Psychological Pain, Depression, and Suicide: Recent Evidences and Future Directions

The effect of major identity on depression among Chinese university students: A moderated mediation model

The mechanisms and boundary conditions through which major identity affects university students' depression remain unclear. To fill this gap, the present study aimed to examine the relationship between major identity and university students' depression, revealing the mediating role of self-esteem in this relationship and the moderating role of perceived social support. A total of 436 Chinese university students participated in this study. The results showed that major identity was significantly and negatively related to depression and significantly and positively related to self-esteem. Self-esteem was significantly and negatively related to depression. Self-esteem mediated the relationship between major identity and university students' depression. Perceived social support not only moderated the relationships between major identity and university students' depression but also moderated the relationship between self-esteem and university students' depression. In addition, perceived social support moderated the mediating effect of self-esteem between major identity and university students' depression. The theoretical and practical implications of this study are discussed in depth.

Let's Move Towards Precision Suicidology

PURPOSE OF REVIEW

Suicidal behaviour remains a critical public health issue, with limited progress in reducing suicide rates despite various prevention efforts. The introduction of precision psychiatry offers hope by tailoring treatments based on individual genetic, environmental, and lifestyle factors. This approach could enhance the effectiveness of interventions, as current strategies are insufficient-many individuals who die by suicide had recently seen a doctor, but interventions often fail due to rapid progression of suicidal behaviour, reluctance to seek treatment, and poor identification of suicidal ideation.

RECENT FINDINGS

Precision medicine, particularly through the use of machine learning and 'omics' techniques, shows promise in improving suicide prevention by identifying high-risk individuals and developing personalised interventions. Machine learning models can predict suicidal risk more accurately than traditional methods, while genetic markers and environmental factors can create comprehensive risk profiles, allowing for targeted prevention strategies. Stratification in psychiatry, especially concerning depression, is crucial, as treating depression alone does not effectively reduce suicide risk. Pharmacogenomics and emerging research on inflammation, psychological pain, and anhedonia suggest that specific treatments could be more effective for certain subgroups. Ultimately, precision medicine in suicide prevention, though challenging to implement, could revolutionise care by offering more personalised, timely, and effective interventions, potentially reducing suicide rates and improving mental health outcomes. This new approach emphasizes the importance of suicide-specific strategies and research into stratification to better target interventions based on individual patient characteristics.

Unraveling the Complexities Between Reasons and Motivations Behind Suicide Behaviors: A Population-Based Study of Hong Kong Secondary School Students

PURPOSE

To explore the importance of and interconnected nature between the reasons and motivations underlying suicide behaviors among adolescents in Hong Kong.

METHODS

Suicide behaviors include suicidal ideation and suicide attempts. A subset of data was extracted for analysis from the 2016 wave of the Hong Kong Youth Sexuality Study. This subset comprised 1,744 adolescents who had considered, or attempted, suicide. Descriptive and network analysis was applied to explore the connections between suicide behavior reasons and motivations.

RESULTS

Both the descriptive and network analyses revealed that Hong Kong adolescents experienced multiple reasons and motivations behind their suicidal thoughts and suicide attempts. The primary reasons were emotional problems, family-related issues, and academic pressures. The main motivations were to get relief from a terrible state of mind, to escape from an impossible situation, and to end suffering. While these three main motivations were prevalent across nearly all the reasons, distinctive associations also emerged. Desire to die was a key motivation when suicide behaviors stemmed from a sense of meaninglessness or financial problems. Expressing love was a significant motivation when suicide behavior was related to the loss of a loved one. Sex differences were observed in the patterns of reasons and motivations.

DISCUSSION

The factors driving suicide behaviors among adolescents are complex and exhibit sex differences. Suicide behaviors may function as a coping mechanism for severe psychological distress. Distinctive reason-motivation connections underscore elevated risk levels among specific groups of adolescents and provide critical insights for designing targeted interventions.

Predictive validity of the SAD PERSONS and NO HOPE scales in a sample of suicide cases

Introduction

Suicide is a global public health issue necessitating evidence-based prevention strategies. Many individuals who die by suicide have had prior contact with healthcare services. Nearly half visit a primary care provider within a month before their death, and many visit emergency departments (EDs) frequently. Effective risk assessment in EDs is critical for suicide prevention but remains challenging. Inadequate risk assessments are a common error identified in suicide deaths. While clinical interviews are vital, risk assessment scales can support decision-making. The SAD PERSONS and NO HOPE scales are widely used but have limitations in predictive value.

Materials and methods

A case-control study using psychological autopsy (PA) was conducted from 2006 to 2016. Data were collected from 662 individuals in southern Spain, including 487 suicide cases and 175 controls. PAs involved interviews with close relatives and were conducted by trained psychiatrists or psychologists. The SAD PERSONS and NO HOPE scales were utilised, and data were analysed using sensitivity, specificity, and logistic regression to develop an improved predictive model.

Results

The SAD PERSONS scale showed high specificity but low sensitivity in predicting suicide risk. In the non-suicide group, 91.6% were classified as low risk. In the suicide group, nearly half were classified as low risk (49.6%). The modified SAD PERSONS scale showed similar results. The NO HOPE scale had low sensitivity but high specificity. An improved predictive model incorporating key variables from both scales demonstrated higher sensitivity (93.609%) and specificity (91.608%).

Discussion

The SAD PERSONS scale has limitations in effectively predicting suicide risk, particularly due to its focus on non-modifiable factors. Adding variables from the NO HOPE scale improves predictive utility. Comprehensive clinical assessments, considering psychological, social, and environmental factors, are essential for accurate suicide risk evaluation and tailored intervention.

The association of pain phenotype and providing caregiving with depressive symptom trajectory for older adults: a longitudinal analysis using the health and retirement study

BACKGROUND

This study aims to analyze the association between different pain phenotypes and depressive symptom trajectory among community-dwelling older adults, and whether and how providing caregiving render older adults with pain more prone to a deteriorating depressive trajectory.

METHODS

Data were derived from the Health and Retirement Study between 2008 and 2020. Older adults were classified into different pain phenotypes leveraging four pain characteristics at baseline (i.e. 2008) using latent class analysis, including pain intensity, pain interference, pain location, and pain persistence. Caregiving status was collected at baseline using helper lists. Depressive symptoms were measured biennially from 2008 to 2020. Linear mixed models were constructed to explore the independent and interacted effects of pain phenotypes and providing caregiving on depressive symptom trajectory.

RESULTS

Among 8486 participants aged 60 years old or over (58.8% females, and mean age of 74.28), four pain phenotypes were identified: Severe-persistent pain group (15.0%), Moderate pain group (17.3%), Back pain group (7.0%), and Pain-free group (60.7%). Compared to the Pain-free group, other three pain subtypes exhibited higher baseline depression symptoms with a gradient trend. Older adults with Severe-persistent pain had a significantly slower rate of depression symptom increase. Caregiving did not moderate the impact of any pain subtype on baseline depression symptoms, but it significantly reduced the rate of increase in depression symptoms for both Severe-persistent pain group and Back pain group.

CONCLUSIONS

Pain phenotype-informed depression services should be delivered. Promoting the caregiving benefit finding for the elderly would contribute to the remission of depressive symptom.

Biological research on mental pain, social pain and other pains not primarily felt in the body: methodological systematic review

BACKGROUND

Researchers explore the biology of painful experiences not primarily felt in the body ('non-physical pain'), sometimes referred to as mental, social or emotional pain. A critical challenge lies in how to operationalise this subjective experience for biological research, a crucial process for translating findings into clinical practice.

AIMS

To map studies investigating biological features of non-physical pain, focusing on their conceptual features (i.e. terms and definitions of non-physical pain) and methodological characteristics (e.g. experimental paradigms and measures).

METHOD

This methodological systematic review searched reports of primary research on the biological features of non-physical pain across Embase, MEDLINE and Web of Science. Using a meta-research approach, we synthetised results on terms, definitions, populations, experimental paradigms, confounders, measures of non-physical pain and investigation methods (e.g. functional magnetic resonance imaging).

RESULTS

We identified 92 human studies, involving 7778 participants. Overall, 59.1% of the studies did not report any definition of non-physical pain, and 82% of studies did not use a specific measure. Regarding the possibility of translating results to clinical settings, most of the human studies involved only healthy participants (71.7%) and the seven different experimental paradigms used to induce non-physical pain had unknown external validity. Confounders were not considered by 32.4% of the experimental studies. Animal studies were rare, with only four rodent studies.

CONCLUSIONS

Biomedical studies of non-physical pain use heterogeneous concepts with unclear overlaps and methods with unknown external validity. As has been done for physical pain, priority actions include establishing an agreed definition and measurement of non-physical pain and developing experimental paradigms with good external validity.

Latent profile analysis of depression in older adults spouse caregivers

Objective

With advancing age, older adults are more likely to experience health problems and a decline in functioning, necessitating long-term care. Spouses play a crucial role in providing care for the older adults. Depression is a significant mental health issue faced by older adult's spouses. Categorizing depression into homogeneous subgroups can unveil hidden insights.

