Bidirectional relationship between borderline personality features and depressive symptoms in early adolescence: A school-based cohort study

Depressive symptoms is a public health concern worldwide, and adolescents may experience more depressive symptoms. Although the relationship between borderline personality features (BPFs) disorder and depressive symptoms has been established, it is unclear whether the longitudinal relationship between them is unidirectional or bidirectional and whether these symptoms are different between boys and girls. In this study, Chinese adolescents (1608 total and separately 972 for boys and 636 girls) were enrolled between September 2019 and September 2021, and we analyzed the data using a cross-lagged model. The results suggested a bidirectional relationship between BPFs and depressive symptoms in boys (β = 0.191 and 0.117, P < 0.001). However, in girls, depressive symptoms were predicted based on BPFs (β = 0.225, P < 0.001), whereas BPFs were not predicted based on depressive symptoms (β = 0.035, P = 0.535). The findings suggest that borderline personality traits and depressive symptoms are only bilaterally associated in girls, which also provides important evidence for the treatment and prevention of adolescent BPFs and depressive symptoms.

Navigating the intersection of psychiatry and ophthalmology: A comprehensive review of depression and anxiety management in glaucoma patients

Glaucoma, a prevalent and debilitating eye disease, has long been associated with vision impairment and blindness. However, recent research has shed light on the often-underestimated psychological dimensions of this condition. Anxiety and depression, two pervasive psychiatric comorbidities, have been increasingly recognized among glaucoma patients. This comprehensive review aims to explore the intricate relationship between psychiatry and ophthalmology, in the context of managing depression and anxiety in glaucoma patients. By meticulously examining peer-reviewed literature, we synthesize current knowledge on the prevalence, risk factors, and underlying mechanisms of anxiety and depression in glaucoma. The evidence reveals that glaucoma patients face an elevated risk of experiencing these mood disorders. Factors such as progressive vision loss, complex medication regimens, and the fear of further visual deterioration contribute to their vulnerability. Moreover, we delve into the bidirectional relationship between glaucoma and mood disorders, shedding light on the complex interplay between ocular and emotional health. Our review investigates the implications of anxiety and depression on glaucoma management, including their potential impact on treatment adherence, disease progression, and overall quality of life. We also explore the neurobiological pathways linking glaucoma and mood disorders, providing a foundation for future research and potential therapeutic interventions. In conclusion, recognizing the psychological burden carried by glaucoma patients is essential for holistic and patient-centered care. This review underscores the pressing need for integrated approaches that bring together ophthalmological and psychiatric expertise to optimize the well-being of individuals facing the challenges of glaucoma. By addressing anxiety and depression in glaucoma care, healthcare providers can enhance the overall quality of life for these patients, ultimately leading to improved outcomes and a brighter future for those affected by this condition. This review offers valuable insight for healthcare practitioners and researchers, providing a concise overview of key topics and research in the field of managing depression and anxiety in glaucoma patients.

The relationship between mobile phone addiction and time management disposition among Chinese college students：A cross-lagged panel model

Previous research has identified a negative association between mobile phone addiction and time management disposition among college students; however, the direction of this relationship remains divergent. This study utilized a cross-lagged panel model to elucidate the directionality of the relationship between mobile phone addiction and time management disposition. A total of 466 college students completed two measures at seven-month intervals. The findings revealed a prevalence of mobile phone addiction at 10.94 % and 13.73 % in the two surveys. Notably, both mobile phone addiction and time management disposition demonstrated stability over time. Furthermore, a discernible negative bidirectional relationship was observed between the two. The present findings underscore the importance of timely intervention for college students facing challenges in mobile phone usage and time management.

Bidirectional Association Between Cardiovascular Disease and Lung Cancer in a Prospective Cohort Study

INTRODUCTION

The study aimed to prospectively investigate the bidirectional association between cardiovascular disease (CVD) and lung cancer, and whether this association differs across genetic risk levels.

