Risk Factors For Major Depression Research Articles

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.

Depression Among Immigrant Nigerians in Canada.

Immigrant status, especially a few years post arrival, is a major risk factor for depression in populations that have been adequately studied. While information on depression among Asian migrants, including those from India, China and Philippines, in Canada have been reported in previous studies, there is inadequate information about depression among Nigerian immigrants who make up the largest percentage of African migrants and black population residing in Canada. A cross-sectional study was conducted among 187 Nigerian immigrants in Canada. Participants completed the Patient Health Questionnaire (PHQ-9). Descriptive and multivariate logistic regression analyses were carried out using IBM SPPS. About half (51.7%, n = 91) of the participants screened positive to the PHQ-9. Being female, unmarried, not being at all satisfied with the decision to migrate, and having stayed for more than 10 years in Canada significantly increased the risk of screening positive to depression. More than half of the participants screened positive for depression, suggesting an important mental health concern and the potential need for intervention. This population differed from other immigrant populations from previous studies because the absence of social support, satisfaction with employment status, and perceived discrimination did not significantly predict a positive screen for depression in this study.

Bullying victimization and depressive symptoms in Chinese adolescents: A moderated mediation model of self-esteem and friendship intimacy

BackgroundDepression is a major mental disorder and poses a serious threat to public health. Bullying victimization is identified as one of the major risk factors for depression in adolescence. Understanding the mechanism that explain why bullying victimization leads to depression, and identifying protective factors that could alleviate the negative effects of bullying victimization are pivotal to developing effective intervention programs. MethodsA sample of Chinese adolescents in junior high schools (N = 458, 50.58 % girls, M age = 11.63 years at T1) was followed for three years. The data on depression, bullying victimization, self-esteem, and friendship intimacy were collected from adolescents' self-report. ResultsAfter controlling related variables, T1 bullying victimization positively predicted T3 depressive symptoms. T2 self-esteem mediated the link between T1 bullying victimization and T3 depressive symptoms when T1 friendship intimacy was low. More specifically, only for youth who reported low friendship intimacy, bullying victimization would lead to a lower level of self-esteem, which in turn, was associated with a higher level of depression. LimitationsThe study only considered the roles of self-esteem as the mediator and friendship intimacy as the moderator. All measures were based on self-report. ConclusionsThe results highlighted the role of friendship intimacy and self-esteem in the longitudinal relation between bullying victimization and depressive symptoms. The results suggest that intervention programs aiming at reducing victimized adolescents' depressive symptoms should consider the buffering effect of friendship intimacy.

Developing and validating a prediction model of adolescent major depressive disorder in the offspring of depressed parents.

Parental depression is common and is a major risk factor for depression in adolescents. Early identification of adolescents at elevated risk of developing major depressive disorder (MDD) in this group could improve early access to preventive interventions. Using longitudinal data from 337 adolescents at high familial risk of depression, we developed a risk prediction model for adolescent MDD. The model was externally validated in an independent cohort of 1,384 adolescents at high familial risk. We assessed predictors at baseline and MDD at follow-up (a median of 2-3 years later). We compared the risk prediction model to a simple comparison model based on screening for depressive symptoms. Decision curve analysis was used to identify which model-predicted risk score thresholds were associated with the greatest clinical benefit. The MDD risk prediction model discriminated between those adolescents who did and did not develop MDD in the development (C-statistic = .783, IQR (interquartile range) = .779, .778) and the validation samples (C-statistic = .722, IQR = -.694, .741). Calibration in the validation sample was good to excellent (calibration intercept = .011, C-slope = .851). The MDD risk prediction model was superior to the simple comparison model where discrimination was no better than chance (C-statistic = .544, IQR = .536, .572). Decision curve analysis found that the highest clinical utility was at the lowest risk score thresholds (0.01-0.05). The developed risk prediction model successfully discriminated adolescents who developed MDD from those who did not. In practice, this model could be further developed with user involvement into a tool to target individuals for low-intensity, selective preventive intervention.

Depression and quality of life in Tunisian institutionalized elderly subjects

IntroductionDepression in the elderly is common and closely interrelated with the deterioration of the quality of life, especially in the institutionalized elderly.ObjectivesIn this work, we propose to determine the prevalence of depression in the elderly in institution, to assess their quality of life and to evaluate the correlations between depression and the quality of life.MethodsOur study concerned 30 elderly subjects institutionalized at the retirement home(Sousse, Tunisia). Three validated Arabic version scales were used: The 30-item GDS (Geriatric Depression Scale), the MMSE (Mini Mental State Examination) and the SF36 (assessing the quality of life).ResultsThe mean age of our population was 75±7.3 years, the sex ratio was 1.73. The prevalence of depression was 37%. The elderly had a cognitive impairment in 16.7%. The mean global SF36 score were 11.2, attesting an altered quality of life in all our subjects: the mental component (9.43) were more altered than the physical one (13.03). No correlation between depression and quality of life was found. Depression was significantly correlated with the presence of a medical history (p=0.05). Depression had a negative and statistically significant correlation with the physical score of SF36 (r=-0.41, p=0.02) and tended towards significance for the “general health” dimension of SF36 (r=-0.32, p=0.08).ConclusionsOur study shows a high frequency of depression in the institutionalized elderly as well as a deterioration in their quality of life. Depression is strongly linked to deterioration in physical condition.Our results underline the influence of somatic diseases as a major risk factor for depression in the elderly.DisclosureNo significant relationships.

