Depress Anxiety [JOURNAL]
Sun
200 papers
Analysis of Depression and Anxiety in Patients With Tinnitus: A Focus on Specific Age Groups and Sex-Related Differences.
Zhou J, Liu Y, Xie H … +3 more , Yang S, Jiang Y, Han Z
Depress Anxiety · 2026 · PMID 42131799 · Full text
OBJECTIVE: To investigate the relationships between anxiety, depression, and insomnia and tinnitus severity among high-functioning employed adults, stratified by age and gender, and to describe age- and gender-specific p...
OBJECTIVE: To investigate the relationships between anxiety, depression, and insomnia and tinnitus severity among high-functioning employed adults, stratified by age and gender, and to describe age- and gender-specific patterns of prevalence and symptom burden in order to support a biopsychosocial framework for understanding tinnitus onset, progression, and clinical management. METHODS: An analysis was performed on data from 745 patients with chronic subjective tinnitus, aged 25-60 years, to assess levels of anxiety (HADS-A), depression (HADS-D), insomnia (ISI), and the perceived severity of tinnitus (THI and VAS). RESULTS: The findings showed that anxiety was significantly correlated with the tinnitus Handicap Inventory in younger patients, particularly in men ( = 0.611, < 0.001) and women ( = 0.577, < 0.001) aged 25-40 years. In women aged 51-60 years, depression demonstrated the strongest association with tinnitus ( = 0.545, < 0.001). In the overall cohort, insomnia exhibited a weak but statistically significant correlation with tinnitus ( ≤ 0.3). Additionally, women were more likely to link tinnitus loudness to reduced quality of life, especially in the 25-40 ( = 0.722, < 0.01) and 51-60 ( = 0.689, < 0.01) age groups. CONCLUSION: The findings indicate that anxiety in younger patients is closely related to tinnitus, whereas depressive symptoms are more prominent among middle-aged and older women. These variations indicate that patients with tinnitus may present different psychological profiles across gender and age groups. Future research may further explore the underlying pathophysiological mechanisms of tinnitus and examine its progression through long-term follow-up to improve understanding of its clinical heterogeneity.
Nonlinear Association Between NHHR and Suicide Attempts in First-Episode Untreated Depression With a Threshold Effect.
Shang X, Shen D, Sun YN … +3 more , Lang XE, Liu J, Zhang X
Depress Anxiety · 2026 · PMID 42125500 · Full text
OBJECTIVE: To investigate, with an emphasis on possible nonlinearity, the relationship between suicide attempts (SAs) and the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol rati...
OBJECTIVE: To investigate, with an emphasis on possible nonlinearity, the relationship between suicide attempts (SAs) and the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) in patients with first-episode untreated (FEU) major depressive disorder (MDD). METHODS: A total of 1718 FEU MDD were included in this cross-sectional study. NHHR was calculated from the fasting lipid profiles. Multivariable logistic regression was used to assess the independent association between the NHHR and SA across the three adjusted models. Restricted cubic splines (RCSs) and two-piecewise logistic regression were applied to characterize the dose-response relationship and identify the inflection point. RESULTS: SA occurred in 346 (20.1%) patients. SA prevalence increased progressively across the NHHR tertiles: 10.82% (T1), 17.13% (T2), and 32.46% (T3) ( < 0.001). Higher SA risk was independently linked to each unit increase in NHHR in the fully adjusted model (OR = 1.08, 95% CI: 1.01-1.16). At NHHR = 5.76, a significant nonlinear threshold effect was found; below the limit, every unit increase in NHHR was associated with a 27% greater likelihood of SA (OR = 1.27, 95% CI: 1.12-1.43, < 0.001), while outside the limits, no significant association emerged (OR = 0.85, = 0.092). CONCLUSIONS: NHHR was independently and nonlinearly associated with SA in patients with FEU MDD, with a clinically meaningful threshold of 5.76. As a readily available lipid-derived marker calculable from standard fasting panels, NHHR may serve as a practical tool for early suicide risk stratification in clinical settings.
Relationship Between Internet Use Purposes and Depressive Symptoms Among Chinese Older Adults: A Cross-Lagged Panel Network Analysis.
Wu Y, Yang Y
Depress Anxiety · 2026 · PMID 42111087 · Full text
BACKGROUND: There were debates in the results about the complex associations between Internet use purposes and depressive symptoms. A key limitation of prior research is its treatment of depressive symptoms as a unitary...
BACKGROUND: There were debates in the results about the complex associations between Internet use purposes and depressive symptoms. A key limitation of prior research is its treatment of depressive symptoms as a unitary construct, which neglects the dynamic and specific interactions between different online activities and distinct depressive symptoms. Therefore, this study aimed to explore the relationships between Internet use purposes and depressive symptoms by cross-lagged panel network (CLPN) analysis. METHODS: Data comes from two waves of the China Health and Retirement Longitudinal Study (CHARLS; 2018 and 2020). Internet use purposes were assessed by a single item. Depressive symptoms were assessed by the Center for Epidemiological Studies Depression Scale (CES-D). The CLPN analysis was used to explore the dynamic network interactions between Internet use purposes and depressive symptoms. RESULTS: We included a total of 9290 older adults. A higher level of "Watching news" (In2) can predict lower level of multiple depressive symptoms, such as "Everything was an effort" (De4) ( = -0.19), "Feeling hopeful about the future" (De5) ( = -0.16). "Chatting" (In1) predicted lower "Lack of happiness" (De8) ( = -0.09), and "Playing games" (In4) predicted lower "Everything was an effort" (De4) ( = -0.12). In contrast, "Watching videos" (In3) predicted higher "Everything was an effort" (De4) ( = 0.09), and "Financial management" (In5) predicted higher "Lack of happiness" ( = 0.14). In addition, "Lackness of happy" (De8) was had higher out expected-influence (Out-EI) and in expected-influence (In-EI) of the node. CONCLUSION: This study indicated that different Internet use purposes had distinct and specific associations with specific depressive symptoms among older adults. These findings underscore the necessity for future interventions to move beyond general Internet use and instead digital strategies designed to address particular depressive symptoms.
