Journal Of Affective Disorders[JOURNAL]
Sun
200 papers
A more optimistic outlook about disease-modifying therapies and depressive symptoms in multiple sclerosis: A cross-sectional analysis.
Freedman DE, Oh J, Feinstein A
J Affect Disord · 2026 May · PMID 42217643 · Publisher ↗
Disease-modifying therapies (DMTs) prevent relapses and slow disability progression in people with relapsing-remitting multiple sclerosis (pwRRMS). Yet, it remains unclear whether DMTs influence depressive symptoms. Prio...
Disease-modifying therapies (DMTs) prevent relapses and slow disability progression in people with relapsing-remitting multiple sclerosis (pwRRMS). Yet, it remains unclear whether DMTs influence depressive symptoms. Prior research failed to account for antidepressant use. This study aimed to clarify whether DMT use is linked to decreased depressive symptoms in pwRRMS. This cross-sectional retrospective analysis included a consecutive sample of 782 pwRRMS assessed at a tertiary neuropsychiatry clinic between 2020 and 2025 in Toronto, Canada. Covariates included age, sex, education, Expanded Disability Status Scale scores, and disease duration. Stratified by the presence or absence of antidepressant use, analyses of covariance were undertaken to evaluate for a difference in Hospital Anxiety and Depression Scale depression sub-scale (HADS-D) scores between the presence or absence of DMT use, controlling for covariates (p < 0.050). Mean age was 41.9 years (SD = 10.51), 78.4% were female, median EDSS was 2.0 (IQR = 1.5-2.5), 80.3% received DMTs, and 38.3% used antidepressants. Only in the absence of antidepressants, DMT use was connected to reduced HADS-D scores (p = 0.011, η = 0.014), with a mean difference of -1.1 points (95% CI [-2.0, -0.3]). Overall, DMT use is independently associated with decreased depressive symptoms in pwRRMS not receiving antidepressants. This study supports the need to include measures of depressive symptoms in randomized controlled trials of DMTs.
Comparison of the accuracy of latent factor and sum scoring of the Hospital Anxiety and Depression Scale to screen for major depression: An individual participant data meta-analysis.
Zhang J, Fischer F, Falk C … +17 more , Wu Y, Alkan A, Sun Y, González-Domínguez NP, Boruff JT, Cuijpers P, Gilbody S, Harel D, Ioannidis JPA, Levis B, Markham S, Patten SB, Takwoingi Y, Ziegelstein RC, Benedetti A, Thombs BD, DEPRESSD HADS Collaboration
J Affect Disord · 2026 May · PMID 42217642 · Publisher ↗
BACKGROUND: Latent factor scoring may provide more precise score estimates than sum scores, but this has not been evaluated for the Hospital Anxiety and Depression Scale (HADS). We investigated whether latent factor scor...
BACKGROUND: Latent factor scoring may provide more precise score estimates than sum scores, but this has not been evaluated for the Hospital Anxiety and Depression Scale (HADS). We investigated whether latent factor scores could improve HADS depression screening accuracy. METHODS: We used a HADS screening accuracy individual participant data meta-analysis (IPDMA) database. We included 42 studies (7982 participants; 12 to 1143 per study) with a semi-structured interview reference standard. We randomly split the database into calibration and validation datasets. In calibration, we estimated latent scores using one-factor models (14-item HADS total scale [HADS-T], 7-item depression subscale [HADS-D]) plus HADS-T two-factor and bi-factor (general factor and two specific factors) models. We estimated cut-offs that maximized combined sensitivity and specificity for each method. In validation, we compared screening accuracy between latent variable approaches and the HADS-D sum score. The process was repeated 1000 times to estimate 95% confidence intervals for parameters. RESULTS: After removing iterations with failed models in confirmatory factor analysis (N = 304) or IPDMA (N = 31), aggregated results showed that confidence intervals for sensitivity, specificity, and combined sensitivity and specificity included 0 for all comparisons between factor scores and sum scores. Statistically significant but minimal advantages appeared in the receiver operating characteristic curve for the two-factor and bi-factor models (0.01, 95% CI [0.01, 0.02]; 0.02, 95% CI [0.01, 0.02]). Sensitivity analysis confirmed findings. CONCLUSIONS: Latent factor scoring did not meaningfully improve HADS screening accuracy compared with sum scores. Sum scores may be preferred in applied settings for their simplicity and feasibility.
Understanding how depression genetic liability shapes executive function: Epidemiological evidence for symptom-mediated pathways.
Camerini L, Carpena MX, Santana VF … +6 more , Santos IS, Munhoz TN, Genro JP, Oliveira IO, Matijasevich A, Tovo-Rodrigues L
J Affect Disord · 2026 Oct · PMID 42217641 · Publisher ↗
Executive function (EF) impairments are common in depression (MD), yet the developmental pathways linking MD genetic liability to cognitive outcomes remain unclear. In this study, we examined whether genetic liability to...
