Depress Anxiety [JOURNAL]
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200 papers
Machine Learning-Based Identification of Preoperative Psychological Distress and Its Association With Adverse Surgery-Related Outcomes: Evidence From the China Surgery and Anesthesia Cohort (CSAC).
Hou C, Yang Y, Chen W … +4 more , Yang L, Zeng Y, Li Q, Song H
Depress Anxiety · 2025 · PMID 41180150 · Full text
BACKGROUND: Many patients experience psychological distress in the preoperative phase, whilst screening based on cut-off points of assessment scales showed limited value in predicting clinical postoperative adverse outco...
BACKGROUND: Many patients experience psychological distress in the preoperative phase, whilst screening based on cut-off points of assessment scales showed limited value in predicting clinical postoperative adverse outcomes. METHODS: To identify preoperative psychological distress and investigate their associations with adverse surgery-related outcomes, we included 16,662 patients from the China Surgery and Anesthesia Cohort (CSAC). We applied dimensionality reduction and unsupervised machine learning algorithms to classify participants into distinct psychological patterns. We then assessed the associations of machine learning-identified psychological patterns and traditional cut-off based psychological symptoms, with various adverse surgery-related outcomes, using logistic and linear regression models while adjusting for other relevant covariates. RESULTS: We successfully established clustering algorithms for 16,298 participants, demonstrating strong consistency in pattern features. Six distinct psychological patterns among participants were identified, including one group with normal psychological functioning and five groups with varying levels of psychological distress. All identified psychological distress patterns were significantly associated with most surgery-related adverse outcomes, both in short-term (e.g., any within-hospital postoperative complication, odds ratios [ORs] = 1.24-1.30) and long-term (e.g., cognitive impairment at 12 months postsurgery, 1.29-2.35). In contrast, traditional cut-off-based methods identified only 266 patients with significant psychological symptoms, which showed no association with some key short-term outcomes (e.g., length of hospital stay and postoperative complication), though they remained linked to most long-term outcomes. CONCLUSIONS: Our findings demonstrate the effectiveness of machine learning in accurately identifying patients with preoperative psychological distress who may require clinical attention, highlighting the potential of these techniques to guide targeted preoperative interventions and ultimately improve surgical outcomes.
Longitudinal Associations Between Depression Symptoms and Cognitive Functions in Chinese Older Adults: A Cross-Lagged Panel Network Analysis.
Ma H, Zhao M, Yin H … +2 more , Zhao S, Wei P
Depress Anxiety · 2025 · PMID 41114131 · Full text
BACKGROUND: With rapid population aging in China, understanding the relationship between depression symptoms and cognitive function is crucial for improving the mental health of older adults. This study investigates thes...
BACKGROUND: With rapid population aging in China, understanding the relationship between depression symptoms and cognitive function is crucial for improving the mental health of older adults. This study investigates these dynamics using data from the China Health and Retirement Longitudinal Study (CHARLS). METHODS: We analyzed data from the 2015, 2018, and 2020 waves of CHARLS, including 5203 participants aged 60 and above. Depression symptoms were measured using the Centre for Epidemiological Studies Depression-10 (CESD-10) scale, while cognitive function was assessed via the Mini-Mental State Examination (MMSE) scale. Cross-sectional network analysis was utilized for constructing the contemporaneous network, and cross-lagged panel network (CLPN) analysis was subsequently employed for longitudinal analysis. RESULTS: In all three cross-sectional networks, "Hope" was identified as a key bridge symptom connecting the depression symptom community and the cognitive function community, while "Depressed mood" was found to be the central symptom of the entire network. In temporal networks, higher drawing ability at wave 1 was associated with greater "Hope" at wave 2, whereas higher "Fear" at wave 1 was related to lower recall ability at wave 2. Moreover, lower memory ability at wave 2 was associated with lower "Bothered" at wave 3. CONCLUSION: This study uncovered the dynamic interplay between specific depression symptoms and cognitive functions among Chinese older adults, thereby providing further validation for the scar theory and the cognitive vulnerability model. Additionally, it provides a critical theoretical foundation for developing intervention strategies targeting mental health and cognitive function in the aging population, as well as a scientific basis for related policy formulation. Future research should integrate quantitative and qualitative data for stronger causal validation.
Interrelationships Among Personality Traits, Depressive Symptoms, Childhood Abuse, and Social Disability.
Feng Z, Zhou J, Liu R … +8 more , Xiao L, Feng Y, Li R, Li X, Zhang X, Liu J, Wang G, Zhou J
Depress Anxiety · 2025 · PMID 41069642 · Full text
BACKGROUND: Personality traits and childhood abuse were found to be associated with depressive symptoms and with each other. However, no previous study has elucidated the directional interrelationship among those factors...
