Severe Depression Research Articles

Depressive intensity, duration, and their associations with cognitive decline: a population-based study in Korea.

Existing epidemiological studies have ignored the effect of depressive duration on cognitive decline despite the presence of biological cues and understudied the depression-cognition association in Asian countries in the context of increasing cognitive burden worldwide. We aimed to comprehensively characterize the effects of depressive duration and intensity on cognitive decline at the population level. A total of 6406 individuals from the Korean Longitudinal Study of Aging (KLoSA) from 2010 to 2018 were included to generate four datasets with durations of 2, 4, 6, and 8years. Depressive intensity was categorized as no, mild, and major depression according to the Center for Epidemiological Studies Depression scale (CES-D10), and duration was measured by the span of consecutive interviews. Cognitive function was assessed using the Korean Mini-Mental Status Examination (K-MMSE). Multiple linear regressions and meta-regressions were used to estimate the effects of depressive intensity and duration on global cognition and seven cognitive subdomains. Stratified analyses were performed to explore effect differences between subpopulations of different sexes and ages. The potential bias in the effect of depressive intensity on cognitive decline when ignoring duration was also explored. On average, a 1-year longer duration decreased the global cognitive scores by 0.44 (95% CI 0.36, 0.51) across intensities and major depression decreased the scores by an additional 0.82 (95% CI 0.59, 1.04) points than mild depression across durations. Similar trends held for seven cognitive subdomains except for visual construction. Older adults suffered more cognitive decline from major depression than middle-aged adults did. More severe and longer-duration depression lead to greater cognitive decline. Ignoring depressive duration can lead to an overestimated effect of depressive intensity on cognitive decline. The depressive effects and susceptible populations clarified in our study have important implications for the preservation of cognitive health in Asian region.

Beyond the Visible: The Relationship Between Social Appearance Anxiety, Hopelessness, and Depression in Women with Urinary Incontinence.

This study aims to examine the relationship between the severity of urinary incontinence and levels of social appearance anxiety, hopelessness, and depression in women. A total of 393 women participated in this descriptive and correlational study. Data were collected using the Introductory Information Form, Incontinence Severity Index (ISI), Social Appearance Anxiety Scale (SAAS), Beck Hopelessness Scale (BHS), and Beck Depression Inventory (BDI). Of the participants, 46.3% reported moderate social appearance anxiety, while 25.2% had severe depression. The mean BHS score was 8.80 ± 5.63. No significant correlation was found between the severity of incontinence and social appearance anxiety (p > 0.05). A strong positive correlation was observed between the BDI and BHS scores (p < 0.001). A one-unit increase in age was associated with a 0.172 (B) increase in incontinence severity, and a one-unit increase in BDI score was linked to a 0.137 (B) increase in incontinence severity. The results suggest that increasing age is associated with greater severity of urinary incontinence. Higher incontinence severity is also correlated with higher levels of hopelessness and depression. The psychological impact of urinary incontinence on women's mental health should be addressed, and referrals to psychiatric care should be considered when necessary for a comprehensive treatment approach.

Induction of DNA damage and growth arrest by citalopram in breast cancer cells mediated via activation of Gadd45a and apoptotic genes

ABSTRACT Breast cancer patients experience more severe emotional distress and depression compared to those with other cancers. Selective serotonin reuptake inhibitors (SSRIs), like citalopram, are commonly used to treat depression. However, the link between SSRI use and breast cancer progression is debated. This study examined the cytotoxic effects of citalopram on triple-negative (MDA-MB231) and ER-positive (MCF-7) breast cancer cells. Results showed a significant decrease in cell viability in both cell lines following citalopram treatment. Interestingly, flow cytometry analysis revealed increased apoptotic cells and induction of cell cycle arrest upon treatment of the cells with citalopram. MCF-7 cells were arrested in the sub-G0-G1 phase, while MDA-MB231 cells accumulated in the S phase. Gene expression analysis demonstrated increased Bax expression and decreased Bcl2 levels. Moreover, cytochrome c and NF-κB were upregulated upon treatment with citalopram. Furthermore, transmission electron microscopy (TEM) analysis of treated cells showed apoptotic morphological changes including shrunken nuclei, membrane blebbing, and chromatin condensation with prominent appearance of autophagosomes and autolysosomes. Additionally, GADD45a and p21, involved in growth arrest and DNA damage, were significantly upregulated. In conclusion, citalopram’s ability to induce apoptosis and alter cell cycle suggests its potential in breast cancer treatment.