Executive function (EF) impairments are common in depression (MD), yet the developmental pathways linking MD genetic liability to cognitive outcomes remain unclear. In this study, we examined whether genetic liability to MD is associated with EF performance at ages 11 and 15 in a Brazilian population-based birth cohort and assessed whether MD symptoms in adolescents and their mothers mediate these associations. Data were drawn from the 2004 Pelotas Birth Cohort (Brazil), including 3206 participants at age 11 and 1753 at age 15. EF was assessed using selective attention and cognitive flexibility tasks at age 11 and spatial working memory at age 15. A polygenic score for MD (MD-PGS), derived from a trans-ancestry genome-wide association study (GWAS) using SBayesRC, was examined in relation to EF using structural equation modeling, considering adolescent and maternal MD symptoms as potential mediators. Higher MD-PGS were associated with EF performance in adolescence. In adjusted models, a one-SD increase in MD-PGS was associated with worse selective attention at age 11 (β = 0.15, p = 0.012) and poorer working memory at age 15 (β = 0.52, p = 0.011). Mediation analyses showed that adolescent MD symptoms partially mediated the associations between MD-PGS and EF, ranging from 7% to 12%. After adjustment for socioeconomic factors, indirect effects through maternal MD symptoms were attenuated across all EF domains. These findings underscore the role of familial emotional environments in shaping cognitive development. Identifying these mediating pathways is crucial for early prevention efforts, as reducing MD symptoms may lessen downstream impacts on cognitive development.
Unique predictive effects of anxiety sensitivity, depression sensitivity, and anxiety sensitivity-suicidal cognitive concerns on anxiety, depression, interpersonal hopelessness, and past month and lifetime suicidal ideation.
Buerke M, Pleiman AJ, Stoneking F … +1 more , Capron DW
J Affect Disord · 2026 May · PMID 42217640 · Publisher ↗
Previous literature has established anxiety sensitivity as a risk factor for the development of several psychopathologies, including anxiety and depressive disorders. Recently, scales were developed to test two sensitivi...
Previous literature has established anxiety sensitivity as a risk factor for the development of several psychopathologies, including anxiety and depressive disorders. Recently, scales were developed to test two sensitivity types akin to anxiety sensitivity; depression sensitivity and anxiety sensitivity-suicidal cognitive concerns. The former refers to fears related to depressive symptoms, whereas the latter refers to fear of suicidal thoughts. Despite these scales' potential merits in capturing mental health sensitivities currently missed by existing anxiety sensitivity measures, they have had limited examination. Using a cross-sectional sample of 128 adults with past month suicidal ideation, the current study investigated the utility of these measures to predict mental health outcomes using stepwise linear regression. Anxiety and depression symptoms were added into step one, anxiety sensitivity subscales (i.e., physical, cognitive, social) in step two, depression sensitivity in step three, and anxiety sensitivity-suicidal cognitive concerns in step four to predict anxiety and depression symptoms, past month and lifetime suicidal ideation, and interpersonal hopelessness. Anxiety sensitivity physical concerns was associated with anxiety across steps. Depression sensitivity was associated with depression across steps. Interpersonal hopelessness was uniquely predicted by anxiety sensitivity social concerns in step one, but only by depression sensitivity in step two. Anxiety sensitivity cognitive concerns predicted lifetime suicidal ideation before anxiety sensitivity-suicidal cognitive concerns was added. No other constructs were associated with suicidal ideation. Anxiety sensitivity-suicidal cognitive concerns predicted no outcomes. These findings indicate the unique predictive ability of depression sensitivity for depression and interpersonal hopelessness. Anxiety sensitivity-suicidal cognitive concerns warrants further study.
Clinical and sociodemographic predictors of AI use for mental health among college students.
Liu CH, Zhang W, Lou F … +3 more , Zhao C, Chow A, Yip T
J Affect Disord · 2026 May · PMID 42217639 · Publisher ↗
BACKGROUND: Generative AI tools are increasingly accessible to college students, yet little is known about who uses them for mental health support. This study examined predictors of AI use for mental health among college...
BACKGROUND: Generative AI tools are increasingly accessible to college students, yet little is known about who uses them for mental health support. This study examined predictors of AI use for mental health among college students at two U.S. institutions. METHODS: Data were drawn from students (n = 896) who completed an AI module as part of the 2024-2025 Healthy Minds Study. The analytic sample comprised 675 students with complete data. Descriptive analyses compared three groups: never use AI, use AI but not for mental health, and use AI for mental health. Hierarchical logistic regression examined predictors of AI use for mental health using a binary outcome (AI use for mental health vs. no AI use for mental health), as the three-group structure could not accommodate general AI use as a predictor due to structural confounding. A supplementary multinomial logistic regression compared all three groups without general AI use. RESULTS: Approximately 18% of students reported using AI for mental health. The never-use-AI group had higher proportions of non-binary/other gender and LGBQ+ students; the proportion of Asian students increased across groups in a stepwise pattern; and the AI-not-for-MH group showed better mental health profiles than both other groups. In regression models, frequent general AI use was the strongest predictor (OR = 11.42-12.87). Moderate depression (OR = 2.06), severe depression (OR = 2.49), severe anxiety (OR = 2.04), and suicidality (OR = 1.97) each predicted AI use for mental health. Asian students showed elevated odds (OR = 2.03-2.08). Lifetime therapy predicted AI use (OR = 2.21), but current therapy did not. LIMITATIONS: Data were from only two institutions. The cross-sectional design precludes causal inference. Prevalence estimates are time-sensitive given rapid AI adoption. CONCLUSIONS: Students with severe mental health symptoms and some marginalized groups are using unregulated AI tools at elevated rates. Findings underscore the need for research on AI safety for distressed individuals and policies accounting for heterogeneity in who uses these tools.