Methods

This study utilized the Harmonized CHARLS dataset to investigate. Latent Profile Analysis (LPA) was employed to identify subgroups of older adult's spouses who experience depression, and chi-square tests were conducted for univariate analysis. Furthermore, multiple logistic regression was utilized to analyze the associated factors.

Results

Spouse caregivers were identified and classified as Low Level Depression (50.6%), High Level Depression (20.0%), and Unstable Affective Depression (29.4%). Gender, education level, self-assessment of health, communication with children, social participation, life satisfaction, and place of residence were found to be influential factors for depression among older adults spouse caregivers. Multiple logistic regression analysis indicated that, compared to individuals with low levels of depression, those with high levels were significantly associated with gender, education level, self-assessed health status, social engagement, life satisfaction, and place of residence. Similarly, compared to individuals with low levels of depression, those classified as having an unstable affective type were significantly associated with gender, education level, self-assessed health status, and life satisfaction. Furthermore, compared to individuals with high levels of depression, those with unstable affective depression were significantly associated with gender, self-assessed health status, weekly interactions with children, and participation in social activities.

Conclusion

This study revealed distinct subtypes of depression among older adults spousal caregivers, emphasizing the importance of targeted interventions in primary care. Tailored intervention strategies addressing the specific characteristics of each subtype may improve caregivers' mental health and enhance their quality of life.

Exploring the active components and potential mechanisms of Zhimu-Huangbai herb-pair in the treatment of depression

BACKGROUND

The Zhimu-Huangbai herb-pair (ZB) is commonly used to treat depression. Previous research has verified that ZB is effective as an antidepressant. Nevertheless, its active components and potential mechanism still require further elucidation.

PURPOSE

This study aims to analyze the compounds of ZB penetrating into the brain using UPLC-MS and investigate the potential mechanisms of ZB in the treatment of depression through in vivo and in vitro experiments.

METHODS

The compounds of ZB that penetrate into the brain were identified using the UPLC-MS method. Network pharmacology analysis was employed to predict the therapeutic targets and mechanisms of the compounds of ZB in the brain for the treatment of depression. Subsequently, the molecular docking method was used to analyze the binding between active compounds and target proteins. Rat depression models induced by CUMS were used to investigate the impact of ZB on depression. Finally, the mechanism of ZB treatment for depression was investigated using the LPS-induced BV2 cell inflammation model.

RESULTS

A total of 17 compounds were identified in ZB that crossed the blood-brain barrier (BBB). The network pharmacological analysis showed that the anti-depressant mechanism of ZB is closely related to inflammatory cytokines, including TNF and IL-6. Furthermore, KEGG and PPI analyses demonstrated that ZB regulates the microglia M1/M2 phenotypic polarization by modulating inflammation-related pathways. ZB was found to improve depression-like behavior in vivo. The molecular docking indicated that the compounds in ZB that penetrate into the brain have a strong binding ability to RELA and PPAR-γ. ZB inhibited the expression of p-p65 and increased the expression of PPAR-γ in the mPFC. By rebalancing the ratio of pro-inflammatory/anti-inflammatory cytokines, ZB was able to reduce neuroinflammation in the mPFC and hippocampus regions. The immunofluorescence results showed that ZB-containing serum reduced M1 polarization induced by LPS in BV2 cells.

CONCLUSION

This study reveals that ZB effectively alleviates depression by regulating the M1/M2 phenotypic polarization of microglial cells. The mechanism may be that the active compounds of ZB reduce M1 phenotypic polarization by inhibiting P65 and increase M2 phenotypic polarization by promoting PPARγ.

Associations of suicidal behaviors with body weight and body weight perception in Chinese adolescents: 2007-2022

PURPOSE

To estimate the time trend in the prevalence of suicidal behaviors including ideation and attempts in Chinese adolescents; to examine the association between suicidal behaviors and overweight (OW)/obesity (OB) and self-perceived weight status.

METHODS

Data from Youth Risk Behavior Surveys conducted in Ningbo in 2007, 2012, 2017 and 2022 were used for the study. A multistage sampling procedure was used to select respondents aged 12 to 19 years who participated in each survey. Repeated cross-sectional data of anthropometry, weight perception and suicidal behaviors were collected through self-administered questionnaires. A generalized linear model was used to assess associations of ideation and attempts, and weight status and self-perceived weight status.

RESULTS

The sample sizes for each survey wave were 937, 889, 1528 and 2655. The prevalence of ideation increased from 11.95% in 2007 to 18.15% in 2022, while the prevalence of attempts remained stable (4.48%-4.26%). An increasing trend in ideation and attempts was found in adolescents who were OW/obese and self-perceived OW/OB from 2007 to 2022. Self-perceived OW/OB adolescents had a significant increase in ideation. Girls had higher likelihood of ideation and attempts for both weight status and self- perceived weight status. While, adolescents aged 12.0-15.9 years had higher odds of ideation than those aged 16.0-19.9 years.

CONCLUSION

Adolescents' self-weight perception, rather than actual weight status, is a critical risk factor of increased likelihood of ideation and attempts in Chinese adolescents. Our findings can support to promote self-esteem growth in school-based health education programmes for prevention of suicidality and psychological health problems.

The Golden Year? Early Intervention Yields Superior Outcomes in Chronic Pelvic Pain with Pudendal Neuralgia: A Comparative Analysis of Early vs. Delayed Treatment

BACKGROUND

Chronic pelvic pain (CPP) associated with pudendal neuralgia (PN) significantly impacts quality of life (QoL). Pudendal nerve infiltration is a recognized treatment, but the optimal timing of intervention remains unclear.

METHODS

This prospective study included 81 patients diagnosed with PN and treated with pudendal nerve infiltrations. Outcomes were assessed using the Visual Analog Scale (VAS), Spanish Pain Questionnaire (CDE-McGill), and the SF-12 health survey. Significant improvement was defined as a VAS reduction > 4 points and a QoL increase > 15 points. An ROC curve analysis identified a 13-month time-to-treatment threshold (sensitivity 78%, specificity 72%), categorizing patients into early (n = 27) and delayed treatment groups (n = 54).

RESULTS

The early treatment group showed significantly greater reductions in VAS scores (5.4 vs. 3.4 points, p < 0.01) and QoL improvements (18 vs. 8 points, p < 0.01) compared to the delayed group. Early intervention reduced reinfiltration rates (10% vs. 35%, p < 0.05) and decreased medication use, with 81% discontinuing gabapentin compared to 41% in the delayed group. Similar trends were observed for tryptizol (44% vs. 35%) and tramadol (74% vs. 30%). Multivariate analysis confirmed time to treatment as the strongest predictor of outcomes, with each additional month delaying treatment associated with a 0.18-point increase in final VAS scores (p < 0.001). Delayed treatment was linked to higher final doses of gabapentin (p = 0.01), dexketoprofen (p < 0.001), and tramadol (p = 0.012). Minimal complications were reported (15%, Clavien I).

CONCLUSIONS

Early intervention in PN significantly improves pain, QoL, and reduces reinfiltration and medication reliance, supporting timely treatment for optimal outcomes.

Association analysis of suicide risk assessed with Mini International Neuropsychiatric Interviews' Suicidality Module in adolescents with non suicidal self injury disorder

Objective

Many adolescents with non suicidal self injury disorder have suicidal ideation. However, the specific characteristics of adolescents with NSSI-D that contribute to high suicide risk remain unclear. This study observes the association between depressive and anxiety symptoms and suicide risk among adolescents with non suicidal self injury disorder, and explores the mechanism underlying the high risk of suicide in this population.

Method

Adolescents with non suicidal self injury disorder and their parents from a psychiatric outpatient clinic were selected to conduct paper questionnaires to measure their sociodemographic conditions. The Mini International Neuropsychiatric Interviews' Suicidality Module(MINISM) was used to assess suicide risk of participants. The Self-Rating Depression Scale(SDS), Self-Rating Anxiety Scale(SAS), and Piers-Harris Children's Self-Concept Scale(PHCSS) were used to measure depressive and anxiety symptoms, and self-concept of adolescents with non suicidal self injury disorder. According to the high suicide risk cutoff value of MINISM, the sample was divided into high suicide risk group and non-high suicide risk group. We performed descriptive and correlation statistical and network analysis to study the types of depressive and anxiety symptoms associated with suicide risk and the mechanism underlying suicide risk among non suicidal self injury disorder adolescents.

Results

A total of 112 non suicidal self injury disorder adolescent participants were included in this study. Severe depressive symptoms(OR=8.205, 95%CI=3.454-19.490) and severe anxiety symptoms(OR=3.926, 95%CI=1.613-9.554) are associated with a high risk of suicide. The father's college/university education(p<0.01) is associated with severe anxiety symptoms, and low self-concept(p<0.01) is associated with severe depressive symptoms. Network analysis suggests the centrality of anxiety symptoms and father's education level.

Conclusion

The results of statistical analysis suggest that severe depressive symptoms are related to the high risk of suicide (based on MINISM) in adolescents with NSSI-D statistical significantly, and anxiety symptoms and low self-concept are associated with depressive symptoms in NSSI-D adolescents. Interventions targeting anxiety symptoms in adolescents with NSSI-D may help reduce their suicide risk.

