BACKGROUND Knee osteoarthritis(KOA),a common disabling pathology characterized by knee joint pain,swelling,and functional impairment,primarily affects middle-aged and older adults.In addition to physical limitations,c...BACKGROUND Knee osteoarthritis(KOA),a common disabling pathology characterized by knee joint pain,swelling,and functional impairment,primarily affects middle-aged and older adults.In addition to physical limitations,chronic pain often leads to psychological problems,including anxiety and depression,which further impact patients’quality of life.AIM To examine the efficacy and safety of celecoxib plus duloxetine in managing chronic pain,anxiety,and depression in patients with KOA.METHODS A retrospective analysis was conducted on 123 patients with KOA treated at our center between February 2020 and February 2023.Of these,66 received celecoxib plus duloxetine,and 57 received celecoxib alone.Outcomes were assessed using the Visual Analog Scale(VAS),the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),and the Self-Rating Anxiety Scales(SAS)/Self-Rating Depression Scales(SDS).Safety was evaluated by monitoring changes in liver function enzymes(alanine aminotransferase,aspartate aminotransferase),creatinine,and blood urea nitrogen.RESULTS Patients receiving celecoxib plus duloxetine showed significantly greater reductions in VAS and WOMAC and greater improvements in SAS and SDS scores compared with those receiving celecoxib alone.Hepatorenal function did not differ significantly between the treatment groups.Logistic regression analysis identified patient age,educational background,and treatment regimen as independent predictors of inadequate improvement in negative emotional symptoms.CONCLUSION In patients with KOA,celecoxib plus duloxetine effectively mitigates chronic pain and improves anxiety and depressive symptoms without increasing adverse hepatic or renal effects.These findings support its use as a safe and effective treatment option.展开更多
BACKGROUND There is a possible link between depression and anxiety about suicidal ideation among parents of children with congenital heart disease(CHD).AIM To document the effects of depression and anxiety on parental...BACKGROUND There is a possible link between depression and anxiety about suicidal ideation among parents of children with congenital heart disease(CHD).AIM To document the effects of depression and anxiety on parental suicidal ideation among children with CHD and the associated factors.METHODS This was a cross-sectional study among 50 parents of children with CHD who attended the Cardiac Clinic of University of Nigeria Teaching Hospital Ituku-Ozalla.Information was obtained using the Columbia Suicide Severity Rating Scale and the Hospital Anxiety and Depression Scale.RESULTS A greater percentage of parents whose child had a heart defect had anxiety symptoms(50.0%)than did those whose child had no heart defect(24.0%),and the difference in proportions was statistically significant(χ^(2)=7.250,P=0.007).A greater percentage of parents whose child had a heart defect had suicidal ideation(28.0%)than did those whose child had no heart defect(8.0%),and the difference in proportions was statistically significant(χ^(2)=6.775 P=0.009).A positive correlation was elicited between anxiety and suicide ideation,and this correlation was statistically significant(r=0.748,P<0.001).A positive correlation was elicited between depression and suicidal ideation scores,and this was statistically significant(r=0.617,P<0.001).CONCLUSION There is strong interconnectivity between anxiety and depression with suicidal ideation.There is an urgent need to start screening for the mental health of parents of children with CHD to avert the high propensity of complete suicide.In addition,policy makers may introduce a national clinical practice guideline on the importance of psychotherapy and mental health screening and targeted interventions for parents of children with CHD.展开更多
In this editorial,we comment on the study of the Yu et al on psychological distress in patients with hepatobiliary and pancreatic malignancies.Hepatobiliary and pancreatic malignancies include hepatocellular carcinoma...In this editorial,we comment on the study of the Yu et al on psychological distress in patients with hepatobiliary and pancreatic malignancies.Hepatobiliary and pancreatic malignancies include hepatocellular carcinoma,cholangiocarcinoma,gallbladder cancer and pancreatic cancer.These cancers are among the most aggressive and difficult to treat.Although improvements in surgery,drug treatments and palliative care have led to better survival rates and quality of life,the significant psychological impact on patients remains underrecognized.Anxiety and depression are prevalent at every stage of the disease,from the initial diagnosis to treatment,recurrence and end-of-life care.However,these issues often take a backseat to the urgent need to manage physical symptoms.Mental health challenges can greatly affect how well patients follow treatment plans,recover and their overall outlook.Yu et al explore the causes of psychological distress in hepatobiliary and pancreatic cancers,including disease severity,symptom burden,financial stress and fears about life and death.We highlight the importance of regular mental health screenings,psychological support and teamwork in oncology care.By focusing on emotional health alongside physical treatment,doctors can build resilience,improve outcomes and address a frequently ignored aspect of cancer care.展开更多
BACKGROUND Parkinson’s disease(PD)is a common neurodegenerative disorder in the elderly population.Non-motor symptoms such as anxiety and depression are often subtle,hindering early detection and intervention,yet the...BACKGROUND Parkinson’s disease(PD)is a common neurodegenerative disorder in the elderly population.Non-motor symptoms such as anxiety and depression are often subtle,hindering early detection and intervention,yet they markedly affect quality of life and clinical outcomes.AIM To investigate the prevalence of anxiety and depression in elderly PD patients,identify associated risk factors,and assess their relationship with fatigue severity.METHODS A cross-sectional analysis was conducted in 123 elderly PD patients treated at The Second Rehabilitation Hospital of Shanghai between January 2023 and December 2024.Demographic and clinical data were obtained using standardized questionnaires.Anxiety,depression,and fatigue were assessed using the Beck Anxiety Inventory(BAI),Geriatric Depression Scale(GDS),and Fatigue Scale-14(FS-14),respectively.Binary logistic regression identified risk factors for anxiety and depression,whereas Spearman’s correlation assessed associations with fatigue.RESULTS Anxiety and depression prevalence rates were 64.2%(mean BAI score:19.59±10.92)and 56.1%(mean GDS score:12.82±6.37),respectively.The mean FS-14 total score was 9.46±1.89,comprising physical(5.77±1.51)and mental(3.69±1.20)fatigue components.Significant positive correlations were observed between fatigue scores(total,physical,and mental)and both anxiety and depression(all P<0.05).Univariate analysis revealed statistically significant associations between anxiety/depression and monthly income,disease duration,and disease severity(all P<0.05).Multivariate logistic regression indicated higher anxiety risk in patients with lower monthly income,prolonged disease duration,advanced disease severity,or multimorbidity.Depression risk was elevated in patients with lower monthly income and severe disease,whereas longer disease duration unexpectedly served as a protective factor.CONCLUSION Elderly PD patients show high rates of anxiety and depression,both of which are significantly correlated with fatigue severity.These findings highlight the importance of psychological monitoring and targeted mental health interventions in PD management among the elderly.展开更多
Stroke is the second leading cause of death worldwide and a major cause of disability among adults.With the advancement of medical technology,the survival period of stroke patients has been significantly prolonged,but...Stroke is the second leading cause of death worldwide and a major cause of disability among adults.With the advancement of medical technology,the survival period of stroke patients has been significantly prolonged,but the neuropsychiatric sequelae in the chronic stage have become increasingly prominent.Post-stroke depression is one of the very important manifestations.This article conducts a further discussion on this issue.展开更多
BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly...BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly impact the quality of life of patients.AIM To explore the correlations between ocular surface function,sleep quality,and anxiety/depression in patients with DED.METHODS This was a cross-sectional investigative study that included 358 patients with DED between January 2022 and January 2025.Ocular surface was assessed using the ocular surface disease index(OSDI),tear film break-up time,fluorescein staining score,and Schirmer I test.The Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were used to evaluate sleep quality and anxiety/depression levels.Correlation and linear regression analyses were used to explore the relationships.RESULTS The mean PSQI score of the patients was 9.94±2.18;the mean SAS score was 47.30±4.90,and the mean SDS score was 50.08±5.52.These suggested a prevalence of sleep and psychological abnormalities.There was a significant correlation between the indicators of ocular surface function(OSDI,tear film break-up time,fluorescein staining,and Schirmer I test)and PSQI,SAS,and SDS scores(P<0.05).Moreover,multiple regression revealed that age≥50 years(β=1.55,P=0.029),PSQI scores(β=0.58,P<0.001),SAS scores(β=0.17,P=0.017),and SDS scores(β=0.15,P=0.019)were independent predictors of the OSDI scores.CONCLUSION Ocular surface function in patients with DED is closely related to sleep quality and anxiety/depression,emphasizing the need for holistic clinical management.展开更多
BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery...BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery speed and quality of life.Effective prevention of anxiety and depression in elderly patients has become an urgent problem.AIM To investigate the trajectory of anxiety and depression levels in elderly patients after LIF,and the influencing factors.METHODS Random sampling was used to select 239 elderly patients who underwent LIF from January 2020 to December 2024 in Shenzhen Pingle Orthopedic Hospital.General information and surgery-related indices were recorded,and participants completed measures of psychological status,lumbar spine dysfunction,and quality of life.A latent class growth model was used to analyze the post-LIF trajectory of anxiety and depression levels,and unordered multi-categorical logistic regression was used to analyze the influencing factors.RESULTS Three trajectories of change in anxiety level were identified:Increasing anxiety(n=26,10.88%),decreasing anxiety(n=27,11.30%),and stable anxiety(n=186,77.82%).Likewise,three trajectories of change in depression level were identified:Increasing depression(n=30,12.55%),decreasing depression(n=26,10.88%),and stable depression(n=183,76.57%).Regression analysis showed that having no partner,female sex,elevated Oswestry dysfunction index(ODI)scores,and reduced 36-Item Short Form Health Survey scores all contributed to increased anxiety levels,whereas female sex,postoperative opioid use,and elevated ODI scores all contributed to increased depression levels.CONCLUSION During clinical observation,combining factors to predict anxiety and depression in post-LIF elderly patients enables timely intervention,quickens recovery,and enhances quality of life.展开更多
BACKGROUND Ischemic stroke is one of the leading global causes of disability and death.Despite advances in modern medical technology that improve acute treatment and rehabilitation measures,post-stroke anxiety and dep...BACKGROUND Ischemic stroke is one of the leading global causes of disability and death.Despite advances in modern medical technology that improve acute treatment and rehabilitation measures,post-stroke anxiety and depression(PSD)do not receive sufficient attention.AIM To systematically evaluate risk factors and early identification markers for PSD for more precise screening and intervention strategies in clinical practice.METHODS This retrospective study analyzed clinical data from 112 patients with ischemic stroke admitted between January 2022 and December 2024.Based on assessments using the Hamilton Rating Scale for Anxiety(HAMA)and Hamilton Rating Scale for Depression(HAMD)at 2 weeks(±3 days)post-stroke,patients were classified into the PSD group(HAMA≥7 and/or HAMD≥7)and the non-PSD group(HAMA<7 and HAMD<7).Observation indicators included psychological assessment,demographic and clinical characteristics,stroke-related clinical indicators,neuroimaging assessments,and laboratory biomarkers.Multivariate logistic regression analysis was used to identify independent risk factors for PSD,and receiver operating characteristic curve analysis was used to evaluate the diagnostic value of potential biomarkers.RESULTS Of the 112 patients,46(41.1%)were diagnosed with PSD.Multivariate analysis identified five independent risk factors:Female gender[Odds ratio(OR)=2.32,95%confidence interval(CI):1.56-3.45],history of mental disorders prior to stroke(OR=3.17,95%CI:1.89-5.32),infarct location in the frontal lobe or limbic system(OR=2.86,95%CI:1.73-4.71),stroke severity with National Institutes of Health Stroke Scale≥8 at admission(OR=2.54,95%CI:1.62-3.99),and low social support(Social Support Rating Scale<35,OR=2.18,95%CI:1.42-3.36).Subgroup analysis showed that depression patients more commonly had left hemisphere lesions(68.4%vs 45.2%),while anxiety patients more frequently presented with right hemisphere lesions(59.5%vs 39.5%).The PSD group exhibited larger infarct volumes(8.7 cm^(3) vs 5.3 cm^(3)),more severe white matter hyperintensities,and more pronounced frontal lobe atrophy.Analysis of inflammatory markers showed significantly elevated levels of interleukin-6(7.8 pg/mL vs 4.5 pg/mL)and tumor necrosis factor-alpha(15.6 pg/mL vs 9.8 pg/mL)in the PSD group,while hypothalamicpituitary-adrenal axis function assessment revealed higher cortisol levels(386.5±92.3 nmol/L vs 328.7±75.6 nmol/L)and flattened diurnal rhythm in the PSD group.CONCLUSION PSD is a complex neuropsychiatric consequence of stroke involving disruption of the frontal-limbic circuitry,neuroinflammatory responses,and dysfunction of the hypothalamic-pituitary-adrenal axis.展开更多
BACKGROUND Post-stroke depression(PSD)is associated with hypothalamic-pituitary-adrenal(HPA)axis dysfunction and neurotransmitter deficits.Selective serotonin reuptake inhibitors(SSRIs)are commonly used,but their effi...BACKGROUND Post-stroke depression(PSD)is associated with hypothalamic-pituitary-adrenal(HPA)axis dysfunction and neurotransmitter deficits.Selective serotonin reuptake inhibitors(SSRIs)are commonly used,but their efficacy is limited.This study investigated whether combining SSRIs with traditional Chinese medicine(TCM)Free San could enhance their therapeutic effects.AIM To evaluate the clinical efficacy and safety of combining SSRIs with Free San in treating PSD,and to assess its impact on HPA axis function.METHODS Ninety-two patients with PSD were enrolled and randomly divided into control groups(n=46)and study groups(n=46).The control group received the SSRI paroxetine alone,whereas the study group received paroxetine combined with Free San for 4 weeks.Hamilton Depression Scale and TCM syndrome scores were assessed before and after treatment.Serum serotonin,norepinephrine,cortisol,cor-ticotropin-releasing hormone,and adrenocorticotropic hormone were measured.The treatment responses and adverse reactions were recorded.RESULTS After treatment,the Hamilton Depression Scale and TCM syndrome scores were significantly lower in the study group than in the control group(P<0.05).Serum serotonin and norepinephrine levels were significantly higher in the study group than in the control group,whereas cortisol,corticotropin-releasing hormone,and adrenocorticotropic hormone levels were significantly lower(P<0.05).The total efficacy rates were 84.78%and 65.22%in the study and control groups,respectively(P<0.05).No significant differences in adverse reactions were observed between the two groups(P>0.05).CONCLUSION Combining SSRIs with Free San can enhance therapeutic efficacy,improve depressive symptoms,and regulate HPA axis function in patients with PSD with good safety and clinical application value.展开更多
This scoping review aims to synthesize evidence on exercise interventions for adolescents with depression by examining their components and evaluating their effects,thereby informing the development of standardized ex...This scoping review aims to synthesize evidence on exercise interventions for adolescents with depression by examining their components and evaluating their effects,thereby informing the development of standardized exercise programs for this population.Based on the Arksey and O’Malley framework for scoping reviews,the following databases were systematically searched:PubMed,Web of Science,Cochrane Library,Embase,EBSCO,China National Knowledge Infrastructure,Wanfang Database,VIP Database,and China Biomedical Literature Database.Based on the inclusion and exclusion criteria,the original studies applying exercise intervention in adolescents with depression were screened.A total of 9 papers were included,including 7 randomized controlled trials,1 quasi-experimental study,and 1 mixed study.The types of exercise interventions included aerobic exercise,resistance training,anti-gravity exercise,and stretching.The frequency of exercise was 30–60 min,3–5 times per week in most studies,with most intensities being moderate to high.Exercise intervention is feasible and effective in adolescents with depression.Nursing staff play a crucial role in implementing and supervising these interventions,from initial assessment to continuous monitoring of motivation and safety.In future studies,healthcare professionals should focus on assessing the condition and physical functional status of adolescents with depression and improving the specific content of exercise intervention to develop a scientific and standardized exercise training program for adolescents with depression.展开更多
BACKGROUND Perimenopausal women are prone to anxiety and depression due to fluctuating hormone levels,which significantly impair their quality of life.The current treatments have certain limitations.In traditional Chi...BACKGROUND Perimenopausal women are prone to anxiety and depression due to fluctuating hormone levels,which significantly impair their quality of life.The current treatments have certain limitations.In traditional Chinese medicine,liver-soothing formulas are commonly prescribed for mood-related disorders,but their overall efficacy in perimenopausal anxiety and depression remains uncertain and requires verification through meta-analysis.AIM To provide evidence-based support for clinical decision-making and research,a meta-analysis was conducted to evaluate the effectiveness of liver-soothing formulas in treating perimenopausal anxiety and depression.METHODS Relevant studies published up to April 2025 were retrieved from ClinicalTrials.gov,PubMed,Web of Science,EMBASE,and the Cochrane Library.Eligible studies were screened according to predefined inclusion and exclusion criteria.Data were extracted and analyzed using the Stata 12.0 software.RESULTS After searching and screening,12 articles involving 1798 patients(922 in the treatment group and 876 in the control group)were included in the analysis.Meta-analysis showed that the standardized scores for anxiety[standardized mean difference(SMD)=-0.71,95%confidence interval(95%CI):-1.06 to-0.36]and depression(SMD=-0.67,95%CI:-1.06 to-0.27)of the treatment group were lower than those of the control group.Subgroup analysis results revealed that for anxiety,liver-soothing formulas used alone(SMD=-0.34,95%CI:-0.50 to-0.18)or in combination(SMD=-0.88,95%CI:-1.43 to-0.34)both significantly reduced scores compared with the control group.For depression,monotherapy of liversoothing formulas showed no significant statistical difference between the treatment and control groups(SMD=-0.47,95%CI:-1.11 to 0.17),whereas combination therapy produced significantly lower standardized scale scores in the treatment group than in the control group,with a statistically significant difference(SMD=-0.83,95%CI:-1.39 to-0.28).Regarding Greene scores,no statistically significant difference was observed with monotherapy(SMD=0.87,95%CI:-0.32 to 2.06),whereas combination therapy had significantly lower Greene scores(SMD=-0.24,95%CI:-0.44 to-0.04).No statistically significant difference was found between the groups in the occurrence of adverse reactions(odds ratio=0.90,95%CI:0.57-1.43).However,liver-soothing formulas did not affect estrogen levels in perimenopausal women.CONCLUSION Compared with placebo,conventional Western medicine,or other interventions,the monotherapy of liver-soothing formulas demonstrates superior efficacy in treating perimenopausal anxiety.When used as an adjuvant,they exert a synergistic effect in alleviating negative emotions and improving overall perimenopausal symptoms.展开更多