The Transdiagnostic Role of Emotion Regulation Difficulties and Repetitive Negative Thinking in Depression, Anxiety, and Their Comorbidity.
Herzog E, Wolf S, Studnitz T … +16 more , Frei AK, Seiffer B, Welkerling J, Zeibig JM, Sudeck G, Müller CL, Günak MM, Nakagawa TT, Ehring T, Sundmacher L, Peters S, Flagmeier AL, Zwanzleitner L, Ramos-Murguialday A, Takano K, Cludius B
Depress Anxiety · 2026 · PMID 42094245 · Full text
This study investigated emotion regulation (ER) difficulties and repetitive negative thinking (RNT) in individuals with depression, anxiety disorders, or both, compared to nonclinical controls. We aimed to determine whic...
This study investigated emotion regulation (ER) difficulties and repetitive negative thinking (RNT) in individuals with depression, anxiety disorders, or both, compared to nonclinical controls. We aimed to determine which aspects of ER difficulties and RNT are transdiagnostic or specific to one of the disorders, and whether the presence of comorbidities is associated with greater ER difficulties and higher levels of RNT. A total of = 731 participants, including = 354 individuals with depression, anxiety disorders, or both (mixed group), and = 377 nonclinical controls, completed the Difficulties in Emotion Regulation Scale (DERS) and the Perseverative Thinking Questionnaire (PTQ). Parametric and nonparametric analyses were conducted to assess group differences and comorbidity effects. The depression and anxiety disorders groups exhibited significantly greater ER difficulties and higher levels of RNT than nonclinical controls. The mixed group showed more pronounced difficulties in certain aspects of ER (nonacceptance of emotional responses, difficulties engaging in goal-directed behavior, impulse control difficulties, and limited access to ER strategies) and higher levels of RNT compared to the single-diagnosis groups. No significant differences were found in emotional awareness and clarity across clinical groups. Evidence regarding the relationship between the number of comorbid diagnoses and the severity of the difficulties was less clear. This suggests that specific disorders may have a more significant impact than comorbidity alone. Our findings highlight the transdiagnostic role of ER difficulties and RNT in depression and anxiety disorders and suggest that they may be a promising target for transdiagnostic interventions. Future research should further explore the nuanced ways in which ER difficulties and RNT vary across different mental disorders.
Postnatal Common Mental Disorders and Their Predictors in Northwest Ethiopia: A Community-Based Cohort Study.
Kurbi HA, Abebe SM, Mengistu NW … +2 more , Toni AT, Ayele TA
Depress Anxiety · 2026 · PMID 42088033 · Full text
BACKGROUND: Postnatal common mental disorders (PCMDs) are the most common complications after childbirth and are associated with many adverse effects on infant growth and development. Undiagnosed and untreated PCMDs sign...
BACKGROUND: Postnatal common mental disorders (PCMDs) are the most common complications after childbirth and are associated with many adverse effects on infant growth and development. Undiagnosed and untreated PCMDs significantly affect the health and lives of the mother, their children, and families. Although PCMDs are a significant public health concern, evidence from Ethiopia is limited. This study aimed to assess PCMDs and their predictors among postnatal women in the Dabat HDSS, Northwestern Ethiopia. METHODS: A community-based cohort study involved 872 pregnant women, who were evaluated for common mental disorders during their second and third trimesters and again two to 8 weeks postpartum. Women with a self-reporting questionnaire-20 (SRQ-20) score of ≥6 were considered to have common mental disorders. A modified Poisson regression model was used to identify the independent predictors of pCMDs. RESULTS: The prevalence and incidence of pCMDs were 16.05% (95% CI: 13.67, 18.74) and 14.02% (95% CI: 11.64, 16.79), respectively, with 3.83% of women exhibiting perinatal CMD during the study period. PCMDs are independently predicted by experiencing labor complications (IRR = 2.43, 95% CI: 1.69, 3.47), preterm birth (IRR = 1.72, 95% CI: 1.26, 2.35), antenatal CMD (IRR = 1.89, 95% CI: 1.37, 2.61), and a history of CMD before pregnancy (IRR = 2.29, 95% CI: 1.32, 3.98). CONCLUSION: The observed incidence and prevalence of PCMDs in Ethiopia were lower than in previous studies. Common mental disorders before and during pregnancy, preterm birth, and the presence of labor complications increase the risk of pCMDs. Early detection and treatment of mental disorders before and during pregnancy, along with interventions to reduce preterm birth and labor complications, could decrease the incidence of postnatal mental disorders.
Individual Participant Data Meta-Analysis Identifies Risk Factors for Acute and Persistent Posttraumatic Stress Disorder and Depression Symptoms Following Trauma.
Ratanatharathorn A, Bryant RA, Kessler RC … +7 more , Keyes KM, Matsuoka Y, Olff M, Polimanti R, Rundle AG, Koenen KC, Shalev AY
Depress Anxiety · 2026 · PMID 42088032 · Full text
BACKGROUND: Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are common sequelae to trauma. Identifying individuals at risk for persistent symptomology allows for targeted interventions. METHODS:...