Impact of the five-pattern personality traits of traditional Chinese medicine on workplace violence and depression among nurses

BackgroundDepression seriously damage the health of nurses. It is not conducive to the provision of medical services and hospital management. Meanwhile, nurses are a highly vulnerable group to workplace violence (WPV), increasing the risk of depression. Nurses with different personalities may have various views and feelings towards WPV, and their impact on depression may also vary. This study aims to reveal the impact of the five-pattern personality traits of traditional Chinese medicine (TCM) on WPV and depression among nurses, providing a new perspective for managers to implement psychological interventions.MethodsA cross-sectional study was conducted. 2,788 valid questionnaires nationwide were collected based on Wenjuanxing from June to July 2024. We used Patient Health Questionnaire Depression Scale-9 item, The five- pattern Personality Traits of TCM Scale, and Workplace Violence Scale. We used latent class analysis, structural equation modeling, and simple slope analysis to analyze depression classes, mediating effects, and moderation effects, respectively.ResultsDepression is classified into three types: “Good mental health group” (34.2%), “Moderate depression group” (23.0%), and “Severe depression group” (42.8%). “Taiyang”, “Shaoyang”, and “Balance of Yin-Yang” personalities alleviate nurses’ feelings of WPV, thereby reducing the impact of WPV on depression. The values of mediating effect are -0.402, -0.393, and -0.426, respectively (P < 0.05). “Taiyin” personality exacerbate nurses’ perception of WPV, thereby increasing the impact of WPV on depression. The value of mediating effect is 0.418 (P < 0.05). “Taiyang” and “Shaoyang” personalities reduce the impact of WPV on depression of nurses, and the effect become more significant as the scores increase. The values of moderating effect are 0.033 and -0.0563 respectively (P < 0.05). “Taiyin” and “Shaoyin” personalities increase the impact of WPV on depression, and the effect become more significant as the scores increase. The values of moderating effect are -0.0444 and -0.0220 respectively (P < 0.05).ConclusionsThe prevalence of depression and WPV among Chinese nurses is serious. Excellent personality effectively improve the relationship between WPV and depression. Nursing managers should arrange suitable positions for nurses based on their different personality traits. At the same time, it is necessary to actively cultivate excellent personality traits in nurses to reduce the frequency of WPV and improve their mental health.

Using Motion-Graphic Media to Educate Higher Education Students About Depression: A Randomized Controlled Trial

Objective: This study aims to compare the effectiveness of motion graphics versus pamphlets for educating young adults about depression. Methods: A multicenter randomized controlled trial was conducted from April to June 2024; participants were randomly assigned to Group A (motion-graphic media) or Group B (pamphlets) in a 1:1 ratio. Pre- and post-intervention knowledge scores were collected, and satisfaction scores were collected after intervention from group A. Findings: A total of 78 participants with a median age of 19.0 years (IQR 2.0) and predominantly women (64.1%), completed pre- and post-intervention questionnaires. The median knowledge score for Group A increased from 15.0 (IQR 4.0) pre-intervention to 18.0 (IQR 3.0) post-intervention, while Group B's scores improved from 12.0 (IQR 4.0) to 16.0 (IQR 3.0). Post-intervention scores were significantly higher in Group A compared to Group B (p = 0.002). Participants in Group A also reported high satisfaction with the educational material. Novelty:This study highlights the potential of innovative media for patient education, particularly in addressing mental health issues. Long-term cohort studies are required to assess whether this approach can improve clinical outcomes and reduce the incidence of severe depression. Doi: 10.28991/ESJ-2024-SIED1-015 Full Text: PDF

Prevalence of suicidal ideation and its associated factors among the geriatric population in Vyas Municipality, Tanahun District, Nepal: a cross-sectional study

