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
AIM:To investigate the impact of depression-like behavior on ocular surface homeostasis in a mouse model,with a focus on dry eye-like alterations.METHODS:Male C57BL/6J mice(10-12 weeks old)were randomly assigned to co...AIM:To investigate the impact of depression-like behavior on ocular surface homeostasis in a mouse model,with a focus on dry eye-like alterations.METHODS:Male C57BL/6J mice(10-12 weeks old)were randomly assigned to control or restraint stress(RS)groups.The RS group underwent three intermittent 24-hour restraint sessions to induce depressive-like behavior.Behavioral testing,tear secretion measurement,and corneal Oregon Green Dextran(OGD)staining were performed.Postmortem analyses included histological evaluation of lacrimal glands,goblet cell quantification using periodic acid-Schiff staining,and assessment of key inflammatory and apoptotic markers:interleukin(IL)-17,matrix metalloproteinases(MMP)-3,MMP-9,IL-13,interferon(IFN)-γ,and cleaved caspase-3 and-8.RESULTS:Repeated RS induced depression-like behavior and significant ocular surface changes.RStreated mice showed increased corneal OGD uptake and upregulation of gene/protein expression of IL-17,MMP-3,and MMP-9(P<0.05).Goblet cell density and IL-13 protein expression were reduced,while IFN-γprotein expression was elevated(P<0.05).Cleaved caspase-3 and-8 levels were significantly increased in both cornea and conjunctiva.Tear volume and lacrimal gland size were unchanged;however,mild inflammatory infiltration was observed in lacrimal glands.CONCLUSION:Repeated RS leads to ocular surface inflammation and dry eye-like pathology,including corneal barrier disruption,goblet cell loss,and epithelial apoptosis.These findings suggest that depression contributes to the pathogenesis of dry eye disease via immune-mediated mechanisms.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
Background:Depression is prevalent among female college students,with eating behavior potentially related to this issue.This study examines the relationship between eating behavior and depression,focusing on the role ...Background:Depression is prevalent among female college students,with eating behavior potentially related to this issue.This study examines the relationship between eating behavior and depression,focusing on the role of social appearance anxiety and physical activity.Methods:We recruited 2161 female college students from nine universities in China via convenience sampling.Data was collected via an online questionnaire.Eating behavior was assessed via the Eating Behavior Scale short form(EBS-SF),depression was measured via the Center for Epidemiological Studies Depression Scale(CES-D),social appearance anxiety was evaluated via the Social Appearance Anxiety Scale,and physical activity was assessed via a single-item question.Descriptive statistics were analyzed via SPSS 26.0,and moderated mediation analysis was conducted via PROCESS version 3.5.Results:Unhealthy eating behavior was significantly associated with higher levels of depression(β=0.285,p<0.001).Social appearance anxiety mediated this relationship,accounting for 46%of the total effect(β=0.132,95%CI=[0.108,0.158]).The interaction effect between eating behavior and physical activity was significantly and negatively correlated with depression(β=−0.052,p<0.01).The association between eating behavior and depression was stronger under conditions of low physical activity(β=0.210,p<0.001)than under conditions of high physical activity(β=0.105,p<0.001).Conclusions:Integrating nutritional guidance,body image acceptance training,and exercise promotion into campus mental health programs is crucial for addressing depression in female college students.Future research should use longitudinal designs and broader participant ranges to increase the general applicability of the findings.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
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
Selective depression of pyrite remains a major bottleneck in copper flotation,particularly when high-pyrite ores are processed and saline water is used.In such environments,conventional approaches using lime and inert...Selective depression of pyrite remains a major bottleneck in copper flotation,particularly when high-pyrite ores are processed and saline water is used.In such environments,conventional approaches using lime and inert grinding media often fail to discriminate ef-fectively between pyrite and valuable copper minerals due to strong copper activation on pyrite surfaces.This study introduced a novel approach using inorganic radicals generated from peroxymonosulfate(PMS)to selectively oxidize and depress pyrite.Flotation tests with synthetic high-pyrite ore blends showed that PMS significantly