BACKGROUND Paternal perinatal depression(PPD)is closely associated with maternal mental health challenges,marital strain,and adverse child developmental outcomes.Despite its significant impact,PPD remains under-recogn...BACKGROUND Paternal perinatal depression(PPD)is closely associated with maternal mental health challenges,marital strain,and adverse child developmental outcomes.Despite its significant impact,PPD remains under-recognized in family-centered clinical practice.Concurrently,against the backdrop of rising rates of delayed marriage and China’s Maternity Incentive Policy,the proportion of women giving birth at an advanced maternal age is increasing.Nevertheless,research specifically examining PPD among spouses of older mothers remains critically scarce,both in China and globally.AIM To investigate PPD and its influencing factors in Chinese advanced maternal age families.METHODS This cross-sectional study included 358 participants;it was conducted among fathers of pregnant women of advanced maternal age at five hospitals in the Pearl River Delta region of China from September 2023 to June 2024.Data were collected via a general information questionnaire,the Social Support Rating Scale,and the Edinburgh Postnatal Depression Scale.Latent profile analysis and regression mixture models(RMMs)were adopted to analyze the latent PPD types and factors that influenced PPD.RESULTS The incidence of PPD was 16.48%,and three profiles were identified:Low-symptomatic(175 cases,48.89%),monophasic(140 cases,39.10%),and high-symptomatic(43 cases,12.01%).The RMM analysis revealed that first pregnancy,low income(<¥3000/month),part-time work,and a history of abnormal pregnancy were positively associated with the high-symptomatic type(P<0.05).Conversely,high subjective support and support utilization were negatively associated with the high-symptomatic type compared with the low-symptomatic type(P<0.05).Good couple relationships,high objective and subjective support,and high support utilization were negatively associated with monophasic disorder(P<0.05).CONCLUSION PPD incidence is high among Chinese fathers with advanced maternal age partners,and the characteristics of depression are varied.Healthcare practitioners should prioritize individuals with low levels of social support.展开更多
BACKGROUND Esophageal cancer is highly malignant and frequently metastasizes to bones.Concomitant depression worsens prognosis;however,its incidence and determinants in this specific population remain poorly defined.A...BACKGROUND Esophageal cancer is highly malignant and frequently metastasizes to bones.Concomitant depression worsens prognosis;however,its incidence and determinants in this specific population remain poorly defined.AIM To determine the incidence of depression and its independent risk factors in patients with esophageal cancer and bone metastasis.METHODS A total of 100 consecutive eligible patients admitted between March 2022 and March 2025 were recruited.Depression was assessed with the Beck Depression Inventory-II;scores>4 defined the depression group(n=42)and scores≤4 the non-depression group(n=58).Demographic,clinical,and laboratory variables were compared between the groups.Multivariate logistic regression was used to identify independent risk factors.RESULTS Depression prevalence was 42.0%(42/100).Univariate analysis demonstrated significant differences in monthly per-capita household income,education level,social support,sleep disorders,and serum high-sensitivity C-reactive protein(all P<0.05);no differences were observed in sex,age,tumor characteristics,or other laboratory indices(all P>0.05).Multivariable analysis revealed the following independent risk factors for depression:Low income[odds ratio(OR)=2.66,95%confidence interval(CI):1.17-6.03],low education(OR=2.46,95%CI:1.08-5.61),low social support(OR=5.10,95%CI:1.81-14.39),sleep disorders(OR=2.79,95%CI:1.23-6.35),and elevated high-sensitivity C-reactive protein(OR=1.31 per unit increase,95%CI:1.18-1.46).CONCLUSION Depression is common among patients with esophageal cancer and bone metastasis.Low socioeconomic status,limited education,insufficient social support,sleep disturbances,and systemic inflammation were independent predictors.Interventions that address these modifiable factors may reduce depression risk in this population.展开更多
BACKGROUND Suicide constitutes the second leading cause of death among adolescents globally and represents a critical public health concern.The neural mechanisms underlying suicidal behavior in adolescents with major ...BACKGROUND Suicide constitutes the second leading cause of death among adolescents globally and represents a critical public health concern.The neural mechanisms underlying suicidal behavior in adolescents with major depressive disorder(MDD)remain poorly understood.Aberrant resting-state functional connectivity(rsFC)in the amygdala,a key region implicated in emotional regulation and threat detection,is strongly implicated in depression and suicidal behavior.AIM To investigate rsFC alterations between amygdala subregions and whole-brain networks in adolescent patients with depression and suicide attempts.METHODS Resting-state functional magnetic resonance imaging data were acquired from 32 adolescents with MDD and suicide attempts(sMDD)group,33 adolescents with MDD but without suicide attempts(nsMDD)group,and 34 demographically matched healthy control(HC)group,with the lateral and medial amygdala(MeA)defined as regions of interest.The rsFC patterns of amygdala subregions were compared across the three groups,and associations between aberrant rsFC values and clinical symptom severity scores were examined.RESULTS Compared with the nsMDD group,the sMDD group exhibited reduced rsFC between the right lateral amygdala(LA)and the right inferior occipital gyrus as well as the left middle occipital gyrus.Compared with the HC group,the abnormal brain regions of rsFC in the sMDD group and nsMDD group involve the parahippocampal gyrus(PHG)and fusiform gyrus.In the sMDD group,right MeA and right temporal pole:Superior temporal gyrus rsFC value negatively correlated with the Rosenberg Self-Esteem Scale scores(r=-0.409,P=0.025),while left LA and right PHG rsFC value positively correlated with the Adolescent Self-Rating Life Events Checklist interpersonal relationship scores(r=0.372,P=0.043).CONCLUSION Aberrant rsFC changes between amygdala subregions and these brain regions provide novel insights into the underlying neural mechanisms of suicide attempts in adolescents with MDD.展开更多
BACKGROUND Digestive tract subepithelial lesions(SELs)are relatively common,and early diagnosis and treatment are critical for improving patient quality of life and prognosis.However,diagnostic uncertainty often leads...BACKGROUND Digestive tract subepithelial lesions(SELs)are relatively common,and early diagnosis and treatment are critical for improving patient quality of life and prognosis.However,diagnostic uncertainty often leads to negative psychological effects,including anxiety and depression.AIM To investigate the prevalence of anxiety and depressive symptoms and identify associated factors among patients with digestive tract SELs.METHODS This retrospective study included 296 consecutive patients diagnosed with digestive tract SELs at the Affiliated Hospital of North Sichuan Medical College Endoscopy Center between October 2024 and April 2025.Demographic and clinical data were collected through standardized questionnaires.Anxiety and depression were assessed using the Self-Rating Anxiety Scale and the Self-Rating Depression Scale,respectively,while sleep quality was evaluated using the Pittsburgh Sleep Quality Index.Participants were classified into anxiety vs nonanxiety and depression vs non-depression groups based on established cutoff scores,and potential determinants were examined.RESULTS Anxiety symptoms were observed in 35.8%of cases(mean Self-Rating Anxiety Scale score:46.56±9.13)and depressive symptoms in 33.1%(mean Self-Rating Depression scale score:48.64±8.30).Pittsburgh Sleep Quality Index scores were positively correlated with both anxiety and depression(P<0.05).Univariate analysis identified age,annual income,sleep disorders,and endoscopic ultrasonography(EUS)evaluation status as significant factors(P<0.05).Multivariable analysis revealed that low annual income(<10000 Chinese yuan)and sleep disorders were independent risk factors,whereas undergoing EUS examination and having disease awareness were protective factors against anxiety and depression(P<0.05).CONCLUSION Patients with digestive tract SELs are at increased risk for anxiety and depression,with poor sleep strongly linked to worsening psychological symptoms.Early diagnostic assessment with EUS appears to serve a protective role against the onset of these psychological disorders.展开更多
