Risk Factors For Major Depression Research Articles

Predictors Of Loneliness In Older Irish Adults And Its Relationship To Depression

Abstract Background Loneliness can affect up to 30% of older adults and is associated with increased morbidity and all cause mortality. Loneliness is also a major risk factor for depression. We aimed to explore the predictors of loneliness in older Irish adults and its relationship to depression. Methods Study participants were Irish adults aged >60 years in the Trinity Ulster University Department of Agriculture (TUDA) study. Participants with an MMSE <24 were excluded, to prevent the inclusion of individuals with dementia. Loneliness in the last week was identified from the 'loneliness' question in the Center for Epidemiological Studies Depression Scale (CES-D) and considered present when experienced ≥1-2 days in the last week and absent when experienced rarely or none of the time. Depression was defined as a CES-D ≥16. Predictors of loneliness were explored in multinomial regression models as well as its association with depression. Results There were 4561 participants, 70% female, mean age 70.1 years and 21.6% experienced loneliness. Positive independent predictors of loneliness were living alone (OR 5.2, CI 4.41-6.14, p<0.001), female sex (OR 1.29, CI 1.07-1.56, p=0.009), timed up and go >12 seconds (OR 1.46-2.32, p<0.001) non-driving status (OR 1.37, CI 1.13-1.67, P=0.001) and lower MMSE (OR 0.57, CI 0.41-0.79, p=0.0006). Those who reported loneliness had a higher prevalence of depression (32.1 vs 3.3%, p<0.0001). Conclusion Living alone was, as expected, the greatest predictor of loneliness followed by physical frailty, non-driving status, female sex, and lower cognition. A high proportion (one third) who felt lonely had depression, though low mood may increase the perception of loneliness independent of social engagement. A limitation is that we did not have a specific validated tool to assess loneliness or to distinguish between `emotional' or `social' loneliness.

Association between serum Klotho and major depression: Results from the NHANES 2007–2016 and Mendelian randomization studies

BackgroundMajor depression is a public health problem facing the world. This study aimed to identify the risk factors for major depression and clarify their causal effects. MethodsData from the National Health and Nutrition Examination Survey (NHANES). Multifactorial logistic regression analysis was used to calculate the effect of each variable on major depression. Subgroup analyses and interaction tests were conducted to observe the stability of the association between them. Nonlinear correlations were explored using restricted cubic spline plots. The causal effects of serum Klotho on major depression were assessed using Mendelian randomization (MR) analysis. ResultsA total of 8359 participated in the study. After adjusting for all covariates, the risk of having major depression was 1.47 times higher for each unit rise in serum Klotho (OR = 1.47, 95 % CI = 1.07–2.02; P = 0.0183). MR analysis showed no causal relationship between serum Klotho levels and risk of major depression (OR = 1.09, 95 % CI = 0.91–1.30; P = 0.4120). Sensitivity analysis verified the reliability of the results. ConclusionsSerum Klotho is positively associated with an increased risk of major depression in the U.S. population, but MR analyses did not show genetic causality between Klotho and major depression in individuals of European ancestry. Based on the results of the current study, no indication maintaining high levels of Klotho may increase the risk of major depression. LimitationsThe main limitation of this study is the inconsistency of the cross-sectional study and the MR population.

The impact of family-genetic risk scores on social functioning in individuals affected with six major psychiatric and substance use disorders in a Swedish National Sample.

To examine whether the level of genetic risk in psychiatric disorders impacts the social functioning of affected individuals, we examine the relationship between genetic risk factors for major depression (MD), anxiety disorders (AD), bipolar disorder (BD), non-affective psychosis (NAP), alcohol use disorder (AUD), and drug use disorder (DUD) in disordered individuals and five adverse social outcomes: unemployment, residence in areas of social deprivation, social welfare, early retirement, and divorce. We examine all cases with registration for these disorders from 1995 to 2015 in individuals born in Sweden. Genetic risk was assessed by the family genetic risk score (FGRS) and statistical estimates by Cox proportional hazard models. High genetic risk was significantly and modestly associated with poorer social outcomes in 23 of 30 analyses. Overall, genetic risk for MD, AD, AUD, and DUD impacted social functioning more strongly in affected individuals than did genetic risk for BD and NAP. Social welfare had the strongest associations with genetic risk, and residence in areas of high deprivation had the weakest. In individuals suffering from psychiatric and substance use disorders, high levels of genetic risk impact not only clinical features but also diverse measures of social functioning.