reduced pyrite recovery while maintaining or improving chalcopyrite flot-ation.Ethylenediaminetetraacetic acid(EDTA)extraction confirmed selective oxidation of pyrite,and electron paramagnetic resonance(EPR)spectroscopy identified hydroxyl(·OH)and sulfate(SO_(4)^(·-))radicals as the dominant reactive species.Iron ions from grinding me-dia and mineral surfaces were identified as key activators of PMS.A major insight was pyrite’s dual role,acting both as a radical scav-enger and an activator,which made it highly reactive and susceptible to radical-induced oxidation.This process converted surface copper-sulfur species into copper hydroxides,effectively suppressing pyrite flotation.While previous studies have applied EPR to detect radicals in simplified activator/precursor systems,this study provides the first direct mechanistic evidence of radical-driven selectivity in flotation by detecting inorganic radicals in a complex flotation slurry,thereby demonstrating their persistence under industrially relevant conditions and establishing a foundation for more effective and targeted flotation strategies.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 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
Objective:To observe the clinical efficacy of acupuncture and moxibustion plus traditional Chinese herbs in treating depression after ischemic stroke and its effects on monoamine neurotransmitter levels.Methods:A tota...Objective:To observe the clinical efficacy of acupuncture and moxibustion plus traditional Chinese herbs in treating depression after ischemic stroke and its effects on monoamine neurotransmitter levels.Methods:A total of 80 patients with depression after ischemic stroke were divided into a control group and an observation group using the random number table method,with 40 cases in each group.The two groups were treated with Wen Yang Jie Yu Tang(decoction for warming Yang and relieving depression).The observation group was treated with additional acupuncture and moxibustion therapy.The therapeutic effect was evaluated after 4 weeks of treatment.The traditional Chinese medicine(TCM)main symptoms and depression symptoms were scored before and after 4 weeks of treatment.Neurological function was assessed using the National Institutes of Health stroke scale(NIHSS),depressive symptoms were evaluated by the 17-item Hamilton depression scale(HAMD-17),and sleep quality was assessed using the Pittsburgh sleep quality index(PSQI).Meanwhile,the serum levels of monoamine neurotransmitters,including 5-hydroxytryptamine(5-HT),noradrenaline(NE),and dopamine(DA),were measured.The incidence of adverse reactions during treatment was compared between the two groups.Results:The total effective rates in improving depression symptoms and TCM main symptoms in the observation group were both higher than those in the control group(P<0.05).After treatment,the scores of each TCM main symptom,NIHSS,HAMD-17,and PSQI in both groups were all lower than those before treatment(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).After 4 weeks of treatment,the serum levels of 5-HT,NE,and DA in both groups were all higher than those before treatment(P<0.05),and the serum levels in the observation group were higher than those in the control group(P<0.05).During the treatment period,there was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The treatment of acupuncture and moxibustion plus traditional Chinese herbs has significant efficacy in treating depression after ischemic stroke;it can effectively relieve the symptoms,improve neurological function and sleep quality,increase monoamine neurotransmitter levels,and has high safety.展开更多
Objectives:Although standardized residency trainees are at high risk for depression,anxiety,and suicidal ideation,the psychological pathways connecting depression and anxiety to suicidal ideation,especially the modera...Objectives:Although standardized residency trainees are at high risk for depression,anxiety,and suicidal ideation,the psychological pathways connecting depression and anxiety to suicidal ideation,especially the moderating role of resilience,remain elusive.This study aimed to examine the associations between depression,anxiety,and suicidal ideation among physicians undergoing standardized residency training,and to investigate the moderating roles of different dimensions of individual resilience,namely tenacity,strength,and optimism.Methods:A convenience sampling method was adopted to recruit 133 resident physicians.Validated instruments assessing individual resilience,depressive symptoms,anxiety levels,and suicidal ideation were administered.Spearman correlation analysis was used to evaluate the relationships among the variables.Hierarchical regression analysis was conducted to assess the moderating roles of