BACKGROUND: Personality traits and childhood abuse were found to be associated with depressive symptoms and with each other. However, no previous study has elucidated the directional interrelationship among those factors in a clinical population of patients with major depressive disorder (MDD). This study sought to construct networks to explicate the directional interrelationship among those factors and social disability, identify the most central factor, and explore potentially existing causality chains implied by the directed association chains. METHODS: This cross-sectional study analyzed data from 1445 patients with MDD in a national cohort. Personality traits were measured using the Eysenck Personality Questionnaire-Revised Short Scale for Chinese (EPQ-RSC). Seven dimensions of depressive symptoms were measured with various scales: depression, anxiety, insomnia, and somatic symptoms with the 17-item Hamilton Depression Rating Scale (HAMD-17), the loss of pleasure sensation with the Snaith-Hamilton Pleasure Scale (SHAPS), apathy with the Modified Apathy Evaluation Scale (MAES), and fatigue with the Chalder Fatigue Scale (CFS-11). Childhood abuse experience was measured using the Childhood Trauma Questionnaire-Short Form (CTQ-SF). Social disability was measured with the Sheehan Disability Scale (SDS). Undirected and Bayesian network analyses were used to identify central factors and explore directional interrelationships among the variables. RESULTS: The loss of pleasure sensation was the most central in terms of strength and closeness. In the directed acyclic graph (DAG) derived from the Bayesian network analysis, psychoticism was positioned at the highest level in the model, suggesting its causal precedence. One key directed association chain, which implied a potentially existing causality chain, was that psychoticism predicted the loss of pleasure sensation, and this symptom predicted social disability. CONCLUSION: Loss of pleasure sensation and psychoticism might be important for future research in MDD. The appearance of psychoticism at the beginning of the directed association chain (which implied a potentially existing causality chain) involving the central factor and the characteristics of high psychoticism implied that the social/interpersonal component of the loss of pleasure sensation may be a meaningful focus of future research and intervention of MDD. TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR2200059053.
Autistic Traits and Social Anxiety in Chinese College Students: The Longitudinal Mediating Role of Rumination.
Hou L, Shi W
Depress Anxiety · 2025 · PMID 41069641 · Full text
BACKGROUND: Autistic traits (ATs) and social anxiety (SA) are closely associated; however, few studies have investigated the potential mediating mechanism of this relationship using longitudinal data. This study examined...
BACKGROUND: Autistic traits (ATs) and social anxiety (SA) are closely associated; however, few studies have investigated the potential mediating mechanism of this relationship using longitudinal data. This study examined: (1) the developmental trajectories of ATs, rumination, and SA among college students; (2) whether the baseline levels of ATs predicted the developmental trajectories of SA; and (3) whether the trajectories of rumination mediated this longitudinal association. METHODS: This study enrolled 397 college students to complete Broad Autism Phenotype Questionnaire, Discriminative Response Scale, and SA Disorder Dimension three times over the course of a year. Three unconditional latent growth models (LGMs) were first used to explore the trajectories of ATs, rumination, and SA, respectively. Then, a conditional LGM was used to examine the direct longitudinal association between ATs and SA. Finally, a structural equation model was further used to examine the longitudinal mediating role of rumination between ATs and SA. RESULTS: For college students, ATs remained relatively stable, whereas rumination and SA declined across the study period. Furthermore, ATs positively predicted the intercept of SA ( = 0.66, < 0.001), and negatively predicted the slope of SA ( = -0.29, < 0.001). More importantly, higher baseline levels of rumination mediated ATs on the baseline value of SA (0.14, 95% confidence interval [CI] [0.08 0.22]), and slower rates of decline of rumination mediated ATs on the change in SA (-0.15, 95% CI [-0.46 -0.01]). CONCLUSIONS: These results indicate that college is a critical period for the abatement of rumination and SA. Furthermore, rumination might be one of the mechanisms underlying the link between ATs and SA. Interventions to prevent the negative impact of ATs might help to decrease the risk of rumination and SA in the college students.
The Association Between Age at First Live Birth and Depression: Results From NHANES 2005-2018.
Kolahdooz A, Movahed F, Yousefi M … +3 more , Salehi A, Goodarzi S, Shafiee A
Depress Anxiety · 2025 · PMID 41063845 · Full text
BACKGROUND: This cross-sectional study, utilizing National Health and Nutritional Examination Surveys (NHANESs) data from 2005 to 2018, examines the association between age at first live birth and depression among women...