Analysis of Influencing Factors of Major Depression After Spinal Cord Injury.

To analyze the risk factors of major depressive disorder (MDD) after spinal cord injury (SCI). Patients with SCI in our hospital from February 2020 to February 2023 were selected as the study objects. According to the Hamilton Depression Scale (HAMD) score, patients with 36~75 points were included in the major depression group, and 0~35 points were included in the non-major depression group. The general sociological characteristics (age, gender, educational level, place of residence, family economic status, payment method of medical expenses, marital status) and disease-related characteristics (course of disease, cause of injury, neurological level of injury, type of injury, degree of pain) of all patients were collected, and the items with differences were selected for logistic regression analysis to analyze the risk factors for major depression in patients with spinal cord injury. Totally 216 patients were enrolled in our study, including 45 patients (18.98%) had moderate-to-severe depression and 175 patients (81.02%) had non-severe depression. Univariate analysis showed that gender (χ2 = 11.865, P < .001), course of disease (χ2 = 12.967, P < .001), family economic status (χ2 = 8.610, P = .003), educational level (χ2 =15.287, P < .001), neurological level of injury (χ2 = 9.013, P = .003) and pain level (χ2 = 16.673, P < .001) were statistically significant differences between the 2 groups. Multivariate logistic regression analysis showed that gender [odds ratio (OR) (95 % CI) = 3.986 (1.743~9.116), P = .001], course of disease [OR (95 % CI) = 4.033 (1.818~8.947), P = .001], family economic status [OR (95 % CI) = 3.136 (1.449~6.785), P = .004], educational level [OR (95 % CI) = 4.332 (1.998~9.388), P = .000], neurological level of injury [OR (95 % CI) = 2.848 (1.414~5.734), P = .003], and pain level [OR (95 % CI) = 5.767 (2.309~14.404), P < .001] were risk factors for major depressive disorder in SCI patients. Gender, disease duration, family economic status, education level, level of nerve injury, and pain level may be the independent risk factors of MDD incidence in patients with spinal cord injury.

Relationship of depression symptoms with emotional maturity and dysfunctional attitudes in married students: The mediating role of emotional divorce

Background and aims: Maladaptive cognitive patterns including negative cognitive style and dysfunctional attitudes are major risk factors for depression. This study aimed to investigate the relationship of depression symptoms with emotional maturity and dysfunctional attitudes mediated by emotional divorce in married students. Methods: The statistical population included all married students at the Islamic Azad University of Ahvaz (Iran) during the academic year 2021–2022. A total of 301 students were selected as the research sample based on the research variables. The research instrument included Beck’s Depression Inventory, Emotional Maturity Scale, Dysfunctional Attitudes Scale, and Emotional Divorce Scale. Path analysis was used to evaluate the proposed model in SPSS version 27 and AMOS version 25. Results: The relationship between emotional maturity and emotional divorce was negative and significant (β=-0.45, P&lt;0.001). The relationship between dysfunctional attitudes and depression symptoms was positive and significant (β=0.17, P=0.002). There was a positive and significant relationship between dysfunctional attitudes and emotional divorce (β=0.30, P&lt;0.001) and between emotional divorce and depression symptoms (β=0.39, P&lt;0.001). There were also significant indirect paths from emotional maturity and dysfunctional attitudes to depression symptoms mediated by emotional divorce (P&lt;0.001). Conclusion: The research results indicated that the proposed model had a good fit. Therefore, it was considered a major step in identifying the factors affecting depression symptoms in married students.

Bidirectional causal relationship between psychiatric disorders and osteoarthritis: A univariate and multivariate Mendelian randomization study.

