Background Dynamic interpersonal therapy(DIT)is a short-term psychodynamic psychotherapy that has been shown to effectively reduce depressive symptoms in patients with major depressive disorder(MDD).In DIT,the depress...Background Dynamic interpersonal therapy(DIT)is a short-term psychodynamic psychotherapy that has been shown to effectively reduce depressive symptoms in patients with major depressive disorder(MDD).In DIT,the depressive symptoms are formulated as responses to impaired mentalisation.DIT aims to alleviate depressive symptoms by improving mentalising.Aims This study aimed to examine the effect of DIT on improving mentalising and the mediating effect of mentalising in changes in depressive symptoms.Methods Outpatients received either DIT combined with antidepressant medication treatment(DIT group)or antidepressant medication treatment alone(ADM group)for 16 weeks.The Hamilton Depression Rating Scale(HAMD),Patient Health Questionnaire(PHQ)and Reflective Functioning Questionnaire(RFQ)were used.The intention-to-treat principle,mixed linear models,multiple imputation,Pearson's correlation analysis and mediation analysis were conducted.The per-protocol principle was used as sensitivity analysis.Results The DIT group had significantly lower HAMD(least-squares(LS)mean difference=-3.756,p<0.001),PHQ(LS mean difference=-4.188,p<0.001),uncertainty about mental states in the RFQ(RFQ-U,LS mean difference=-2.116,p<0.001)and higher certainty about mental states in the RFQ(RFQ-C,LS mean difference=2.214,p=0.028)scores than the ADM group at post-treatment.The change in RFQ-C was marginally significantly correlated with the change in HAMD(r=-0.218,poretao=0.090),The change in RFQ-U was significantly correlated with the change in HAMD(r=-0.269,poroco-0.024)and the change in PHQ(r=-0.43,Peoretceo l<e0.001).When using RFQ-U as the mediating variable and PHQ as the dependent variable,a significant mediating effect was found(p=0.043,95% confidence interval 0.024 to 1.453).Conclusions The DIT group yielded better outcomes compared with the ADM group in reducing depressive symptoms and improving mentalising.Improvements in mentalising were associated with reductions in depressive symptoms.These findings support that mentalising may contribute to the therapeutic effects of DIT in MDD.展开更多
BACKGROUND Sensitivity to stress is essential in the onset,clinical symptoms,course,and prognosis of major depressive disorder(MDD).Meanwhile,it was unclear how variously classified but connected stress-sensitivity va...BACKGROUND Sensitivity to stress is essential in the onset,clinical symptoms,course,and prognosis of major depressive disorder(MDD).Meanwhile,it was unclear how variously classified but connected stress-sensitivity variables affect MDD.We hypothesize that high-level trait-and state-related stress-sensitivity factors may have different cumulative effects on the clinical symptoms and follow-up outcomes of MDD.AIM To investigate how stress-sensitivity factors added up and affected MDD clinical symptoms and follow-up results.METHODS In this prospective study,281 MDD patients were enrolled from a tertiary care setting.High-level stress-sensitivity factors were classified as trait anxiety,state anxiety,perceived stress,and neuroticism,with a total score in the top quartile of the research cohort.The cumulative effects of stress-sensitivity factors on cognitive dysfunction,disability and functional impairment,suicide risk,and depressive and anxiety symptoms were examined using an analysis of variance with linear trend analysis.Correlations were investigated further using multiple regression analysis.RESULTS Regarding high-level stress-sensitivity factors,53.40%of patients had at least one at baseline,and 29.61%had two or more.Four high-level stress-sensitivity components had significant cumulative impacts on MDD symptoms at baseline(all P<0.001).Perceived stress predicted the greatest effect sizes of state-related factors on depressive symptoms(partialη^(2)=0.153;standardizedβ=0.195;P<0.05).The follow-up outcomes were significantly impacted only by the high-level trait-related components,mainly when it came to depressive symptoms and suicide risk,which were predicted by trait anxiety and neuroticism,respectively(partialη^(2)=0.204 and 0.156;standardizedβ=0.247 and 0.392;P<0.05).CONCLUSION To enhance outcomes of MDD and lower the suicide risk,screening for stress-sensitivity factors and considering multifaceted measures,mainly focusing on trait-related ones,should be addressed clinically.展开更多
Background Mental disorders rank among the leading contributors to the global disease burden, with depressive disorders being among the most prevalent.Aims The objective of this study is to examine the prevalence, inc...Background Mental disorders rank among the leading contributors to the global disease burden, with depressive disorders being among the most prevalent.Aims The objective of this study is to examine the prevalence, incidence and years lived with disability (YLDs) associated with depressive disorders, particularly major depressive disorder and dysthymia, in Iran from 1990 to 2021. To achieve this, the research focused on analysing these metrics across various dimensions, including temporal trends, sex differences, age categories and subnational regions.Methods The data used in this study are sourced directly from the Institute for Health Metrics and Evaluation, ensuring that the information is both authoritative and reliable. All-age count estimates and age-standardised rates (per 100 000) were calculated for prevalence, incidence and YLDs. The disease burden indicators were analysed for the period spanning from 1990 to 2021, stratified by sex, age and location. The percentage change between 1990 and 2021 was also documented. The 95% uncertainty interval (UI) was reported for each of the reported estimates.Results The prevalence of depressive disorders in Iran demonstrated a notable upward trend from 1990 to 2021, with the rate of growth being particularly pronounced within the country. The age-standardised prevalence rate per 100 000 individuals for depressive disorders in Iran was 5609 (95% UI 4810 to 6488). By 2021, the number of depression cases in Iran reached 5.2 million, which is approximately 2.37 times the figure reported in 1990. The prevalence of depressive disorders was notably higher among females compared with males. The age-standardised prevalence rate per 100 000 individuals for males was 4184 (95% UI 3545 to 4929). For females, this figure was significantly greater, reaching 7077 (95% UI 6115 to 8172). Out of the total reported cases of depressive disorders in Iran, 3.2 million were observed in females, while males accounted for 2 million cases.Conclusions The findings highlighted the considerable impact of depressive disorders in Iran, both nationally and regionally, while also revealing variations across sex and age groups. Given the shifts in the demographic structure and the growing burden of these disorders, it is essential to prioritise screening initiatives, education programmes and strategies aimed at enhancing mental health awareness and ensuring improved access to mental health services in health policy planning.展开更多
Major depressive disorder(MDD),a psychiatric disorder characterized by functional brain deficits,poses considerable diagnostic and treatment challenges,especially in adolescents owing to varying clinical presentations...Major depressive disorder(MDD),a psychiatric disorder characterized by functional brain deficits,poses considerable diagnostic and treatment challenges,especially in adolescents owing to varying clinical presentations.Biomarkers hold substantial clinical potential in the field of mental health,enabling objective assessments of physiological and pathological states,facilitating early diagnosis,and enhancing clinical decision-making and patient outcomes.Recent breakthroughs combine neuroimaging with machine learning(ML)to distinguish brain activity patterns between MDD patients and healthy controls,paving the way for diagnostic support and personalized treatment.However,the accuracy of the results depends on the selection of neuroimaging features and algorithms.Ensuring privacy protection,ML model accuracy,and fostering trust are essential steps prior to clinical implementation.Future research should prioritize the establishment of comprehensive legal frameworks and regulatory mechanisms for using ML in MDD diagnosis while safeguarding patient privacy and rights.By doing so,we can advance accuracy and personalized care for MDD.展开更多
Background Numerous studies have consistently demonstrated that a considerable proportion of patients with major depressive disorder (MDD) frequently exhibit pronounced dyslipidaemia. However, the causal dynamics betw...Background Numerous studies have consistently demonstrated that a considerable proportion of patients with major depressive disorder (MDD) frequently exhibit pronounced dyslipidaemia. However, the causal dynamics between MDD and dyslipidaemia remain elusive.Aims To comprehensively disentangle the genetic causality between MDD and various phenotypes of blood lipids, thereby facilitating the advancement of management strategies for these conditions.Methods We conducted a two-sample univariable Mendelian randomisation (MR) analysis using different models, including the inverse variance weighted (IVW) method and causal analysis using the summary effect (CAUSE) estimates, as well as a multivariable MR analysis. This analysis used summary statistics from genome-wide association studies (GWAS) of MDD and five lipid traits: low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, total cholesterol and triglycerides (TG), encompassing 5 237 893 individuals of European and East Asian ancestries. For MDD, a total of 598 701 individuals were included, with 500 199 individuals of European ancestry (Ncase=170 756, Ncontrol=329 443) and 98 502 of East Asian ancestry (Ncase=12 588, Ncontrol=85 914). Lipid data were collected from 4 639 192 individuals through the Global Lipids Genetics Consortium (European, N=4 096 085;East Asian, N=543 107). Next, we used the two-step MR to explore the mediating factors between MDD and TG, and the risk factors affecting TG through MDD. Finally, we conducted a GWAS meta-analysis and