Antidepressants are the main drugs used to treat depression,but they have not been shown to be effective in the treatment of child and adolescent depression.However,many adolescent depression treatment guidelines stil...Antidepressants are the main drugs used to treat depression,but they have not been shown to be effective in the treatment of child and adolescent depression.However,many adolescent depression treatment guidelines still recommend the use of antidepressants,especially specific serotonin re-uptake inhibitors.Previous studies have suggested that antidepressants have little therapeutic effect but many side effects,such as switching to mania,suicide,and non-suicidal self injury(NSSI),in the treatment of child and adolescent depression.In the process of developing guidelines,drug recommendations should not only focus on impro-ving symptoms,but they should also consider potential side effects.This review discusses the serious side effects of antidepressants,including switching to mania,suicide,and NSSI.展开更多
Following an acute stroke,patients often encounter a range of impairments affecting their physical,cognitive,verbal,and social capabilities.Poststroke depression(PSD)has been identified as a significant consequence of...Following an acute stroke,patients often encounter a range of impairments affecting their physical,cognitive,verbal,and social capabilities.Poststroke depression(PSD)has been identified as a significant consequence of stroke and serves as a crucial predictor of patient outcomes.The diagnosis of PSD presents a challenge,as the physical manifestations following a stroke can overlap with certain depressive symptoms,leading to a potential underdiagnosis of this condition.This review employs a narrative approach to synthesize diverse findings within this domain.PSD is categorized as an organic mood disorder,and a more accurate diagnosis may be achieved by considering the location of the stroke,the patient's specific symptoms,and the timeline of depressive symptom onset.Notably,if depressive symptoms emerge at more than one year poststroke,the likelihood of PSD diminishes.The etiology of PSD is currently understood to stem from a combination of physiological and psychosocial factors,as well as their interactions.Several mechanisms associated with PSD have been identified,including inflammation,dysregulation of the hypothalamic-pituitary-adrenal axis,oxidative stress,autophagy,apoptosis,abnormal neurotrophic responses,glutamate-mediated excitotoxicity,dysfunction within brain networks,reduced monoamine levels,locations of brain lesions,and psychosocial influences.This review also outlines potential directions for future research.展开更多
Postpartum depression(PPD)is a severe mental health disorder affecting 10%to 15%of postpartum women worldwide.Pre-eclampsia is a hypertensive disorder of pregnancy that has been identified as a significant factor for ...Postpartum depression(PPD)is a severe mental health disorder affecting 10%to 15%of postpartum women worldwide.Pre-eclampsia is a hypertensive disorder of pregnancy that has been identified as a significant factor for PPD due to its vascular dysfunction,systemic inflammation and neurobiological alterations.The neuroinflammatory mechanisms common to both pre-eclampsia and PPD,that contribute to depressive symptoms include elevated proinflammatory cytokines(interleukin-6,tumor necrosis factor-alpha),activation of the kynurenine pathway,and oxidative stress.To critically evaluate Wu et al's study,which investigates blood pressure variability(BPV)and gestational body mass index(BMI)as independent predictors of PPD.To integrate recent findings on the metabolic and cardiovascular links between depression,pre-eclampsia,and postpartum mental health outcomes.Pre-pregnancy BMI is found to be a stronger predictor of PPD than gestational weight gain.A vascular-neuropsychiatric connection has been indicated in pre-eclamptic women,indicating a significant correlation between BPV and depressive postpartum symptoms.There is increased susceptibility to depression due to neuroinflammation contributed by blood pressure fluctuations and metabolic dysregulation.The incidence of PPD could be reduced by early identification and intervention for BP fluctuations.Early detection and intervention in high-risk pregnancies should be conducted through public health strategies that prioritize awareness,education,and accessibility to mental health care.展开更多
BACKGROUND Postpartum depression(PPD)is a prevalent and debilitating psychiatric disorder affecting maternal mental health,infant development,and family well-being.Despite increasing global awareness,significant dispa...BACKGROUND Postpartum depression(PPD)is a prevalent and debilitating psychiatric disorder affecting maternal mental health,infant development,and family well-being.Despite increasing global awareness,significant disparities remain in screening,diagnosis,and treatment,particularly in low-resource and culturally diverse settings.The complex interplay of biological and psychosocial determinants complicates conventional intervention models.Integrating epidemiological patterns,pathophysiological mechanisms,and sociocultural factors will inform more effective and equitable strategies for PPD screening,prevention,and treatment.METHODS A narrative review was conducted following PRISMA 2020 guidelines.Peer-reviewed studies published from January 2010 to May 2025 were systematically searched in PubMed,Web of Science,EMBASE,and PsycINFO.Inclusion criteria comprised studies addressing PPD epidemiology,risk stratification,biological mechanisms,and intervention strategies.After screening and full-text review,84 studies were included.Study designs primarily involved cohort studies,randomized controlled trials,and meta-analyses.Extracted data were categorized thematically and assessed for methodological quality and generalizability.RESULTS PPD arises from multifactorial interactions involving hormonal dysregulation,neurochemical changes,psychosocial stressors,and cultural influences.Primary risk factors include personal or family history of depression,antenatal anxiety,low maternal self-efficacy,and inadequate social support.Evidence-based interventions encompass Edinburgh Postnatal Depression Scale-based screening,cognitive behavioral therapy,interpersonal psychotherapy,psychoeducation,and pharmacological treatments such as brexanolone and zuranolone.Culturally adapted,community-integrated models—including stepped-care approaches and task-shifting—improve feasibility and scalability,particularly in underserved populations.Emerging evidence highlights inflammatory biomarkers(e.g.,interleukin-6 and C-reactive protein),AI-assisted screening tools,and family-inclusive strategies as promising for enhanced detection and outcomes.CONCLUSION Effective PPD management requires integrative,culturally sensitive approaches,prioritizing scalable,personalized non-pharmacological interventions to reduce disparities and enhance maternal mental health equity across diverse populations.展开更多
BACKGROUND Depression is a disorder characterized by significant and persistent depressed mood,cognitive impairment,impaired voluntary activity,working memory,and somatic symptoms.AIM To determine the efficacy of Qi-b...BACKGROUND Depression is a disorder characterized by significant and persistent depressed mood,cognitive impairment,impaired voluntary activity,working memory,and somatic symptoms.AIM To determine the efficacy of Qi-based mindfulness therapy(QMT)in treating anxiety,depression,and sleep disturbances in individuals with mild-to-moderate depression.METHODS A self-controlled before–after trial was conducted.The study invited online participants for recruitment between May and July 2023.Participants(n=18)aged 18-65 years with mild-to-moderate depression,who were receiving QMT training for 4 weeks,were included.The primary efficacy indicators were the 17 Hamilton Depression Rating Scale and Hamilton Anxiety Scale scores.The secondary outcome indicators included the Zung Self-rating Depression Scale,the self-rating Anxiety Scale,and the Insomnia Severity Index.Pre-and postintervention assessments were conducted.The patients’symptoms related to depression,anxiety,and insomnia were reassessed 4 weeks after the post-intervention evaluation.RESULTS Patients who underwent the QMT intervention for 4 weeks exhibited a statistically significant reduction in scores on the 17 Hamilton Depression Rating Scale,Hamilton Anxiety Scale,the Zung Self-Rating Depression Scale,the Self-Rating Anxiety Scale,and the Insomnia Severity Index relative to their pre-intervention scores(all P<0.05).CONCLUSION QMT training for 4 weeks is an effective nonpharmacological treatment for symptoms of depression,anxiety,and insomnia among patients with mild-to-moderate depression.展开更多
文摘BACKGROUND Knee osteoarthritis(KOA),a common disabling pathology characterized by knee joint pain,swelling,and functional impairment,primarily affects middle-aged and older adults.In addition to physical limitations,chronic pain often leads to psychological problems,including anxiety and depression,which further impact patients’quality of life.AIM To examine the efficacy and safety of celecoxib plus duloxetine in managing chronic pain,anxiety,and depression in patients with KOA.METHODS A retrospective analysis was conducted on 123 patients with KOA treated at our center between February 2020 and February 2023.Of these,66 received celecoxib plus duloxetine,and 57 received celecoxib alone.Outcomes were assessed using the Visual Analog Scale(VAS),the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),and the Self-Rating Anxiety Scales(SAS)/Self-Rating Depression Scales(SDS).Safety was evaluated by monitoring changes in liver function enzymes(alanine aminotransferase,aspartate aminotransferase),creatinine,and blood urea nitrogen.RESULTS Patients receiving celecoxib plus duloxetine showed significantly greater reductions in VAS and WOMAC and greater improvements in SAS and SDS scores compared with those receiving celecoxib alone.Hepatorenal function did not differ significantly between the treatment groups.Logistic regression analysis identified patient age,educational background,and treatment regimen as independent predictors of inadequate improvement in negative emotional symptoms.CONCLUSION In patients with KOA,celecoxib plus duloxetine effectively mitigates chronic pain and improves anxiety and depressive symptoms without increasing adverse hepatic or renal effects.These findings support its use as a safe and effective treatment option.