BACKGROUND: Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are common sequelae to trauma. Identifying individuals at risk for persistent symptomology allows for targeted interventions. METHODS: We conducted an individual participant data meta-analysis (IPD-MA) by pooling data from five prospective emergency room and critical care unit studies ( participants = 2571) to examine risk factors for PTSD and MDD. We derived harmonized measures of PTSD and MDD in the acute period (0-60 days) following a traumatic event and in the follow-up persistent period (122-456 days). Multinomial logistic regression was used to estimate associations between seven risk factors for acute and persistent MDD and PTSD. Logistic models examined the association between acute symptoms and persistence of PTSD and MDD. RESULTS: Female sex (odds ratio [OR] range: 1.48-2.14) was associated with increased risk for acute and persistent MDD and PTSD while individuals who experienced an accident versus an assault or other traumatic event as the index trauma were at reduced risk (OR range: 0.39-0.66). Acute MDD symptom severity was associated with persistent PTSD (OR: 1.17; 95% CI: 1.08, 1.27) and remained significant after inclusion of acute PTSD symptom severity (OR: 1.14; 95% CI: 1.01, 1.29). In an analysis of PTSD symptom clusters, reexperiencing symptoms (OR: 1.18; 95% CI: 1.02, 1.36) and MDD symptom severity were associated with persistent PTSD. In models of persistent MDD, acute PTSD symptom severity was associated with persistence (OR: 1.15; 95% CI: 1.03, 1.28), but neither overall symptom severity nor cluster symptom severities were associated with persistence after inclusion of acute MDD symptom severity (OR: 1.13; 95% CI: 1.00, 1.26). CONCLUSION: Early symptoms of MDD and reexperiencing were associated with the persistence of psychopathology indicating that depressive rumination may play a role in the maintenance of MDD and PTSD.
Temporal Patterns and Predictive Factors of Childhood Depressive Disorders Across Asia.
Zhang K, Kan C, Ma Y … +3 more , Tian Z, Han F, Sun X
Depress Anxiety · 2026 · PMID 42079035 · Full text
BACKGROUND: Childhood depressive disorders represent a growing mental health concern, yet region-specific evidence in Asia remains limited. Asia hosts more than half of the global child population and has experienced rap...
BACKGROUND: Childhood depressive disorders represent a growing mental health concern, yet region-specific evidence in Asia remains limited. Asia hosts more than half of the global child population and has experienced rapid social and environmental changes that may heighten psychosocial stress. This study assessed the burden, temporal trends, geographic variation, and determinants of childhood depressive disorders across Asia from 1990 to 2023. METHODS: Data for children aged 0-14 years were obtained from the Global Burden of Disease (GBD) 2023 study. Incidence and disability-adjusted life years (DALYs) were analyzed by age, sex, region, and country. Joinpoint regression quantified annual and long-term temporal trends. Bullying victimization was evaluated as a behavioral risk factor. Extreme Gradient Boosting (XGBoost) models with Shapley Additive Explanations (SHAP), which show how each variable influences model predictions, were used to identify the major predictors of incidence and DALYs. RESULTS: In 2023, South Asia showed the highest incidence rate (1099 per 100,000) and DALYs rate (119 per 100,000). Across all regions, children aged 10-14 years and girls had the greatest incidence and DALYs rates. India, China, and Pakistan contributed the largest absolute numbers of cases and DALYs, while Mauritius, Bangladesh, and Pakistan recorded the highest rates. Pakistan demonstrated the steepest long-term increases in both incidence and DALYs. Bullying-attributable DALYs increased across all regions, with the largest growth in South and Southeast Asia. SHAP analyses identified age, sex, calendar year, and population size as the strongest predictors, with older children and girls showing markedly higher predicted burdens. CONCLUSION: Childhood depressive disorders have increased steadily across Asia over the past three decades, with clear demographic and geographic disparities. These findings highlight the urgency of early detection, school-based mental health programs, antibullying interventions, and gender-responsive services. Strengthening child mental health systems in Asia is critical for improving developmental outcomes.
Frontal Cortex Entropy Derived From Resting-State fNIRS for Brain Age Prediction in Major Depressive Disorder.
Ji S, Tian Y, Lin X … +2 more , Liu X, Yu H
Depress Anxiety · 2026 · PMID 42079034 · Full text
OBJECTIVE: This study investigated the potential of frontal brain entropy (BEN) metrics derived from resting-state functional near-infrared spectroscopy (rs-fNIRS) as neurophysiological biomarkers for predicting brain ag...
OBJECTIVE: This study investigated the potential of frontal brain entropy (BEN) metrics derived from resting-state functional near-infrared spectroscopy (rs-fNIRS) as neurophysiological biomarkers for predicting brain age in patients with major depressive disorder (MDD). METHODS: Rs-fNIRS data (26 channels) were acquired from the frontal cortex of 49 healthy controls (HCs) and 35 MDD patients. Time-series signals for oxyhemoglobin (HbO), deoxyhemoglobin (HbR), and total hemoglobin (HbT) were extracted. Static BEN was computed as permutation entropy (PE) using the full time series for each channel, while dynamic BEN was derived by calculating PE within consecutive time windows. Support vector regression (SVR) was applied to predict brain age in the HC group using static and dynamic BEN features. The optimal model was then used to predict brain age in the MDD group. Finally, receiver operating characteristic (ROC) curve analysis was conducted to evaluate the discriminative capacity of BEN and brain age metrics for distinguishing MDD from HC. RESULTS: In HC, the strongest brain age prediction was achieved by dynamic BEN derived from HbR signals ( = -0.62, < 0.001), while in MDD, the best performance was obtained using dynamic BEN from HbO signals ( = -0.78, < 0.001). MDD patients exhibited a significantly elevated brain age gap (BAG) compared with HC across all entropy-based features (all < 0.001). Moreover, both group-discriminative BEN and brain age metrics derived from static and dynamic BEN achieved outstanding diagnostic performance, with several combinations reaching an area under the ROC curve of 1.00 in distinguishing MDD from HC. CONCLUSIONS: Frontal BEN derived from rs-fNIRS represents a potential neurophysiological biomarker of accelerated brain aging in patients with MDD. Furthermore, brain age estimated from cerebrovascular hemodynamic complexity demonstrates high discriminative ability for identifying MDD. Collectively, these findings suggest that frontal neurovascular complexity metrics may serve as both diagnostic markers for MDD and quantitative indicators of pathological aging progression.
