Cortisol and development of depression in adolescence and young adulthood - a systematic review and meta-analysis

Synergistic effects of a body shape index and depression on mortality in individuals with low sexual frequency

BACKGROUND

Individuals with low sexual frequency often experience comorbidities that exacerbate mortality. This article evaluates the predictive value of five body fat anthropometric indicators for all-cause mortality and explores the interaction between obesity and depression in mortality among young and middle-aged individuals with sexual frequency <12 times per year.

METHODS

This study included participants with a sexual frequency of <12 times per year from the 2015-2016 National Health and Nutrition Examination Survey (NHANES). We assessed the impact of anthropometric indicators and depression on mortality, as well as their synergistic interactions, and further developed an accessible predictive survival model.

RESULTS

A total of 4978 participants aged 20-59 were included, with 215 deaths (4.3 %) over 15 years of follow-up. A Body Shape Index (ABSI) showed the strongest association with all-cause mortality, with an AUC of 0.67. Participants with ABSI ≥0.082 had a significantly higher risk of death (HR: 1.87, 95%CI: 1.31-2.68), as did those with depression (HR: 1.86, 95%CI: 1.19-2.92). Interaction analysis revealed a synergistic effect between depression and ABSI, increasing death risk by 293 % when both were present. Significant survival differences were observed between men and women with these risk factors, with median survival rates of 76.3 % and 90.8 %, respectively. The model based on ABSI and depression provided valuable mortality predictions, with AUC of 0.78, 0.77, and 0.77 for 3-year, 5-year, and 10-year survival.

CONCLUSION

ABSI and depression are associated with all-cause mortality in individuals with low sexual frequency, potentially creating a synergistic effect on mortality risk.

Associations between sugar-sweetened beverage consumption, moderate-to-vigorous physical activity duration and psychological symptoms in adolescents: A nationwide study in China

BACKGROUND

The prevalence of psychological symptoms among adolescents continues to increase. Sugar-sweetened beverage (SSB) consumption and moderate-to-vigorous physical activity (MVPA) duration are associated with psychological symptoms, respectively. However, few national studies have been conducted in developing countries, and there is a lack of research on the association between the combined effects of SSB consumption and MVPA duration and psychological symptoms in adolescents.

METHODS

In this study, 50,222 adolescents aged 12-18 years nationwide in China were assessed cross-sectionally for SSB consumption, MVPA duration, psychological symptoms, and basic participant characteristics using stratified whole-cluster random sampling in 2023. The associations of SSB consumption, MVPA duration, and psychological symptoms were analyzed using nonparametric tests, t-tests, logistic regression analyses, and ordered logistic regression analyses with generalized linear models.

RESULTS

The prevalence of psychological symptoms among Chinese adolescents is 20.1 %. The proportion of adolescents with SSB consumption >4 times/week was 14.8 %. The results of ordered logistic regression analysis showed that the adolescents in the group with SSB consumption <1 times/week and MVPA duration >60 min/day were used as the reference group， adolescents in the group with SSB consumption >4 times/week and MVPA duration <30 min/day had the highest risk (OR = 2.28, 95 % CI: 1.98-2.64) of the prevalence of psychological symptoms (P < 0.001). The same trend was observed in boys and girls.

CONCLUSIONS

SSB consumption, MVPA duration, and psychological symptoms were associated with each other in Chinese adolescents. Increasing SSB consumption and decreasing MVPA duration will lead to an increase in the prevalence of psychological symptoms in adolescents. In the future, SSB consumption and MVPA duration should be effectively controlled to reduce the prevalence of psychological symptoms and to promote the physical and mental health of Chinese adolescents.

Corydalis yanhusuo Polysaccharides regulates HPA-axis mediated microglia activation and inhibits astrocyte A1 transformation to improve depression-like behavior

Depression is a common emotional disorder characterized by persistent low mood and decreased interest. Corydalis yanhusuo polysaccharides (CYP) are extracts from Corydalis yanhusuo, which have the effects of promoting blood circulation, relieving pain, anti-inflammation, and neuroprotection. This study investigates the effects and its underlying mechanisms of CYP in a chronic unpredictable mild stress (CUMS)-induced depression model using C57BL/6J mice. After 4 weeks of CYP treatment, the depressive behavior of mice was observed, and Nissl staining, H&E staining, and immunofluorescence were performed. The hypothalamic-pituitary-adrenal (HPA) axis factors levels were determined by enzyme-linked immunosorbent assay. Western blotting was used to detect protein expression. The results showed that CYP treatment improved depression-like behaviors in mice that received CUMS and ameliorated pathological damage the hippocampus and synaptic damage via regulating the expression of NeuN, SYP, and PSD95 proteins. CYP also reduced neuroinflammation by decreasing the expression of IL-1β, IL-18, NLRP3, and Caspase-1. In addition, CYP reduced adrenocorticotropic hormone (ACTH), corticotropin-releasing hormone (CRH), corticosterone (CORT), corticotropin releasing factor (CRF), mineralocorticoid receptor (MR) levels, and increased glucocorticoid receptor (GR) levels. Furthermore, CYP could regulate microglial activation and transform A1 astrocytes into neuroprotective A2 astrocytes, thereby mitigating neuronal damage by decreasing the expression of complement C3 (C3) and ionized calcium-binding adaptor molecule 1 (Iba-1), while increasing the expression of S100A10. However, CORT treatment significantly reversed above changes and aggravated depressive behavior in mice. In conclusion, CYP could improve CUMS-induced depression-like behaviors by regulating HPA axis-mediated microglial activation and inhibiting A1 transformation of astrocytes.

Mechanisms of oral ciprofloxacin-induced depressive-like behavior and the potential benefit of lactulose: A correlation analysis

Prolonged administration of antibiotics may be associated with depression due to the potential risk of dysbiosis. Thus, the restoration of microbial balance, through administration of prebiotics, might overcome the problem. This study investigated the mechanisms of antibiotic-induced depression, which were explored through statistical correlation analysis. The potential benefit of lactulose, a prebiotic, on this behavioral disorder was further assessed. The rats were assigned to groups receiving 102.8 mg/kg ciprofloxacin daily for 1, 8, 15, or 22 days. A different group of rat was given the same regimen for 8 days accompanied with lactulose at 2056 mg/kg. Upon completion of ciprofloxacin administration, the rats were tested for depression-like behavior (forced swimming test, FST; and sucrose preference test, SPT). They were then sacrificed for biochemical assessment in the hippocampus and prefrontal cortex. The mechanism studies revealed significant correlation between SPT vs. serotonin in the hippocampus, and SPT vs. serotonin, cortisol, NF-κB in the prefrontal cortex. Meanwhile, FST was significantly correlated with serotonin in the hippocampus and the prefrontal cortex, while in the prefrontal cortex it was significantly correlated with cortisol, NF-κB, and IL-6. Based on the afore-mentioned results, it was found that lactulose improved FST by targeting serotonin in the hippocampus. This study indicate that ciprofloxacin induce depression-like behavior via modulation of several neurotransmitter system as well as proinflammatory cytokines in the hippocampus and prefrontal cortex. The results further suggest the potential of lactulose to improve this behavior.

Ferroptosis: a new target for depression prevention and treatment

Depression, a significant mental health issue, is one of the diseases with the highest disability rates worldwide. The exact etiology of depression remains undetermined, complicating the development of treatment strategies targeting specific mechanisms, and there is currently no effective cure. In this context, ferroptosis may represent a breakthrough in the understanding of depression. Ferroptosis is primarily associated with iron accumulation and lipid peroxidation, and recent studies have revealed its potential association with depression. Clinical evidence suggests that ferroptosis may influence the development and function of the hippocampus through interactions with neuroinflammation. Activated microglia, astrocytes, and neurons are involved in ferroptosis. This review summarizes recent findings on how ferroptosis contributes to depression, including glutathione peroxidase 4 (GPX4), nuclear factor-erythroid 2-related factor 2 (Nrf2), phase separation, and neuroinflammatory pathways, allowing the proposal of some new hypotheses. We hope that exploring the role of ferroptosis in the mechanism of depression will offer a new perspective on the complex biological basis of depression and provide theoretical support for the development of new therapeutic methods.

Self-reported and actimetry-based cluster analysis of mood rhythmicity profiles in adolescents with and at risk for Major Depressive Disorder

Greater self-perceived rhythmicity of mood-related symptoms and behaviors has been associated with depressive symptoms in the general public. We aimed to evaluate differences in adolescents at risk for or with a diagnosis of major depressive disorder (MDD) regarding perception of symptom rhythmicity and actimetry parameters. In this cross-sectional study, 96 adolescents were stratified into three groups based on either a diagnosis of MDD or on a composite score for the risk of developing depression: MDD, high risk (HR), and low risk (LR). Participants completed questionnaires regarding depressive symptoms (Mood and Feelings Questionnaire for adolescents) and self-perceived mood rhythmicity (Mood Rhythm Instrument for Youth - MRhI-Y). Actimetry data were collected for 10 continuous days and Non-Parametric Circadian Rhythm Analyses were performed. The MDD group reported higher MRhI-Y total scores, particularly in affective symptoms compared to both other groups. In spite of actimetry variables that did not correlate with MRhI-Y total scores, cluster analysis using MRhI-Y and actimetry revealed three distinct profiles corresponding to all groups. Identifying rhythmicity in mood-related behaviors in adolescents may help distinguish different groups at-risk for MDD and in a current depressive episode. Understanding these patterns could inform early interventions, potentially preventing the onset of the disorder in susceptible individuals.

