Journal Of Affective Disorders[JOURNAL]
Sun
200 papers
Effects of two psychotherapies for obsessive-compulsive disorder on brain activity during emotional processing.
Vriend C, Broekhuizen A, Wolf N … +3 more , van Oppen P, van den Heuvel OA, Visser HAD
J Affect Disord · 2026 Jun · PMID 42314787 · Publisher ↗
BACKGROUND: To clarify the working mechanisms of psychotherapy for obsessive-compulsive disorder (OCD), we studied the neural effects of two psychotherapies: cognitive behavioral therapy with exposure and response preven...
BACKGROUND: To clarify the working mechanisms of psychotherapy for obsessive-compulsive disorder (OCD), we studied the neural effects of two psychotherapies: cognitive behavioral therapy with exposure and response prevention (CBT-ERP) and inference-based cognitive behavioral therapy (I-CBT). METHODS: Fifty-five individuals with OCD completed an emotional processing task during fMRI before and after 20 weekly psychotherapy sessions, using general fear and OCD-related visual stimuli. We used Bayesian region-of-interest analyses to assess changes in brain activation in prefrontal, limbic, sensory, subcortical, and visual areas, and their association with symptom reduction. RESULTS: After treatment, both the CBT-ERP (N = 28) and I-CBT group (N = 27) showed strong credible evidence for increased activation of the lateral occipital cortex (LOC) and decreased activation of, amongst others, the dorsolateral prefrontal cortex in both the fear and OCD contrast. Symptom reduction was associated with activity decreases after CBT-ERP, mainly in the OCD contrast. Symptom reduction was associated with increased activity in the I-CBT group, particularly in the medial prefrontal cortex. Across all ROIs, higher baseline fear-related activity was associated with symptom reduction in CBT-ERP, while lower baseline activity was associated with symptom reduction in I-CBT in the precentral gyrus and dorsolateral prefrontal cortex. Lower baseline LOC activation during OCD-related stimuli was linked to symptom reduction after both psychotherapies. CONCLUSIONS: CBT-ERP and I-CBT showed overlapping changes in brain activity after treatment, although these changes related to symptom reduction in opposite directions, suggesting the two treatments achieve their effects through distinct mechanisms. Visual brain activity during emotional processing may predict treatment response across psychotherapies.
Sex-specific cognitive profiles and correlations with dimensional symptoms in first-episode major depressive disorder.
Xin LM, Fan HZ, Lin JY … +4 more , Yan F, Yu X, Su YA, Si TM
J Affect Disord · 2026 Jun · PMID 42314786 · Publisher ↗
BACKGROUND: This study explored sex-related cognitive differences and their associations with clinical symptom in first-episode, drug-naive patients with major depressive disorder (MDD). METHODS: We enrolled 410 MDD pati...
BACKGROUND: This study explored sex-related cognitive differences and their associations with clinical symptom in first-episode, drug-naive patients with major depressive disorder (MDD). METHODS: We enrolled 410 MDD patients and 287 healthy controls (HCs). Cognitive function across five domains and depressive symptoms were assessed. Multivariate analysis of covariance (MANCOVA) was used to examine the main and interaction effect of diagnosis and sex. Stratified correlation and regression analyses were performed to explore symptoms and cognitive associations by sex. RESULTS: MDD patients exhibited significant impairments across five cognitive domains. Main effects of diagnosis and sex were significant. A tentative diagnosis × sex interaction was observed for processing speed, while the interaction for executive function was no longer significant after multiple comparison correction. Symptom-cognition associations differed evidently between males and females. In male patients, sleep disturbance was independently associated with poorer processing speed. In females, sleep disturbance showed negative correlations with processing speed, verbal learning, and executive function; anxiety-somatization was weakly positively related to processing speed, verbal learning, and visual learning, and psychomotor retardation was positively associated with attention. CONCLUSION: First-episode MDD presents notable cognitive deficits and distinct sex-specific symptom-cognition relationships. These findings provide preliminary evidence for future studies on sex-specific interventions targeting cognitive dysfunction.
High-risk psychiatric outpatients' perspectives on Brazil's yellow September suicide prevention campaign.
Beiram L, Cacciacarro M, Damiano BBF … +5 more , Morais A, Pereira CCM, Santos JM, Martin A, Damiano RF
J Affect Disord · 2026 Jun · PMID 42314785 · Publisher ↗
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Sterol carrier protein 2 loss reduces anxiety and enhances fear extinction.
Liedhegner ES, Stuhr KL, Doncheck EM … +5 more , Tinklenberg J, Pollock S, Sterrett J, Gunduz-Cinar O, Hillard CJ
J Affect Disord · 2026 Jun · PMID 42314784 · Publisher ↗
Brain endocannabinoid (eCB) signaling, which includes CB1 cannabinoid receptors (CB1R) and the eCBs N-arachidonoylethanolamine (AEA) and 2-arachidonoylglycerol (2-AG), modulates behavioral responses to stress and fear ex...