BackgroundSuicidal ideation among the geriatric population is a pressing concern, particularly in regions such as Nepal where mental health resources are limited. This study aimed to determine the prevalence of suicidal ideation and its associated factors among the geriatric population in Vyas Municipality, Nepal.MethodsA cross-sectional study was conducted among individuals aged 60 years and above in Vyas Municipality, Nepal. A total of 311 participants were selected using multistage sampling. The data were collected through face-to-face interviews using a structured interview schedule. Multivariate logistic regression analysis was performed to identify independent variables associated with suicidal ideation.ResultsThe overall prevalence of suicidal ideation within the last twelve months among the geriatric population was 6.4% (n = 20). After adjustment for covariates in multivariate logistic regression analysis, living in a nuclear family (OR: 3.033, C.I. 95%:1.007–9.136), and experiencing depressive symptoms [(Mild depression:- OR: 5.358, C.I. 95%:1.548–18.539), (Moderate depression:- OR: 15.739, C.I. 95%:2.536–97.687), and (Severe depression:- OR: 17.423, C.I. 95%:2.218-136.878)] were found to be significant influencing factors for suicidal ideation.ConclusionThis study emphasizes the need to enhance mental health services and strengthen family and community support systems to address suicidal ideation among older adults in Nepal. Further research is required to identify additional determinants and evaluate interventions to mitigate this risk.

Kinesiophobia and associated factors among people with musculoskeletal disorders in Ethiopia: a multicenter cross-sectional study

IntroductionKinesiophobia has a major health impact on patients with Musculoskeletal disorders (MSDs) in their functional and physical activities, which leads to poor outcomes, loss of motivation, loss of mobility, and decreased quality of life. Despite the burden of kinesiophobia among MSDs, there is limited evidence about the burden of kinesiophobia in Ethiopia. Thus, this study aimed to assess the prevalence and its associated factors of kinesiophobia among MSD patients attending physiotherapy outpatient clinics.MethodAn institutional multi-center cross-sectional study was conducted from February to April 2023 with a sample size of 424. A systematic random sampling technique and face-to-face interviews using a structured questionnaire and chart review were used. The collected data was entered into Epi-data version 4.6.0.6 and analyzed using SPSS version 25. Binary logistic regression analysis was employed to identify the potential candidates for multivariable logistic regression with a p-value less than 0.25. Finally, multivariate logistic regression analysis was employed and variables at p < 0.05 with 95% CI were considered statistically significant contributors to kinesiophobia.ResultThe overall prevalence of kinesiophobia among MSD patients was 48.3% (95% CI, 43.3–53.3). Being overweight and obese BMI value (AOR = 3.98; 95% CI, 2.17–7.29), having moderate pain level (AOR = 3.31; 95% CI, 1.51–7.26), having severe pain level (AOR = 9.29; 95% CI, 3.79–22.77), physical inactivity (AOR = 3.00; 95% CI = 1.84–4.89), anxiety (AOR = 2.57; 95% CI = 1.57–4.19), and depression (AOR = 8.21; 95% CI = 3.47–19.46) were significantly associated with kinesiophobia among musculoskeletal disorder patients.Conclusionkinesiophobia is a public health burden among patients with MSDs. Nearly half of the people with MSDs had reported kinesiophobia. Being overweight and obese BMI value, pain severity level, physical inactivity, anxiety, and depressive symptoms were significantly associated with kinesiophobia. Thus, we suggest screening for kinesiophobia, be physically active, avoiding being overweight and obese, and managing depression, anxiety and pain will help to reduce the occurrence of kinesiophobia.

Determinants of Dropout From a Virtual Agent-Based App for Insomnia Management in a Self-Selected Sample of Users With Insomnia Symptoms: Longitudinal Study.