enrichment analysis.Results In univariable MR, we observed a negative causal effect of low-density lipoprotein on MDD in both European populations (IVW: odds ratio (OR): 0.972, 95% confidence interval (CI) 0.947 to 0.998, p=0.037) and East Asian populations (IVW: OR: 0.928, 95% CI 0.864 to 0.997, p=0.042). Additionally, we identified a bidirectional causal relationship between TG and MDD, with TG having a causal effect on MDD (IVW: OR: 1.052, 95% CI 1.020 to 1.085, p=0.001) and MDD having a causal effect on TG (IVW: OR: 1.075, 95% CI 1.047 to 1.104, p<0.001). Multivariable MR analysis further supported the role of TG in MDD (OR: 1.205, 95% CI 1.034 to 1.405, p=0.017). CAUSE estimates indicated that the causal model of MDD on TG provided a better fit than the sharing model (p=0.003), while the association of TG on MDD was more likely due to horizontal correlated pleiotropy than causality. Mediation analyses revealed that waist-hip ratio (WHR) mediated 69% of the total causal effect of MDD on TG, while other identified risk factors exhibited lower mediating proportions either mediated through MDD (≤17%) or originating from MDD (≤29%). The GWAS meta-analysis highlighted potential pathways related to lipid processes and nucleosome assembling, with significant cell types identified in brain regions and liver tissues.Conclusions The findings indicate that genetic proxies of MDD are associated with elevated levels of TG, with WHR serving as a clinical indicator of the association. This suggests that interventions targeting WHR may be effective in reducing TG levels in patients with MDD.展开更多
Background The patient-reported Dimensional Anhedonia Rating Scale(DARS)has been adapted into Chinese,so there is a need to evaluate its measurement properties in a Chinese population.Aims To evaluate the reliability ...Background The patient-reported Dimensional Anhedonia Rating Scale(DARS)has been adapted into Chinese,so there is a need to evaluate its measurement properties in a Chinese population.Aims To evaluate the reliability and validity of the DARS among Chinese individuals with major depressive disorder(MDD)and its treatment sensitivity in a prospective clinical study.Methods Data were from a multicentre,prospective clinical study(NCT03294525),which recruited both patients with MDD,who were followed for 8 weeks,and healthy controls(HCs),assessed at baseline only.The analysis included confirmatory factor analysis,validity and sensitivity to change.Results Patients’mean(standard deviation(SD))age was 34.8(11.0)years,with 68.7%being female.75.2%of patients with MDD had melancholic features,followed by 63.8%with anxious distress.Patients had experienced MDD for a mean(SD)of 9.2(18)months.DARS scores covered the full range of severity with no major floor or ceiling effects.Confirmatory factor analysis showed adequate fit statistics(comparative fit index 0.976,goodness-of-fit index 0.935 and root mean square error of approximation 0.055).Convergent validity with anhedonia-related measures was confirmed.While the correlation between the DARS and the Hamilton Depression Rating Scale was not strong(r=0.31,baseline),the DARS was found to differentiate between levels of depression.Greater improvements in DARS scores were seen with the Hamilton Rating Scale for Depression responder group(effect size 1.16)compared with the non-responder group(effect size 0.46).Conclusions This study comprehensively evaluated the measurement properties of the DARS using a Chinese population with MDD.Overall,the Chinese version of DARS demonstrates good psychometric properties and has been found to be responsive to change during antidepressant treatment.The DARS is a suitable scale for assessing patient-reported anhedonia in future clinical trials.展开更多
BACKGROUND Childhood maltreatment has a potentially lasting influence on subthreshold depressive symptoms(SDS)and major depressive disorder(MDD).This study aimed to explore the association of childhood maltreatment wi...BACKGROUND Childhood maltreatment has a potentially lasting influence on subthreshold depressive symptoms(SDS)and major depressive disorder(MDD).This study aimed to explore the association of childhood maltreatment with MDD and SDS,focusing on the differences between young and middle-aged adults.AIMTo examine the associations among childhood maltreatment, SDS, and MDD in young and middle-aged adults.METHODSA total of 3209 adults were recruited from 34 primary healthcare settings. The Childhood Trauma Questionnaire-28item Short Form was used to assess childhood maltreatment. The Patient Health Questionnaire-9 was used toassess SDS and the Mini-International Neuropsychiatric Interview depression module was used to assess MDD.RESULTSChildhood maltreatment was significantly associated with higher odds of developing SDS and MDD than in thenon-depressed control group (P < 0.05). Childhood maltreatment significantly increased the risk of developing SDSin young adults but was not significantly associated with SDS in middle-aged adults (P = 0.055). Conversely,childhood maltreatment was significantly associated with MDD in both young (P < 0.001) and middle-aged adults(P < 0.05). In young adults, various types of childhood maltreatment were associated with MDD;however, onlyemotional abuse and neglect were significantly associated with MDD in middle-aged adults.CONCLUSIONOur study revealed a strong association among childhood maltreatment, SDS, and MDD across age groups,highlighting the impact of emotional abuse and need for trauma-informed depression care.展开更多
BACKGROUND At present,the influencing factors of social function in patients with residual depressive symptoms are still unclear.Residual depressive symptoms are highly harmful,leading to low mood in patients,affectin...BACKGROUND At present,the influencing factors of social function in patients with residual depressive symptoms are still unclear.Residual depressive symptoms are highly harmful,leading to low mood in patients,affecting work and interpersonal communication,increasing the risk of recurrence,and adding to the burden on families.Studying the influencing factors of their social function is of great significance.AIM To explore the social function score and its influencing factors in patients with residual depressive symptoms.METHODS This observational study surveyed patients with residual depressive symptoms(case group)and healthy patients undergoing physical examinations(control group).Participants were admitted between January 2022 and December 2023.Social functioning was assessed using the Sheehan Disability Scale(SDS),and scores were compared between groups.Factors influencing SDS scores in patients with residual depressive symptoms were analyzed by applying multiple linear regression while using the receiver operating characteristic curve,and these RESULTS The SDS scores of the 158 patients with depressive symptoms were 11.48±3.26.Compared with the control group,the SDS scores and all items in the case group were higher.SDS scores were higher in patients with relapse,discon-tinuous medication,drug therapy alone,severe somatic symptoms,obvious residual symptoms,and anxiety scores≥8.Disease history,medication compliance,therapy method,and residual symptoms correlated positively with SDS scores(r=0.354,0.414,0.602,and 0.456,respectively).Independent influencing factors included disease history,medication compliance,therapy method,somatic symptoms,residual symptoms,and anxiety scores(P<0.05).The areas under the curve for predicting social functional impairment using these factors were 0.713,0.559,0.684,0.729,0.668,and 0.628,respectively,with sensitivities of 79.2%,61.8%,76.8%,81.7%,63.6%,and 65.5%and specificities of 83.3%,87.5%,82.6%,83.3%,86.7%,and 92.1%,respectively.CONCLUSION The social function scores of patients with residual symptoms of depression are high.They are affected by disease history,medication compliance,therapy method,degree of somatic symptoms,residual symptoms,and anxiety.展开更多
INTRODUCTION.Depressive disorders are mental illnesses that seriously affect public health.There are approximately 320 million patients with depression worldwide,accounting for 4.4% of the total disease burden.1Depres...INTRODUCTION.Depressive disorders are mental illnesses that seriously affect public health.There are approximately 320 million patients with depression worldwide,accounting for 4.4% of the total disease burden.1Depression leads to social and occupational impairment,diminished quality of life and an elevated risk of death by suicide.展开更多
In the pathogenesis of major depressive disorder, chronic stress-related neuroinflammation hinders favorable prognosis and antidepressant response. Mitochondrial DNA may be an inflammatory trigger, after its release f...In the pathogenesis of major depressive disorder, chronic stress-related neuroinflammation hinders favorable prognosis and antidepressant response. Mitochondrial DNA may be an inflammatory trigger, after its release from stress-induced dysfunctional central nervous system mitochondria into peripheral circulation. This evidence supports the potential use of peripheral mitochondrial DNA as a neuroinflammatory biomarker for the diagnosis and treatment of major depressive disorder. Herein, we critically review the neuroinflammation theory in major depressive disorder, providing compelling evidence that mitochondrial DNA release acts as a critical biological substrate, and that it constitutes the neuroinflammatory disease pathway. After its release, mitochondrial DNA can be carried in the exosomes and transported to extracellular spaces in the central nervous system and peripheral circulation. Detectable exosomes render encaged mitochondrial DNA relatively stable. This mitochondrial DNA in peripheral circulation can thus be directly detected in clinical practice. These characteristics illustrate the potential for mitochondrial DNA to serve as an innovative clinical biomarker and molecular treatment target for major depressive disorder. This review also highlights the future potential value of clinical applications combining mitochondrial DNA with a panel of other biomarkers, to improve diagnostic precision in major depressive disorder.展开更多
