Self-reported Depressive Symptoms Research Articles

Bidirectional Mendelian Randomization and Multiphenotype GWAS Show Causality and Shared Pathophysiology Between Depression and Type 2 Diabetes.

Depression is a common comorbidity of type 2 diabetes. We assessed the causal relationships and shared genetics between them. We applied two-sample, bidirectional Mendelian randomization (MR) to assess causality between type 2 diabetes and depression. We investigated potential mediation using two-step MR. To identify shared genetics, we performed 1) genome-wide association studies (GWAS) separately and 2) multiphenotype GWAS (MP-GWAS) of type 2 diabetes (19,344 case subjects, 463,641 control subjects) and depression using major depressive disorder (MDD) (5,262 case subjects, 86,275 control subjects) and self-reported depressive symptoms (n = 153,079) in the UK Biobank. We analyzed expression quantitative trait locus (eQTL) data from public databases to identify target genes in relevant tissues. MR demonstrated a significant causal effect of depression on type 2 diabetes (odds ratio 1.26 [95% CI 1.11-1.44], P = 5.46 × 10-4) but not in the reverse direction. Mediation analysis indicated that 36.5% (12.4-57.6%, P = 0.0499) of the effect from depression on type 2 diabetes was mediated by BMI. GWAS of type 2 diabetes and depressive symptoms did not identify shared loci. MP-GWAS identified seven shared loci mapped to TCF7L2, CDKAL1, IGF2BP2, SPRY2, CCND2-AS1, IRS1, CDKN2B-AS1. MDD has not brought any significant association in either GWAS or MP-GWAS. Most MP-GWAS loci had an eQTL, including single nucleotide polymorphisms implicating the cell cycle gene CCND2 in pancreatic islets and brain and the insulin signaling gene IRS1 in adipose tissue, suggesting a multitissue and pleiotropic underlying mechanism. Our results highlight the importance to prevent type 2 diabetes at the onset of depressive symptoms and the need to maintain a healthy weight in the context of its effect on depression and type 2 diabetes comorbidity.

Depressive Symptoms Longitudinally Mediate the Effect of Hyperglycemia on Memory Decline in Type 2 Diabetes.

We sought to examine the mediating role of changes in depressive symptoms in the association between chronic hyperglycemia and longitudinal cognition in a sample of older adults with type 2 diabetes (T2D). We conducted a longitudinal mediation analysis using structural equation modeling of observational data collected over 6 years from 2,155 participants with T2D (aged ≥51 years) in the U.S.-wide Health and Retirement Study. T2D was defined using self-reported diagnosis, and HbA1c was assessed at study baseline. Self-reported depressive symptoms were assessed at two time points 4 years apart. Episodic memory was measured using a list-learning test administered at three time points over 6 years. We adjusted for sociodemographics, chronic health comorbidities, medication adherence, study enrollment year, and prior years' depressive symptoms and memory scores. At baseline, participants' mean age was 69.4 (SD = 9.1), mean HbA1c was 7.2% (SD = 1.4%), 55.0% were women, 19.3% were non-Latinx Black, and 14.0% were Latinx. Higher baseline levels of HbA1c were associated with increases in depressive symptoms over 4 years, which, in turn, were associated with poorer memory 2 years later. Depressive symptoms accounted for 19% of the longitudinal effect of HbA1c on memory over the 6-year period. Sensitivity analyses ruled out alternative directions of associations. Incident elevations in depressive symptoms mediated the longitudinal association between hyperglycemia and 6-year episodic memory scores. For older adults with T2D, interventions to prevent HbA1c-related incident depressive symptoms may be beneficial in reducing the neurotoxic effects of chronic hyperglycemia on cognition.

Association of cannabis, cannabidiol and synthetic cannabinoid use with mental health in UK adolescents.