Fully automated digital interventions delivered via smartphone apps have proven efficacious for a wide variety of mental health outcomes. An important aspect is that they are accessible at a low cost, thereby increasing their potential public impact and reducing disparities. However, a major challenge to their successful implementation is the phenomenon of users dropping out early. The purpose of this study was to pinpoint the factors influencing early dropout in a sample of self-selected users of a virtual agent (VA)-based behavioral intervention for managing insomnia, named KANOPEE, which is freely available in France. From January 2021 to December 2022, of the 9657 individuals, aged 18 years or older, who downloaded and completed the KANOPEE screening interview and had either subclinical or clinical insomnia symptoms, 4295 (44.5%) dropped out (ie, did not return to the app to continue filling in subsequent assessments). The primary outcome was a binary variable: having dropped out after completing the screening assessment (early dropout) or having completed all the treatment phases (n=551). Multivariable logistic regression analysis was used to identify predictors of dropout among a set of sociodemographic, clinical, and sleep diary variables, and users' perceptions of the treatment program, collected during the screening interview. The users' mean age was 47.95 (SD 15.21) years. Of those who dropped out early and those who completed the treatment, 65.1% (3153/4846) were women and 34.9% (1693/4846) were men. Younger age (adjusted odds ratio [AOR] 0.98, 95% CI 0.97-0.99), lower education level (compared to middle school; high school: AOR 0.56, 95% CI 0.35-0.90; bachelor's degree: AOR 0.35, 95% CI 0.23-0.52; master's degree or higher: AOR 0.35, 95% CI 0.22-0.55), poorer nocturnal sleep (sleep efficiency: AOR 0.64, 95% CI 0.42-0.96; number of nocturnal awakenings: AOR 1.13, 95% CI 1.04-1.23), and more severe depression symptoms (AOR 1.12, 95% CI 1.04-1.21) were significant predictors of dropping out. When measures of perceptions of the app were included in the model, perceived benevolence and credibility of the VA decreased the odds of dropout (AOR 0.91, 95% CI 0.85-0.97). As in traditional face-to-face cognitive behavioral therapy for insomnia, the presence of significant depression symptoms plays an important role in treatment dropout. This variable represents an important target to address to increase early engagement with fully automated insomnia management programs. Furthermore, our results support the contention that a VA can provide relevant user stimulation that will eventually pay out in terms of user engagement.

Association between depression and the prevalence and prognosis of prediabetes: Data from National Health and Nutrition Examination Survey (NHANES) 2013-2018.

Diagnosis and intervention of prediabetes is an emerging approach to preventing the progression and complications of diabetes. Inflammatory factors and dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis have been suggested as potential mechanisms underlying the pathogenesis of both diabetes and depression. However, the relationship between depression levels and the prevalence of prediabetes and its prognosis remains elusive. This study aimed to explore the relationship between depression and the prevalence of prediabetes and to further explore the all-cause mortality of different levels of depression in patients with prediabetes. Our study used a data set from the National Health and Nutrition Examination Survey (NHANES). Participants were initially divided into two groups (depression vs. non-depression) and further stratified by different depression severity levels. We used a weighted multiple logistic regression model to analyze the association between depression and prediabetes prevalence and a Cox regression model to assess all-cause mortality in prediabetic patients. A total of 4384 participants were included, divided into depression group (n = 1379) and non-depression group (n = 3005). Results showed that people with depression were at higher risk of developing prediabetes. After adjusting for covariates, moderate to severe depression was positively associated with prediabetes (moderate to severe depression vs no depression: OR = 1.834, 95%CI: 0.713-4.721; severe depression vs no depression: OR = 1.004, 95% CI 0.429-2.351). In addition, we explored the relationship between all-cause mortality and depressive status in patients diagnosed with prediabetes (n = 2240) and found that moderate to severe depression (HR = 2.109, 95%CI 0.952-4.670) was associated with higher mortality in patients with prediabetes. Overall, the findings consistently suggest that depression is positively associated with both the prevalence and mortality risk among individuals with prediabetes. This suggests that depression may be a new and valuable indicator of prediabetes risk. Early treatment of depression improves outcomes in prediabetes.

Evaluation of an AI-Based Voice Biomarker Tool to Detect Signals Consistent With Moderate to Severe Depression.

Mental health screening is recommended by the US Preventive Services Task Force for all patients in areas where treatment options are available. Still, it is estimated that only 4% of primary care patients are screened for depression. The goal of this study was to evaluate the efficacy of machine learning technology (Kintsugi Voice, v1, Kintsugi Mindful Wellness, Inc) to detect and analyze voice biomarkers consistent with moderate to severe depression, potentially allowing for greater compliance with this critical primary care public health need. We performed a cross-sectional study from February 1, 2021 to July 31, 2022 to examine ≥25 seconds of free-form speech content from English-speaking samples captured from 14,898 unique adults in the United States and Canada. Participants were recruited via social media, provided informed consent, and their voice biomarker results were compared with a self-reported Patient Health Questionnaire-9 (PHQ-9) at a cut-off score of 10 (moderate to severe depression). From as few as 25 seconds of free-form speech, machine learning technology was able to detect vocal characteristics consistent with an increased PHQ-9 ≥10, with a sensitivity of 71.3 (95% CI, 69.0-73.5) and a specificity of 73.5 (95% CI, 71.5-75.5). Machine learning has potential utility in helping clinicians screen patients for moderate to severe depression. Further research is needed to measure the effectiveness of machine learning vocal detection and analysis technology in clinical deployment.