There is growing evidence that lipid metabolism instability in depressive disorder may be a core early pathological event associated with numerous pathogenesis hypotheses.However,spatial distributions and quantitative...There is growing evidence that lipid metabolism instability in depressive disorder may be a core early pathological event associated with numerous pathogenesis hypotheses.However,spatial distributions and quantitative changes of lipids in specific brain regions associated with depressive disorder are far from elucidated.In the present study,lipid profiling characteristics of whole brain sections are systematically determined by using matrix-assisted laser desorption ionization-mass spectrometry imaging(MALDI-MSI)-combined with histomorphological analysis in rats with depressive-like behavior induced by multiple early life stress(mELS)and unstressed control.Lipid dyshomeostasis and different degrees of metabolic disturbance occur in the eight paired representative brain sections from micro-region and molecular level.More specifically,17 lipid molecules show the severe dyshomeostasis between intergroup(control and depressed rats)or intra-group(multiple emotion-regulation-related brain regions).Quite specially,phosphatidylcholine(PC)(39:6)expression in section 7 is significantly upregulated only in the amygdala of depressed rat relative to control rat,by contrast,up-regulated phosphatidylglycerol(PG)(34:2)in section 2 emerges in the medial prefrontal cortex,insular cortex,and nucleus accumbens simultaneously.Linking spatial distribution to quantitative variation of lipids from the whole brain sections contributes the uncovering of new insights in causal mechanism of lipid dyshomeostasis in depression investigation and related targeting interventions.展开更多
Breast cancer is the most common cancer in women worldwide.A high percentage of these patients may have depressive symptoms and an early detection is crucial as part of a comprehensive management of the disease.Mao et...Breast cancer is the most common cancer in women worldwide.A high percentage of these patients may have depressive symptoms and an early detection is crucial as part of a comprehensive management of the disease.Mao et al recently conducted a study constructing a depression risk predictive model in young and middle-aged breast cancer patients.Four questionnaires(a general one,Patient Health Questionnaire-9,Perceived Social Support From Family Scale and International Physical Activity Questionnaire)and the Visual Analogue Scale were used to examine the correlation between different variables and depressive symptoms.The constructed predictive model showed strong predictive capability with an area under the receiver operating characteristic curve of 0.852 and high sensitivity and specificity values.However,the screening depression tools and questionnaires to assess social support or physical activity are not originally designed for oncological patients and further investigation to corroborate their applicability in this context is relevant.The cross-sectional design of the study prevents establishing clear causal relationships between the identified risk factors and depression.Besides,the study includes only a sample of Chinese patients and the applicability in a different sociocultural context is uncertain.Further investigation is crucial to corroborate the results in larger samples and different contexts.展开更多
BACKGROUND Depression is a significant risk factor for diabetes,particularly type 2 diabetes.However,depressive symptoms differ from clinical depression.Previous research has not fully considered the relationship betw...BACKGROUND Depression is a significant risk factor for diabetes,particularly type 2 diabetes.However,depressive symptoms differ from clinical depression.Previous research has not fully considered the relationship between the trajectory of depressive symptoms and the risk of developing diabetes over time.AIM To investigate the association between depressive symptoms,their trajectories,and the risk of developing diabetes in two prospective cohort studies.METHODS In the first phase we analyzed the association between depressive symptoms and the risk of developing diabetes separately using the Health and Retirement Study(HRS).Depressive symptom trajectories were assessed by examining changes in depressive symptoms at baseline and again 8 years later.We then identified specific depressive symptom trajectories that increased the risk of diabetes in the second phase.Finally,we confirmed the association between depressive symptoms and their trajectories with diabetes risk using the English Longitudinal Study of Ageing(ELSA)as a validation study.Depressive symptom trajectories were categorized into five states based on changes in the modified 8-item Center for Epidemiological Studies-Depression scores:Persistently high;increasing;fluctuating;decreasing;and persistently low.Diabetes mellitus was defined as self-reported,physician-diagnosed diabetes.Cox proportional hazards models were used to assess hazard ratios(HR)and 95%confidence intervals(CI),adjusting for potential confounders.RESULTS In the first phase a total of 27658 participants were included(HRS:18633,ELSA:9025),among whom 6582 had depressive symptoms(HRS:4547,ELSA:2035),6407 had somatic depressive symptoms(HRS:4414,ELSA:1993),and 26415 had cognitive-affective depressive symptoms(HRS:17755,ELSA:8660).We found that overall depressive symptoms(HRS:HR=1.14,95%CI:1.07-1.22;ELSA:HR=1.18,95%CI:1.03-1.34)and somatic depressive symptoms(HRS:HR=1.14,95%CI:1.07-1.22;ELSA:HR=1.25,95%CI:1.10-1.42)increased the risk of diabetes,while cognitive depressive symptoms were not associated with diabetes risk.Over an 8-year follow-up we identified 19729 trajectories of overall,somatic,and cognitive-affective depressive symptoms(HRS:13918,ELSA:5811).In the second phase we found that persistently high(HRS:HR=1.22,95%CI:1.06-1.40,ELSA:HR=1.54,95%CI:1.16-2.05 in total and HRS:HR=1.24,95%CI:1.07-1.43,ELSA:HR=1.79,95%CI:1.36-2.35 in somatic)and fluctuating(HRS:HR=1.09,95%CI:1.01-1.17,ELSA:HR=1.33,95%CI:1.14-1.55 in total and HRS:HR=1.10,95%CI:1.02-1.18,ELSA:HR=1.31,95%CI:1.13-1.53 in somatic)trajectories of overall and somatic depressive symptoms increased the risk of diabetes,while increasing trajectories may also raise diabetes risk.However,decreasing trajectories were not associated with diabetes risk.Cognitive-affective depressive symptoms showed no association with diabetes risk regardless of trajectory changes.Sensitivity analyses confirmed the reliability of the findings.CONCLUSION Persistently high and fluctuating trajectories of overall and somatic depressive symptoms increased the risk of diabetes,while decreasing trajectories were not associated with diabetes risk.In contrast trajectories of cognitiveaffective depressive symptoms show no relationship with diabetes risk.Focusing on depressive symptom trajectories,particularly those of somatic depressive symptoms,represented a viable strategy for future diabetes prevention.展开更多
Major depressive disorder(MDD),one of the most prevalent mental illnesses,is characterized by anhedonia,the inability to experience pleasure from rewarding activities.This minireview examines the complex relationship ...Major depressive disorder(MDD),one of the most prevalent mental illnesses,is characterized by anhedonia,the inability to experience pleasure from rewarding activities.This minireview examines the complex relationship between music,anhedonia,and neural activity from neuroimaging and neuroelectrophysiological perspectives.It synthesizes the latest advances in music neuroscience,exploring music's potential to modulate emotional responses and alleviate anhedonia in depressed individuals.Anhedonia has been linked to dysfunctional brain reward circuits.Functional magnetic resonance imaging studies have revealed that the potential mechanism by which music exerts its anti-depressive effect may involve the reactivation of the anterior cingulate cortex,while electroencephalographic studies have revealed that oscillatory network dysfunction significantly impairs music perception engagement in patients with MDD.Musical chills,representing intense emotional peaks during musical experiences,can evoke profound plea-sure in healthy individuals and may offer a therapeutic modality for alleviating anhedonia in MDD.This review discusses how music therapy may support emotional regulation by activating these neural pathways and enhancing affective processing.Despite promising developments,this field remains understudied.A more nuanced research approach is urgently needed to better understand the mechanisms underlying music's effects on anhedonia and to develop effective interventions.展开更多
BACKGROUND Cognitive impairment is one of the common clinical manifestations of depression,causing negative distress to patients.Elevated homocysteine(Hcy)concentrations and gut microbiome dysfunction may be observed ...BACKGROUND Cognitive impairment is one of the common clinical manifestations of depression,causing negative distress to patients.Elevated homocysteine(Hcy)concentrations and gut microbiome dysfunction may be observed in patients with depression.AIM To investigate the relationship between Hcy,microbiome,and cognition in depressive patients.METHODS We recruited 67 patients with major depressive disorder(MDD)(MDD group)and 94 healthy controls(HCs)individuals(HCs group).Serum Hcy levels were determined using the enzyme circulation method.16s rRNA sequencing was used to classify and identify the fecal bacteria.17 Hamilton depression rating scale and MATRICS consensus cognitive battery were used to evaluate mood states and cognition in patients with MDD. Correlation analysis was performed to explore the correlation between fecal flora,Hcy, and depressive cognitive function.RESULTSElevated serum levels of Hcy were seen in patients with MDD compared to healthy individuals. Patients withMDD indicated significant decreases in cognitive scores (P < 0.001) in six modules: Speed of processing, workingmemory, visual learning, reasoning and problem-solving, social cognition, and total scores. Hcy levels showed anegative correlation with processing speed, social cognition, and total MDD scores (P < 0.05). Hcy was alsosignificantly negatively correlated with Alistipes, Ruminococcae, Tenericides, and Porphyromonas (P < 0.05).CONCLUSIONOur results highlight that Hcy was correlated with cognition and gut microbiome in MDD. This interaction may berelated to the physiological and pathological mechanisms underlying cognitive deficits in depression.展开更多