Cannabis has been associated with poorer mental health, but little is known of the effect of synthetic cannabinoids or cannabidiol (often referred to as CBD). To investigate associations of cannabis, synthetic cannabinoids and cannabidiol with mental health in adolescence. We conducted a cross-sectional analysis with 13- to 14-year-old adolescents across England and Wales in 2019-2020. Multilevel logistic regression was used to examine the association of lifetime use of cannabis, synthetic cannabinoids and cannabidiol with self-reported symptoms of probable depression, anxiety, conduct disorder and auditory hallucinations. Of the 6672 adolescents who participated, 5.2% reported using of cannabis, 1.9% reported using cannabidiol and 0.6% reported using synthetic cannabinoids. After correction for multiple testing, adolescents who had used these substances were significantly more likely to report a probable depressive, anxiety or conduct disorder, as well as auditory hallucinations, than those who had not. Adjustment for socioeconomic disadvantage had little effect on associations, but weekly tobacco use resulted in marked attenuation of associations. The association of cannabis use with probable anxiety and depressive disorders was weaker in those who reported using cannabidiol than those who did not. There was little evidence of an interaction between synthetic cannabinoids and cannabidiol. To our knowledge, this study provides the first general population evidence that synthetic cannabinoids and cannabidiol are associated with probable mental health disorders in adolescence. These associations require replication, ideally with prospective cohorts and stronger study designs.

Positive effects of the COVID-19 pandemic on depression and anxiety in Chinese adolescents

The potential impact on mental health of home schooling and social isolation due to COVID-19 lockdowns has led to widespread concern, particularly for adolescents. However, studies including pre-pandemic data from longitudinal cohorts with an assessment of the longer-term impact of the Covid-19 pandemic beyond the first months of 2020 are scarce. This longitudinal study of 1534 adolescents attending a secondary school in Hunan province investigated self-reported symptoms of anxiety and depression using two validated scales (Screen for Child Anxiety Related Disorders, Child Mood and Feelings Questionnaire) at six time points before, during, and after the 2020 national lockdown restrictions in China. Perceived COVID-related stress was assessed by an author-developed scale at two timepoints during the lockdown. We investigated trends in symptoms over time with a fixed effects model and multiple imputations of missing data. Counter to our expectations, depressive and anxiety symptoms were reduced during the 2020 lockdown relative to pre-lockdown (depression: b = − 3.37, SE = 0.345, Cohen’s d = − 0.25, p < 0.0001; anxiety: b = − 4.55, SE = 0.382, Cohen’s d = − 0.30, p < 0.0001). Symptoms remained significantly reduced even after lockdown restrictions eased. Higher symptom levels during lockdown were associated with greater self-reported COVID-related stress (depression: b = 0.11, SE = 0.026, p < 0.0001; anxiety: b = 0.11, SE = 0.036, p < 0.0001). Although COVID-related stresses correlated with higher levels of anxiety and depression, the lockdown period was associated with improved symptom levels in the adolescents taking part in our study. School closures may have improved the mental health of adolescents in China. We speculate this beneficial effect of lockdown can be explained by the adverse effects of attending school itself such as exposure to bullying and achievement pressures.

Mild Cognitive Impairment, But Not HIV Status, is Related to Reduced Awareness of Level of Cognitive Performance Among Older Adults

Self-assessment of cognitive abilities can be an important predictor of clinical outcomes. This study examined impairments in self-assessments of cognitive performance, assessed with traditional neuropsychological assessments and novel virtual reality tests among older persons with and without human immunodeficiency virus (HIV) and mild cognitive impairment (MCI). One hundred twenty-two participants (82 persons with HIV; 79 MCI+) completed a traditional neuropsychological battery, DETECT virtual reality cognitive battery, and self-reported their general cognitive complaints, depressive symptoms, and perceptions of DETECT performance. Relationships between DETECT performance and self-assessments of performance were examined as were the correlations between general cognitive complaints and performance. These relations were evaluated across HIV and MCI status, considering the associations of depressive symptoms, performance, and self-assessment. We found no effect of HIV status on objective performance or self-assessment of DETECT performance. However, MCI+ participants performed worse on DETECT and traditional cognitive tests, while also showing a directional bias towards overestimation of their performance. MCI- participants showed a bias toward underestimation. Cognitive complaints were reduced compared to objective performance in MCI+ participants. Correlations between self-reported depressive symptoms and cognitive performance or self-assessment of performance were nonsignificant. MCI+ participants underperformed on neuropsychological testing, while overestimating performance. Interestingly, MCI- participants underestimated performance to approximately the same extent as MCI+ participants overestimated. Practical implications include providing support for persons with MCI regarding awareness of limitations and consideration that self-assessments of cognitive performance may be overestimated. Similarly, supporting older persons without MCI to realistically appraise their abilities may have clinical importance.