Interactions between ABC gene polymorphisms and processing speed in predicting depression severity

BACKGROUND

ABC family genes encode ATP-binding cassette proteins, which are involved in the transport of various substances and are associated with major depressive disorder (MDD); however, their clinical significance in MDD remains unclear. Therefore, this study aimed to investigate whether ABC family genes are associated with cognitive function, and the combined effects of genes and cognitive function on the severity of depression.

METHOD

Linear models or logistic regression models were used to investigate the associations of ABC family gene variants with clinical symptoms and cognitive function in 805 MDD patients (12-65 years old) and 1493 age-matched healthy controls (HCs). Seven single nucleotide polymorphisms (rs28401781, rs4148739, rs3747802, rs1109866, rs1109867, rs3731885, and rs3755047) of ABCB1 and ABCB6 were selected. The cognitive function was assessed by the Wisconsin Card Sorting Test (WCST), Tower of Hanoi Test (TOH), Trail Making Test (TMT), and Verbal Fluency Test (VF).

RESULTS

Significant differences in gene frequency and genotype frequency were observed at the rs1109866 (X2 = 8.22, p = 0.004; X2 = 9.82, p = 0.007) and rs1109867 (X2 = 7.35, p = 0.007; X2 = 9.15, p = 0.010) between MDD patients and HCs, even after correction. While rs28401781 (t = 2.78, p = 0.006) and rs4148739 (t = 3.08, p = 0.003) were associated with the TOH test. And both rs1109866 and rs1109867 interacted with TMT results to influence depression severity in MDD patients.

CONCLUSION

The results suggest that ABC family genes influence the severity of depression through cognitive functioning, providing possible evidence for genetic markers in MDD patients.

Time perception and suicidal ideation during COVID-19 pandemic: A longitudinal study

BACKGROUND

There are several reports of disruptions in time perception during lockdown periods throughout the COVID-19 pandemic. Our aim was to study the role of subjective flow of time (SFT) in the triggering of suicidal ideation in patients with a history of suicide attempt (SA), as compared with affective controls without such history (AC).

METHODS

This study involved 296 psychiatric patients that were assessed five times between 2020 and 2021. We analyzed the SFT using a mixed logistic model and characterized SFT during significant periods of governmental restrictions. Multivariate logistic regressions were used to identify independent SFT characteristics. We evaluated the association between SFT and suicidal ideation, considering interactions with depression, insomnia, loneliness, and social support.

RESULTS

The findings revealed a significant alteration in SFT, closely linked to the implementation and easing of governmental restrictions. During the initial lockdown, SA exhibited lower SFT levels compared to AC. Furthermore, the relationship between SFT and suicidal ideation was influenced by depression. In the interim period between lockdowns, SFT's impact on suicidal ideation was mediated by insomnia.

DISCUSSION

Disturbances in SFT could be related to adaptability to lockdown conditions or may be a coping mechanism with depression, insomnia, suicidal ideation and overall psychological distress. Understanding the interplay of SFT with these factors provides crucial insights into the complex psychological mechanisms involved.

Relationship Between Sleep Time and Depressive Symptoms in Middle-Aged and Elderly Chinese: Mediating Role of Body Pain

Objective

Existing research has yet to adequately examine the correlation between sleep time, body pain, and depressive symptoms. This study seeks to elucidate the interconnections between these three elements.

Methods

The study used 2020 CHARLS data for analysis. To assess the intricate association among sleep time, body pain, and depressive symptoms, the study employed Spearman correlation analysis, multiple logistic regression, restricted cubic splines, and mediation effect analysis based on bootstrap testing.

Results

Risk factors for depressive symptoms in middle-aged and elderly Chinese include physical pain and reduced sleep duration. Results from the RCS suggest that the lowest risk of depressive symptoms occurs when the sleep time for the middle-aged and elderly population is approximately 7.5 hours. Body pain accounts for a 19.05% mediating effect between sleep time and depressive symptoms, and even after controlling confounding factors, there remains a 7.5% mediating effect.

Conclusion

The research findings indicate that there is a significant correlation among sleep time, body pain, and depressive symptoms. Insufficient sleep time and body pain can lead to depressive symptoms. Body pain plays a partial mediating role between sleep time and depressive symptoms.

ABC Family Gene Polymorphisms and Cognitive Functions Interact to Influence Antidepressant Efficacy

INTRODUCTION

The importance of identifying relevant indicators of antidepressant efficacy is highlighted by the low response rates to antidepressant treatment for depression. The ABC gene family, encoding ATP-dependent transport proteins facilitating the transport of psychotropic drugs, has drawn attention. This study delved into the relationship between antidepressant efficacy and seven single nucleotide polymorphisms of ABCB1 and ABCB6 genes.

METHODS

A total of 549 depressed patients participated in the study, and all completed a 6-week course of antidepressant treatment. Cognitive function was assessed at baseline and post-treatment. Patients were categorized based on post-treatment HAMD-17 scores (with HAMD≤7 indicating remission), and comparisons were made between different groups in terms of allelic gene frequencies and genotypes. Logistic regression was used to explore the interaction between cognitive function and genotype on efficacy. Dual-luciferase reporter assays were performed to compare the regulatory effects of rs1109866 allele variants on the ABCB6 promoter.

RESULTS

There were no notable differences in allelic gene frequencies and genotypes between the remission and non-remission groups. Nonetheless, a significant interaction was identified between the rs1109866 genotype and language fluency-related indicators concerning efficacy (p=0.029) before correction. The dual-luciferase reporter assays demonstrated markedly higher fluorescence intensity of rs1109866-C compared to that of rs1109866-T (p<0.001).

DISCUSSION

Relying solely on genetic polymorphisms of ABC family genes as predictors of antidepressant treatment response may not be sufficient. However, the interaction between the rs1109866 and cognition plays a pivotal role. The potentially enhanced transcriptional activity of rs1109866-C might offer insight into its impact on antidepressant efficacy.

Pathological mechanisms of glial cell activation and neurodegenerative and neuropsychiatric disorders caused by Toxoplasma gondii infection

Toxoplasma gondii is an intracellular opportunistic parasite that exists in a latent form within the human central nervous system (CNS), even in immune-competent hosts. During acute infection, T. gondii traverses the blood-brain barrier (BBB). In the subsequent chronic infection phase, the infiltration of immune cells into the brain, driven by T. gondii infection and the formation of parasitic cysts, leads to persistent activation and proliferation of astrocytes and microglia. This process results in neuronal damages that are fatal in some cases. Through inducing systemic immune responses, T. gondii infection can dramatically alter the behavior of rodents and increase the risk of various neuropsychiatric disorders in humans. In this review, we explore some recent research progress on the major events involved in BBB disruption, glial cell activation and neuronal damage following T. gondii infection in hosts. It further discusses potential pathological mechanisms and the feasible treatment approaches for the neurodegenerative and neuropsychiatric disorders caused by T. gondii infection to extend our understanding for pathogenesis and preventive control of toxoplasmosis in humans.

The association among multiple-site chronic pain, sedentary behavior, and major depressive disorders: a mendelian randomization study

OBJECTIVE

Observational studies have reported that major depressive disorder (MDD) is associated with sedentary behavior (SB) and multiple chronic pain (MCP), but their associations remain unclear. Mendelian randomization analysis was used to assess the association.

METHODS

Single nucleotide polymorphisms (SNPs) associated with MCP, SB [time spent watching television (Tel), using a computer (Com), or driving (Dri)], and MDD were collected from genome-wide association studies and screened as instrumental variants with a threshold of 1 × 10 -5 . Mendelian randomization was performed to examine their associations. Sensitivity analyses were conducted to evaluate robustness.

RESULTS

MCP was associated with a higher risk of MDD [odds ratio (OR) inverse variance weighting (IVW)  = 1.88; 95% confidence interval (CI), 1.64-2.15; P  = 4.26 × 10 -8 ), and causally related to SB (Tel: OR IVW  = 1.23; 95% CI, 1.19-1.26; P  = 6.02 × 10 -38 ) (Dri: OR IVW  = 1.05; 95% CI, 1.03-1.08; P  = 3.92 × 10 -5 ). Causality of SB on MCP was detected for Tel (OR IVW  = 1.46; 95% CI, 1.39-1.53; P  = 1.40 × 10 -54 ) and Com (OR IVW  = 0.88; 95% CI, 0.83-0.93; P  = 2.50 × 10 -6 ). No association was observed for SB on MDD. There is currently insufficient evidence to support that leisure activities are a mediating factor in MCP-induced MDD.

CONCLUSION

There are complex relationships among MCP, SB, and MDD. More research and learning about potential relationships and mechanisms among these phenotypes should be supplied.

Dysfunctional attitudes, social support, negative life events, and depressive symptoms in Chinese adolescents: A moderated mediation model

BACKGROUND

Depression is a prevalent psychological issue in adolescents that is significantly related to negative life events (NLEs) and dysfunctional attitudes. High levels of social support can significantly buffer NLEs' effect on depression. Currently, there is limited research on how social support moderates the relationship between NLEs, dysfunctional attitudes, and depression in adolescents in China. It is imperative to investigate this moderating effect to mitigate dysfunctional attitudes in adolescent undergoing depressive mood, ultimately enhancing their overall mental health.

