Depress Anxiety [JOURNAL]
Sun
200 papers
Systematic Review and Exploratory Meta-Analysis of AI-Enabled and Digital Technology-Assisted Interventions for Dental Anxiety During Dental Treatment.
Saghiri MA, Saini RS, Alshahrani AA … +3 more , Vaddamanu SK, Alqahtani A, Baba NZ
Depress Anxiety · 2026 · PMID 42395591 · Full text
BACKGROUND: Dental anxiety adversely affects receiving dental care when needed. Artificial intelligence (AI)-enabled and digital technology-assisted interventions have been recently explored for assessment, monitoring or...
BACKGROUND: Dental anxiety adversely affects receiving dental care when needed. Artificial intelligence (AI)-enabled and digital technology-assisted interventions have been recently explored for assessment, monitoring or alleviation of anxiety during dental treatment. The aim of this systematic review was to summarise current evidence and review effectiveness of AI-enabled or digital technology-assisted interventions on anxiety and treatment-related outcomes in dentistry. METHOD: The review was conducted in accordance with Preferred Reporting for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Searches were conducted across ScienceDirect, PubMed, Scopus, Google Scholar and Cochrane Library. There were no date limitations applied. Search was restricted to human studies involving AI-enabled or digital technology-assisted interventions for dental anxiety management. Both interventional and observational studies were included for review. Data were extracted regarding study characteristics, intervention type, anxiety outcome measures, behavioural response, treatment adherence and satisfaction. Risk of bias was assessed utilising Mixed Methods Appraisal Tool (MMAT). Owing to significant clinical and methodological heterogeneity among the included studies, quantitative synthesis was limited to a small subset of comparable studies and was therefore considered exploratory. RESULTS: Seven studies met our eligibility criteria. Eligible studies varied widely in design, population, intervention and outcome assessment modalities used. These were computerised cognitive behavioural therapy (CBT), humanoid robots, smartphone applications, machine learning (ML) approaches to assessment, AI-linked virtual reality (VR) or biofeedback programs. Narrative synthesis suggested that several interventions were associated with reductions in dental anxiety or improvements in patient behaviour. Quantitative pooling was possible for only a few studies which were found to be comparable. Our conclusions from this exploratory meta-analysis are limited by the small number of studies with comparison groups available and considerable heterogeneity. CONCLUSION: AI-enabled and digital technology-assisted interventions have potential to improve dental anxiety-related outcomes and dental patient experience. The evidence is currently limited. The available studies are small and heterogeneous and methodologically limited. Future investigations should include larger, robust trials with standardised outcome measures and consistent operational definitions of AI.
Measurement of Serum Parameters Attributes the Therapeutic Effects of Music Therapy to Augmented Stress-Coping Ability and Diminished Systemic Inflammation.
Lu Y, Yao J, Gu KS … +5 more , Wu A, Yang X, Wu H, Xiao L, Zhang J
Depress Anxiety · 2026 · PMID 42382375 · Full text
Major depressive disorder (MDD) is a leading cause of disability worldwide. It remains elusive whether serum levels of cortisol, amino acids and their downstream neurotransmitters, and inflammatory cytokines can reflect...
Major depressive disorder (MDD) is a leading cause of disability worldwide. It remains elusive whether serum levels of cortisol, amino acids and their downstream neurotransmitters, and inflammatory cytokines can reflect the therapeutic response of MDD. Although music seems to be beneficial to MDD treatment, the optimal treatment strategy remains to be explored. Here, we report that the combination of pharmacotherapy and music therapy with both D major K. 448 and G minor K. 550, but not pharmacotherapy alone, significantly downregulated or presented numerical trends to downregulate serum levels of cortisol and norepinephrine (NE) in MDD patients. Furthermore, serum levels of L_Histidine, L_Glutamic acid, L_Aspartic acid, tumor necrosis factor-α (TNF-α), TNF-receptor I (TNFR I), and C-C motif ligand 11 (CCL11) were significantly downregulated or exhibited numerical trends to be downregulated by the combination of pharmacotherapy and music therapy, whereas those of cluster of differentiation 30 (CD30) exhibited opposite effects. Therefore, music therapy with both D major K. 448 and G minor K. 550 should be recommended as adjuvant therapy to MDD patients. Certain serum markers can reflect the therapeutic response of MDD. The therapeutic effects of music therapy may be attributed to augmented stress-coping ability and diminished systemic inflammation.
Differential Patterns of Social Attention and Memory Profiles in Depression: Evidence From Third-Person Social Interaction Processing.
Tang E, Zhang XM, Li J … +3 more , Liu Y, Shen ZX, Chen H
Depress Anxiety · 2026 · PMID 42382374 · Full text
Although social interaction is crucial for human social life, it poses unique challenges for individuals with depressive symptoms. From a third-person perspective, this study employed two cross-sectional experiments to i...