Biological pathways underlying the relationship between childhood maltreatment and Multimorbidity: A two-step, multivariable Mendelian randomisation study

Childhood maltreatment has been associated with multimorbidity of depression, coronary artery disease and type 2 diabetes. However, the biological mechanisms underlying this association remain unclear. We employed two-step and multivariable Mendelian randomisation (MR) to understand the role of three potential biological mediating mechanisms - inflammation (92 proteins), metabolic processes (54 markers), and cortisol - in the link between childhood maltreatment liability and multimorbidity. Using summary statistics from large-scale genome-wide association studies of European ancestry for childhood maltreatment (N = 185,414) and multimorbidity (Neffective = 156,717), we tested for the presence of an indirect effect via each mediator individually. We found a potential role of metabolic pathways. Up to 11% of the effect of childhood maltreatment on multimorbidity was mediated by triglycerides (indirect effect [95% CI]: 0.018 [0.009-0.027]), 8% by glycated haemoglobin (indirect effect: 0.013 [0.003-0.023]), and up to 7% by high-density lipoprotein cholesterol (indirect effect: 0.011 [0.005-0.017]). We did not find evidence for mediation via any inflammatory protein or cortisol. Our findings shed light on the biological mechanisms linking childhood maltreatment liability to multimorbidity, highlighting the role of metabolic pathways. Future studies may explore underlying pathways via non-biological mediators (e.g., lifestyle factors) or via multiple mediators simultaneously.

The impact of pituitary adenomas on cognitive performance: a systematic review

Purpose

Increasing evidence suggests that beyond classical endocrine and visual symptoms, patients with pituitary adenoma (PA) may experience neurocognitive impairment, potentially resulting in reduced productivity and diminished quality of life. Prior studies have used diverse cognitive assessment tools across heterogeneous populations, leading to inconsistent findings. To address the variability, our study systematically analyzes the assessment batteries used in previous research, clarifying their corresponding cognitive domains. We seek to provide a more consistent and comprehensive understanding of the neurocognitive implications associated with PAs.

Methods

This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline. Individual patient-level data, including clinical characteristics, tumor subtype, treatment interventions, hormonal status, and psychological outcomes, were systematically collected. Cognitive assessment tools were categorized according to their corresponding cognitive domains to facilitate domain-specific analyses.

Results

This systematic review included 70 studies encompassing a total of 3,842 patients with PA. Of these, 60 studies employed either objective neuropsychological tests or subjective questionnaires to evaluate cognitive function. The most frequently utilized assessment was the Digit Span test, with 42.9% of studies reporting significant impairments in complex attention and executive functioning among patients with PA. Twelve studies focused on structural brain changes as assessed by magnetic resonance imaging, with half documenting volumetric reductions in gray matter. Across the various PA subtypes, a consistent decline in discrete cognitive domains was observed, most notably in memory and executive function. Treatment-related data were provided in 59 studies. Perioperative changes in cognitive performance were described in 14 studies, of which 11 reported post-surgical improvement in at least one cognitive domain. Twenty studies investigated the potential adverse effects of radiotherapy on cognitive function; among them, 16 found no significant differences following treatment. Eight studies examined the association between tumor size and cognitive impairment; seven reported no statistically significant correlation. In contrast, 24 studies identified a significant relationship between hormonal dysregulation and cognitive decline.

Conclusions

The literature contains heterogeneous findings about the cognitive performance, nature of cognitive impairment, and subsequent effects of treatment. Patients with PA may experience cognitive decline in specific areas and are notably affected by hormone levels, while treatment may lead to cognitive recovery. The proposed tiered cognitive evaluation approach can improve assessment consistency in future practice.

Lifetime heterosexist victimization and diurnal cortisol predict depression trajectories among sexual and gender minority emerging adults

Heterosexist victimization constitutes a severe source of social stress with enduring effects on mental health and the adrenocortical functioning of lesbian, gay, bisexual, transgender, and queer (LGTBQ) emerging adults. However, it is unknown what roles lower or higher diurnal cortisol at waking (cortisol intercepts) and less variable fluctuations ("flatter" slopes) play in the links between heterosexist victimization and depressive symptoms. In accordance with diathesis-stress, allostatic load, and biological embedding perspectives, we examined whether cortisol intercepts and slopes moderated or mediated the predictive associations of heterosexist victimization with depressive symptoms over 24-months. Heterosexist victimization was expected to predict depressive symptoms most strongly for LGBTQ emerging adults with flatter cortisol slopes (i.e., moderation), and cortisol intercepts and slopes were expected to indirectly link heterosexist victimization with depressive symptoms (i.e., mediation). Latinx and White LGBTQ emerging adults (N = 97; ages 18-29, M = 23.91 years, SD = 2.63) provided saliva samples and questionnaire responses during a four-day testing protocol at baseline; two additional assessments of depressive symptoms were completed 9- and 24-months later. Cortisol intercepts and slopes moderated associations of heterosexist victimization with both contemporaneous and prospective depressive symptoms. Heterosexist victimization was positively associated with contemporaneous depressive symptoms and decreases in depressive symptoms over two years when LGBTQ emerging adults also had steeper cortisol slopes. Heterosexist discrimination was associated with increases in depressive symptoms prospectively among participants with lower cortisol intercepts. There was no evidence for mediation. Thus, patterns of diurnal adrenocortical functioning may distinguish between LGBTQ emerging adults who are more prone to acute versus prolonged depressive symptoms when they experience heterosexist victimization.

BDNF mediates the heart-brain axis: implications for cardiovascular diseases and mental disorders

The comorbidity of cardiovascular diseases (CVDs) and mental disorders (MD) has become a significant challenge in modern medicine, severely affecting patients' quality of life and prognosis. The heart-brain axis, a bidirectional pathway connecting the central nervous system and the cardiovascular system, plays a critical role in the comorbidity mechanisms of CVDs and MD. In recent years, brain-derived neurotrophic factor (BDNF) has emerged as a key molecule in the study of CVDs and MD. By binding with high affinity to TrkB receptors and activating various signaling pathways, BDNF exerts multiple functions in both the nervous and cardiovascular systems. BDNF may participate in the pathogenesis of CVDs combined with MD through multiple mechanisms such as regulating inflammatory responses, oxidative stress (OS), and the hypothalamic-pituitary-adrenal (HPA) axis, making it a promising new target for future diagnosis and treatment. This review systematically summarizes the mechanisms by which BDNF functions in heart-brain comorbidity, particularly its multifaceted influence on inflammation, OS, and neuroendocrine regulation. Additionally, we discuss the clinical application prospects of BDNF in disease diagnosis and treatment, as well as progress in related drug development. A deeper understanding of BDNF's role in the heart-brain axis will provide new insights and strategies for the prevention, diagnosis, and treatment of CVDs and MD.

Advancing Depression Management Through Biomarker Discovery with a Focus on Genetic and Epigenetic Aspects: A Comprehensive Study on Neurobiological, Neuroendocrine, Metabolic, and Inflammatory Pathways

Introduction: Depression is a pervasive global health issue, affecting millions worldwide and causing significant disability. Despite its prevalence, current diagnostic and treatment approaches often yield suboptimal outcomes. The complexity of depression, characterized by diverse causes and symptoms, highlights the urgent need for advanced diagnostic tools and personalized therapies. Biomarkers, particularly genetic and epigenetic depression biomarkers, offer promise in uncovering the biological mechanisms underlying depression, potentially revolutionizing its management. Aim: Primary aim: To identify biomarkers associated with depressive disorders, with a focus on genetic and epigenetic biomarkers. Secondary aim: To optimize the current classification of biomarkers associated with different types of depressive disorders, with a focus on genetic and epigenetic biomarkers. Methods: We integrated findings with strategic keywords extracted from relevant studies, conducting a thorough literature review across the Google Scholar, PubMed, and Web of Science databases. Lastly, final reference inclusion had stringent criteria: recent, diverse peer-reviewed articles in English, all study designs, ensuring up-to-date coverage of genetic and epigenetic depression biomarker research. Results: The review reveals the classification of genetic and epigenetic biomarkers in regard to the type of biomarker, the system of the human body it derives from, and the sampling entity. All of the findings show promise in diagnosing depression, with the potential of predicting treatment outcomes and guiding personalized therapeutic approaches. We defined the significant correlations between genetic and epigenetic biomarker profiles and clinical parameters such as symptom severity and treatment response, thereby enhancing diagnostic accuracy and guiding treatment strategies tailored to individual patient needs across diverse depressive subtypes and treatment responses. Conclusion: Identifying biomarkers associated with depressive disorders, with a focus on genetic and epigenetic biomarkers, represents a critical step toward improving diagnostic precision and treatment efficacy. By elucidating the complex biological underpinnings of depression, this study contributes to the development of targeted therapies that address the diverse needs of individuals affected by this debilitating group of disorders. Future research should focus on validating these genetic and epigenetic biomarkers in larger cohorts and clinical trials to facilitate their clinical implementation and enhance patient outcomes.

The intersection and developmental trajectory of morning cortisol and testosterone in autistic and neurotypical youth

BACKGROUND

Behavioral endocrinology examines associations between hormone expression, such as testosterone and cortisol, and behavior; both of which have been implicated in autism spectrum disorder (ASD). The overarching aim of the study was to examine the intersection of sex-based (Male, Female), hormonal (testosterone, cortisol), diagnostic (ASD, typically developing, (TD)) and developmental (age, puberty) patterns over four years of a longitudinal study in a well-characterized sample of youth (spanning 10 to 17 years).

METHODS

In year 1 (Y1), participants included 140 autistic youth (36 females, 104 males) and 105 TD youth (46 females, 59 males.). For Y4, participants included 83 ASD and 77 TD youth. Immediate waking morning salivary samples were collected for hormone assay. Mixed effects and ordinary linear regression models were used, as well as mediation effects of hormones on behavior.

RESULTS

For cortisol, there was a significant diagnosis by sex by age interaction (X2 = 15.62, df = 3, p = 0.0014, S = 0.2446) showing that autistic females evidence higher morning cortisol that increased over developmental progression compared to TD females. Moreover, ASD males had stunted testosterone growth compared to TD males (Est = 0.1530, p = 0.0130). Regarding biobehavioral associations in year 1, diagnosis (X2 = 80.72, df = 1, p < 0.0001, S = 0.5704) and cortisol (X2 = 14.42, df = 3, p = 0.0024, S = 0.2159) were associated with social problems; however, there were no effects for testosterone on diagnosis or a mediation effect on social problems. There was a significant effect of diagnosis on CBCL Aggression score (X2 = 34.39, df = 1, p < 0.0001, S = 0.3692) independent of hormonal measurements.