Multi-task deep learning for sub-clinical screening of mood and sleep disturbances using physical activity biomarkers.
Ho CC, Huang MS, Chang MC … +2 more , Huang SH, Chang YC
J Affect Disord · 2026 May · PMID 42217638 · Publisher ↗
BACKGROUND: Sub-clinical screening for mood disorders and sleep disturbances remains challenging due to limited accessibility of mental health screening. Physical activity patterns serve as accessible biomarkers reflecti...
BACKGROUND: Sub-clinical screening for mood disorders and sleep disturbances remains challenging due to limited accessibility of mental health screening. Physical activity patterns serve as accessible biomarkers reflecting psychological wellbeing, offering potential for community-based screening. This study aims to develop and validate a multi-task deep learning framework (MUSCLE) for concurrent risk identification of mood disturbances and sleep disorders using physical activity data. METHODS: We analyzed a comprehensive Taiwanese national dataset (n = 69,559) containing physical fitness assessments and self-reported wellbeing indicators. After preprocessing, 44,477 complete records underwent analysis using our Multi-task Synchronized Convolutional LSTM Evaluator (MUSCLE) model, which integrates convolutional neural networks with long short-term memory networks to simultaneously predict mood disturbance risk, sleep disorder indicators, and psychological wellbeing. Performance was evaluated through 10-fold cross-validation against nine alternative approaches. RESULTS: MUSCLE demonstrated superior performance in detecting mood disturbances with precision of 0.929, recall of 0.899, and F₁-score of 0.914, while sleep disorder detection achieved precision of 0.881, recall of 0.983, and F₁-score of 0.930. Psychological wellbeing assessment achieved precision of 0.746, recall of 0.834, and F₁-score of 0.787. The model significantly outperformed traditional machine learning and single-task neural networks across all screening tasks. CONCLUSION: This study establishes multi-task deep learning efficacy for sub-clinical screening of mood and sleep disturbances using accessible physical activity biomarkers. MUSCLE's ability to capture interdependencies between physical activity patterns and mental health enables comprehensive concurrent risk identification, providing a cost-effective and scalable complement to traditional mental health screening that supports timely clinical referral for at-risk individuals.
Persistent anhedonic dysregulation of positive social emotion processing in major depression.
Bezmaternykh DD, Melnikov MY, Petrovskiy ED … +10 more , Mazhirina KG, Savelov AA, Natarova KA, Hu Q, Wang J, Wang J, Sambataro F, Vuilleumier P, Shtark MB, Koush Y
J Affect Disord · 2026 May · PMID 42217637 · Publisher ↗
Major depressive disorder (MDD) is characterized by core anhedonic symptoms, including pervasive dampening of positive responsiveness and social interactions mediated by the habitual avoidance of strategies involving eng...
Major depressive disorder (MDD) is characterized by core anhedonic symptoms, including pervasive dampening of positive responsiveness and social interactions mediated by the habitual avoidance of strategies involving engagement with positive emotions. Current MDD treatments primarily aim at rebalancing the regulation of negative emotions and at modulating limbic activity. Understanding neural deficits in positive social regulation is critical for developing therapeutic interventions for MDD and social anhedonia symptoms. We used fMRI to assess positive social emotion upregulation in 40 women, comprising 20 medicated patients with MDD and matched healthy controls. Ecologically valid conditions with robust activation patterns were designed to investigate disruptions within prefrontal emotion regulation circuits by contrasting active upregulation of positive social situations with passive viewing of neutral social situations. We assessed connectivity network models using a probabilistic empirical Bayes approach. Although patients rated positive social pictures lower in valence and had greater social anhedonia scores, we identified similar activity in bilateral amygdala and ventromedial prefrontal cortex (vmPFC) during upregulation. However, superior frontal gyrus (SFG) and posterior right ventrolateral PFC (prvlPFC) were hypoactive, while dorsolateral PFC and anterior right vlPFC (arvlPFC) were hyperactive. We unveiled impaired cognitive control pathways from SFG and dorsolateral PFC to arvlPFC, between functional subdivisions of vlPFC, and contextual modulation by social appraisal. Our preliminary findings indicate that despite medicated patients having proper evaluation of sociality and stabilized limbic responses, their positive social responsiveness, top-down upregulation and appraisal efficacy remained deficient. These findings complement neurobiological bases underlying aberrant positive social emotion upregulation and appraisal processes.
Risk factors for suicidal behaviour in people with dementia: A systematic review and meta-analysis.
Chen YT, Kausar S, Lindenmeyer A … +1 more , Marshall T
J Affect Disord · 2026 Oct · PMID 42217636 · Publisher ↗
BACKGROUND: Dementia-related affective symptoms and social withdrawal increase vulnerability to suicidal behaviour. This study evaluates the magnitude of this risk and its determinants, focusing specifically on suicide a...