A protocol for a wait list control trial of an intervention to improve pain and depressive symptoms among middle-aged and older African American women

BackgroundPain and depression frequently co-occur among older adults with comorbidities and can exacerbate one another. The intersection of race, gender and age puts older African American women at high risk of experiencing comorbid pain and depression. The purpose of this study is to test the feasibility and acceptability of a 12-week behavioral activation intervention called DAPPER (Depression and Pain Perseverance through Empowerment and Recovery) that uses non-pharmacological, tailored strategies to target pain and mood symptoms. We will measure pain intensity and depressive symptoms as outcomes, although we are not powered to test differences. MethodsWe describe the protocol for this study that uses a randomized waitlist control design to examine acceptability and feasibility of an intervention. The study population is comprised of self-identified African American women, 50 years of age or older with chronic pain and who self-report of depressive symptoms. Participants must also be pre-frail or frail and have an ADL or IADL limitation. The intervention consists of eight 1–2-h visits with a nurse interventionist via in-person or virtual telecommunication methods and two visits for non-invasive specimen collection. The primary outcomes include goal attainment, pain and depressive symptoms. Secondary outcomes include stress, frailty, and communication with providers. Follow-up qualitative interviews are conducted with participants to assess intervention acceptability. DiscussionFindings from this pilot study will provide further evidence supporting the use of non-pharmacological techniques to intervene in the cycle of pain and depression among an at-risk sub-population.

Traumatic Life Events and Association With Depression, Anxiety, and Somatization Symptoms in Female Refugees

Different types of traumatic life events have varying impacts on symptoms of depression, anxiety, and somatization. For women from areas of the world experiencing war and humanitarian crises, who have experienced cumulative trauma exposure during war and forced migration, it is not known whether cumulative trauma or particular events have the greatest impact on symptoms. To examine which traumatic life events are associated with depression, anxiety, and somatization symptoms, compared with the cumulative amount, in a sample of female refugees. For this cross-sectional study, data were collected in 2016 as a part of The Study on Female Refugees. The current analysis was conducted in 2022 to 2023. This multicenter study covered 5 provinces in Germany. Participants were recruited at reception centers for refugees. Women volunteered to participate and to be interviewed after information seminars at the different centers. Traumatic life events experienced by refugees from areas of the world experiencing war and humanitarian crises. Demographic variables (age, country of origin, religion, education, relationship status, and children), traumatic and adverse life events, and self-reported depression, anxiety, and somatization symptoms were measured. Random forest regressions simultaneously examined the importance of these variables on symptom scores. Follow-up exploratory mediation models tested potential associative pathways between the identified variables of importance. For the final sample of 620 refugee women (mean [SD] age, 32.34 [10.35] years), family violence was most associated with depression (mean [SD] variable of importance [VIM], 2.93 [0.09]), anxiety (mean [SD] VIM, 4.15 [0.11]), and somatization (mean [SD] VIM, 3.99 [0.15]), even though it was less common than other traumatic experiences, including war, accidents, hunger, or lack of housing. Other factors, such as childhood sexual abuse, injury, near-death experiences, and lack of access to health care, were also important. Follow-up analyses showed partial mediation effects between these factors in their association with symptoms, supporting the unique importance of family violence in understanding mental health. The findings of this cross-sectional study of refugee women who experienced multiple severe traumas related to war in their home countries and danger encountered during their migration suggest that family violence was key to their current mental health problems. Culturally sensitive assessment and treatment need to place special emphasis on these family dynamics.