Brain endocannabinoid (eCB) signaling, which includes CB1 cannabinoid receptors (CB1R) and the eCBs N-arachidonoylethanolamine (AEA) and 2-arachidonoylglycerol (2-AG), modulates behavioral responses to stress and fear extinction. Sterol carrier protein 2 (SCP-2) is an intracellular lipid binding protein expressed in brain that binds AEA and 2-AG at nanomolar concentrations and facilitates their cellular accumulation. SCP-2 mRNA is present in mouse limbic brain regions and is increased in the prefrontal cortex (PFC) and amygdalar complex in mice with impaired (129S1/Sv1mJ) fear extinction compared to mice with normal (C57BL/6J) fear extinction. In this study, we utilized mice with deletion of the gene for SCP-2 and an overlapping gene, SCP-X (SCP-2/X), to examine the hypothesis that SCP-2 regulates behaviors associated with anxiety and fear. Compared to WT mice, SCP-2/X mice exhibit enhanced fear extinction and reduced anxiety-driven behaviors in the elevated plus maze. These differences are abrogated by treatment with a CB1R antagonist and not recapitulated in mice with selective deletion of SCP-X. While baseline brain tissue concentrations of AEA and 2-AG are not different between WT and SCP-2/X mice, amygdalar and PFC 2-AG concentrations are significantly higher in SCP-2/X mice 24 h following foot shock. There are no differences between WT and SCP-2/X mice in rectal temperature; or in tail flick and catalepsy assays. These findings support the hypothesis that as yet unproven functions of the lipid carrier protein SCP-2 regulate behaviors associated with fear memory and anxiety and suggest that pharmacological inhibitors of SCP-2 could reduce acute anxiety and enhance fear extinction.
Preliminary efficacy of a self-guided mobile intervention for reducing stress in depression: A randomized controlled crossover trial.
Kim J, Lee SH, Shin C … +3 more , Han KM, Jeon SW, Han C
J Affect Disord · 2026 Jun · PMID 42309193 · Publisher ↗
Stress worsens clinical outcomes in patients with major depressive disorder (MDD); however, timely accessible stress management tools remain limited. Digital interventions offer scalable adjunctive solutions early during...
Stress worsens clinical outcomes in patients with major depressive disorder (MDD); however, timely accessible stress management tools remain limited. Digital interventions offer scalable adjunctive solutions early during pharmacological treatment. In this multicenter, assessor-blinded, randomized controlled crossover pilot trial, we conducted a preliminary evaluation of the short-term efficacy of a self-guided digital health intervention (inMind) in reducing psychological stress in individuals with mild-to-moderate MDD undergoing pharmacological treatment. We randomly assigned 39 participants to the App-first or Delayed-app sequence, with 36 analyzed. inMind comprised cognitive-behavioral therapy and mindfulness-based stress-reduction modules, relaxation audio, and heart-rate-variability-based stress monitoring. The primary outcome was change in the Depression Anxiety Stress Scales-Stress subscale (DASS-Stress), with secondary measures of depression, anxiety, and perceived stress. Analyses followed a modified intention-to-treat approach using linear mixed-effects models. The inMind condition was associated with a reduction in DASS-Stress (estimate = -2.41; p = 0.047), narrowly exceeding the published minimum clinically important difference, with directionally consistent reductions in depressive and anxiety symptoms. Significant carry-over effects complicated causal interpretation under the no-washout design. Usage metrics showed no significant association with outcomes, consistent with a low-intensity, flexible intervention. Adherence was high in both groups. These preliminary findings suggest that inMind, a 4-week self-guided digital adjunct, may produce modest short-term reductions in stress, depression, and anxiety alongside pharmacotherapy in mild-to-moderate MDD; if confirmed in adequately powered trials, such tools may complement pharmacotherapy and inform future digital adjuncts.
Integrative genomic characterization of the FADS1-2-3 mood disorder risk locus: implications for the role of polyunsaturated fatty acids.
Stacey D, Reay WR, Veltman LJ … +3 more , Benyamin B, Lee SH, Hyppönen E
J Affect Disord · 2026 Jun · PMID 42309192 · Publisher ↗
BACKGROUND: Polyunsaturated fatty acids (PUFA) have been implicated in mood disorder pathophysiology, with Mendelian randomisation studies suggesting a causal role. However, much of this evidence centres on the highly pl...
BACKGROUND: Polyunsaturated fatty acids (PUFA) have been implicated in mood disorder pathophysiology, with Mendelian randomisation studies suggesting a causal role. However, much of this evidence centres on the highly pleiotropic FADS1-2-3 gene cluster, raising concerns about horizontal pleiotropy and uncertainty regarding the true effector gene(s). To assess the validity of these concerns, we performed integrative genetic characterization of the FADS1-2-3 mood disorder risk locus. METHODS: We analysed summary statistics from the largest (up to n = 4 million) genome-wide association studies (GWASs) of bipolar disorder (BD) and major depressive disorder (MDD) and performed pairwise genetic colocalization. Lead and proxy variants were annotated across global populations, and cis-eQTL effects were assessed using bulk tissue and single-cell RNA-seq datasets. RESULTS: BD and MDD GWAS signals at the FADS1-2-3 locus shared a common causal variant (PPH = 0.956) with directionally consistent risk alleles. Colocalization analyses prioritised FADS1 over FADS2 and FADS3 as the most likely effector gene, with robust colocalization across multiple brain tissues. Beyond PUFA metabolism, TMEM258 and MYRF emerged as credible alternative effector genes, implicating N-linked glycosylation and axonal myelination as alternative mechanisms through which this locus could influence mood disorder risk. CONCLUSIONS: These findings illustrate the mechanistic complexity of the FADS1-2-3 mood disorder risk locus. While the evidence prioritising FADS1 as a likely effector gene is consistent with a potential aetiological role for PUFA in mood disorders, our findings also highlight genetic co-regulation of other local genes as a potential source of horizontal pleiotropy. Future studies using orthogonal approaches are necessary to fully address this open question.