Observational studies have shown associations between psychiatric disorders and osteoarthritis (OA). However, the causal impact of different psychiatric disorder types on specific sites of osteoarthritis remains unclear. This study aimed to comprehensively understand the potential causal associations between psychiatric disorders and osteoarthritis using Mendelian randomization (MR) analysis. We collected data from genome-wide association studies of knee osteoarthritis (KOA) (n=403,124), hip osteoarthritis (HOA) (n=393,873), osteoarthritis of the knee or hip (KHOA) (n=417,596), as well as three psychiatric disorders: bipolar disorder (n=41,917), major depressive disorder (n=170,756), and schizophrenia (n=76,755) among European populations. We applied bidirectional univariate and multivariate MR analyses, including inverse variance weighted, Mendelian randomization-Egger, weighted median, simple mode, and weighted mode. We considered p<.05 as a criterion for identifying potential evidence of association. Bonferroni correction was used for multiple tests. Our univariate MR analysis results demonstrated that bipolar disorder is a protective factor for KOA (OR=0.90, 95% CI=0.83 to 0.97, p=0.0048) and may also be protective for KHOA (p=0.02). Conversely, major depression has a positive causal effect on both KOA (OR=1.27; 95% CI=1.08 to 1.49; p=0.0036) and KHOA (OR=1.24; 95% CI=1.12 to 1.37; p=3.62×10-05 ). Furthermore, our analysis suggested that KHOA may be a risk factor for major depression (OR=1.06; 95% CI=1.00 to 1.12; p=0.0469) in reverse MR. After adjusting smoking (OR=1.46; 95% CI=1.19 to 1.65; p=0.0032) and body mass index (OR=1.44; 95% CI=1.09 to 1.81; p=8.56×10-04 ), the casual association between major depression and KHOA remained. Our study indicates that major depression is a great risk factor for KHOA, increasing the likelihood of their occurrence. However, further in-depth studies will be required to validate these results and elucidate the underlying molecular mechanisms.

The joint effects of genetic liability and the death of close relatives on risk for major depression and alcohol use disorder in a Swedish national sample.

To determine whether genetic risk factors for major depression (MD) and alcohol use disorder (AUD) interact with a potent stressor - death of spouse, parent, and sibling - in predicting episodes of, respectively, MD and AUD. MD and AUD registrations were assessed from national Swedish registries. In individuals born in Sweden 1960-1970, we identified 7586, 388 459, and 34 370 with the loss of, respectively, a spouse, parent, and sibling. We started following subjects at age 18 or the year 2002 with end of follow-up in 2018. We examined time to event - a registration for MD within 6 months or AUD within a year - on an additive scale, using the Nelson-Aalen estimator. Genetic risk was assessed by the Family Genetic Risk Score (FGRS). In separate models controlling for the main effects of death of spouse, parent, and sibling, FGRS, and sex, significant interactions were seen in all analyses between genetic risk for MD and death of relative in prediction of subsequent MD registration. A similar pattern of results, albeit with weaker interaction effects, was seen for genetic risk for AUD and risk for AUD registration. Genetic risk for bipolar disorder (BD) and anxiety disorders (AD) also interacted with event exposure in predicting MD. Genetic risk for both MD and AUD act in part by increasing the sensitivity of individuals to the pathogenic effects of environmental stressors. For prediction of MD, similar effects are also seen for genetic risk for AD and BD.

Gender, homelessness, hospitalization and methamphetamine use fuel depression among people who inject drugs: implications for innovative prevention and care strategies.