Directional Asymmetry Without Timescale Dependence: Longitudinal Associations Between Procrastination and Depressive Symptoms.
Zhang R, Tan H, Wang L … +1 more , Zhang S
Depress Anxiety · 2026 · PMID 42064265 · Full text
BACKGROUND: Longitudinal research has examined procrastination-emotion dynamics across diverse temporal intervals, yet it remains unclear whether findings obtained at different timescales reflect distinct underlying mech...
BACKGROUND: Longitudinal research has examined procrastination-emotion dynamics across diverse temporal intervals, yet it remains unclear whether findings obtained at different timescales reflect distinct underlying mechanisms. Guided by an emotion-regulation account, the present study tested the hypotheses that negative emotions predicted subsequent procrastination more strongly at shorter intervals, whereas procrastination predicted increases in depressive symptoms over longer intervals. METHODS: To test whether the procrastination-depressive symptoms coupling varied across temporal scales, we integrated three longitudinal datasets (i.e., daily, 1-month, and half-yearly intervals) and compared models in which within-person lagged effects (i.e., from depressive symptoms to procrastination and the reverse path) were allowed to vary versus constrained to be invariant across timescales. Directional paths were then reported based on the better-fitting model. RESULTS: Model comparisons favored the timescale-invariant model over the timescale-variant model for both directional paths. Across multiple temporal scales, the timescale-invariant model showed negligible effects of depressive symptoms on subsequent procrastination, while procrastination predicted increases in depressive symptoms. CONCLUSION: Contrary to timescale-dependent expectations, no evidence for temporally distinct mechanisms was observed within the examined intervals. Instead, the findings reveal a modest directional asymmetry across timescales, suggesting that procrastination may have consistent but small effects on subsequent increases in depressive symptoms rather than forming a reciprocal feedback loop.
Compositional Associations of 24-h Movement Behaviors With Depressive and Anxiety Symptoms in Middle-Aged Adults.
Tan C, Niemelä M, Seppänen M … +2 more , Leinonen AM, Farrahi V
Depress Anxiety · 2026 · PMID 42058849 · Full text
BACKGROUND: Physical activity could reduce the risk of depression and anxiety. A 24-h day includes time spent sleeping, in sedentary behavior (SB), or engaging in physical activities. However, the joint and combined asso...
BACKGROUND: Physical activity could reduce the risk of depression and anxiety. A 24-h day includes time spent sleeping, in sedentary behavior (SB), or engaging in physical activities. However, the joint and combined associations of these 24-h movement behaviors with depressive and anxiety symptoms remain unclear. AIM: To investigate the compositional associations of 24-h movement behaviors with depressive and anxiety symptoms in a population-based sample of middle-aged adults. METHODS: The study population ( = 4490) comprised of participants from the Northern Finland Birth Cohort 1966 (NFBC1966). Over 14 consecutive days, movement behaviors-SB, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA)-were recorded using a hip-worn accelerometer and were combined with self-reported sleep duration to obtain the 24-h time-use composition. Three different screening tools-Beck Depression Inventory-II (BDI-II), Generalized Anxiety Disorder-7 (GAD-7), and Hopkins Symptom Checklist-25 (HSCL-25)-were utilized to assess the severity of depressive and anxiety symptoms. Compositional linear regression and time reallocation analysis were performed to examine the associations of 24-h movement behaviors with depressive and anxiety symptoms. RESULTS: Compositional 24-h movement behaviors were significantly associated with depressive and anxiety symptoms. Higher MVPA relative to other components of 24-h movement behaviors was associated with significantly lower depressive and anxiety symptoms. A 30-min reallocation of time from SB to MVPA was associated with 9.0% (95% confidence interval [CI]: 6.3%, 11.6%) lower depressive symptoms and 4.5% (95% CI: 2.1%, 6.9%) lower anxiety symptoms assessed with BDI-II and GAD-7 tools, respectively. Similar patterns of associations were observed in the time reallocation analysis when depressive and anxiety symptoms were assessed with the HSCL-25 screening tool. CONCLUSION: Each component of 24-h movement behaviors was associated with depressive and anxiety symptoms. Among the component parts of 24-h movement behaviors, MVPA was most strongly associated with lower depressive and anxiety symptoms, whereas LPA only showed marginal favorable benefits.
Analysis of Psychotropic Polypharmacy and Associated Factors in Antidepressant-Treated Patients With Depressive Disorder: A Population-Based Cohort Study Using Real World Data.
Infante-Ventura D, Rodríguez-Díaz B, García-Bello MÁ … +6 more , Válcarcel-Nazco C, Estupiñán-Romero F, Acosta Artiles FJ, González de León B, Hurtado-Navarro I, Del Pino-Sedeño T
Depress Anxiety · 2026 · PMID 42058848 · Full text
INTRODUCTION: Psychotropic polypharmacy typically refers to the prescription of more than one psychotropic medication to a patient. While polypharmacy can sometimes be clinically justified, it is widely recognized that m...