BACKGROUND Diabetes mellitus(DM)is a rapidly growing global health emergency of the 21st century.Comorbidities,such as DM and depression,are common,presenting challenges to the healthcare system.AIM To investigate the...BACKGROUND Diabetes mellitus(DM)is a rapidly growing global health emergency of the 21st century.Comorbidities,such as DM and depression,are common,presenting challenges to the healthcare system.AIM To investigate the prevalence of depression and its associated factors in patients with DM and to strengthen the management of depression in this patient group.METHODS Participants were selected from the 2018 China Health and Retirement Longitudinal Study.Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale,with a score of 10 or more indicating depression.Group differences were compared using analysis of variance andχ^(2)tests.Binary logistic regression was conducted to explore the odds ratios(ORs)of independent variables.Following Andersen’s behavioral model,predisposing,enabling,health need,and health behavior variables were introduced stepwise into the logistic model.RESULTS Of the 1673 patients with diabetes,41.4%had depressive symptoms.Regarding the predisposing characteristics,patients who were male(OR 0.426,P<0.05),married(OR 0.634,P<0.05),and received a high school education or higher(OR 0.432,P<0.05)reported fewer depressive symptoms.Healthcare needs,including better self-rated health(OR 0.458 for fair and OR 0.247 for good,P<0.05)and more sleep(OR 0.642,P<0.05),were associated with a lower likelihood of depressive symptoms.In contrast,pain(OR 1.440 for mild and OR 2.644 for severe,P<0.05)and impairment in the basic activities of daily living(OR 1.886,P<0.05)were inversely associated.Additionally,patients highly satisfied with healthcare services(OR 0.579,P<0.05)were less likely to have depressive symptoms.CONCLUSION Nearly half of the patients with DM reported depressive symptoms,which were strongly associated with predisposing characteristics and healthcare needs,particularly physical pain and impairment in basic activities of daily living.Our study emphasizes the significance of enhanced screening and intervention for depression in diabetes care along with improved management of functional impairments.展开更多
Objective:To identify promising biomarkers for the pathogenesis of major depressive disorder(MDD).Methods:Microarray chips of MDD patients,including the GSE98793,GSE52790,and GSE39653 datasets,were obtained from the G...Objective:To identify promising biomarkers for the pathogenesis of major depressive disorder(MDD).Methods:Microarray chips of MDD patients,including the GSE98793,GSE52790,and GSE39653 datasets,were obtained from the Gene Expression Omnibus database.The biological processes and pathways related to MDD were investigated using the GO and KEGG pathway tools.Weighted gene coexpression network analysis was conducted to identify modules related to MDD.The hub genes associated with MDD were obtained via protein-protein interaction analysis.Finally,the expression of hub genes in the hippocampal tissues of depression-like rats was detected by reverse transcription-polymerase chain reaction and Western blotting.Results:A total of 658 differentially expressed genes were identified from the Gene Expression Omnibus datasets;thus,these genes and the GSE98793 dataset were used to conduct weighted gene coexpression network analysis.A total of 244 module-related genes were identified and these genes were highly correlated with MDD.These genes were involved in the Ras signaling pathway,regulation of the actin cytoskeleton,and axon guidance according to the KEGG analysis.Hub genes,including MAPK14,SOCS1,TLR2,PTK2B,and GRB2,were obtained via protein-protein interaction analysis.All these hub genes showed better diagnostic efficiency in the GSE52790,GSE39653,and GSE98793 datasets.In vivo experiments revealed that compared with those in control rats,SOCS1 and MAPK14 expression was significantly decreased;while GRB2,TLR2,and PTK2B expression was increased in the hippocampi of depression-like rats.Conclusions:Our study demonstrates that GRB2,TLR2,SOCS1,PTK2B,and MAPK14 are promising hub genes,and targeting these five genes may be an effective treatment strategy for MDD.展开更多
Breast cancer ranks among the most prevalent cancers worldwide,particularly affecting young and middle-aged women,who face higher recurrence rates,lower survival rates,and substantial psychological health challenges.D...Breast cancer ranks among the most prevalent cancers worldwide,particularly affecting young and middle-aged women,who face higher recurrence rates,lower survival rates,and substantial psychological health challenges.Depressive symptoms,frequently observed in breast cancer patients,significantly influence treatment outcomes and quality of life.Recent years have seen a growing focus on these symptoms,emphasizing early identification and intervention.This editorial comments on the recent study by Mao et al on a risk prediction model for de-pression in young and middle-aged breast cancer patients.Research suggests that factors such as tumor grade,monthly income,pain perception,family support,and physical activity critically influence the onset of depressive symptoms.By developing personalized risk prediction models,it becomes possible to identify high-risk patients early,allowing healthcare professionals to implement pre-ventive strategies proactively.The editorial advocates for increased attention and resources dedicated to psychological health interventions for breast cancer pa-tients,aiming to foster comprehensive care strategies that mitigate the impacts of depression and enhance overall quality of life.展开更多
Major depressive disorder(MDD)is a debilitating psychiatric condition associated with substantial personal,societal,and economic costs.Despite considerable advances in research,most conventional antidepressant therapi...Major depressive disorder(MDD)is a debilitating psychiatric condition associated with substantial personal,societal,and economic costs.Despite considerable advances in research,most conventional antidepressant therapies fail to achieve adequate response in a significant proportion of patients,underscoring the need for novel,mechanism-based interventions.Lycium barbarum glycopeptide(LbGp),a bioactive compound with emerging neuroprotective properties,has been proposed as a candidate for antidepressant development;however,its therapeutic efficacy and underlying mechanisms remain largely uncharacterized.In this study,ventral forebrain organoids were generated from patients with MDD to investigate disease-related neurophysiological abnormalities.These organoids exhibited disrupted neuronal morphology,diminished calcium signaling,and impaired electrophysiological activity.Administration of LbGp effectively restored structural and functional deficits in MDD-derived organoids.Transcriptomic profiling revealed that LbGp ameliorated endoplasmic reticulum(ER)stress responses.To investigate the causative role of ER stress,control organoids were treated with the ER stress agonist CCT020312,which elicited neural activity impairments resembling those observed in MDD organoids.Notably,LbGp reversed the phenotypic consequences of CCT020312 exposure in control organoids.In conclusion,ventral forebrain organoids derived from individuals with MDD demonstrated that LbGp ameliorates disease-associated phenotypes by modulating ER stress.展开更多
BACKGROUND Evaluating the relationship between sleep quality and depressive symptoms after laparoscopic hysterectomy under general anesthesia can help improve postoperative depressive symptoms.AIM To evaluate the corr...BACKGROUND Evaluating the relationship between sleep quality and depressive symptoms after laparoscopic hysterectomy under general anesthesia can help improve postoperative depressive symptoms.AIM To evaluate the correlation between sleep quality and depression symptoms in patients after laparoscopic hysterectomy under general anesthesia and explore factors associated with postoperative sleep disturbances and depression.METHODS This retrospective case-control study included 102 females who underwent laparoscopic hysterectomy under general anesthesia at our hospital between January 2022 and June 2024,excluding those with severe cardiovascular/cerebrovascular disease,liver/kidney dysfunction,or other underlying conditions.Sleep quality and depressive symptoms were evaluated preoperatively and at 1-week,1-month,and 3-months postoperatively using the Pittsburgh Sleep Quality Index(PSQI)and the Hamilton Depression Rating Scale(HAMD).Physiological indicators(heart rate,blood pressure,and oxygen saturation)and laboratory parameters were monitored.Pearson correlation and logistic regression analyses were performed to examine the association between sleep quality and depressive symptoms.RESULTS Mean age of participants was(52.30±8.39)years,with a body mass index of(23.56±2.79)kg/m².Preoperative comorbidities included hypertension(25.49%),diabetes(14.71%),and heart disease(9.80%).Patients with poor preoperative sleep quality(higher PSQI scores)exhibited significantly more severe depressive symptoms(P<0.05).Postoperative PSQI scores improved at 1-week,1-month,and 3-months compared to baseline(P<0.05).HAMD scores decreased at 1-week and 1-month postoperatively but returned to near preoperative levels at 3-months.Physiological indicators remained within normal ranges,and the postoperative complication rate was<5%.Logistic regression showed that poor postoperative sleep quality was an independent predictor of depressive symptoms(odds ratio=1.64,95%CI:1.22-2.20,P<0.05).CONCLUSION Sleep quality was significantly correlated with depressive symptoms after laparoscopic hysterectomy under general anesthesia.Patients with poor postoperative sleep quality were more prone to depression.Early interventions for sleep disturbances are potentially beneficial for mitigating depression and improve mental health.展开更多
基金funded by Science and Technology Commission of Shanghai Municipality(No.21Y11905400)National Natural ScienceFoundationof China(General Program,No.82371555).