AIM

To investigate the relationship and underlying mechanisms between specific dysfunctional attitudes, social support, and depression among Chinese adolescents.

METHODS

This is a cross-sectional study which selected five middle schools in Shandong Province for investigation in March 2022. Participants included 795 adolescents (49.87% male, mage = 15.15, SD = 1.84, age range = 11-18 years old). All participants completed the Dysfunctional Attitude Scale, Adolescent Life Event Scale, Beck Depression Inventory, and Social Support Rating Scale. A moderated mediation model was conducted to examine the relationship between specific dysfunctional attitudes, social support, and depression.

RESULTS

Results indicated that NLEs affected depression through the mediating role of specific dysfunctional attitudes (autonomy attitudes β = 0.21; perfectionism β = 0.25). Moreover, social support was found to moderate the mediating effect between NLEs, specific dysfunctional attitudes, and depressive symptoms (autonomy attitudes b2 = -0.08; perfectionism b2 = -0.09).

CONCLUSION

Dysfunctional attitudes mediated and social support moderated the relationship between NLEs and depression. Social support can buffer depression symptoms among adolescents with autonomy attitudes and perfectionism.

Suboptimal health among Chinese middle school students may be associated with psychological symptoms and sleep duration: a cross-sectional survey in China

BACKGROUND

Suboptimal health status (SHS) is an intermediate status between ideal heath and illness, it is characterized by the perception of health complaints, general weakness, decreased immunity and low energy. An increasing number of Chinese middle school students are suffering from psychological symptoms (PS), particularly anxiety and depression. The relationship between SHS and PS is unclear in adolescents. This study aimed to investigate the prevalence of SHS and the correlation between SHS and PS among Chinese middle school students and to identify the SHS-related risk factors from the perspective of public health.

METHODS

A cross-sectional study was conducted with the cluster sampling method among 1955 middle school students in Shantou, China. SHS was assessed by Suboptimal Health Status Questionnaire-25 (SHSQ-25). And the PS of anxiety and depression were assessed with Generalized Anxiety Disorder Scale (GAD-7) and Beck Depression Inventory-II Scale (BDI-II) self-assessment questionnaires. Variate logistic analysis was applied to explore risk factors of SHS. The relationship between SHS and PS among Chinese middle school students was subsequently analyzed.

RESULTS

Among the 1955 participants, 1904 middle school students were finally included in the analysis, the effective response rate was 97.39%. The prevalence of SHS was 10.3% (197/1904) while the prevalence of anxiety and depression was 30.7% (585/1904) and 34.1% (649/1904), respectively. A strong correlation was identified between SHS and PS among middle school students. With the aggravation of anxiety and depression, the probability of suffering from SHS increased (both P<0.01). The scores for various dimensions of SHS among the depression and anxiety groups were higher compared to those of the non-depression and non-anxiety groups (all P<0.01 ). Multivariate regression showed that compared with sleeping less than six hours, 6-8 h is a protective factor for SHS (OR = 0.486, 95%CI = 0.278-0.851).

CONCLUSIONS

Attention should be given to SHS and PS in Chinese middle school students, as they are strongly associated. Lack of sleep is a risk factor for SHS, so sufficient sleep should be recommended to prevent it. Identifying additional risk factors and promoting adequate sleep will improve adolescent health.

Risk factors and prognosis of depression in Takayasu arteritis patients

Background

Takayasu arteritis (TA) is associated with an increased risk of developing complicated comorbidities, which can bring both psychological and physical burdens to the patients.

Objective

TA is found to carry a high risk of developing depression. This research aimed to investigate the risk factors and prognosis of depression in TA patients.

Design

A longitudinal observation cohort was conducted on TA patients with or without depression to explore the clinical characteristics.

Methods

In this cohort study, 90 TA patients were split into two groups with or without depression. Depression was evaluated by the Hospital Anxiety and Depression Scale (HADS) in TA patients. TA patients with depression were followed up for at least 3 months. We used multivariate logistic regression analysis to find the risk factors and Kaplan-Meier curve analysis to determine the prognosis.

Results

We concluded 90 TA patients in this research, 29 of whom were in depression. Indian Takayasu's Arteritis Activity Score (ITAS2010) ⩾2 (odds ratio (OR) (95% confidence interval, CI) 26.664 (2.004-354.741), p = 0.013), interleukin-6 (IL-6) (OR (95% CI) 1.070 (1.022-1.121), p = 0.004), prednisone equivalents (OR (95% CI) 1.101 (1.030-1.177), p = 0.005), and carotidynia (OR (95% CI) 5.829 (1.142-29.751), p = 0.034) have been shown independent risk factors for depression in TA patients. We also identified the association between disease remission with the improvement of HADS-D score (Log-rank p = 0.005, hazard ratio (HR) 0.25) and depression (Log-rank p = 0.043, HR 0.28).

Conclusion

Aggressive treatment to achieve remission can promote improvement of depression in patients with TA. Screening for depression should also be performed in patients with elevated disease activity, IL-6, glucocorticoid use, and carotidynia.

Association between adolescent depression and adult suicidal behavior: A systematic review and meta-analysis

This meta-analysis aims to estimate the association between adolescent depression and adult suicidal behavior, while systematically evaluating gender differences reported in literature. A random-effects model was used to determine the pooled association, reporting odds ratios (ORs) with corresponding 95 % confidence intervals (CIs). Nine articles comprising over 6084 adolescents together showed that people with a history of depression in adolescence are more likely to gain suicidal behaviors during adulthood (OR = 3.97, 95 % Cl: 2.79, 5.63). Sex-specific analysis indicated that males who experienced depression in adolescence developed a higher incidence of suicidal behavior in adulthood compared to females with a similar history (Males: OR = 3.61, 95 % Cl: 1.02, 12.78; Females: OR = 3.56, 95 % Cl: 1.71, 7.43). Furthermore, suicide attempts emerged as the predominant outcome among various suicidal behaviors (OR = 3.43, 95 % Cl: 1.75, 6.71). This meta-analysis provides robust evidence that depression in adolescence significantly increases the risk of suicidal behavior in adulthood.

Suicidal behaviors among refugee women in Jordan: post-traumatic stress disorder, social support and post-displacement stressors

BACKGROUND

This paper examines the frequency of suicidal behaviors (suicidal ideation or attempt) among a sample of Syrian refugee women living in non-camp settings in Jordan. We asked several questions surrounding suicide and examined the associations between post-traumatic stress disorder (PTSD), social connectedness, post-displacement stressors and suicidal behaviors.

METHODS

Participants (n = 507) were recruited using a clinic-based systematic sampling from four health clinics throughout Jordan in 2018. We used a multivariable logistic regression to examine the hypothesis of whether positive screening for PTSD (PCL-5), social isolation (have no friends or family members available to help), and greater number of post-displacement stressors (PMLD Checklist) is associated with suicidal behaviors.

RESULTS

Approximately one-tenth (9.86%) of participants surveyed reported suicidal behaviors (suicidal ideation or attempt) in the past six months. Our hypothesis was partially supported. In the adjusted multivariable analyses, screening positive for PTSD [OR:4.02 (95% CI:1.33, 12.15)] increased odds of suicidal behaviors, while having one friend or family member available to help when in need [OR:0.31 (95% CI:0.13, 0.78)] decreased odds of suicidal behaviors. We did not find any associations between the number of post-displacement stressors and suicidal behaviors in the multivariable model.

CONCLUSION

Agencies and practitioners addressing suicidal behaviors among Syrian refugee women should provide interventions that aim to reduce PTSD symptoms and social isolation. Potential intervention includes screening for mental health symptoms and suicidal behaviors during routine visits with service providers, as well as providing proper mental health and psychosocial support services according to the mapping of available services.

Using Multimodal Assessments to Reevaluate Depression Designations for Spine Surgery Candidates

BACKGROUND

Depression is common in spine surgery candidates and may influence postoperative outcomes. Ecological momentary assessments (EMAs) can overcome limitations of existing depression screening methods (e.g., recall bias, inaccuracy of historical diagnoses) by longitudinally monitoring depression symptoms in daily life. In this study, we compared EMA-based depression assessment with retrospective self-report (a 9-item Patient Health Questionnaire [PHQ-9]) and chart-based depression diagnosis in lumbar spine surgery candidates. We further examined the associations of each depression assessment method with surgical outcomes.

METHODS

Adult patients undergoing lumbar spine surgery (n = 122) completed EMAs quantifying depressive symptoms up to 5 times daily for 3 weeks preoperatively. Correlations (rank-biserial or Spearman) among EMA means, a chart-based depression history, and 1-time preoperative depression surveys (PHQ-9 and Psychache Scale) were analyzed. Confirmatory factor analysis was used to categorize PHQ-9 questions as somatic or non-somatic; subscores were compared with a propensity score-matched general population cohort. The associations of each screening modality with 6-month surgical outcomes (pain, disability, physical function, pain interference) were analyzed with multivariable regression.