Although social interaction is crucial for human social life, it poses unique challenges for individuals with depressive symptoms. From a third-person perspective, this study employed two cross-sectional experiments to investigate how depressive symptoms modulate whether the benefits of social interaction transfer to attention and memory functions, which constitute core processes underpinning successful interpersonal relationships and social engagement. A total of 72 patients with major depressive disorder (MDD) and 72 demographically matched healthy control subjects (HCS) were recruited. Experiment 1 adopted a visual search (VS) task in which participants identified socially interactive or noninteractive individuals amid distractors. Experiment 2 included a working memory (WM) task focusing on interpersonal spatial distance and a long-term memory (LTM) task requiring the recollection of paired relationships. Compared to HCS, MDD patients exhibited preserved social attention benefits induced by social interactions, as evidenced by their higher search efficiency for socially interactive dyads. In contrast, MDD patients showed no evidence of either spatial compression effects induced by social intimacy in working memory or enhanced memory traces for interactive dyads in LTM. These findings suggest that individuals with depressive symptoms can benefit from social interactions to facilitate attention, but not memory functioning. Uncovering these differential patterns of attention and memory performance in social cognition challenges the traditional conceptualization of global social cognitive impairment in depression. The current findings also pave the way for targeted social memory training programs and interventions aimed at improving the quality of life in this population.
Associations Between Adverse Childhood Experiences and Prenatal Depression Mediated Through Family Communication in Chinese Pregnant Women: Causal Mediation Analysis.
Wen Y, Li Y, Li Y … +2 more , Liu M, Guo N
Depress Anxiety · 2026 · PMID 42382373 · Full text
BACKGROUND: Adverse childhood experiences (ACEs) have shown impacts on prenatal depression. Most studies examined the cumulative risk of ACE scores, though impacts of different ACE types can vary. And less is known about...
BACKGROUND: Adverse childhood experiences (ACEs) have shown impacts on prenatal depression. Most studies examined the cumulative risk of ACE scores, though impacts of different ACE types can vary. And less is known about the psychosocial mechanisms underlying the impacts. Supportive communication within a family formed through marriage may serve as a psychosocial resource for pregnant women. OBJECTIVES: To differentiate the associations of ACE scores and types with prenatal depression. The mediation effect of family communication was further investigated. STUDY DESIGN: A cross-sectional study in 873 Chinese pregnant women (mean age 30.89 [SD 3.93] years). METHODS: ACEs, family communication, and prenatal depression were measured using the ACE International Questionnaire (ACE-IQ), Family Communication Scale (FCS), and Edinburgh Postnatal Depression Scale (EPDS), respectively. Specifically, 13 types of ACEs included physical abuse, emotional abuse, sexual abuse, physical neglect, emotional neglect, domestic violence, parental death or separation, family substance use, family mental illness, family incarceration, bullying, collective violence, and community violence. Multivariable linear regression examined the associations of ACE scores and types with prenatal depression, adjusting for demographic, lifestyle, and pregnancy-related covariates. Causal mediation analysis investigated the mediation effect of family communication. RESULTS: Childhood abuse (physical, emotional, and sexual), neglect (physical and emotional), domestic violence, collective violence, and bullying showed associations with prenatal depression (adjusted range 1.34-3.28, all s <0.05). ACE scores were associated with prenatal depression (adjusted = 0.55, 95% confidence interval [CI] 0.38, 0.72). Family communication mediated the associations of ACE scores (proportion of total effect [TE] mediated = 22%), physical (26%) and emotional abuse (15%), physical (57%) and emotional neglect (31%), and domestic violence (22%) with prenatal depression. CONCLUSIONS: Associations with prenatal depression were observed with ACE scores and were various across ACE types, which were medicated through family communication. Pregnant women with high ACE scores and specific ACE types can be vulnerable groups for prenatal depression, and interventions for promoting family communication are needed.
How Does Fertility Stress Influence Depressive Symptoms in Female Partners of Infertile Couples in China? A Parallel Mediation Analysis of Infertility Stigma and Family Function.
Li Y, Wang Y, Wang M … +2 more , Yang H, Qiu L
Depress Anxiety · 2026 · PMID 42369866 · Full text
OBJECTIVE: This study aims to explore the impact of fertility stress on depressive symptoms, with a focus on analyzing the potential mediating effects of infertility stigma and family function in this process. METHODS: A...
OBJECTIVE: This study aims to explore the impact of fertility stress on depressive symptoms, with a focus on analyzing the potential mediating effects of infertility stigma and family function in this process. METHODS: A cross-sectional design was employed in which 1294 female partners of infertile couples were recruited from two tertiary-grade A hospitals in Hainan Province, China. Fertility stress, depressive symptoms, infertility stigma, and family function were assessed with validated self-report questionnaires. Structural equation modeling (SEM) was used to estimate the direct effect of fertility stress and the parallel mediating effects of infertility stigma and family function. RESULTS: The prevalence rate of depressive symptoms was 26.35%. The direct effect model indicated a significant positive association between fertility stress and depressive symptoms ( = 0.260, < 0.001). The parallel mediation model revealed that infertility stigma ( = 0.176, < 0.001) and family function ( = 0.052, < 0.001) exerted full mediating effects. Specifically, fertility stress indirectly increased depressive symptoms by exacerbating infertility stigma; concurrently, low levels of family function exacerbated the negative impact of fertility stress on mental health. CONCLUSION: Fertility stress not only directly affects depressive symptoms, but also indirectly exacerbates depressive symptoms by intensifying infertility stigma and impairing family function. This study provides a new perspective for understanding the mental health mechanism in female partners of infertile couples, emphasizing that psychological interventions need to simultaneously focus on reducing infertility stigma and improving family function, which may offer a basis for informing relevant clinical practices and public health policies.
Network and Factor Structure of Depression and Anxiety Symptoms in Telemental Healthcare Patients From Bangladesh: Evidence for Precision Mental Healthcare.