LIMITATIONS

Despite the large sample, it was not fully representative based on race, ethnicity or intellectual profile. Attrition of the sample is also acknowledged especially between portions of Y2 and Y3 due to the COVID-19 pandemic. Finally, only the immediate morning salivary samples were used due to lower and undetectable concentration levels of testosterone in younger and female children.

CONCLUSIONS

Collectively, these findings underscore the need to elucidate the biobehavioral patterns that emerge during the complex adolescent transition for autistic youth to determine how they impact clinical and long-term outcomes. The unique hormonal trajectories may be related to differences in advanced pubertal progression and affective states found in autistic females.

Correlation Between Systemic Immune Inflammatory Index and Suicidal Attempt in Patients with First-Episode Untreated Depression and its Risk Factors

Objective

To examine the relationship between the systemic immune inflammatory index (SII) and suicide attempts (SA) in individuals experiencing their first episode of major depressive disorder (MDD).

Methods

A retrospective analysis of 338 MDD patients (2020-2023) at the First Affiliated Hospital of Wannan Medical College and 76 healthy controls (HC) was conducted. MDD patients were categorized based on their history of SA. Differences in SII and clinical characteristics were analyzed, and a receiver operating characteristic (ROC) curve was used to determine the optimal SII cutoff for predicting SA. Binary logistic regression identified independent risk factors associated with SA.

Results

MDD patients exhibited higher levels of neutrophils, platelets, and SII compared to HC (all p<0.05). SA Patients had higher HDRS scores, neutrophil counts, mean platelet counts, and SII values compared to those without SA (all p<0.05). ROC analysis identified an optimal SII cutoff of 515.3, with 67% sensitivity, 70% specificity, and an area under the curve (AUC) of 0.692. After adjusting for gender, age, body mass index, disease duration, and quality of life, individuals with elevated SII values were 8.318 times more likely to have recent SA (OR=8.318, 95% CI: 3.767-17.546, p<0.05). Patients with high SII values were 14.101 times more likely to have recent SA compared to those with low SII values (OR=14.101, 95% CI: 5.356-34.235, p<0.05). However, high SII was not identified as a significant risk factor for previous SA (OR=0.607, 95% CI: 0.061-4.961, p>0.05).

Conclusion

SII represents a cost-effective and accessible method for evaluating suicide risk in patients with MDD.

Interplay of Endoplasmic Reticulum Stress, Inflammation, Apoptosis, and Oxidative Stress in Corticosteroid-Induced Anxiety and Depression: Exploring Therapeutic Potential of Hydrogen Sulfide and Sertraline

Prolonged exposure to corticosteroids (CORTs) triggers depression and anxiety symptoms either endogenously or exogenously via stimulating endoplasmic reticulum stress (ERS). The study assessed the therapeutic implications of hydrogen sulfide (H2S) versus sertraline (SERT) in alleviating anxiety and depression induced by CORTs through the modulation of ERS and its inflammatory, oxidative, and apoptotic consequences. Rats were subdivided into four groups: control, CORT (20 mg/kg), NaHS (100 μmol/kg), and SERT (10 mg/kg) for 21 days. Behavioral and histological examinations of the cerebral cortex were performed. The levels of CHOP, GADD34, EIF2AK3, GRP78, caspase 3, and miR-146a were analyzed using qRT-PCR. The levels of CORTs, serotonin, BDNF, TNF-α, BCL2, NRF2, and ATF4 were measured using ELISA, whereas those of IL-1β and BAX were measured using immunohistochemical techniques. Total and phosphorylated PERK were assessed via western blotting, whereas GSH and MDA were assessed via a colorimetric assay. In the present study, CORTs upregulated the gene expression of CHOP, GADD34, EIF2AK3, GRP78, and Caspase 3, whereas it downregulated that of miR-146a. The levels of serotonin, BDNF, BCL2, GSH, and NRF2 were decreased, whereas those of ATF4, TNF-α, IL-1β, BAX, and MDA were elevated. On the contrary, NaHS and SERT reversed all the above-mentioned changes. H2S shows promise in counteracting anxiety and depression symptoms induced by CORTs by targeting ERS cascades, mitigating inflammation, oxidative insults, and apoptosis in the cerebral cortex. H2S elicits neuroprotective effects by targeting the miR-146a-3p/GRP78/CHOP/PERK/ATF4/GADD34 signaling pathway and regulating apoptotic markers BAX/BCL2 and inflammatory markers TNF-α and/IL-1β. Compared with SERT, H2S exhibited superior anxiolytic and antidepressive effects.

Five hypothesized biological mechanisms linking adverse childhood experiences with anxiety, depression, and PTSD: A scoping review

Adults with symptoms of anxiety, depression, or PTSD and a history of adverse childhood experiences (ACEs) may experience more severe symptoms than those without ACEs. The identification of mechanisms linking ACEs to later mental health problems may provide salient treatment targets to improve outcomes. Several biological markers (cortisol, inflammation, allostatic load, DNA methylation, and telomere length) that are indicative of functional variation in stress response systems, have been hypothesized as potential mechanisms linking ACEs to later mental health outcomes. Much of the evidence supporting this hypothesis examines isolated pairwise associations between variables and it is unclear whether statistical tests of mediation support these conclusions. It is also unclear how much of the extant research has used theory to guide mediation analyses, which may be a salient factor in the recognition of a mechanism. This scoping review surveyed research conducting mediation analysis examining the indirect effect of any of these five biological markers on the relationship between ACEs and anxiety, depression, or PTSD. It further surveyed the use of theory in these analyses. Pubmed and seven electronic databases were searched: (1) APA PsychInfo (2) CINAHL Plus (3) Health Source: Nursing/Academic Edition (4) MEDLINE (5) Psychology and Behavioral Sciences Collection (6) Science and Technology Collection, and (7) SocINDEX. A total of 16 articles were identified. The majority of studies examined depression as an outcome and the statistical significance of indirect effects were mixed across mediators. Common theoretical models and frameworks were consistent with life course theory and evolutionary or developmental perspectives.

Untargeted metabolomics revealed that quercetin improved adrenal gland metabolism disorders and modulated the HPA axis in perimenopausal depression model rats

Perimenopausal depression is a psychiatric disorder that occurs around the time of menopause and seriously affects women's health. The pathogenesis of perimenopausal depression is unclear which affects its prevention and treatment. Quercetin is a flavonoid compound with antidepressant and estrogen-like effects. The aim of this research was to investigate the role of quercetin on adrenal gland metabolic disorders in perimenopausal depressed rats based on untargeted metabolomics. Female Wistar rats with no difference in sucrose preference were randomly separated into four groups (n = 12): sham-operated group; perimenopausal depression model group; model + 50 mg/kg.bw quercetin group; model + 0.27 mg/kg.bw 17β-estradiol group. After successful modeling, adrenal gland and hypothalamic samples were collected for metabolomics experiments and detection of related indicators. A total of 22 differential metabolites were identified in the model group, and pathway analysis revealed adrenal gland metabolism abnormalities including steroid hormone biosynthesis, arachidonic acid metabolism, and linoleic acid metabolism. Notably, Spearman's rank correlation analysis between differential metabolites and rat behavioral results showed strong positive or negative correlations (P < 0.01). Meanwhile, the hypothalamus of the model group showed TrkB-BDNF signaling pathway abnormality, and the HPA axis was found to play an important role in perimenopausal depression. Treatment with quercetin or 17β-estradiol restored these abnormal changes. It suggested that quercetin can regulate adrenal metabolic disorders through multiple pathways, thereby ameliorating perimenopausal depression.Further more, quercetin can modulate HPA axis through the TrkB-BDNF signaling pathway. This research provides new ideas for the application of quercetin in the precaution and treatment of perimenopausal depression.

Application of Optogenetic Neuromodulation in Regulating Depression

Depression is a multifaceted disorder with a largely unresolved etiology influenced by a complex interplay of pathogenic factors. Despite decades of research, it remains a major condition that significantly diminishes patients' quality of life. Advances in optogenetics have introduced a powerful tool for exploring the neural mechanisms underlying depression. By selectively expressing optogenes in specific cell types in mice, researchers can study the roles of these cells through targeted light stimulation, offering new insights into central nervous system disorders. The use of viral vectors to express opsins in distinct neuronal subtypes enables precise activation or inhibition of these neurons via light. When combined with behavioral, morphological, and electrophysiological analyses, optogenetics provides an invaluable approach to investigating the neural mechanisms of psychiatric conditions. This review synthesizes current research on the application of optogenetics to understand the mechanisms of depression. This study aims to enhance our knowledge of optogenetic strategies for regulating depression and advancing antidepressant research.

Neuroinflammation-A Crucial Factor in the Pathophysiology of Depression-A Comprehensive Review

Depression is a multifactorial psychiatric condition with complex pathophysiology, increasingly linked to neuroinflammatory processes. The present review explores the role of neuroinflammation in depression, focusing on glial cell activation, cytokine signaling, blood-brain barrier dysfunction, and disruptions in neurotransmitter systems. The article highlights how inflammatory mediators influence brain regions implicated in mood regulation, such as the hippocampus, amygdala, and prefrontal cortex. The review further discusses the involvement of the hypothalamic-pituitary-adrenal (HPA) axis, oxidative stress, and the kynurenine pathway, providing mechanistic insights into how chronic inflammation may underlie emotional and cognitive symptoms of depression. The bidirectional relationship between inflammation and depressive symptoms is emphasized, along with the role of peripheral immune responses and systemic stress. By integrating molecular, cellular, and neuroendocrine perspectives, this review supports the growing field of immunopsychiatry and lays the foundation for novel diagnostic biomarkers and anti-inflammatory treatment approaches in depression. Further research in this field holds promise for developing more effective and personalized interventions for individuals suffering from depression.