BACKGROUND: Dementia-related affective symptoms and social withdrawal increase vulnerability to suicidal behaviour. This study evaluates the magnitude of this risk and its determinants, focusing specifically on suicide attempts and deaths. METHODS: A systematic review and meta-analysis of observational studies was conducted. Eight English- and Chinese-language databases were searched from inception to May 2025. Pooled odds ratios (OR) were estimated using random-effects models to compare people with dementia (PwD) with controls and to identify risk factors within the dementia population. RESULTS: Thirty-seven studies met the inclusion criteria. Dementia was associated with a 62% increased risk of suicidal behaviour compared with non-dementia controls (pooled OR = 1.62; 95% CI 1.32-1.98). Risk was notably concentrated in specific subgroups: younger patients were nearly three times more likely to die by suicide than older patients, and men faced 28% higher odds of suicide attempts and 188% increased odds of suicide deaths compared to women. Social isolation and psychiatric history-particularly depression-were robust risk markers. Notably, the exhaustive search of Chinese-language databases yielded no eligible publications, revealing a significant geographical evidence gap. CONCLUSIONS: PwD face a significant increase in suicidal behaviour, concentrated within subgroups with psychiatric and social vulnerabilities. Prevention should prioritise younger patients, men, and socially isolated individuals. The identified lack of diverse data necessitates future cross-cultural qualitative research in English and Chinese to bridge the gap between Western and Eastern perspectives and capture culturally situated risk factors currently missing from the literature.
The impact of insomnia and excessive daytime sleepiness on depression and suicidal ideation in adolescents: A three-year longitudinal study.
Wei Y, Chen X, Chen SJ … +6 more , Li SX, Chan JWY, Chan KCC, Li AM, Wing YK, Chan RNY
J Affect Disord · 2026 May · PMID 42208818 · Publisher ↗
BACKGROUND: Insomnia and excessive daytime sleepiness (EDS) were associated with adverse mental health outcomes in adolescents, but their combined effects remained unclear. This study examined the associations between in...
BACKGROUND: Insomnia and excessive daytime sleepiness (EDS) were associated with adverse mental health outcomes in adolescents, but their combined effects remained unclear. This study examined the associations between insomnia and EDS with mental health outcomes over a 3-year follow-up period. METHODS: This study was a three-year longitudinal investigation. Adolescents were invited to fill in a set of questionnaires covering their insomnia symptoms, daytime sleepiness, and mental health outcomes. They were categorised into four groups: 1) insomnia-only, 2) EDS-only, 3) both insomnia and EDS, and 4) healthy adolescents. Logistic regression analyses were employed to examine the associations between insomnia and EDS with depression and suicidal ideation, adjusting for potential confounders. RESULTS: A total of 458 adolescents (Mean age: 13.8 ± 1.2 years old at baseline; female 53.9%) participated in this study. Our results suggested an increased prevalence of EDS and a decrease in the prevalence of insomnia symptoms over the three-year period. Compared to the healthy group, adolescents with insomnia + EDS or either condition had higher odds of depression after controlling for confounders. For suicidal ideation, significant associations were found in the insomnia + EDS group and the insomnia-only group, but not in the EDS-only group. CONCLUSIONS: These findings indicate an increased prevalence of EDS during adolescence. The co-occurrence of insomnia and EDS is associated with the heightened risk of depression and suicidality, representing a high-risk clinical group. Early interventions with this comorbid group may help mitigate the mental health risks in adolescents.
Neuroclearance dysfunction in autism with sleep disorder: MRI evidence and mediation by systemic iron deficiency.
Yin BY, Deng YY, Chen X … +11 more , Zhao JY, Ni YX, Zhong SS, Zou FY, Shen LS, Luo XW, Zhou X, Zhang JL, Zhou WY, Deng HZ, Guo RM
J Affect Disord · 2026 Oct · PMID 42208817 · Publisher ↗
BACKGROUND: Sleep disturbances are highly prevalent in children with autism spectrum disorder (ASD) and exacerbate neurodevelopmental impairments. Yet, the mechanistic link between sleep disruption, brain fluid clearance...
BACKGROUND: Sleep disturbances are highly prevalent in children with autism spectrum disorder (ASD) and exacerbate neurodevelopmental impairments. Yet, the mechanistic link between sleep disruption, brain fluid clearance, and systemic trace element status remains unclear. METHODS: We enrolled 230 children with ASD (114 with sleep disorder, ASD-SD; 116 without, ASD-nSD) and 110 typically developing controls. Neuroclearance function was quantified using diffusion kurtosis imaging along the perivascular space (DKI-ALPS), free water fraction (FW), and perivascular space volume fraction (PVSVF). Serum iron (Fe), lead (Pb), and magnesium (Mg) were measured. Group comparisons, correlations, ROC analysis, and mediation modeling assessed relationships among sleep, iron status, and neuroclearance. RESULTS: ASD-SD children exhibited significantly reduced ALPS indices and elevated FW compared with ASD-nSD and controls, indicating impaired perivascular clearance. Serum Fe was markedly lower in ASD-SD, whereas Pb was elevated; Mg showed no significant differences. ALPS indices strongly correlated with Fe levels (r = 0.75-0.95). Mediation analysis revealed that iron deficiency partially reduced ALPS via increased FW, supporting a hypothesized "Fe deficiency → cerebral edema → impaired neuroclearance" pathway. Combined ALPS and serum Fe distinguished ASD-SD from ASD-nSD and controls with high accuracy (AUC up to 0.94). CONCLUSION: Children with ASD and comorbid sleep disorder exhibit pronounced neuroclearance dysfunction linked to systemic iron deficiency. The combination of DKI-ALPS and serum Fe shows potential as a candidate biomarker for ASD-SD, highlighting a potential cascade from sleep disruption to impaired neuroclearance and suggesting targeted interventions integrating iron supplementation and sleep optimization.