tenacity,strength,and optimism in the associations between depression,anxiety,and suicidal ideation.Results:Depressive symptoms and anxiety levels were both positively associated with suicidal ideation(p<0.001).All three resilience dimensions were negatively correlated with suicidal ideation(tenacity:r=−0.504,strength:r=−0.477,optimism:r=−0.440,all p<0.001).Tenacity,strength,and optimism significantly moderated the associations between depression and suicidal ideation(all p<0.05).When resilience levels in these dimensions were high,the associations between depression and suicidal ideation were weaker.Strength and optimism also moderated the associations between anxiety and suicidal ideation(strength:p=0.028,optimism:p=0.028).When the resiliences(strength and optimism)were high,the associations between anxiety and suicidal ideation were weaker.Conclusion:Individual resilience,particularly in the dimensions of tenacity,strength,and optimism,may serve as protective correlates for physicians in training,being associated with weaker relationships between depression,anxiety,and suicidal ideation.These findings highlight the potential value of resilience-enhancing strategies in clinical training settings,although causal inferences cannot be drawn due to the cross-sectional design.展开更多
Background:The phenomenon of multimorbidity in chronic diseases among the elderly is prevalent,and its significant association with depression poses a serious threat to the physical and mental health of older adults.C...Background:The phenomenon of multimorbidity in chronic diseases among the elderly is prevalent,and its significant association with depression poses a serious threat to the physical and mental health of older adults.Current research on the associations between 24-hour movement behaviors(including physical activity,sedentary behavior,and sleep)and depression has largely been confined to examining the effects of single behaviors,overlooking the intrinsic compositional nature and interrelationships among these behaviors.Therefore,it is necessary to investigate the integrated effects of 24-hour movement behaviors on depression in older adults with multimorbidity from a holistic,compositional perspective.Methods:From November 2024 to April 2025,a total of 226 older adult patients with multimorbidity were recruited from a tertiary hospital in Changzhou City.Data were collected using a general information questionnaire,the International Physical Activity Questionnaire–Short Form(IPAQ-SF),the Pittsburgh Sleep Quality Index(PSQI),and the Patient Health Questionnaire-9(PHQ-9).Compositional data analysis and isotemporal substitution models were employed for statistical analysis.Results:The mean daily durations of Light-Intensity Physical Activity(LPA),Moderate-to-Vigorous Physical Activity(MVPA),Sedentary Behavior(SB),and Sleep(SLP)in older adults with multimorbidity were 402.48 min,12.04 min,511.52 min,and 458.68 min,respectively.The prevalence of depressive symptoms was 37.6%.Compositional data analysis revealed that SB was positively associated with depression(βSB=1.005,P=0.006),while SLP was negatively associated with depression(βSLP=−1.736,P<0.001).No statistically significant associations were found between MVPA or LPA and depression(P>0.05).In the 10-minute isotemporal substitution model,replacing SB with any other behavioral component was associated with a decrease in depression scores.Conversely,substituting SLP with either LPA or SB resulted in an increase in depression scores,while substituting SLP with MVPA led to a decrease in depression scores.The dose-response analysis revealed that,among the isotemporal substitution effects,replacing SB with SLP and replacing SLP with MVPA were the substitution pathways associated with the most rapid decline in depression scores,representing the greatest beneficial health effects.Conclusion:The prevalence of depression is notably high among older adults with multimorbidity.Reducing daily sedentary behavior(SB),maintaining adequate sleep(SLP),and increasing moderate-to-vigorous physical activity(MVPA)can improve depressive symptoms and enhance overall health in this population.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