Systematic Review and Meta-Analysis: Predictors of Relapsing, Recurrent, and Chronic Depression in Young People

OBJECTIVE

Youth depression disrupts the social and vocational transition into adulthood. Most depression burden is caused by recurring or chronic episodes. Identifying young people at risk for relapsing, recurring, or chronic depression is critical. We systematically reviewed and meta-analyzed the literature on prognostic factors for relapsing, recurrent, and chronic depression in young people.

METHOD

We searched the literature up (MEDLINE, PsycINFO, CINAHL, Embase, CENTRAL, WHO ICTRP, ClinicalTrials.gov, bioRxiv, MedRxiv) to March 6, 2024, and included cohort studies and randomized trials that assessed any prognostic factor for relapse, recurrence, or chronicity of depression in young people (aged 10-25 years at baseline) with a minimum of a 3-month follow-up. We assessed individual study risk of bias using the QUIPS tool and the certainty of evidence via the GRADE approach. We conducted random-effects meta-analyses with Hartung-Knapp-Sidik-Jonkman adjustment when 3 or more estimates on the same prognostic factor were available. Qualitative synthesis was conducted to identify promising prognostic factors that could not be meta-analyzed.

RESULTS

A total of 76 reports of 46 studies (unique cohorts or trials) were included that tested 388 unique prognostic factors in 7,488 young people experiencing depression. The majority of the reports were at high risk of bias (87%). We conducted 22 meta-analyses on unadjusted, and 7 on adjusted, prognostic factors of a poor course trajectory (ie, combined relapse, recurrence, and chronicity). Female sex (adjusted; odds ratio [95% CI] = 1.49 [1.15, 1.93], p = .003), higher severity of depressive symptoms (unadjusted; standardized mean difference [95% CI] = 0.53 [0.33, 0.73], p < .001), lower global functioning (unadjusted; standardized mean difference [95% CI] = -0.35 [-0.60, -0.10], p = .005), more suicidal thoughts and behaviors (unadjusted; standardized mean difference [95% CI] = 0.52 [0.03, 1.01], p = .045), and longer sleep-onset latency (unadjusted; mean difference [95% CI] = 6.96 [1.48, 12.44] minutes, p = .013) at baseline predicted a poor course trajectory of depression. The certainty of the evidence was overall very low to moderate. Promising prognostic factors that could not be meta-analyzed included relational/interpersonal factors (friend relationships and family relationships/structure).

CONCLUSION

Our findings demonstrate the prognostic value of demographic and clinical factors for poor course trajectories of depression in young people. More research is needed to confirm the potential value of relational/interpersonal factors in predicting poor depression course. Limitations of the literature include the high risk of bias of included studies, which indicates that future studies should include large sample sizes and wider diversity of prognostic markers (eg, genetic and neurobiological) in multivariable models. The critical next step is to combine the identified prognostic factors and to evaluate their clinical value in identifying individuals at risk for a poor course trajectory of depression during youth, a life stage in which most of the disability and burden attributable to depression can be averted.

STUDY PREREGISTRATION INFORMATION

Prognostic factors for relapsing, recurrent or chronic depression in youth: a systematic review with meta-analysis; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023458646.

A Critical Advantage of Hypnobirthing to Ameliorate Antenatal Depression: A Systematic Review and Meta-Analysis

BACKGROUND

Pregnant women are likely to experience depression due to various factors. Hypnobirthing is a non-invasive therapy that can be used to treat depression during pregnancy. This study aims to systematically review the effect of hypnobirthing on antenatal depression.

METHODS

This study employs a systematic review following PRISMA guidelines. Articles were retrieved from PubMed, ScienceDirect, the Cochrane Library, Google Scholar, and hand searches. Articles were included for review if they met the following inclusion criteria: (1) published in the last ten years (2014-2024); (2) the articles published in English; (3) article types are original research articles and reviews; (4) the full text can be retrieved; and (5) the findings of the selected articles should discuss the effect of hypnobirthing or hypnosis for birth. Articles were critically appraised using Joanna Briggs Institute tools.

RESULTS

The initial search yielded 7603 records; nine studies met the inclusion criteria for systematic review, and four studies for meta-analysis. The articles were analyzed, and findings were presented in narrative ways and categorized into three themes: the effect of therapy, the administration of the therapy, and the mechanism of the therapy. The therapy was performed by different methods, involving hypnosis, daily relaxation, progressive muscle relaxation, breathing exercises, the J-breathing technique, meditation, visualization, and ego strengthening. Additionally, participants were encouraged to do self-practice at home and were followed up by personal visits, phone calls, or text messages.

CONCLUSIONS

The majority of the studies found that hypnobirthing ameliorated antenatal depression, despite the variation in initial administration and the duration of therapy. Further research is needed to standardize therapy protocols and explore long-term outcomes.

Neural circuits mediating chronic stress: Implications for major depressive disorder

Major depressive disorder (MDD), also known as depression, is a prevalent mental disorder that leads to severe disease burden worldwide. Over the past two decades, significant progress has been made in understanding the pathogenesis and developing novel treatments for MDD. Among the complicated etiologies of MDD, chronic stress is a major risk factor. Exploring the underlying brain circuit mechanisms of chronic stress regulation has been an area of active research for recent years. A growing body of preclinical and clinical research has revealed that abnormalities in the brain circuits are closely associated with failures in coping with stress in depressed individuals. Nevertheless, neural circuit mechanisms underlying chronic stress processing and the onset of depression remain a major puzzle. Here, we review recent literature focusing on circuit- and cell-type-specific dissection of depression-like behaviors in chronic stress-related animal models of MDD and outline the key questions.

The effect of MIND diet on sleep status, mental health, and serum level of BDNF in overweight/obese diabetic women with insomnia: a randomized controlled trial

Insomnia is common in type 2 diabetes mellitus (T2DM) and affects mental health and quality of life. The present study aimed to examine the efficacy of MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diet on the anthropometric measurements, sleep quality, depression, anxiety, and serum levels of cortisol and brain derived neurotrophic factor (BDNF) in type 2 diabetic women with insomnia. This randomized controlled trial (RCT) involved 44 type 2 diabetic women with insomnia, aged 30 to 65 years, who were randomly assigned to be under the MIND low-calorie diet (n = 22) or a low-calorie diet (LCD) as the control group (n = 22) for 12 weeks. The above-mentioned variables were assessed at the beginning and the end of intervention. Following the MIND diet for 12 weeks accompanied by the significant decrease of waist circumference and significant improvement of sleep quality, depression, and anxiety compared to the control group. In addition, the MIND diet vs. LCD group exhibited a significant reduction in the cortisol levels and a significant increase in BDNF. This study provides promising evidence of the effectiveness of the MIND diet in improving the sleep quality, mental health, and some related biochemical parameters in diabetic women with insomnia.Trial registration: IRCT20181111041611N8.

Dog companionship and cortisol levels in youth. A systematic review and meta-analysis

OBJECTIVE

Traditional and non-traditional strategies have been employed to improve youth health. Dog-assisted interventions have been proposed as a novel strategy to regulate stress and its consequences across all age groups. This systematic review and multilevel meta-analysis assessed the influence of dog-assisted interventions on cortisol levels in youth and explored potential moderators.

SOURCES

We conducted a comprehensive systematic search across multiple databases, including PubMed, Scopus, Web of Science, Cochrane Library, and ScienceDirect, up to June 17, 2024, to evaluate the impact of dog-assisted interventions on youth cortisol levels. Two reviewers independently extracted and verified data from eligible randomized clinical trials, with a third reviewer ensuring accuracy. Cochrane's RoB 2.0 tool was used to assess the risk of bias. Heterogeneity was analyzed using Q and I2 statistics. A random-effects model was employed to calculate effect sizes (ES) using R software.

SUMMARY OF THE FINDINGS

Significant cortisol reductions were found for interventions lasting >15 min (ES: 0.65; p = .038), with a non-significant trend towards reduced cortisol in non-medical settings (ES: 0.46; p = .070). No significant effects were observed for shorter interventions, different control groups, or age-specific analyses. Meta-regression analysis revealed significant differences, showing better outcomes with longer intervention times and fewer female participants.

CONCLUSION

Dog-assisted interventions lasting >15 min seem to be a promising and non-traditional strategy for regulating cortisol levels in children and adolescents in stressful situations. This study outlines gaps in the research and future directions.

Peer victimization in early adolescence and maladjustment in adulthood

Studies report different effect sizes for associations between peer victimization and later maladjustment. A possible origin of this heterogeneity is the length of the interval between victimization and maladjustment assessments. Effect sizes might also vary as a function of reporter. Longitudinal data from TRAILS, a study of adolescents followed from age 11 to 29 (baseline n = 2229) were used to test whether peer victimization assessed from adolescents themselves, their parents, teachers, and peers predicted internalizing symptoms, thought problems, and somatic complaints at six follow-ups with a temporal distance of up to 19 years. Neither self- nor peer-reported victimization predicted later maladjustment. In contrast, parent-reported victimization stably predicted adult maladjustment. Teacher-reported victimization also predicted maladjustment but associations were weaker and largely non-significant when parent reports were accounted for simultaneously. Parent-reported peer victimization has traditionally played a minor role in bullying research as parents are usually not present when victimization occurs. The results of this study however suggest that parents should be listened to when talking about their offspring being victimized.

Transcriptional evidence of HPA axis dysregulation in adolescent females: Unique contributions of chronic early-life stressor exposure and maternal depression history

BACKGROUND

Depression risk increases dramatically for adolescent females following the pubertal transition. Although chronic early-life stressor exposure and a maternal history of depression are established risk factors for depression onset in this population, we know little about the biological mechanisms underlying these associations.

METHOD

To investigate, we examined how chronic early-life stressor exposure and maternal depression history were associated with stress-related gene expression patterns, using a high-risk family design in 48 psychiatrically healthy adolescent females, 20 of whom had a mother with a lifetime history of depression. Lifetime chronic stressor exposure was assessed using the STRAIN and gene expression patterns were estimated using transcriptional profiling of whole blood.