A lifespan perspective on depression in the postpartum period in a racially and socioeconomically diverse sample of young mothers.

Consistent evidence from retrospective reports and case registry studies indicates that a history of depression is a major risk factor for depression in the peripartum period. However, longitudinal studies with racially and socioeconomically diverse samples of young mothers are lacking, and little is known about developmental patterns of depression across the lifespan that can inform preventive interventions. Young primiparous mothers (n = 399, 13-25 years, 81% Black) were recruited from a population-based prospective study that began in childhood. Women reported on depression symptoms for at least 3 years prior to their pregnancy, during pregnancy, and at 4 months postpartum. Linear regression models were used to estimate change in pre-pregnancy depression severity and to evaluate associations between patterns of lifetime history and postpartum depression symptoms. Results revealed high levels of continuity in depression from pregnancy to postpartum, and across multiple years pre-pregnancy to postpartum. Overall, depression severity leading up to pregnancy decreased over time, but patterns of worsening or improving symptoms were not associated with depression severity in the postpartum period. Instead, area under the pre-pregnancy trajectory curve, representing cumulative lifetime depression burden, was uniquely associated with postpartum depression after adjusting for prenatal depression severity. Depression in the postpartum period should be considered within a lifespan perspective of risk that accumulates before conception. Clinical screening and early interventions are needed in adolescence and young adulthood to prevent the onset and persistence of depressive symptoms that could have long-term implications for peripartum health.

Stress and Susceptibility in the Ventral Hippocampus to Nucleus Accumbens Pathway

Stress is a major risk factor for depression, yet not everyone who experiences stress becomes depressed. Identifying mechanisms of differential vulnerability is important for targeted treatment and prevention. We previously identified a role for the ventral hippocampus (vHPC) to nucleus accumbens (NAc) pathway in stress-induced susceptibility. Here, we hypothesized that pre-stress differences in vHPC-NAc neural activity may predict susceptibility to future stress.

P216. Effects of Acute Stress on Dorsal Anterior Cingulate Encoding of Expected Value in MDD

Stress is a major risk factor for depression and is known to alter cortostriatal networks critical for reinforcement learning. To date, however, the specific computational mechanisms that are affected by stress and MDD are unclear.

P212. Sidekick-1, a Novel Regulator of Stress Resilience in the Prefrontal Cortex

Stress is a major risk factor for depression, yet some individuals remain resilient. We previously identified Sidekick-1 (Sdk1) as a hub-gene in a network regulating resilience in male mice. Here we probe Sdk1 expression in the adult prefrontal cortex (PFC) and modulation by stress in male and female mice.

The structure of the symptoms of major depression: Factor analysis of a lifetime worst episode of depressive symptoms in a large general population sample

BackgroundA range of depressive symptoms may occur during an episode of major depression (MD). Do these symptoms describe a single disorder liability or different symptom dimensions? This study investigates the structure and clinical relevance of an expanded set of depressive symptoms in a large general population sample. MethodsWe studied 43,431 subjects from the Dutch Lifelines Cohort Study who participated in an online survey assessing the 9 symptom criteria of MD (DSM-IV-TR) and additional depressive symptoms during their worst lifetime episode of depressive symptoms lasting two weeks or more. Exploratory factor analyses were performed on expanded sets of 9, 14, and 24 depressive symptoms. The clinical relevance of the identified symptom dimensions was analyzed in confirmatory factor analyses including ten external validators. ResultsA single dimension adequately accounted for the covariation among the 9 DSM-criteria, but multiple dimensions were needed to describe the 14 and 24 depressive symptoms. Five dimensions described the structure underlying the 24 depressive symptoms. Three cognitive affective symptom dimensions were mainly associated with risk factors for MD. Two somatic dimensions –appetite/weight problems and sleep problems—were mainly associated with BMI and age, respectively. LimitationsRespondents of our online survey tended to be more often female, older, and more highly educated than non-respondents. ConclusionsDifferent symptom dimensions described the structure of depressive symptoms during a lifetime worst episode in a general population sample. These symptom dimensions resembled those reported in a large clinical sample of Han-Chinese women with recurrent MD, suggesting robustness of the syndrome of MD.

