Predictors of suicidal ideation severity among treatment-seeking young people with major depressive disorder: The role of state and trait anxiety

Trait anxiety predicting the developmental trajectories of depression symptoms in children: The mediating role of attentional control

Trait anxiety and attentional control are important factors related to depression symptoms. The study investigated how trait anxiety and attentional control predicted the trajectories of depression symptoms during the transition into early adolescence. The mediating effect of attentional control on the relationship of trait anxiety to the trajectories of depression symptoms was also examined. Children of 9 to 10 years were recruited at Time 1. Trait anxiety, attentional control, and depression symptoms were assessed at Time 1. Depression symptoms were measured at three follow-up assessments across 18 months. Latent class growth modeling revealed high (14.4%) and low (85.6%) trajectories of depression symptoms. Higher trait anxiety and lower attentional control predicted a higher likelihood of showing the trajectory of high depressive symptoms. Attentional control mediated the relationship of trait anxiety to the trajectory membership of depression symptoms. The findings had important implications for the association of trait anxiety with the trajectory membership of depression symptoms and highlighted the importance of attentional control in the development of depression symptoms for children with high trait anxiety.

Development and Validation of a Prediction Model for Co-Occurring Moderate-to-Severe Anxiety Symptoms in First-Episode and Drug Naïve Patients With Major Depressive Disorder

Background: Moderate-to-severe anxiety symptoms are severe and common in patients with major depressive disorder (MDD) and have a significant impact on MDD patients and their families. The main objective of this study was to develop a risk prediction model for moderate-to-severe anxiety in MDD patients to make the detection more accurate and effective. Methods: We conducted a cross-sectional survey and tested biochemical indicators in 1718 first-episode and drug naïve (FEDN) patients with MDD. Using machine learning, we developed a risk prediction model for moderate-to-severe anxiety in these FEDN patients with MDD. Results: Four predictors were identified from a total of 21 variables studied by least absolute shrinkage and selection operator (LASSO) regression analysis, namely psychotic symptoms, suicide attempts, thyroid stimulating hormone (TSH), and Hamilton Depression Scale (HAMD) total score. The model built from the four predictors showed good predictive power, with an area under the receiver operating characteristic (ROC) curve of 0.903 for the training set and 0.896 for the validation set. The decision curve analysis (DCA) curve indicated that the nomogram could be applied to clinical practice if the risk thresholds were between 13% and 40%. In the external validation, the risk threshold was between 14% and 40%. Conclusion: The inclusion of psychotic symptoms, suicide attempts, TSH, and HAMD in the risk nomogram may improve its utility in identifying patients with MDD at risk of moderate-to-severe anxiety. It may be helpful in clinical decision-making or for conferring with patients, especially in risk-based interventions.

Incidence and correlates of suicide attempts in adolescents with major depressive versus bipolar disorders: A cross-sectional study

BACKGROUND

Major depressive disorders (MDD) and bipolar disorders (BD) are the most common psychiatric diagnoses of suicide attempts (SA) in adolescents. However, little is known regarding the differences in incidence and clinical-related features of SA between these two disorders. The study aims to examine the SA incidence and related factors in adolescents with MDD versus BD.

METHOD

A retrospective survey was conducted in outpatients. SA incidence, demographic characteristics and substance use history were collected. Symptom Checklist-90 was used to measure the severity of symptoms. The Revised Chinese internet addiction scale and Barratt Impulsiveness Scale-11 were utilized to assess the presence of internet addiction and impulsiveness. The Childhood Trauma Questionnaire was used to measure childhood maltreatment subtypes.

RESULTS

295 MDD and 205 BD adolescents were recruited. The incidence of SA for MDD and BD were 52.5 % and 56.4 %, respectively. BD adolescents who attempted suicide showed worse symptoms, higher rates of nicotine and alcohol use, higher motor and non-planning impulsivity, and a more childhood physical abuse proportion than MDD adolescents with SA. Physical abuse in childhood was found to be associated with SA in both disorders (OR = 1.998 for MDD; OR = 2.275 for BD), while higher anxiety (OR = 1.705), and alcohol use (OR = 2.094) were only associated with SA in MDD.

LIMITATIONS

Retrospective, cross-sectional design cannot draw causality, and biases in self-report measurements cannot be ignored.

CONCLUSIONS

The findings revealed some difference between BD and MDD for adolescents with SA, and it emphasize significance of prompt identification and exact distinction between BD and MDD in adolescents.

Network analysis of suicide ideation and depression-anxiety symptoms among Chinese adolescents

Background

The co-occurrence of depression and anxiety among adolescents is typically associated with suicide ideation.

Aims

The study aimed to investigate the symptom-level relationship between suicide ideation and the comorbidity of depression and anxiety.

Methods

1501 adolescents aged 12-19 years were assessed using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale, and 716 adolescents who scored ≥5 on both scales were selected as participants. Network analysis was used to identify the network structure of depressive symptoms and anxiety symptoms. Participants were categorised into either the suicide ideation or non-suicide ideation groups based on their scoring on the suicide-related item in PHQ-9. A comparison was made between the depression-anxiety symptom networks of the two groups.

Results

'Restlessness', 'sad mood' and 'trouble relaxing' were the most prominent central symptoms in the depression-anxiety symptom network, and 'restlessness', 'nervousness' and 'reduced movement' were the bridge symptoms in this network. 'Sad mood' was found to be directly related to 'suicide ideation' with the highest variance. The network structure was significantly different in properties between the suicide ideation group and the non-suicide ideation group, with 'restlessness' and 'sad mood' exhibiting significantly higher influence in the network of the suicide ideation group than that in the non-suicide ideation group.

Conclusion

Restlessness and sad mood could be targeted for the intervention of depression-anxiety symptoms among adolescents with suicide ideation.