The co-occurrence of substance use disorder and mental disorder, known as dual diagnosis, has a distressingly high prevalence among individuals grappling with either of these conditions. Mood disorders, especially depression, constitute a substantial burden for People Who Inject Drugs (PWID) and a significant public health concern in Vietnam. Identifying risk factors for depression in PWID is imperative for the development of targeted interventions. We enrolled PWID into a cohort using the respondent-driven sampling method. Over a 36-month period, we systematically tracked the emergence of depression and employed multiple imputation in conjunction with a mixed nonlinear model to pinpoint risk factors for depression in this demographic. At inclusion, depression was screened using the PHQ-2 questionnaire, and subsequent episodes of depression were assessed semi-annually using the CES-D8. Three hundred and ninety-one PWID (26.6%) were depressed. Major risk factors for depression included being female, not having a permanent residency, having been hospitalized and using methamphetamine more than weekly. Other risk factors included age, being single, not having a health insurance card and not being on methadone. The exclusion of missing visits and social desirability could have led to selection and information biases. In this observational study, confusion biases are possible despite our best efforts. Depression is alarmingly frequent in PWID. In this study taking in account the chronological relationship between sociodemographic and clinical factors and depression, risk factors were identified in this specific setting of low-to-middle income country. The findings highlight the need to develop innovative targeted psychiatric interventions with the help of supporting peers.

Si-Ni-San alleviates early life stress-induced depression-like behaviors in adolescence via modulating Rac1 activity and associated spine plasticity in the nucleus accumbens.

Background: Early life stress (ELS) is a major risk factor for depression in adolescents. The nucleus accumbens (NAc) is a key center of the reward system, and spine remodeling in the NAc contributes to the development of depression. The Si-Ni-San formula (SNS) is a fundamental prescription for treating depression in traditional Chinese medicine. However, little is known about the effects of SNS on behavioral abnormalities and spine plasticity in the NAc induced by ELS. Purpose: This study aimed to investigate the therapeutic effect and the modulatory mechanism of SNS on abnormal behaviors and spine plasticity in the NAc caused by ELS. Methods: We utilized a model of ELS that involved maternal separation with early weaning to explore the protective effects of SNS on adolescent depression. Depressive-like behaviors were evaluated by the sucrose preference test, the tail suspension test, and the forced swimming test; anxiety-like behaviors were monitored by the open field test and the elevated plus maze. A laser scanning confocal microscope was used to analyze dendritic spine remodeling in the NAc. The activity of Rac1 was detected by pull-down and Western blot tests. Viral-mediated gene transfer of Rac1 was used to investigate its role in ELS-induced depression-like behaviors in adolescence. Results: ELS induced depression-like behaviors but not anxiety-like behaviors in adolescent mice, accompanied by an increase in stubby spine density, a decrease in mushroom spine density, and decreased Rac1 activity in the NAc. Overexpression of constitutively active Rac1 in the NAc reversed depression-related behaviors, leading to a decrease in stubby spine density and an increase in mushroom spine density. Moreover, SNS attenuated depression-like behavior in adolescent mice and counteracted the spine abnormalities in the NAc induced by ELS. Additionally, SNS increased NAc Rac1 activity, and the inhibition of Rac1 activity weakened the antidepressant effect of SNS. Conclusion: These results suggest that SNS may exert its antidepressant effects by modulating Rac1 activity and associated spine plasticity in the NAc.

Activation of cell-free mtDNA-TLR9 signaling mediates chronic stress-induced social behavior deficits

Inflammation and social behavior deficits are associated with a number of neuropsychiatric disorders. Chronic stress, a major risk factor for depression and other mental health conditions is known to increase inflammatory responses and social behavior impairments. Disturbances in mitochondria function have been found in chronic stress conditions, however the mechanisms that link mitochondrial dysfunction to stress-induced social behavior deficits are not well understood. In this study, we found that chronic restraint stress (RS) induces significant increases in serum cell-free mitochondrial DNA (cf-mtDNA) levels in mice, and systemic Deoxyribonuclease I (DNase I) treatment attenuated RS-induced social behavioral deficits. Our findings revealed potential roles of mitophagy and Mitochondrial antiviral-signaling protein (MAVS) in mediating chronic stress-induced changes in cf-mtDNA levels and social behavior. Furthermore, we showed that inhibition of Toll-like receptor 9 (TLR9) attenuates mtDNA-induced social behavior deficits. Together, these findings show that cf-mtDNA-TLR9 signaling is critical in mediating stress-induced social behavior deficits.

Developing a nomogram for predicting depression in diabetic patients after COVID-19 using machine learning.