Characterizing mood disorders in the AFFECT study: a large, longitudinal, and phenotypically rich genetic cohort in the US

There has recently been marked progress in identifying genetic risk factors for major depression (MD) and bipolar disorder (BD); however, few systematic efforts have been made to elucidate heterogeneity that exists within and across these diagnostic taxa. The Affective disorders, Environment, and Cognitive Trait (AFFECT) study presents an opportunity to identify and associate the structure of cognition and symptom-level domains across the mood disorder spectrum in a prospective study from a diverse US population.Participants were recruited from the 23andMe, Inc research participant database and through social media; self-reported diagnosis of MD or BD by a medical professional and medication status data were used to enrich for mood-disorder cases. Remote assessments were used to acquire an extensive range of phenotypes, including mood state, transdiagnostic symptom severity, task-based measures of cognition, environmental exposures, personality traits. In this paper we describe the study design, and the demographic and clinical characteristics of the cohort. In addition we report genetic ancestry, SNP heritability, and genetic correlations with other large cohorts of mood disorders.A total of 48,467 participants were enrolled: 14,768 with MD, 9864 with BD, and 23,835 controls. Upon enrollment, 47% of participants with MD and 27% with BD indicated being in an active mood episode. Cases reported early ages of onset (mean = 13.2 and 14.3 years for MD and BD, respectively), and high levels of recurrence (78.6% and 84.9% with >5 episodes), psychotherapy, and psychotropic medication use. SNP heritability on the liability scale for the ascertained MD participants (0.19–0.21) was consistent with the high level of disease severity in this cohort, while BD heritability estimates (0.16–0.22) were comparable to reports in other large scale genomic studies of mood disorders. Genetic correlations between the AFFECT cohort and other large-scale cohorts were high for MD but not for BD. By incorporating transdiagnostic symptom assessments, repeated measures, and genomic data, the AFFECT study represents a unique resource for dissecting the structure of mood disorders across multiple levels of analysis. In addition, the fully remote nature of the study provides valuable insights for future virtual and decentralized clinical trials within mood disorders.

Housing quality determinants of depression and suicide ideation by age and gender

The Covid-19 pandemic and subsequently increased time spent at home signified the importance of understanding on the link between housing and mental health. This paper examines how housing qualities affect depression and suicide ideation for each age group (i.e. young adults, middle-aged and older adults) and gender. With South Korea population-based panel data, fixed-effect models and a partial least squares structural equation model were used. A functional problem was a major risk factor for depression in women, whereas a structural problem was a key risk factor for men’s depression. For older adults, living in basement and vulnerability to natural disaster were detrimental to mental health. Functional problems increased the likelihood of suicide ideation in the middle-aged. The mechanisms of the housing qualities-mental health nexus were varied by age and gender. This paper proposed policy suggestions including a tailored housing policy and provision, a housing rating system for health and a support system for noise control.

A psychological intervention by community pharmacies to prevent depression in adults with subthreshold depression and long-term conditions: the CHEMIST pilot RCT

Background Depression is common in people with long-term health conditions, and this combination can lead to worsened health outcomes and increased health-care costs. Subthreshold depression, a risk factor for major depression, is prevalent in this population, but many people remain untreated due to the demand on services. The community pharmacy may be an alternative setting to offer mental health support; however, insufficient evidence exists to support implementation. Objectives To conduct a feasibility study and pilot randomised controlled trial of a community pharmacy-delivered psychological intervention aimed at preventing depression in adults with long-term health conditions. Design A feasibility study with nested qualitative evaluation and an external pilot, two-arm, 1 : 1 individually randomised controlled trial with nested process and economic evaluations. Setting Community pharmacies in the north of England. Participants Adults aged ≥ 18 years with subthreshold depression and at least one long-term health condition. Intervention A bespoke enhanced support intervention (behavioural activation within a collaborative care framework) involving up to six sessions delivered by trained community pharmacy staff (intervention facilitators) compared with usual care. Main outcome measures Recruitment and retention rates, completeness of outcome measures and intervention engagement. The intended primary outcome was depression severity at 4 months, assessed by the Patient Health Questionnaire-9. Results In the feasibility study, 24 participants were recruited. Outcome measure completeness was 95–100%. Retention at 4 months was 83%. Seventeen participants (71%) commenced intervention sessions and all completed two or more sessions. Depression symptoms reduced slightly at 4 months. The process evaluation suggested that the intervention was acceptable to participants and intervention facilitators. In the pilot randomised controlled trial, 44 participants (target of 100 participants) were randomised (intervention, n = 24; usual care, n = 20). Outcome measure completeness was 100%. Retention at 4 months was 93%. Eighteen participants (75%) commenced intervention sessions and 16 completed two or more sessions. Depression symptoms reduced slightly at 4 months, with a slightly larger reduction in the usual-care arm, although the small sample size limits any conclusions. The process evaluation reported good acceptability of the intervention and identified barriers associated with study implementation and its impact on core pharmacy functions. The economic analysis revealed some indication of reduced resource use/costs associated with the intervention, but this is limited by the small sample size. Intervention costs were low. Limitations The main limitation is the small sample size due to difficulties with recruitment and barriers to implementing the study within existing pharmacy practices. Conclusions The community pharmacy represents a new setting to deliver a depression prevention intervention. Recruitment was a challenge and pharmacy staff encountered barriers to effective implementation of the study within busy pharmacy practice. Despite these challenges, good retention rates and intervention engagement were demonstrated, and process evaluation suggested that the intervention was acceptable in this setting. To the best of our knowledge, this is the first study to demonstrate that community pharmacy staff can be trained to deliver a depression prevention intervention. Future work Further work is needed to address barriers to recruitment, intervention delivery and implementation of psychological interventions in the community pharmacy setting. Trial registration This trial is registered as ISRCTN11290592. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 10, No. 5. See the NIHR Journals Library website for further project information.