Rahman MH, Manna RM, Usmani NG … +13 more , Chandra P, Amin MB, Ara T, Amin MR, Khan MA, Ahmed HU, Akter E, Islam SMH, Ahmed A, Shomik MS, Arifeen SE, Hossain AT, Rahman AE
Depress Anxiety · 2026 · PMID 42317393 · Full text
BACKGROUND: Identifying core mental health symptoms is crucial for precision-targeted interventions, especially in resource-limited settings. However, symptom structures among individuals actively seeking telemental heal...
BACKGROUND: Identifying core mental health symptoms is crucial for precision-targeted interventions, especially in resource-limited settings. However, symptom structures among individuals actively seeking telemental healthcare remain underexplored in Bangladesh and similar contexts. This study aimed to map symptom severity, factor structures, and interrelationships between depressive and anxiety symptoms to inform precision-driven mental healthcare approaches. METHODS: We conducted an observational study among 4,900 patients who attended a health facility-based telemental healthcare in Bangladesh from January 2023 to July 2024. We assessed depression using PHQ-9 and anxiety using GAD-7 and applied exploratory factor analysis and network analysis. RESULTS: Overall, 84% (95% CI: 83-86) screened positive for depressive symptoms, 85% (95% CI: 83-86) screened positive for anxiety symptoms, and 77% (95% CI: 76-78) presented co-occurring symptoms. Commonly reported symptoms included fatigue (57%), anhedonia (42%), sleep disturbance (42%), nervousness (70%), and uncontrollable worrying (66%). Factor analysis revealed "depressed mood" (λ = 0.58) and "anhedonia" (λ = 0.51) as core depressive features, and "uncontrollable worry" (λ = 0.68) and "nervousness" (λ = 0.61) as core anxiety features. Network analysis revealed strong associations between "anhedonia" and "depressed mood" in depression and "trouble relaxing" and "restlessness" in anxiety. "Uncontrollable worrying" showed the highest centrality, and "sleep disturbance" and "trouble relaxing" served as important bridge symptoms linking depression and anxiety domains. CONCLUSIONS: Depressive and anxiety symptoms in people seeking telemental healthcare cluster around a small number of key and connecting symptoms, rather than contributing equally to overall distress. Precision mental healthcare in resource-limited settings can use this structure to direct limited time and resources toward the symptoms that matter most. Institutional Review Board (IRB) of https://www.icddrb.org/. Protocol number: PR-22103.
Association Between Intergenerational Relationship With Adult Children and Anxiety-Depression Comorbidity Symptoms in Older Women in China: A National Study Using Latent Profile Analysis.
Huang Z, Ren J, Tang H … +4 more , Qiu G, Yang B, Wang Y, Zhou H
Depress Anxiety · 2026 · PMID 42312227 · Full text
BACKGROUND: The phenomenon of global aging is becoming increasingly salient, and the mental health of older women requires greater attention. However, there is a conspicuous paucity in the exploration of anxiety-depressi...
BACKGROUND: The phenomenon of global aging is becoming increasingly salient, and the mental health of older women requires greater attention. However, there is a conspicuous paucity in the exploration of anxiety-depression comorbidity patterns among Chinese older women, as well as the correlation between intergenerational relationships with adult children and these comorbid conditions. METHODS: About 20,153 older women aged 65 years or above from the China Aging and Health Survey (CAHS) were included in the study. Depression and anxiety were assessed using the Patient Health Questionnaire-9 (PHQ-9) and the 7-item Generalized Anxiety Disorder (GAD-7) Questionnaire, respectively. Latent profile analysis (LPA) was utilized to identify subgroups of older women exhibiting similar patterns of symptoms. To examine the association between intergenerational relationships with adult children and the comorbid patterns of anxiety and depression, multinomial logistic regression was employed. Finally, stratified analyses were conducted to perform sensitivity testing. RESULTS: LPA revealed three profiles: low ( = 13,658), moderate ( = 5762), and high comorbidity ( = 733). Poorer intergenerational relationships with adult children significantly increased odds of moderate (odds ratio [OR] = 1.079, 95% confidence interval [CI]:1.045-1.114) and high comorbidity (OR = 1.187, 95% CI:1.006-1.275) versus the low-comorbidity group after covariate adjustment. Stratified analyses confirmed robustness. CONCLUSION: Anxiety-depression comorbidity patterns in older women can be classified into three categories: low, moderate, and high comorbidity. Moreover, intergenerational relationships with adult children are associated with these comorbid patterns, with more frequent interactions corresponding to lower levels of comorbidity.
Understanding and Reducing Appearance Anxiety for Social Media Users: A Study Using Ecological Momentary Assessment and Ecological Momentary Intervention.
Chen R, Bai JT, Liu Y
Depress Anxiety · 2026 · PMID 42305822 · Full text
Appearance anxiety for social media users (AASMU) is emotional distress linked to social media use (SMU), negatively affecting mental and physical health. However, little is known about the dynamic relationship between A...
Appearance anxiety for social media users (AASMU) is emotional distress linked to social media use (SMU), negatively affecting mental and physical health. However, little is known about the dynamic relationship between AASMU and SMU, and effective interventions. Study 1 used Ecological Momentary Assessment (EMA) with 206 participants completing daily surveys for 20 days. Dynamic structural equation modeling (DSEM) revealed that AASMU tended to persist from 1 day to the next ( = 1.45) and that higher levels of AASMU and SMU often occurred together on the same day ( = 2.57). A higher level of self-compassion (SC) or a healthier lifestyle moderated this relationship, providing resilience against SMU's negative effects ( = -0.40 or -0.41). Study 2 utilized an ecological momentary intervention (EMI) with 200 participants, where the intervention group read SC statements daily. Results showed a significant reduction in both the mean level ( = -0.05) and intra-individual variability of AASMU in the intervention group ( = -0.11), suggesting SC-based EMI is an effective approach to reducing AASMU.