METHODS

This study prospectively followed 455,804 participants from the United Kingdom Biobank cohort who were free of lung cancer at baseline. Cox proportional hazard models were used to estimate the hazard ratio (HR) for incident lung cancer according to CVD status. In parallel, similar approaches were used to assess the risk of incident CVD according to lung cancer status among 478,756 participants free of CVD at baseline. The bidirectional causal relations between these conditions were assessed using Mendelian randomization analysis. Besides, polygenic risk scores were estimated by integrating genome-wide association studies identified risk variants.

RESULTS

During 4,007,477 person-years of follow-up, 2006 incident lung cancer cases were documented. Compared with participants without CVD, those with CVD had HRs (95% confidence interval [CI]) of 1.49 (1.30-1.71) for NSCLC, 1.80 (1.39-2.34) for lung squamous cell carcinoma (LUSC), and 1.25 (1.01-1.56) for lung adenocarcinoma (LUAD). After stratification by smoking status, significant associations of CVD with lung cancer risk were observed in former smokers (HR = 1.44, 95% CI: 1.20-1.74) and current smokers (HR = 1.38, 95% CI: 1.13-1.69), but not in never-smokers (HR = 0.98, 95% CI: 0.60-1.61). In addition, CVD was associated with lung cancer risk across each genetic risk level (pheterogeneity = 0.336). In the second analysis, 32,974 incident CVD cases were recorded. Compared with those without lung cancer, the HRs (95% CI) for CVD were 2.33 (1.29-4.21) in NSCLC, 3.66 (1.65-8.14) in LUAD, and 1.98 (0.64-6.14) in LUSC. In particular, participants with lung cancer had a high risk of incident CVD at a high genetic risk level (HR = 3.79, 95% CI: 1.57-9.13). No causal relations between these conditions were observed in Mendelian randomization analysis.

CONCLUSIONS

CVD is associated with an increased risk of NSCLC including LUSC and LUAD. NSCLC, particularly LUAD, is associated with a higher CVD risk. Awareness of this bidirectional association may improve prevention and treatment strategies for both diseases. Future clinical demands will require a greater focus on cardiac oncology.

Bidirectional relationship between frailty and cognitive function among Chinese older adults

BACKGROUND

Frailty and cognitive function are two common aging-related conditions among older adults. This study examined the bidirectional relationship between frailty and cognitive function according to sex.

METHODS

All older adults aged ≥65 years who participated in the 2008 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey were included in this study. Binary logistic regression and generalized estimating equation models were used to determine the bidirectional relationship between frailty and cognitive function in cross-sectional and cohort studies, and sex differences were assessed.

RESULTS

We included 12,708 participants who were interviewed in the baseline study. The participants' mean (standard deviation) age was 85.6 (11.1%) years. In the cross-sectional study, the multivariate-adjusted odds ratio (OR; 95% confidence interval [CI]) for pre-frailty and frailty among participants with cognitive impairment was 3.68 (3.29-4.13). Older adults with pre-frailty and frailty had higher risks of cognitive impairment (OR = 3.79, 95% CI: 3.38-4.25). The GEE models showed that pre-frailty and frailty predicted a higher likelihood of cognitive impairment (OR = 2.02, 95% CI, 1.67-2.46) during follow-up. Moreover, the temporal relationship between these relationships differed slightly by sex. Older women with cognitive impairment at baseline were more likely to develop pre-frailty or frailty than did older men.

CONCLUSIONS

This study demonstrated a significant bidirectional relationship between frailty and cognitive function. Moreover, this bidirectional relationship varied by sex. These findings confirm the need to integrate sex-specific interventions for frailty and cognitive functioning problems to improve the quality of life of older adults.