文摘BACKGROUND There is a possible link between depression and anxiety about suicidal ideation among parents of children with congenital heart disease(CHD).AIM To document the effects of depression and anxiety on parental suicidal ideation among children with CHD and the associated factors.METHODS This was a cross-sectional study among 50 parents of children with CHD who attended the Cardiac Clinic of University of Nigeria Teaching Hospital Ituku-Ozalla.Information was obtained using the Columbia Suicide Severity Rating Scale and the Hospital Anxiety and Depression Scale.RESULTS A greater percentage of parents whose child had a heart defect had anxiety symptoms(50.0%)than did those whose child had no heart defect(24.0%),and the difference in proportions was statistically significant(χ^(2)=7.250,P=0.007).A greater percentage of parents whose child had a heart defect had suicidal ideation(28.0%)than did those whose child had no heart defect(8.0%),and the difference in proportions was statistically significant(χ^(2)=6.775 P=0.009).A positive correlation was elicited between anxiety and suicide ideation,and this correlation was statistically significant(r=0.748,P<0.001).A positive correlation was elicited between depression and suicidal ideation scores,and this was statistically significant(r=0.617,P<0.001).CONCLUSION There is strong interconnectivity between anxiety and depression with suicidal ideation.There is an urgent need to start screening for the mental health of parents of children with CHD to avert the high propensity of complete suicide.In addition,policy makers may introduce a national clinical practice guideline on the importance of psychotherapy and mental health screening and targeted interventions for parents of children with CHD.
文摘In this editorial,we comment on the study of the Yu et al on psychological distress in patients with hepatobiliary and pancreatic malignancies.Hepatobiliary and pancreatic malignancies include hepatocellular carcinoma,cholangiocarcinoma,gallbladder cancer and pancreatic cancer.These cancers are among the most aggressive and difficult to treat.Although improvements in surgery,drug treatments and palliative care have led to better survival rates and quality of life,the significant psychological impact on patients remains underrecognized.Anxiety and depression are prevalent at every stage of the disease,from the initial diagnosis to treatment,recurrence and end-of-life care.However,these issues often take a backseat to the urgent need to manage physical symptoms.Mental health challenges can greatly affect how well patients follow treatment plans,recover and their overall outlook.Yu et al explore the causes of psychological distress in hepatobiliary and pancreatic cancers,including disease severity,symptom burden,financial stress and fears about life and death.We highlight the importance of regular mental health screenings,psychological support and teamwork in oncology care.By focusing on emotional health alongside physical treatment,doctors can build resilience,improve outcomes and address a frequently ignored aspect of cancer care.
基金Supported by Foundation of Shanghai Baoshan Science and Technology Commission,No.2024-E-66Shanghai Nursing Association Scientific Research Project,No.2024MS-B02.
文摘BACKGROUND Parkinson’s disease(PD)is a common neurodegenerative disorder in the elderly population.Non-motor symptoms such as anxiety and depression are often subtle,hindering early detection and intervention,yet they markedly affect quality of life and clinical outcomes.AIM To investigate the prevalence of anxiety and depression in elderly PD patients,identify associated risk factors,and assess their relationship with fatigue severity.METHODS A cross-sectional analysis was conducted in 123 elderly PD patients treated at The Second Rehabilitation Hospital of Shanghai between January 2023 and December 2024.Demographic and clinical data were obtained using standardized questionnaires.Anxiety,depression,and fatigue were assessed using the Beck Anxiety Inventory(BAI),Geriatric Depression Scale(GDS),and Fatigue Scale-14(FS-14),respectively.Binary logistic regression identified risk factors for anxiety and depression,whereas Spearman’s correlation assessed associations with fatigue.RESULTS Anxiety and depression prevalence rates were 64.2%(mean BAI score:19.59±10.92)and 56.1%(mean GDS score:12.82±6.37),respectively.The mean FS-14 total score was 9.46±1.89,comprising physical(5.77±1.51)and mental(3.69±1.20)fatigue components.Significant positive correlations were observed between fatigue scores(total,physical,and mental)and both anxiety and depression(all P<0.05).Univariate analysis revealed statistically significant associations between anxiety/depression and monthly income,disease duration,and disease severity(all P<0.05).Multivariate logistic regression indicated higher anxiety risk in patients with lower monthly income,prolonged disease duration,advanced disease severity,or multimorbidity.Depression risk was elevated in patients with lower monthly income and severe disease,whereas longer disease duration unexpectedly served as a protective factor.CONCLUSION Elderly PD patients show high rates of anxiety and depression,both of which are significantly correlated with fatigue severity.These findings highlight the importance of psychological monitoring and targeted mental health interventions in PD management among the elderly.
基金Supported by Science and Technology Program of Nantong City,No.Key003 and No.JCZ2022040Nantong Young Medical Expert,No.46+2 种基金Science and Technology Program of Nantong Health Committee,No.MA2019003,No.MA2021017,and No.MSZ2024038Kangda College of Nanjing Medical University,No.KD2021JYYJYB025,No.KD2022KYJJZD022,and No.KD2024KYJJZD289Nantong Municipal Health Commission Project,No.MSZ2023020.
文摘Stroke is the second leading cause of death worldwide and a major cause of disability among adults.With the advancement of medical technology,the survival period of stroke patients has been significantly prolonged,but the neuropsychiatric sequelae in the chronic stage have become increasingly prominent.Post-stroke depression is one of the very important manifestations.This article conducts a further discussion on this issue.
