Self-reported Depressive Symptoms Research Articles

Remote cognitive behavioral therapy for older adults with anxiety symptoms: A systematic review and meta-analysis

Introduction In-person cognitive behavioral therapy (CBT) can reduce self-reported anxiety in older adults. However, studies are limited for remote CBT. We assessed the effectiveness of remote CBT in mitigating self-reported anxiety in older adults. Methods We conducted a systematic review and meta-analysis based on a literature search of PubMed, Embase, PsycInfo, and Cochrane databases up to March 31, 2021, for randomized controlled clinical trials comparing the effectiveness of remote CBT versus non-CBT controls on mitigating self-reported anxiety in older adults. We calculated within-group pre-to-post-treatment standardized mean difference using Cohen's d, obtained the difference between a remote CBT group and a non-CBT control group as our effect size for cross-study comparison, and conducted a random-effects meta-analysis. Changes in scores on self-reported anxiety symptoms (Generalized Anxiety Disorder-7 item Scale, Penn State Worry Questionnaire, or Penn State Worry Questionnaire – Abbreviated), and self-reported depressive symptoms (Patient Health Questionnaire-9 item Scale or Beck Depression Inventory) were primary and secondary outcomes, respectively. Results Six eligible studies, containing 633 participants with a pooled mean age of 66.6 years, were included in the systematic review and meta-analysis. There was a significant mitigating effect of intervention on self-reported anxiety, favoring remote CBT over non-CBT controls (between-group effect size: −0.63; 95% CI: −0.99 to −0.28). We also found a significant mitigating effect of intervention on self-reported depressive symptoms (between-group effect size: −0.74; 95% CI: −1.24 to −0.25). Discussion Remote CBT is more effective in reducing self-reported anxiety and depressive symptoms than non-CBT control in older adults.

Short-term improvement of mental health after a COVID-19 vaccination.

The role of COVID-19 vaccination on the mental health of the general population remains poorly understood. This study aims to assess the short-term change in depressive and anxiety symptoms in relation to COVID-19 vaccination among Swedish adults. A prospective study of 7,925 individuals recruited from ongoing cohort studies at the Karolinska Institutet, Stockholm, Sweden, or through social media campaigns, with monthly data collections on self-reported depressive and anxiety symptoms from December 2020 to October 2021 and COVID-19 vaccination from July to October 2021. Prevalence of depressive and anxiety symptoms (defined as a self-reported total score of ≥10 in PHQ-9 and GAD-7, respectively) was calculated one month before, one month after the first dose, and, if applicable, one month after the second dose. For individuals not vaccinated or choosing not to report vaccination status (unvaccinated individuals), we selected three monthly measures of PHQ-9 and GAD-7 with 2-month intervals in-between based on data availability. 5,079 (64.1%) individuals received two doses of COVID-19 vaccine, 1,977 (24.9%) received one dose, 305 (3.9%) were not vaccinated, and 564 (7.1%) chose not to report vaccination status. There was a lower prevalence of depressive and anxiety symptoms among vaccinated, compared to unvaccinated individuals, especially after the second dose. Among individuals receiving two doses of vaccine, the prevalence of depressive and anxiety symptoms was lower after both first (aRR = 0.82, 95%CI 0.76-0.88 for depression; aRR = 0.81, 95%CI 0.73-0.89 for anxiety) and second (aRR = 0.79, 95%CI 0.73-0.85 for depression; aRR = 0.73, 95%CI 0.66-0.81 for anxiety) dose, compared to before vaccination. Similar results were observed among individuals receiving only one dose (aRR = 0.76, 95%CI 0.68-0.84 for depression; aRR = 0.82, 95%CI 0.72-0.94 for anxiety), comparing after first dose to before vaccination. We observed a short-term improvement in depressive and anxiety symptoms among adults receiving COVID-19 vaccines in the current pandemic. Our findings provide new evidence to support outreach campaigns targeting hesitant groups.

Longitudinal associations of anticholinergic medications on cognition and possible mitigating role of physical activity.