Poorer aging trajectories are associated with elevated serotonin synthesis capacity.

The dorsal raphe nucleus (DRN) is one of the earliest targets of Alzheimer's disease-related tau pathology and is a major source of brain serotonin. We used [18F]Fluoro-m-tyrosine ([18F]FMT) PET imaging to measure serotonin synthesis capacity in the DRN in 111 healthy adults (18-85 years-old). Similar to reports in catecholamine systems, we found elevated serotonin synthesis capacity in older adults relative to young. To establish the structural and functional context within which serotonin synthesis capacity is elevated in aging, we examined relationships among DRN [18F]FMT net tracer influx (Ki) and longitudinal changes in cortical thickness using magnetic resonance imaging, longitudinal changes in self-reported depression symptoms, and AD-related tau and β-amyloid (Aβ) pathology using cross-sectional [18F]Flortaucipir and [11C]Pittsburgh compound-B PET respectively. Together, our findings point to elevated DRN [18F]FMT Ki as a marker of poorer aging trajectories. Older adults with highest serotonin synthesis capacity showed greatest temporal lobe cortical atrophy. Cortical atrophy was associated with increasing depression symptoms over time, and these effects appeared to be strongest in individuals with highest serotonin synthesis capacity. We did not find direct relationships between serotonin synthesis capacity and AD-related pathology. Exploratory analyses revealed nuanced effects of sex within the older adult group. Older adult females showed the highest DRN synthesis capacity and exhibited the strongest relationships between entorhinal cortex tau pathology and increasing depression symptoms. Together these findings reveal PET measurement of the serotonin system to be a promising marker of aging trajectories relevant to both AD and affective changes in older age.

Fathers' subjective childbirth stress predicts depressive symptoms at six months postpartum

BackgroundChildbirth is a seminal experience in parents' lives. However, little research has investigated the link between fathers' birth experiences and their postpartum mental health. We hypothesized that a more subjectively stressful birth will predict greater self-reported depressive symptoms in fathers at six months postpartum. We also investigated the association between mode of delivery and paternal subjective stress. MethodsSeventy-seven heterosexual fathers expecting their first child and cohabiting with their pregnant partners participated in the study. Depressive symptoms were assessed in pregnancy and again at six months postpartum. Subjective birth stress was measured within the first few days of the birth, and birth charts were collected to examine mode of delivery. ResultsFathers' ratings of subjective birth stress significantly predicted postpartum depressive symptoms at six months postpartum. Subjective birth stress ratings varied significantly for fathers whose partners delivered via emergency cesarean section compared to those whose partners gave birth via both medicated and the unmedicated vaginal delivery. LimitationsThe study was limited by its small community (non-clinical) sample, which was restricted to heterosexual, cohabitating couples. Additionally, births were mostly uncomplicated and only 14 mothers underwent emergency cesarean section. ConclusionThese findings highlight that the days immediately following childbirth are a window of opportunity for early intervention in new fathers at risk for postpartum depression.

Metabolomics and Self-Reported Depression, Anxiety, and Phobic Symptoms in the VA Normative Aging Study.

Traditional approaches to understanding metabolomics in mental illness have focused on investigating a single disorder or comparisons between diagnoses, but a growing body of evidence suggests substantial mechanistic overlap in mental disorders that could be reflected by the metabolome. In this study, we investigated associations between global plasma metabolites and abnormal scores on the depression, anxiety, and phobic anxiety subscales of the Brief Symptom Inventory (BSI) among 405 older males who participated in the Normative Aging Study (NAS). Our analysis revealed overlapping and distinct metabolites associated with each mental health dimension subscale and four metabolites belonging to xenobiotic, carbohydrate, and amino acid classes that were consistently associated across all three symptom dimension subscales. Furthermore, three of these four metabolites demonstrated a higher degree of alteration in men who reported poor scores in all three dimensions compared to men with poor scores in only one, suggesting the potential for shared underlying biology but a differing degree of perturbation when depression and anxiety symptoms co-occur. Our findings implicate pathways of interest relevant to the overlap of mental health conditions in aging veterans and could represent clinically translatable targets underlying poor mental health in this high-risk population.