Associations between vitamin intake and depression severity: A cross-sectional analysis of NHANES 2005-2014.
Mistry N, Cowan LT, Samawi HM … +3 more , Qotineh A, Gomez O, Sullivan KL
J Affect Disord · 2026 Oct · PMID 42208816 · Publisher ↗
PURPOSE: Prior observational studies on vitamins and depression have shown conflicting results and limited generalizability. This study evaluated associations between individual vitamin intake and depression using nation...
PURPOSE: Prior observational studies on vitamins and depression have shown conflicting results and limited generalizability. This study evaluated associations between individual vitamin intake and depression using nationally representative data from the National Health and Nutrition Examination Survey (NHANES). METHODS: NHANES 2005-2014 data were analyzed. Depression was assessed using the PHQ-9, and dietary intake was measured through 24-h recall and laboratory assays. A composite nutritional score was created from vitamin and nutrient data. Logistic regression models were used to estimate associations between vitamin intake and depression, adjusting for demographic, socioeconomic, and health factors. RESULTS: Depressive symptoms (PHQ-9 ≥ 5) were present in about 25% of participants. Despite observed associations between several vitamins and depression in crude models, most vitamins were not associated with depression presence or severity after adjusting for demographic, socioeconomic, behavioral, and health-related covariates, though small effects persisted for Vitamin B6 (adjusted OR for moderate+ depression = 0.99; 95% CI: 0.98-1.00). CONCLUSIONS: Only weak vitamin-depression associations were observed, and most diminished after adjusting for confounders. These findings may reflect broader differences in dietary patterns, demographic characteristics that influence health, and health behaviors, as observed in the adjusted results. Interpretation is limited by differences in data-collection timing across specific vitamins and by the lack of prospective data needed to evaluate temporality.
Life-course trajectories of body size from childhood to adulthood and risk of incident depression and anxiety: a prospective cohort study.
Li DR, Li KR, Liu BQ … +5 more , Liu JC, Zheng WR, Gong TT, Gao SY, Wu QJ
J Affect Disord · 2026 Oct · PMID 42208815 · Publisher ↗
BACKGROUND: While associations between adult obesity and mental health are established, the independent and combined influences of childhood body size and its life-course transition remain poorly understood. We investiga...
BACKGROUND: While associations between adult obesity and mental health are established, the independent and combined influences of childhood body size and its life-course transition remain poorly understood. We investigated associations of childhood body size, adulthood body mass index (BMI), and life-course body size trajectories with the risk of incident depression and anxiety. METHODS: We analyzed data from 368,756 UK Biobank participants. Life-course trajectories were derived from self-reported comparative body size at age 10 (thinner, average, or plumper) and measured BMI at recruitment. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: Over a median follow-up of 13.2 years, 11,546 depression and 15,780 anxiety cases occurred. Compared with average childhood body size, both thinner (depression HR 1.09, 95% CI 1.04-1.13; anxiety HR 1.13, 95% CI 1.09-1.17) and plumper (depression HR 1.19, 95% CI 1.13-1.25; anxiety HR 1.11, 95% CI 1.06-1.16) childhood body sizes were associated with higher risks. Adulthood BMI showed U-shaped associations with both outcomes (P for non-linearity <0.001), with lowest risks at approximately 23-24 kg/m. Trajectory analysis revealed that thinner-to-obesity trajectory exhibited the highest risk (depression HR 1.73, 95% CI 1.59-1.87; anxiety HR 1.33, 95% CI 1.23-1.42), whereas plumper-to-normal weight trajectory showed no significant increase. CONCLUSIONS: Deviations from average body size in both childhood and adulthood are associated with elevated mental health risks, with adulthood BMI as the dominant factor. Notably, achieving normal weight in adulthood may mitigate childhood adiposity-associated risks, suggesting that weight optimization could yield mental health benefits regardless of childhood starting point.
Sensory impairment and mental health in old age: The moderating role of physical activity.
Rosenberg D
J Affect Disord · 2026 Oct · PMID 42208814 · Publisher ↗
PURPOSE: To establish the interactive association between physical activity, sensory impairment and mental health. METHODS: The data were obtained from Wave 9 of the Survey of Health, Ageing, and Retirement in Europe (SH...