文摘Background Dynamic interpersonal therapy(DIT)is a short-term psychodynamic psychotherapy that has been shown to effectively reduce depressive symptoms in patients with major depressive disorder(MDD).In DIT,the depressive symptoms are formulated as responses to impaired mentalisation.DIT aims to alleviate depressive symptoms by improving mentalising.Aims This study aimed to examine the effect of DIT on improving mentalising and the mediating effect of mentalising in changes in depressive symptoms.Methods Outpatients received either DIT combined with antidepressant medication treatment(DIT group)or antidepressant medication treatment alone(ADM group)for 16 weeks.The Hamilton Depression Rating Scale(HAMD),Patient Health Questionnaire(PHQ)and Reflective Functioning Questionnaire(RFQ)were used.The intention-to-treat principle,mixed linear models,multiple imputation,Pearson's correlation analysis and mediation analysis were conducted.The per-protocol principle was used as sensitivity analysis.Results The DIT group had significantly lower HAMD(least-squares(LS)mean difference=-3.756,p<0.001),PHQ(LS mean difference=-4.188,p<0.001),uncertainty about mental states in the RFQ(RFQ-U,LS mean difference=-2.116,p<0.001)and higher certainty about mental states in the RFQ(RFQ-C,LS mean difference=2.214,p=0.028)scores than the ADM group at post-treatment.The change in RFQ-C was marginally significantly correlated with the change in HAMD(r=-0.218,poretao=0.090),The change in RFQ-U was significantly correlated with the change in HAMD(r=-0.269,poroco-0.024)and the change in PHQ(r=-0.43,Peoretceo l<e0.001).When using RFQ-U as the mediating variable and PHQ as the dependent variable,a significant mediating effect was found(p=0.043,95% confidence interval 0.024 to 1.453).Conclusions The DIT group yielded better outcomes compared with the ADM group in reducing depressive symptoms and improving mentalising.Improvements in mentalising were associated with reductions in depressive symptoms.These findings support that mentalising may contribute to the therapeutic effects of DIT in MDD.
基金Supported by Science and Technology Innovation 2030-Major Projects,No.2021ZD0202000National Key Research and Development Program of China,No.2019YFA0706200+2 种基金National Natural Science Foundation of China,No.82371535Science and Technology Innovation Program of Hunan Province,No.2023RC3083Fundamental Research Funds for the Central Universities of Central South University,No.2023ZZTS0838.
文摘BACKGROUND Sensitivity to stress is essential in the onset,clinical symptoms,course,and prognosis of major depressive disorder(MDD).Meanwhile,it was unclear how variously classified but connected stress-sensitivity variables affect MDD.We hypothesize that high-level trait-and state-related stress-sensitivity factors may have different cumulative effects on the clinical symptoms and follow-up outcomes of MDD.AIM To investigate how stress-sensitivity factors added up and affected MDD clinical symptoms and follow-up results.METHODS In this prospective study,281 MDD patients were enrolled from a tertiary care setting.High-level stress-sensitivity factors were classified as trait anxiety,state anxiety,perceived stress,and neuroticism,with a total score in the top quartile of the research cohort.The cumulative effects of stress-sensitivity factors on cognitive dysfunction,disability and functional impairment,suicide risk,and depressive and anxiety symptoms were examined using an analysis of variance with linear trend analysis.Correlations were investigated further using multiple regression analysis.RESULTS Regarding high-level stress-sensitivity factors,53.40%of patients had at least one at baseline,and 29.61%had two or more.Four high-level stress-sensitivity components had significant cumulative impacts on MDD symptoms at baseline(all P<0.001).Perceived stress predicted the greatest effect sizes of state-related factors on depressive symptoms(partialη^(2)=0.153;standardizedβ=0.195;P<0.05).The follow-up outcomes were significantly impacted only by the high-level trait-related components,mainly when it came to depressive symptoms and suicide risk,which were predicted by trait anxiety and neuroticism,respectively(partialη^(2)=0.204 and 0.156;standardizedβ=0.247 and 0.392;P<0.05).CONCLUSION To enhance outcomes of MDD and lower the suicide risk,screening for stress-sensitivity factors and considering multifaceted measures,mainly focusing on trait-related ones,should be addressed clinically.
文摘Background Mental disorders rank among the leading contributors to the global disease burden, with depressive disorders being among the most prevalent.Aims The objective of this study is to examine the prevalence, incidence and years lived with disability (YLDs) associated with depressive disorders, particularly major depressive disorder and dysthymia, in Iran from 1990 to 2021. To achieve this, the research focused on analysing these metrics across various dimensions, including temporal trends, sex differences, age categories and subnational regions.Methods The data used in this study are sourced directly from the Institute for Health Metrics and Evaluation, ensuring that the information is both authoritative and reliable. All-age count estimates and age-standardised rates (per 100 000) were calculated for prevalence, incidence and YLDs. The disease burden indicators were analysed for the period spanning from 1990 to 2021, stratified by sex, age and location. The percentage change between 1990 and 2021 was also documented. The 95% uncertainty interval (UI) was reported for each of the reported estimates.Results The prevalence of depressive disorders in Iran demonstrated a notable upward trend from 1990 to 2021, with the rate of growth being particularly pronounced within the country. The age-standardised prevalence rate per 100 000 individuals for depressive disorders in Iran was 5609 (95% UI 4810 to 6488). By 2021, the number of depression cases in Iran reached 5.2 million, which is approximately 2.37 times the figure reported in 1990. The prevalence of depressive disorders was notably higher among females compared with males. The age-standardised prevalence rate per 100 000 individuals for males was 4184 (95% UI 3545 to 4929). For females, this figure was significantly greater, reaching 7077 (95% UI 6115 to 8172). Out of the total reported cases of depressive disorders in Iran, 3.2 million were observed in females, while males accounted for 2 million cases.Conclusions The findings highlighted the considerable impact of depressive disorders in Iran, both nationally and regionally, while also revealing variations across sex and age groups. Given the shifts in the demographic structure and the growing burden of these disorders, it is essential to prioritise screening initiatives, education programmes and strategies aimed at enhancing mental health awareness and ensuring improved access to mental health services in health policy planning.
文摘Major depressive disorder(MDD),a psychiatric disorder characterized by functional brain deficits,poses considerable diagnostic and treatment challenges,especially in adolescents owing to varying clinical presentations.Biomarkers hold substantial clinical potential in the field of mental health,enabling objective assessments of physiological and pathological states,facilitating early diagnosis,and enhancing clinical decision-making and patient outcomes.Recent breakthroughs combine neuroimaging with machine learning(ML)to distinguish brain activity patterns between MDD patients and healthy controls,paving the way for diagnostic support and personalized treatment.However,the accuracy of the results depends on the selection of neuroimaging features and algorithms.Ensuring privacy protection,ML model accuracy,and fostering trust are essential steps prior to clinical implementation.Future research should prioritize the establishment of comprehensive legal frameworks and regulatory mechanisms for using ML in MDD diagnosis while safeguarding patient privacy and rights.By doing so,we can advance accuracy and personalized care for MDD.
基金supported by the National Natural Science Foundation of China(82071500,82271540,32370724,82401759,81871055,32070679)Shanghai Clinical Research Center for Mental Health(19MC1911100)+11 种基金Shanghai Key Laboratory of Psychotic Disorders(13dz2260500)Shanghai Municipal Administrator of Traditional Chinese Medicine(ZY-(2021-2023)-0207-01)Shanghai Municipal Health Commission Collaborative Innovation Group(2024CXJQ03)Shanghai Science and Technology Innovation Action Program(24JS2840400,24ZR1439900,21Y11921100)Shanghai Municipal Science and Technology Major Project,the National Key R&D Program of China(2023YFA0913804,2024YFA0916603,2022FYC2503300)the Program of Shanghai Academic/Technology Research Leader(21XD1423300)Shanghai Pujiang Program(21PJD063)Shanghai Municipal Science and Technology Major Project(2017SHZDZX01)Shanghai Municipal Commission of Education(2024AIZD016)the National Key R&D Program of China(2019YFA0905400,2017YFC0908105,2021YFC2702100)National Program for Support of Top-Notch Young Professionals,Taishan Scholar Program of Shandong Province(tstp20240526)the Natural Science Foundation of Shandong Province(ZR2019YQ14,YDZX2021009,2021ZDSYS06).
文摘Background Numerous studies have consistently demonstrated that a considerable proportion of patients with major depressive disorder (MDD) frequently exhibit pronounced dyslipidaemia. However, the causal dynamics between MDD and dyslipidaemia remain elusive.Aims To comprehensively disentangle the genetic causality between MDD and various phenotypes of blood lipids, thereby facilitating the advancement of management strategies for these conditions.Methods We conducted a two-sample univariable Mendelian randomisation (MR) analysis using different models, including the inverse variance weighted (IVW) method and causal analysis using the summary effect (CAUSE) estimates, as well as a multivariable MR analysis. This analysis used summary statistics from genome-wide association studies (GWAS) of MDD and five lipid traits: low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, total cholesterol and triglycerides (TG), encompassing 5 237 893 individuals of European and East Asian ancestries. For MDD, a total of 598 701 individuals were included, with 500 199 individuals of European ancestry (Ncase=170 756, Ncontrol=329 443) and 98 502 of East Asian ancestry (Ncase=12 588, Ncontrol=85 914). Lipid data were collected from 4 639 192 individuals through the Global Lipids Genetics Consortium (European, N=4 096 085;East Asian, N=543 107). Next, we used the two-step MR to explore the mediating factors between MDD and TG, and the risk factors affecting TG through MDD. Finally, we conducted a GWAS meta-analysis and enrichment analysis.Results In univariable MR, we observed a negative causal effect of low-density lipoprotein on MDD in both European populations (IVW: odds ratio (OR): 0.972, 95% confidence interval (CI) 0.947 to 0.998, p=0.037) and East Asian populations (IVW: OR: 0.928, 95% CI 0.864 to 0.997, p=0.042). Additionally, we identified a bidirectional causal relationship between TG and MDD, with TG having a causal effect on MDD (IVW: OR: 1.052, 95% CI 1.020 to 1.085, p=0.001) and MDD having a causal effect on TG (IVW: OR: 1.075, 95% CI 1.047 to 1.104, p<0.001). Multivariable MR analysis further supported the role of TG in MDD (OR: 1.205, 95% CI 1.034 to 1.405, p=0.017). CAUSE estimates indicated that the causal model of MDD on TG provided a better fit than the sharing model (p=0.003), while the association of TG on MDD was more likely due to horizontal correlated pleiotropy than causality. Mediation analyses revealed that waist-hip ratio (WHR) mediated 69% of the total causal effect of MDD on TG, while other identified risk factors exhibited lower mediating proportions either mediated through MDD (≤17%) or originating from MDD (≤29%). The GWAS meta-analysis highlighted potential pathways related to lipid processes and nucleosome assembling, with significant cell types identified in brain regions and liver tissues.Conclusions The findings indicate that genetic proxies of MDD are associated with elevated levels of TG, with WHR serving as a clinical indicator of the association. This suggests that interventions targeting WHR may be effective in reducing TG levels in patients with MDD.