RESULTS

The association between EMA Depression scores and a depression history was weak (r rb = 0.34 [95% confidence interval (CI), 0.14 to 0.52]). Moderate correlations with EMA-measured depression symptoms were observed for the PHQ-9 (r s = 0.51 [95% CI, 0.37 to 0.63]) and the Psychache Scale (r s = 0.68 [95% CI, 0.57 to 0.76]). Compared with the matched general population cohort, spine surgery candidates endorsed similar non-somatic symptoms but significantly greater somatic symptoms on the PHQ-9. EMA Depression scores had a stronger association with 6-month surgical outcomes than the other depression screening modalities did.

CONCLUSIONS

A history of depression in the medical record is not a reliable indication of preoperative depression symptom severity. Cross-sectional depression assessments such as PHQ-9 have stronger associations with daily depression symptoms but may conflate somatic depression symptoms with spine-related disability. As an alternative to these methods, mobile health technology and EMAs provide an opportunity to collect real-time, longitudinal data on depression symptom severity, potentially improving prognostic accuracy.

LEVEL OF EVIDENCE

Diagnostic Level III . See Instructions for Authors for a complete description of levels of evidence.

A bibliometric analysis of research on psychedelics for depression treatment

Psychedelics, as a class of potent psychoactive substances, significantly alter sensory perception and mood, thereby profoundly impacting cognition. Increasing evidence indicates that psychedelics can facilitate individual social function and rapidly and sustainably improve symptoms of moderate and severe depression. The growing interest in psychedelics as potential treatments for depression has led to a substantial increase in related publications; however, the overall quantity and quality of these works remain unclear. To address this issue, we conducted a bibliometric analysis of literature on psychedelic drugs for depression published between 2004 and October 2023. Our study meticulously collected 710 publications, allowing for a comprehensive analysis of bibliographic elements such as annual publication trends, authorship, country of origin, institutional affiliations, journals, and keywords. By visualizing trends, emerging frontiers, popular topics, author collaborations, and influential factors in the field of psychedelics for depression, we have enhanced our understanding of advancements in this area. On this basis, we assert that the regulation of psychedelic drugs is necessary, but it should not hinder the scientific research progress.

Psychological Risk Factors in the Transition from Suicidal Ideation to Suicidal Behavior in Young Adults

Background: Suicidal behaviour, defined as acting with the intention of killing oneself and thinking about doing so, is a serious public health problem. Being able to list the risk factors in the process from suicidal ideation to suicidal behaviour is important in preventing suicide. Objectives: The study was conducted to examine the psychological variables that discriminate between individuals who attempt suicide and those who only have suicidal ideation. Methods: The sample of the study consisted of 108 individuals who attempted suicide and 197 individuals with suicidal ideation, aged 18-25 years. Data were collected using the Demographic Information Form, Anger/Impulsivity (A/I) and Hopelessness/Loneliness (H/L) subscales of the Suicide Probability Scale (SPS), Psychological Pain Scale (PPS), State and Trait Anxiety Scale (STAS), Beck Depression Inventory (BDI), Interpersonal Needs Questionnaire (INQ), Acquired Suicide Efficacy/Death Fearlessness Scale (ASE/DFS) and General Attitudes and Beliefs Scale Short Form (GABS-SF). Results: Results showed that anger/impulsivity (Wald = 4.827; p < 0.05), perceived burden on others (Wald = 8.613; p < 0.05), acquired suicide efficacy/death fearlessness (Wald = 13.377; p < 0.001), being female (Wald = 3.925; p < 0.05), presence of diagnosed psychiatric illness in the family (Wald = 5.705; p < 0.05), and receiving psychological support (Wald = 4.381. p < 0.05) variables are significant predictors of the transition from suicidal ideation to suicidal action. Conclusions: The identification of psychological factors between suicide attempters and suicide ideation groups may guide clinicians in the follow-up and treatment of individuals at risk of attempting suicide. In addition, the results may contribute to the development of new intervention, education and treatment programmes for suicide.

The pain and relief of grief: Mental pain and mental pain acceptance associations with post-loss pathologies and growth among young widows and widowers

Mental pain is a core symptom of bereavement, yet its study with grief pathologies is still scarce. Mental pain acceptance may also affect the associations between mental pain, grief pathologies, and post-loss growth (PLG). The current study aims to investigate the associations between mental pain, mental pain acceptance, and post-loss outcomes in a sample of young widow(er)s. 257 young Israeli widow(er)s completed questionnaires assessing mental pain, mental pain acceptance, depression, complicated grief (CG), suicidal risk and PLG. Paths analyses revealed that depression mediated the positive associations between mental pain and suicidal risk and CG, and mental pain acceptance moderated the positive association between mental pain and depression. Mental pain acceptance also moderated the negative association between mental pain and PLG. The study's findings highlight the crucial role of mental pain and mental pain acceptance in the associations between adverse and favorable post-loss outcomes among bereaved individuals.

Alpha oscillation mediates the interaction between suicide risk and symptom severity in Major Depressive Disorder

Objective

The aim of our study was to explore the relationship between changes in neural oscillatory power in the EEG, the severity of depressive-anxiety symptoms, and the risk of suicide in MDD.

Methods

350 MDD patients' demographic and clinical data were collected, and their depressive and anxious symptoms were evaluated using HDRS-17 and HAMA-14, along with a suicide risk assessment using the Nurses' Global Assessment of Suicide Risk (NGASR). EEG data were captured, processed, and analyzed to study brain activity patterns related to MDD. The participants were divided based on suicide risk levels, and statistical analyses, including chi-square, t-tests, Pearson's correlations were used to explore the associations between brain activity, symptom severity, and suicide risk. Closely related variables were identified and ultimately the optimal model was screened using stepwise regression analysis with a forward strategy, and mediation effects were further used to determine the possible interactions between the variables in the regression model.

Results

The regression model showed a significant effect of HDRS-17 and alpha power of Medial Occipital Cortex (MOC) on suicide risk, with elevated HDRS-17 increasing suicide risk and elevated alpha power decreasing suicide risk. Mediation effect analyses showed that MOC alpha power partially mediated the effect of depression level on suicide risk, and that an increase in depression severity may lead to a decrease in MOC alpha power, while a decrease in MOC alpha power may lead to an increase in suicide risk.

Conclusion

The severity of depression directly increases suicide risk, whereas higher alpha power in the MOC serves as a protective factor, reducing this risk. Notably, MOC alpha power not only directly impacts suicide risk but also mediates the effects of both depression severity and anxiety levels on this risk.

Limitations

The relatively small sample size of this study may limit the representativeness of the overall MDD patient population and the detailed analysis of different subgroups. This study did not delve into the relationship between the severity of cognitive symptoms in MDD patients and suicide risk.

The forensic aspects of suicide and neurotrophin factors: a research study

Introduction: Suicide represents a significant public health problem whose neurobiology is not yet fully understood. In many cases, suicidal behavior and psychiatric spectrum disorders are linked, in particular, to major depression. An emerging pathophysiological hypothesis underlines the role of neurotrophic factors, proteins involved in neurogenesis, in synaptic plasticity in response to stressors. Our research aims to evaluate the degree of expression of brain neurotrophic factor (BDNF) in brain areas involved in depressive disorder in suicidal subjects. Furthermore, we want to evaluate the expression of glial cell line-derived neurotrophic factor (GDNF) in suicidal subjects. Methods: We selected twenty confirmed cases of suicide among subjects with a clinical history of depressive pathology and possible psychopharmacological treatment, compared to ten controls of individuals who died of non-suicidal causes. For all selected cases and controls, immunohistochemical investigations were performed using a panel of antibodies against the BDNF and GDNF antigens on samples from the various brain areas. Results and discussion: The results show that BDNF was under-expressed in the cerebral parenchyma of subjects who died by suicide compared to controls, while there was an overexpression of GDNF in suicide victims, these data could be useful for a clinical application as potential markers for suicidal risk, to assess the severity of depression and development of specific pharmacological therapies for depression.

Unveiling the interoception impairment in various major depressive disorder stages

BACKGROUND

The intricate pathophysiological mechanisms of major depressive disorder (MDD) necessitate the development of comprehensive early indicators that reflect the complex interplay of emotional, physical, and cognitive factors. Despite its potential to fulfill these criteria, interoception remains underexplored in MDD. This study aimed to evaluate the potential of interoception in transforming MDD's clinical practices by examining interoception deficits across various MDD stages and analyzing their complex associations with the spectrum of depressive symptoms.

METHODS

This study included 431 healthy individuals, 206 subclinical depression individuals, and 483 MDD patients. Depressive symptoms and interoception function were assessed using the PHQ-9 and MAIA-2, respectively.

RESULTS

Interoception dysfunction occurred in the preclinical phase of MDD and further impaired in the clinical stage. Antidepressant therapies showed limited efficacy in improving interoception and might damage some dimensions. Interoceptive dimensions might predict depressive symptoms, primarily enhancing negative thinking patterns. The predictive model based on interoception was built with random split verification and demonstrated good discrimination and predictive performance in identifying MDD.