Underlying patterns of the co-occurrence of tobacco use and mental health among youth

We aimed to examine how bidirectional relationships between mental health problems and tobacco use are formed over time by types of tobacco use in recent samples of U.S. youth. Data were drawn from Waves 1-4 of the Population Assessment of Tobacco and Health Study (N = 10,082) and analyzed using cross-lagged panel models. A high level of internalizing problems at Wave 1 predicted conventional cigarette smoking (adjusted odds ratio [AOR] = 1.19, 95% CI = 1.06-1.34) and e-cigarette use (AOR = 1.25, 95% CI = 1.09-1.43) at Wave 2, but not vice versa. Both cigarette smoking and e-cigarette use at Wave 2 tended to persist into Wave 3, which, in turn, increased the risk of subsequent internalizing problems in late adolescence or young adulthood (Wave 4). The bidirectional relationship between tobacco use and internalizing problems seems to begin as a procession from internalizing problems to tobacco use, and then from persistent tobacco use to exacerbated internalizing problems over time.

Exploring the bidirectional relationship between pain and mental disorders: a comprehensive Mendelian randomization study

BACKGROUND

The close relationship between pain and mental health problems is well-known, and psychological intervention can provide an effective alternative to medication-based pain relief. However, previous studies on the connection between pain and psychological problems, the findings thus far have been inconclusive, limiting the potential for translating psychological interventions into clinical practice. To complement the gap, this study utilized genetic data and Mendelian randomization (MR) to examine the potential relationship between pain in different parts and common mental disorders.

METHODS

Based on the instrumental variables selected from the Genome-wide association study summary statistics of localized pain and mental disorders, we conducted bidirectional two-sample MR analyses to infer bidirectional causal associations between pain and mental disorders. The inverse-variance weighted MR method and MR-Egger were used as the primary statistical method according to the horizontal pleiotropy and heterogeneity level. We reported the odds ratio to infer the causal effect between pain and mental disorders. F statistic was calculated to measure the statistical efficacy of the analyses.

RESULTS

Insomnia is causally related to the genetic susceptibility of multisite pain including head (OR = 1.09, 95% CI: 1.06-1.12), neck/shoulder (OR = 1.12, 95% CI: 1.07-1.16), back (OR = 1.12, 95% CI: 1.07-1.18) and hip (OR = 1.08, 95% CI: 1.05-1.10). Reversely, headache (OR = 1.14, 95% CI: 1.05-1.24), neck/shoulder pain (OR = 1.95, 95% CI: 1.03-3.68), back pain (OR = 1.40, 95% CI: 1.22-1.60), and hip pain (OR = 2.29, 95% CI: 1.18-4.45) promote the genetic liability of insomnia. Depression is strongly associated with the predisposition of multisite pain including headache (OR = 1.28, 95% CI: 1.08-1.52), neck/shoulder pain (OR = 1.32, 95% CI: 1.16-1.50), back pain (OR = 1.35, 95% CI: 1.10-1.66) and stomach/abdominal pain (OR = 1.14, 95% CI: 1.05-1.25), while headache (OR = 1.06, 95% CI: 1.03-1.08), neck/shoulder (OR = 1.09, 95% CI: 1.01-1.17), back (OR = 1.08, 95% CI: 1.03-1.14), and stomach/abdominal pain (OR = 1.19, 95% CI: 1.11-1.26) are predisposing factors for depression. Additionally, insomnia is associated with the predisposition of facial, stomach/abdominal, and knee pain, anxiety was associated with the predisposition of neck/shoulder and back pain, while the susceptibilities of hip and facial pain are influenced by depression, but these associations were unidirectional.

CONCLUSIONS

Our results enhance the understanding of the complex interplay between pain and mental health and highlight the importance of a holistic approach to pain management that addresses both physical and psychological factors.