基金supported by the National Natural Science Foundation of China(No.82371530,82171529)the Capital Health Development Special Research Project(2022-1-4111)the National Key Technology R and D Program(No.2015BAI13B01).
文摘Background The patient-reported Dimensional Anhedonia Rating Scale(DARS)has been adapted into Chinese,so there is a need to evaluate its measurement properties in a Chinese population.Aims To evaluate the reliability and validity of the DARS among Chinese individuals with major depressive disorder(MDD)and its treatment sensitivity in a prospective clinical study.Methods Data were from a multicentre,prospective clinical study(NCT03294525),which recruited both patients with MDD,who were followed for 8 weeks,and healthy controls(HCs),assessed at baseline only.The analysis included confirmatory factor analysis,validity and sensitivity to change.Results Patients’mean(standard deviation(SD))age was 34.8(11.0)years,with 68.7%being female.75.2%of patients with MDD had melancholic features,followed by 63.8%with anxious distress.Patients had experienced MDD for a mean(SD)of 9.2(18)months.DARS scores covered the full range of severity with no major floor or ceiling effects.Confirmatory factor analysis showed adequate fit statistics(comparative fit index 0.976,goodness-of-fit index 0.935 and root mean square error of approximation 0.055).Convergent validity with anhedonia-related measures was confirmed.While the correlation between the DARS and the Hamilton Depression Rating Scale was not strong(r=0.31,baseline),the DARS was found to differentiate between levels of depression.Greater improvements in DARS scores were seen with the Hamilton Rating Scale for Depression responder group(effect size 1.16)compared with the non-responder group(effect size 0.46).Conclusions This study comprehensively evaluated the measurement properties of the DARS using a Chinese population with MDD.Overall,the Chinese version of DARS demonstrates good psychometric properties and has been found to be responsive to change during antidepressant treatment.The DARS is a suitable scale for assessing patient-reported anhedonia in future clinical trials.
基金Supported by National Natural Science Foundation of China,No.82373660 and No.81761128030Sanming Project of Medicine in Shenzhen Nanshan,No.11the China Scholarship Council。
文摘BACKGROUND Childhood maltreatment has a potentially lasting influence on subthreshold depressive symptoms(SDS)and major depressive disorder(MDD).This study aimed to explore the association of childhood maltreatment with MDD and SDS,focusing on the differences between young and middle-aged adults.AIMTo examine the associations among childhood maltreatment, SDS, and MDD in young and middle-aged adults.METHODSA total of 3209 adults were recruited from 34 primary healthcare settings. The Childhood Trauma Questionnaire-28item Short Form was used to assess childhood maltreatment. The Patient Health Questionnaire-9 was used toassess SDS and the Mini-International Neuropsychiatric Interview depression module was used to assess MDD.RESULTSChildhood maltreatment was significantly associated with higher odds of developing SDS and MDD than in thenon-depressed control group (P < 0.05). Childhood maltreatment significantly increased the risk of developing SDSin young adults but was not significantly associated with SDS in middle-aged adults (P = 0.055). Conversely,childhood maltreatment was significantly associated with MDD in both young (P < 0.001) and middle-aged adults(P < 0.05). In young adults, various types of childhood maltreatment were associated with MDD;however, onlyemotional abuse and neglect were significantly associated with MDD in middle-aged adults.CONCLUSIONOur study revealed a strong association among childhood maltreatment, SDS, and MDD across age groups,highlighting the impact of emotional abuse and need for trauma-informed depression care.
文摘BACKGROUND At present,the influencing factors of social function in patients with residual depressive symptoms are still unclear.Residual depressive symptoms are highly harmful,leading to low mood in patients,affecting work and interpersonal communication,increasing the risk of recurrence,and adding to the burden on families.Studying the influencing factors of their social function is of great significance.AIM To explore the social function score and its influencing factors in patients with residual depressive symptoms.METHODS This observational study surveyed patients with residual depressive symptoms(case group)and healthy patients undergoing physical examinations(control group).Participants were admitted between January 2022 and December 2023.Social functioning was assessed using the Sheehan Disability Scale(SDS),and scores were compared between groups.Factors influencing SDS scores in patients with residual depressive symptoms were analyzed by applying multiple linear regression while using the receiver operating characteristic curve,and these RESULTS The SDS scores of the 158 patients with depressive symptoms were 11.48±3.26.Compared with the control group,the SDS scores and all items in the case group were higher.SDS scores were higher in patients with relapse,discon-tinuous medication,drug therapy alone,severe somatic symptoms,obvious residual symptoms,and anxiety scores≥8.Disease history,medication compliance,therapy method,and residual symptoms correlated positively with SDS scores(r=0.354,0.414,0.602,and 0.456,respectively).Independent influencing factors included disease history,medication compliance,therapy method,somatic symptoms,residual symptoms,and anxiety scores(P<0.05).The areas under the curve for predicting social functional impairment using these factors were 0.713,0.559,0.684,0.729,0.668,and 0.628,respectively,with sensitivities of 79.2%,61.8%,76.8%,81.7%,63.6%,and 65.5%and specificities of 83.3%,87.5%,82.6%,83.3%,86.7%,and 92.1%,respectively.CONCLUSION The social function scores of patients with residual symptoms of depression are high.They are affected by disease history,medication compliance,therapy method,degree of somatic symptoms,residual symptoms,and anxiety.
基金funded by the Construction Project of the"Flagship"Department of Chinese and Western Medicine Coordination(LiuL/2024-221)the 2024 Medical Service and Security Capacity Improvement Project(National Clinical Key Specialty Construction)(LiuL/Huwei Medical/2024-65)+5 种基金the Shanghai Traditional Chinese Medicine Standardization Project(LiuL/No.2023JSP03)the Shanghai Key Discipline Construction Project of Traditional Chinese Medicine(Clinical)(LiuL/2024-No.3)the Shanghai Technical Standardization Management and Promotion Project(LiuL/No.SHDC22023212)the Shanghai Municipal Health Commission Traditional Chinese Medicine Research Project(2022)(LiuL/No.2022Cx004)Clinical research project of Shanghai Health Commission-Youth Project(LW/No.20214Y0056)Shanghai Institute of Traditional Chinese Medicine for Mental Health(LW/No.SZB2023201).
文摘INTRODUCTION.Depressive disorders are mental illnesses that seriously affect public health.There are approximately 320 million patients with depression worldwide,accounting for 4.4% of the total disease burden.1Depression leads to social and occupational impairment,diminished quality of life and an elevated risk of death by suicide.
基金supported by the National Natural Science Foundation of China,No.81971269 (to DP)the Science and Technology Commission of Shanghai,No.YDZX20213100001003 (to DP)。
文摘In the pathogenesis of major depressive disorder, chronic stress-related neuroinflammation hinders favorable prognosis and antidepressant response. Mitochondrial DNA may be an inflammatory trigger, after its release from stress-induced dysfunctional central nervous system mitochondria into peripheral circulation. This evidence supports the potential use of peripheral mitochondrial DNA as a neuroinflammatory biomarker for the diagnosis and treatment of major depressive disorder. Herein, we critically review the neuroinflammation theory in major depressive disorder, providing compelling evidence that mitochondrial DNA release acts as a critical biological substrate, and that it constitutes the neuroinflammatory disease pathway. After its release, mitochondrial DNA can be carried in the exosomes and transported to extracellular spaces in the central nervous system and peripheral circulation. Detectable exosomes render encaged mitochondrial DNA relatively stable. This mitochondrial DNA in peripheral circulation can thus be directly detected in clinical practice. These characteristics illustrate the potential for mitochondrial DNA to serve as an innovative clinical biomarker and molecular treatment target for major depressive disorder. This review also highlights the future potential value of clinical applications combining mitochondrial DNA with a panel of other biomarkers, to improve diagnostic precision in major depressive disorder.