文摘BACKGROUND Dry eye disease(DED)is a multifactorial ocular surface disorder with rising prevalence.It is closely related to systemic health and psychological factors,such as sleep and mood disorders,which significantly impact the quality of life of patients.AIM To explore the correlations between ocular surface function,sleep quality,and anxiety/depression in patients with DED.METHODS This was a cross-sectional investigative study that included 358 patients with DED between January 2022 and January 2025.Ocular surface was assessed using the ocular surface disease index(OSDI),tear film break-up time,fluorescein staining score,and Schirmer I test.The Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were used to evaluate sleep quality and anxiety/depression levels.Correlation and linear regression analyses were used to explore the relationships.RESULTS The mean PSQI score of the patients was 9.94±2.18;the mean SAS score was 47.30±4.90,and the mean SDS score was 50.08±5.52.These suggested a prevalence of sleep and psychological abnormalities.There was a significant correlation between the indicators of ocular surface function(OSDI,tear film break-up time,fluorescein staining,and Schirmer I test)and PSQI,SAS,and SDS scores(P<0.05).Moreover,multiple regression revealed that age≥50 years(β=1.55,P=0.029),PSQI scores(β=0.58,P<0.001),SAS scores(β=0.17,P=0.017),and SDS scores(β=0.15,P=0.019)were independent predictors of the OSDI scores.CONCLUSION Ocular surface function in patients with DED is closely related to sleep quality and anxiety/depression,emphasizing the need for holistic clinical management.
基金Supported by the Scientific Research Projects of the Health System in Pingshan District,No.2023122.
文摘BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery speed and quality of life.Effective prevention of anxiety and depression in elderly patients has become an urgent problem.AIM To investigate the trajectory of anxiety and depression levels in elderly patients after LIF,and the influencing factors.METHODS Random sampling was used to select 239 elderly patients who underwent LIF from January 2020 to December 2024 in Shenzhen Pingle Orthopedic Hospital.General information and surgery-related indices were recorded,and participants completed measures of psychological status,lumbar spine dysfunction,and quality of life.A latent class growth model was used to analyze the post-LIF trajectory of anxiety and depression levels,and unordered multi-categorical logistic regression was used to analyze the influencing factors.RESULTS Three trajectories of change in anxiety level were identified:Increasing anxiety(n=26,10.88%),decreasing anxiety(n=27,11.30%),and stable anxiety(n=186,77.82%).Likewise,three trajectories of change in depression level were identified:Increasing depression(n=30,12.55%),decreasing depression(n=26,10.88%),and stable depression(n=183,76.57%).Regression analysis showed that having no partner,female sex,elevated Oswestry dysfunction index(ODI)scores,and reduced 36-Item Short Form Health Survey scores all contributed to increased anxiety levels,whereas female sex,postoperative opioid use,and elevated ODI scores all contributed to increased depression levels.CONCLUSION During clinical observation,combining factors to predict anxiety and depression in post-LIF elderly patients enables timely intervention,quickens recovery,and enhances quality of life.
文摘BACKGROUND Ischemic stroke is one of the leading global causes of disability and death.Despite advances in modern medical technology that improve acute treatment and rehabilitation measures,post-stroke anxiety and depression(PSD)do not receive sufficient attention.AIM To systematically evaluate risk factors and early identification markers for PSD for more precise screening and intervention strategies in clinical practice.METHODS This retrospective study analyzed clinical data from 112 patients with ischemic stroke admitted between January 2022 and December 2024.Based on assessments using the Hamilton Rating Scale for Anxiety(HAMA)and Hamilton Rating Scale for Depression(HAMD)at 2 weeks(±3 days)post-stroke,patients were classified into the PSD group(HAMA≥7 and/or HAMD≥7)and the non-PSD group(HAMA<7 and HAMD<7).Observation indicators included psychological assessment,demographic and clinical characteristics,stroke-related clinical indicators,neuroimaging assessments,and laboratory biomarkers.Multivariate logistic regression analysis was used to identify independent risk factors for PSD,and receiver operating characteristic curve analysis was used to evaluate the diagnostic value of potential biomarkers.RESULTS Of the 112 patients,46(41.1%)were diagnosed with PSD.Multivariate analysis identified five independent risk factors:Female gender[Odds ratio(OR)=2.32,95%confidence interval(CI):1.56-3.45],history of mental disorders prior to stroke(OR=3.17,95%CI:1.89-5.32),infarct location in the frontal lobe or limbic system(OR=2.86,95%CI:1.73-4.71),stroke severity with National Institutes of Health Stroke Scale≥8 at admission(OR=2.54,95%CI:1.62-3.99),and low social support(Social Support Rating Scale<35,OR=2.18,95%CI:1.42-3.36).Subgroup analysis showed that depression patients more commonly had left hemisphere lesions(68.4%vs 45.2%),while anxiety patients more frequently presented with right hemisphere lesions(59.5%vs 39.5%).The PSD group exhibited larger infarct volumes(8.7 cm^(3) vs 5.3 cm^(3)),more severe white matter hyperintensities,and more pronounced frontal lobe atrophy.Analysis of inflammatory markers showed significantly elevated levels of interleukin-6(7.8 pg/mL vs 4.5 pg/mL)and tumor necrosis factor-alpha(15.6 pg/mL vs 9.8 pg/mL)in the PSD group,while hypothalamicpituitary-adrenal axis function assessment revealed higher cortisol levels(386.5±92.3 nmol/L vs 328.7±75.6 nmol/L)and flattened diurnal rhythm in the PSD group.CONCLUSION PSD is a complex neuropsychiatric consequence of stroke involving disruption of the frontal-limbic circuitry,neuroinflammatory responses,and dysfunction of the hypothalamic-pituitary-adrenal axis.
基金Supported by Open Project of Jiangsu Province Key Laboratory of Integrated Traditional Chinese and Western Medicine for the Prevention and Treatment of Geriatric Diseases,No.202232.
文摘BACKGROUND Post-stroke depression(PSD)is associated with hypothalamic-pituitary-adrenal(HPA)axis dysfunction and neurotransmitter deficits.Selective serotonin reuptake inhibitors(SSRIs)are commonly used,but their efficacy is limited.This study investigated whether combining SSRIs with traditional Chinese medicine(TCM)Free San could enhance their therapeutic effects.AIM To evaluate the clinical efficacy and safety of combining SSRIs with Free San in treating PSD,and to assess its impact on HPA axis function.METHODS Ninety-two patients with PSD were enrolled and randomly divided into control groups(n=46)and study groups(n=46).The control group received the SSRI paroxetine alone,whereas the study group received paroxetine combined with Free San for 4 weeks.Hamilton Depression Scale and TCM syndrome scores were assessed before and after treatment.Serum serotonin,norepinephrine,cortisol,cor-ticotropin-releasing hormone,and adrenocorticotropic hormone were measured.The treatment responses and adverse reactions were recorded.RESULTS After treatment,the Hamilton Depression Scale and TCM syndrome scores were significantly lower in the study group than in the control group(P<0.05).Serum serotonin and norepinephrine levels were significantly higher in the study group than in the control group,whereas cortisol,corticotropin-releasing hormone,and adrenocorticotropic hormone levels were significantly lower(P<0.05).The total efficacy rates were 84.78%and 65.22%in the study and control groups,respectively(P<0.05).No significant differences in adverse reactions were observed between the two groups(P>0.05).CONCLUSION Combining SSRIs with Free San can enhance therapeutic efficacy,improve depressive symptoms,and regulate HPA axis function in patients with PSD with good safety and clinical application value.
文摘This scoping review aims to synthesize evidence on exercise interventions for adolescents with depression by examining their components and evaluating their effects,thereby informing the development of standardized exercise programs for this population.Based on the Arksey and O’Malley framework for scoping reviews,the following databases were systematically searched:PubMed,Web of Science,Cochrane Library,Embase,EBSCO,China National Knowledge Infrastructure,Wanfang Database,VIP Database,and China Biomedical Literature Database.Based on the inclusion and exclusion criteria,the original studies applying exercise intervention in adolescents with depression were screened.A total of 9 papers were included,including 7 randomized controlled trials,1 quasi-experimental study,and 1 mixed study.The types of exercise interventions included aerobic exercise,resistance training,anti-gravity exercise,and stretching.The frequency of exercise was 30–60 min,3–5 times per week in most studies,with most intensities being moderate to high.Exercise intervention is feasible and effective in adolescents with depression.Nursing staff play a crucial role in implementing and supervising these interventions,from initial assessment to continuous monitoring of motivation and safety.In future studies,healthcare professionals should focus on assessing the condition and physical functional status of adolescents with depression and improving the specific content of exercise intervention to develop a scientific and standardized exercise training program for adolescents with depression.