Distinct Trajectories of Amygdala Connectivity Patterns Characterize Remission vs. Non-Remission in Patients With Major Depressive Disorder.
Zhang S, Zhang Z, Li X … +10 more , Zhou J, Li R, Liu R, Wang Y, Chen X, Feng Y, Cui J, Zhang L, Zhou Y, Wang G
Depress Anxiety · 2026 · PMID 42292915 · Full text
BACKGROUND: This study aimed to investigate the neural basis of individual differences in antidepressant efficacy using an 8-week longitudinal multitime point resting-state functional magnetic resonance imaging (fMRI) de...
BACKGROUND: This study aimed to investigate the neural basis of individual differences in antidepressant efficacy using an 8-week longitudinal multitime point resting-state functional magnetic resonance imaging (fMRI) design. METHODS: Forty-eight patients with major depressive disorder (MDD) completed two or three scans, and 44 healthy controls (HCs) underwent a baseline scan. Patients were categorized into remission (MDDr) and nonremission (MDDnr) groups based on treatment outcomes. Group differences in resting-state functional connectivity (rsFC) of the amygdala subregions at baseline were examined among MDDr, MDDnr, and HCs. Longitudinal changes in the identified rsFC were compared between the MDDr and MDDnr groups. Correlation analyses were conducted to explore the relationship between baseline rsFC or its longitudinal changes and depressive symptom severity or improvement. RESULTS: At baseline, rsFC between the right basolateral (BL) amygdala and the right supplementary motor area (SMA) was lower in the MDDr group but higher in the MDDnr group compared with HCs, although this effect did not survive multiple comparisons correction across amygdala subregions. The trajectory of this rsFC differed between the two patient groups during treatment, with normalization observed at 2 and 8 weeks posttreatment. Correlation analyses indicated that baseline rsFC was associated with treatment response and that longitudinal changes in rsFC were aligned with symptom improvement, although some associations did not survive multiple comparisons correction. CONCLUSIONS: Our findings provide novel and valuable insights into the neural mechanisms underlying antidepressant response and highlight the role of amygdala subregional connectivity in explaining interindividual variability in treatment efficacy. TRIAL REGISTRATION: ClinicalTrials.gov identifier: ChiCTR2400093823.
Bridging Fear of Negative Evaluation and Cognitive Emotion Regulation Strategies: A Network Perspective on the Roles of Family Functioning and Self-Control.
Wang X, Li Y, Zhang D … +1 more , Chang H
Depress Anxiety · 2026 · PMID 42255922 · Full text
BACKGROUND: In the context of intensifying social pressure, college students' high sensitivity to negative evaluations significantly affects their mental health. This study uses network analysis to explore the network st...
BACKGROUND: In the context of intensifying social pressure, college students' high sensitivity to negative evaluations significantly affects their mental health. This study uses network analysis to explore the network structure characteristics of Chinese college students' fear of negative evaluations, family functioning, and self-control, as well as their conditional associations with cognitive emotion regulation strategies (CERSs). METHOD: A convenience sampling method was used to conduct a cross-sectional online questionnaire survey of 5527 college students enrolled at three universities in Wuhan. The study employed the Fear of Negative Evaluation Scale, Family Care Scale, Self-Control Scale, and CERSs Scale. Data analysis was conducted using SPSS 26.0 and R Studio 4.5.1 software to construct a psychological trait network, identify core and bridge nodes, and analyze their associations with CERSs (adaptive and maladaptive). RESULTS: BFNE9 (continuous concern about others' impressions) had the highest expected influence (EI); FC4 (family emotional support) and FC2 (family partnership) had high centrality, highlighting the core role of family functioning. Bridge analysis indicated that BS4 (difficulty controlling attention) was the strongest bridge node connecting different psychological dimensions, followed by BS1 (self-control) and BS7 (impulsivity). Flow network analysis further revealed that BFNE12 (fear of saying the wrong thing) exhibited the strongest positive association for both adaptive (ER1) and nonadaptive (ER2) CERSs, suggesting that expressive evaluation anxiety is strongly connected with multiple components within the emotional regulation network. CONCLUSION: This study used psychological network analysis to reveal the complex interactive structure between fear of negative evaluation, family functioning, and self-control and highlighted the central role of expressive evaluation anxiety (BFNE12) within the network. The results provide a new perspective and theoretical basis for understanding the psychological mechanisms related to social anxiety in college students and for informing future research on potential intervention directions. However, given the cross-sectional design, causal interpretations cannot be inferred.
Bidirectional Associations Between Primary Caregivers' and Adolescents' Depressive and Anxiety Symptoms: An Intergenerational Actor-Partner Interdependence Model Analysis.
Hou H, Luo D, Zhu S … +7 more , Zhou SC, Yan S, Jiang YL, Wang XQ, Liu Q, Zou H, Yang BX
Depress Anxiety · 2026 · PMID 42255921 · Full text
BACKGROUND: Extensive research has focused on the top-down intergenerational transmission of psychopathological symptoms (ITP). However, little is known about the bidirectional and transactional dynamics of ITP between p...