Relationship between severe hypoglycemia or impaired awareness of hypoglycemia and diabetes-related health status, global cognition and executive functions in adults with type 1 diabetes without severe anxiety or depression.

To explore the relationship between impaired awareness of hypoglycemia (IAH) or severe hypoglycemia (SH), and health status and cognition in adults with type 1 diabetes (T1D). T1D adults attending a tertiary diabetes service were recruited into this cross-sectional study. People screening positive for severe anxiety or depression were not included. Hypoglycemia awareness status was assessed using the full-scale and factor 1 of the Minimally Modified Clarke Hypoglycemia Survey (MMCHS; ≥4 and ≥ 2 = IAH); and data collected on health status (Diabetes Health Profile: barriers to activity, BA; psychological distress, PD; disinhibited eating); global cognition (Montreal Cognitive Assessment); and executive functions (EF; INECO Frontal Screening, IFS). A score of reduced awareness in item 3 and/or 4 of the MMCHS defined experience of ≥1 SH in past 6-12 months. In 165 T1D adults, prevalences of SH, IAH by MMCHS full-scale and factor 1 were 35 %, 13 % and 28 %. Participants with IAH by factor 1 had higher scores for PD (p = 0.008). Participants with SH and IAH (full-scale or factor 1) had higher BA scores (all p < 0.05) but no impairment of global cognition or EF. Participant Z-score IFS was lower than in non-diabetic individuals (p < 0.001). In our cohort, executive dysfunction in T1D was not associated with SH or IAH. IAH was associated with PD, and both SH and IAH were related to behavioral dysfunction.

Clinical outcomes of a digital musculoskeletal women’s pelvic health program: an observational, longitudinal study with comparison group

BackgroundChronic pelvic pain is a common yet undertreated condition that significantly impacts quality of life for women worldwide. Digital exercise therapy designed to target pelvic pain can improve symptomology while reducing time and cost-related barriers to in-person clinical care.MethodsThis longitudinal, observational study of a digital women’s pelvic health program examined pelvic pain, anxiety, and depression at 4 and 12 weeks in female adults experiencing chronic pelvic pain. Intervention participants received a digital pelvic health program including personalized exercise therapy sessions, health education articles, and health coaching. A comparison group of nonparticipants received a series of education articles related to pelvic health. Data were collected at baseline, 4 and 12 weeks. Unadjusted and adjusted linear mixed effects models were conducted to model changes in clinical outcomes over time.ResultsA total of 797 participants (intervention: 495, nonparticipants: 302) were included in the sample. Baseline mean (SD) age was 41.5 (11.7) years and mean pain was 45.7 (18.5) out of 100. Compared to baseline, the intervention group showed significantly more pain improvement at 4 and 12 weeks versus nonparticipants after adjusting for baseline factors. The intervention group’s pain scores decreased by 44.5% at 4 weeks and 53.6% at 12 weeks. The intervention group’s adjusted pain scores decreased from 42.0 (95% CI: [39.4, 44.7]) at baseline to 23.3 (95% CI: [20.5, 26.2]) at 4 weeks to 19.5 (95% CI: [16.7, 22.4]) at 12 weeks. In contrast, nonparticipants’ pain scores decreased by 21.6% at 4 weeks and 32.7% at 12 weeks. Nonparticipants’ adjusted pain scores decreased from 42.1 (95% CI: [38.4, 45.9]) at baseline to 33.0 (95% CI: [29.2, 36.8]) at 4 weeks to 28.3 (95% CI: [24.5, 32.2]) at 12 weeks. After adjustments, the probability of the intervention group screening for moderate or severe depression was significantly lower by 11.0% at 12 weeks versus nonparticipants. There were no significant differences in anxiety outcomes between groups at baseline, week 4, or week 12. ConclusionsA digital women’s pelvic health program may help reduce short-term pelvic pain and depression symptoms.Trial registrationThe WIRB-Copernicus Group Institutional Review Board (registration number IRB20234932) approved this study on November 6, 2023.