Psychological-behavioral risk profiles of adolescents and their associations with suicidal behaviors.
Xu L, Xiao C, Yan J … +8 more , Zhu Y, Zhang L, Feng S, Yang Y, Wang W, Guo Y, Yan H, Yu B
J Affect Disord · 2026 Jun · PMID 42309191 · Publisher ↗
OBJECTIVE: Adolescent suicidal behaviors pose a critical public health challenge. This study examined the co-occurrence patterns of psychological and behavioral risk factors and evaluated their associations with suicidal...
OBJECTIVE: Adolescent suicidal behaviors pose a critical public health challenge. This study examined the co-occurrence patterns of psychological and behavioral risk factors and evaluated their associations with suicidal ideation (SI) and suicide attempts (SA). METHODS: A multicenter adolescent survey conducted in 2023-2024 (n = 19,312) collected sociodemographic, psychological, and behavioral data. Complex survey logistic regression was applied to identify factors associated with SI and SA. Latent class analysis (LCA) was used to derive psychological-behavioral risk profiles, and their discriminative performance was evaluated using logistic regression with 10-fold cross-validation. RESULTS: The prevalence of SI and SA was 25.41% and 8.03%, respectively. Fourteen factors were associated with SI, including resilience, social capital, hostility, depression, anxiety, maladjustment, emotional instability, psychological disequilibrium, virtual world integration, adverse childhood experiences, negative life events, sleep quality, internet addiction and alcohol use. For SA, academic stress and smoking were additionally retained, whereas anxiety, emotional instability, psychological disequilibrium and internet addiction were not retained. Four distinct profiles were identified: Low-risk/High-protection, Moderate distress, Psychological-problem dominant and High-risk/Multi-problem. Compared with the Low-risk group, adolescents in the High-risk group demonstrated substantially higher odds of SI (aOR = 15.87, 95% CI: 13.96-18.03) and SA (aOR = 11.72, 95% CI: 10.11-13.60). The LCA-based model showed good discrimination (AUC = 0.796 for SI; 0.772 for SA), outperforming single-variable models. CONCLUSION: Psychological and behavioral factors among adolescents cluster into distinct risk profiles that are associated with different levels of suicidal behaviors. These findings provide a person-centered, multidimensional perspective for understanding heterogeneity in adolescent suicide-related risk.
Does ecological momentary assessment improve prediction of suicide risk among military personnel and veterans, and how frequent should it be?
Lin T, Rosaz Shariyf L, Kautz M … +4 more , Baker JC, Khazem L, Bryan CJ, Brown LA
J Affect Disord · 2026 Jun · PMID 42309190 · Publisher ↗
OBJECTIVES: Suicidal risk fluctuates rapidly, yet suicide monitoring primarily relies on retrospective assessments. Ecological momentary assessment (EMA) offers a promising approach for capturing real-time fluctuations i...
OBJECTIVES: Suicidal risk fluctuates rapidly, yet suicide monitoring primarily relies on retrospective assessments. Ecological momentary assessment (EMA) offers a promising approach for capturing real-time fluctuations in suicidal urges and identifying elevated suicidal risks beyond clinical settings, but poses substantial participant burden. This study aimed to examine the incremental predictive value of EMA and its optimal sampling frequency. METHODS: Military service members and veterans (N = 62) with recent suicidal ideation or attempts received outpatient psychotherapy weekly. Participants completed measures of suicidal ideation at each session and four daily EMA surveys of suicidal urges over 28 days. Mixed-effects models examined whether EMA-assessed suicidal urges during the inter-session window predicted suicidal ideation at the subsequent therapy session beyond retrospective measures. We simulated reduced EMA frequencies by probabilistically thinning EMA observations and re-estimated model performance with different EMA frequencies. RESULTS: Both the mean and maximum levels of EMA-assessed suicidal urges significantly improved the prediction of next-session suicidal ideation beyond prior session-based measures (p < .001). Simulation analyses revealed a nonlinear relationship between EMA frequency and its predictive utility. The predictive utility of EMA remained nearly unchanged as sampling frequency decreased from highly frequent (twice per day) to moderately frequent (once every other day) schedules but declined more sharply with further reductions in EMA frequency. CONCLUSIONS: EMA enhanced the prediction of near-term suicidal risks beyond session-based assessments. Moderate EMA sampling frequencies (once every other day) may preserve most predictive utility while reducing participant burden, offering a practical approach for scalable suicide monitoring in clinical populations.