This study identified major risk factors for depression in community diabetic patients using machine learning techniques and developed predictive models for predicting the high-risk group for depression in diabetic patients based on multiple risk factors. This study analyzed 26,829 adults living in the community who were diagnosed with diabetes by a doctor. The prevalence of a depressive disorder was the dependent variable in this study. This study developed a model for predicting diabetic depression using multiple logistic regression, which corrected all confounding factors in order to identify the relationship (influence) of predictive factors for diabetic depression by entering the top nine variables with high importance, which were identified in CatBoost. The prevalence of depression was 22.4% (n = 6,001). This study calculated the importance of factors related to depression in diabetic patients living in South Korean community using CatBoost to find that the top nine variables with high importance were gender, smoking status, changes in drinking before and after the COVID-19 pandemic, changes in smoking before and after the COVID-19 pandemic, subjective health, concern about economic loss due to the COVID-19 pandemic, changes in sleeping hours due to the COVID-19 pandemic, economic activity, and the number of people you can ask for help in a disaster situation such as COVID-19 infection. It is necessary to identify the high-risk group for diabetes and depression at an early stage, while considering multiple risk factors, and to seek a personalized psychological support system at the primary medical level, which can improve their mental health.

Depression, a major comorbidity of psoriatic disease, is caused by metabolic inflammation.

Psoriatic disease is a chronic, systemic immune-mediated inflammatory disorder comprising three major domains, skin, vascular and bone/joint inflammation. It is known for a long time that psoriatic disease is associated with a number of conditions such as hypertension, dyslipidemia, diabetes (metabolic syndrome) and depression. Up to one out of five people with psoriasis show concomitant depression. In the past, this was attributed to psychological stress of suffering from a chronic condition that is often visible and itchy, leading to stigmatization and adding to a significant burden of disease. Recent data provide evidence that depression associated with psoriatic disease is linked to the specific inflammatory pattern with IL-23, IL-17 family cytokines, TNF, IL-6 and IL-8 causing neuroinflammation and subsequently depression or depressive behaviour and/or anxiety. Psoriatic disease shows a distinct pattern of immune cells (e.g. dendritic cells, Th17 cells, neutrophils), mediators (e.g. IL-17A/F, IL-23, TNF) and tissue-related factors in all major domains that is different from other inflammatory dermatoses. There is a striking similarity between the inflammatory pattern in psoriatic disease and neuroinflammation that leads to depression. A number of risk factors have been identified in psoriatic disease, the most important of which are obesity and tobacco smoking. Obesity is known as a major risk factor for depression and anxiety due to its inflammatory signature. Apart from psychotherapy and anti-depressive medication, targeted treatments for psoriasis, including TNF, IL-17 and IL-23 inhibitors, can improve depression/depressive symptoms. The review summarizes the current knowledge about depression as a comorbidity in psoriatic disease.

Gender inequalities in violence victimization and depression in Brazil: results from the 2019 national health survey

BackgroundViolence is a worldwide public health challenge and has been linked to depression in many settings. Depression is higher in women and differential exposure to violence is a potential risk factor – especially in countries with high-levels of violence. This paper provides a comprehensive characterization of the association between violence victimization and depression in Brazil, focusing on sex/gender inequalities.MethodsWe used data from the 2019 wave of the National Health Survey (PNS) in Brazil to assess whether respondents had depression (using PHQ-9) and if they were victims of violence, differentiating by the type of violence, the frequency of victimization, and the primary aggressor. We used logit models to assess the association between victimization and the likelihood of having depression. We predicted probabilities of being depressed, considering the interaction between violence victimization and sex/gender, to analyze the differences between men and women.ResultsRates of violence victimization and depression were higher among women than among men. The odds of being depressed were 3.8 (95%CI: 3.5–4.2) times higher among victims of violence than among non-victims, and 2.3 (95%CI: 2.1–2.6) times higher among women than among men, adjusting for socioeconomic factors. For any given income level, racial/ethnic or age group, victims of violence who were women had the highest predicted probabilities of being depressed – e.g., 29.4% (95%CI: 26.1–32.8) for lower-income women, 28.9% (95%CI: 24.4–33.2) for black women, and 30.4% (95%CI: 25.4–35.4) for younger women that suffered violence. Over one in three women that suffered multiple types of violence, experienced violence more frequently, or where the aggressor was an intimate partner or another family member were predicted to have depression.ConclusionsBeing a victim of violence was strongly associated with higher risk of depression in Brazil, with women more likely to be both victims of violence and develop depression. Frequent, sexual, physical or psychological violence, and intimate partners or family member perpetrators were major risk factors for depression and should be a public health priority.