Major Depression in Chronic Kidney Disease Patients Attending the Renal Clinic in a Teaching Hospital in Port Harcourt Nigeria

Background: Depression is the commonest mental disorder associated with chronic disorders such as chronic kidney disease (CKD), cancer, hypertension and diabetes. This study is aimed at analyzing depression, focusing on prevalence, its predictors and associated factors in CKD patients Methods: Using a convenient sampling approach, patients attending the renal clinic in a teaching hospital between February and September 2024, who met the inclusion criteria were recruited into the study. Data was collected via interviewer administered approach and examination of the medical records of the 200 participants. Socio-demographic data was obtained and the “Patients Health Questionnaire (PHQ)-9” was used as the instrument for depression related data. Results: The patients were predominantly males (n=115;57%). Majority of the patients n=82;41% were of low socioeconomic class and 30% had no financial support. Hypertension was the leading comorbidity 62%. The mean depression (PHQ-9) score was 7.10+5.202, with 126(63%) having depressive symptoms out of which 55(43.7%) had major depression (PHQ&gt;10). 71(56.3%) had mild depression, 32(25.4%) had moderate, 21(16.7%) had moderate to severe depression, while 2(1.6%) had severe depression. Nine of the variables showed significant association (p=.05) with depression, out of which, employment OR:8.56 p=.001, financial support p=.001, CKD stages OR: 64,742 p=.003 and medication dependence OR: 3.661 p=0,009 were predictive. Conclusion: Major depression is of high prevalence in patients with CKD. Low income and lack of financial support play significant role in major depression. Functional social support and routine screening for depression are strongly recommended.

Assessment of factors influencing suicidal thoughts and attempts among population in Mosul.

Suicide is one of the leading causes of death worldwide especially in low- middle-income areas as Mosul City. It exposed to wars and various stressors for decades that directly affecting populations' stability, psych and daily life. we aim to explore suicidal thoughts and attempts rates and their influencing risk factors. A cross-sectional study was performed among 652 individuals in Mosul along ten months period since March 2023. The questionnaire was distributed among them by using convenient sampling technique. According to PHQ-9 and ASQ, the sample was divided into three groups: normal people (396), suicidal thoughts (166), and suicidal attempts (90). Chi-square, Fishers' exact, and independent t-tests were used for significant association between variables. One quarter (25.46%) of population had suicidal thoughts and 13.8% attempted suicide. Among the risk factors were female sex, low education, low social class, big family size, sedative drug use, introverted personality, poor family and personal relationships, bullying, severe depression, and chronic diseases (p-values 0.031 - <0.001). Suicidal thoughts and attempts were present in high levels in Mosul City compared with other regions in the world. This should be addressed carefully while implanting national preventive and social welfare services.

Identification of risk factors and development of a predictive nomogram for sarcopenia in Alzheimer's disease.

Sarcopenia, with its complex diagnostic process, is a likely independent predictor of poor prognosis in patients with Alzheimer's disease (AD). However, research on the clinical characteristics and biomarkers of AD patients with sarcopenia (ADSA) is limited. This study included 180 ADSA and 188 AD patients without sarcopenia (ADNSA), and evaluated demographics, cognitive function, motor capacity, emotional state, and daily living abilities. ADSA patients were older, with worse motor and cognitive functions, more severe depression, poorer social functioning, and lower daily living abilities compared to ADNSA patients. Multivariate regression identified age, low Frailty Rating Scale (FRS) scores, low serum albumin level, and low creatinine/cystatin C ratio (CCR) as risk factors for sarcopenia. A nomogram model based on these indicators demonstrated high discriminative power and clinical utility. Sarcopenia significantly affects AD patients' various functions. The nomogram model aids in the early detection of and personalized interventions for sarcopenia in AD. Sarcopenia is a risk factor for Alzheimer's disease (AD), and the coexistence of sarcopenia affects various functions and quality of life in patients with AD. Serum albumin and Frailty Rating Scale (FRS) scores are significantly associated with both sarcopenia and cognitive assessment indicators in AD patients with sarcopenia (ADSA). The combined sarcopenia nomogram model with indexes of age at diagnosis, creatinine/cystatin C ratio (CCR), FRS score, and albumin levels can aid in effectively identifying and personalizing interventions for sarcopenia in the AD population.