RESULTS

Consistent with hypotheses, we found that adolescent females with greater chronic stressor exposure had higher NR3C1 expression levels compared to those with less chronic stressor exposure. Additionally, youth with a depressed mother had lower levels of FKBP5 expression compared to those without a depressed mother. Levels of FKBP5 expression, in turn, interacted with chronic stressor exposure to predict NR3C1 expression. Specifically, for those with low chronic stressor exposure, levels of FKBP5 and NR3C1 expression were strongly interrelated, whereas for those with high chronic stressor exposure, NR3C1 expression was high regardless of levels of FKBP5 expression.

LIMITATIONS

This study was correlational, the sample size was limited, and additional research is needed to elucidate the underlying mechanisms and predict who subsequently develops depression.

CONCLUSIONS

Notwithstanding these limitations, these data indicate that having low FKBP5 expression, alongside high NR3C1 expression, may be a potential preclinical marker of depression risk in adolescent females that warrants additional investigation.

Unraveling the Complex Interplay Between Neuroinflammation and Depression: A Comprehensive Review

The relationship between neuroinflammation and depression is a complex area of research that has garnered significant attention in recent years. Neuroinflammation, characterized by the activation of glial cells and the release of pro-inflammatory cytokines, has been implicated in the pathophysiology of depression. The relationship between neuroinflammation and depression is bidirectional; not only can inflammation contribute to the onset of depressive symptoms, but depression itself can also exacerbate inflammatory responses, creating a vicious cycle that complicates treatment and recovery. The present comprehensive review aimed to explore the current findings on the interplay between neuroinflammation and depression, as well as the mechanisms, risk factors, and therapeutic implications. The mechanisms by which neuroinflammation induces depressive-like behaviors are diverse. Neuroinflammation can increase pro-inflammatory cytokines, activate the hypothalamus-pituitary-adrenal (HPA) axis, and impair serotonin synthesis, all of which contribute to depressive symptoms. Furthermore, the activation of microglia has been linked to the release of inflammatory mediators that can disrupt neuronal function and contribute to mood disorders. Stress-induced neuroinflammatory responses can lead to the release of pro-inflammatory cytokines that not only affect brain function but also influence behavior and mood. Understanding these mechanisms is crucial for developing targeted therapies that can mitigate the effects of neuroinflammation on mood disorders.

Pathways linking loneliness and depressive symptoms among Chinese adolescents: The mediating role of sleep disturbance

BACKGROUND

Despite growing evidence linking loneliness and depressive symptoms, the underlying pathways remain unclear. This study aims to assess the impact of loneliness on depressive symptoms among Chinese adolescents and investigate the potential mediating role of sleep disturbance.

METHODS

A cross-sectional study was conducted between November and December 2021. Loneliness, depressive symptoms, and sleep disturbance were assessed using the UCLA Loneliness Scale, the 9-item Patient Health Questionnaire, and the Pittsburgh Sleep Quality Index questionnaire, respectively. Baron and Kenny's causal steps method and the Karlson-Holm-Breen method were applied to explore the mediating role of sleep disturbance. Subgroup analysis by gender was also conducted.

RESULTS

A total of 6838 adolescents were included, with 52.2 % boys and a mean age of 14.5 (SD = 1.6) years. Approximately 15.8 % of the adolescents reported depressive symptoms. Loneliness was positively associated with depressive symptoms after controlling for covariates (OR = 1.34, 95%CI = 1.31-1.36). After incorporating sleep disturbance into the model, the association was still significant (OR = 1.28, 95%CI = 1.25-1.31). Sleep disturbance partially mediated this association, contributing to 18.89 % of the total effects. The associations and mediation effects were consistent across both genders, with no moderating effect of gender observed.

LIMITATIONS

The cross-sectional design limits the ability to establish causality.

CONCLUSION

Loneliness was significantly associated with depressive symptoms in Chinese adolescents and this association was partially mediated by sleep disturbance. Interventions aimed at reducing loneliness and improving sleep quality may help lower the risk of depressive symptoms in Chinese adolescents, regardless of genders. Nevertheless, further randomized controlled trials are needed to confirm these findings.

Unconscious will as a neurobehavioral mechanism against adversity

Incentive salience theory both explains the directional component of motivation (in terms of cue attraction or "wanting") and its energetic component, as a function of the strength of cue attraction. This theory characterizes cue- and reward-triggered approach behavior. But it does not tell us how behavior can show enhanced vigor under reward uncertainty, when cues are inconsistent or resources hidden. Reinforcement theory is also ineffective in explaining enhanced vigor in case reward expectation is low or nil. This paper provides a neurobehavioral interpretation of effort in situations of adversity (which always include some uncertainty about outcomes) that is complementary to the attribution of incentive salience to environmental cues. It is argued that manageable environmental challenges activate an unconscious process of self-determination to achieve "wanted" actions. This unconscious process is referred to as incentive effort, which involves the hypothalamo-pituitary-adrenal (HPA) axis, noradrenaline, as well as striatal dopamine. Concretely, HPA-induced dopamine release would have the function to make effort-or effortful actions-"wanted" in a challenging context, in which the environmental cues are poorly predictive of reward-i.e., unattractive. Stress would only emerge in the presence of unmanageable challenges. It is hypothesized that incentive effort is the core psychological basis of will-and is, for this reason, termed "willing."

The association of energy or macronutrient intake in three meals with depression in adults with cardiovascular disease: the United States National Health and Nutrition Examination Survey, 2003-2018

BACKGROUND

There is growing evidence that individuals with cardiovascular disease (CVD) are more likely to develop depression. The timing of food intake can significantly alter the body's circadian rhythm and affect the occurrence of depression. Currently, it is unknown whether and how energy or macronutrient intake times are associated with depression in adults with CVD.

OBJECTIVE

To evaluate dietary energy or macronutrient intake (across three meals) associations with depression in adults with CVD in a nationally representative sample.

METHODS

The study population consisted of 3,490 U.S. adults with CVD (including 554 with depression) from the National Health and Nutrition Examination Survey 2003-2018. Energy and macronutrient intake was measured by a 24-h dietary recall, and depression was diagnosed by the Patient Health Questionnaire (PHQ-9, score ≥ 10). According to dietary energy or macronutrient intake across three meals, adults with CVD were divided into five groups. Logistic regression analysis was performed to examine associations between energy or macronutrient intake and depression after adjusting for a series of confounding factors, including age, gender, education level, household income, smoking status, drinking status, physical activity, marital status, skipping breakfast/lunch/dinner, total energy, carbohydrate, protein, dietary fiber, SFA, MUFA, and PUFA intake, T2DM and hypertension status, and BMI. Dietary substitution models were used to explore changes in depression risk when 5% dietary energy intake at dinner or lunch was substituted with energy intake at breakfast.

RESULTS

When compared with participants in the lowest quintile of breakfast energy intake, those who received energy intake in the highest quintile at breakfast were associated with lower depression risk in those with CVD, and the adjusted odds ratio (OR) was 0.71 (95% CI, 0.51 to 0.91). When compared with participants in the lowest quintile of lunch or dinner energy intake, the risk of depression did not exhibit statistical significance when lunch or dinner energy intake was in the highest quintile, and the adjusted ORs were 1.08 (95% CI, 0.65 to 1.83) and 0.92 (95% CI, 0.62 to 1.37), respectively. Isocalorically replacing 5% of total energy at dinner or lunch with breakfast was associated with 5% (OR: 0.95, 95% CI 0.93 to 0.97) and 5% (OR: 0.95, 95% CI 0.93 to 0.96) lower risk of depression, respectively.

CONCLUSIONS

High energy intake at breakfast may be associated with a lower risk of depression in those with CVD. We should focus on the potential role of breakfast energy intake in preventing the onset of depression.

Maternal History of Child Maltreatment Predicts Dysregulated Offspring Stress Response System Functioning

Identifying proximal and multigenerational distal risk mechanisms through which adversity exposure may shape neuroendocrine dysregulation among children is critical to advancing effective preventive interventions for adversity-exposed individuals. Utilizing longitudinal data (N = 247), the current study examined maternal and offspring history of childhood maltreatment (CM) as predictors of offspring cortisol/DHEA ratios, and, in exploratory analyses, extended this longitudinally to offspring depressive symptoms in young adulthood. Youth (ages 8-13 years) initially attended a research camp, then were followed up approximately eight years later (ages 18-22 years). Maternal history of CM significantly predicted their offspring's childhood cortisol/DHEA ratio over and above the effects of the offspring's history of CM. Offspring CM was not a significant predictor of the ratio. The cortisol/DHEA ratio did not mediate the relationship between maternal history of CM and offspring emerging adulthood depression. Results highlight an intergenerational cascade of CM and negative outcomes and support inclusion of maternal experiences in screening for at-risk youth.

Beyond digestion: Exploring how the gut microbiota modulates human social behaviors

For a long time, traditional medicine has acknowledged the gut's impact on general health. Contemporary science substantiates this association through investigations of the gut microbiota, the extensive community of microorganisms inhabiting our gastrointestinal system. These microscopic residents considerably improve digestive processes, nutritional absorption, immunological function, and pathogen defense. Nevertheless, a variety of gastrointestinal and extra-intestinal disorders can result from dysbiosis, an imbalance of the microbial composition of the gut microbiota. A groundbreaking discovery is the gut-brain axis, a complex communication network that links the enteric and central nervous system (CNS). This bidirectional communication allows the brain to influence gut activities and vice versa, impacting mental health and mood disorders like anxiety and depression. The gut microbiota can influence this communication by creating neurotransmitters and short-chain fatty acids, among other biochemical processes. These factors may affect our mental state, our ability to regulate our emotions, and the hypothalamic-pituitary-adrenal (HPA) axis. This study aimed to explore the complex interrelationships between the brain and the gut microbiota. We also conducted a thorough examination of the existing understanding in the area of how microbiota affects social behaviors, including emotions, stress responses, and cognitive functions. We also explored the potential of interventions that focus on the connection between the gut and the brain, such as using probiotics to treat diseases of the CNS. This research opens up new possibilities for addressing mental health and neurological conditions in an innovative manner.