Many older adults take at least one prescription medication with anticholinergic (ACH) activity, which can impact the central nervous system and can lead to cognitive decline and impairment especially in an aging population susceptible to cognitive changes. We examined this relationship between ACH burden and cognitive function in middle-aged and older adults. We further determined if increased activity levels mitigated the relationships between ACH burden and cognition. Data from The Reasons for Geographic and Racial Differences in Stroke project were used. We included 20,575 adults aged ≥45 years with longitudinal cognitive testing. The anticholinergic cognitive burden (ACB) scale was used to assess for ACH use and overall burden. Cognitive data included an overall composite score, a memory, and verbal fluency composites. Mixed effects models were conducted to determine if cognitive function worsened over time for participants with higher ACB (>3) scores. The full model adjusted for age, sex, race, education, diabetes, hypertension, cardiovascular disease, congestive heart failure, and dyslipidemia, self-reported physical activity (PA) and depressive symptoms. A significant relationship between ACH burden and composite cognitive scores was found (p= <0.001), with those with higher ACB showing more rapid cognitive decline over time. There was an effect of age for participants with higher ACB (>3) scores and ACB as a continuous variable. Baseline PA level was associated with less cognitive decline over time and this effect was greater in older cohorts. We observed an effect of ACHs on cognition in adults ≥45 years old that worsened with age. ACH users showed more cognitive effects, whereas PA emerged as a possible mitigating factor.

Childhood trauma and depressive symptoms in bipolar disorder: A network analysis.

Childhood trauma is related to an increased number of depressive episodes and more severe depressive symptoms in bipolar disorder. The evaluation of the networks of depressive symptoms-or the patterns of relationships between individual symptoms-among people with bipolar disorder with and without a history of childhood trauma may assist in further clarifying this complex relationship. Data from over 500 participants from the Heinz C. Prechter Longitudinal Study of Bipolar Disorder were used to construct a series of regularised Gaussian Graphical Models. The networks of individual depressive symptoms-self-reported (Patient Health Questionnaire-9; n=543) and clinician-rated (Hamilton Depression Rating Scale-17; n=529)-among participants with bipolar disorder with and without a history of childhood trauma (Childhood Trauma Questionnaire) were characterised and compared. Across the sets of networks, depressed mood consistently emerged as a central symptom (as indicated by strength centrality and expected influence); regardless of participants' history of childhood trauma. Additionally, feelings of worthlessness emerged as a key symptom in the network of self-reported depressive symptoms among participants with-but not without-a history of childhood trauma. The present analyses-although exploratory-provide nuanced insights into the impact of childhood trauma on the presentation of depressive symptoms in bipolar disorder, which have the potential to aid detection and inform targeted intervention development.

Relationships between Physical Activity Frequency and Self-Perceived Health, Self-Reported Depression, and Depressive Symptoms in Spanish Older Adults with Diabetes: A Cross-Sectional Study.

Diabetes is one of the most prevalent noncommunicable diseases in the world. This disease can affect both physical and mental health in the population. This study analyzed the prevalence of Self-Perceived Health (SPH), self-reported depression, and depressive symptoms in comparison with the Physical Activity Frequency (PAF) reported by Spanish older adults with diabetes. A cross-sectional study was carried out with data from 2799 self-reported diabetic participants, all of whom were residents of Spain, aged 50-79 years, and included in the European Health Surveys carried out in Spain (EHIS) both in 2014 and 2020. The relationships between the variables were analysed with a chi-squared test. A z-test for independent proportions was performed to analyze differences in proportions between the sexes. A multiple binary logistic regression was carried out on the prevalence of depression. Linear regressions were performed on depressive symptoms and SPH. Dependent relationships were found between the SPH, self-reported depression, and depressive symptoms with PAF. Most of the very active participants reported a higher prevalence of self-reported depression. Physical inactivity increased the risk of depression, major depressive symptoms, and negative SPH.