Caregiver Thrive, Learn, & Connect: Testing the Efficacy of an Online Psychoeducational Program for Family Caregivers

ABSTRACT Objectives Research reports that providing care to a relative or friend with a chronic health condition or significant neurocognitive disorders, such as dementia is a demanding job. Caregiving often leads to higher risk for adverse mental health outcomes. In this study, we examine the short-term efficacy of the CaregiverTLC online psychoeducational program to caregivers of adults with chronic health or significant memory troubles. Method Using pre-post data from the CaregiverTLC randomized controlled trial (n = 81) we examined differences between the intervention and control conditions on caregivers’ psychosocial outcomes for depressive symptoms, self-efficacy, burden, anxiety, and caregiver gains. Results Data analyses indicated significant decrease in self-reported depressive symptoms, burden, anxiety, and significant increases in self-efficacy and caregiver gains for caregivers in the active intervention compared to those in the control condition. Conclusions These results suggest that regardless of whether caregivers care for a person with a chronic illness or significant neurocognitive disorder, they can benefit from participation in this online psychoeducational program. Clinical Implications The CaregiverTLC program may be an effective method to teach skills to reduce depression, burden, and anxiety, and improve self-efficacy and personal gains among caregivers of older adults with chronic illnesses.

Adolescent Anxiety, Depression and Flourishing before and During COVID-19 and the Predictive Role of Baseline Psychological Capital (PsyCap) on Student Mental Health and Subjective Wellbeing During the Pandemic.

Studies indicate the COVID-19 pandemic has resulted in rises in adolescent mental health symptoms globally, although the impact of the pandemic on subjective wellbeing is under-researched in this population. Psychological capital (PsyCap), a cluster of four positive psychological constructs comprising hope, efficacy, resilience and optimism (HERO), has demonstrated preventative and promotive qualities on mental health symptoms and subjective wellbeing outcomes with adult populations (employees, university students). However, PsyCap's influence on these outcomes in young people is unclear. The present exploratory study investigated changes in self-reported anxiety and depressive symptoms (measured via the RCADS-SV) and subjective wellbeing (measured by the Flourishing Scale) from pre-pandemic levels to 3 months into the pandemic and explored gender differences at each time point in a sample of Australian Year 10 students (N = 56, Mage = 14.93 years, SD = 0.50, 51.8% male). The longitudinal predictive role of baseline PsyCap on follow-up assessments of anxiety symptoms, depressive symptoms and flourishing were also examined. There were no significant changes in levels of anxiety and depressive symptoms between the timepoints, but flourishing significantly declined from T1 to T2. Baseline PsyCap was not a significant predictor of T2 anxiety and depressive symptoms but was a significant predictor of T2 flourishing. Further, different baseline HERO constructs predicted T2 mental health symptoms and flourishing. Future larger studies building on the current preliminary findings investigating the roles of student PsyCap, mental health and subjective wellbeing are warranted to better understand these constructs in the COVID-19 era and beyond.

Multisystemic Resources Matter for Resilience to Depression: Learning From a Sample of Young South African Adults.