Efficacy and safety of adjunctive orexin receptor antagonist therapy in major depressive disorder: A systematic review and meta-analysis of randomized controlled trials.
Pereira SIDS, Kotochinsky M, Amador WFO … +6 more , Alessi MR, Fonseca PEO, Fidelis AMF, Barroso D, Sherpa NN, Lezana AG
J Affect Disord · 2026 Jun · PMID 42309189 · Publisher ↗
BACKGROUND: A substantial proportion of adults with major depressive disorder (MDD) exhibit an inadequate response to selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs...
BACKGROUND: A substantial proportion of adults with major depressive disorder (MDD) exhibit an inadequate response to selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) and experience persistent insomnia. Orexin receptor antagonists (ORAs) have emerged as a potential adjunctive treatment targeting hyperarousal mechanisms; however, their efficacy and safety remain uncertain. METHODS: A systematic search of PubMed (including MEDLINE), Web of Science, Cochrane CENTRAL, Scopus, Europe PMC, and CINAHL (via EBSCO), as well as ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP), was conducted from inception to August 2025. Randomized controlled trials (RCTs) evaluating adjunctive ORAs in adults with MDD and inadequate response to SSRIs/SNRIs were included. Outcomes included depressive severity (Montgomery-Åsberg Depression Rating Scale [MADRS], MADRS without sleep item [MADRS-WOSI], 17-item Hamilton Depression Rating Scale [HAMD17], Patient Health Questionnaire-9 [PHQ-9]), sleep disturbance (Patient-Reported Outcomes Measurement Information System-Sleep Disturbance [PROMIS-SD]), and safety (adverse events [AEs], serious adverse events [SAEs], and discontinuations). RESULTS: ORA therapy was associated with statistically significant improvements in depressive symptoms on MADRS (MD -1.96, 95% CI -3.29 to -0.63), MADRS-WOSI (MD -1.40, 95% CI -2.70 to -0.11), and PHQ-9 (MD -1.15, 95% CI -2.13 to -0.18), while no significant effect was observed for HAMD17. An exploratory pooled analysis combining MADRS and HAM-D17 suggested a small effect favoring ORA therapy; however, this finding should be interpreted with caution (SMD -0.15, 95% CI -0.27 to -0.03). Sleep improved on PROMIS-SD (MD -3.39, 95% CI -4.78 to -2.00). Safety outcomes did not differ significantly from placebo, and no drug-related deaths were reported. CONCLUSIONS: Adjunctive ORA therapy is associated with modest improvements in depressive symptoms and sleep disturbance, with no clear signal of increased adverse events; however, the available evidence is insufficient to establish comparative tolerability in SSRI/SNRI partial responders. These findings should be interpreted with caution given the limited number of studies. Larger, longer-duration, and more diverse RCTs are needed to define clinical relevance and long-term safety.
Prenatal inflammation and postpartum anxiety: Findings from a prospective pregnancy cohort in New York City.
Kaplan C, Milazzo F, Suleri A … +5 more , Gigase F, Lieb W, de Witte LD, Bergink V, Rommel AS
J Affect Disord · 2026 Jun · PMID 42302973 · Publisher ↗
BACKGROUND: Inflammatory processes have been implicated in perinatal mood disorders. Yet, evidence linking prenatal inflammatory markers to postpartum anxiety is limited. We investigated whether third trimester inflammat...
BACKGROUND: Inflammatory processes have been implicated in perinatal mood disorders. Yet, evidence linking prenatal inflammatory markers to postpartum anxiety is limited. We investigated whether third trimester inflammatory markers were associated with postpartum anxiety symptoms. METHODS: Participants were drawn from Generation C, a prospective pregnancy cohort established in New York City (April 2020-February 2022). Prenatal inflammatory markers (IL-6, IL-17A, IL-1β, and C-reactive protein [CRP]) were measured from routine clinical blood samples collected ≥28 weeks' gestation and > 7 days before delivery. Postpartum anxiety symptoms were assessed using the Generalized Anxiety Disorder-7 (GAD-7) questionnaire completed within 24 weeks postpartum. Multivariable quantile regression models (50th, 75th, and 90th percentiles) examined associations between log2-transformed inflammatory markers and postpartum GAD-7 scores, adjusting for sociodemographic, clinical, and pandemic-related factors, including a history of anxiety and/or depression. Missing data were imputed and p-values were adjusted for multiple testing using the false discovery rate (FDR). RESULTS: The analytic sample included 237 participants. After FDR correction, none of the inflammatory markers were associated with postpartum GAD-7 scores at any quantile. A history of anxiety or depression was consistently associated with higher postpartum anxiety symptoms across all quantiles (β range 3.6-4.9; all p < 0.01). CONCLUSIONS: Third trimester circulating IL-1β, IL-6, IL-17A, and CRP were not associated with postpartum anxiety symptom burden in this population-based cohort. A history of anxiety/depression remained the strongest risk factor for postpartum anxiety symptoms. These findings suggest that late-pregnancy systemic inflammatory markers may have limited utility for identifying postpartum anxiety risk in general obstetric populations.
The quest to find genuine adult ADHD: Navigating diagnostic challenges of malingering - a review.