BACKGROUND: This cross-sectional study, utilizing National Health and Nutritional Examination Surveys (NHANESs) data from 2005 to 2018, examines the association between age at first live birth and depression among women aged 12 years or older. METHODS: Data encompassed 10,399 participants, with 1260 exhibiting depressive symptoms. The 9-item Patient Health Questionnaire (PHQ-9) assessed depression. Age at first live birth was categorized as <18, 18-25, and >25. RESULTS: Women with depressive symptoms were more likely to be single, have lower incomes and education levels, be smokers, and exhibit higher body mass indexes (BMIs) or sleep disorders. Younger age at first live birth correlated with higher depression prevalence. Univariate analysis shows decreased depression chances for women with first live births at 18-25 (47% decrease) or >25 (76% decrease), with an 11% reduction for every year increase in age at first birth. Multivariate analyses confirm a significant association between age at first live birth and depression, even after adjusting for various factors. CONCLUSION: This study underscores the association between age at first live birth and depression, highlighting the need for considering reproductive history in mental health assessments. The findings emphasize the multifaceted nature of this relationship, demonstrating the impact of sociodemographic and lifestyle factors on mental health outcomes among women.
Differential Anxiety-Depression-CRP Network Structures Across Insomnia Severity Levels: Evidence From UK Biobank.
Luo X, Zheng S, Cheng Y … +8 more , Liu S, Zeng S, Fang L, Du S, Li W, Yang H, Huang Z, Zhang B
Depress Anxiety · 2025 · PMID 41048872 · Full text
This study investigated the relationships between anxiety, depression symptoms, and C-reactive protein (CRP) across insomnia severity levels using network analysis and examined the structural differences within these net...
This study investigated the relationships between anxiety, depression symptoms, and C-reactive protein (CRP) across insomnia severity levels using network analysis and examined the structural differences within these networks. Gaussian graphical model network analysis with Least Absolute Shrinkage and Selection Operator (LASSO) regularization was conducted on UK Biobank data ( = 143,027). Depression and anxiety symptoms were assessed using the 9-item Patient Health Questionnaire (PHQ-9) and 7-item Generalized Anxiety Disorder Scale (GAD-7), respectively. CRP was quantified using immunoturbidimetric-high-sensitivity analysis. Participants were categorized by insomnia frequency (never/rarely, sometimes, and usually). The strength symptoms and expected influence identified core symptoms, while bridge expected influence (bridge EI) determined bridge symptoms. Network comparison tests (NCTs) were performed pairwise across the three groups to assess differences in global strength and edge weights. Across all networks, "Depressed mood" demonstrated the highest strength centrality, while "Irritability" exhibited the highest bridge EI. "Depressed mood" had the highest expected influence centrality in the never/rarely insomnia group and "Uncontrollable worry" in other groups. NCTs revealed significant differences in global strength ( = 0.178, < 0.01) and edge weights ( = 0.062, < 0.01) between the never/rarely and usually insomnia groups, with stronger connections between depressive symptoms (energy/appetite) and CRP in the usually insomnia group ( < 0.001). The central roles of depressed mood, uncontrollable worry, and irritability in the anxiety-depression-CRP network across all insomnia severity groups suggest that these symptoms represent potential targets for future intervention research. Notably, network structure differed across insomnia severity; the strengthened associations between depressive symptoms and CRP in the usually insomnia group suggest that insomnia severity may be an important factor to consider in understanding the relationships between affective and inflammatory processes.
Development and Validation of the Schedule for the Assessment of Insight in Anxiety Disorders (SAI-A).
Halaj A, Huppert JD, Konstantakopoulos G … +1 more , David AS
Depress Anxiety · 2025 · PMID 41041438 · Full text
There is a growing interest in understanding insight or illness awareness in anxiety; however, most assessment instruments were designed for psychosis. The unique features of anxiety highlight the need for tailored measu...
There is a growing interest in understanding insight or illness awareness in anxiety; however, most assessment instruments were designed for psychosis. The unique features of anxiety highlight the need for tailored measures to accurately evaluate insight. The aim of this study was to develop and validate the Schedule for the Assessment of Insight in Anxiety (SAI-A), a clinician-rated scale for assessing insight in anxiety disorders. We interviewed 46 participants diagnosed with anxiety disorders, conducted SAI-A interviews, and administered self-report measures. Using correlation and principal component analysis (PCA), we identified and assessed scale components, ensuring their reliability and consistency. The SAI-A demonstrated acceptable psychometric properties, including convergent validity with an established self-report measure ( = -0.39, =0.008) and internal consistency (Cronbach's α = 0.70). It showed moderate to strong agreement, interrater reliability (weighted kappa = 0.53, intraclass correlation coefficient [ICC] = 0.67), and test-retest reliability (ICC = 0.65). Two distinct insight components emerged: awareness of disorder and need for treatment. Higher overall SAI-A scores correlated with symptom severity and impairment ( = 0.56, = 0.51, < 0.001, respectively) and medication usage. The SAI-A is a valid and reliable assessment tool, providing a comprehensive framework for understanding and addressing insight in the context of anxiety disorders.
Layer-Wise Relevance Propagation Approach for Diagnosis of Drug-Naïve Men With Major Depressive Disorder Using Resting-State Electroencephalography.
