing remain unclear. The primary objective of this current study was to investigate the impact of an acute dose of lamotrigine on the neural response to a well-characterised fMRI task probing implicit emotional processing relevant to negative bias. 31 healthy participants were administered either a single dose of lamotrigine (300 mg, n = 14) or placebo (n = 17) in a randomized, double-blind design. Inside the 3 T MRI scanner, participants completed a covert emotional faces gender discrimination task. Brain activations showing significant group differences were identified using voxel-wise general linear model (GLM) nonparametric permutation testing, with threshold free cluster enhancement (TFCE) and a family wise error (FWE)-corrected cluster significance threshold of p < 0.05. Participants receiving lamotrigine were more accurate at identifying the gender of fearful (but not happy or angry) faces. A network of regions associated with emotional processing, including amygdala, insula, and the anterior cingulate cortex (ACC), was significantly less activated in the lamotrigine group compared to the placebo group across emotional facial expressions. A single dose of lamotrigine reduced activation in limbic areas in response to faces with both positive and negative expressions, suggesting a valence-independent effect. However, at a behavioural level lamotrigine appeared to reduce the distracting effect of fear on face discrimination. Such effects may be relevant to the mood stabilisation effects of lamotrigine.

An Evaluation of the Health Economics of Postnatal Depression Prevention and Treatment Strategies in China: A Cost-Effectiveness Analysis.

The primary objectives of this study are to assess the cost-effectiveness of early postnatal screening and prenatal psychological interventions for the prevention and treatment of postpartum depression (PPD) among Chinese pregnant women. Additionally, we aim to explore the most cost-effective prevention and treatment strategies for PPD in China. We used TreeAge 2019 to construct a decision tree model, with the model assuming a simulated queue size of 10,000 people. The model employed Monte Carlo simulation to assess the cost-effectiveness of PPD prevention and treatment strategies. Transfer probabilities were derived from published studies and meta-analyses. Cost and effectiveness data were obtained from published sources and relevant studies. Incremental cost-effectiveness ratios (ICERs) were used to describe the results, with willingness-to-pay (WTP) thresholds set at China's gross domestic product (GDP) per capita. Compared to the usual care group, the cost per additional quality-adjusted life year (QALY) for the early postnatal screening group and the prenatal psychological interventions is USD 6840.28 and USD 3720.74, respectively. The cure rate of mixed treatments for PPD has the greatest impact on the model, while patient participation in treatment has a minor impact on the cost-effectiveness of prevention and treatment strategies. Both early postnatal screening and prenatal psychological interventions are found to be highly cost-effective strategies for preventing and treating PPD in China. Prenatal psychological interventions for pregnant women are the most cost-effective prevention and treatment strategy. As such, from the perspective of national payers, we recommend that maternal screening for PPD be implemented in China to identify high-risk groups early on and to facilitate effective intervention.