BACKGROUND: Extensive research has focused on the top-down intergenerational transmission of psychopathological symptoms (ITP). However, little is known about the bidirectional and transactional dynamics of ITP between primary caregivers and their adolescent offspring in community-based samples. In particular, the moderating roles of caregiver and adolescent gender in these intergenerational associations remain underexplored. METHODS: Between 2021 and 2022, a total of 1414 primary caregiver-adolescent dyads completed two waves of surveys assessing sociodemographic characteristics, as well as depressive and anxiety symptoms. The actor-partner interdependence model (APIM) was applied to examine the bidirectional transactional patterns of psychopathological symptoms within these dyads. Multiple-group comparison tests were conducted to evaluate the moderating effects of caregiver and adolescent gender on these associations. RESULTS: Adolescents' depressive and anxiety symptoms significantly predicted subsequent depressive and anxiety symptoms in their primary caregivers. In contrast, only caregivers' anxiety symptoms were found to predict subsequent adolescents' depressive and anxiety symptoms. Multiple-group comparison tests indicated no significant moderating effects of caregiver or adolescent gender on the ITP. CONCLUSION: These findings suggest that depressive and anxiety symptoms may be mutually reinforced between adolescents and primary caregivers over time. A family-based approach to early identification and prevention could be a promising direction for interrupting escalating cycles of negative emotions across generations.
Virtual Reality Exposure-Enhanced Cognitive Behavioral Therapy (CBT + VRE) vs. CBT With Imaginal Exposure (CBT + IE) for Adolescent Patients Treatment of Social Anxiety Disorder Symptoms: A Pilot Randomized Controlled Trial.
Azimisefat P, Ravanbod S, de Jongh A … +5 more , AdliHamzehkhanlou M, Jamshidi F, Dehghani Y, Yazdani F, Herzog P
Depress Anxiety · 2026 · PMID 42205114 · Full text
BACKGROUND: The purpose of the present study was to investigate the relative effectiveness of cognitive-behavioral therapy (CBT) with imaginal exposure (CBT + IE) and CBT combined with virtual reality exposure (CBT + VRE...
BACKGROUND: The purpose of the present study was to investigate the relative effectiveness of cognitive-behavioral therapy (CBT) with imaginal exposure (CBT + IE) and CBT combined with virtual reality exposure (CBT + VRE) for symptoms of social anxiety disorder (SAD) and fear of negative evaluation (FNE) in adolescents. METHODS: In a three-armed randomized controlled trial (RCT), a total of 51 adolescents who met the DSM-5 criteria for SAD were randomly assigned to either CBT + IE ( = 17; = 16.41; = 0.61), CBT + VRE ( = 17; = 16.35; = 0.70), or a waitlist control condition (WLCC; = 17; = 16.00; = 0.70). Participants were assessed pre and posttreatment and followed up 3 months after the last treatment session regarding symptoms of social phobia, measured with the social phobia inventory (SPIN), and FNE, measured with the FNE Questionnaire. RESULTS: A linear mixed model (LMM) analysis revealed significant differences between the treatment groups and WLCC in interaction with the three assessment times in SAD and FNE. A significant reduction of both CBT + VRE and CBT + IE treatments on symptoms of SAD from pretreatment to posttreatment and 3 months follow-up ( = 1.31 and = 1.43 in CBT + VRE group; = 1.90 and = 2.04 in CBT + IE group) and FNE ( = 1.35 and = 1.68 in the CBT + VRE group; = 1.95 and = 1.59 in the CBT + IE group) compared to the WLCC was observed. No significant differences were observed between the VRE + CBT and CBT + IE groups on FNE. With respect to SAD, statistically significant between-group differences emerged in favour of the CBT + IE group, accompanied by substantial effect sizes at posttreatment ( = 0.87) and follow-up ( = 0.73). CONCLUSION: The results support the effectiveness of CBT + IE and CBT + VRE in reducing the symptoms of SAD and FNE, which were maintained 3 months after treatment. Future research should focus on optimizing VRE protocols, exploring long-term outcomes, and investigating its applicability across diverse populations. Further exploration of the cost-effectiveness and accessibility of VR technology in clinical settings is required. ClinicalTrials.gov identifier: IRCT20210213050343N2.
The Relationship Between Anxiety, Stress, Depression, Traumatic Childbirth Perception, and Prenatal Attachment in Pregnant Women: A Cross-Sectional Study.
Yücesoy H, Yildirim F, Arar MA … +1 more , Erbil N
Depress Anxiety · 2026 · PMID 42205113 · Full text
AIM: This study aims to examine the relationships between perception of traumatic childbirth, prenatal attachment, stress, anxiety, and depression in pregnant women. METHOD: This cross-sectional study involved 304 pregna...