CONCLUSIONS

Early alterations in the preclinical stage, multivariate associations with depressive symptoms, and good discrimination and predictive performance highlight the importance of interoception in MDD management, pointing to a paradigm shift in diagnostic and therapeutic approaches.

Exploring the Relationship between Self-Compassion and Psychological Pain: A Canonical Correlation Analysis

This study investigated the association between self-compassion and psychological pain across various demographic variables. Using canonical correlation analysis, we observed an inverse relationship between the combined factors of the Self-Compassion Scale (SCS) and the Orbach and Mikulincer Mental Pain Scale (OMMP-8). Subgroup analyses revealed differences in SCS subscales among demographic groups with females, individuals with mental health diagnoses, and non-athletes displaying higher scores on negative SCS subscales and PsyPn. Injury status did not significantly affect self-compassion levels, although injured individuals scored higher on the irreversibility subscale of PsyPn. Negative SCS factors exhibited larger group differences and stronger correlations with PsyPn, indicating the potency of negative thinking in influencing psychological pain. These findings underscore the importance of self-compassion in mental health and suggest potential implications for intervention strategies.

Association between weekend catch-up sleep and depression of the United States population from 2017 to 2018: A cross-sectional study

Insufficient sleep on weekdays has become a societal norm, and studies have shown that sleep deprivation increases the risk of depression. Although individuals often resort to weekend catch-up sleep (CUS) as a compensatory measure, the present evidence supporting its efficacy in mitigating the risk of depression is limited. This article attempts to explore the relationship between CUS and depression. In this study, a total of 5510 participants were included, characterized into two groups: nondepressed (n = 5051) and depressed (n = 459), with data extracted from the National Health and Nutrition Examination Survey (NHANES). Compared with people without CUS, those practicing CUS exhibited a significantly lower risk of depression (OR = 0.81, P = 0.048). In subgroup analysis, this reduction effect was only observed in males (OR = 0.70, 95 % CI 0.05 to 0.99, P = 0.04), middle-aged (>40, ≤60) (OR: 0.57, 95 % CI: 0.40 to 0.81, P = 0.002), married or living with parents (OR: 0.61, 95 % CI: 0.44 to 0.86, P = 0.004), groups with three or more family members (OR: 0.69, 95 % CI: 0.52 to 0.93, P = 0.01), and individuals without alcohol intake (OR: 0.24,95 % CI: 0.09 to 0.67, P = 0.006). Therefore, in the realm of depression treatment, doctors may consider advising patients to get adequate sleep on weekends as part of their overall treatment plan. At the same time, individuals can also choose weekend sleep as a proactive strategy for regulating their psychological status.

Mental Health Treatment Use, Perceived Treatment Need, and Reasons for Non-Use Among U.S. Adults with Serious Suicidal Thoughts During the COVID-19 Pandemic

Analyzing the 2021 National Survey on Drug Use and Health data with generalized linear models, we examined: (1) COVID pandemic-related and other correlates of mental health treatment use and unmet perceived treatment need among U.S. adults who experienced serious suicidal thoughts (N = 3,177); and (2) correlates of self-reported reasons for not receiving treatment. We found that 61% used any mental health treatment, and 48% of users and 37% of nonusers reported perceived treatment need. Significant correlates of treatment use were demographic factors, insurance, major depressive disorder, and illicit drug use disorder. Significant correlates of perceived treatment need were age 18-34, some college education, and major depressive episode. Perceived negative effect of the COVID pandemic on mental health was a significant factor for both treatment use and perceived need. The most frequent reasons for not getting treatment were the cost of treatment or lack of insurance and stigma-related concerns.

A control study on pain characteristics and influencing factors in patients with depressive disorders-based on a 5-year follow-up report from the epidemiological survey of mental disorders in Shandong Province, China

BACKGROUND

This study extends from the 2015 Shandong Province Epidemiological Survey of Mental Disorders in adults aged 18 and above. Over five years, it investigates pain characteristics and influencing factors in individuals with depressive disorders in Shandong Province.

METHODS

The study encompasses 871 individuals who met DSM-IV criteria for depressive disorders in 2015. Using 1:1:1 matching by gender, age, and residence, 825 non-afflicted individuals were selected as high-risk controls, and 825 screening-negative individuals became low-risk controls. A follow-up study in 2020 involved 1848 participants. Survey tools included a general information questionnaire, General Health Questionnaire-12 (GHQ-12), SCID-I/P, Global Pain Scale (GPS), Quality of Life Questionnaire (QLQ), PSQI, MoCA, and clinical data questionnaire.

RESULTS

GPS scores in the current depressive group were higher than in non-current depressive group (Z = 14.36, P < 0.01). GPS scores in study group exceeded those in high-risk and low-risk control groups (H = 93.71, P < 0.01). GPS scores in non-remission group were higher than in the remission group (Z = 8.90, P < 0.01). Regression analysis revealed positive correlations between GPS scores and physical illnesses, current depression, incumbency, GHQ-12 total score, and PSQI total score. Negative correlations were observed with QLQ total score and MoCA total score.

LIMITATIONS

The study could not assess pain during the 2015 survey, limiting controlled pain analysis before and after five years.

CONCLUSION

Depression sufferers may experience prolonged heightened pain, potentially relieved when depression subsides. Individual pain is influenced by depression, physical illnesses, sleep quality, quality of life, cognitive function, gender, residence, and occupation.

What differentiates suicidal ideation from depressive symptoms amongst Korean young adults aged 20-39 years?

This study aimed to examine and compare factors influencing depressive symptoms from those influencing suicidal ideation in Korean adults aged 20-39 years. Data were collected from September 15 to 23, 2021 using an online survey company because of the limitations of face-to-face surveys during the coronavirus 2019 pandemic. Participants were also recruited from the Seoul Suicide Prevention Center. Suicidal ideation, depressive symptoms, and general health and demographic characteristics were determined based on existing standardized questionnaires. Multiple logistic regression analysis was used to determine associations with depressive symptoms and suicidal ideation. Based on data from 1014 participants, age, sex, alcohol consumption, sleep duration, and stress were associated with depressive symptoms. In contrast, income, subjective health status, and stress were found to influence suicidal ideation; the effect of income disappeared when adjusted for depression. Lower income, poor subjective health status, higher stress levels, and depression were associated with a higher risk of suicidal ideation. These findings suggest that depression and suicidal ideation have distinct influencing factors and that simply viewing depression as a risk factor for suicidal ideation may lead to other important factors being overlooked.

Depression in older women who died by suicide: associations with other suicide contributors and suicide methods

Suicides among older women have received little research attention. In this study based on the 2017-2019 National Violent Death Reporting System data, we examined the prevalence of depression in older female suicide decedents (N = 3,061), associations between depression and other suicide precipitants, and the associations between suicide methods and depression. Descriptive statistics and generalized linear models (GLM) for a Poisson distribution with a log link were used to examine the research questions. Of the decedents, 15.0% had depressed mood without a reported diagnosis and 41.8% had a depression diagnosis. Nearly one-half of the decedents with reported depression were receiving mental health/substance use treatment at the time of injury. The likelihood of depression was lower among those who were age 85 and older compared to those were age 65-74, but higher among those who had anxiety disorder (IRR = 1.50, 95% CI = 1.33-1.69), history of suicidal ideation (IRR = 1.22, 95% CI = 1.10-1.35), history of suicide attempt (IRR = 1.27, 95% CI = 1.14-1.41), and bereavement problems (IRR = 1.45, 95% CI = 1.27-1.65). Those who had depression were less likely to have used firearms (IRR = 0.85, 95% CI = 0.75-0.97) but more likely to have used hanging/suffocation (IRR = 1.37, 95% CI = 1.13-1.67). The findings show that gun ownership was likely an important factor for firearm use. The high prevalence of depressed mood and/or depression diagnosis among older female suicide decedents at the time of their fatal injury underscores the importance of assessing depression and providing evidence-based depression treatment as an essential suicide prevention approach.

Association between thiamine intake and depression: A national cross-sectional study

BACKGROUND

Recent years have seen increasing attention to improving depressive symptoms through dietary intakes, yet the association between thiamine intake and depression remains unclear. The present study aimed to explore this association using data from an American cross-sectional study.

METHODS

We explored the association of covariates, exposure, and outcome with logistic regression equations. Multivariable regression models were performed to further exclude confounding factors. To investigate nonlinear relationships, we employed restricted cubic splines. Recursive algorithms were utilized to identify inflection points. Additionally, we conducted stratified analyses by age and sex to uncover differences among subgroups.

RESULTS

When all covariates were adjusted, the association between thiamine intake and depression was not statistically significant [0.93 (0.82, 1.07)]. In the linear trend test using Q1 as the reference, the ORs (95%CI) for Q2, Q3, and Q4 were 0.87 (0.73, 1.04), 0.83 (0.68, 1.00), and 0.92 (0.73, 1.16), which suggested that the association might be nonlinear. We then confirmed this nonlinear relationship with a restricted cubic spline, and the inflection point of 1.35 mg/day was calculated. Before the inflection point, the effect value of the relationship was 0.68 (0.53, 0.89). After the inflection point, no significant association was found [1.10 (0.92, 1.31)]. Stratified analyses revealed that this nonlinear relationship was consistent among women and individuals aged <60 years.