Symptoms of Depression and Anxiety and Subsequent Use of Nicotine and THC in Electronic Cigarettes

Background: This study examines whether symptoms of depression, anxiety, or comorbid depression and anxiety are associated with future use of nicotine or THC in e-cigarettes. Methods: Data were from an online survey of youth and young adults in urban areas of Texas with complete data (n = 2,307) in spring 2019 (baseline) and spring 2020 (12-month follow-up). Multivariable logistic regression models examined associations between self-reported symptoms of depression, anxiety, or comorbid depression and anxiety at baseline and past 30-day e-cigarette use with nicotine or THC at 12-month follow-up. Analyses adjusted for baseline demographics and baseline past 30-day e-cigarette, combustible tobacco, marijuana, and alcohol use and stratified by race/ethnicity, gender, grade level, and SES. Results: Participants were 16–23 years old, 58.1% female and 37.9% Hispanic. At baseline, 14.7% reported symptoms of comorbid depression and anxiety, 7.9% depression, and 4.7% anxiety. Prevalence of past 30-day e-cigarette use at 12-month follow-up was 10.4% with nicotine and 10.3% with THC. Symptoms of depression and comorbid depression and anxiety at baseline were significantly associated with both nicotine and THC use in e-cigarettes 12 months later. Symptoms of anxiety were associated with nicotine use in e-cigarettes 12 months later. Conclusions: Symptoms of anxiety and depression may be important indicators of future nicotine and THC vaping among young people. Clinicians should be aware of groups most at risk who may benefit from substance use counseling and intervention.

Cardiac Vagal Control Among Community Cigarette Smokers with Low to Moderate Depressive Symptoms.

Impairments in cardiac vagal control (CVC) have been independently linked to smoking status and depression and are implicated in self-regulatory processes that may exacerbate depressive symptoms and maintain smoking behavior. Yet, few studies have examined how depressive symptoms, even at low levels, influence CVC reactivity among individuals who smoke. Investigating these relationships may provide novel insights into how depressive symptoms exacerbate existing regulatory vulnerabilities among smokers. This study investigated how depression symptoms affect CVC reactivity as a function of changing situational demands among a community sample of 60 daily adult cigarette smokers. Participants completed a mildly demanding cognitive task while physiological data was recorded. Growth curve modeling was used to examine the main and interactive effects of self-reported depressive symptoms on CVC reactivity over the course of the task. We hypothesized that greater depressive symptoms would be associated with less CVC reactivity, characterized by smaller initial reductions in CVC values and a flatter slope over time. Participants were daily smokers with mild to moderate levels of depression. Final model results, where time was specified as linear and the slope was fixed, showed no significant main or interactive effects of time and depression symptoms on CVC reactivity. Findings suggest that at low to moderate levels, depressive symptom severity is not related to patterns of CVC reactivity among adults who smoke. This is the first study to examine this relationship in this population. Future investigations that examine patterns of CVC reactivity among smokers and non-smokers with more severe depression are needed.

The Impact of the COVID-19 Pandemic on Young Adults' Mental Health in Switzerland: A Longitudinal Cohort Study from 2018 to 2021.

Most of the studies that examine the effect of the COVID-19 pandemic on mental health have been restricted to pandemic mental health data alone. The aim of the current study was to estimate the pandemic's effect on young Swiss adults' mental health by comparing pandemic to pre-pandemic mental health. Longitudinal data of 1175 young Swiss adults who participated in the S-YESMH study in 2018 and were followed-up in 2020 and 2021 were analyzed. The study outcomes were self-reported symptoms of depression, generalized anxiety disorder (GAD), attention-deficit/hyperactivity disorder (ADHD), thoughts about death or self-harm, and risky single-occasion drinking (RSOD). Generalized estimation equations, logistic regression and statistical mediation analysis were used to analyze the data. Evidence was found of increased depression, GAD, and ADHD among young women and increased depression among young men, resulting from the COVID-19 pandemic. Uncertainty about the future predicted young women's depression and anxiety in 2021. COVID-19 stress in 2021 fully mediated the effect of COVID-19 stress in 2020 on depression and GAD in 2021. Young Swiss women's and men's mental health appears to have been adversely affected by the COVID-19 pandemic, especially during the second pandemic year. Uncertainty about the future and stress becoming chronic in 2021 likely explain some of the adverse effects.