Yi EG, Shim M, Lee SH … +1 more , Hwang HJ
Depress Anxiety · 2025 · PMID 41036429 · Full text
The advancement of artificial intelligence (AI) tools utilizing electroencephalography (EEG) for diagnosing major depressive disorder (MDD) has shown significant progress. However, the practical implementation of these t...
The advancement of artificial intelligence (AI) tools utilizing electroencephalography (EEG) for diagnosing major depressive disorder (MDD) has shown significant progress. However, the practical implementation of these tools is often impeded by the large amount of EEG data required for training AI models and the lack of explanations for the MDD diagnoses. This study aims to develop an interpretable deep-learning-based computer-aided diagnostic system for diagnosing male MDD patients using explainable AI (XAI) algorithms. The CAD system was designed to facilitate the diagnostic process by using a reduced number of EEG channels and data length while enhancing understanding of the neurophysiological characteristics of male MDD. Resting-state EEG data were collected from 40 male MDD patients (20-63 years) and 41 gender-matched healthy controls (HCs, 19-61 years). A shallow convolutional neural network (CNN; Shallow ConvNet) model was utilized to distinguish between MDD patients and HCs. Relevance scores were extracted by the layer-wise relevance propagation (LRP) method, integrated with the Shallow ConvNet, to interpret the outcomes of the deep-learning-based CAD system. Additionally, changes in diagnostic performance were assessed by progressively reducing the number of channels using an LRP-based channel selection method, as well as EEG data length. Our XAI-based CAD system showed a high diagnostic performance of 100% when using the whole 62 channels with 180-s EEG data. A relatively high diagnostic performance over 90% was retained with only five channels with 60-s EEG data. Neurophysiologically meaningful brain areas, such as fronto-central, centro-parietal, and occipital areas, also revealed significant differences in relevance scores extracted by the LRP-method between the two groups. This study successfully developed a high performance and practical XAI-based CAD system for male MDD patients. Our developed CAD system not only achieves high diagnostic accuracy but also provides meaningful neurophysiological biomarkers for male MDD patients.
Bidirectional Association Between Internet Use and Depressive Symptoms Among Middle-Aged and Older Adults in China: A Cross-Lagged Model of Proactive Health Behavior as the Mediating Role.
Li Z, Liu H
Depress Anxiety · 2025 · PMID 41030518 · Full text
The present study aimed to examine the bidirectional relationship between internet use and depressive symptoms among middle-aged and older adults. Moreover, it explored whether proactive health behavior mediates the asso...
The present study aimed to examine the bidirectional relationship between internet use and depressive symptoms among middle-aged and older adults. Moreover, it explored whether proactive health behavior mediates the association between internet use and depressive symptoms. We used the latest three-wave data (2015, 2018, and 2020) from the China Health and Retirement Longitudinal Study (CHARLS), which included 11,332 participants aged 45 years and older. The bidirectional relationship between internet use and depressive symptoms was examined using a cross-lagged model. The mediating role of proactive health behavior was also investigated using a cross-lagged mediation model. Cross-lagged models indicated reciprocal effects between depressive symptoms and internet use. Internet use had a greater impact on subsequent depressive symptoms than vice versa. Mediation analyses further revealed that proactive health behavior significantly mediated the path from internet use to depressive symptoms. Furthermore, subgroup analyses showed these effects were not significantly heterogeneous in subgroups by age and chronic disease status. This study sheds light on the direction of the association between internet use and depressive symptoms. Internet use could reduce depressive symptoms among middle-aged and older adults by enhancing proactive health behavior.
Extent of Anxiety Among Married Women in Bangladesh and its Potential Predictors: A Nation-Wide Cross-Sectional Study.
Tohan MM, Zaman S, Paul P … +3 more , Sultana N, Nurullah AS, Rahman MA
Depress Anxiety · 2025 · PMID 41030517 · Full text
Anxiety is a significant mental health challenge for women of reproductive age worldwide, often contributing to broader psychological issues. However, research on anxiety prevalence among this demographic, particularly i...
Anxiety is a significant mental health challenge for women of reproductive age worldwide, often contributing to broader psychological issues. However, research on anxiety prevalence among this demographic, particularly in Bangladesh, remains limited. This study addresses this gap by identifying potential predictors of anxiety among married women in Bangladesh. Using data from the nationally representative Bangladesh Demographic and Health Survey (BDHS) 2022, the generalized anxiety disorder (GAD-7) scale was employed to assess anxiety levels. Descriptive and inferential statistical analyses, including one-way ANOVA and stepwise multiple regression, were conducted to identify key predictors. The findings reveal that 25.8% of married women in Bangladesh experience mild to severe anxiety, with 4.1% reporting moderate to severe anxiety. A six-factor model derived from stepwise multiple regression explained 17.3% of the variance in anxiety levels. The most significant predictor was a history of terminated pregnancy, accounting for 6.8% of the variance ( change = 0.068; ≤ 0.001). Other notable predictors included pressure from spouses or family members ( change = 0.038; ≤ 0.001), educational status ( change = 0.028; < 0.001), religion ( change = 0.019.; =0.018), continuation of education after marriage ( change = 0.012; =0.030), and husband's educational attainment ( change = 0.007; =0.033). Additional factors such as employment after marriage, age at first sexual intercourse, and wealth status also played significant roles. The study highlights the substantial prevalence of anxiety among married women in Bangladesh, emphasizing the influence of socioeconomic along with other potential factors. Further research is needed to develop targeted interventions addressing socioeconomic and behavioral determinants, ensuring the mental well-being of married women.