Understanding the nexus between environmental, social, and governance (ESG) and financial performance: evidence from Chinese-listed companies

Before discussing how to balance and decide on environmental, social, and corporate governance (ESG) and traditional revenue enhancement projects, it is crucial to clarify the relationship between corporate financial performance (CFP) and ESG. However, little attention has been paid to the nexus of ESG and CFP. This paper attempts firstly to investigate the bidirectional causality of ESG and CFP, followed by the micro-foundations, and finally, the moderating effect of intrinsic factors. A GMM-PVAR method was used to examine the research hypotheses, which can effectively deal with endogenous problems that have been ignored by traditional literature. The findings of this research demonstrate that CFP promoted ESG growth, but ESG did not boost CFP. This asymmetric causality was because CFP had a supportive effect on the environment and society pillars, while the social pillar cannot promote CFP, and the environment pillar negatively affects CFP. The relationship between ESG and CFP was moderated by total quality management, environmental sensitivity, and the pay gap. Furtherly, a panel threshold model was constructed to access the threshold effects of ESG on CFP, showing an inverted U-shape. Based on these findings, the theoretical implications, managerial prescriptions, and limitations are also discussed.

Depressive symptoms and falls among Chinese older adults: A bidirectional relationship

BACKGROUND

Falls and depressive symptoms are prevalent and costly. Although they are frequently interrelated, the nature of interrelationships between them was not well understood. Therefore, using longitudinal data, we aimed to explore whether there is a longitudinal bidirectional relationship between falls and depressive symptoms among older Chinese and whether this is different for men and women.

METHODS

Older adults aged 60 years+ who completed all 2011, 2013, 2015 waves of data from the China Health and Retirement Longitudinal Study on falls and depressive symptoms were included (N=2,203). Random intercept multilevel models were used to analyze data.

RESULTS

Significant bidirectional associations at between-person (b=0.09, SE=0.01, p<0.001) and within-person levels (b=0.05, SE=0.02, p=0.005) were observed between depressive symptoms and falls. When participants reported falls, they reported higher levels of depressive symptoms. However, no gender differs in these relationships.

CONCLUSIONS

Regardless of gender, there are significant bidirectional associations between falls and depressive symptoms.

The Impact of Smoking on the Development and Severity of Chronic Pain

PURPOSE OF REVIEW

The purpose of this review is to examine the impact of smoking and its role on the development of chronic pain and provide a critical review of recent literature.

RECENT FINDINGS

Recent studies demonstrate the bidirectional and dependent relationship between smoking and chronic pain. Those who are in pain have a more difficult time in the cessation of smoking as well as an increased sensitivity to pain during abstinence, lower confidence, and higher relapse rates. The fear of pain and the anxiety and depression that abstinence causes results in a grim outcome for long-term cessation. The dependent nature between chronic pain and smoking is affected by numerous variables. Providers should consider a multiprong approach to treating chronic pain and targeting smoking cessation treatment by providing motivational therapy, nicotine replacement, and medication therapies to prevent relapse, and providing those who are more likely to relapse with a higher level of care.

Ontogeny of the Dyad: the Relationship Between Maternal and Offspring Neuroendocrine Function

PURPOSE OF REVIEW

We review ontogeny of the maternal-offspring neuroendocrine relationship in human pregnancy. We present bidirectional genetic, physiological, and behavioral influences that enhance or disrupt HPA activity and its end product cortisol at the individual level and within the dyad.

RECENT FINDINGS

Consistent evidence supports that maternal mood and caregiving behavior are associated with maternal and offspring cortisol levels. Select studies support the buffering effects of antidepressant use and maternal positive affect on offspring cortisol. Growing research highlights evocative effects of fetal neuroendocrine activity, antenatal gene transfer, and infant behavioral distress and risk characteristics on maternal cortisol levels and dyadic attunement. There is potential to advance our understanding of the mother-offspring neuroendocrine relationship by consideration of other neuroactive steroids in addition to cortisol, and to consider developmental timing and measurement source in study design. Future study should emphasize in what context or for whom neuroendocrine attunement is adaptive versus maladaptive for mother and child.

Impact of the bidirectional relationship between communication and cognitive efficacy on orthopedic patient adherence behavior

Background

There is growing interest in patient autonomy, and communication between physicians and patients has become the essential cornerstone for improving the quality of healthcare services. Previous research has concentrated on the direct effect of physician-patient communication on service outcomes. In the present study, we examined the influence among constructs in the service process and the impact on healthcare outcomes. The present study used behavioral theory to expand the process aspect of the Donabedian healthcare service quality structure-process-outcome model to examine the impact of cognitive changes and communication feedback on patients’ adherence behavior. In addition, the moderating effect of hospital facility levels is examined.