Quality of life and mood disorders of mild to moderate stroke survivors in the early post-hospital discharge phase: a cross-sectional survey study

BackgroundExploring sociodemographic and disease characteristics that contribute to patient-reported outcomes can inform targeting of strategies to support recovery and adaptation to stroke. This study aimed to examine among a sample of stroke survivors at three months post-hospital discharge: (1) self-reported physical and mental health quality of life scores; (2) self-reported depressive and anxiety symptoms; and (3) sociodemographic and clinical predictors of these outcomes.MethodsThis cross-sectional survey study recruited stroke survivors from eight hospitals in one Australian state. Adult survivors recently discharged from hospital stroke wards (within 3 months) were mailed a study information package and invited to complete a pen-and paper survey. Survey items assessed: quality of life (SF12v2), depression (PHQ-9), anxiety (GAD-7) and sociodemographic and clinical characteristics. Predictors were examined using multiple linear regression analysis.ResultsOf the 1161 eligible patients who were posted a recruitment pack, 401 (35%) returned a completed survey. Participants reported a mean SF-12v2 Physical Composite Score (PCS) quality of life score of 44.09 (SD = 9.57); and a mean SF-12v2 Mental Composite Score (MCS) quality of life score of 46.84 (SD = 10.0). Approximately one third of participants (34%; n = 132) were classified as depressed (PHQ-9 ≥ 10); and 27% (n = 104) were classified as anxious (GAD-7 ≥ 8). Lower PCS was associated with being female, not employed and having a comorbid diagnosis of diabetes and atrial fibrillation. Lower MCS was associated with a history of transient ischemic attack (TIA). Males and those with higher levels of education, had greater odds of having lower depression severity; those with a history of TIA or diabetes had lower odds of having lower depression severity. Males had greater odds of having lower anxiety severity; those with a history of TIA had lower odds of having lower anxiety severity.ConclusionSub-groups of stroke survivors may be at-risk of poorer quality of life and psychological morbidity in the early post-discharge phase. These findings support the role of early identification and prioritisation of at-risk survivors at discharge, as they may require modifications to standard hospital discharge processes tailored to their level of risk.

Patients with neuropathic pain from lumbosacral radiculopathy demonstrate similar pressure pain thresholds and conditioned pain modulation to those with fibromyalgia

ObjectiveThe purpose of the study was to evaluate pain thresholds, impairment of the endogenous pain modulatory system, and self-reported cognitive-emotional and central sensitization-related symptoms among three subject groups: a rarely studied patient cohort with neuropathic pain from lumbosacral radiculopathy (NPLSR), patients with fibromyalgia (FM) and healthy controls (HC). MethodsPatient-reported pain-related symptomology was evaluated with psychometricallyvalidated questionnaires. Pressure pain threshold (PPT), heat pain threshold (HPT), and cold pain threshold (CPT) were assessed in the low back and contralateral forearm. Conditioned pain modulation (CPM) was evaluated with a recently introduced methodology that accounts for a standard error of measurement. ResultsCompared to the HC subjects, the FM and NPLSR subjects had significantly lower pain thresholds and more CPM impairment. No significant differences in PPT and CPM were observed between the FM and NPLSR groups. Significant group differences were found in self-reported symptoms of depression, anxiety, stress, and central sensitization. Self-reported symptom severity increased in a stair-step fashion, with the HC group scoring lowest and FM group scoring highest. ConclusionThe NPLSR group manifested CPM dysfunction and pressure hyperalgesia at similar levels to the FM group, indicating that these two chronic pain syndromes, likely based on different pathophysiological mechanisms, in fact share some common pain processing features. However, though both patient groups demonstrated similarities in pain processing, self-reported cognitive-emotional and central sensitization-related symptom severity was significantly higher in the FM cohort, which distinguished them from the chronic NPLSR cohort.

Theory of Mind in Typical Adults: Sex-Differences and Its Associations with Anxiety and Depression Symptoms.