The prevalence and risk of developing major depression among individuals with subthreshold depression in the general population.

Subthreshold depression could be a significant precursor to and a risk factor for major depression. However, reliable estimates of the prevalence and its contribution to developing major depression under different terminologies depicting subthreshold depression have to be established. By searching PubMed and Web of Science using predefined inclusion criteria, we included 1 129 969 individuals from 113 studies conducted. The prevalence estimates were calculated using the random effect model. The incidence risk ratio (IRR) was estimated by measuring the ratio of individuals with subthreshold depression who developed major depression compared to that of non-depressed individuals from 19 studies (88, 882 individuals). No significant difference in the prevalence among the different terminologies depicting subthreshold depression (Q = 1.96, p = 0.5801) was found. By pooling the prevalence estimates of subthreshold depression in 113 studies, we obtained a summary prevalence of 11.02% [95% confidence interval (CI) 9.78-12.33%]. The youth group had the highest prevalence (14.17%, 95% CI 8.82-20.55%), followed by the elderly group (12.95%, 95% CI 11.41-14.58%) and the adult group (8.92%, 95% CI 7.51-10.45%). Further analysis of 19 studies' incidence rates showed individuals with subthreshold depression had an increased risk of developing major depression (IRR = 2.95, 95% CI 2.33-3.73), and the term minor depression showed the highest IRR compared with other terms (IRR = 3.97, 95% CI 3.17-4.96). Depression could be a spectrum disorder, with subthreshold depression being a significant precursor to and a risk factor for major depression. Proactive management of subthreshold depression could be effective for managing the increasing prevalence of major depression.

Neural correlates of negative emotion processing in subthreshold depression.

Subthreshold depression (SD) is regarded as a major risk factor for major depression. However, little is known about the neural mechanism of negative emotion processing in SD. The study aimed to examine the different neural correlates for negative emotion processing in SD and health controls (HCs) and to investigate changes in functional connectivity in SD compared with HC. Blood oxygenation level-dependent (BOLD) responses of SD and HC were captured while performing a passive viewing task, which comprised a negative condition and a masked condition. A total of 42 SD and 32 HC adolescents participated in the study. Between-group comparisons revealed significant reduced activations in the superior frontal gyrus (SFG), middle frontal gyrus and middle cingulate gyrus. Region of interest (ROI) analyses did not find correlations between contrast values of the ROIs and depressive symptoms. In addition, we found a significant increased functional connectivity between the SFG and caudate, pallidum and insula, which was significantly correlated with depressive symptoms in the SD group (P < 0.05). Altered functional connectivity between the SFG and caudate, pallidum and insula may underlie the pathology of SD. This is the first study to investigate neural mechanisms of negative emotion processing in SD using task-based functional magnetic resonance imaging.

It's giving me the blues: A fixed-effects and g-formula approach to understanding job insecurity, sleep disturbances, and major depression

Research suggests that work-related factors like job insecurity increases the risk of major depression (MD), although it is unclear whether the association is causal. Research further suggests that job insecurity increases sleep disturbances, which is also a risk factor for MD. Based on current knowledge, it is possible that job insecurity operates through sleep disturbances to affect MD, but this pathway has not been examined in the literature. The current study extends the literature by using two complementary, counterfactual approaches (i.e., random- and fixed-effects regression and a mediational g-formula) to examine whether job insecurity causes MD and whether sleep disturbances mediate the relationship. A methodological triangulation approach allowed us to adjust for unobserved and intermediate confounding, which has not been addressed in prior research. Findings suggest that the relationship between job insecurity and MD is primarily direct, that hypothetically intervening on job insecurity (in our g-formula) would reduce MD by approximately 10% at the population level, and this relationship operates via sleep disturbances to some degree. However, the indirect pathway had a high degree of uncertainty.