INTRODUCTION: Psychotropic polypharmacy typically refers to the prescription of more than one psychotropic medication to a patient. While polypharmacy can sometimes be clinically justified, it is widely recognized that multiple drug use and exposure can be problematic. The aim of this article is to analyze polypharmacy experienced by patients with depressive disorders, estimating its incidence during the first year after diagnosis and exploring the sociodemographic, clinical, and health-related lifestyle factors related to psychotropic polypharmacy. METHODS: A retrospective population-based cohort study was conducted among adults (aged 18 and over) within the Canary Islands Health Service. The study analyzed routine health record data from patients diagnosed with depressive disorders who received antidepressant treatment between 2013 and 2022. Psychotropic polypharmacy refers to the concurrent use of two or more psychotropic medications by the same patient. To explore the relationship with sociodemographic, clinical, and lifestyle characteristics, multivariate logistic regression analyses were conducted. RESULTS: The study included a total of 39,800 participants, with a polypharmacy incidence of 86.28%. Most patients (48.10%) received three or more medications ( = 19,145). Factors associated with polypharmacy included the 45-64 age group (OR: 1.21), previous depressive episodes (OR: 1.15), number of comorbidities (OR: 1.11), and male gender (OR: 0.83). CONCLUSION: The results highlight the complexity of psychotropic polypharmacy, especially in patients with previous episodes and comorbidities. While the use of multiple medications may be necessary, it is critical to periodically review treatments to ensure their safety, especially in vulnerable populations. New prescription trends suggest a shift toward more rational approaches, although further research is required to support clinical guidelines.
Abnormal Activation and Connection in Middle Frontal Gyrus: A Potential Imaging Feature for Facial Synkinesis Comorbid Depression.
Guan H, Wang L, Dong F … +6 more , Hu W, Zhang Z, Wu J, Lu Y, Ding W, Jiang J
Depress Anxiety · 2026 · PMID 42046659 · Full text
Patients with facial synkinesis (FS) comorbid depression may experience aggravated symptoms of perceived synkinesis and poorer recovery outcomes. Exploring imaging features associated with depressive symptoms could help...
Patients with facial synkinesis (FS) comorbid depression may experience aggravated symptoms of perceived synkinesis and poorer recovery outcomes. Exploring imaging features associated with depressive symptoms could help us better understand disease conditions and formulate appropriate rehabilitation plans. Although abnormal activation in the middle frontal gyrus (MFG) has been reported in depression patients, whether it represents an imaging correlate of depressive symptoms in patients with FS is still unknown. Therefore, a total of 52 participants (20 normal controls [NCs], 32 patients) with both task and resting-state functional magnetic resonance imaging (rs-fMRI) data were included in this study. Comorbid depression was assessed with the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V), and depressive symptom severity was measured with the Beck Depression Inventory-II (BDI-II). We investigated brain activation during motor tasks (smiling, blinking, and grinning). In addition, the seed-based functional connectivity (FC) between the MFG and other brain areas was calculated in the resting state. Additionally, we analyzed the associations between brain activity and clinical scale scores. The results revealed reduced activation in the sensorimotor and MFG during affected side movements across all tasks (voxel-level < 0.05, cluster-level < 0.05, Gaussian random field [GRF]-corrected). Moreover, seed-based FC between the MFG and emotion-related areas was increased (voxel-level < 0.05, cluster-level < 0.05, GRF-corrected), indicating impaired emotional networks in patients. Scores on the BDI-II were negatively associated with MFG activation during tasks (R = -0.318, = 0.027) and positively associated with the FC of the MFG ( = 0.387, = 0.029). Thus, the MFG activation and connectivity may represent an increased risk for elevated depressive symptoms in patients with FS, warranting further validation in future studies. Chinese Clinical Trial Registry: ChiCTR1800014630.
Rumination Out Loud? Linguistic, Neural, and Psychophysiological Correlates of the Think-Aloud Paradigm.
Int-Veen I, Fallgatter AJ, Ehlis AC … +1 more , Rosenbaum D
Depress Anxiety · 2026 · PMID 42038197 · Full text
Stress and rumination are closely linked and contribute to the development and maintenance of mental disorders, yet assessing rumination in an ecologically valid way remains challenging. Conducting the think aloud paradi...
Stress and rumination are closely linked and contribute to the development and maintenance of mental disorders, yet assessing rumination in an ecologically valid way remains challenging. Conducting the think aloud paradigm (TAP) following the Trier Social Stress Test (TSST) allows for the real-time evaluation of ruminative responses, providing insights beyond traditional self-report measures. This study aimed to investigate ruminative responses to the TSST using the TAP, while simultaneously assessing psychological (stress, affect, state rumination), physiological (heart rate), and neural data with functional near-infrared spectroscopy (fNIRS). For this, a total of 58 healthy participants (mean age 23.47 years ( = 3.87), 63.8% females) completed a 10-min resting-state period both before and after the TSST, verbalizing their thoughts. In response to the TSST, we observed significant increases in stress, state rumination, negative affect, heart rate, and cortical oxygenation in all regions of interest except the inferior frontal gyrus (IFG), reflecting a successful stress induction. Although we observed higher stress, state rumination, and negative affect, alongside lower positive affect in high ruminators using questionnaires, linguistic evaluation of the verbalized thought content showed no significant time effects but revealed generally lower sentiment scores for high ruminators and only partly showed differences dependent on trait rumination levels. With respect to neural correlates, we observed prefrontal hypoactivation under stress in medium and high compared to low ruminators. Comparing the results with previous studies, the administration of the TAP following the TSST seems to function as a form of emotion regulation, thereby reducing state rumination. Further studies are required to explore the underlying mechanisms.