Despite an increased interest in research of theory of mind (ToM) in recent years-both related to psychopathology (depression and anxiety spectrum disorders) and within the typical adults, the existing literature is scarce and presents some conflicting results. Present study aimed to explore sex differences in ToM, alongside its associations with current anxiety and depression symptoms, in a large sample of typical adults collected online. Participants completed the 15-minutes survey obtaining socio-demographic data, current self-reported depression and anxiety symptom severity, and ToM ability (the Reading the Mind in the Eyes Task). The sample comprised 605 participants-mostly younger adults, women, and high school graduate/student population. The majority of participants reported minimal/mild depressive and anxiety symptoms that were significantly more severe in women. Women also displayed significantly better overall ToM ability than men. Significant negative correlation between the severity of current depressive and anxiety symptoms and ToM ability was also observed, but only in individuals expressing the symptoms requiring clinical attention (such association was absent in those exhibiting minimal/mild symptoms). Present research adds to the existing knowledge on the association between ToM ability, anxiety, and depressive symptoms in typical adults as well as on the sex-differences in this important social cognitive domain. Exploring the factors representing indicators of vulnerability for depression-anxiety spectrum disorders is important for their timely detection and treatment.

Design and rationale of the REStoring mood after early life trauma with psychotherapy (RESET-psychotherapy) study: a multicenter randomized controlled trial on the efficacy of adjunctive trauma-focused therapy (TFT) versus treatment as usual (TAU) for adult patients with major depressive disorder (MDD) and childhood trauma

BackgroundMajor depressive disorder (MDD) is a common, recurrent mental disorder and a leading cause of disability worldwide. A large part of adult MDD patients report a history of childhood trauma (CT). Patients with MDD and CT are assumed to represent a clinically and neurobiologically distinct MDD subtype with an earlier onset, unfavorable disease course, stress systems’ dysregulations and brain alterations. Currently, there is no evidence-based treatment strategy for MDD that specifically targets CT. Given the central role of trauma in MDD patients with CT, trauma-focused therapy (TFT), adjunctive to treatment as usual (TAU), may be efficacious to alleviate depressive symptoms in this patient population.MethodsThe RESET-psychotherapy study is a 12-week, single-blind, randomized controlled trial testing the efficacy of TFT in 158 adults with moderate to severe MDD, as a ‘stand-alone’ depression diagnosis or superimposed on a persistent depressive disorder (PDD), and CT. TFT (6–10 sessions of Eye Movement Desensitization and Reprocessing and/or imagery rescripting) + TAU is compared to TAU only. Assessments, including a wide range of psychological/psychiatric and biological characteristics, take place before randomization (T0), during treatment (T1), at post-treatment (T2) and at 6-month follow-up (T3). Pre-post treatment stress-related biomarkers in hair (cortisol) and blood (epigenetics and inflammation) will be assessed to better understand working mechanisms of TFT. A subgroup of 60 participants will undergo structural and functional Magnetic Resonance Imaging (MRI) assessments to determine pre-post treatment brain activity. The primary outcome is self-reported depression symptom severity at post-treatment, measured with the 30-item Inventory of Depressive Symptomatology – Self Report (IDS-SR).DiscussionIf adjunctive TFT efficaciously alleviates depressive symptoms in MDD patients with CT, this novel treatment strategy could pave the way for a more personalized and targeted MDD treatment.Trial registrationClinicalTrials.gov, registered at 08–12-2021, number of identification: NCT05149352.

Improvements in Glycemic Control and Depressive Symptoms Among Adults With Type 2 Diabetes: Retrospective Study.