PURPOSE: To establish the interactive association between physical activity, sensory impairment and mental health. METHODS: The data were obtained from Wave 9 of the Survey of Health, Ageing, and Retirement in Europe (SHARE). The sample included responses of 68,709 participants aged 50 years and older. The analysis was performed with regard to both risk of being in each state (logistic regression models) and the extent of their severity (linear regression models). RESULTS: Engagement in physical activity was associated with reduction of the negative association between sensory impairment and the risk and the severity of depression, being evident mainly in respondents with visual and dual sensory impairments. In contrast, engagement in physical activity was associated with reduction of the negative effect sensory impairment had on the severity, but not the risk, of loneliness. CONCLUSIONS: The findings support previous research. They largely suggest that engagement in physical activity represents a protective factor against the negative effect of sensory impairment on mental health. However, this protective role is pronounced more in older adults with particular types of sensory impairments than others as well as with respect to different mental health indicators.
Reducing state anxiety with alpha-frequency transcranial alternating current stimulation.
Romero-Marín R, Fankhauser S, Solana-Sánchez J … +7 more , Perellón-Alfonso R, Tormos-Muñoz JM, Pessoa L, Bartrés-Faz D, Cappon D, Pascual-Leone Á, Cattaneo G
J Affect Disord · 2026 Oct · PMID 42208813 · Publisher ↗
BACKGROUND: Anxiety reactivity to acute stress is a transdiagnostic vulnerability factor. We tested whether a single session of alpha-frequency transcranial alternating current stimulation (tACS) targeting the frontopari...
BACKGROUND: Anxiety reactivity to acute stress is a transdiagnostic vulnerability factor. We tested whether a single session of alpha-frequency transcranial alternating current stimulation (tACS) targeting the frontoparietal control network reduces stress-evoked state anxiety in healthy adults. METHODS: In a randomized, blinded, sham-controlled study, 42 participants (mean age 58.9 years) completed an acute stress task before and after stimulation. The task was an adapted moving-circles paradigm in which circle collisions triggered a brief aversive event (mild electric shock plus unpleasant noise and a white flash). Active stimulation consisted of 20 min of 10-Hz tACS (2.0 mA/channel; 30-s ramp up/down) delivered via electrodes at F3, P3, Cz, and T7 (0° phase at F3/P3; 180° at Cz/T7). Sham stimulation used the same montage and ramp periods but no sustained current. RESULTS: State anxiety showed a significant Time × Protocol interaction (F(1,35) = 4.22, p = .047): STAI-S decreased after active tACS (Δ = -3.16) but increased slightly after sham (Δ = +1.17). Perceived stress appraisal (SAAS) did not change. Resting-state alpha power at F3/P3 showed no reliable pre-post effects. During the task, left-frontal relative alpha differed by protocol and showed a trend toward larger increases following active tACS. Electrodermal and pupil indices changed across sessions in both groups, with no differential stimulation effects. CONCLUSIONS: A single alpha-tACS session produced a modest, selective reduction in stress-evoked state anxiety, supporting oscillatory neuromodulation as a scalable approach to dampen anxiety reactivity.
At the core of relational vs. non-relational post-traumatic stress disorders: Distinct profiles of dissociative and emotion regulation mechanisms.
Cavicchioli M, Masoumi S, Maffei C … +4 more , Galli F, Scaini S, Mucci C, Scalabrini A
J Affect Disord · 2026 May · PMID 42208812 · Publisher ↗
BACKGROUND: Theoretical and clinical models have suggested a distinction between post-traumatic stress disorder (PTSD) due to relational (e.g., sexual and physical violence; PTSD-R) and non-relational (e.g., natural disa...
BACKGROUND: Theoretical and clinical models have suggested a distinction between post-traumatic stress disorder (PTSD) due to relational (e.g., sexual and physical violence; PTSD-R) and non-relational (e.g., natural disasters, accidents; PTSD-NR) traumatic experiences. A further differentiation exists between Disorders of Extreme Stress Not Otherwise Specified (DESNOS) and complex PTSD (CPTSD) from "simple" PTSD. On the one hand, dissociation and alterations of emotion regulation (ER) processes play a key role in these conditions. On the other hand, there are no studies that have clarified how these mechanisms might be differentially involved in CPTSD/DESNOS, PTSD-R and PTSD-NR. METHODS: A multilevel meta-analysis was conducted of studies evaluating the associations between dissociation, adaptive and maladaptive ER processes with clinical features of CPTSD/DESNOS, PTSD-R and PTSD-NR. Comparisons among effect sizes of dissociation and ER processes were conducted within and between groups. RESULTS: A total of 189 studies (i.e. , CPTSD/DESNOS: N = 48; PTSD-R: N = 71; PTSD-NR: N = 70) were included. Dissociation emerged as a key psychopathological dimension for both CPTSD/DESNOS and PTSD-R. In the PTSD-NR group, aversive cognitive perseveration mechanisms showed a larger pooled effect size than dissociation. CPTSD/DESNOS, PTSD-R and PTSD-R groups were quantitatively distinguishable based on their levels of dissociation and deficits in adaptive ER. CONCLUSIONS: These findings support the diagnostic differentiation between CPTSD, PTSD-R, and PTSD-NR, based on the specific impacts of dissociation and ER. Furthermore, this evidence suggests the need for tailored treatment approaches for these trauma-related conditions, specifically designed to target underlying dissociation and ER mechanisms.