基金supported by the China Science and Technology Innovation 2030-Major Project(Nos.2022ZD0211701,2021ZD0200700)the National Natural Science Foundation of China(Nos.82130042,81830040,22176195,82127801)+3 种基金Shenzhen Science and Technology Serial Funds(Nos.GJHZ20210705141400002,KCXFZ20211020164543006,JCYJ20220818101615033,ZDSYS20220606100606014,KQTD 20221101093608028)the National Key R&D Program of China(No.2022YFF0705003)Guangdong Province Zhu Jiang Talents Plan(No.2021QN02Y028)the Guangdong Science and Technology Department(No.2021B1212030004)。
文摘There is growing evidence that lipid metabolism instability in depressive disorder may be a core early pathological event associated with numerous pathogenesis hypotheses.However,spatial distributions and quantitative changes of lipids in specific brain regions associated with depressive disorder are far from elucidated.In the present study,lipid profiling characteristics of whole brain sections are systematically determined by using matrix-assisted laser desorption ionization-mass spectrometry imaging(MALDI-MSI)-combined with histomorphological analysis in rats with depressive-like behavior induced by multiple early life stress(mELS)and unstressed control.Lipid dyshomeostasis and different degrees of metabolic disturbance occur in the eight paired representative brain sections from micro-region and molecular level.More specifically,17 lipid molecules show the severe dyshomeostasis between intergroup(control and depressed rats)or intra-group(multiple emotion-regulation-related brain regions).Quite specially,phosphatidylcholine(PC)(39:6)expression in section 7 is significantly upregulated only in the amygdala of depressed rat relative to control rat,by contrast,up-regulated phosphatidylglycerol(PG)(34:2)in section 2 emerges in the medial prefrontal cortex,insular cortex,and nucleus accumbens simultaneously.Linking spatial distribution to quantitative variation of lipids from the whole brain sections contributes the uncovering of new insights in causal mechanism of lipid dyshomeostasis in depression investigation and related targeting interventions.
文摘Breast cancer is the most common cancer in women worldwide.A high percentage of these patients may have depressive symptoms and an early detection is crucial as part of a comprehensive management of the disease.Mao et al recently conducted a study constructing a depression risk predictive model in young and middle-aged breast cancer patients.Four questionnaires(a general one,Patient Health Questionnaire-9,Perceived Social Support From Family Scale and International Physical Activity Questionnaire)and the Visual Analogue Scale were used to examine the correlation between different variables and depressive symptoms.The constructed predictive model showed strong predictive capability with an area under the receiver operating characteristic curve of 0.852 and high sensitivity and specificity values.However,the screening depression tools and questionnaires to assess social support or physical activity are not originally designed for oncological patients and further investigation to corroborate their applicability in this context is relevant.The cross-sectional design of the study prevents establishing clear causal relationships between the identified risk factors and depression.Besides,the study includes only a sample of Chinese patients and the applicability in a different sociocultural context is uncertain.Further investigation is crucial to corroborate the results in larger samples and different contexts.
文摘BACKGROUND Depression is a significant risk factor for diabetes,particularly type 2 diabetes.However,depressive symptoms differ from clinical depression.Previous research has not fully considered the relationship between the trajectory of depressive symptoms and the risk of developing diabetes over time.AIM To investigate the association between depressive symptoms,their trajectories,and the risk of developing diabetes in two prospective cohort studies.METHODS In the first phase we analyzed the association between depressive symptoms and the risk of developing diabetes separately using the Health and Retirement Study(HRS).Depressive symptom trajectories were assessed by examining changes in depressive symptoms at baseline and again 8 years later.We then identified specific depressive symptom trajectories that increased the risk of diabetes in the second phase.Finally,we confirmed the association between depressive symptoms and their trajectories with diabetes risk using the English Longitudinal Study of Ageing(ELSA)as a validation study.Depressive symptom trajectories were categorized into five states based on changes in the modified 8-item Center for Epidemiological Studies-Depression scores:Persistently high;increasing;fluctuating;decreasing;and persistently low.Diabetes mellitus was defined as self-reported,physician-diagnosed diabetes.Cox proportional hazards models were used to assess hazard ratios(HR)and 95%confidence intervals(CI),adjusting for potential confounders.RESULTS In the first phase a total of 27658 participants were included(HRS:18633,ELSA:9025),among whom 6582 had depressive symptoms(HRS:4547,ELSA:2035),6407 had somatic depressive symptoms(HRS:4414,ELSA:1993),and 26415 had cognitive-affective depressive symptoms(HRS:17755,ELSA:8660).We found that overall depressive symptoms(HRS:HR=1.14,95%CI:1.07-1.22;ELSA:HR=1.18,95%CI:1.03-1.34)and somatic depressive symptoms(HRS:HR=1.14,95%CI:1.07-1.22;ELSA:HR=1.25,95%CI:1.10-1.42)increased the risk of diabetes,while cognitive depressive symptoms were not associated with diabetes risk.Over an 8-year follow-up we identified 19729 trajectories of overall,somatic,and cognitive-affective depressive symptoms(HRS:13918,ELSA:5811).In the second phase we found that persistently high(HRS:HR=1.22,95%CI:1.06-1.40,ELSA:HR=1.54,95%CI:1.16-2.05 in total and HRS:HR=1.24,95%CI:1.07-1.43,ELSA:HR=1.79,95%CI:1.36-2.35 in somatic)and fluctuating(HRS:HR=1.09,95%CI:1.01-1.17,ELSA:HR=1.33,95%CI:1.14-1.55 in total and HRS:HR=1.10,95%CI:1.02-1.18,ELSA:HR=1.31,95%CI:1.13-1.53 in somatic)trajectories of overall and somatic depressive symptoms increased the risk of diabetes,while increasing trajectories may also raise diabetes risk.However,decreasing trajectories were not associated with diabetes risk.Cognitive-affective depressive symptoms showed no association with diabetes risk regardless of trajectory changes.Sensitivity analyses confirmed the reliability of the findings.CONCLUSION Persistently high and fluctuating trajectories of overall and somatic depressive symptoms increased the risk of diabetes,while decreasing trajectories were not associated with diabetes risk.In contrast trajectories of cognitiveaffective depressive symptoms show no relationship with diabetes risk.Focusing on depressive symptom trajectories,particularly those of somatic depressive symptoms,represented a viable strategy for future diabetes prevention.
基金Supported by the Wuxi Municipal Health Commission Research Project Plan,No.Q202450Wuxi Scientific and technological breakthrough of“Light of the Taihu Lake”(Basic Research),No.K20221039Top Talent Support Program for Young and Middleaged People of Wuxi Health Committee,No.BJ2023086.
文摘Major depressive disorder(MDD),one of the most prevalent mental illnesses,is characterized by anhedonia,the inability to experience pleasure from rewarding activities.This minireview examines the complex relationship between music,anhedonia,and neural activity from neuroimaging and neuroelectrophysiological perspectives.It synthesizes the latest advances in music neuroscience,exploring music's potential to modulate emotional responses and alleviate anhedonia in depressed individuals.Anhedonia has been linked to dysfunctional brain reward circuits.Functional magnetic resonance imaging studies have revealed that the potential mechanism by which music exerts its anti-depressive effect may involve the reactivation of the anterior cingulate cortex,while electroencephalographic studies have revealed that oscillatory network dysfunction significantly impairs music perception engagement in patients with MDD.Musical chills,representing intense emotional peaks during musical experiences,can evoke profound plea-sure in healthy individuals and may offer a therapeutic modality for alleviating anhedonia in MDD.This review discusses how music therapy may support emotional regulation by activating these neural pathways and enhancing affective processing.Despite promising developments,this field remains understudied.A more nuanced research approach is urgently needed to better understand the mechanisms underlying music's effects on anhedonia and to develop effective interventions.
基金Supported by the Wuxi Municipal Health Commission Youth Fund Project,No.Q202268Wuxi Scientific and technological breakthrough of“Light of the Taihu Lake”(Basic Research),No.K20221039+4 种基金Jiangsu Shuangchuang Doctoral Program,No.JSSCBS20221991Beijing Municipal Administration of Hospital Incubating Program,No.PX2023070 and No.PX2024072Capital’s Funds for Health Improvement and Research,No.SF2024-4-2134Beijing Hospitals Authority Youth Program,No.QML20232003the Top Talent Support Program for young and middle-aged people of Wuxi Health Committee,No.HB2023089.
文摘BACKGROUND Cognitive impairment is one of the common clinical manifestations of depression,causing negative distress to patients.Elevated homocysteine(Hcy)concentrations and gut microbiome dysfunction may be observed in patients with depression.AIM To investigate the relationship between Hcy,microbiome,and cognition in depressive patients.METHODS We recruited 67 patients with major depressive disorder(MDD)(MDD group)and 94 healthy controls(HCs)individuals(HCs group).Serum Hcy levels were determined using the enzyme circulation method.16s rRNA sequencing was used to classify and identify the fecal bacteria.17 Hamilton depression rating scale and MATRICS consensus cognitive battery were used to evaluate mood states and cognition in patients with MDD. Correlation analysis was performed to explore the correlation between fecal flora,Hcy, and depressive cognitive function.RESULTSElevated serum levels of Hcy were seen in patients with MDD compared to healthy individuals. Patients withMDD indicated significant decreases in cognitive scores (P < 0.001) in six modules: Speed of processing, workingmemory, visual learning, reasoning and problem-solving, social cognition, and total scores. Hcy levels showed anegative correlation with processing speed, social cognition, and total MDD scores (P < 0.05). Hcy was alsosignificantly negatively correlated with Alistipes, Ruminococcae, Tenericides, and Porphyromonas (P < 0.05).CONCLUSIONOur results highlight that Hcy was correlated with cognition and gut microbiome in MDD. This interaction may berelated to the physiological and pathological mechanisms underlying cognitive deficits in depression.