Methods

A conceptual model was developed and tested using a questionnaire administered to patients in eight hospitals. A total of 397 respondents returned usable surveys, with a response rate of 92.11%. Structural equation modeling was used to analyze the data in two steps that involved a measurement model and a structural model. The former was applied to estimate the Cronbach’s alphas, intercorrelations of factors, and descriptive statistics; the latter was used to test the hypothesized relationships of the constructs.

Results

The results identified three mediators of the healthcare process within the healthcare services framework: physician-patient communication, cognitive efficacy, and adherence behavior. Physician-patient communication influenced cognitive efficacy (β = 0.16, p < 0.001), and cognitive efficacy influenced physician-patient communication (β = 0.18, p < 0.001). The effect of this bidirectional relationship on adherence behavior was positive (β = 0.38, p < 0.001). The healthcare structure influenced healthcare outcomes via these three healthcare process constructs. The adherence behavior of patients who were treated in the medical center has greater influences by the structure and physician-patient communication than it was treated in the regional hospitals.

Conclusions

This study revealed a complex pattern in relationships among process constructs for healthcare services. The findings of this study acknowledge the important potential interrelationships among the healthcare service constructs to improve the quality of healthcare outcomes.

Trial registration

CRREC104107. Date: 22/01/2016. Prospectively Registered.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-07575-5.

Longitudinal research on the bidirectional association between depression and arthritis

PURPOSE

Studies evaluating the mutual relation between depression and arthritis have been limited and yielded inconsistent results. The aim of this study was to investigate the bidirectional relationship between depression and arthritis in a middle-aged and elderly Chinese population.

METHODS

Participants ≥ 45 years of age were included from the China Health and Retirement Longitudinal Study (CHARLS). In stage I, we assessed the association of baseline depression with follow-up arthritis. In stage II, we examined whether the onset of arthritis predicted future depression. Logistic regression analyses were conducted to estimate the odds ratios (ORs) and confidence intervals (CIs) in stage I and stage II, respectively.

RESULTS

In stage I, 24.3% (679/2794) of the depression group and 15.4% (1000/6482) of the non-depression group developed new arthritis cases. Compared with non-depression individuals, the risk of developing arthritis in depression patients was significantly higher (OR: 1.56, 95% CI 1.37-1.79). In stage II, 39.7% (973/2453) subjects in the arthritis group and 26.7% (1667/6236) subjects in the non-arthritis group developed depressive symptoms. The adjusted OR (95% CI) for depression in the arthritis group was 1.64 (1.45-1.86) times higher than that in the non-arthritis group. In the subgroup analyses according to sex, age, household income, residence, body mass index, smoking and drinking, all sub-groups yielded consistent associations.

CONCLUSION

The onset of depression increased the risk of incident arthritis; in addition, baseline arthritis predicted future depression in middle-aged and elderly Chinese adults.

Bidirectional relationship between depressive symptoms and physical performance in community-dwelling older people with subjective memory complaints

PURPOSE

This study examined the bidirectional relationship between depressive symptoms and physical performance in community-dwelling older people with subjective memory complaints.

METHODS

Secondary analyses using data from the Multidomain Alzheimer Preventive Trial (MAPT) study were performed. The participants were 1679 subjects (female, 64.8%; mean age, 75.3 ± 4.4 years). The outcome measures were depressive symptoms assessed by the 15-item Geriatric Depression Scale (GDS) and physical performance assessed by the Short Physical Performance Battery (SPPB) and handgrip strength (HGS). All measurements were performed at baseline and at 6, 12, 24, and 36 months. The bidirectional relationships of GDS with SPPB and HGS were examined using mixed-effect regression analysis.