Present Focus Moderated the Relationship Between Academic Stress, Self-Stigma, and Anxiety Level: A Longitudinal Study.
Yang M, Luo S, Miao M … +3 more , Han P, Yan L, Wang G
Depress Anxiety · 2026 · PMID 42038196 · Full text
The study was mainly aimed to explore reciprocally temporal relationships between academic stress, self-stigma, and anxiety level, and the moderating effect of present focus among high school students with learning diffi...
The study was mainly aimed to explore reciprocally temporal relationships between academic stress, self-stigma, and anxiety level, and the moderating effect of present focus among high school students with learning difficulties (LDs). Academic stress, self-stigma, anxiety level, and present focus were measured at Time 1 (T1) and Time 2 (T2, 5 weeks later) among 3000 senior high school students in Liaoning, China. Using structural equation modeling (SEM), the researchers conducted cross-lag analyses of academic stress, self-stigma, and anxiety level among two samples of the selected 735 students with LDs (M ± SD = 16.32 ± 0.97 [years]) and 733 students with excellent performance, respectively. Correlation analysis showed that the positively simultaneous and successive correlations between academic stress, self-stigma, and anxiety level of the students with LDs were significant. Cross-lagged analysis showed that, among the students with LDs, academic stress at T1 only had a positive relationship with academic stress at T2 ( = 0.36, < 0.001), whereas self-stigma at T1 had positively predictive links to self-stigma ( = 0.42, < 0.001) and anxiety level ( = 0.08, = 0.031) at T2, and anxiety level at T1 had positively predictive links to anxiety level ( = 0.37, < 0.001), academic stress ( = 0.13, = 0.001), and self-stigma ( = 0.10, = 0.006) at T2. Whereas among the students with excellent performance, academic stress at T1 was positively related to academic stress ( = 0.39, < 0.001) and anxiety level ( = 0.09, = 0.015) at T2, anxiety level at T1 was also positively linked to anxiety level ( = 0.35, < 0.001), academic stress ( = 0.13, < 0.001), and self-stigma ( = 0.10, = 0.026) at T2, whereas self-stigma at T1 only had a reciprocal relationship with itself ( = 0.49, < 0.001) at T2. Besides, high present focus at T2 exaggerated the temporal association of academic stress at T1 with anxiety level at T2 among students with LDs ( = 0.01, = 2.07, = 0.039, 95% CI [0.001, 0.024]). This investigation elucidated the dynamic patterns of anxiety level, offering a nuanced comprehension of its relationship with academic stress and self-stigma, and the moderating role of present focus. Moreover, the results hold implications for the prevention and intervention targeting the reduction of anxiety among students with LDs and students with excellent performance.
The Role of Voice Acoustics in Depression Assessment: Findings From Bibliometric Analysis, Literature Review, and Meta-Analysis.
Cantor-Cutiva LC, Carrillo-González A, Yousef AM … +2 more , Berardi M, Hunter EJ
Depress Anxiety · 2026 · PMID 42038195 · Full text
BACKGROUND: Depression is a prevalent mental health disorder that significantly impairs psychosocial functioning and quality of life. Recent advances in health sciences and digital technologies have highlighted the poten...
BACKGROUND: Depression is a prevalent mental health disorder that significantly impairs psychosocial functioning and quality of life. Recent advances in health sciences and digital technologies have highlighted the potential of voice acoustic parameters as objective indicators of health status, including depression. METHODS: A bibliometric analysis, systematic literature review, and meta-analysis were conducted to consolidate and critically evaluate the current evidence regarding the relationship between voice acoustic parameters and depression. The search was performed in January 2024 across seven databases, including PubMed, Web of Science, and Scopus. Studies were included if they involved participants with clinically significant depression, identified either through formal diagnostic criteria or through validated depression rating scales with established clinical thresholds and explicitly reported voice acoustic parameters. A total of 31 potential publications were identified and analyzed, and after full-text reading, 17 publications were included. Only six out of the 17 included studies reported sufficient numerical fundamental frequency (fo) data for meta-analysis; other parameters could not be synthesized quantitatively due to a lack of extractable values. RESULTS: The bibliometric analysis suggests an evolution from studies identifying "valid" assessment tools towards the modeling of potential discriminatory factors. The mean difference (MD) suggests a decreased fo of 1.82 Hz among participants identified with depression compared to participants identified as the control group. However, the difference between the groups was not statistically significant ( test = 0.58; -value 0.56). CONCLUSIONS: Voice acoustic parameters seem to have the potential to be noninvasive, cost-effective biomarkers for measuring and monitoring depression symptomatology. Although there was a trend of decreased fo of 1.82 Hz among participants identified with depression compared to participants identified as the control group, the meta-analysis suggests a nonsignificant difference in average values.
Stronger Activation of the Right Primary Motor Cortex in the Early Processing Stage of Negative Emotional Scenes Stimulation.
Meng H, Zhang X, Zhang J … +1 more , Zheng C
Depress Anxiety · 2026 · PMID 42022914 · Full text
BACKGROUND: To identify threatening emotional information in a natural scene and form a rapid behavioral response, which is crucial for individual survival. The motor cortex is thought to play a key role in this process....