Ratti G, Callari A, Nosari G … +3 more , Peyvandi A, Bianchi AR, Delvecchio G
J Affect Disord · 2026 Jun · PMID 42297153 · Publisher ↗
BACKGROUND: Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity that impair daily functioning. Accurate dia...
BACKGROUND: Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity that impair daily functioning. Accurate diagnosis is therefore essential, particularly in adulthood, where symptom reporting may be influenced by external incentives. Malingering, defined as the deliberate fabrication or exaggeration of symptoms for external gain, is a relevant concern in ADHD assessment, particularly for academic accommodations, stimulant medications, and avoidance of responsibilities. This review examined current evidence on the detection of malingered presentations in adult ADHD assessment. METHODS: We searched PubMed, Scopus, and Web of Science for empirical studies examining feigned, malingered, exaggerated, or otherwise noncredible ADHD presentations and 29 peer-reviewed studies met the inclusion criteria. RESULTS: Detecting malingering in ADHD remains challenging. Validity measures showed heterogeneous effectiveness, and ADHD symptom scales appeared vulnerable to manipulation. However, the available evidence suggests that performance validity tests, including the Test of Memory Malingering (TOMM), Word Memory Test (WMT), Letter Memory Test (LMT), Digit Memory Test (DMT), and Nonverbal Medical Symptom Validity Test (NV-MSVT), may help differentiate genuine ADHD from noncredible presentations when interpreted within a multi-method assessment framework. LIMITATIONS: Most studies relied heavily on self-report symptom measures, used heterogeneous validity criteria, and lacked independent external corroboration, limiting comparability across findings. Evidence largely comes from the United States, and longitudinal data remain scarce. DISCUSSION: Distinguishing ADHD from malingering requires a specialist-led assessment. Greater standardization of diagnostic protocols and validity-assessment procedures remains urgently needed.
The effect of a mindfulness-based stress reduction program on stress and quality of life in mothers of children with physical disabilities: A single-blind randomized controlled trial.
Taşkaya C, Sezgin L, Çiftci N
J Affect Disord · 2026 Jun · PMID 42297152 · Publisher ↗
BACKGROUND: Mothers of children with physical disabilities often experience caregiving-related stress that may negatively affect their psychological well-being and quality of life. Mindfulness-based interventions may hel...
BACKGROUND: Mothers of children with physical disabilities often experience caregiving-related stress that may negatively affect their psychological well-being and quality of life. Mindfulness-based interventions may help reduce stress by improving awareness and emotional regulation. OBJECTIVES: This study aimed to examine the effect of a mindfulness-based stress reduction (MBSR) program on parental stress, mindfulness, and quality of life in mothers of children with physical disabilities. METHOD: This single-blind randomized controlled trial included 62 mothers randomly assigned to either the MBSR group (n = 32) or the control group (n = 30). The intervention group received an 8-week MBSR program with weekly 60-90 minute sessions, while the control group received no intervention. Outcomes were assessed at baseline and post-intervention using the Parent Stress Scale (PSS), Mindful Attention Awareness Scale (MAAS), and World Health Organization Quality of Life Questionnaire-Brief Version (WHOQOL-BREF). Data were analyzed using repeated measures two-way analysis of variance in SPSS version 25. RESULTS: Compared with the control group, the MBSR group showed a significant reduction in parental stress and a significant increase in mindfulness (p < 0.05). Significant improvements were also observed in the psychological and environmental domains of quality of life (p < 0.05), whereas no significant between-group differences were found in the physical and social domains (p > 0.05). CONCLUSIONS: The MBSR program increases the level of mindfulness in parents of physically disabled children, reduces perceived stress, and significantly improves the quality of life, particularly in terms of psychological and environmental dimensions. Mindfulness-based interventions may be considered as a supportive approach within family-centered rehabilitation programs.
Heterogeneous trajectories of psychological distress among individuals with moderate or severe distress: A five-year longitudinal study.
Kanamori Y, Asaoka H, Tabuchi T … +1 more , Nishi D
J Affect Disord · 2026 Jun · PMID 42297151 · Publisher ↗
PURPOSE: While trajectory research has advanced understanding of population-wide psychological distress patterns, heterogeneity among already-distressed individuals remains largely overlooked. This study aimed to classif...
PURPOSE: While trajectory research has advanced understanding of population-wide psychological distress patterns, heterogeneity among already-distressed individuals remains largely overlooked. This study aimed to classify five-year trajectories among individuals with moderate and severe distress, and to identify psychosocial factors related to more symptomatic trajectories. METHODS: Using a nationwide cohort data (2020-2024), latent class growth analysis was employed to identify distinct trajectories within moderate (K6 5-12; n = 6243) and severe (K6 ≥ 13; n = 2346) distress groups. Multinomial logistic regression examined predictors of trajectory membership with multiple imputation. RESULTS: Three trajectories emerged for those with moderate baseline distress: recovery (51.5%), persistently moderate (41.6%), and progressively severe (6.9%). Among those with severe baseline distress, four trajectories were identified: recovery (43.4%), improved but moderate (27.2%), improved but severe (17.9%), and persistently severe (11.5%). In both groups, a substantial proportion showed recovery within the first year; however, those who did not recover by the following year tended to remain distressed throughout. Most demographic characteristics and health behaviors showed inconsistent or null associations across groups. Adverse childhood experiences demonstrated a consistent dose-response association with more symptomatic trajectories. Loneliness and psychiatric history also strongly predicted higher-risk trajectories. CONCLUSIONS: Among individuals with psychological distress, early recovery within one year might be an important indicator of subsequent trajectory: those who do not show improvement by the following year are at substantially elevated risk of persistent burden. These findings support the importance of secondary prevention efforts targeting already-affected individuals, particularly those with early-life adversity and current psychosocial risks.