AIM: This study aims to examine the relationships between perception of traumatic childbirth, prenatal attachment, stress, anxiety, and depression in pregnant women. METHOD: This cross-sectional study involved 304 pregnant women who visited the obstetrics and gynecology outpatient clinic of a hospital in Türkiye between June 2024 and June 2025. Data were collected using a Demographic Information Form, the Depression, Anxiety, Stress Scale (DASS-21), the Traumatic Childbirth Perception Scale (TCPS), and the Prenatal Attachment Inventory (PAI). Descriptive statistical methods, Pearson correlation, and multiple linear regression analysis were used in the analysis of the data. RESULTS: The study determined that 22% of pregnant women experienced stress, 45.1% experienced depression, and 62.8% experienced anxiety. The mean PAI score of pregnant women was found to be 40.53 ± 7.97, and the mean TCPS score was 71.64 ± 28.02 (moderate). The study found that stress, depression, and anxiety scores in pregnant women were significantly correlated positively with the TCPS score and significantly correlated negatively with the PAI score. Depression ( = 0.003) and prenatal attachment ( = 0.018) were determined to be the predictors of traumatic birth perception. CONCLUSION: This study determined that as women's depression, stress, anxiety, and levels increased, their perception of traumatic childbirth increased, and their prenatal attachment levels decreased. Depression and prenatal attachment were identified as predictors of traumatic childbirth perception. Providing mental health support to pregnant women by nurses can contribute to the protection and improvement of maternal and infant health.
Prefrontal Structural Asymmetry Mediates Body Mass Index and Treatment Response in Major Depressive Disorder.
Qiao K, Zang Z, Wang Y … +11 more , Chen X, Liu K, Zhang Z, Liu R, Li D, Luo Y, Xiao L, Zhu X, Zhou J, Yang Z, Wang G
Depress Anxiety · 2026 · PMID 42199997 · Full text
BACKGROUND: Elevated body mass index (BMI) predicts poor treatment response in major depressive disorder (MDD), yet the neurobiological mechanisms underlying this association remain poorly understood. Cortical thickness...
BACKGROUND: Elevated body mass index (BMI) predicts poor treatment response in major depressive disorder (MDD), yet the neurobiological mechanisms underlying this association remain poorly understood. Cortical thickness asymmetry has been proposed as a structural correlate of affective regulation and may represent a pathway through which metabolic factors influence treatment outcomes. We investigated whether BMI-related alterations in prefrontal cortical asymmetry mediate antidepressant treatment resistance in MDD. METHODS: We analyzed baseline structural MRI (sMRI) and 12-week clinical outcome data from 312 adults with MDD across a discovery cohort ( = 107) and an independent replication cohort ( = 205). Treatment response was operationalized as absolute reduction in Hamilton depression rating scale (HAMD-17) scores. Cortical thickness asymmetry indices were derived from regional parcellations. Associations between BMI and asymmetry were examined using linear regression models; mediation analyses tested whether BMI-related asymmetry statistically mediates the link between higher BMI and reduced treatment response. Sex-stratified analyses were conducted to identify divergent pathways. RESULTS: Across both cohorts, higher BMI was consistently associated with greater leftward cortical thickness asymmetry in the prefrontal cortex (PFC). This structural asymmetry significantly mediated the relationship between BMI and poorer treatment response. Sex-stratified analyses revealed additional female-specific mediation through prefrontal opercular regions, with no corresponding effect in males. Transcriptomic annotation of implicated regions identified enrichment for genes involved in metabolic and cytoplasmic signaling pathways. CONCLUSIONS: BMI-associated leftward prefrontal asymmetry statistically mediates antidepressant resistance in MDD via both a sex-shared structural pathway and a female-specific opercular circuit. These findings suggest that metabolic factors may influence treatment outcomes partly through hemispheric structural imbalance in prefrontal regions and position cortical thickness asymmetry as a candidate neuroimaging biomarker for patient stratification in precision psychiatry.
Depression and Anxiety Among Women in Lesotho: A Multilevel Analysis of the 2023-2024 LSDHS.
Endalew HL, Bazezew AM, Alemu EA … +9 more , Mekonen EG, Mengistie BA, Zeleke GA, Ayele DG, Yirsaw AN, Aragaw GM, Abuhay AE, Anteneh DE, Lakew G
Depress Anxiety · 2026 · PMID 42180156 · Full text
BACKGROUND: Women's mental health significantly influences families, communities, and national development. In low-resource settings like Lesotho, factors such as chronic illness, financial barriers, and limited access t...
BACKGROUND: Women's mental health significantly influences families, communities, and national development. In low-resource settings like Lesotho, factors such as chronic illness, financial barriers, and limited access to care contribute to the burden of mental health conditions. However, population-level evidence on depression and anxiety among reproductive age women remains limited. METHODS: A cross-sectional multilevel analysis was conducted using data from the 2023-2024 Lesotho Demographic and Health Survey (LSDHS). A weighted sample of 3265 women aged 15-49 years was included. Outcomes were defined as physician-diagnosed depression, Patient Health Questionnaire (PHQ)-based depressive symptoms, and self-reported anxiety. Multilevel multivariable logistic regression models were fitted separately for each outcome to identify associated factors while accounting for the hierarchical structure of the data. RESULTS: The prevalence of self-reported physician-diagnosed depression was 10.62%, PHQ-based depressive symptoms 5.37%, and self-reported physician-diagnosed anxiety was 9.07%. Chronic illness was significantly associated with all three outcomes. Financial barriers to healthcare were associated with self-reported physician-diagnosed depression and PHQ-based depressive symptoms, while higher parity and younger age were associated with PHQ-based depressive symptoms. Smoking and lack of media exposure were associated with higher odds of self-reported physician-diagnosed anxiety. Regional disparities were observed for self-reported physician-diagnosed depression and anxiety. CONCLUSIONS: Mental health problems remain a significant concern among women in Lesotho. Both shared and outcome-specific factors were identified, with chronic illness emerging as a consistent determinant. These findings highlight the need for integrated and targeted mental health interventions, particularly within primary healthcare and chronic disease management, alongside efforts to improve access to information and reduce regional inequalities.