BACKGROUND: To identify threatening emotional information in a natural scene and form a rapid behavioral response, which is crucial for individual survival. The motor cortex is thought to play a key role in this process. However, little research has addressed differences in the motor system responses to valence-specific emotional stimuli across multiple temporal windows. METHODS: Twenty-eight participants were asked to complete the emotional picture classification task, and then triggered the single-pulse transcranial magnetic stimulation in a specific time window after various emotional pictures were presented, to evaluate the excitability of left and right primary motor cortex (M1) in different time windows after emotional picture presentation. RESULTS: In the early time window (150 ms), the right side of M1 was more excited when viewing negative emotional pictures than neutral emotional pictures and positive emotional pictures, while in the late time window (350 ms), the right side of M1 was more excited when viewing negative emotional pictures than neutral emotional pictures, and the excitability of right-side M1 was higher when viewing positive and negative emotion pictures, but there was no significant difference in the excitability of right-side M1 induced by emotional pictures in the medium-term time window (250 ms). CONCLUSION: The response of motor system to emotional stimulation is mainly reflected in the right hemisphere. In the early time window, negative emotional stimuli elicited a stronger response in right M1, whereas in the late time window, positive and negative emotional stimuli elicited a similar response in right M1. These findings may shed light on the neural basis of emotional motor biases, which could be disrupted in mood disorders like depression and anxiety.
Joint Association of Household Pesticide Exposure With Depression in Adults: A Cross-Sectional Analysis From National Health and Nutrition Examination Survey 2007-2014.
Chen M, Dai H, Tong Z … +1 more , Lin M
Depress Anxiety · 2026 · PMID 42006864 · Full text
OBJECTIVES: This study aimed to investigate the association between household pesticide exposure and depression risk in adults, with a particular focus on sex- and age-specific vulnerabilities. The analysis utilized inte...
OBJECTIVES: This study aimed to investigate the association between household pesticide exposure and depression risk in adults, with a particular focus on sex- and age-specific vulnerabilities. The analysis utilized integrated biomarker assessment and advanced mixture modeling techniques. METHODS: Cross-sectional data from 6502 adults (National Health and Nutrition Examination Survey [NHANES] 2007-2014) were analyzed. Household pesticide exposure was evaluated through self-reports as well as urinary metabolites (DEET, DCBA, DHMB, 3-phenoxybenzoic acid [3-PBA], 4F-3-PBA, and cis-DCBA). To assess exposure-response relationships, nonlinear trends, and mixture effects while adjusting for sociodemographic factors, lifestyle choices, and clinical covariates, we employed survey-weighted logistic regression models along with restricted cubic spline (RCS), Bayesian kernel machine regression (BKMR), and weighted quantile sum (WQS) analyses. RESULTS: Self-reported pesticide exposure demonstrated a marginal association with depression (adjusted odds ratio [OR] = 1.43; 95% confidence interval [CI]: 0.91-2.25). Urinary pyrethroid metabolite 3-PBA exhibited dose-dependent relationships with depression (OR = 1.02 per 1 μg/L; 95% CI: 1.00-1.04). Notable sex-specific vulnerabilities were identified; females exhibited stronger associations with both 3-PBA (OR = 1.04) and 4F-3-PBA (OR = 1.69), whereas males showed heightened sensitivity to DCBA (weight = 0.35). Mixture analyses indicated joint effects involving DHMB and 3-PBA as notable contributors to the observed outcomes. Additionally, fatigue (OR = 1.26), self-blame (OR = 1.30), and appetite disturbances (OR = 1.17) statistically contributed to pesticide exposure. Nonlinear dose-response patterns were particularly evident among males and younger adults. CONCLUSIONS: This cross-sectional analysis demonstrates an association between exposure to household pesticides, particularly pyrethroids, and an increased risk of depression, with variation across demographic groups. These findings underscore the need for further longitudinal investigation to establish causality and understand the implications of pesticide usage on public health.
Increased Glymphatic System Activity and Hypothalamic Connectivity in Patients With Premenstrual Dysphoric Disorder.
Liu C, Xu X, Li Y … +6 more , Chen S, Liu D, Liu Y, Lu J, Liu P, Liao H
Depress Anxiety · 2026 · PMID 41994625 · Full text
OBJECTIVES: Premenstrual dysphoric disorder (PMDD), which is an emotional disorder characterized by symptoms of irritability, depression, anxiety, and sleep disturbances during the luteal phase of the menstrual cycle. Ad...
OBJECTIVES: Premenstrual dysphoric disorder (PMDD), which is an emotional disorder characterized by symptoms of irritability, depression, anxiety, and sleep disturbances during the luteal phase of the menstrual cycle. Advanced neuroimaging findings provided insights into the neurobiological underpinnings of PMDD. However, the role of the glymphatic system and hypothalamus-related functional connectivity (FC) remains unclear. We aimed to investigate the abnormalities of glymphatic system and hypothalamus-related FC in PMDD patients. METHODS: In this study, 23 PMDD patients and 27 healthy controls (HCs) underwent diffusion tensor imaging (DTI) and functional magnetic resonance imaging scan. The DTI along the perivascular space (DTI-ALPS) indices were used as an indirect evaluation of glymphatic function. Altered hypothalamus-related FC was detected between PMDD patients and HCs, and machine learning was performed to assess the classification performance of these FC abnormalities in distinguishing PMDD patients from HCs. Leave-one-out cross-validation was used for modal validation. Classification accuracy and area under the receiver operating characteristic (ROC) curve were evaluated. Furthermore, the associations between DTI-ALPS index, clinical features, and hypothalamus-seeded FC were explored. RESULTS: Compared to HCs, PMDD patients exhibited: (1) significantly higher value of left DTI-ALPS index; (2) increased intrinsic connectivity between the hypothalamus and anterior/middle cingulate cortex (ACC/MCC), middle frontal cortex (MFC), orbitofrontal cortex (OFC), insula, inferior temporal cortex (ITC), inferior parietal lobe (IPL), caudate, lentiform nucleus, and thalamus. The right and mean DTI-ALPS indices were positively correlated with the hypothalamus-right ACC/MCC FC in PMDD patients. Significantly positive correlations were observed between the hypothalamus-right ITC FC and anxiety, depression scores, as well as between the hypothalamus-bilateral lentiform nucleus FC and severity of symptoms in PMDD patients. Hypothalamus-related FC showed superior discriminative ability in differentiating PMDD patients from HCs. CONCLUSION: The increased glymphatic system activity and hypothalamus-related FC might be associated with the supersensitive reactivity of emotional processing in PMDD patients. Brain regions primarily involved in the emotional network showed potential group-discriminative features when comparing PMDD patients to HCs. Chinese Clinical Trial Registry identification: ChiCTR2000040935.