Understanding the bidirectional association between obesity and risk of psychological distress and depression in young adults in the US: available evidence, knowledge gaps, and future directions

While the physical health effects of obesity are well-characterized, an emerging branch of research has shown that obesity additionally plays a critical role in one's mental health. Young adults, in a pivotal transition phase in their lives, may be particularly prone to the concurrent effects of obesity and adverse mental health outcomes. The purpose of this review is to comprehensively examine existing data regarding the connection between obesity and two widely validated measures of mental health: psychological distress and depression. The connection between mental health outcomes and obesity is mediated by a complex interplay between biological and sociocultural factors, which is explored in this review with particular focus on younger adults aged 20-39. Further, the impact of several demographic factors including race/ethnicity, gender, and immigration status are examined closely. To our knowledge, this review is one of the first efforts to integrate existing knowledge between obesity and mental health, with particular regard for young adults and the impact of other key sociodemographic characteristics. This review has important implications at the interface of two of the most pressing public health crises in the United States.

Developing a translational research framework for MDD: combining biomolecular mechanisms with a spiraling risk factor model

Objective

The global incidence and burden of Major Depressive Disorder (MDD) are increasing annually, with current antidepressant treatments proving ineffective for 30-40% of patients. Biomolecular mechanisms within the microbiota-gut-brain axis (MGBA) may significantly contribute to MDD, potentially paving the way for novel treatment approaches. However, integrating the MGBA with the psychological and environmental aspects of MDD remains challenging. This manuscript aims to: 1) investigate the underlying biomolecular mechanisms of MDD using a modeling approach, and 2) integrate this knowledge into a comprehensive 'spiraling risk factor model' to develop a biopsychosocial translational research framework for the prevention and treatment of MDD.

Methods

For the first aim, a systematic review (PROSPERO registration) was conducted using PubMed, Embase, and Scopus to query literature published between 2016-2020, with select additional sources. A narrative review was performed for the second aim.

Results

In addition to genetics and neurobiology, research consistently indicates that hyperactivation of the HPA axis and a pro-inflammatory state are interrelated components of the MGBA and likely underlying mechanisms of MDD. Dysregulation of the MGBA, along with imbalances in mental and physical conditions, lifestyle factors, and pre-existing treatments, can trigger a downward spiral of stress and anxiety, potentially leading to MDD.

Conclusions

MDD is not solely a brain disorder but a heterogeneous condition involving biomolecular, psychological, and environmental risk factors. Future interdisciplinary research can utilize the integrated biopsychosocial insights from this manuscript to develop more effective lifestyle-focused multimodal treatment interventions, enhance diagnosis, and stimulate early-stage prevention of MDD.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42020215412.

Depression in adolescence and young adulthood: the difficulty to integrate motivational/emotional systems

Depression is presented as a multi-factorial bio-psycho-social expression that has evolved primarily as an effect of stressors related to the motivational/emotional systems that regulate the BrainMind in our relationship with conspecifics. These stressors may be caused by two sources of threat, firstly, the loss of bonding with the caregiver and later with a partner and/or group which relates to the SEPARATION (PANIC/GRIEF) system, secondly, social defeat as an expression of the social competition and social dominance. The sexual maturity drives the individual to social competition and social dominance, even if the latter often occurs before sexual maturity, e.g., chickens, dogs, non-human primates, and humans. Depression is an evolutionarily conserved mechanism in mammals to terminate both separation anxiety, so as to protect the vulnerable social brain from the consequences of prolonged separation anxiety, and the stress of social competition when social defeat is predictable. Adolescence and Young adulthood are particularly susceptible to these two types of threat because of human developmental characteristics that are summarized by the term neoteny. This refers to the slowing down of growth and development, resulting in both a prolonged period of dependence on a caring/protective adult and the persistence of juvenile characteristics throughout life. Therefore, neoteny makes the transition from childhood to sexual maturity more dramatic, making the integration of the SEPARATION (PANIC/GRIEF) system with the dynamics of social competition and dominance more stressful and a source of depression. Stress is an expression of the HPA-Hypothalamic-Pituitary-Adrenal axis that articulates with other systems, mainly the autonomic nervous system and the immune-inflammatory system. The latter is believed to be one of the most significant components in the dynamics of depressive processes, connected to the prodromes of its activation in childhood, under the pressure of environmental and relational stressors which can lead to learned helplessness. The recurrence of stressors makes it easier for the immune-inflammatory system to be activated in later life, which could make a significant contribution to the establishment of a depressive disease. The possible contribution of children's identification processes with their parents' depressive personalities through observational learning is considered.

Evaluating the Significance of Obesity or Excessive Weight in Various Mental Health Disorders: A Systematic Review

Obesity is a major global public health challenge affecting all countries and communities. The link between obesity and various types of physical morbidities has been widely acknowledged in different studies. Despite the immense impact of obesity on mental health, its full effect on the areas has not been as explored as the impact on physical health has been. Following an extensive review of various recent studies, the objective of this study is to evaluate the correlations and effects of obesity on mental health disorders, in addition to reflecting on the significance of assessing the correlation. The other objective of this study is to evaluate obesity prevalence in mentally ill individuals. We believe that the realization of these objectives will address the existing literature gaps within the population of mentally ill persons in addition to aiding with the necessary preventive knowledge that will enable the provision of optimum mental and physical health. Therefore, this study entailed the performance of a systematic review of several online databases, including Scopus, Web of Sciences, PubMed, Google Scholar, and MEDLINE. This systematic review also utilized an increasingly robust methodology based on the Cochrane guidelines and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Thus, the inclusion criteria stipulated that only studies published between 2010 and 2024 and published in the English language were to be included in this systematic review. The quality of the included studies was assessed using an appraisal tool for cross-sectional studies. As a result, 12 studies met the inclusion criteria for this systematic review and were reviewed. The findings indicate that the prevalence rate of obesity in individuals with mental health disorders surpasses the prevalence of the condition within the general population, suggesting that mentally ill persons are at a higher risk of developing obesity, even as one of the major side effects of psychiatric treatment is excessive weight gain. Individuals with personality disorders, including borderline personality disorder, avoidant personality disorder, dependent personality disorder, and antisocial personality disorder, among others, presented the highest prevalence rate of obesity compared to those with psychosis. Prospective studies should focus on evaluating the various mitigating factors that underlie the weight gain and obesity development that occur across mental health disorders.

Gender differences of neurometabolic and neuroendocrine alternations and its lateralization in adolescents with major depressive disorder

BACKGROUND

The clinical characteristics of major depressive disorder (MDD) in adolescents show notable gender-related differences, but the cause of these differences is still not understood. The current research concentrates on the changes in neurometabolism and neuroendocrine function, aiming to identify differences in endocrine function and brain metabolism between male and female adolescents with MDD.

METHODS

A total of 121 teenagers diagnosed with MDD (43 males and 78 females) were enlisted as participants. Measurement was conducted on levels of endocrine hormones, which included free tri-iodothyronine (FT3), total tri-iodothyronine (TT3), free thyroxin (FT4), total thyroxin (TT4), thyroid-stimulating hormone (TSH), cortisol, and adrenocorticotropic hormone (ACTH). Obtained through 1H-MRS, the N-acetyl aspartate (NAA) and choline containing compounds (Cho) to creatine (Cr) ratios were acquired for the prefrontal whiter matter (PWM), anterior cingulate cortex (ACC), basal ganglia (BG), thalamus, and cerebellum.

RESULT

After adjusting for multiple comparisons, female adolescents with MDD showed lower ACTH levels compared to their male counterparts. An increased lateralization index (LI) was observed in female patients for both the thalamic Cho/Cr ratio and the basal ganglia NAA/Cr ratio. Additionally, an intriguing finding was that in male adolescent patients, TT4 levels were significantly correlated with the Cho/Cr ratio in the left cerebellum. However, no such correlation between hormones and brain metabolism was found in females.

CONCLUSIONS

Gender differences in endocrine and neurometabolic abnormalities may contribute to the gender-specific pathophysiology of MDD in adolescent patients. Metabolic abnormalities and lateralization changes are observed in different brain regions for male and female MDD patients.

Individualized identification value of stress-related network structural-functional properties and HPA axis reactivity for subthreshold depression

Accumulating studies have highlighted the links between stress-related networks and the HPA axis for emotion regulation and proved the mapping associations between altered structural and functional networks (called SC-FC coupling) in depression. However, the signatures of SC-FC coupling in subthreshold depression (StD) individuals and their relationships with HPA axis reactivity, as well as the predictive power of these combinations for discriminating StD, remain unclear. This cross-sectional study enrolled 160 adults, including 117 StD and 43 healthy controls (HC). The propensity score matching method was applied for match-pair analysis between StD and HC. Herein, we measured depression level, cortisol level, and brain imaging outcomes. The functional MRI and diffusion tensor imaging methods were employed to acquire the network SC-FC couplings and topological attributes. Support vector machine models were employed to discriminate StD from HC. Herein, 43 pairs were matched, but four participants were excluded due to over-threshold head motion, leaving 41 participants in each group. General linear model results revealed a significant SC-FC coupling increase in the default mode network (DMN) and decrements of global efficiency in DMN and frontoparietal control network (P < 0.05), while the cortisol secretion significantly increased (P < 0.001) in StD individuals. Partial correlation analysis revealed positive associations between DMN coupling and cortisol values (r = 0.298, P = 0.033), and their combination provided greater power for discriminating StD than another single model, with the classification accuracy and AUC value up to 85.71% and 0.894, respectively. In summary, this study clarified the relationship between stress-related network SC-FC coupling and cortisol secretion in influencing depressive symptoms, whose combination would contribute to discriminating subthreshold depressive states in the future.

Dietary fiber intake moderates the impact of blood cadmium on depression: a nationally representative cross-sectional study

BACKGROUND

Cadmium (Cd) is a very poisonous pollutant in the environment that has harmful implications on the neurological system. While high fiber intake is beneficial for mental health, it remains unknown whether the recommended basis for dietary fiber intake (DFI) (14 g/1000 kcal per day) can alleviate Cd-induced depression.