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:American ginseng has been used in the food processing and pharmaceutical industry as a medicinal plant with both nutritional value and economic benefit.Panax quinquefolius saponins(PQS),the main active comp...Background:American ginseng has been used in the food processing and pharmaceutical industry as a medicinal plant with both nutritional value and economic benefit.Panax quinquefolius saponins(PQS),the main active component,have significant antioxidant,neuroprotective,and cardioprotective effects.Clinically,myocardial ischemia(MI)and depression often interact,which has increasing morbidity and mortality rates.However,the mechanism of PQS on MI with depression remains unclear.Methods:The study employed both in vivo and in vitro experiments.Depression-like behaviour changes and cardiac function were observed in mice with MI and depression induced by a high-fat diet(HFD)and intraperitoneal injection of isoproterenol(ISO)plus chronic unpredictable mild stress(CUMS).Both ISO-exposed H9c2 cells and corticosterone(CORT)-induced HT22 cells were selected for in vitro experiments.Biochemical indices and PI3K/Akt/eNOS pathway-related proteins were measured through enzyme-linked immunosorbent assay(ELISA)and Western blotting.Results:PQS significantly improved depression-like behaviour and heart damage in mice and substantially increased H9c2 and HT22 cell activities in vitro.Western blotting analysis showed that PQS could dramatically reverse the changes in the PI3K/AKT/eNOS signalling pathway both in vivo and in vitro.In addition,applying the PI3K inhibitor LY294002 weakened the neuroprotective and cardioprotective effects of PQS.Conclusion:PQS can effectively improve MI with depression,probably through activating PI3K/Akt/eNOS pathway.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:Maternal mental health literacy is a cognitive resource that may support preschoolers’emotional development,yet its influence on emotional regulation and the related mechanisms remains unclear.This study e...Background:Maternal mental health literacy is a cognitive resource that may support preschoolers’emotional development,yet its influence on emotional regulation and the related mechanisms remains unclear.This study examined whether maternal depressive mood and democratic parenting form a chain pathway linking maternal mental health literacy to preschoolers’emotional regulation ability.Methods:Mothers of 544 preschoolers in China’s Mainland completed an online questionnaire that assessed maternal mental health literacy,depressive mood,democratic parenting,and child emotional regulation.Structural path analysis was conducted with child age and gender controlled.Indirect effects were tested using 5000 bootstrap samples.Results:Maternal mental health literacy did not directly predict preschoolers’emotional regulation.Three indirect effects were significant.The pathway through depressive mood had an effect of 0.005,the pathway through democratic parenting had an effect of 0.004,and the chain pathway through depressive mood and democratic parenting had an effect of 0.002.All confidence intervals excluded 0.Conclusion:Maternal mental health literacy influences preschoolers’emotional regulation only through maternal depressive mood and democratic parenting,indicating that cognitive resources affect child emotional outcomes through emotional and behavioral processes rather than a direct pathway.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.
基金Supported by the Key Program of the National Natural Science Foundation of China(No.82530034)the National Natural Science Foundation of China(No.82271054)the Nature Science Foundation of Xiamen,China(No.3502Z20227121).
文摘AIM:To investigate the impact of depression-like behavior on ocular surface homeostasis in a mouse model,with a focus on dry eye-like alterations.METHODS:Male C57BL/6J mice(10-12 weeks old)were randomly assigned to control or restraint stress(RS)groups.The RS group underwent three intermittent 24-hour restraint sessions to induce depressive-like behavior.Behavioral testing,tear secretion measurement,and corneal Oregon Green Dextran(OGD)staining were performed.Postmortem analyses included histological evaluation of lacrimal glands,goblet cell quantification using periodic acid-Schiff staining,and assessment of key inflammatory and apoptotic markers:interleukin(IL)-17,matrix metalloproteinases(MMP)-3,MMP-9,IL-13,interferon(IFN)-γ,and cleaved caspase-3 and-8.RESULTS:Repeated RS induced depression-like behavior and significant ocular surface changes.RStreated mice showed increased corneal OGD uptake and upregulation of gene/protein expression of IL-17,MMP-3,and MMP-9(P<0.05).Goblet cell density and IL-13 protein expression were reduced,while IFN-γprotein expression was elevated(P<0.05).Cleaved caspase-3 and-8 levels were significantly increased in both cornea and conjunctiva.Tear volume and lacrimal gland size were unchanged;however,mild inflammatory infiltration was observed in lacrimal glands.CONCLUSION:Repeated RS leads to ocular surface inflammation and dry eye-like pathology,including corneal barrier disruption,goblet cell loss,and epithelial apoptosis.These findings suggest that depression contributes to the pathogenesis of dry eye disease via immune-mediated mechanisms.
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.