The prevalence of diabetes remains high, with traditional lifestyle interventions demonstrating limited success in improving diabetes-related outcomes, particularly among individuals with diabetes-related mental health comorbidities. Digital health interventions provide the ability to ease the sustained and rigorous self-management needs associated with diabetes care and treatment. Current interventions though, are plagued by small sample sizes, underpowered pilot studies, and immense heterogeneity in program intervention, duration, and measured outcomes. Therefore, this work aimed to evaluate the effectiveness of a mobile health diabetes management program on measures of glycemic control in a high-risk population with type 2 diabetes (hemoglobin A1c [HbA1c] ≥8.0%), utilizing a sample of 1128 participants who provided baseline and follow-up data. The sustainability of this change in glycemic control was examined in a subset of participants (n=455) at 6 months and 1 year following program enrollment. A secondary analysis examined changes in glycemic control among a subset of participants with self-reported mild-to-moderate depression at baseline. This study utilized a single-arm, retrospective design. Participants were enrolled in the Vida Health Diabetes Management Program. This app-based intervention utilized one-on-one remote sessions with a health coach, registered dietitian nutritionist, and/or a certified diabetes care and education specialist and structured lessons and tools related to diabetes management and self-care. Participants provided baseline (-365 to 21 days of program enrollment) as well as follow-up (at least 90 days following program enrollment) HbA1c values. Paired t tests were used to evaluate changes in HbA1c between baseline and follow-up time points. The 8-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder Scale were utilized to assess self-reported depressive and anxiety symptoms, respectively. Paired t tests and linear regression modeling accounting for pertinent covariates were used to evaluate changes in mental health symptom acuity and their relationship with changes in glycemic control. We observed a significant decrease in HbA1c of -1.35 points between baseline (mean 9.84, SD 1.64) and follow-up (mean 8.48, SD 1.77; t=22.56, P<.001) among this large, high-risk sample. This decrease was sustained up to 1 year following program enrollment. Additionally, a significant relationship between improvements in depressive symptom acuity and improvements in HbA1c was observed (β=-0.74, P=.03). This study demonstrates clinically meaningful improvements in glycemic control among participants enrolled in the Vida Health Diabetes Management Program. Additionally, this work presents one of the largest studied samples of participants enrolled in a digital health diabetes management program to date.

Postpartum Medicaid Eligibility Expansions and Postpartum Health Measures.

Maternal mortality and morbidity in the United States are high compared with those in similar countries, and racial/ethnic disparities exist, with many of these events occurring in the later postpartum period. Proposed federal and recently enacted state policy interventions extend pregnancy Medicaid from covering 60 days to a full year postpartum. This study estimates the association between maintaining Medicaid eligibility in the later postpartum period (relative to only having pregnancy Medicaid eligibility) with postpartum checkup attendance and depressive symptoms using regression analysis, overall and stratified by race/ethnicity. People with postpartum Medicaid eligibility were 1.0%-1.4% more likely to attend a postpartum checkup relative to those with only pregnancy Medicaid eligibility overall, primarily driven by a 3.8%-4.0% higher likelihood among Hispanic postpartum people. Conversely, postpartum Medicaid is associated with a 2.2%-2.3% lower likelihood of postpartum checkup attendance for Black postpartum people. Postpartum eligibility is also associated with a 9.7%-11.6% lower likelihood of self-reported depressive symptoms compared with only pregnancy Medicaid eligibility for White postpartum people only. Postpartum Medicaid eligibility is associated with some improvements in maternal health care utilization and mental health, but differences by race and ethnicity imply that inequitable systems and structures that cannot be overcome by insurance alone may also play an important role in postpartum health.

Associations between epigenetic aging and childhood peer victimization, depression, and suicidal ideation in adolescence and adulthood: A study of two population-based samples.

Background: Prior studies indicate that peer victimization (including bullying) is associated with higher risk for depression and suicidal ideation across the life course. However, molecular mechanisms underlying these associations remain unclear. This two-cohort study proposes to test whether epigenetic aging and pace of aging, as well as a DNA methylation marker of responsive to glucocorticoids, are associated to childhood peer victimization and later depressive symptoms, or suicidal ideation. Methods: Cohort 1: Epigenome-wide DNA methylation (EPIC array) was measured in saliva collected when participants were 10.47years (standard deviation = 0.35) in a subsample of the Quebec Longitudinal Study of Child Development (QLSCD, n = 149 participants), with self-reported peer victimization at 6-8years, depressive symptoms (mean symptoms, and dichotomized top 30% symptoms) and suicidal ideation at 15-17years. Cohort 2: Epigenome-wide DNA methylation (EPIC array) was measured in blood collected from participants aged 45.13years (standard deviation = 0.37) in a subsample of the 1958 British Birth cohort (1958BBC, n = 238 participants) with information on mother-reported peer victimization at 7-11years, self-reported depressive symptoms at 50years, and suicidal ideation at 45years. Five epigenetic indices were derived: three indicators of epigenetic aging [Horvath's pan-tissue (Horvath1), Horvath's Skin-and-Blood (Horvath2), Pediatric-Buccal-Epigenetic age (PedBE)], pace of aging (DunedinPACE), and stress response reactivity (Epistress). Results: Peer victimization was not associated with the epigenetic indices in either cohort. In the QLSCD, higher PedBE epigenetic aging and a slower pace of aging as measured by DunedinPACE predicted higher depressive symptoms scores. In contrast, neither the Horvath1, or Horvath2 epigenetic age estimates, nor the Epistress score were associated with depressive symptoms in either cohort, and none of the epigenetic indices predicted suicidal ideation. Conclusion: The findings are consistent with epigenome-wide and candidate gene studies suggesting that these epigenetic indices did not relate to peer victimization, challenging the hypothesis that cumulative epigenetic aging indices could translate vulnerability to depressive symptoms and suicidal ideation following peer victimization. Since some indices of epigenetic aging and pace of aging signaled higher risk for depressive symptoms, future studies should pursue this investigation to further evaluate the robustness and generalization of these preliminary findings.