METHODS

The investigation employed data from the National Health and Nutrition Examination Survey (NHANES) conducted between the years 2005 and 2020. The research encompassed individuals who had information on blood Cd concentrations, two 24-hour dietary recalls, and depression diagnosis. We deployed weighted logistic regression analyses to estimate the association of exposure to Cd and DFI with depression risk.

RESULTS

The adjusted ORs (95% CI) for depression were 1.33 (95% CI: 1.08, 1.65) and 1.64 (95% CI: 1.38, 1.94) for the third and fourth quartiles of blood Cd concentrations, respectively (Ptrend < 0.001). Doubling DFI was connected with a 0.78-fold (95% CI: 0.71, 0.85) decrease in the risk of depression. Participants below recommended DFI levels had a greater depression risk with higher blood Cd concentrations: OR of 1.39 (95% CI: 1.11, 1.73) for the third and 1.67 (95% CI: 1.40, 1.98) for the fourth quartile. No significant association between Cd exposure and depression was perceived for participants meeting recommended DFI levels.

CONCLUSIONS

Higher blood Cd burden was associated with elevated depression risk, while recommended DFI could alleviate this effect. High-fiber dietary pattern may counteract the deleterious effect of environmental pollutants such as Cd on depression.

CLINICAL TRIAL NUMBER

Not applicable.

Association of Combined Effect of Metals Exposure and Behavioral Factors on Depressive Symptoms in Women

This study investigates the combined effects of environmental pollutants (lead, cadmium, total mercury) and behavioral factors (alcohol consumption, smoking) on depressive symptoms in women. Data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018 cycle, specifically exposure levels of heavy metals in blood samples, were used in this study. The analysis of these data included the application of descriptive statistics, linear regression, and Bayesian Kernel Machine Regression (BKMR) to explore associations between environmental exposures, behavioral factors, and depression. The PHQ-9, a well-validated tool that assesses nine items for depressive symptoms, was used to evaluate depression severity over the prior two weeks on a 0-3 scale, with total scores ranging from 0 to 27. Exposure levels of heavy metals were measured in blood samples. BKMR was used to estimate the exposure-response relationship, while posterior inclusion probability (PIP) in BKMR was used to quantify the likelihood that a given exposure was included in the model, reflecting its relative importance in explaining the outcome (depression) within the context of other predictors in the mixture. A descriptive analysis showed mean total levels of lead, cadmium, and total mercury at 1.21 µg/dL, 1.47 µg/L, and 0.80 µg/L, respectively, with a mean PHQ-9 score of 5.94, which corresponds to mild depressive symptoms based on the PHQ-9 scoring. Linear regression indicated positive associations between depression and lead as well as cadmium, while total mercury had a negative association. Alcohol and smoking were also positively associated with depression. These findings were not significant, but limitations in linear regression prompted a BKMR analysis. BKMR posterior inclusion probability (PIP) analysis revealed alcohol and cadmium as significant contributors to depressive symptoms, with cadmium (PIP = 0.447) and alcohol (PIP = 0.565) showing notable effects. Univariate and bivariate analyses revealed lead and total mercury's strong relationship with depression, with cadmium showing a complex pattern in the bivariate analysis. A cumulative exposure analysis of all metals and behavioral factors concurrently demonstrated that higher quantile levels of combined exposures were associated with an increased risk of depression. Finally, a single variable-effects analysis in BKMR revealed lead, cadmium, and alcohol had a stronger impact on depression. Overall, the study findings suggest that from exposure to lead, cadmium, mercury, alcohol, and smoking, cadmium and alcohol consumption emerge as key contributors to depressive symptoms. These results highlight the need to address both environmental and lifestyle choices in efforts to mitigate depression.

Ginsenoside Rg1: A Neuroprotective Natural Dammarane-Type Triterpenoid Saponin With Anti-Depressive Properties

BACKGROUND

Depression, a widespread mental disorder, presents significant risks to both physical and mental health due to its high rates of recurrence and suicide. Currently, single-target antidepressants typically alleviate depressive symptoms or delay the progression of depression rather than cure it. Ginsenoside Rg1 is one of the main ginsenosides found in Panax ginseng roots. It improves depressive symptoms through various mechanisms, suggesting its potential as a treatment for depression.

MATERIALS AND METHODS

We evaluated preclinical studies to comprehensively discuss the antidepressant mechanism of ginsenoside Rg1 and review its toxicity and medicinal value. Additionally, pharmacological network and molecular docking analyses were performed to further validate the antidepressant effects of ginsenoside Rg1.

RESULTS

The antidepressant mechanism of ginsenoside Rg1 may involve various pharmacological mechanisms and pathways, such as inhibiting neuroinflammation and over-activation of microglia, preserving nerve synapse structure, promoting neurogenesis, regulating monoamine neurotransmitter levels, inhibiting hyperfunction of the hypothalamic-pituitary-adrenal axis, and combatting antioxidative stress. Moreover, ginsenoside Rg1 preserves astrocyte gap junction function by regulating connexin43 protein biosynthesis and degradation, contributing to its antidepressant effect. Pharmacological network and molecular docking studies identified five targets (AKT1, STAT3, EGFR, PPARG, and HSP90AA1) as potential molecular regulatory sites of ginsenoside Rg1.

CONCLUSIONS

Ginsenoside Rg1 may exert its antidepressant effects via various pharmacological mechanisms. In addition, multicenter clinical case-control and molecular targeted studies are required to confirm both the clinical efficacy of ginsenoside Rg1 and its potential direct targets.

Unraveling the complexities of adolescent depression: A call for action

The adolescent years are a period of profound change, both physically and psychologically. For many, these years are marked by excitement and exploration, but for others, they are fraught with challenges that can lead to significant mental health issues. Depression, in particular, has become an increasingly prevalent concern among adolescents worldwide, and its multifaceted etiology requires a comprehensive approach to understanding and intervention. A recent study on the relationships among negative life events, dysfunctional attitudes, social support, and depressive symptoms in Chinese adolescents offers valuable insights into the complex interplay between various factors contributing to adolescent depression. The authors explore a moderated mediation model to better understand how these factors interact with and contribute to the onset of depression. This article aims to delve into the key findings of the study, highlight its implications for clinical practice, and encourage further research in this critical area.

Greater perceived stress and lower cortisol concentration increase the odds of depressive symptoms among adolescents

BACKGROUND

Adolescent depression is a major public health concern. Although stress has been linked to more severe depression, its association with mild depression among adolescents is not understood. This study assesses the relationship between perceived stress and cortisol (a physiologic measure of stress) and examines the relationships between these stress measures and depressive symptoms among adolescents 13-19 years of age.

METHODS

Stress was measured with the Perceived Stress Scale-10 and through salivary sampling for cortisol four times throughout the day. The Patient Health Questionnaire-9 was used to measure depressive symptoms (range 0-27), where ≥5 indicated the threshold for experiencing at least mild depressive symptoms. Spearman coefficients and multiple logistic regression models were used to examine the relationships between our variables of interest.

RESULTS

The mean age of the 73 participants in our study was 15.82 years. 49 % of the participants reported depressive symptoms (PHQ-9 score ≥ 5). Both higher perceived stress (odds ratio [OR] = 1.11, p = 0.022) and lower cortisol (area-under-the curve; AUCG) (OR = 0.99, p = 0.009) were associated with increased odds of having depressive symptoms.

LIMITATIONS

Few participants had moderate to severe PHQ-9 depression, therefore our study reported findings on mild depression or greater.

CONCLUSIONS

Perceived stress and cortisol appear to reflect distinct, independent components of the stress experience. However, both greater perceived stress and less circulating cortisol may indicate difficulties in regulating stress as potential factors underlying depressive symptoms. Future research should focus on the different types of adolescent stressors and the importance of routine screening of stress and depression, including mild depression.

Hair cortisol and psychiatric symptomatology in children; outcomes of group CBT

The associations between hair cortisol concentration (HCC), a biomarker of chronic stress, and behavior and sleep disturbance symptoms have not been studied in children with psychiatric disorders. While cognitive behavioral therapy (CBT) has proven effective in treating psychiatric symptoms in children, its potential biological implications as determined by HCC have not been investigated. We explored associations between HCC, behavior and sleep disturbance symptoms, and different diagnostic groupings (depression/anxiety, ADHD, or other types of psychiatric disorders) in clinician-diagnosed 6-12-year-old children (n = 100) with mixed psychiatric disorders and comorbidities. In addition, we examined whether group CBT led to changes in HCC, behavior symptoms, and sleep disturbance symptoms and whether any fluctuations in HCC levels were associated with potential symptom change. We collected data on HCC, internalizing and externalizing symptoms (The Spence Children's Anxiety Self-Report, Child Behavior Checklist, and Teacher Report Form), and sleep disturbance symptoms (The Sleep Disturbance Scale for Children) at three time points (baseline, post-treatment, and seven-month follow-up). Baseline HCC was not associated with behavior or sleep disturbance symptoms, whereas behavior and sleep disturbance symptoms were mutually correlated. No changes in HCC levels were observed with group CBT. Moreover, potential variations in HCC levels over the course of the study did not appear to be associated with behavior symptom relief after group CBT. Our findings suggest that HCC may not be a methodologically relevant biomarker of behavior or sleep disturbance symptoms in children with diverse psychiatric disorders.