文摘Background:Depression is prevalent among female college students,with eating behavior potentially related to this issue.This study examines the relationship between eating behavior and depression,focusing on the role of social appearance anxiety and physical activity.Methods:We recruited 2161 female college students from nine universities in China via convenience sampling.Data was collected via an online questionnaire.Eating behavior was assessed via the Eating Behavior Scale short form(EBS-SF),depression was measured via the Center for Epidemiological Studies Depression Scale(CES-D),social appearance anxiety was evaluated via the Social Appearance Anxiety Scale,and physical activity was assessed via a single-item question.Descriptive statistics were analyzed via SPSS 26.0,and moderated mediation analysis was conducted via PROCESS version 3.5.Results:Unhealthy eating behavior was significantly associated with higher levels of depression(β=0.285,p<0.001).Social appearance anxiety mediated this relationship,accounting for 46%of the total effect(β=0.132,95%CI=[0.108,0.158]).The interaction effect between eating behavior and physical activity was significantly and negatively correlated with depression(β=−0.052,p<0.01).The association between eating behavior and depression was stronger under conditions of low physical activity(β=0.210,p<0.001)than under conditions of high physical activity(β=0.105,p<0.001).Conclusions:Integrating nutritional guidance,body image acceptance training,and exercise promotion into campus mental health programs is crucial for addressing depression in female college students.Future research should use longitudinal designs and broader participant ranges to increase the general applicability of the findings.
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 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.
基金support from the Australian Research Council(ARC)Linkage Project(No.LP230100166).
文摘Selective depression of pyrite remains a major bottleneck in copper flotation,particularly when high-pyrite ores are processed and saline water is used.In such environments,conventional approaches using lime and inert grinding media often fail to discriminate ef-fectively between pyrite and valuable copper minerals due to strong copper activation on pyrite surfaces.This study introduced a novel approach using inorganic radicals generated from peroxymonosulfate(PMS)to selectively oxidize and depress pyrite.Flotation tests with synthetic high-pyrite ore blends showed that PMS significantly reduced pyrite recovery while maintaining or improving chalcopyrite flot-ation.Ethylenediaminetetraacetic acid(EDTA)extraction confirmed selective oxidation of pyrite,and electron paramagnetic resonance(EPR)spectroscopy identified hydroxyl(·OH)and sulfate(SO_(4)^(·-))radicals as the dominant reactive species.Iron ions from grinding me-dia and mineral surfaces were identified as key activators of PMS.A major insight was pyrite’s dual role,acting both as a radical scav-enger and an activator,which made it highly reactive and susceptible to radical-induced oxidation.This process converted surface copper-sulfur species into copper hydroxides,effectively suppressing pyrite flotation.While previous studies have applied EPR to detect radicals in simplified activator/precursor systems,this study provides the first direct mechanistic evidence of radical-driven selectivity in flotation by detecting inorganic radicals in a complex flotation slurry,thereby demonstrating their persistence under industrially relevant conditions and establishing a foundation for more effective and targeted flotation strategies.
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 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 Science and Technology Research and Development Program Project of Qinhuangdao(秦皇岛市科学技术研究与发展计划项目,No.202301A067).