Parental traumatic brain injuries and their association with major depressive disorder in offspring: A study based on national registers in Finland.
Sucksdorff D, Upadhyaya S, Suominen A … +3 more , Abio A, Joelsson P, Sourander A
J Affect Disord · 2026 Jun · PMID 42297150 · Publisher ↗
BACKGROUND: Traumatic brain injuries (TBIs) can cause long-term brain dysfunction. Clinical studies suggest that parental TBI increases the risk of depressive symptoms in offspring. We aimed to investigate: 1) the associ...
BACKGROUND: Traumatic brain injuries (TBIs) can cause long-term brain dysfunction. Clinical studies suggest that parental TBI increases the risk of depressive symptoms in offspring. We aimed to investigate: 1) the association between parental TBI of different severities and later diagnosed offspring major depressive disorder (MDD) and 2) the association between the first parental TBI after offspring birth and subsequent offspring MDD, depending on child's age at injury. METHODS: This nested case-control study identified 37,682 cases aged ≤25 years, 148795 matched controls, and their parents from Finnish national registers. Associations were calculated applying conditional logistic regression, comparable to Cox regression in this study design. Hazard ratios (HR) were estimated with 95% confidence intervals and two-sided significance limits, p < 0.05. Associations were adjusted for parental psychopathology and maternal socio-economic status. RESULT: After adjustments, maternal and paternal TBIs of all severities were associated with offspring MDD. Concussions {aHR(maternal) 1.26 (95% CI 1.18-1-35); aHR(paternal) 1.14 (95% CI 1.07-1.21)}. Severe intracranial head injuries {aHR(maternal) 1.39 (95% CI 1.18-1.65); aHR(paternal) 1.30 (95% CI 1.18-1.44)}. Any first-time parental TBI occurring after offspring birth was associated with MDD in offspring, aged 1-18 years for mothers and aged 1-12 years for fathers. The association was strongest for offspring aged 0-6 years when maternal TBI happened {aHR 1.47 (95% CI 1.22-1.78)}. LIMITATIONS: Diagnoses were register-based without direct ascertainment. CONCLUSIONS: Parental TBIs of all severities were associated with offspring MDD. These families may need supportive services, with special attention warranted for maternal TBI when children are very young.
Heterogeneous developmental trajectories and predictors of self-harm in early adolescence: A machine learning study.
Zhang Z, Lei H, Wang Y … +3 more , Wang X, Ling F, Zhang C
J Affect Disord · 2026 Jun · PMID 42297149 · Publisher ↗
BACKGROUND: Although prior studies have examined developmental trajectories of adolescent self-harm in terms of frequency and severity, a fundamental gap remains: we lack a dynamic, state-specific understanding of how se...
BACKGROUND: Although prior studies have examined developmental trajectories of adolescent self-harm in terms of frequency and severity, a fundamental gap remains: we lack a dynamic, state-specific understanding of how self-harm ideation and behavior develop during early adolescence. Moreover, few studies have prospectively examined how baseline predictors relate to subsequent self-harm pathways. METHODS: Using four annual waves of data from a large-scale Chinese adolescent cohort (N = 11,366; 48.6% female; T1: M = 10.72 ± 0.29 years), this study used a person-centered approach to delineate distinct self-harm trajectories and interpretable machine learning methods to identify their baseline predictors. RESULTS: Five heterogeneous trajectories were identified: persistently low-risk, persistent ideation, ideation remission, behavior-to-ideation, and ideation-to-behavior. Although depressive symptoms, self-blame, family stress, and gender emerged as the most influential predictors overall, the predictors varied substantially across trajectories, indicating meaningful differences in their developmental drivers. CONCLUSIONS: These findings demonstrate the heterogeneous developmental trajectories of self-harm states in early adolescents and reveal trajectory-specific risk predictors, underscoring the importance of prevention efforts that should consider both shared and distinct factors across pathways.
Mapping mental health and suicide-related discourse on TikTok: An AI-based social media listening study.
Marti-Ochoa J, Freire A, Plamenova Djourova N
J Affect Disord · 2026 Jun · PMID 42297148 · Publisher ↗
PURPOSE: To examine engagement patterns around mental health and suicide-related discourse on TikTok, a platform widely used by youth and Generation Z, by comparing problem-focused (e.g., depression, loneliness, suicide)...