Difficulties in Identifying Causes of Emotions Prospectively Predict the Persistence of Suicidal Thoughts: A Six-Week Longitudinal Study.
Chernetska V, Millgram Y
J Affect Disord · 2026 May · PMID 42203051 · Publisher ↗
BACKGROUND: Suicidal thoughts affect approximately 10% of the population during their lifetime. In about one-third of cases, these thoughts persist, contributing to poorer health and elevated suicide risk. Emotion regula...
BACKGROUND: Suicidal thoughts affect approximately 10% of the population during their lifetime. In about one-third of cases, these thoughts persist, contributing to poorer health and elevated suicide risk. Emotion regulation deficits were found to be a central prospective risk factor for suicidal thought persistence. Still, little is known about the mechanisms driving these deficits. Difficulties in identifying causes of emotions could undermine emotion regulation by limiting the ability to target the source of distress. Recent cross-sectional evidence suggests that such difficulties are linked to the occurrence of suicidal thoughts. However, these associations were never examined longitudinally. This study tested whether difficulties in identifying the cause of negative emotions predicted the persistence and severity of suicidal thoughts over 6 weeks, and whether perceived regulatory success mediated this link. METHODS: Participants who reported suicidal thoughts in the past week (N = 138) completed baseline and 6-week follow-up assessments including questionnaires and Ecological Momentary Assessments (EMAs). Difficulties in identifying causes of emotions were assessed using EMAs and language processing. RESULTS: Difficulties in identifying causes of negative emotions predicted greater persistence of suicidal thoughts at follow-up, even after accounting for initial suicidal thought severity and initial depressive and psychiatric symptoms. Mediation analysis revealed that this effect was partly accounted for by lower perceived success in emotion regulation. However, such difficulties did not predict suicidal thought severity. CONCLUSION: Findings point to difficulties in identifying causes of emotions as a novel predictor for the persistence of suicidal thoughts, and as a potential target for intervention.
Association between adherence to 24-hour movement guidelines and anxiety and depression: A systematic review and meta-analysis of observational studies.
Zhao X, Wang Y, Yi Y … +3 more , Zhan H, Chen H, Song Q
J Affect Disord · 2026 Oct · PMID 42203050 · Publisher ↗
BACKGROUND: Depression and anxiety constitute a global health crisis, with prevalence increasing by 27.6% during the COVID-19 pandemic. The 24-Hour Movement Guidelines, integrating physical activity, sedentary behavior,...
BACKGROUND: Depression and anxiety constitute a global health crisis, with prevalence increasing by 27.6% during the COVID-19 pandemic. The 24-Hour Movement Guidelines, integrating physical activity, sedentary behavior, and sleep, have been linked to improved mental health, yet no meta-analysis has quantified these associations. METHODS: Following PRISMA guidelines, PubMed, Embase, Cochrane Library, and Web of Science were searched through January 1, 2026. Observational studies examining adherence to the 24-Hour Movement Guidelines and anxiety or depression were included. Cross-sectional and cohort studies were assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Tools, with the 8-item checklist for cross-sectional studies and the 11-item checklist for cohort studies. Random-effects models generated pooled odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: Twenty studies (17 cross-sectional, 3 cohort) involving 323,440 participants from seven countries were included, with the majority being adolescents (n = 210,394, 65%). Adherence to the 24-Hour Movement Guidelines was significantly associated with lower odds of anxiety and depression symptoms. Meeting one, two, or three guideline components was consistently linked to lower odds of anxiety (ORs = 0.74, 0.59, and 0.43, respectively) and depression (ORs = 0.73, 0.55, and 0.41, respectively). Among individual components, adherence to sleep recommendations demonstrated the strongest associations for both anxiety (OR = 0.72) and depression (OR = 0.69), followed by sedentary behavior and physical activity. Sensitivity and publication bias analyses confirmed robustness. CONCLUSIONS: Adherence to the 24-Hour Movement Guidelines is significantly associated with lower risks of anxiety and depression, supporting their integration into mental health prevention strategies.
Home-based low-field magnetic stimulation as an adjunctive treatment for bipolar depression: A randomized double-blind study.
Wu J, Li Y, Zou Y … +4 more , Zhu X, Li X, Liu J, Xiao L
J Affect Disord · 2026 Oct · PMID 42203049 · Publisher ↗
BACKGROUND: Bipolar depression (BD-D) is associated with high morbidity and suicide risk, yet effective non-pharmacological interventions remain limited. Low-field magnetic stimulation (LFMS), an ultra-low intensity whol...