Puberty in Context: Accounting for Psychosocial Experiences in the Association Between Pubertal Timing, Sex/Gender, and Adolescent Depressive Symptoms in Canadian Youth.
Duchesne A, White N, Cooke BC … +1 more , Sanders C
Depress Anxiety · 2026 · PMID 41983113 · Full text
Literature suggests that early pubertal timing constitutes a risk factor for adolescent depression, especially in girls. However, adverse experiences preceding (e.g., childhood adversity), co-occurring with (e.g., changi...
Literature suggests that early pubertal timing constitutes a risk factor for adolescent depression, especially in girls. However, adverse experiences preceding (e.g., childhood adversity), co-occurring with (e.g., changing peer and parent relationships), and following puberty (e.g., delinquent behavior) have been associated with both pubertal timing and adolescent depression, and little is currently known about how these experiences may be differentially associated with the correspondence between pubertal timing and depression across sex/gender. Using Canadian data from the National Longitudinal Survey of Children and Youth (NLSCY), the present study investigated how sex/gender and relevant childhood, peri, and postpubertal psychosocial variables informed the relationship between pubertal timing and adolescent depressive symptoms. Preliminary models examining the relationship between pubertal timing and depressive symptoms in girls and boys suggested a linear association for both groups, facilitating a mixed-sex/gender analysis supporting direct testing of sex/gender interactions. Data from 1400 Canadian youth (53% female; 96% Caucasian) showed that girls were more likely to report earlier pubertal development and higher rates of depressive symptoms at age 16-17. In a base model ignoring psychosocial context, we observed a significant interaction where early pubertal timing was associated with greater depressive symptoms in girls, with no pubertal timing effect apparent in boys. However, after accounting for psychosocial factors, adolescent depressive symptoms were best predicted by childhood emotional problems, peripubertal body dissatisfaction and perceived parental rejection irrespective of sex/gender, with additional sex/gender-contingent effects of childhood family dysfunction and postpubertal delinquency. Moreover, pubertal timing did not explain significant variance in depressive symptoms in girls or boys after accounting for psychosocial context. These findings support the context-contingency of sex/gender differences in the association between pubertal timing and adolescent depression. Conceptual and methodological ramifications of the need for an integrated biopsychosocial focus are discussed.
Symptom Structure of Depression and Anxiety in Mothers Following Child Loss: A Network and Bayesian Graph Analysis.
Al-Mamun F, Mamun MA, Almerab MM … +3 more , Holroyd S, Gozal D, Muhit M
Depress Anxiety · 2026 · PMID 41971225 · Full text
BACKGROUND: Bereavement, especially following the loss of a child, is a profoundly distressing life event associated with heightened risks of depression and anxiety. However, limited evidence exists on the symptom-level...
BACKGROUND: Bereavement, especially following the loss of a child, is a profoundly distressing life event associated with heightened risks of depression and anxiety. However, limited evidence exists on the symptom-level structure and statistical interrelations of these conditions among bereaved individuals, particularly in low- and middle-income countries (LMICs). METHODS: Using nationally representative data from the 2022 Bangladesh Demographic and Health Survey (BDHS), we identified 2276 bereaved mothers. We applied psychological network analysis to estimate the partial correlation network structure of nine-item Patient Health Questionnaire (PHQ-9) depressive and seven-item Generalized Anxiety Questionnaire (GAD-7) anxiety symptoms. Centrality, predictability, and bridge metrics were computed. Network comparison tests (NCTs) assessed structural invariance across bereavement subgroups. Bayesian directed acyclic graphs (DAGs) were used to explore conditional dependency patterns and probabilistic edge orientations among symptoms. RESULTS: The prevalence of probable major depressive disorder (MDD) was 6.69% (95% CI: 5.52-7.86). Prevalence estimates were comparable by bereavement recency, with overlapping confidence intervals among mothers bereaved within the past 3 years (5.34%, 95% CI: 3.06-9.15) and those bereaved more than 3 years earlier (6.83%, 95% CI: 5.69-8.19). The symptom network revealed interconnected domains corresponding to anxiety and depression symptoms. Trouble relaxing and psychomotor disturbance showed the highest strength centrality, while suicidal ideation exhibited the highest predictability in the network. Bridge centrality analysis identified feeling afraid, sadness, irritability, and psychomotor disturbance as the strongest cross-domain connectors linking anxiety and depression symptoms. Bayesian DAG analysis indicated strong conditional dependencies among worry-related anxiety symptoms, while psychomotor disturbance showed a strong conditional association with suicidal ideation. CONCLUSIONS: This study offers novel symptom-level insights into bereavement-related anxiety and depression among mothers in Bangladesh. The observed symptom patterns are consistent with enduring depressive and anxiety symptoms rather than acute grief alone. Symptom-focused approaches targeting central and bridge symptoms may support more efficient screening and scalable intervention strategies in bereaved populations.
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