文摘BACKGROUND Perimenopausal women are prone to anxiety and depression due to fluctuating hormone levels,which significantly impair their quality of life.The current treatments have certain limitations.In traditional Chinese medicine,liver-soothing formulas are commonly prescribed for mood-related disorders,but their overall efficacy in perimenopausal anxiety and depression remains uncertain and requires verification through meta-analysis.AIM To provide evidence-based support for clinical decision-making and research,a meta-analysis was conducted to evaluate the effectiveness of liver-soothing formulas in treating perimenopausal anxiety and depression.METHODS Relevant studies published up to April 2025 were retrieved from ClinicalTrials.gov,PubMed,Web of Science,EMBASE,and the Cochrane Library.Eligible studies were screened according to predefined inclusion and exclusion criteria.Data were extracted and analyzed using the Stata 12.0 software.RESULTS After searching and screening,12 articles involving 1798 patients(922 in the treatment group and 876 in the control group)were included in the analysis.Meta-analysis showed that the standardized scores for anxiety[standardized mean difference(SMD)=-0.71,95%confidence interval(95%CI):-1.06 to-0.36]and depression(SMD=-0.67,95%CI:-1.06 to-0.27)of the treatment group were lower than those of the control group.Subgroup analysis results revealed that for anxiety,liver-soothing formulas used alone(SMD=-0.34,95%CI:-0.50 to-0.18)or in combination(SMD=-0.88,95%CI:-1.43 to-0.34)both significantly reduced scores compared with the control group.For depression,monotherapy of liversoothing formulas showed no significant statistical difference between the treatment and control groups(SMD=-0.47,95%CI:-1.11 to 0.17),whereas combination therapy produced significantly lower standardized scale scores in the treatment group than in the control group,with a statistically significant difference(SMD=-0.83,95%CI:-1.39 to-0.28).Regarding Greene scores,no statistically significant difference was observed with monotherapy(SMD=0.87,95%CI:-0.32 to 2.06),whereas combination therapy had significantly lower Greene scores(SMD=-0.24,95%CI:-0.44 to-0.04).No statistically significant difference was found between the groups in the occurrence of adverse reactions(odds ratio=0.90,95%CI:0.57-1.43).However,liver-soothing formulas did not affect estrogen levels in perimenopausal women.CONCLUSION Compared with placebo,conventional Western medicine,or other interventions,the monotherapy of liver-soothing formulas demonstrates superior efficacy in treating perimenopausal anxiety.When used as an adjuvant,they exert a synergistic effect in alleviating negative emotions and improving overall perimenopausal symptoms.
基金Supported by High-level Professional Groups in Gangdong Province,No.GSPZYQ2020101Guangdong Province Educational Research Planning Project,No.2024GXJK742。
文摘BACKGROUND Paternal perinatal depression(PPD)is closely associated with maternal mental health challenges,marital strain,and adverse child developmental outcomes.Despite its significant impact,PPD remains under-recognized in family-centered clinical practice.Concurrently,against the backdrop of rising rates of delayed marriage and China’s Maternity Incentive Policy,the proportion of women giving birth at an advanced maternal age is increasing.Nevertheless,research specifically examining PPD among spouses of older mothers remains critically scarce,both in China and globally.AIM To investigate PPD and its influencing factors in Chinese advanced maternal age families.METHODS This cross-sectional study included 358 participants;it was conducted among fathers of pregnant women of advanced maternal age at five hospitals in the Pearl River Delta region of China from September 2023 to June 2024.Data were collected via a general information questionnaire,the Social Support Rating Scale,and the Edinburgh Postnatal Depression Scale.Latent profile analysis and regression mixture models(RMMs)were adopted to analyze the latent PPD types and factors that influenced PPD.RESULTS The incidence of PPD was 16.48%,and three profiles were identified:Low-symptomatic(175 cases,48.89%),monophasic(140 cases,39.10%),and high-symptomatic(43 cases,12.01%).The RMM analysis revealed that first pregnancy,low income(<¥3000/month),part-time work,and a history of abnormal pregnancy were positively associated with the high-symptomatic type(P<0.05).Conversely,high subjective support and support utilization were negatively associated with the high-symptomatic type compared with the low-symptomatic type(P<0.05).Good couple relationships,high objective and subjective support,and high support utilization were negatively associated with monophasic disorder(P<0.05).CONCLUSION PPD incidence is high among Chinese fathers with advanced maternal age partners,and the characteristics of depression are varied.Healthcare practitioners should prioritize individuals with low levels of social support.
文摘BACKGROUND Esophageal cancer is highly malignant and frequently metastasizes to bones.Concomitant depression worsens prognosis;however,its incidence and determinants in this specific population remain poorly defined.AIM To determine the incidence of depression and its independent risk factors in patients with esophageal cancer and bone metastasis.METHODS A total of 100 consecutive eligible patients admitted between March 2022 and March 2025 were recruited.Depression was assessed with the Beck Depression Inventory-II;scores>4 defined the depression group(n=42)and scores≤4 the non-depression group(n=58).Demographic,clinical,and laboratory variables were compared between the groups.Multivariate logistic regression was used to identify independent risk factors.RESULTS Depression prevalence was 42.0%(42/100).Univariate analysis demonstrated significant differences in monthly per-capita household income,education level,social support,sleep disorders,and serum high-sensitivity C-reactive protein(all P<0.05);no differences were observed in sex,age,tumor characteristics,or other laboratory indices(all P>0.05).Multivariable analysis revealed the following independent risk factors for depression:Low income[odds ratio(OR)=2.66,95%confidence interval(CI):1.17-6.03],low education(OR=2.46,95%CI:1.08-5.61),low social support(OR=5.10,95%CI:1.81-14.39),sleep disorders(OR=2.79,95%CI:1.23-6.35),and elevated high-sensitivity C-reactive protein(OR=1.31 per unit increase,95%CI:1.18-1.46).CONCLUSION Depression is common among patients with esophageal cancer and bone metastasis.Low socioeconomic status,limited education,insufficient social support,sleep disturbances,and systemic inflammation were independent predictors.Interventions that address these modifiable factors may reduce depression risk in this population.
基金Supported by Suzhou Clinical Medical Center for Mood Disorders,No.Szlcyxzx202109Suzhou Key Laboratory,No.SZS2024016Multicenter Clinical Research on Major Diseases in Suzhou,No.DZXYJ202413.
文摘BACKGROUND Suicide constitutes the second leading cause of death among adolescents globally and represents a critical public health concern.The neural mechanisms underlying suicidal behavior in adolescents with major depressive disorder(MDD)remain poorly understood.Aberrant resting-state functional connectivity(rsFC)in the amygdala,a key region implicated in emotional regulation and threat detection,is strongly implicated in depression and suicidal behavior.AIM To investigate rsFC alterations between amygdala subregions and whole-brain networks in adolescent patients with depression and suicide attempts.METHODS Resting-state functional magnetic resonance imaging data were acquired from 32 adolescents with MDD and suicide attempts(sMDD)group,33 adolescents with MDD but without suicide attempts(nsMDD)group,and 34 demographically matched healthy control(HC)group,with the lateral and medial amygdala(MeA)defined as regions of interest.The rsFC patterns of amygdala subregions were compared across the three groups,and associations between aberrant rsFC values and clinical symptom severity scores were examined.RESULTS Compared with the nsMDD group,the sMDD group exhibited reduced rsFC between the right lateral amygdala(LA)and the right inferior occipital gyrus as well as the left middle occipital gyrus.Compared with the HC group,the abnormal brain regions of rsFC in the sMDD group and nsMDD group involve the parahippocampal gyrus(PHG)and fusiform gyrus.In the sMDD group,right MeA and right temporal pole:Superior temporal gyrus rsFC value negatively correlated with the Rosenberg Self-Esteem Scale scores(r=-0.409,P=0.025),while left LA and right PHG rsFC value positively correlated with the Adolescent Self-Rating Life Events Checklist interpersonal relationship scores(r=0.372,P=0.043).CONCLUSION Aberrant rsFC changes between amygdala subregions and these brain regions provide novel insights into the underlying neural mechanisms of suicide attempts in adolescents with MDD.
基金Supported by Nanchong Social Science Research“14^(th) Five-Year Plan”2025 Annual Project,No.NC25B244.