Associations Between Rumination and the Incidence of First-Episode Major Depressive Disorder in a Sample of Chinese University Students: From a 1-Year Longitudinal Study.
Guo N, Zheng Y, Xu R … +5 more , Niu X, Qin Y, Li H, Wang J, Liu Y
Depress Anxiety · 2026 · PMID 42180155 · Full text
BACKGROUND: As a core risk factor for major depressive disorder (MDD), rumination has been confirmed to predict the onset of MDD in adolescents significantly. However, its pathogenic effect on first-episode MDD in univer...
BACKGROUND: As a core risk factor for major depressive disorder (MDD), rumination has been confirmed to predict the onset of MDD in adolescents significantly. However, its pathogenic effect on first-episode MDD in university freshmen has not been systematically evaluated. This study aims to investigate the impact of rumination on the incidence of first-episode MDD among university freshmen. METHODS: In this longitudinal cohort study, 6985 participants without MDD at baseline completed a follow-up survey 1 year later. The Chinese version of the Composite International Diagnostic Interview 3.0 (CIDI-3.0) was used to assess MDD. Rumination was measured by the Ruminative Responses Scale. RESULTS: The incidence of first-episode MDD among Chinese freshmen was 2.26%. Symptomatic rumination was significantly associated with a 1-year incidence of MDD (OR = 1.72, 95% CI: 1.33-2.23), controlling for the effects of baseline depressive symptoms and stressful life events. LIMITATIONS: All the information collected in this survey was from the participants' recall and selection, making recall and reporting biases possible. CONCLUSIONS: Rumination increases the likelihood of first-episode MDD among Chinese university freshmen. Therefore, mitigating or even avoiding rumination could be beneficial in reducing the risk of MDD among university freshmen.
Cognitive Symptoms and Overall Functioning During Major Depressive Episodes: Correlation Analysis of Patients With Unipolar and Bipolar Disorders.
Porceddu G, Garrone C, Maina G … +1 more , Rosso G
Depress Anxiety · 2026 · PMID 42145967 · Full text
AIM: This cross-sectional observational study was designed to characterize global functioning in patients with unipolar depression (UD) and bipolar depression (BD), focusing on the relationship between functional impairm...
AIM: This cross-sectional observational study was designed to characterize global functioning in patients with unipolar depression (UD) and bipolar depression (BD), focusing on the relationship between functional impairment and objectively assessed and subjectively perceived cognitive deficits, as well as to potential domain-specific cognitive-functional patterns across diagnostic groups. METHODS: Individuals experiencing a major depressive episode (MDE) in the context of major depressive or bipolar disorder were recruited. Global functioning was assessed with the Functional Assessment Short Test (FAST), objective cognition with the Screen for Cognitive Impairment in Psychiatry (SCIP), and subjective cognition with the Perceived Deficits Questionnaire-Depression-5-item (PDQ-D-5). Group differences were analyzed using tests and ANCOVA, adjusting for illness duration and age at onset. Associations between cognitive measures and global functioning were examined using Pearson's correlations. RESULTS: A total of 102 patients were recruited: 54 with UD, 48 with BD. Clinically relevant functional impairment was observed in 87% of UD patients and 93.7% of BD patients. BD individuals showed greater global functional impairment than UD patients, with higher FAST total scores (44.5 ± 23.1 vs. 33.5 ± 14.6, = 0.006) and worse functioning across most domains. Global functioning was strongly associated with subjectively perceived cognitive difficulties in both UD ( = 0.609, < 0.001) and BD ( = 0.475, < 0.001), whereas no significant associations were found with objective cognitive performance. Domain-specific analyses revealed different patterns of association, with attention and organization related to functioning in UD and retrospective memory in BD. CONCLUSION: MDEs in unipolar and bipolar disorders are associated with marked functional impairment. Perceived cognitive difficulties may impact daily functioning more than objectively assessed deficits, highlighting their clinical relevance. The distinct cognitive-functional profiles in UD and BD patients underscore the importance of domain-specific assessments to guide interventions targeting both symptom remission and functional recovery.
Postpartum Mental Health Problems in the Mothers of Very, Moderately and Late Preterm Infants During and After COVID-19 Pandemic: A Cross-Sectional Comparison Study and Possible Risk Factors.
Chrzan-Dętkoś M, Murawska N, Łockiewicz M
Depress Anxiety · 2026 · PMID 42145966 · Full text
BACKGROUND: Preterm birth (PTB) affects ~11% of women worldwide. The COVID-19 pandemic put an additional burden on this already challenging situation. AIMS: We aimed to analyse (1) the impact of the COVID-19 pandemic on...