A Systematic Review of Factors Associated With Treatment Engagement and Outcome for Women in the Perinatal Period Receiving Individual Cognitive Behavioral Therapy (CBT) for Depression, Anxiety, and Trauma-Related Disorders.
Simon NA, Evans J, Bispham D … +4 more , Williams F, Jones J, Roberts NP, Waters CS
Depress Anxiety · 2025 · PMID 41019913 · Full text
Depression, anxiety, and trauma-related disorders commonly occur in the perinatal period, with high rates of comorbidity, and potentially adverse outcomes for women and children. Cognitive behavioral therapy (CBT) is an...
Depression, anxiety, and trauma-related disorders commonly occur in the perinatal period, with high rates of comorbidity, and potentially adverse outcomes for women and children. Cognitive behavioral therapy (CBT) is an effective treatment, however less than half of new mothers experiencing symptoms seek treatment. This review was focused on factors affecting treatment engagement and outcome in a clinical perinatal population. A mixed-methods systematic review was conducted according to Cochrane Collaboration Guidelines. We included randomized controlled trials (RCTs) of individual CBT where at least 70% of women met diagnostic criteria for depression, anxiety, or trauma-related disorders during the perinatal period. Information on, and factors associated with treatment engagement, satisfaction, therapeutic alliance were examined as risk ratios (RRs). Twenty-eight studies relating to 19 RCTs, with 2557 participants were reviewed. Most studies examined CBT adapted to the perinatal context. Engagement was good overall, and high levels of satisfaction and therapeutic alliance were reported. A relationship was demonstrated between engagement and outcome in three studies. Dropout did not differ for studies of CBT compared to treatment as usual (TAU), but there was greater dropout for CBT across four studies where the guiding therapist/coach had a minimal level of psychological therapy training and qualifications ( = 4; = 675; RR 2.38; CI 1.17-4.83). Findings indicate the importance of engagement, which may be optimized by adapting CBT to be relevant to the unique challenges faced by women in the perinatal period, and through therapeutic provision from therapists with at least a moderate amount of psychological therapy training and qualifications.
Pathways Linking Parental Social Support and Decision-Making Participation to Medication Adherence in Children With Epilepsy: The Moderating Role of Parental Anxiety.
Yang C, Huang R, Tao Q … +3 more , Hao Z, Zhao L, Zhang L
Depress Anxiety · 2025 · PMID 40995429 · Full text
Medication adherence among pediatric epilepsy patients is frequently suboptimal, and the complex interplay between parental social support, decision-making participation, treatment satisfaction, and parental anxiety in i...
Medication adherence among pediatric epilepsy patients is frequently suboptimal, and the complex interplay between parental social support, decision-making participation, treatment satisfaction, and parental anxiety in influencing medication adherence remains underexplored. This study investigates both the direct and indirect pathways linking these factors to medication adherence and examines the mediating role of treatment satisfaction and the moderating role of parental anxiety. A cross-sectional study was conducted at three medical institutions between January 2020 and June 2024. Data on patient demographics and standardized scales measuring medication adherence, social support, communication and decision-making participation, treatment satisfaction, and parental anxiety were collected. Relationships among these variables were analyzed using structural equation modeling (SEM) and moderation analysis. A total of 1056 patients were included in the study, with a mean age of 8.86 ± 3.99 years; 51.7% were male. Path analysis showed that parental social support (STD = 0.344, < 0.001), communication and decision-making participation (STD = 0.392, < 0.001), and treatment satisfaction (STD = 0.090, < 0.05) had significant positive effects on medication adherence. Parental social support (STD = 0.483, < 0.001) and communication and decision-making participation (STD = 0.203, < 0.001) also strongly influenced treatment satisfaction. The indirect effects of social support and decision-making participation on medication adherence, mediated through treatment satisfaction, were statistically significant ( < 0.05). Parental anxiety, as a moderating factor, weakened the positive effects of social support, decision-making participation, and treatment satisfaction on medication adherence ( < 0.05). This study systematically develops an integrated model linking parental social support, communication and decision-making participation, treatment satisfaction, and anxiety to medication adherence in pediatric epilepsy. It highlights the mediating role of treatment satisfaction and the moderating role of parental anxiety. Enhancing parental social support and communication, improving treatment satisfaction, and addressing parental anxiety are key strategies to promote medication adherence.