文摘Objective:To observe the clinical efficacy of acupuncture and moxibustion plus traditional Chinese herbs in treating depression after ischemic stroke and its effects on monoamine neurotransmitter levels.Methods:A total of 80 patients with depression after ischemic stroke were divided into a control group and an observation group using the random number table method,with 40 cases in each group.The two groups were treated with Wen Yang Jie Yu Tang(decoction for warming Yang and relieving depression).The observation group was treated with additional acupuncture and moxibustion therapy.The therapeutic effect was evaluated after 4 weeks of treatment.The traditional Chinese medicine(TCM)main symptoms and depression symptoms were scored before and after 4 weeks of treatment.Neurological function was assessed using the National Institutes of Health stroke scale(NIHSS),depressive symptoms were evaluated by the 17-item Hamilton depression scale(HAMD-17),and sleep quality was assessed using the Pittsburgh sleep quality index(PSQI).Meanwhile,the serum levels of monoamine neurotransmitters,including 5-hydroxytryptamine(5-HT),noradrenaline(NE),and dopamine(DA),were measured.The incidence of adverse reactions during treatment was compared between the two groups.Results:The total effective rates in improving depression symptoms and TCM main symptoms in the observation group were both higher than those in the control group(P<0.05).After treatment,the scores of each TCM main symptom,NIHSS,HAMD-17,and PSQI in both groups were all lower than those before treatment(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).After 4 weeks of treatment,the serum levels of 5-HT,NE,and DA in both groups were all higher than those before treatment(P<0.05),and the serum levels in the observation group were higher than those in the control group(P<0.05).During the treatment period,there was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The treatment of acupuncture and moxibustion plus traditional Chinese herbs has significant efficacy in treating depression after ischemic stroke;it can effectively relieve the symptoms,improve neurological function and sleep quality,increase monoamine neurotransmitter levels,and has high safety.
基金supported by Jiangsu Cancer Hospital Science and Technology Development Fund Project(NO.XHMS202404)Nanjing Medical Science and Technology Development Fund Project(GBX22289).
文摘Objectives:Although standardized residency trainees are at high risk for depression,anxiety,and suicidal ideation,the psychological pathways connecting depression and anxiety to suicidal ideation,especially the moderating role of resilience,remain elusive.This study aimed to examine the associations between depression,anxiety,and suicidal ideation among physicians undergoing standardized residency training,and to investigate the moderating roles of different dimensions of individual resilience,namely tenacity,strength,and optimism.Methods:A convenience sampling method was adopted to recruit 133 resident physicians.Validated instruments assessing individual resilience,depressive symptoms,anxiety levels,and suicidal ideation were administered.Spearman correlation analysis was used to evaluate the relationships among the variables.Hierarchical regression analysis was conducted to assess the moderating roles of tenacity,strength,and optimism in the associations between depression,anxiety,and suicidal ideation.Results:Depressive symptoms and anxiety levels were both positively associated with suicidal ideation(p<0.001).All three resilience dimensions were negatively correlated with suicidal ideation(tenacity:r=−0.504,strength:r=−0.477,optimism:r=−0.440,all p<0.001).Tenacity,strength,and optimism significantly moderated the associations between depression and suicidal ideation(all p<0.05).When resilience levels in these dimensions were high,the associations between depression and suicidal ideation were weaker.Strength and optimism also moderated the associations between anxiety and suicidal ideation(strength:p=0.028,optimism:p=0.028).When the resiliences(strength and optimism)were high,the associations between anxiety and suicidal ideation were weaker.Conclusion:Individual resilience,particularly in the dimensions of tenacity,strength,and optimism,may serve as protective correlates for physicians in training,being associated with weaker relationships between depression,anxiety,and suicidal ideation.These findings highlight the potential value of resilience-enhancing strategies in clinical training settings,although causal inferences cannot be drawn due to the cross-sectional design.
基金supported by the 2025 Jiangsu Province Graduate Student Practice Innovation Program(No.SJCX25_1696)the 2024 Changzhou University Educational Research Project(No.GJY2024009).