RESULTS

Baseline physical performance was significantly associated with a decreased GDS score (SPPB score: β = - 0.210, 95% confidence interval [CI], - 0.283 to - 0.137; HGS: β = - 0.038, 95% CI - 0.056 to - 0.019). The baseline GDS score was significantly associated with decreased physical performance (SPPB score: β = - 0.082, 95% CI - 0.107 to - 0.056; HGS: β = - 0.261, 95% CI - 0.370 to - 0.152).

CONCLUSION

Since depressive symptoms and physical performance had a bidirectional relationship, prevention or improvement of decreased physical performance could play a role in reducing depressive symptoms, and addressing depressive symptoms may play a role in improving physical performance.

TRIAL REGISTRATION NUMBER

NCT01513252.

The Bidirectional Relationship Between Obstructive Sleep Apnea and Chronic Kidney Disease

Sleep apnea is a condition with significant health risks and increased risk of mortality and is prevalent in patients with chronic kidney disease. This paper describes the detrimental cardiovascular sequelae of sleep-disordered breathing and explores the bidirectional relationship between chronic kidney disease and obstructive sleep apnea. Obstructive sleep apnea-related hypoxia produces a range of harmful systemic effects including oxidative stress, inflammation, and sympathetic activation that collectively worsen the progression of renal disease. In turn, chronic kidney disease can result in increased severity of sleep apnea through inducing (1) uremic neuropathy and myopathy, (2) altered chemosensitivity, and (3) hypervolemia. Continuous positive airway pressure therapy remains the mainstay of treatment for reversing the health risks of apnea. Other strategies aimed at decreasing the high prevalence and associated morbidity of sleep apnea include weight loss, oral appliances, and corrective surgery in the case of airway obstruction.

The longitudinal relationship between sleep problems and school burnout in adolescents: A cross-lagged panel analysis

INTRODUCTION

Despite the growing body of cross-sectional research linking sleep problems and school burnout, hardly any research has investigated the longitudinal relationship between these two constructs. The aim of this study was to examine the bidirectional association between sleep problems and school burnout in middle school students.

METHODS

A prospective design was used incorporating four time points (approximately 6-month interval). The participants were 1226 (50.3% girls) middle school students from 4 public schools who were in 7th grade at baseline. On average, participants were approximately 12.5 years old at the beginning of the study (M_age = 12.73, SD = 0.68). All participants completed self-report measures in classrooms during regular school hours. The data were analyzed using a cross-lagged structural equation model. We also examined the stability of sleep problems and school burnout in time, and investigated the moderating role of gender.

RESULTS

The results indicated there is a moderate stability for both sleep problems and school burnout, and those students with sleep problems were more likely to develop school burnout, and vice versa. Gender did not moderate the bidirectional relationship.

CONCLUSIONS

These results suggest that future studies should investigate whether implementing intervention for sleep problems can decrease the occurrence of school burnout and whether interventions targeting school burnout can improve sleep problems.

Exploring the directionality in the relationship between descriptive and injunctive parental and peer norms and snacking behavior in a three-year-cross-lagged study

Background

People’s eating behavior is assumed to be influenced by what other people do (perceived descriptive norms) and what others approve of (perceived injunctive norms). It has been suggested that adolescents are more susceptible to peer norms than parental norms, because they experience a strong need for group acceptance that leads to conforming to peer group norms. The current study examined changes in snacking behavior and four types of social norms (i.e., parental and peer descriptive and injunctive norms) that promoted fruit and vegetable intake among adolescents. This study was the first to examine whether snacking behavior also influenced norm perceptions by testing the directionality of these associations.

Methods

The study consisted of 819 participants (M [SD] age = 11.19 [1.36]; 46.1% boys), collected at three time points (T1 = 2016, T2 = 2017 and T3 = 2018) during the MyMovez project. Self-reported frequency of snack consumption, perceived parental and peer descriptive and injunctive norms were assessed. The primary analysis consisted of a series of cross-lagged autoregressive models specified in a structural equation modeling framework.