PURPOSE: To examine engagement patterns around mental health and suicide-related discourse on TikTok, a platform widely used by youth and Generation Z, by comparing problem-focused (e.g., depression, loneliness, suicide) with recovery-, support-, and prevention-oriented hashtags (e.g., #mentalhealth, #youarenotalone, #selflove). We further assess whether engagement differs by sentiment, discrete emotions, creator type, geotagging, verification status, and publication year. METHODOLOGY: We collected 12,587 TikTok posts published between 2020 and 2025 from 27 Spanish, English, and recovery-, support-, and prevention-oriented hashtags and analyzed them using an automated low-code pipeline integrating AI-based sentiment and emotion models. Preprocessing was conducted in Python under privacy-by-design principles; identifiers were anonymised, and engagement differences tested with t-tests and ANOVA. FINDINGS: Posts classified as neutral or negative, and those expressing sadness and fear, were associated with higher engagement than positive content. Engagement was higher for nano- and micro-creators, unverified accounts, and posts without geotags, consistent with the prominence of perceived authenticity and proximity on the platform. Engagement peaked in 2020-2021, declined during 2022-2024, and increased again in 2025. Problem-focused hashtags related to depression, loneliness, and suicide showed the highest engagement; several recovery-, support-, and prevention-oriented hashtags, particularly #mentalhealth, #youarenotalone, #selflove, and #suicideprevention, also attracted substantial engagement. ORIGINALITY: TikTok simultaneously hosts visible well-being-oriented discourse, while highly negative emotional content is associated with higher levels of engagement. Interpreted through the Werther/Papageno dual framework, these patterns indicate that while negative emotional tone attracts interaction, the specific topical focus (hashtag) is a far stronger driver of engagement. Mapping how engagement varies across emotional tone, creator attributes, and hashtag communities can inform youth-centered communication strategies and improve understanding of content visibility and interaction patterns on the platform.
Putamen function and MAOA genotype define genetic and neural subtypes of hyperactivity-impulsivity in ADHD.
Feng Y, Gao Y, Liu Q … +12 more , Zhu Y, Dang C, Wu G, Zhong S, Shi N, Lin X, Zhu Z, Ju C, Zhang H, Sui J, Liu L, Sun L
J Affect Disord · 2026 Jun · PMID 42285531 · Publisher ↗
BACKGROUND: Hyperactivity-impulsivity (HI) is a core ADHD symptom associated with the monoamine oxidase A (MAOA) gene. The neurobiological mechanisms underlying HI heterogeneity in children carrying the MAOA risk genotyp...
BACKGROUND: Hyperactivity-impulsivity (HI) is a core ADHD symptom associated with the monoamine oxidase A (MAOA) gene. The neurobiological mechanisms underlying HI heterogeneity in children carrying the MAOA risk genotype remain unclear and may involve distinct subtypes. METHODS: A total of 326 children with ADHD were genotyped for MAOA, including 108 non-risk and 218 risk carriers. Semi-supervised clustering of HI and executive function (EF) scores from the ADHD Rating Scale, Conners' Rating Scale, and BRIEF was used to classify MAOA risk carriers into subtypes, with non-risk patients as the reference. fALFF differences across subtypes, cognitive mediation between brain activity and behavior, and treatment response at follow-up were examined. RESULTS: Two subtypes were identified among MAOA risk carriers. Compared with the non-risk group, Subtype 1 showed elevated HI and impaired EF, whereas Subtype 2 showed preserved EF and no HI elevation. Subtype 1 had increased fALFF in the inferior temporal gyrus and higher putamen fALFF than Subtype 2, while Subtype 2 showed increased fALFF in the angular gyrus relative to the non-risk group. Putamen fALFF was associated with inhibition, shifting, emotional control, and the Behavioral Regulation Index (BRI), and mediation analysis suggested an indirect effect on HI via the BRI. After 4 weeks of medication, Subtype 2 showed greater improvement in conduct problems and anxiety. CONCLUSION: Putamen function may underlie HI heterogeneity among MAOA risk carriers and was associated with better EF, milder symptoms, and greater treatment response.
Sustainable eating for a healthy mind: Association between the EAT-Lancet diet and depression subtypes in a Swiss cohort.
Martins LB, Ranjbar S, Strippoli MF … +5 more , Lasserre AM, Marques-Vidal P, Vuilleumier S, Preisig M, Chatelan A
J Affect Disord · 2026 Jun · PMID 42285530 · Publisher ↗
BACKGROUND: Higher adherence to healthy dietary patterns appears to play a role in the prevention of Major Depressive Disorder (MDD). However, the association between the EAT-Lancet diet, developed to promote both human...