BACKGROUND: Preterm birth (PTB) affects ~11% of women worldwide. The COVID-19 pandemic put an additional burden on this already challenging situation. AIMS: We aimed to analyse (1) the impact of the COVID-19 pandemic on the severity of specific depressive, anhedonia, anxiety and self-harm thoughts (SHTs) symptoms in mothers of preterm babies, (2) differences in the severity of these symptoms among mothers who gave birth very preterm, moderately and late preterm and (3) potential socio-demographic, psychological, birth-related and COVID-19-related factors associated with an increase in the mothers' scores. METHODS: A total of 948 mothers of preterm children took part in a midwife-led postpartum depression (PPD) screening; 543 of them gave birth during the pandemic, and 405-after. A sociodemographic survey and the Edinburgh postnatal depression scale (EPDS) were administered. To investigate possible differences between comparison groups, we conducted -tests, one-way ANOVAs with Tukey post hoc tests, and chi-square tests. Several hierarchical multiple regression analyses were performed to assess possible risk factors for postpartum mental health problems. RESULTS: We found that mothers who gave birth to very preterm children scored higher in depressive symptoms than mothers of moderately and late preterm children. In general, women who gave birth during COVID-19 scored higher in anxiety (a statistical trend), but not in depression. The significant predictors of increased mental health problems were a worse financial situation, a higher education level, previous maternal mental health problems and a child's physical health (lower birth weight and the presence of medical complications during delivery). CONCLUSIONS: The severity of depressive symptoms was not explained by COVID-19, but gestational age. It shows that mothers of very preterm infants need additional attention and support in the postpartum period.
Fear Generalization in Adolescent Anxiety Disorders: A MEG Study.
Roesmann K, Junghöfer M, Kleinhölting P … +2 more , Straube T, Wessing I
Depress Anxiety · 2026 · PMID 42145965 · Full text
BACKGROUND: Adult patients with anxiety disorders (ADs) as well as healthy children and adolescents generalize learned fear responses to a larger degree than healthy adults. Although such overgeneralization of fear is ce...
BACKGROUND: Adult patients with anxiety disorders (ADs) as well as healthy children and adolescents generalize learned fear responses to a larger degree than healthy adults. Although such overgeneralization of fear is central to theories of AD, little research has examined the respective mechanisms in pediatric populations. Therefore, we investigated behavioral and neural processes associated with fear generalization in adolescent patients with AD. METHODS: Magnetoencephalography (MEG) was recorded while 30 adolescent patients with AD and matched healthy controls (HCs) performed a prevalidated fear conditioning and generalization paradigm. Differently tilted Gabor gratings served as conditioned and generalization stimuli (CS+, CS-, GS) and a screaming female face as the unconditioned stimulus (UCS). Participants rated CS and GS regarding fear and UCS expectancy. The final analyses included participants showing good data quality and contingency awareness (15 AD, 16 HC; mean age: 15.65 [±1.02], 14-17 years). RESULTS: On the behavioral level, evidence for qualitatively different generalization patterns between groups was weak. Instead, fear and UCS-expectancy ratings were overall higher in the AD group. On the neural level, qualitative differences emerged as a function of time. AD patients showed lower neural responses to the CS- and CS--like GS in frontoparietal regions (330-370 ms), while HCs showed the reverse pattern. Additionally, AD patients showed lower neural responses to the CS+ and CS+-like GS in a sensory occipitotemporal region (>230 ms) that later showed higher responses to the CS+ (a positive gradient) in both groups (>360 ms). CONCLUSIONS: Results argue against strong qualitative differences in fear generalization in adolescent AD on a behavioral level. The observed time-dependent qualitative differences in magnetoencephalographic responses occurred in brain regions associated with inhibitory processes (frontoparietal regions) and motivated attention (occipitotemporal regions). Further research applying temporally highly resolving electrophysiological neuroimaging appears promising to investigate the interplay of developmental and pathological generalization and its neurocognitive basis.
Blunted Niacin Skin Flushing Response in Mood Disorders: A Meta-Analysis of Case-Control Studies.
Wang Q, Wang J, Hu X … +5 more , Gao Y, Li S, Wang T, Wang D, Wan C
Depress Anxiety · 2026 · PMID 42137476 · Full text
BACKGROUND: Mood disorders (MDs), including depressive disorder (DD) and bipolar disorder (BD), represent a major global health burden, yet the absence of objective biomarkers has persistently hindered their accurate cli...
BACKGROUND: Mood disorders (MDs), including depressive disorder (DD) and bipolar disorder (BD), represent a major global health burden, yet the absence of objective biomarkers has persistently hindered their accurate clinical diagnosis. The niacin skin flushing response (NSFR) has shown promise as a potential biomarker; however, inconsistencies in diagnostic efficacy and response characteristics across studies have limited its utility. This meta-analysis aims to systematically evaluate the NSFR in MD patients to address these discrepancies. METHODS: A comprehensive search of PubMed, Embase, Cochrane Library, and Scopus databases was conducted for articles published through May 2025, identifying 18 eligible case-control studies involving 1848 participants (888 MD patients and 960 HC). Random-effects models were used to assess the degree, speed, and sensitivity of NSFR, while subgroup analyses and meta-regression explored potential sources of heterogeneity. RESULTS: MD patients exhibited markedly blunted NSFR, characterized by reduced degree and speed of response (standardized mean difference [SMD] = -0.59, 95% confidence interval [CI]: [-1.12; -0.05] and SMD = 0.72, 95% CI: [0.35; 1.10]), while no statistically significant difference in NSFR sensitivity was observed (SMD = 0.51, 95% CI: [-0.18; 1.20]). Subgroup analyses identified substantial heterogeneity across detection methods, geographical regions, and control sources, highlighting the need for standardized protocols. Meta-regression analyses indicated that sample size, publication year, gender distribution, and age did not significantly affect outcomes, further strengthening the robustness of our findings. CONCLUSION: This study reinforces the potential of NSFR as a biomarker for MD and highlights the critical need to address heterogeneity through standardized methodologies in future research to enhance its diagnostic reliability.
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