DISCUSSION

In this cross-sectional study among American general adults, we found a nonlinear association between thiamine intake and depression and further observed differences by age and sex.

Latent profile analysis of depression in US adults with obstructive sleep apnea hypopnea syndrome

Objective

This study used latent profile analysis to explore the level of depression among US adults with obstructive sleep apnea hypopnea syndrome (OSAHS) symptoms and to identify different latent categories of depression to gain insight into the characteristic differences between these categories.

Methods

The data of this study were obtained from the National Health and Nutrition Examination Survey (NHANES) database, and the subjects with OSAHS symptoms were aged 18 years and older. The latent profile analysis (LPA) method was used to fit the latent depression categories in subjects with OSAHS symptoms. The chi-square test, rank sum test, and binary logistic regression were used to analyze the influencing factors of depression subgroups in subjects with OSAHS symptoms.

Results

Three latent profiles were identified: low-level (83.7%), moderate-level (14.5%) and high-level (1.8%) depression. The scores of 9 items in the high-level depression group were higher than those in the other two groups. Among them, item 4 "feeling tired or lack of energy" had the highest score in all categories.

Conclusion

Depression in subjects with OSAHS symptoms can be divided into low-level, moderate-level and high-level depression. There are significant differences among different levels of depression in gender, marital status, PIR, BMI, smoking, general health condition, sleep duration and OSAHS symptom severity.

Identifying suicide attempter in major depressive disorder through machine learning: the importance of pain avoidance, event-related potential features of affective processing

How to achieve a high-precision suicide attempt classifier based on the three-dimensional psychological pain model is a valuable issue in suicide research. The aim of the present study is to explore the importance of pain avoidance and its related neural features in suicide attempt classification models among patients with major depressive disorder. By recursive feature elimination with cross-validation and support-vector-machine algorithms, scores from the measurements and the task-based EEG signals were chosen to achieve a suicide attempt classification model. In the multimodal suicide attempt classifier with an accuracy of 83.91% and an area under the curve of 0.90, pain avoidance ranked as the top one in the optimal feature set. Theta (reward positive feedback minus neutral positive feedback) was the shared neural representation ranking as the top one of event-related potential features in pain avoidance and suicide attempt classifiers. In conclusion, the suicide attempt classifier based on pain avoidance and its related affective processing neural features has excellent accuracy among patients with major depressive disorder. Pain avoidance is a stable and strong indicator for identifying suicide risks in both traditional analyses and machine-learning approaches. A novel methodology is needed to clarify the relationship between cognitive and affective processing evoked by punishment stimuli and pain avoidance.

The relationship between chronotype, psychological pain, problematic social media use, and suicidality among university students in Turkey

Chronotype has been extensively linked to various psychological outcomes, including suicide, which significantly impacts the mortality rate among young adults worldwide. Research on the extent of these links is still ongoing. This cross-sectional study aimed to explore the complex relationships between chronotype, internet addiction, problematic social media use (PSMU), psychological pain, and suicidality in a student population. A total of 571 Turkish students (65.3% female, mean age 20.3 ± 1.63 years) completed the following scales: the Suicide Probability Scale (SPS), the Mee-Bunney Psychological Pain Assessment Scale (MBPPAS), the Social Media Disorder Scale (SMDS), the Internet Addiction Test (IAT), the Morningness - Eveningness Questionnaire (MEQ), and the Hospital Anxiety and Depression Scale (HADS). The results showed that the relationship between chronotype and suicidality was partially mediated by SMDS and MBPPAS but not by anxiety, depression, or IAT. These findings suggest that psychological pain and PSMU may be important factors that contribute to suicidality in evening-type individuals. These findings have significant implications for the development of interventions aimed at reducing suicidality among evening-type individuals. By addressing the underlying factors of psychological pain and PSMU, it may be possible to mitigate the increased risk of suicidality among this population.

Suicidal ideation in female individuals with fibromyalgia and comorbid obesity: prevalence and association with clinical, pain-related, and psychological factors

OBJECTIVE

Individuals with fibromyalgia report alarming levels of suicidal ideation, and comorbidity with other chronic health conditions such as obesity-a risk factor for suicidal ideation per se-could further complicate the clinical picture. The aim of this study is to determine, in a sample of women with fibromyalgia and comorbid obesity, the prevalence of suicidal ideation and to evaluate clinical, pain-related and psychological factors associated with suicidal ideation.

METHODS

In total, 156 female individuals with fibromyalgia and obesity were recruited and completed a series of self-report measures that assessed (i) the level of pain intensity, (ii) depressive symptomatology, (iii) sleep quality, and (iv) pain catastrophizing. Suicidal ideation was evaluated by item #9 of the Beck Depression Inventory. In addition, information regarding previous suicide attempts and current opioid use was collected.

RESULTS

3n sum, 7.8% of participants reported presence of suicidal ideation. According to the results of the multiple logistic regression, depressive symptomatology, sleep quality, and pain catastrophizing were associated with the presence of suicidal ideation.

DISCUSSION

The presence of suicidal ideation in our sample was significantly associated with depressive symptomatology, sleep quality, and pain catastrophizing. Our findings are the first to suggest a unique (ie, independent of depressive symptomatology, and sleep quality) association between pain catastrophizing and suicidal ideation in the context of fibromyalgia and comorbid obesity. In order to prevent and reduce suicidal ideation, these factors should be assessed and targeted in interventions for pain management. Future research should investigate the extent to which addressing depressive symptoms, sleep quality, and pain catastrophizing reduces suicidal ideation.

Assessing the association of coffee consumption on the relationship of chronic pain with depression and anxiety

BACKGROUND

A bidirectional relationship between chronic pain (CP) and mental disorders has been reported, and coffee was believed to be associated with both. However, the association of coffee in this bidirectional relationship remains unclear. We aim to analyze the association of coffee consumption on the relationship of CP with depression and anxiety.

METHODS

A total of 376,813 participants from UK Biobank were included. We collected data on anxiety, depression and CP from objects of our study population. The association of coffee consumption on the relationship of CP with depression and anxiety was assessed through logistic/linear regression models. Moreover, seemingly unrelated estimation test (SUEST) was used to compare whether the coefficients differed in two different groups.

RESULTS

We observed significant associations of coffee consumption in the interaction of CP with depression and anxiety, such as the association of multisite chronic pain (MCP) on self-reported depression (βcoffee = 0.421, βnon-coffee = 0.488, PSUEST = 0.001), and the association of MCP on generalized anxiety disorder-7 (GAD-7) scores (βcoffee = 0.561, βnon-coffee = 0.678, PSUEST = 0.004) were significantly different between coffee drinking and non-coffee drinking groups. Furthermore, in analysis stratified by gender, we found headache (βmale = 0.392, βfemale = 0.214, PSUEST = 0.022) and hip pain (βmale = 0.480, βfemale = 0.191, PSUEST = 0.021) had significant associations with self-reported depression between males and females groups in coffee drinkers.

CONCLUSIONS

Our results suggested that coffee consumption has a significant association on the relationship of CP with depression and anxiety.

Multitask Learning for Mental Health: Depression, Anxiety, Stress (DAS) Using Wearables

This study investigates the prediction of mental well-being factors-depression, stress, and anxiety-using the NetHealth dataset from college students. The research addresses four key questions, exploring the impact of digital biomarkers on these factors, their alignment with conventional psychology literature, the time-based performance of applied methods, and potential enhancements through multitask learning. The findings reveal modality rankings aligned with psychology literature, validated against paper-based studies. Improved predictions are noted with temporal considerations, and further enhanced by multitasking. Mental health multitask prediction results show aligned baseline and multitask performances, with notable enhancements using temporal aspects, particularly with the random forest (RF) classifier. Multitask learning improves outcomes for depression and stress but not anxiety using RF and XGBoost.

Psychiatric profiles in suicidal attempters: Relationships with suicide behaviour features

BACKGROUND

Suicide constitutes a major health concern worldwide, being a significant contributor of death, globally. The diagnosis of a mental disorder has been extensively linked to the varying forms of suicidal ideation and behaviour. The aim of our study was to identify the varying diagnostic profiles in a sample of suicide attempters.

METHODS

A sample of 683 adults (71.3% females, 40.10±15.74 years) admitted at a hospital emergency department due to a suicide attempt was recruited. Latent class analysis was used to identify diagnostic profiles and logistic regression to study the relationship between comorbidity profile membership and sociodemographic and clinical variables.

RESULTS

Two comorbidity profiles were identified (Class I: low comorbidity class, 71.3% of attempters; Class II: high comorbidity class, 28.7% of attempters). Class I members were featured by the diagnosis of depression and general anxiety disorder, and low comorbidity; by contrast, the high comorbidity profile was characterized by a higher probability of presenting two or more coexisting psychiatric disorders. Class II included more females, younger, with more depressive symptoms and with higher impulsivity levels. Moreover, Class II members showed more severe suicidal ideation, higher number of suicide behaviours and a greater number of previous suicide attempts (p<.01, for all the outcomes), compared to Class I members.