BACKGROUND: Higher adherence to healthy dietary patterns appears to play a role in the prevention of Major Depressive Disorder (MDD). However, the association between the EAT-Lancet diet, developed to promote both human health and environmental sustainability, and MDD remains largely unexplored. OBJECTIVE: To explore the association between adherence to the EAT-Lancet diet and MDD subtypes and assess how dietary patterns among individuals with and without MDD align with EAT-Lancet recommendations. METHODS: We conducted a cross-sectional analysis of 3558 adults from the CoLaus|PsyCoLaus cohort. Adherence to the EAT-Lancet diet was scored based on intake of 12 food components and categorized into tertiles (low, medium, high). Psychiatric information was obtained using the Diagnostic Interview for Genetic Studies. MDD subtypes (melancholic, atypical, and unspecified) were diagnosed according to DSM-IV specifiers. Multinomial logistic regression models assessed associations between diet adherence and MDD subtypes. RESULTS: High EAT-Lancet adherence was associated with a lower relative risk of atypical MDD (RRR: 0.68, 95% CI: 0.55-0.84). No clear associations were observed for melancholic or unspecified MDD. Across all groups, intake of unsaturated oils, legumes, and whole grains was insufficient, while red meat, potatoes, and added sugars exceeded recommendations. CONCLUSIONS: The association of a sustainable and healthy diet with MDD differs across clinical subtypes, suggesting that diet may play distinct roles in the pathophysiology of each. Improving specific dietary components may support mental health and sustainability goals.
A longitudinal study of partner support and maternal mental health following pregnancy during public health crises.
Mewton P, Leach L, Cherbuin N … +12 more , Bansal A, Nolan CJ, Broom M, Carlisle H, Christensen BK, Dahlstrom JE, Macleod E, Pasalich D, Peek MJ, Revius K, Schoenaker D, Dawel A
J Affect Disord · 2026 Jun · PMID 42285529 · Publisher ↗
BACKGROUND: Public health crises like environmental disasters and COVID-19 place psychological burden on affected communities, with pregnant and new mothers disproportionately impacted. With the escalating incidence of s...
BACKGROUND: Public health crises like environmental disasters and COVID-19 place psychological burden on affected communities, with pregnant and new mothers disproportionately impacted. With the escalating incidence of such crises, understanding the mechanisms that support maternal resilience is crucial for effective intervention. METHOD: We investigated partner support as a potential protective factor for mothers' mental health following the Australian 2019-2020 bushfires and COVID-19 pandemic. Data were from 278 mothers living in the ACT and NSW who were pregnant during the bushfires and participants in the Mother and Child 2020 (MC2020) longitudinal cohort study, and 99 of their partners. Moderation analyses tested whether total partner support (dyadic coping) predicted the impact of crises during pregnancy on maternal mental health at 21-38 months postpartum. Secondary analyses examined how mothers' and partners' perceptions of the support provided to mothers contributed to maternal mental health. RESULTS: Mothers with greater crisis impact reported higher depression, anxiety and stress symptoms, and lower wellbeing at 21-38 months postpartum. The effect of crisis impact on mothers' mental health was not moderated by partner support; however, partner support showed the strongest association with maternal mental health, including improvements from the perinatal period to 21-38 months postpartum. Critically, the relationship between partner support and mothers' mental health was primarily driven by mothers' perceptions of the support they received. CONCLUSION: Strengthening partner support may significantly enhance maternal mental health and resilience surrounding public health crises. Intervention efforts should focus on guiding partners to provide support that aligns with mothers' needs.
Neuroelectrophysiological clinical exploration of reward expectation and sensitivity abnormalities in adolescent melancholic MDD.
Liu Z, Qi Y, Cheng W … +8 more , Wen Y, Qiao D, Zhang Y, Huang F, Lu Y, Li G, Li H, Yang C
J Affect Disord · 2026 Jun · PMID 42285528 · Publisher ↗
INTRODUCTION: Adolescent major depressive disorder (MDD) is highly heterogeneous, and melancholic MDD is featured by more severe symptoms and lower treatment response, yet its underlying mechanism remains unclear. METHOD...
INTRODUCTION: Adolescent major depressive disorder (MDD) is highly heterogeneous, and melancholic MDD is featured by more severe symptoms and lower treatment response, yet its underlying mechanism remains unclear. METHODS: This study included two experiments. Experiment 1 recruited 91 adolescent MDD patients (45 mMDD, 46 NmMDD) and 40 healthy controls. Clinical scales and event-related potentials were used to detect SPN and RewP. Experiment 2 enrolled 30 adolescent mMDD patients receiving 2-week deep transcranial magnetic stimulation (dTMS) targeting the medial prefrontal cortex. Clinical symptoms, ERP components and power spectral density were compared before and after intervention. RESULTS: Experiment 1 showed that the mMDD group exhibited significantly higher depression, anxiety, and anhedonia relative to the NmMDD group. Patients showing higher SPN and lower RewP amplitudes, and the mMDD group demonstrating lower RewP compared to the NmMDD group. In both patient groups, SPN was positively correlated with anhedonia (r = 0.437, p < 0.05), while RewP was negatively correlated with anhedonia (r = -0.520, p < 0.01). Experiment 2 showed that following the 2-week dTMS intervention, significant pre-post differences were observed in clinical symptoms, SPN and RewP amplitudes (p < 0.05). We also detected notable increases in delta-band and theta-band power at the Fz electrode (p < 0.05). CONCLUSION: Electrophysiological alterations linked to reward processing are closely correlated with adolescent mMDD. This open-label, uncontrolled study documented pre-post improvements in clinical symptoms and neuroelectrophysiological indices among participants who received mPFC-targeted dTMS. Given the absence of sham or waitlist controls, these changes cannot be conclusively linked to the neuromodulatory effects of dTMS.
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