Gut microbiota changes require vagus nerve integrity to promote depressive-like behaviors in mice.

Chronic stress constitutes a major risk factor for depression that can disrupt various aspects of homeostasis, including the gut microbiome (GM). We have recently shown that GM imbalance affects adult hippocampal (HPC) neurogenesis and induces depression-like behaviors, with the exact mechanisms being under active investigation. Here we hypothesized that the vagus nerve (VN), a key bidirectional route of communication between the gut and the brain, could relay the effects of stress-induced GM changes on HPC plasticity and behavior. We used fecal samples derived from mice that sustained unpredictable chronic mild stress (UCMS) to inoculate healthy mice and assess standard behavioral readouts for anxiety- and depressive-like behavior, conduct histological and molecular analyses for adult HPC neurogenesis and evaluate neurotransmission pathways and neuroinflammation. To study the potential role of the VN in mediating the effects of GM changes on brain functions and behavior, we used mice that sustained subdiaphragmatic vagotomy (Vx) prior the GM transfer. We found that inoculation of healthy mice with GM from UCMS mice activates the VN and induces early and sustained changes in both serotonin and dopamine neurotransmission pathways in the brainstem and HPC. These changes are associated with prompt and persistent deficits in adult HPC neurogenesis and induce early and sustained neuroinflammatory responses in the HPC. Remarkably, Vx abrogates adult HPC neurogenesis deficits, neuroinflammation and depressive-like behavior, suggesting that vagal afferent pathways are necessary to drive GM-mediated effects on the brain.

Influence Of Baseline Comorbid Diseases on Major Depression and The Effect of Intensive Medical Treatment on Functional Mobility in Depressed Patients Compared with Those Without Depression

Objectives Somatic diseases, depression and functional mobility were examined in a follow-up study in geriatric patients. The first aim of the study was to assess the independent and moderator effects of baseline diseases on depression before adjustment by examining whether this influence will sustain or switch after adjustment. The second aim was to explore the differential treatment outcomes in functional mobility in depressed patients versus those with no depression. Methods A sample of n = 1,816 multimorbid patients consisting of n = 902 with a diagnosis of major depression and their counterparts n = 914 without depression were examined at two time points. They all underwent acute rehabilitation. Those who were diagnosed with major depression received an antidepressant and psychotherapy treatment. Depressive symptoms were recorded with the Geriatric Depression Scale. Functional mobility was measured using the Tinetti Test. Results We found that 431 patients (47%) were in partial remission at follow-up. The results yield a significant improvement in functional mobility in both groups as an effect of the intensive rehabilitation program. These findings support published findings highlighting an overall functional health enhancement owing to a combined medical rehabilitation, antidepressant and psychotherapeutic treatment as a result of early intensive rehabilitation for elderly patients with multiple medical conditions. The findings show that elderly patients with multiple chronic conditions benefit from intensive rehabilitation, psychotherapy and antidepressant treatment within three weeks of intensive stationary treatment. Results showed that baseline comorbid diseases (mainly focal neurologic deficits and coronary artery diseases) each act as risk factors for major depression before treatment. An intercept effect was unveiled between obesity and arterial hypertension that arises as risk factors for depression before adjustment. After adjustment, we found that baseline chronic conditions, specifically coronary artery disease, focal neurologic deficits, heart or valvular insufficiency, artificial valvular or pace maker and tumour diagnosis in respiratory organ each act as a potential risk factor for depression occurrence. The intercept effect erased after treatment. Functional health was increased significantly in both groups at follow-up. However, there was no difference in the increase of functional mobility (Tinetti Test) in non-depressed and depressed patients following the rehabilitation. Conclusion The results bolster up the conjecture that specific somatic diseases influence major depression before and after treatment and support an association between somatic diseases, depression, and functional health in elderly patients. In depressed and non-depressed patients, geriatric rehabilitation boosts functional mobility, which is crucial for the maintenance of autonomy in elderly patients. Major depression may hamper functional mobility rehabilitation’s outcome only if not well managed or overlooked.