Food as medicine, community as medicine: Mental health effects of a social care intervention.

To assess mental health related outcomes of Recipe4Health, a multisectoral social care partnership implementing produce prescriptions with or without group medical visits (GMVs). Recipe4Health was implemented at five community health centers from 2020 to 2023. Primary care teams referred patients with food insecurity and/or nutrition-sensitive chronic conditions (e.g., diabetes, depression) to 16 weeks of Food Farmacy (produce prescriptions) with the option of GMV participation. We used a convergent mixed-methods design including survey and interview data. We conducted (1) participant surveys pre- and post-intervention and (2) semi-structured interviews with Recipe4Health participants and partner organization staff. Linear mixed effects models examined changes in mental health and related outcomes. Interviews were analyzed using codebook thematic analysis. Program participants were middle-aged, primarily women, and from diverse racial/ethnic backgrounds (majority Latine and Black). At baseline, moderate or severe depression and/or anxiety symptoms were reported by 77/188 (41%) of Food Farmacy-only participants, and 113/284 (40%) of Food Farmacy +GMV participants. Among Food Farmacy-only participants, post-intervention depression and anxiety symptoms significantly improved only among those who did not have baseline depression/anxiety (PHQ9: -1.7 [95% CI: -2.8, -0.6]; GAD7: -1.8 [95% CI: -2.9, -0.8]). Among Food Farmacy +GMV participants, mental health symptoms improved regardless of baseline mental health; among those with baseline depression/anxiety: PHQ9: -2.4 (95% CI: -3.6, -1.2); GAD7: -0.9 (95% CI: -2.0, 0.1); among those without: PHQ9: -2.2 (95% CI: -3.2, -1.2); GAD7: -2.2 (95% CI: -3.1, -1.2). Improvements in social needs (food insecurity, loneliness) and health-related behaviors (fruit/vegetable intake, physical activity) varied by intervention arm and baseline depression/anxiety symptom level. In interviews, staff and patients endorsed produce prescriptions for improving nutrition and food insecurity, and GMVs for increasing social support. Social care interventions providing vegetables and fruit, with or without group medical visits, may concurrently address mental health symptoms and social needs.

Characterizing PTSD Using Electrophysiology: Towards A Precision Medicine Approach

Objective. Resting-state EEG measures have shown potential in distinguishing individuals with PTSD from healthy controls. ERP components such as N2, P3, and late positive potential have been consistently linked to cognitive abnormalities in PTSD, especially in tasks involving emotional or trauma-related stimuli. However, meta-analyses have reported inconsistent findings. The understanding of biomarkers that can classify the varied symptoms of PTSD remains limited. This study aimed to develop a concise set of electrophysiological biomarkers, using neutral cognitive tasks, that could be applied across psychiatric conditions, and to identify biomarkers associated with the anxiety and depression dimensions of PTSD. Approach. Continuous simultaneous recordings of EEG and electrocardiogram (ECG) were obtained in veterans with PTSD (n = 29) and healthy controls (n = 62) during computerized tasks. EEG, ERP, and heart rate measures were evaluated in terms of their ability to discriminate between the groups or correlate with psychological measures. Results. The PTSD cohort exhibited faster alpha oscillations, reduced alpha power, and a flatter power spectrum. Furthermore, stronger reduction in alpha power was associated with higher trait anxiety, while a flatter slope was related to more severe depression symptoms in individuals with PTSD. In ERP tasks of visual memory and sustained attention, the PTSD cohort demonstrated delayed and exaggerated early components, along with attenuated LPP amplitudes. The three tasks revealed distinct and complementary EEG signatures PTSD. Significance. Multimodal individualized biomarkers based on EEG, cognitive ERPs, and ECG show promise as objective tools for assessing mood and anxiety disturbances within the PTSD spectrum.