Results

Model comparisons testing the descriptive and injunctive norms in separate models and in an additional combined model revealed evidence for bi-directional associations between norms and snacking behavior. Descriptive peer and parent norms were not found to have an effect on subsequent snacking behaviors. Perceived injunctive parental norms were positively associated with healthy snack food intake and negatively associated with unhealthy snack intake (forward direction). Injunctive peer norms were negatively associated with healthy snack food intake. In addition, higher unhealthy snack food intake was negatively associated with the perception of descriptive and injunctive parental norms 1 year later (reversed direction). We did not find peer norms to be more closely associated with changes in snacking behaviors compared to parental norms.

Conclusions

Parents expecting their children to snack healthy had a positive influence on healthy snacking behavior whereas only acting as a healthy role model did not. Future research should address the possible interaction between descriptive and injunctive norms. Research should also take into account the bi-directional relations between eating behaviors and normative perceptions.

Biotransformation of dietary phytoestrogens by gut microbes: A review on bidirectional interaction between phytoestrogen metabolism and gut microbiota

Phytoestrogens are a class of plant produced polyphenolic compounds with diphenolic structure, which is similar to 17β-estradiol. These phytoestrogens preferentially bind to estrogen receptors, however, with weak affinity. Recently, many studies have found that these phytoestrogens can be transformed by gut microbiota through novel enzymatic reactions into metabolites with altered bioactivity. Recent studies have also implied that these metabolites could possibly modulate the host gut ecosystem, gene expression, metabolism and the immune system. Thus, isolating gut microbes capable of biotransforming phytoestrogens and characterizing the novel enzymatic reactions involved are principal to understand the mechanisms of beneficial effects brought by gut microbiota and their metabolism on phytoestrogens, and to provide the theoretical knowledge for the development of functional probiotics. In the present review, we summarized works on gut microbial biotransformation of phytoestrogens, including daidzin (isoflavone), phenylnaringenin (prenylflavonoid), lignans, resveratrol (stilbene) and ellagitannins. We mainly focus on gut bacterial isolation, metabolic pathway characterization, and the bidirectional interaction of phytoestrogens with gut microbes to illustrate the novel metabolic capability of gut microbiota and the methods used in these studies.

Diabetic Gastroparesis and Glycaemic Control

PURPOSE OF REVIEW

Gastroparesis is an important complication of diabetes that may have a major impact on the quality of life as a result of upper gastrointestinal symptoms and impaired glycaemic control. Current management strategies include optimising blood glucose control, dietary modifications and supportive nutrition. Pharmacologic approaches with drugs that have prokinetic and/or antiemetic effects are also used widely; however, current available treatments have major limitations. There is increasing recognition that the rate of gastric emptying (GE) is a key determinant of the glycaemic response to a meal.

RECENT FINDINGS

There is ongoing uncertainty regarding the impact of longstanding hyperglycaemia on GE, which requires clarification. New diagnostic techniques have been developed to better characterise the mechanisms underlying gastroparesis in individual patients, and these have the potential to lead to more personalised therapy. Management of gastroparesis is complex and suboptimal; novel approaches are desirable. This review summarises recent advances in the understanding of diabetic gastroparesis, with an emphasis on the current therapies that influence GE, and the bidirectional relationship between glycaemic control and GE.

The bidirectional relationship between sleep duration and depression in community-dwelling middle-aged and elderly individuals: evidence from a longitudinal study

BACKGROUND

There are several studies that have focused on the relationship between sleep duration and depression, however, only a few prospective studies have centered on the bidirectional relationship between them. This four-year longitudinal study aimed to identify the association between sleep duration and depression in community-dwelling mid-age and elderly individuals.

METHODS

10,704 participants from the China Health and Retirement Longitudinal Study (CHARLS) were included for baseline and four-year follow up. Of these individuals, 7866 and 2956 were used to identify the effects of sleep duration on onset and recurrent depression respectively. 4504 individuals with normal sleep duration at baseline were included to examine the effects of depression on changes of sleep time. The 10-item version of the Centre for Epidemiological Studies Depression scale (CESD-10) was used to access depressive symptoms, as well sleep duration was self-reported.