Childhood maltreatment and subsequent depressive symptoms: a prospective study of the sequential mediating role of self-esteem and internalizing/externalizing problems

BackgroundDepression among adolescents is a seriously disabling public health problem with an extremely high prevalence. Identifying risk factors of depression at an early stage is important to reduce the disease burden. Childhood maltreatment (CM) is one of the major risk factors for depression. The key mediating processes that how CM affects the development of depression, however, still need further clarification. The present study tested the mediating effect of self-esteem, internalizing problems, and externalizing problems between CM and depressive symptoms. Potential sex differences in the foregoing associations were also explored.MethodsA three-wave longitudinal study was carried out among 1,957 middle and high school students from 69 classes in 10 public schools in the Guangdong province of China. Data collection started when students were in grades 7 and 10 (median age: 13.0, range: 11–18) between January and April 2019, and the students were followed up once a year thereafter. Self-reported CM, depressive symptoms, self-esteem, internalizing and externalizing problems, and other demographics were collected. The multiple serial mediation analysis was conducted.ResultsWe found that CM was positively related to subsequent internalizing and externalizing problems, as well as depressive symptoms, while self-esteem was negatively related to depressive symptoms. Serial mediation analysis indicated that self-esteem (mediator 1) and internalizing problems (mediator 2) sequentially mediated the path from CM to depressive symptoms in the overall and male population. Moreover, with externalizing problems as mediator 2, self-esteem (mediator 1) acted as a partial mediator in the association between CM and depressive symptoms in males, whereas externalizing problems played a complete mediating role in females.ConclusionFindings revealed that self-esteem and internalizing problems sequentially mediated the influence of CM on depressive symptoms whereas externalizing problems played an independent mediating role. In addition, sex differences need to be taken into consideration when designing prevention and intervention strategies, given the different psychosocial processes between boys and girls.

Prevalence and Risk Factors of Major Depression in Patients with Diabetic Retinopathy in a Nationally Representative Survey

ABSTRACT Purpose Evaluate the prevalence and risk factors of depression in diabetic retinopathy (DR). Compare subjective and objective measures of visual function predictivity of depression. Methods National Health and Nutrition Examination Survey 2005–2008 participants aged ≥40 who underwent fundus photography, Patient Health Questionnaire (PHQ)-9, and Visual Function Questionnaire (VFQ-25) were included in the study. Multivariable logistic regression was used to evaluate whether DR was a significant risk factor for depression and to evaluate the risk factors for depression in those with DR. Results A total of 5704 participants, 47% male, and mean age 56.5 years were included in this study. Persons with moderate, severe non-proliferative diabetic retinopathy (NPDR), or proliferative retinopathy (PDR) had higher prevalence of depression than participants with mild retinopathy or no retinopathy (14.3%, 6.9%, 7.0%). Moderate-to-severe NPDR or PDR (OR: 2.36, p = .04) was associated with depression. Among persons with DR, best-corrected visual acuity and HbA1c were not associated with depression. However, self-reported measures of vision were associated with depression: some of the time spent worrying about eyesight (OR: 4.59, p = .010), vision limit activities some of the time (OR: 8.52, p < .001), vision limits activities most/all of the time (OR: 6.99, p < .001). Conclusions A significant proportion of patients with DR in the NHANES population had co-morbid major depression. Best corrected visual acuity was not associated with depression in those with DR, while subjective, self-reported measures were associated with depression, suggesting subjective measures are a better determinant of poor mood and low functional status.