BACKGROUND: Bipolar depression (BD-D) is associated with high morbidity and suicide risk, yet effective non-pharmacological interventions remain limited. Low-field magnetic stimulation (LFMS), an ultra-low intensity whole-brain neuromodulation, offers potential for home-based therapy. This first randomized controlled trial (RCT) evaluated repeated home-based LFMS efficacy and safety in BD-D. METHODS: Sixty patients with ICD-10-defined bipolar depression (current depressive episode) were randomized to adjunctive active LFMS or sham stimulation (1:1), delivered twice daily for 2 weeks (28 sessions) using a chip-card blinded device. All participants maintained stable lithium. Primary outcome was change in clinician-rated Hamilton Depression Rating Scale-17 (HAMD-17) from baseline to Week 6. Secondary outcomes included self-reported Quick Inventory of Depressive Symptomatology (QIDS-SR16), and safety (affective switches). RESULTS: In the full analysis set (FAS, n = 51), HAMD-17 improvements did not differ between LFMS and sham at any timepoint (Week 6: Δ - 0.27, 95% CI: -1.93 to 1.39; P = 0.7427). However, LFMS significantly improved self-reported depression (QIDS-SR16) at Week 4 (Δ1.79, 95% CI: 0.16-3.43; P = 0.0319) and Week 6 (Δ1.83, 95% CI: 0.30-3.36; P = 0.0200). Baseline anxiety (GAD-7) was lower in the LFMS group (P < 0.05), though adjusted in analyses. Mood switch events occurred in both groups (one each). Safety analysis revealed no severe treatment-related adverse events. CONCLUSIONS: Although home-based LFMS failed to outperform sham on clinician-rated depression, it proved highly feasible and safe while suggesting possible subjective symptom benefits. This divergence emphasizes the need to include subjective endpoints in neuromodulation trials. Future studies should optimize LFMS parameters and target subjective symptom domains in BD-D. TRIAL REGISTRATION: This study was registered at a Chinese drug clinical trial institution under the registration number ChiCTRUE-INR-17013338, Date: 2017-11-10.
Testing within-person correlates of daily fearlessness about death in young adults.
Sherifi E, Dixon A, Filion A … +1 more , Stewart JG
J Affect Disord · 2026 May · PMID 42203048 · Publisher ↗
Fearlessness about death (FAD) reflects a reduced fear of dying that enables individuals to act on suicidal thoughts. Understanding how FAD changes in real time is critical because suicide risk can escalate within hours....
Fearlessness about death (FAD) reflects a reduced fear of dying that enables individuals to act on suicidal thoughts. Understanding how FAD changes in real time is critical because suicide risk can escalate within hours. However, little is known about processes that influence FAD within brief time periods. Painful and provocative events (PPEs), affective lability and impulsivity have each been linked to suicidal behavior and may shape momentary increases in FAD, but prior studies have been largely cross-sectional. To address this gap, we enrolled 148 young adults with past year suicidal thoughts and/or behaviors to complete ecological momentary assessments five times per day for 21 days. Using multi-level modeling, we tested the impact of daily fluctuations in affective states (happy, sad, anxious, angry, ashamed, and hopeless) and impulsivity on same-day FAD, with daily engagement in PPEs as a mediator. Results indicated that greater daily lability in impulsivity, anger, sadness and shame was associated with increased same-day FAD. Contrary to hypotheses, these effects were not mediated by PPE engagement. Short-term increases in FAD may arise from rapid shifts in emotions and impulsivity, rather than experiences such as PPEs. Capturing these dynamic, within-person changes can refine suicide theory and improve real-time suicide risk assessment.
Neural alterations in viral pneumonia patients comorbid with insomnia in a Chinese population: Insight from surface-based morphometry analysis.
Ju C, Yang L, Liu C … +7 more , Du Y, Liu P, Chen Y, Huang Y, Li C, Zou Q, Liu J
J Affect Disord · 2026 Oct · PMID 42190893 · Publisher ↗
BACKGROUND: Emerging evidence suggests that viral pneumonia can affect the central nervous system (CNS), potentially leading to neuropsychiatric sequelae. However, the specific impact of viral pneumonia comorbid with ins...
BACKGROUND: Emerging evidence suggests that viral pneumonia can affect the central nervous system (CNS), potentially leading to neuropsychiatric sequelae. However, the specific impact of viral pneumonia comorbid with insomnia on cortical morphology remains unclear. This study aimed to identify neural markers-specifically cortical grey matter volume (GMV), thickness, and surface area-in patients recovering from Omicron infection with and without insomnia. METHODS: In this prospective cross-sectional study, a total of 172 age-, sex-, and education-matched participants were finally analyzed (57 HCs, 64 Omicron_non_insomnia, and 51 Omicron_insomnia) during the Omicron pandemic (December 2022-May 2023). Insomnia symptoms were screened by a Pittsburgh Sleep Quality Index (PSQI) score > 5. Cortical morphology was evaluated using surface-based morphometry (SBM) analysis based on T1-weighted MPRAGE images. Morphological metrics were correlated with neuropsychiatric assessment scores. RESULTS: Viral pneumonia patients exhibited altered cortical morphology compared to HCs. Significant changes in the temporal, frontal, and cingulate gyrus, as well as the transverse collateral and lingual gyrus, were observed regardless of insomnia comorbidity. Notably, decreased cortical thickness in the left superior temporal gyrus (STG) was identified as a candidate imaging correlate of viral infection comorbid with insomnia. Furthermore, greater cortical size in these regions was significantly correlated with improved neuropsychiatric performance (all P < 0.05). CONCLUSIONS: Our findings delineate distinct patterns of cortical atrophy following Omicron infection and highlight STG thinning as a potential biomarker for insomnia-related CNS involvement. These neural markers provide insight into the mechanisms of post-viral neuropsychiatric sequelae and may guide clinical management and prognostic evaluation.
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