Cross-Lagged Panel Networks of Distinct Complex Post-Traumatic Stress Disorder Symptom Trajectories Among Young Adults With Adverse Childhood Experiences.
Liu A, Zhang L, Liu M … +2 more , Ziwei W, Wu X
Depress Anxiety · 2025 · PMID 40995428 · Full text
Young adults with a history of adverse childhood experiences (ACEs) may exhibit varying trajectories of complex post-traumatic stress disorder (CPTSD) symptoms over time. Unraveling the patterns of interactions between C...
Young adults with a history of adverse childhood experiences (ACEs) may exhibit varying trajectories of complex post-traumatic stress disorder (CPTSD) symptoms over time. Unraveling the patterns of interactions between CPTSD symptoms across distinct trajectories is crucial. This study aimed to investigate the longitudinal relationships, changes, and central symptoms in CPTSD networks over time across distinct CPTSD trajectory groups. This longitudinal study followed 1277 university students (47.5% male) who reported ACEs from China through three waves of surveys. ACEs were assessed at baseline, while symptoms of CPTSD were measured at all three time points. Growth mixture modeling (GMM) was used to identify CPTSD symptom trajectories, and cross-lagged panel network (CLPN) analysis estimated the longitudinal relationships among CPTSD symptoms within these trajectories. Two distinct and consistent CPTSD symptom trajectories were identified: a high-risk group and a resistance group. In the high-risk group, "disturbed relationships" (DRs) and "negative self-concept" (NSC) emerged as the strongest predictors of other symptoms at various time points. In the resilient group, the predictive influence of DR and NSC on other symptoms was attenuated. Instead, "affective dysregulation" (AD) emerged as the central symptom, demonstrating the strong predictive associations with other symptom domains. These findings reveal directional relationships among symptoms in young adults. Symptoms related to disturbances in self-organization (DSO), identified through centrality indices, are key drivers of symptom network development in different CPTSD trajectories. Targeting these symptoms in interventions for young adults with ACEs may help prevent or reduce CPTSD progression.
Temporal Dynamics of Social Anxiety and Depressive Symptoms: The Moderating Role of Cognitive Flexibility.
Zabag R, Mouadeb D, Haim-Nachum S … +2 more , Levy-Gigi E, Gilboa-Schechtman E
Depress Anxiety · 2025 · PMID 40989748 · Full text
Social anxiety (SA) and depressive symptoms frequently coexist, with the onset of SA typically preceding the onset of depression. Individuals experiencing SA-depression comorbidity exhibit increased functional impairment...
Social anxiety (SA) and depressive symptoms frequently coexist, with the onset of SA typically preceding the onset of depression. Individuals experiencing SA-depression comorbidity exhibit increased functional impairments as compared to individuals without this comorbidity. Understanding the mechanisms that underlie the coexistence of SA and depressive symptoms can deepen our theoretical understanding regarding these conditions and contribute to depression prevention efforts. Recent theories suggest that low cognitive flexibility (CF) contributes to the development of depression and may play a role in the relationship between the disorders. However, empirical prospective findings are sparse. We examined whether CF moderates the link between SA and depressive symptoms in two independent preregistered studies: cross-sectional ( = 379) and longitudinal ( = 108, 2-year). Cross-sectionally, higher CF was linked to a weaker relationship between SA and depressive symptoms. Across time, among individuals with low CF at baseline, there was a positive association between SA at baseline and depressive symptoms 2 years later. No such association was found among individuals with high CF. These findings highlight the role of CF in the development of comorbid depressive symptoms among high SA individuals. It may contribute to the clinical prevention of depression through specific psychotherapeutic techniques targeted to enhance CF among SA patients. A preprint of this MS has previously been published.
Implementation of Primary Psychological Healthcare Policy to Address the Risk of Depression in Underprivileged Children and Adolescents, in the Entire Lower-Middle-Economic-Status City of China: An Observational, Multicenter, and Single-Arm Cohort Study.
Li W, Liu XR, Zhang Q … +17 more , Xia L, Li Y, Tian X, Gong J, Ren J, Shen C, Wu Y, Chen J, Hu CP, Zhang JX, Xu T, Hu Y, Hu B, Yan N, Feng T, Feng Z, Chen Z
Depress Anxiety · 2025 · PMID 40979248 · Full text
Given the historically high incidence of depressive disorders among children/adolescents, efforts to implement universally accessible primary psychological health care policies have been undertaken globally. However, the...