文摘Background:The phenomenon of multimorbidity in chronic diseases among the elderly is prevalent,and its significant association with depression poses a serious threat to the physical and mental health of older adults.Current research on the associations between 24-hour movement behaviors(including physical activity,sedentary behavior,and sleep)and depression has largely been confined to examining the effects of single behaviors,overlooking the intrinsic compositional nature and interrelationships among these behaviors.Therefore,it is necessary to investigate the integrated effects of 24-hour movement behaviors on depression in older adults with multimorbidity from a holistic,compositional perspective.Methods:From November 2024 to April 2025,a total of 226 older adult patients with multimorbidity were recruited from a tertiary hospital in Changzhou City.Data were collected using a general information questionnaire,the International Physical Activity Questionnaire–Short Form(IPAQ-SF),the Pittsburgh Sleep Quality Index(PSQI),and the Patient Health Questionnaire-9(PHQ-9).Compositional data analysis and isotemporal substitution models were employed for statistical analysis.Results:The mean daily durations of Light-Intensity Physical Activity(LPA),Moderate-to-Vigorous Physical Activity(MVPA),Sedentary Behavior(SB),and Sleep(SLP)in older adults with multimorbidity were 402.48 min,12.04 min,511.52 min,and 458.68 min,respectively.The prevalence of depressive symptoms was 37.6%.Compositional data analysis revealed that SB was positively associated with depression(βSB=1.005,P=0.006),while SLP was negatively associated with depression(βSLP=−1.736,P<0.001).No statistically significant associations were found between MVPA or LPA and depression(P>0.05).In the 10-minute isotemporal substitution model,replacing SB with any other behavioral component was associated with a decrease in depression scores.Conversely,substituting SLP with either LPA or SB resulted in an increase in depression scores,while substituting SLP with MVPA led to a decrease in depression scores.The dose-response analysis revealed that,among the isotemporal substitution effects,replacing SB with SLP and replacing SLP with MVPA were the substitution pathways associated with the most rapid decline in depression scores,representing the greatest beneficial health effects.Conclusion:The prevalence of depression is notably high among older adults with multimorbidity.Reducing daily sedentary behavior(SB),maintaining adequate sleep(SLP),and increasing moderate-to-vigorous physical activity(MVPA)can improve depressive symptoms and enhance overall health in this population.
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 the study on the material basis and mechanism of action of American ginseng in the treatment of myocardial ischaemia comorbid depression(2024JH2/102500059).
文摘Background:American ginseng has been used in the food processing and pharmaceutical industry as a medicinal plant with both nutritional value and economic benefit.Panax quinquefolius saponins(PQS),the main active component,have significant antioxidant,neuroprotective,and cardioprotective effects.Clinically,myocardial ischemia(MI)and depression often interact,which has increasing morbidity and mortality rates.However,the mechanism of PQS on MI with depression remains unclear.Methods:The study employed both in vivo and in vitro experiments.Depression-like behaviour changes and cardiac function were observed in mice with MI and depression induced by a high-fat diet(HFD)and intraperitoneal injection of isoproterenol(ISO)plus chronic unpredictable mild stress(CUMS).Both ISO-exposed H9c2 cells and corticosterone(CORT)-induced HT22 cells were selected for in vitro experiments.Biochemical indices and PI3K/Akt/eNOS pathway-related proteins were measured through enzyme-linked immunosorbent assay(ELISA)and Western blotting.Results:PQS significantly improved depression-like behaviour and heart damage in mice and substantially increased H9c2 and HT22 cell activities in vitro.Western blotting analysis showed that PQS could dramatically reverse the changes in the PI3K/AKT/eNOS signalling pathway both in vivo and in vitro.In addition,applying the PI3K inhibitor LY294002 weakened the neuroprotective and cardioprotective effects of PQS.Conclusion:PQS can effectively improve MI with depression,probably through activating PI3K/Akt/eNOS pathway.
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:Maternal mental health literacy is a cognitive resource that may support preschoolers’emotional development,yet its influence on emotional regulation and the related mechanisms remains unclear.This study examined whether maternal depressive mood and democratic parenting form a chain pathway linking maternal mental health literacy to preschoolers’emotional regulation ability.Methods:Mothers of 544 preschoolers in China’s Mainland completed an online questionnaire that assessed maternal mental health literacy,depressive mood,democratic parenting,and child emotional regulation.Structural path analysis was conducted with child age and gender controlled.Indirect effects were tested using 5000 bootstrap samples.Results:Maternal mental health literacy did not directly predict preschoolers’emotional regulation.Three indirect effects were significant.The pathway through depressive mood had an effect of 0.005,the pathway through democratic parenting had an effect of 0.004,and the chain pathway through depressive mood and democratic parenting had an effect of 0.002.All confidence intervals excluded 0.Conclusion:Maternal mental health literacy influences preschoolers’emotional regulation only through maternal depressive mood and democratic parenting,indicating that cognitive resources affect child emotional outcomes through emotional and behavioral processes rather than a direct pathway.