This article interrogates the continuing emphasis on personal sources of resilience; it also amends the inattention to the protective factors and processes (PFPs) that support the mental health resilience of African emerging adults. To that end, we report a study that explored which PFPs distinguished risk-exposed South African 18- to 29-year-olds with negligible depression symptoms from those who reported moderate to severe symptoms. Using an arts-based approach, young people volunteered the PFPs they had personally experienced as resilience-enabling. An inductive thematic analysis of visual and narrative data, generated by young people self-reporting high exposure to family and community adversity (n = 233; mean age: 24.63, SD: 2.43), revealed patterns in the PFPs relative to the severity of self-reported depression symptoms. Specifically, young people reporting negligible depression symptoms reported a range of PFPs associated with psychological, social, and ecological systems. In contrast, the PFPs identified by those reporting more serious depression symptoms were mostly restricted to personal strengths and informal relational supports. In the interests of youth mental health, the findings direct society's attention to the criticality of facilitating young people's access to a composite of resources rooted in personal, social, and ecological systems.

Meditation and Cognitive Outcomes: A Longitudinal Analysis Using Data From the Health and Retirement Study 2000-2016.

We aimed to assess the association between meditation practice and cognitive function over time among middle-aged and older adults. We included Health and Retirement Study (HRS) participants assessed for meditation practice in the year 2000 as part of the HRS alternative medicine module (n = 1,160) and were followed up for outcomes over 2000-2016 period. We examined the association between meditation ≥ twice a week vs none/less frequent practice and changes in the outcomes of recall, global cognitive function, and quantitative reasoning using generalized linear regression models. Stratified analyses among persons with/without self-reported baseline depressive symptoms were conducted to assess the link between meditation and cognitive outcomes. Among our full study sample, meditation ≥ twice a week was not significantly associated with total recall [; 95% CI: -0.97, 0.57; p = 0.61], global cognitive function [; 95% CI: -1.01, 1.12; p = 0.92], and quantitative reasoning [; 95% CI: -31.27, 8.32; p = 0.26]. However, among those who did not have self-reported depressive symptoms at baseline, meditation ≥ twice a week was associated with improvement in cognitive outcomes such as total recall [; 95% CI: 0.03, 0.18; p = 0.01] and global cognitive function [; 95% CI: 0.05, 0.40; p = 0.01] over time. Frequent meditation practice might have a protective effect on cognitive outcomes over time, but this protection could be limited to those without self-reported baseline depressive symptoms. Future studies could incorporate more precise meditation practice assessment, investigate the effect of meditation on cognitive outcomes over time, and include more rigorous study designs with randomized group assignment. This study is not preregistered.

The role of cognitive biases and negative life events in predicting later depressive symptoms in children and adolescents

Aims Cognitive models propose that negative cognitive biases in attention (AB) and interpretation (IB) contribute to the onset of depression. This is the first prospective study to test this hypothesis in a sample of youth with no mental disorder. Methods Participants were 61 youth aged 9–14 years with no mental disorder. At baseline (T1) we measured AB (passive-viewing task), IB (scrambled sentences task) and self-report depressive symptoms. Thirty months later (T2) we measured onset of mental disorder, depressive symptoms and life events (parent- and child-report). The sample included children of parents with ( n = 31) and without ( n = 30) parental depression. Results Symptoms of depression at T2 were predicted by IB ( ß = .35, p = .01) but not AB ( ß = .05, p = .72) at T1. This effect was strongest for children who experienced multiple negative life events (F2,48 = 6.0, p = .018, ΔR2 = .08). IB did not predict depressive symptoms at T2 over-and-above the effect of depressive symptoms at T1 ( ß = .21, p = .13). Discussion These findings suggest that IB (but not AB) plays an important role in the aetiology of depression. Modifying IB may have a preventive effect on youth depression, particularly for youth who experience negative life events. This prospective study provides important foundations for future experimental studies.

Randomised controlled trial of cultural-adapted and programme-adopted cognitive behavioural therapy for children and adolescents’ anxiety in Japan: protocol for a Multi-, Inter-, and Cross-cultural Clinical Child Study (MIXCS)

IntroductionThe primary objective of the Multi-, Inter-, and Cross-cultural Clinical Child Study (MIXCS) is to evaluate the hypothesis that the effects of cultural-adapted cognitive behavioural therapy (CA-CBT) and programme-adopted cognitive...