RESULTS

Participants with short sleep duration (<5 and 5-6 h) had a higher risk of depression onset (OR 1.69 [1.36-2.11], 1.48 [1.19-1.84]) and recurrent depression (OR 1.44 [1.12-1.86], 1.32 [1.00-1.74]) compared to participants with normal sleep durations (7-8 h). Long sleep durations (>9 h) had no significant risks for depression. Males and the elderly (over 60 years-old) were more sensitive to short sleep durations and experienced a higher incidence of depression. Individuals with depression were more likely to have short sleep durations instead of long ones (RRR 1.20 [1.02-1.43]).

CONCLUSIONS

The present study identified the bidirectional relationship between sleep duration and depression. Short sleep durations were a risk factor for the onset and recurrent depression. Conversely, depression induced short sleep durations rather than excessive sleep durations. Future studies need to focus on identifying the mechanism between sleep duration and depression, and develop additional evidence-based cost-effective interventions to prevent depression and sleep problems.

Longitudinal Reciprocal Relationships Between Discrimination and Ethnic Affect or Depressive Symptoms Among Chinese American Adolescents

Discrimination plays an important role in the development of ethnic minority adolescents. However, previous studies have often adopted a unidirectional model examining the influence of discrimination on adolescent development, thus leaving the potential reciprocal relationship between them understudied. Moreover, there is a dearth of studies on Chinese Americans in the discrimination literature. Therefore, this study aimed to examine the reciprocal relationships between discrimination and two measures of adolescent outcomes (i.e., ethnic affect and depressive symptoms) from early adolescence to emerging adulthood in Chinese Americans. Participants were 444 adolescents (54 % female), followed at four-year intervals, beginning at 7th or 8th grade (M age.wave1 = 13.03) in 2002, for a total of three waves. An examination of cross-lagged autoregressive models revealed two major findings. First, in contrast to the rejection-identification model, perceived discrimination at early adolescence negatively related to ethnic affect at middle adolescence. Conversely, ethnic affect at early adolescence also negatively related to discrimination at middle adolescence. These results held the same direction but became insignificant from middle adolescence to emerging adulthood. Second, perceived discrimination positively related to depressive symptoms across the studied developmental periods, and depressive symptoms positively related to perceived discrimination from middle adolescence to emerging adulthood. The strength of these longitudinal relationships did not change significantly across developmental periods or gender. These findings highlight the bidirectional relationship between perceived discrimination and adolescent outcomes; they also demonstrate the value of studying the discrimination experiences of Chinese Americans.

The bidirectional relationship between myocardial infarction and depressive disorders: a follow-up study

BACKGROUND

Data from multiple studies have shown the relationship between myocardial infarction (MI) and depressive disorders; however, most of these studies have focused only on one direction in evaluating the effect of depressive disorders on MI outcomes. This study analyzed data compiled from a large-scale dataset, the National Health Insurance Research Database, to determine whether a bidirectional relationship exists between MI and depressive disorders.

METHODS

A total of 3482 patients diagnosed with MI between 2002 and 2004 were included in analyzing the effects of MI on depressive disorders. A total of 26,418 patients diagnosed with depressive disorders between 2002 and 2004 were included in studying the effect of depressive disorders on MI. The comparison groups of both analyses were 4-fold larger than the case group. The Cox proportional hazard regression model was used to analyze the results.

RESULTS

The risk of MI patients developing depressive disorders was significantly higher (P<.001) than that of the comparison group, even after the data were adjusted for the variables of age, gender, income, region, and the Charlson Comorbidity Index. Conversely, the risk of patients with depressive disorders developing MI was not significantly higher than that of the comparison group after we controlled for covariates.

CONCLUSION

The patients with MI exhibited a significantly higher risk of developing depressive disorders compared with the patients without MI. The results suggest that health providers should carefully manage the treatment offered for mental conditions and sensitively detect the psychological reactions of patients with MI.