基金Supported by National Natural Science Foundation of China,No.72104058Open Bidding for Selecting the Best Candidates,Guangzhou University of Chinese MedicineUniversity of Macao Research Funding,No.QRCM-IRG2022-001.
文摘BACKGROUND Diabetes mellitus(DM)is a rapidly growing global health emergency of the 21st century.Comorbidities,such as DM and depression,are common,presenting challenges to the healthcare system.AIM To investigate the prevalence of depression and its associated factors in patients with DM and to strengthen the management of depression in this patient group.METHODS Participants were selected from the 2018 China Health and Retirement Longitudinal Study.Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale,with a score of 10 or more indicating depression.Group differences were compared using analysis of variance andχ^(2)tests.Binary logistic regression was conducted to explore the odds ratios(ORs)of independent variables.Following Andersen’s behavioral model,predisposing,enabling,health need,and health behavior variables were introduced stepwise into the logistic model.RESULTS Of the 1673 patients with diabetes,41.4%had depressive symptoms.Regarding the predisposing characteristics,patients who were male(OR 0.426,P<0.05),married(OR 0.634,P<0.05),and received a high school education or higher(OR 0.432,P<0.05)reported fewer depressive symptoms.Healthcare needs,including better self-rated health(OR 0.458 for fair and OR 0.247 for good,P<0.05)and more sleep(OR 0.642,P<0.05),were associated with a lower likelihood of depressive symptoms.In contrast,pain(OR 1.440 for mild and OR 2.644 for severe,P<0.05)and impairment in the basic activities of daily living(OR 1.886,P<0.05)were inversely associated.Additionally,patients highly satisfied with healthcare services(OR 0.579,P<0.05)were less likely to have depressive symptoms.CONCLUSION Nearly half of the patients with DM reported depressive symptoms,which were strongly associated with predisposing characteristics and healthcare needs,particularly physical pain and impairment in basic activities of daily living.Our study emphasizes the significance of enhanced screening and intervention for depression in diabetes care along with improved management of functional impairments.
基金supported by the National Natural Science Foundation of China(No.81774281 and No.82474303)the Natural Science Foundation of Hunan Province(2023JJ30888)the leading national joint discipline of Chinese and Western medicines to the Chinese Medicine Department,Xiangya Hospital,CSU.
文摘Objective:To identify promising biomarkers for the pathogenesis of major depressive disorder(MDD).Methods:Microarray chips of MDD patients,including the GSE98793,GSE52790,and GSE39653 datasets,were obtained from the Gene Expression Omnibus database.The biological processes and pathways related to MDD were investigated using the GO and KEGG pathway tools.Weighted gene coexpression network analysis was conducted to identify modules related to MDD.The hub genes associated with MDD were obtained via protein-protein interaction analysis.Finally,the expression of hub genes in the hippocampal tissues of depression-like rats was detected by reverse transcription-polymerase chain reaction and Western blotting.Results:A total of 658 differentially expressed genes were identified from the Gene Expression Omnibus datasets;thus,these genes and the GSE98793 dataset were used to conduct weighted gene coexpression network analysis.A total of 244 module-related genes were identified and these genes were highly correlated with MDD.These genes were involved in the Ras signaling pathway,regulation of the actin cytoskeleton,and axon guidance according to the KEGG analysis.Hub genes,including MAPK14,SOCS1,TLR2,PTK2B,and GRB2,were obtained via protein-protein interaction analysis.All these hub genes showed better diagnostic efficiency in the GSE52790,GSE39653,and GSE98793 datasets.In vivo experiments revealed that compared with those in control rats,SOCS1 and MAPK14 expression was significantly decreased;while GRB2,TLR2,and PTK2B expression was increased in the hippocampi of depression-like rats.Conclusions:Our study demonstrates that GRB2,TLR2,SOCS1,PTK2B,and MAPK14 are promising hub genes,and targeting these five genes may be an effective treatment strategy for MDD.
基金Supported by The 2023 Government-Funded Project of the Outstanding Talents Training Program in Clinical Medicine,No.ZF2023165Key Research and Development Projects of Hebei Province,No.18277731DNatural Science Foundation of Hebei Province,No.
文摘Breast cancer ranks among the most prevalent cancers worldwide,particularly affecting young and middle-aged women,who face higher recurrence rates,lower survival rates,and substantial psychological health challenges.Depressive symptoms,frequently observed in breast cancer patients,significantly influence treatment outcomes and quality of life.Recent years have seen a growing focus on these symptoms,emphasizing early identification and intervention.This editorial comments on the recent study by Mao et al on a risk prediction model for de-pression in young and middle-aged breast cancer patients.Research suggests that factors such as tumor grade,monthly income,pain perception,family support,and physical activity critically influence the onset of depressive symptoms.By developing personalized risk prediction models,it becomes possible to identify high-risk patients early,allowing healthcare professionals to implement pre-ventive strategies proactively.The editorial advocates for increased attention and resources dedicated to psychological health interventions for breast cancer pa-tients,aiming to foster comprehensive care strategies that mitigate the impacts of depression and enhance overall quality of life.
基金supported by the National Key Research and Development Program of China(2021YFA1101800,2022YFA1104800,2023YFF1203600)National Natural Science Foundation of China(82325015,82171528,U23A20429,82371260,21904069,22274079,82401794)+2 种基金Jiangsu Provincial Natural Science Fund for Excellent Young Scholars(BK20240131)Natural Science Foundation of Jiangsu Province(BK20200677)Joint Project of the Yangtze River Delta Science and Technology Innovation Community(2024CSJZN0600)。
文摘Major depressive disorder(MDD)is a debilitating psychiatric condition associated with substantial personal,societal,and economic costs.Despite considerable advances in research,most conventional antidepressant therapies fail to achieve adequate response in a significant proportion of patients,underscoring the need for novel,mechanism-based interventions.Lycium barbarum glycopeptide(LbGp),a bioactive compound with emerging neuroprotective properties,has been proposed as a candidate for antidepressant development;however,its therapeutic efficacy and underlying mechanisms remain largely uncharacterized.In this study,ventral forebrain organoids were generated from patients with MDD to investigate disease-related neurophysiological abnormalities.These organoids exhibited disrupted neuronal morphology,diminished calcium signaling,and impaired electrophysiological activity.Administration of LbGp effectively restored structural and functional deficits in MDD-derived organoids.Transcriptomic profiling revealed that LbGp ameliorated endoplasmic reticulum(ER)stress responses.To investigate the causative role of ER stress,control organoids were treated with the ER stress agonist CCT020312,which elicited neural activity impairments resembling those observed in MDD organoids.Notably,LbGp reversed the phenotypic consequences of CCT020312 exposure in control organoids.In conclusion,ventral forebrain organoids derived from individuals with MDD demonstrated that LbGp ameliorates disease-associated phenotypes by modulating ER stress.
文摘BACKGROUND Evaluating the relationship between sleep quality and depressive symptoms after laparoscopic hysterectomy under general anesthesia can help improve postoperative depressive symptoms.AIM To evaluate the correlation between sleep quality and depression symptoms in patients after laparoscopic hysterectomy under general anesthesia and explore factors associated with postoperative sleep disturbances and depression.METHODS This retrospective case-control study included 102 females who underwent laparoscopic hysterectomy under general anesthesia at our hospital between January 2022 and June 2024,excluding those with severe cardiovascular/cerebrovascular disease,liver/kidney dysfunction,or other underlying conditions.Sleep quality and depressive symptoms were evaluated preoperatively and at 1-week,1-month,and 3-months postoperatively using the Pittsburgh Sleep Quality Index(PSQI)and the Hamilton Depression Rating Scale(HAMD).Physiological indicators(heart rate,blood pressure,and oxygen saturation)and laboratory parameters were monitored.Pearson correlation and logistic regression analyses were performed to examine the association between sleep quality and depressive symptoms.RESULTS Mean age of participants was(52.30±8.39)years,with a body mass index of(23.56±2.79)kg/m².Preoperative comorbidities included hypertension(25.49%),diabetes(14.71%),and heart disease(9.80%).Patients with poor preoperative sleep quality(higher PSQI scores)exhibited significantly more severe depressive symptoms(P<0.05).Postoperative PSQI scores improved at 1-week,1-month,and 3-months compared to baseline(P<0.05).HAMD scores decreased at 1-week and 1-month postoperatively but returned to near preoperative levels at 3-months.Physiological indicators remained within normal ranges,and the postoperative complication rate was<5%.Logistic regression showed that poor postoperative sleep quality was an independent predictor of depressive symptoms(odds ratio=1.64,95%CI:1.22-2.20,P<0.05).CONCLUSION Sleep quality was significantly correlated with depressive symptoms after laparoscopic hysterectomy under general anesthesia.Patients with poor postoperative sleep quality were more prone to depression.Early interventions for sleep disturbances are potentially beneficial for mitigating depression and improve mental health.