Open-label study of consecutive ibogaine and 5-MeO-DMT assisted-therapy for trauma-exposed male Special Operations Forces Veterans: prospective data from a clinical program in Mexico

ABSTRACT Background: Research in psychedelic medicine has focused primarily on civilian populations. Further study is needed to understand whether these treatments are effective for Veteran populations. Objectives: Here, we examine the effectiveness of psychedelic-assisted therapy among trauma-exposed Special Operations Forces Veterans (SOFV) seeking treatment for cognitive and mental health problems in Mexico. Methods: Data were collected from an ibogaine and 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) clinical treatment program for SOFV with a history of trauma exposure. This clinical program collects prospective clinical program evaluation data, such as background characteristics, symptom severity, functioning (e.g., satisfaction with life, posttraumatic stress disorder symptoms, depression symptoms, anxiety symptoms, sleep disturbance, psychological flexibility, disability in functioning, cognitive functioning, neurobehavioral symptoms, anger, suicidal ideation), and substance persisting/enduring effects through online surveys at four timepoints (baseline/pre-treatment, one-, three-, and six-months after treatment). Results: The majority of the sample (n = 86; Mean Age = 42.88, SD = 7.88) were Caucasian (87.2%), non-Hispanic (89.5%), and males (100%). There were significant and large improvements in self-reported PTSD symptoms (p < .001, d = .414), depression (p < .001, d = .275), anxiety (p < .001, d = .276), insomnia severity (p < .001, d = .351), and post-concussive symptoms (p < .001, d = .389) as well as self-reported satisfaction with life (p < .001, d = .371), psychological flexibility (p < .001, d = .313) and cognitive functioning (p < .001, d = .265) from baseline to one-month follow-up. Conclusions: Data suggest combined ibogaine and 5-MeO-DMT assisted therapy has potential to provide rapid and robust changes in mental health functioning with a signal of durable therapeutic effects up to 6-months. Future research in controlled settings is warranted.

Effects of reminiscence therapy combined with memory specificity training (RT-MeST) on depressive symptoms in older adults: a randomized controlled trial protocol

BackgroundGeriatric depression has become a serious public health problem, and reduced autobiographical memory and increased overgeneral memory, as the main cognitive markers of depression, are not only associated with current depressive symptoms but also associated with the onset and course of depression, which can lead to a range of harms. Economic and effective psychological interventions are urgently needed. The aim of this study is to confirm the effectiveness of reminiscence therapy combined with memory specificity training in improving autobiographical memory and depressive symptoms in older adults.MethodsIn this multicentre, single-blind, three-arm parallel randomized controlled study, we aim to enrol 78 older adults aged 65 years or older with a score of ≥ 11 on the Geriatric Depression Scale, and participants will be randomly assigned to either a reminiscence therapy group, a reminiscence therapy with memory specificity training group or a usual care group. Assessments will be conducted at baseline (T0) as well as immediately post-intervention (T1) and 1 (T2), 3 (T3) and 6 (T4) months post-intervention. The primary outcome measure is self-reported depressive symptoms, measured using the GDS. Secondary outcome measures include measures of autobiographical memory, rumination, and social engagement.DiscussionWe believe that the intervention will play a positive role in improving autobiographical memory and depressive symptoms in older adults. Poor autobiographical memory is a predictor of depression and a major cognitive marker, and improving autobiographical memory is of great significance in alleviating depressive symptoms in older people. If our program is effective, it will provide a convenient and feasible strategy for further promoting healthy ageing.Trial registrationChiCTR2200065446.