Prevalence and correlates of subjective cognitive concerns in Australian university students during the COVID-19 pandemic.

Coronavirus (COVID-19) instigated unprecedented global effects on healthcare systems, economies, employment, education, travel, and social lives. In addition to increased mental health challenges, pandemic restrictions have triggered emerging cognitive concerns. University students are at particularly high risk of adverse lockdown-related effects, yet despite the substantial adaptions to learning necessitated by COVID-19, limited research has so far focused on the cognitive consequences of the pandemic among university students. This study aimed to comprehensively examine the nature, prevalence, and correlates of subjective cognitive concerns among 972 students (Median age = 22 years, 70% female) enrolled at Monash University, Australia, in December 2020. Students completed the online THRIVE@Monash survey, 5 weeks following prolonged lockdown in Melbourne. Using group comparisons and hierarchical binary logistic regression analyses, we examined associations between demographic and enrolment characteristics, COVID-19-related experiences and impacts (author-developed questions), self-reported anxiety and depression symptoms (PROMIS Anxiety and Depression scales), and students' perceived changes in everyday cognitive functions (author-developed questions). Over 60% of students reported subjective cognitive concerns (SCCs). After controlling for anxiety and depression symptoms, students reporting more SCCs were more likely to be younger, from White/European ethnic backgrounds, and in their first year of undergraduate study. No differences in SCCs were found between male and female students. Greater worry, anxiety, or stress related to COVID-19 (e.g., infection, leaving the house, hygiene and exposure prevention, impact on physical and mental health), and time spent reading or talking about COVID-19, were generally not associated with SCCs after controlling for anxiety and depression symptoms. These findings highlight vulnerable subgroups of students who might benefit from regular monitoring, education, and interventions to support their cognitive health during the pandemic and beyond. In addition, cognitive concerns may provide additional insight into mental health problems among students, and emphasize the importance of understanding factors that impact students' long-term academic and career success.

Stigma and Barriers in Health Care Among a Sample of Transgender and Gender-Diverse Active Duty Service Members.

Transgender and/or gender-diverse (TGD) persons are vulnerable to stigma and health care inequities; however, data are particularly limited among TGD active duty military service members despite ongoing changes to service policies. TGD-related stressors may impede access to and utilization of health care due to fear of potential discrimination and distress, thereby adversely impacting military readiness. We examined stigma and barriers in health care and associations with physical and mental health in an online sample of 177 active duty service members who self-identified as TGD. To assess associations between stigma and barriers in health care with mental and physical health, linear regressions were conducted adjusting for age, gender identity, race, and rank. Over half (65%) of the participants reported at least 1 instance of stigma and/or barrier in health care. Stigma and barriers to health care were significantly associated with greater self-reported depressive symptoms (β=0.20, P =0.03), anxiety (β=0.21, P =0.03), stress (β=0.30, P =0.001), and poorer overall mental health (β=-0.23, P =0.007), after adjusting for covariates. Nearly one-quarter of participants had not disclosed their gender identity to their primary care clinician. Findings suggested that stigma and barriers to affirming health care were prevalent among active duty service members identifying as TGD, specifically, difficulty accessing gender-affirming care and negative assumptions from clinicians. These experiences may adversely affect mental health and impede the quality of health care received by a population already vulnerable to health inequities. Given recent changes to military policy, efforts may be warranted to improve access to timely, affirming care and clinician training.