文摘BACKGROUND Digestive tract subepithelial lesions(SELs)are relatively common,and early diagnosis and treatment are critical for improving patient quality of life and prognosis.However,diagnostic uncertainty often leads to negative psychological effects,including anxiety and depression.AIM To investigate the prevalence of anxiety and depressive symptoms and identify associated factors among patients with digestive tract SELs.METHODS This retrospective study included 296 consecutive patients diagnosed with digestive tract SELs at the Affiliated Hospital of North Sichuan Medical College Endoscopy Center between October 2024 and April 2025.Demographic and clinical data were collected through standardized questionnaires.Anxiety and depression were assessed using the Self-Rating Anxiety Scale and the Self-Rating Depression Scale,respectively,while sleep quality was evaluated using the Pittsburgh Sleep Quality Index.Participants were classified into anxiety vs nonanxiety and depression vs non-depression groups based on established cutoff scores,and potential determinants were examined.RESULTS Anxiety symptoms were observed in 35.8%of cases(mean Self-Rating Anxiety Scale score:46.56±9.13)and depressive symptoms in 33.1%(mean Self-Rating Depression scale score:48.64±8.30).Pittsburgh Sleep Quality Index scores were positively correlated with both anxiety and depression(P<0.05).Univariate analysis identified age,annual income,sleep disorders,and endoscopic ultrasonography(EUS)evaluation status as significant factors(P<0.05).Multivariable analysis revealed that low annual income(<10000 Chinese yuan)and sleep disorders were independent risk factors,whereas undergoing EUS examination and having disease awareness were protective factors against anxiety and depression(P<0.05).CONCLUSION Patients with digestive tract SELs are at increased risk for anxiety and depression,with poor sleep strongly linked to worsening psychological symptoms.Early diagnostic assessment with EUS appears to serve a protective role against the onset of these psychological disorders.
文摘Antidepressants are the main drugs used to treat depression,but they have not been shown to be effective in the treatment of child and adolescent depression.However,many adolescent depression treatment guidelines still recommend the use of antidepressants,especially specific serotonin re-uptake inhibitors.Previous studies have suggested that antidepressants have little therapeutic effect but many side effects,such as switching to mania,suicide,and non-suicidal self injury(NSSI),in the treatment of child and adolescent depression.In the process of developing guidelines,drug recommendations should not only focus on impro-ving symptoms,but they should also consider potential side effects.This review discusses the serious side effects of antidepressants,including switching to mania,suicide,and NSSI.
文摘Following an acute stroke,patients often encounter a range of impairments affecting their physical,cognitive,verbal,and social capabilities.Poststroke depression(PSD)has been identified as a significant consequence of stroke and serves as a crucial predictor of patient outcomes.The diagnosis of PSD presents a challenge,as the physical manifestations following a stroke can overlap with certain depressive symptoms,leading to a potential underdiagnosis of this condition.This review employs a narrative approach to synthesize diverse findings within this domain.PSD is categorized as an organic mood disorder,and a more accurate diagnosis may be achieved by considering the location of the stroke,the patient's specific symptoms,and the timeline of depressive symptom onset.Notably,if depressive symptoms emerge at more than one year poststroke,the likelihood of PSD diminishes.The etiology of PSD is currently understood to stem from a combination of physiological and psychosocial factors,as well as their interactions.Several mechanisms associated with PSD have been identified,including inflammation,dysregulation of the hypothalamic-pituitary-adrenal axis,oxidative stress,autophagy,apoptosis,abnormal neurotrophic responses,glutamate-mediated excitotoxicity,dysfunction within brain networks,reduced monoamine levels,locations of brain lesions,and psychosocial influences.This review also outlines potential directions for future research.
文摘Postpartum depression(PPD)is a severe mental health disorder affecting 10%to 15%of postpartum women worldwide.Pre-eclampsia is a hypertensive disorder of pregnancy that has been identified as a significant factor for PPD due to its vascular dysfunction,systemic inflammation and neurobiological alterations.The neuroinflammatory mechanisms common to both pre-eclampsia and PPD,that contribute to depressive symptoms include elevated proinflammatory cytokines(interleukin-6,tumor necrosis factor-alpha),activation of the kynurenine pathway,and oxidative stress.To critically evaluate Wu et al's study,which investigates blood pressure variability(BPV)and gestational body mass index(BMI)as independent predictors of PPD.To integrate recent findings on the metabolic and cardiovascular links between depression,pre-eclampsia,and postpartum mental health outcomes.Pre-pregnancy BMI is found to be a stronger predictor of PPD than gestational weight gain.A vascular-neuropsychiatric connection has been indicated in pre-eclamptic women,indicating a significant correlation between BPV and depressive postpartum symptoms.There is increased susceptibility to depression due to neuroinflammation contributed by blood pressure fluctuations and metabolic dysregulation.The incidence of PPD could be reduced by early identification and intervention for BP fluctuations.Early detection and intervention in high-risk pregnancies should be conducted through public health strategies that prioritize awareness,education,and accessibility to mental health care.
文摘BACKGROUND Postpartum depression(PPD)is a prevalent and debilitating psychiatric disorder affecting maternal mental health,infant development,and family well-being.Despite increasing global awareness,significant disparities remain in screening,diagnosis,and treatment,particularly in low-resource and culturally diverse settings.The complex interplay of biological and psychosocial determinants complicates conventional intervention models.Integrating epidemiological patterns,pathophysiological mechanisms,and sociocultural factors will inform more effective and equitable strategies for PPD screening,prevention,and treatment.METHODS A narrative review was conducted following PRISMA 2020 guidelines.Peer-reviewed studies published from January 2010 to May 2025 were systematically searched in PubMed,Web of Science,EMBASE,and PsycINFO.Inclusion criteria comprised studies addressing PPD epidemiology,risk stratification,biological mechanisms,and intervention strategies.After screening and full-text review,84 studies were included.Study designs primarily involved cohort studies,randomized controlled trials,and meta-analyses.Extracted data were categorized thematically and assessed for methodological quality and generalizability.RESULTS PPD arises from multifactorial interactions involving hormonal dysregulation,neurochemical changes,psychosocial stressors,and cultural influences.Primary risk factors include personal or family history of depression,antenatal anxiety,low maternal self-efficacy,and inadequate social support.Evidence-based interventions encompass Edinburgh Postnatal Depression Scale-based screening,cognitive behavioral therapy,interpersonal psychotherapy,psychoeducation,and pharmacological treatments such as brexanolone and zuranolone.Culturally adapted,community-integrated models—including stepped-care approaches and task-shifting—improve feasibility and scalability,particularly in underserved populations.Emerging evidence highlights inflammatory biomarkers(e.g.,interleukin-6 and C-reactive protein),AI-assisted screening tools,and family-inclusive strategies as promising for enhanced detection and outcomes.CONCLUSION Effective PPD management requires integrative,culturally sensitive approaches,prioritizing scalable,personalized non-pharmacological interventions to reduce disparities and enhance maternal mental health equity across diverse populations.
基金Supported by the Beijing Tiandehe Public Welfare Foundation,No.2023-7-024.
文摘BACKGROUND Depression is a disorder characterized by significant and persistent depressed mood,cognitive impairment,impaired voluntary activity,working memory,and somatic symptoms.AIM To determine the efficacy of Qi-based mindfulness therapy(QMT)in treating anxiety,depression,and sleep disturbances in individuals with mild-to-moderate depression.METHODS A self-controlled before–after trial was conducted.The study invited online participants for recruitment between May and July 2023.Participants(n=18)aged 18-65 years with mild-to-moderate depression,who were receiving QMT training for 4 weeks,were included.The primary efficacy indicators were the 17 Hamilton Depression Rating Scale and Hamilton Anxiety Scale scores.The secondary outcome indicators included the Zung Self-rating Depression Scale,the self-rating Anxiety Scale,and the Insomnia Severity Index.Pre-and postintervention assessments were conducted.The patients’symptoms related to depression,anxiety,and insomnia were reassessed 4 weeks after the post-intervention evaluation.RESULTS Patients who underwent the QMT intervention for 4 weeks exhibited a statistically significant reduction in scores on the 17 Hamilton Depression Rating Scale,Hamilton Anxiety Scale,the Zung Self-Rating Depression Scale,the Self-Rating Anxiety Scale,and the Insomnia Severity Index relative to their pre-intervention scores(all P<0.05).CONCLUSION QMT training for 4 weeks is an effective nonpharmacological treatment for symptoms of depression,anxiety,and insomnia among patients with mild-to-moderate depression.