Abnormal neurophysiological sensitivity to rewards in depression is moderated by sex and age in middle adulthood

A candidate pathophysiological process in major depressive disorder is diminished neural reactivity to reward delivery, which is theorized to give rise to anhedonia. Reduced amplitude in the reward positivity (RewP), which captures initial reward evaluation, has been linked to current symptoms of depression among child, adolescent, and young adult samples. However, the developmental trajectory of this association is incomplete, with relatively few studies in middle and older adulthood. Further, emerging evidence in the literature also suggests that this association may be linked to female sex-specific processes, but no studies to date have directly contrasted the effect of sex on the depression-RewP association. The current study sought to address these gaps by testing how sex and age may moderate the depression-RewP association within a mature adult community sample. Symptoms of depression were evaluated using a survey and a clinical interview, and the RewP was elicited using a simple guessing task. There was a three-way interaction between depression symptom severity, age, and sex in predicting RewP amplitude. This was driven by younger (late 30’s to early 40’s) female-sexed people such that for this group, elevated symptoms of depression were associated with blunting of the RewP. This association tapered around age 50. This effect was specific to clinician-rated rather than self-reported depressive symptom severity. This pattern of effects suggests that among female-sexed people, developmental processes continue to shape the association between reward responsiveness and depression throughout middle adulthood.

Anxiety and depression in expectant parents: ART versus spontaneous conception.

Do expectant parents experience increased anxiety and depression during pregnancies conceived through ART compared to spontaneous conception? Among all expectant parents in the sample, those who conceived through ART reported overall lower levels of anxiety and depression in pregnancy compared to expectant parents who conceived spontaneously, while in the subsample of parents who conceived both through ART and spontaneous conception, expectant mothers experienced increased anxiety and depression in early pregnancy following ART compared to spontaneous conception. Previous research on expectant parents' psychosocial adjustment in response to ART has found mixed results, with some studies suggesting ART is associated with increased anxiety and depression, and other studies suggesting improved mental health or no relationship. Mixed findings may relate to the use of cross-sectional designs that do not account for confounding differences between groups, or variability in the timing of assessment. This prospective cohort study used data from the Norwegian Mother, Father and Child Cohort Study (MoBa), which includes 2960 pregnant women who underwent ART and 108183 women who conceived spontaneously. Of these, a subsample of expectant parents had two consecutive pregnancies with one pregnancy resulting from ART and one conceived spontaneously (n = 286 women, n = 211 partners). Women self-reported their composite symptoms of anxiety and depression at two timepoints during each pregnancy (gestational weeks 17 and 30). Their partners self-reported composite symptoms of anxiety and depression at 17 weeks gestation during each pregnancy. Couples reported their relationship satisfaction at 17 weeks gestation. Using a conventional full-cohort analysis we found that ART was associated with less total anxiety and depression and greater relationship satisfaction, compared to spontaneous conception among both women and men. However, in the subsample of parents who experienced both ART and spontaneous pregnancies, ART was associated with increased levels of maternal anxiety and depression at gestational age 17 weeks (M = 1.19), compared to spontaneous pregnancies (M = 1.15), 95% CI of the mean difference 0.006, 0.074. At 30 weeks gestation, anxiety and depression were similar across both types of pregnancies. Expectant fathers reported similar levels of anxiety and depression at 17 weeks gestation during both pregnancies. Among women relationship satisfaction was higher following ART conception than spontaneous conception. There is potential for selection effects in the sample, as women who have conceived through both ART and spontaneous conception in their first two pregnancies are rare. In addition, several factors that may be important predictors of mental health in this context, such as previous miscarriages and long-term infertility, were not assessed in the current study. Our findings indicate that previous discrepancies in the literature may be related to inherent differences between the groups of parents receiving reproductive treatment and those who do not. This study addresses that limitation by prospectively comparing different types of pregnancies within the same expectant parents. Earlier inconsistencies may also relate to variations in gestational age when anxiety and depression were assessed. By examining symptoms at two timepoints in each pregnancy, we were able to examine the relation between gestational age and symptoms of anxiety and depression. The MoBa is supported by the Norwegian Ministry of Health and the Norwegian Research Council/FUGE (grant number 151918/S10). This work was also supported by the Research Council of Norway grant number 288083 and 301004. The authors have no conflicts of interest to declare. N/A.