Given the historically high incidence of depressive disorders among children/adolescents, efforts to implement universally accessible primary psychological health care policies have been undertaken globally. However, the practical implementation and its association with depression risk reduction remain uncertain, particularly for underprivileged children/adolescents who are underrepresented in the current system. A large-scale cohort of underprivileged children/adolescent population aged 6-18 was enrolled ( = 290,239). Subgroups with specific underprivileged conditions were identified, including de facto unattended children/adolescents (dfUCA), orphans, and children/adolescents facing especially difficult circumstances, "left-behind" and "single-parent" children/adolescents. A subgroup of matched typically developing individuals was also included. These subgroups underwent longitudinal assessments for the incidence of identifying depression on Oct 30, 2022 (baseline, before implementing primary psychological health care policy), May 21, 2023 (half year follow-up), and Oct 29, 2023 (1-year follow-up), respectively. At baseline, nearly twice as high incidence of depression was found in the underprivileged group (13.9%, 95% confidence interval [CI]: 13.7-14.1) as in the control group (7.5%, 7.2-7.7). After the implementation of the primary psychological policy, at the half year follow-up, a notable decrease in the incidence of depression was observed in both the underprivileged group (5.8%, relative risk reduction (RRR) = 51.6%, 51.5-51.7, < 0.001) and the typically developing group (4.0%, RRR = 34.5%, 27.9-41.0, < 0.001), particularly among orphan girls aged 12-18. The observed changes in depression incidence across all underprivileged populations were statistically noninferior compared to the typically developing group (all < 0.001). At the 1-year follow-up, the observed benefits were consistent across all subgroups when compared to baseline. The average expenditure per child/adolescent was $1.6 in implementing such a health care policy. Implementing the primary psychological health care policy is associated with a reduction in the citywide risk of depression among underprivileged children/adolescents in low-middle-income areas.
Mindfulness-Based Stress Reduction Alleviates Depression, Anxiety, and Internalized Stigma Compared With Treatment-as-Usual Among Head and Neck Cancer Patients: Findings From a Randomized Controlled Trial.
Zhang Z, Zhang Q, Lu P … +7 more , Shari NI, Nik Jaafar NR, Mohamad Yunus MR, Qiu Q, Ismail F, Ab Muin NF, Leong Bin Abdullah MFI
Depress Anxiety · 2025 · PMID 40979247 · Full text
This study aimed to: (1) compare the rates of change in the severity of depression and anxiety symptoms (primary outcomes) as well as internalized stigma and its components (shame with appearance [SWA], speech and social...
This study aimed to: (1) compare the rates of change in the severity of depression and anxiety symptoms (primary outcomes) as well as internalized stigma and its components (shame with appearance [SWA], speech and social concerns [SSCs], sense of stigma [SS], and regret [R]; secondary outcomes) between the mindfulness-based stress reduction (MBSR) group and the treatment-as-usual (TAU) control group across three timepoints ( = baseline assessment, prior to intervention; = postintervention, immediately after completion of intervention or at 8 weeks after commence of intervention; = follow-up assessment, 12 weeks after completion of intervention), and (2) evaluate the mediating effects of reductions in internalized stigma and its components on the relationship between MBSR and the severity of depression and anxiety symptoms among head and neck cancer (HNC) patients. This multicenter, two-armed, parallel, and double-blind randomized controlled trial (RCT) recruited 110 HNC patients. All participants were assessed for the severity of depression and anxiety symptoms, and the degrees of internalized stigma and its components, at each timepoint. MBSR significantly reduced the severity of depression and anxiety symptoms and degrees of internalized stigma and its components across timepoints ( , , and ). In contrast, no reduction in scores was observed in the TAU group. Furthermore, internalized stigma, SWA, and SSC partially mediated the relationship between MBSR and the severity of depression and anxiety symptoms. Sensitivity analyses confirmed that the changes in the severity of depression and anxiety symptoms and degrees of internalized stigma and its components according to intention-to-treat (ITT) analysis were similar to that of per-protocol (PP) and last observation carry forward (LOCF) analyses. MBSR could be recommended as part of the treatment regimen for HNC patients. ClinicalTrials.gov identifier: NCT06991309.
Prevalence and Risk Factors of Depression in Patients With Endemic Osteoarthritis Kashin-Beck Disease.
Liu Y, Wen Y, Yang Z … +10 more , Zhou R, Hui J, Li C, Xu G, Liu C, Liu H, Cheng B, Jia Y, Guo X, Zhang F
Depress Anxiety · 2025 · PMID 40963707 · Full text
Kashin-Beck disease (KBD) is an endemic osteoarthropathy, which occurs in children aged 3-12, with similarity to osteoarthritis (OA). Previous studies have shown significant depression symptoms in OA patients, yet no com...