CONCLUSIONS

Psychiatric profiles may be considered for treatment provision and personalized psychiatric treatment in suicidal attempters as well as tackle suicide risk.

Social exclusion and suicide intention in Chinese college students: a moderated mediation model

Given the growing incidence rates of suicide among college students and the potential lifelong consequences of suicide, it is imperative to better understand the factors that reduce the rates at which college students in a clinical sample engage in suicide. This study examines the relationship between social exclusion and suicide intention, the mediating effect of depression, and the moderating effect of meaning in life. Two hundred and ninety-nine Chinese college students, aged from 18 to 22 years (56.86% female, M age = 20.14, SD = 1.27) completed questionnaires assessing their social exclusion, suicide intention, depression, and meaning in life. The result revealed that social exclusion was positively associated with suicide intention, and depression mediated this relationship. In addition, this mediating effect of depression was moderated by meaning in life. That is, the mediation effect was stronger for students with a higher level of meaning in life. These findings provide educational suggestions for preventing and intervening in suicide intention among college students.

Inhibition of spinal Rac1 attenuates chronic inflammatory pain by regulating the activation of astrocytes

BACKGROUND

Spinal astrocyte-mediated neuroinflammation is an important mechanism for the maintenance of chronic inflammatory pain. Previous studies have investigated that Ras-related C3 botulinum toxin substrate 1 (Rac1) is closely related to astrocyte activation after central nervous system injury. However, the role of Rac1 in astrocyte activation in chronic inflammatory pain has not been reported.

METHODS

Complete Freund's adjuvant (CFA)-induced chronic inflammatory pain model and LPS-stimulated astrocytes were used to investigate the role of Rac1 in astrocyte activation and the underlying mechanism. Rac1-interfering adeno-associated virus (AAV) targeting astrocytes was delivered to spinal astrocytes by intrathecal administration and a Rac1 specific inhibitor, NSC23766, was used to block cultured astrocytes. The glial fibrillary acidic protein (GFAP), proinflammatory cytokines, p-NF-κB, and nod-like receptor thermal protein domain associated protein 3 (NLRP3) inflammasome were detected by RT-qPCR, Western blotting, and immunofluorescence to investigate the activation of astrocytes.

RESULTS

CFA induced spinal astrocyte activation and increased the expression of active Rac1 in spinal astrocytes. Knockdown of astrocyte Rac1 alleviated chronic inflammatory pain and inhibited astrocyte activation. Inhibition of Rac1 activation in cultured astrocytes decreased the expression of GFAP and proinflammatory cytokines. Knockdown of Rac1 inhibited the increase of expression of NLRP3 inflammasome and phosphorylation of NF-κB in the spinal lumbar enlargement after CFA injection. Similarly, the inhibition of Rac1 suppressed the increase of NLRP3 inflammasome and p-NF-κB protein level after LPS stimulation.

CONCLUSION

Knockdown of astrocyte Rac1 attenuated CFA-induced hyperalgesia and astrocyte activation possibly by blocking the expression of NLRP3 inflammasome and phosphorylation of NF-κB.

The role of CD38 in inflammation-induced depression-like behavior and the antidepressant effect of (R)-ketamine

CD38 is involved in immune responses, cell proliferation, and has been identified in the brain, where it is implicated in inflammation processes and psychiatric disorders. We hypothesized that dysfunctional CD38 activity in the brain may contribute to the pathogenesis of depression. To investigate the underlying mechanisms, we used a lipopolysaccharide (LPS)-induced depression-like model and conducted behavioral tests, molecular and morphological methods, along with optogenetic techniques. We microinjected adeno-associated virus into the hippocampal CA3 region with stereotaxic instrumentation. Our results showed a marked increase in CD38 expression in both the hippocampus and cortex of LPS-treated mice. Additionally, pharmacological inhibition and genetic knockout of CD38 effectively alleviated neuroinflammation, microglia activation, synaptic defects, and Sirt1/STAT3 signaling, subsequently improving depression-like behaviors. Moreover, optogenetic activation of glutamatergic neurons of hippocampal CA3 reduced the susceptibility of mice to depression-like behaviors, accompanied by reduced CD38 expression. We also found that (R)-ketamine, which displayed antidepressant effects, was linked to its anti-inflammatory properties by suppressing increased CD38 expression and reversing synaptic defects. In conclusion, hippocampal CD38 is closely linked to depression-like behaviors in an inflammation model, highlighting its potential as a therapeutic target for antidepressant development.

Characteristics of gut microbiota and metabolic phenotype in patients with major depressive disorder based on multi-omics analysis

Depression is a chronic, relapsing mental illness, often accompanied by loss of appetite, increased fatigue, insomnia and poor concentration. Here, we performed serum and urine metabolomics and fecal 16S rDNA sequencing studies on 57 unmedicated patients with major depressive disorder (MDD) and 57 healthy controls to characterize the metabolic and flora profile of MDD patients. We observed significant differences in serum and urinary metabolome between MDD patients and healthy individuals. Specifically, glycerophospholipid metabolism, primary bile acid biosynthesis and linoleic acid metabolism were significantly disordered in serum, and aminoacyl-tRNA biosynthesis, arginine biosynthesis, purine metabolism, phenylalanine metabolism, alanine, aspartate and glutamate metabolism, and pyrimidine metabolism were significantly impaired in urine. On this basis, we identified four potential diagnostic biomarkers for carnitine and four fatty acid classes in serum and urine, respectively. In addition, we observed significant disturbances of the gut microbiota in MDD patients. Spearman correlation analysis showed that imbalances in the gut microbiota were associated with metabolic disturbances, suggesting an important role of the gut microbiota in the pathogenesis of MDD. Our study provides a theoretical basis for further understanding of the pathogenesis of depression and for future clinical diagnosis and screening, as well as a basis for targeting the gut flora to optimize its structure for the prevention and treatment of depression.

Health-related quality of life of Korean older adults according to age, sex, and living arrangements: a cross-sectional study

Introduction

The number and proportion of older adults living alone is a significant issue. While the number of the oldest old people is also expected to increase, their health characteristics are poorly understood. This study aims to evaluate the health-related quality of life (HRQoL) of the oldest old people according to age, sex, and living arrangements.

Methods

This study is based on the Korea Community Health Survey 2021. Among the survey's 229,242 observations, 73,617 observations aged 65 or higher were used for the analysis. The study participants were divided into 5-year age intervals (from 65-69 to 90+), sex, and living arrangements. The outcome variables are the EuroQol 5 Dimensions (EQ-5D) index score and the problem reporting rates of the five dimensions of EQ-5D.

Results

The mean EQ-5D index scores were 0.896 at 65-69 and 0.741 at 90+. The mean EQ-5D index score decreased more rapidly as age increased. Women showed consistently lower mean EQ-5D index scores than men in all age intervals. The proportion of older adults living alone increased from 18.1% at 65-69 to 43.6% at 90+. The odds of reporting problems with anxiety/depression among older men living alone were estimated to be significantly higher than older men living with someone (aOR 1.22 95% CI 1.05-1.43). The odds of reporting problems in self-care and usual activity among older women living alone were estimated to be significantly lower than older women living with someone (aOR 0.88 95% CI 0.70-0.83 and aOR 0.88 95% CI 0.82-0.94).

Conclusion

This study showed that older adults' HRQoL deteriorates as their age increases. Moreover, living alone may lead to different effects on older adults' HRQoL according to sex. More comprehensive studies and collaborative attention are needed to identify and provide customized care for older adults.

Mental Pain Correlates with Mind Wandering, Self-Reflection, and Insight in Individuals with Psychotic Disorders: A Cross-Sectional Study

Understanding the cognitive processes that contribute to mental pain in individuals with psychotic disorders is important for refining therapeutic strategies and improving patient outcomes. This study investigated the potential relationship between mental pain, mind wandering, and self-reflection and insight in individuals diagnosed with psychotic disorders. We included individuals diagnosed with a 'schizophrenia spectrum disorder' according to DSM-5 criteria. Patients in the study were between 18 and 65 years old, clinically stable, and able to provide informed consent. A total of 34 participants, comprising 25 males and 9 females with an average age of 41.5 years (SD 11.5) were evaluated. The Psychache Scale (PAS), the Mind Wandering Deliberate and Spontaneous Scale (MWDS), and the Self-Reflection and Insight Scale (SRIS) were administered. Statistical analyses involved Spearman's rho correlations, controlled for potential confounders with partial correlations, and mediation and moderation analyses to understand the indirect effects of MWDS and SRIS on PAS and their potential interplay. Key findings revealed direct correlations between PAS and MWDS and inverse correlations between PAS and SRIS. The mediation effects on the relationship between the predictors and PAS ranged from 9.22% to 49.8%. The largest statistically significant mediation effect was observed with the SRIS-I subscale, suggesting that the self-reflection and insight component may play a role in the impact of mind wandering on mental pain. No evidence was found to suggest that any of the variables could function as relationship moderators for PAS. The results underscore the likely benefits of interventions aimed at reducing mind wandering and enhancing self-reflection in psychotic patients (e.g., metacognitive therapy, mindfulness). Further research will be essential to elucidate the underlying mechanisms.