Oral health and mental health in healthy adults, a topic of primary prevention and health care, empirical results from two online studies

Oral health is an important, yet often neglected aspect of health and well-being. Among geriatric populations, oral diseases, poor oral health, and reduced oral hygiene behavior are major comorbid factors of geriatric diseases such as dementia, cardiovascular diseases, or mental health conditions. However, little is known so far about the relationships between oral health and mental health in the younger adult population, who is yet not suffering from any disorder. In the present manuscript the results of two online studies, online study 1, n = 133, all-female sample and online study 2: n = 29, mixed gender sample, are reported that investigate the relationship between self-reported oral health impairments and preclinical symptoms of mental disorders including self-reported symptoms associated with depression or eating disorders as well as self-reported perceived stress and behavior change related to the COVID-19 pandemic. The results of both studies support links between self-reported oral health impairments, self-reported depressive symptoms (including anxiety and current affect) and symptoms related to eating disorders (such as bulimic behavior, body dissatisfaction or drive for thinness) among young adults and suggest that perceived stress may contribute to both, impaired oral health and impaired mental health in young adults (women and men).

Frailty among inpatients with Schizophrenia: Status, influencing factors, and their correlation with quality of life.

This study aimed to understand frailty and its influencing factors in inpatients with Schizophrenia in Chengdu and to explore correlations between frailty and quality of life. From May to July 2022, inpatients with Schizophrenia were surveyed using a general information questionnaire, frailty phenotype (FP) scoring, the Self-Rating Depression Scale (SDS), the Mini-Mental State Examination (MMSE), and the SZ Quality of Life Scale (SQLS). Multivariate logistic regression was conducted to assess factors influencing frailty and multivariate linear regression was conducted to assess the factors influencing quality of life. A total of 556 hospitalized patients with Schizophrenia were included and divided into three groups according to the degree of frailty, of which 153 cases (27.5%) were without frailty, 348 cases (62.6%) were in early frailty, and 55 cases (9.9%) were in frailty. Univariate analysis of age, history of falls during hospitalization, polypharmacy, compulsory treatment during hospitalization, self-reported health status, activity level, cognitive impairment, depressive symptoms, "psychology and society," "motivation and energy" and "symptoms and side-effects" showed statistically significant differences between the groups. Multinomial logistic regression showed that age, BMI, self-reported health, activity, cognitive impairment, motivation and energy, and symptoms and side-effects were influencing factors for frailty in hospitalized patients with Schizophrenia. Correlation analysis shows that frailty score positively correlated with SQLS score. We found that frailty was prevalent and that frailty was positively correlated with SQLS scores in inpatients with Schizophrenia. To effectively manage the frailty of hospitalized patients with Schizophrenia, medical staff should pay attention to its influencing factors and quality of life.

Reinforcement-based responsiveness, depression, and anhedonia: A multi-method investigation of intergenerational risk

Offspring of depressed parents are at an increased risk for depression. Reward- and punishment-based systems might be mechanisms linking maternal outcomes to offspring depression and anhedonia. The current study was designed to investigate the intergenerational relations between maternal markers of reward and punishment responsiveness and their offspring's depression and anhedonia in a community sample of 40 mother (mean age = 44.5; SD = 6.82) and adolescent (mean age = 14.73; SD = 1.25; 52.5% female) dyads. Maternal markers of reward and punishment responsiveness were captured using self-report, behavioral, and neurophysiological methods, and self-reported depression and anhedonia symptoms were used as outcomes among the adolescent offspring. Maternal self-reported reward responsiveness and punishment learning rates were differentially associated with depression across male and female offspring. Regarding anhedonia, maternal punishment learning rate was positively related to adolescent anhedonia regardless of offspring biological sex. Maternal reward learning rate was also positively associated with anhedonia among male offspring. In general, low concurrence across self-report, behavioral, and neurophysiological markers of reward and punishment responsiveness was found. The results from the current study suggest that learning-rates on reinforcement-based behavioral tasks may be important objective markers to consider when evaluating intergenerational risk.