Kashin-Beck disease (KBD) is an endemic osteoarthropathy, which occurs in children aged 3-12, with similarity to osteoarthritis (OA). Previous studies have shown significant depression symptoms in OA patients, yet no comparable research has been conducted in KBD patients. We conducted a field investigation in KBD areas in Northwest China. Questionnaires were designed and used to assess demographic characteristics, clinical characteristics, and medical comorbidities. Patient Health Questionnaire-9 (PHQ-9) was included for the prevalence of depression. Finally, 440 subjects were clinically diagnosed and recruited. Depression was diagnosed when PHQ-9 ≥ 5 and classified into mild (5-9), moderate (10-14), and severe (≥ 15) groups. Logistic regression was also used to identify potential associated factors among KBD patients. Depression was present in 53.2% of patients in our KBD samples. Among them, 27.5% had mild depression, 18.4% had moderate depression, and 7.3% had severe depression. Being male (odds ratio [OR]: 0.296, 95% confidence interval [CI]: 0.180-0.486, < 0.001) was an independent protective factor for depression, while the presence of comorbid chronic diseases (OR: 4.701, 95% CI: 2.292-9.640, < 0.001), and a higher visual analog scale (VAS) pain level (OR: 5.275, 95% CI: 1.326-20.978, =0.018) were independent risk factors for depression in KBD patients. This study is the first to investigate the prevalence of depression and associated factors among Chinese KBD patients, suggesting the significance of an early intervention for their mental issues.
The Interaction Among Depressive Symptoms, Pain, and Frailty in Middle-Aged and Older Adults: A Longitudinal Cross-Lagged Panel Analysis.
Song TM, Chen X, Chen XH … +5 more , Tan SJ, Song CH, Fan L, Li JY, Li HL
Depress Anxiety · 2025 · PMID 40963706 · Full text
Depressive symptoms, pain, and frailty interactions in middle-aged and older adults do have longitudinal research support, yet the currently available evidence remains insufficient for a comprehensive understanding. This...
Depressive symptoms, pain, and frailty interactions in middle-aged and older adults do have longitudinal research support, yet the currently available evidence remains insufficient for a comprehensive understanding. This study aimed to examine their interrelationships and underlying mechanisms. This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS), which includes four assessments for depressive symptoms, pain, and frailty over 7 years. We included 4961 participants aged 45 years and older in our analysis. We employed cross-lagged panel models (CLPMs) and random intercept CLPMs (RI-CLPMs) to analyze the bidirectional temporal relationships at the between-person and within-person levels. Cross-lagged panel analysis revealed bidirectional associations between depressive symptoms and pain. A reciprocal predictive relationship was also identified between frailty and pain. After controlling individual differences with the RI-CLPM, depressive symptoms continued to positively predict pain during subsequent periods. However, the predictive effect of pain on subsequent depressive symptoms turned nonsignificant. Although a cross-lagged relationship remained between pain and frailty, it showed a declining trend. While engagement in depressive symptoms, pain, and frailty was assessed via questionnaire, long measurement intervals may not capture short-term fluctuations in the state of each variable. This study differentiated within- and between-individual effects, uncovering distinct lagged effects of pain, depression, and frailty across levels. It underscored the importance of jointly assessing these conditions and integrating within- and between-individual differences to formulate and execute targeted interventions.
The Underlying Mechanisms of Comorbid Anxiety and Depression Among Young Women: Evidence From Brain Structure and Hormone.
Meng Y, Li Z, Hou L … +1 more , Ji Y
Depress Anxiety · 2025 · PMID 40959147 · Full text
Youth is a time of a significant rise in depressive symptoms, particularly impacted by anxiety in females. However, the identification of the transition from anxiety to depression in young women remains ambiguous. This s...
Youth is a time of a significant rise in depressive symptoms, particularly impacted by anxiety in females. However, the identification of the transition from anxiety to depression in young women remains ambiguous. This study collects data on brain structure and hormone levels in young women, intending to investigate the neurophysiological differences among women with anxiety disorders and comorbid anxiety and depression (CAD). 53 young women were divided into three groups, namely an anxiety group, a CAD group, and a control group, aiming to explore the differences in brain structure and ovarian hormone levels. The CAD group exhibited significantly reduced gray matter volume (GMV) in the right superior frontal gyrus (SFG; 0.38 ± 0.05) and right middle occipital gyrus (MOG; 0.37 ± 0.04) compared to the anxiety (SFG: 0.41 ± 0.04; MOG: 0.41 ± 0.04) and control groups (SFG: 0.45 ± 0.04; MOG: 0.44 ± 0.03; all < 0.001). Cortical thickness in the right SFG was also significantly lower in the CAD group (2.81 ± 0.24) than in the anxiety (3.08 ± 0.21) and control groups (3.11 ± 0.19; < 0.001). Progesterone was negatively correlated with GMV in the right MOG ( = -0.48, =0.042) and SFG ( = -0.53, =0.020) only in the CAD group. Further, no significant associations were observed between estradiol levels and brain structure, nor between anxiety/depression scores and hormone or brain data (all > 0.070). The change of brain structure in the SFG and MOG may be one of the mechanisms underlying the progression of symptoms from anxiety to CAD, which may also be related to the increase in progesterone, indicating the exacerbation of emotional disorders in young women.
A New Era for : Global Perspective and Meaningful Impact.
Depress Anxiety · 2025 · PMID 40949013 · Full text
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