Prolonged Physiological Stress Is Associated With a Lower Rate of Exploratory Learning That Is Compounded by Depression

BackgroundStress is a major risk factor for depression, and both are associated with important changes in decision-making patterns. However, decades of research have only weakly connected physiological measurements of stress to the subjective experience of depression. Here, we examined the relationship between prolonged physiological stress, mood, and explore-exploit decision making in a population navigating a dynamic environment under stress: health care workers during the COVID-19 pandemic. MethodsWe measured hair cortisol levels in health care workers who completed symptom surveys and performed an explore-exploit restless-bandit decision-making task; 32 participants were included in the final analysis. Hidden Markov and reinforcement learning models assessed task behavior. ResultsParticipants with higher hair cortisol exhibited less exploration (r = −0.36, p = .046). Higher cortisol levels predicted less learning during exploration (β = −0.42, false discovery rate [FDR]–corrected p [pFDR] = .022). Importantly, mood did not independently correlate with cortisol concentration, but rather explained additional variance (β = 0.46, pFDR = .022) and strengthened the relationship between higher cortisol and lower levels of exploratory learning (β = −0.47, pFDR = .022) in a joint model. These results were corroborated by a reinforcement learning model, which revealed less learning with higher hair cortisol and low mood (β = −0.67, pFDR = .002). ConclusionsThese results imply that prolonged physiological stress may limit learning from new information and lead to cognitive rigidity, potentially contributing to burnout. Decision-making measures link subjective mood states to measured physiological stress, suggesting that they should be incorporated into future biomarker studies of mood and stress conditions.

Efficacy of psychotherapy in subthreshold depression patients: A protocol for an overview of systematic reviews and meta-analyses.

Subthreshold depression is a risk factor for major depression. Psychotherapy is a kind of intervention for subthreshold depression. There have been many systematic reviews synthesized the evidence for its effectiveness toward subthreshold depression. However, there is currently no overview of these systematic reviews. To undertake an overview of meta-analyses and systematic reviews to identify the efficacy of psychotherapy in subthreshold depression patients. We will search several databases such as PubMed, Embase, the Cochrane Library, Web of Science, PsycINFO, CNKI, WanFang and VIP database, for systematic reviews and meta-analyses on psychotherapy in subthreshold depression patients. The search timeline will be from inception up to August 2022. Two researchers will screen related studies back-to-back. We will include studies that evaluate the efficacy of psychotherapy in subthreshold depression patients. We will evaluate the methodological quality, the reporting quality and the quality of evidence for outcomes by AMSTAR-2, the PRISMA 2020 checklist and the GRADE grading system. We will present the results of the overview in alignment with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The anticipated start and completion dates for this overview are 1 August 2022 and 30 December 2022, respectively. From this study, we will evaluate the methodological quality and the level of evidence of the included systematic reviews and meta-analyses, and evaluate the efficacy of psychotherapy in patients with subthreshold depression. We will ascertain the efficacy of psychotherapy in subthreshold depression patients, to provide evidence to guide the treatment of subthreshold depression in the future. Our research protocol has been registered with PROSPERO. The registration number of the protocol is CRD42021278871.

The major risk factor for depression in the Chinese middle-aged and elderly population: A cross-sectional study.

The number of patients suffering from depression is continuously increasing in China. Demographic characteristics, physical health levels, and individual lifestyles/healthy behaviors are associated with the severity of depression. However, the major risk factor for depression remains unclear. In this investigation, 16,512 patients were screened using the CHARLS (China Health and Retirement Longitudinal Study) database after being determined to be eligible based on the inclusion criteria. Depressive symptoms were evaluated through the CESD-10 (10-item Center for Epidemiological Studies Depression Scale). Consequently, various models were developed based on potential predictive factors, employing stepwise LR (Logistic Regression)/RF (Random Forests) models to examine the influence and weighting of candidate factors that affect depression. Gender, residential address location, changes in health status following last interview, physical disabilities, chronic pain, childhood health status, ADL (activity of daily living), and social activity were all revealed to be independent risk factors for depression (p < 0.05) in this study. Depression has a synergic effect (across chronic pain and age groups). In comparison to other factors, RF results showed that chronic pain had a stronger impact on depression. This preliminary study reveals that chronic pain is a major risk factor for depression.