Chronic Corticosterone Administration-Induced Mood Disorders in Laboratory Rodents: Features, Mechanisms, and Research Perspectives

Mood disorders mainly affect the patient's daily life, lead to suffering and disability, increase the incidence rate of many medical illnesses, and even cause a trend of suicide. The glucocorticoid (GC)-mediated hypothalamus-pituitary-adrenal (HPA) negative feedback regulation plays a key role in neuropsychiatric disorders. The balance of the mineralocorticoid receptor (MR)/glucocorticoid receptor (GR) level contributes to maintaining the homeostasis of the neuroendocrine system. Consistently, a chronic excess of GC can also lead to HPA axis dysfunction, triggering anxiety, depression, memory loss, and cognitive impairment. The animal model induced by chronic corticosterone (CORT) administration has been widely adopted because of its simple replication and strong stability. This review summarizes the behavioral changes and underlying mechanisms of chronic CORT administration-induced animal models, including neuroinflammatory response, pyroptosis, oxidative stress, neuroplasticity, and apoptosis. Notably, CORT administration at different doses and cycles can destroy the balance of the MR/GR ratio to make dose-dependent effects of CORT on the central nervous system (CNS). This work aims to offer an overview of the topic and recommendations for future cognitive function research.

The effect of MIND diet on sleep status, anxiety, depression, and cardiometabolic indices in obese diabetic women with insomnia: study protocol for a randomized controlled clinical trial {1}

BACKGROUND

The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet is a plant-based and anti-inflammatory diet that has the ability to protect and manage cardiovascular and nervous system diseases. Regarding that insomnia and cardiovascular problems are x`common in type 2 diabetes mellitus (T2DM), the present study will assess the effectiveness of the MIND dietary pattern on sleep quality, cardiometabolic indicators, and other psychological indicators.

METHODS

Forty-four overweight/obese T2DM women with insomnia, aged 30-65 years, will voluntarily participate in this randomized controlled trial and will be randomized to receive either a MIND low-calorie diet (MLCD) or a low-calorie diet (LCD) over a 3-month period. Before and after the study, sleep quality, some biochemical and cardiometabolic indices, cortisol, brain-derived neurotrophic factor (BDNF), high-sensitivity C-reactive protein (hs-CRP), and oxidative stress indicators will be assessed.

DISCUSSION

The use of dietary interventions in the management of T2DM complications is practical and safe. This research seeks to investigate the capacity of the MIND diet in the management of insomnia and cardiovascular problems of DM. It is expected that the results of this research will provide new perspectives on using an ideal dietary regimen to treat these health conditions.

TRIAL REGISTRATION

IRCT20181111041611N8. Registered on August 7, 2023. https://www.irct.ir/trial/71772.

Past-year counseling and therapy use and severity of depression among university students with depression: The Healthy Minds Study

Background: This exploratory study examined the associations between sociodemographic factors and past-year counseling or therapy use by depression severity among college students with depression. Participants: This cross-sectional analysis included n = 8090 participants from the Healthy Minds Study Winter 2021 Survey. Methods: Main effects and stratified multivariable logistic regression models assessed the relationship between sociodemographic factors and counseling/therapy independently and by depression severity. Results: Depression severity and counseling or therapy use were not independently associated (χ2 = 1.34, p = 0.77). Fourth + year students showed a graded response for past-year counseling/therapy use across depression severity (aOR range: 0.57-0.78, 95% CI range: 0.49-1.24). Males and students living with relatives, and those with stressful financial situations also showed lower odds of past-year counseling/therapy use. Conclusion: Findings indicate vulnerable subpopulations of college students that need support. Future interventions should identify barriers to treatment and pathways to support these students.

Association between depression severity and trouble sleeping: A population-based study

This study investigates the association between insomnia and depression severity, exploring sleep disturbances in individuals with depression. The aim is to establish a new foundation for managing patients with co-occurring depression and insomnia, using 2015 to 2016 National Health and Nutrition Examination Survey (NHANES) data. We employed a cross-sectional design, using NHANES data from 2015 to 2018. The study included 11,261 participants after excluding incomplete data. Depression severity, assessed using Patient Health Questionnaire-9 (PHQ-9) scores, served as the exposure variable. We considered various demographic and lifestyle factors as covariates in the multivariate adjustment model. Statistical analyses adhered to CDC recommendations, with sample weights incorporated to account for NHANES' complex sample design. Our study, encompassing 19,225 participants, revealed that higher PHQ-9 scores correlated with an increased likelihood of sleep disorders. In the fully adjusted model, a positive association emerged between PHQ-9 scores and trouble sleeping (OR = 3.95, 95% CI: 3.35-4.66, P < .0001). This relationship displayed an inverted U-shaped curve, with an inflection point at 28. Subgroup analysis and interaction tests indicated no reliance on factors such as gender, age, marital status, or BMI for the connection between depression severity and trouble sleeping (all P for interaction > .05). We identified a significant inverted U-shaped correlation between sleep disturbances and depression severity. This underscores the crucial importance of assessing sleep disorder risks in individuals with varying degrees of depression severity, facilitating personalized therapeutic interventions.

An epigenome-wide study of a needs-based family intervention for offspring of trauma-exposed mothers in Kosovo

INTRODUCTION

Maternal stress and trauma during pregnancy have been shown to influence cortisol levels and epigenetic patterns, including DNA methylation, in the offspring. This study aimed to determine whether a tailor-made family intervention could help reduce cortisol levels in children born to traumatized mothers, and to determine whether it effected offspring DNA methylation. The secondary aim was to determine whether the family intervention influenced DNA methylation aging, a marker of biological aging.

METHODS

A needs-based family intervention was designed to help address relational difficulties and family functioning, and included a focus on family strengths and problem-solving patterns. Women survivors of sexual violence during the Kosovar war in 1998-1999, and their families (children with or without partners) were randomly assigned to 10 sessions of a family therapy over a 3-5-month period, or to a waitlist control group. Both mothers and children completed assessments prior to and after the intervention phase. Children's blood samples collected at these two time points were used to measure cortisol and epigenome-wide DNA methylation patterns (Illumina EPIC array). Cortisol levels, and genome-wide DNA methylation changes pre-/postintervention were compared between children in the intervention and the waitlist groups. DNA methylation age and accelerated biological aging were calculated.

RESULTS

Sixty-two women-child dyads completed the study, 30 were assigned first to the intervention group, and 32 to the waitlist control group. In adjusted linear regression, the family intervention was associated with a significant decline in cortisol levels compared to the waitlist control (β = -124.72, 95% confidence interval [CI]: -197.4 to -52.1, p = .001). Children in the intervention group, compared to the waitlist control group, showed >1% differential methylation degree at 5819 CpG (5'-C-phosphate-G-3') sites across the genome (p < .01), with the largest methylation difference being 21%. However, none of these differences reached genome-wide significant levels. There was no significant difference in DNA methylation aging between the two groups.

CONCLUSION

We find evidence that a tailored family-based intervention reduced stress levels in the children (based on cortisol levels), and modified DNA methylation levels at a number of sites across the genome. This study provides some preliminary evidence to suggest the potential for tailored interventions to help break the intergenerational transmission of trauma, however, large studies powered to detect associations at genome-wide significant levels are needed.

Arginine vasopressin in mood disorders: A potential biomarker of disease pathology and a target for pharmacologic intervention

Vasopressin or arginine-vasopressin (AVP) is a neuropeptide molecule known for its antidiuretic effects and serves to regulate plasma osmolality and blood pressure. The existing literature suggests that AVP plays a multifaceted-though less well-known-role in the central nervous system (CNS), particularly in relation to the pathophysiology and treatment of mood disorders. Animal models have demonstrated that AVP is implicated in regulating social cognition, affiliative and prosocial behaviors, and aggression, often in conjunction with oxytocin. In humans, AVP is implicated in mood disorders through its effects on the hypothalamic-pituitary-adrenal (HPA) axis as well as on the serotoninergic and glutamatergic systems. Measuring plasma AVP has yielded interesting but mixed results in mood and stress-related disorders. Recent advances have led to the development of copeptin as a stable and reliable surrogate biomarker for AVP. Another interesting but relatively unexplored issue is the interaction between the osmoregulatory system and mood disorder pathophysiology, given that psychotropic medications often cause dysregulation of AVP receptor expression or signaling that can subsequently lead to clinical syndromes like syndrome of inappropriate diuresis and diabetes insipidus. Finally, pharmaceutical trials of agents that act on V1a and V1b receptor antagonists are still underway. This narrative review summarizes: (1) the neurobiology of the vasopressinergic system in the CNS; (2) the interaction between AVP and the monoaminergic and glutamatergic pathways in the pathophysiology and treatment of mood disorders; (3) the iatrogenic AVP dysregulation caused by psychotropic medications; and (4) the pharmaceutical development of AVP receptor antagonists for the treatment of mood disorders.

Developmental activity-based anorexia alters hippocampal non-genomic stress response and induces structural instability and spatial memory impairment in female rats

OBJECTIVE

Anorexia nervosa (AN) is characterized by hyperactivation of the hypothalamic-pituitary-adrenal axis and cognitive deficits. However, little is known about the rapid non-genomic stress response involvement. This study investigates the molecular, structural and behavioral signatures of the anorexic phenotype induction in female rats on stress-related mechanisms in the hippocampus.

METHOD

Female adolescent rats, exposed to the combination of food restriction and wheel access, i.e., the activity-based anorexia (ABA) protocol, were sacrificed in the acute phase of the pathology (postnatal day [P]42) or following a 7-day recovery period (P49).

RESULTS

ABA rats, in addition to body weight loss and increased wheel activity, alter their pattern of activity over days, showing increased food anticipatory activity, a readout of their motivation to engage in intense physical activity. Corticosterone plasma levels were enhanced at P42 while reduced at P49 in ABA rats. In the membrane fraction of the hippocampus, we found reduced glucocorticoid receptor levels together with reduced expression of caldesmon, n-cadherin and neuroligin-1, molecular markers of cytoskeletal stability and glutamatergic homeostasis. Accordingly, structural analyses revealed reduced dendritic spine density, a reduced number of mushroom-shaped spines, together with an increased number of thin-shaped spines. These events are paralleled by impairment in spatial memory measured in the spatial order object recognition test. These effects persisted even when body weight of ABA rats was restored.

DISCUSSION

Our findings indicate that ABA induction orchestrates hippocampal maladaptive structural and functional plasticity, contributing to cognitive deficits, providing a putative mechanism that could be targeted in AN patients.