Research Progress in the Treatment of Depression by Acupuncture and Moxibustion Based on the Five Viscera and Its Mechanism

Severe depression is the most common mental disorder, with a heavy economic burden and limited treatment. The lifetime prevalence of depression among adults in China is 6.8%, with depression accounting for 3.4%. Currently, there are 95 million people suffering from depression in China, with approximately 280,000 people committing suicide each year, of whom 40% suffer from depression. Oral antidepressants are commonly used treatment methods in modern medicine, but they have significant drawbacks. Acupuncture therapy has shown promising physiological and pharmacological research evidence and good clinical efficacy, with small side effects, lasting efficacy, and low cost in depression. Depression is classified as a “depression syndrome” in traditional Chinese medicine, and its disease progress is closely related to the damage of the five zang organs: heart, liver, spleen, lung, and kidney. Acupuncture and moxibustion have been proven to be effective in treating depression by intervening in the points related to the five viscera. This article summarizes the research progress of acupuncture and moxibustion treatment of depression from the perspective of the five viscera.

Brain morphometry, stimulation charge, and seizure duration in electroconvulsive therapy.

Electroconvulsive therapy (ECT) is a well-established and effective treatment for severe depression and other conditions. Though ECT induces a generalized seizure, it is unclear why seizures are therapeutic. This study analyzed relationships between pre-treatment brain morphology, stimulation dose, and seizure duration to better understand ECT-induced seizures. Pre-existing MRI data were analyzed from four cohorts with treatment refractory depression undergoing right unilateral (RUL) ECT (n=166). Regional brain morphometry and magnitude of electrical current (|E|) were analyzed, along with seizure duration and stimulation charge at seizure threshold (ECT1) and 6x seizure threshold (ECT2&3). Linear models controlled for age, sex, and cohort, corrected using false discovery rate q<0.05. Lower ECT1 stimulation charge correlated with less cortical surface area perpendicular to current flow, and greater |E| in nearby white matter. Lower ECT2&3 stimulation charge correlated with less cortical surface area and curvature near the temporal electrode, higher |E| in right amygdala and anterior hippocampus, and lower right thalamic and mid-hippocampal volume. Cortical surface area extending between electrodes (e.g., postcentral gyrus) positively correlated with ECT2&3 seizure duration. Successful antidepressant response associated with less cortical surface area near the temporal electrode and more |E| in anteromedial temporal lobe regions, the latter of which mediated the effects of the former on antidepressant response. Pre-treatment brain morphology influences ECT-induced seizure, particularly in regions near ECT electrodes and those relevant to seizure initiation and modulation. Personalized dosing based on head morphology and other factors may improve antidepressant outcomes and reduce side effects.

Prevalence of body image dissatisfaction and associated factors among high school adolescent in Hawassa city, Ethiopia.

Adolescence is a period in which individuals are more concerned with their body image. However, little is known about the prevalence of body image dissatisfaction and its associated factors. Thus, this study aimed to assess the prevalence of body image dissatisfaction and associated factors among high school adolescents in Hawassa city in 2023. A school-based cross-sectional study was conducted among 421 participants from April 30 to May 30, 2023, in Hawassa City. A stratified sampling technique was employed to select the participants. A structured, self-administered questionnaire was used to collect the data. Anthropometric measurements of body mass and stature were taken. A logistic regression model was fitted and used to identify the factors associated with body image dissatisfaction, and P<0.05 indicated statistical significance. The prevalence of body image dissatisfaction was 18.5% [95% CI=14.8-22.2%]. Being overweight/obese [Adjusted Odds Ratio(AOR)=7.8, 95% CI=2.58-23.83], engaging in a small amount of exercise [AOR=3.66, 95% CI=1.34-10.0], having moderate depression [AOR=3.6, 95% CI=1.25-10.40], having severe depression [AOR=6.8, 95% CI=1.94-24.22], late age of adolescence [AOR=1.9, 95% CI=1.07-3.39], and family pressure [AOR=2.2, 95% CI=1.28-4.04] were associated factors. Body image dissatisfaction among adolescents in Hawassa City is prevalent, influenced by factors such as obesity, depression, limited physical activity, age, and family pressure. To address this issue, a multi-sectoral approach is necessary. The federal Ministry of Health should prioritize initiatives promoting healthy living, physical activity, and media awareness. The Public Health Authority should collaborate with families for healthier lifestyles, while schools and youth centers should implement educational programs to foster positive body image. Parents should model healthy body image behaviors and avoid negative comments. Comprehensive strategies are essential to address obesity, depression, and promote physical activity. This includes encouraging adolescents to engage in regular exercise and providing supportive family feedback.