Calidad de vida relacionada con la salud y los estados de ánimo en estudiantes de instituciones educativas de Antioquia, Colombia / Quality of life related to the health and mood states of students in educational institutions from Antioquia, Colombia / Qualidade de vida relacionada à saúde e ao humor em estudantes de instituições de ensino em Antioquia, Colômbia

Introducción: La calidad de vida relacionada con la salud (CVRS) y los estados de ánimo son indicadores cruciales del bienestar en adolescentes, pero su relación con estudiantes de Antioquia, Colombia, no ha sido ampliamente estudiada. Objetivo: Determinar la CVRS y los estados de ánimo en escolares de Antioquia-Colombia. Materiales y métodos: Estudio transversal con 1957 escolares de 9 a 20 años. Se aplicaron mediciones de CVRS, ansiedad, depresión, hostilidad y alegría, actividad física, comportamiento sedentario, apoyo social de padres y nivel socioeconómico. Resultados: La calidad de vida alta (CVA) es más elevada en hombres, personas con alegría, estudiantes con apoyo de padres, activos físicamente y personas de nivel socioeconómico alto y medio. AL aumentar un año de edad, disminuye en un 15 % la CVA, y al aumentar la depresión, la ansiedad y el comportamiento sedentario disminuye la CVA. Además, los niveles de depresión y ansiedad son mayores en mujeres, estudiantes mayores, sin apoyo de los padres y personas sedentarias. Conclusiones: La CVRS se asocia con estados de ánimo, actividad física, comportamiento sedentario y apoyo de los padres; mientras que los estados de ánimo se asocian con el sexo, el apoyo de los padres, la CVS y el sedentarismo.

Introduction: Even though health-related quality of life (HRQL) and mood states are key indicators of the well-being of adolescents, their relationship has not been analyzed in students from Antioquia, Colombia. Objective: To determine HRQL and mood states in schoolchildren from Antioquia. Materials and methods: A cross-sectional study was conducted on 1,957 schoolchildren and adolescents aged between 9 and 20 years. Measurements of HRQL, anxiety, depression, hostility and happiness, physical activity, sedentary behavior, parental social support, and socioeconomic status were applied. Results: A high quality of life (HQL) was observed more frequently in male participants, students with parental support, physically active, and those belonging to medium and high socioeconomic status. HQL decreased 15% as their age increased by one year. Also, HQL was reduced when depression, anxiety, and sedentary behavior increased. Furthermore, depression and anxiety levels were higher in women, older students, as well as in those without parental control and with sedentary behavior. Conclusions: HRQL is associated with mood states, physical activity, sedentary behavior, and parental support. In contrast, mood states are related to gender, parental support, HQL, and sedentary lifestyle.

Introdução: A qualidade de vida relacionada à saúde (CVRS) e os estados de humor são indicadores cruciais de bem-estar em adolescentes, mas sua relação com estudantes de Antioquia, Colômbia, não foi amplamente estudada. Objetivo: Determinar a CVRS e os estados de humor em escolares de Antioquia-Colômbia. Materiais e métodos: Estudo transversal com 1.957 escolares de 9 a 20 anos. Foram aplicadas medidas de QVRS, ansiedade, depressão, hostilidade e felicidade, atividade física, comportamento sedentário, apoio social dos pais e nível socioeconômico. Resultados: A alta qualidade de vida (CVA) é maior em homens, pessoas com alegria, estudantes com apoio parental, fisicamente ativos e pessoas de nível socioeconômico alto e médio. À medida que a idade aumenta em um ano, diminui em 15% o CVA, e ao aumentar a depressão, a ansiedade e o comportamento sedentário aumentam, o CVA diminui. Além disso, os níveis de depressão e ansiedade são mais elevados nas mulheres, nos estudantes mais velhos, sem apoio dos pais e nas pessoas sedentárias. Conclusões: A QVRS está associada a estados de humor, atividade física, comportamento sedentário e apoio parental; enquanto os estados de humor estão associados ao sexo, apoio parental, CVS e estilo de vida sedentário.

Mindfulness trait and the potential mediating role of emotional regulation strategies in bipolar disorder / Mindfulness rasgo y el potencial papel mediador de las estrategias de regulación emocional en el trastorno bipolar

En este estudio transversal se investiga la asociación entre los principales síntomas del Trastorno bipolar (TB) y las dificultades asociadas a las estrategias de regulación emocional (ERE) adaptativas y desadaptativas. Además, este estudio examina los efectos mediadores de las ERE con el mindfulness rasgo y el TB. Método. Veinticuatro adultos con TB completaron la Escala de Conciencia de Atención Plena (MAAS), el Inventario de Depresión de Beck (BDI-II), la Escala de Autoevaluación de Manía de Altman (ARSM), el Inventario de Ansiedad Rasgo (STAI-R), y el Cuestionario de Regulación Emocional Cognitiva (CERQ). Resultados. El análisis de regresión múltiple mostró cómo la depresión se relacionaba significativa y positivamente con la autoculpabilización, mientras que la ansiedad rasgo estaba positivamente asociada con la autoculpabilización y el catastrofismo. En segundo lugar, el análisis de mediación mostró un efecto de mediación significativo para la autoculpabilidad en la relación entre mindfulness y depresión (a*b = -.15; ICB 95% [-.36, -.03]) y entre mindfulness y ansiedad rasgo (a*b = -.09; ICB 95% [-.27, -.01]). Conclusiones. Nuestros resultados informan del papel de la auto-culpabilidad y el catastrofismo en el TB y de cómo éstas podrían mediar significativamente entre el mindfulness rasgo y el TB. Estos resultados sugieren que una práctica de meditación enfocada en el catastrofismo y la autoculpabilidad puede ser especialmente útil para reducir los síntomas en los pacientes bipolares.(AU)

This cross-sectional study investigates the association between the main symptoms of Bipolar disorder (BD) and emotional regulation dif-ficulties in adaptive and maladaptive emotional regulation strategies (ERS). In addition, this study examines the possible mediating effects of ERS with dispositional mindfulnessand bipolar symptoms. Method.Twenty-four adults diagnosed with BD completed the Mindful Attention Awareness Scale (MAAS), the Beck Depression Inventory (BDI-II), the Altman Mania Self-Assessment Scale (ARSM), the Trait Anxiety Inventory (STAI-R), and the Cognitive Emotional Regulation Questionnaire (CERQ). Results. First, mul-tiple regression analysis showed how depression was significantly positively related to self-blame, whereas trait anxietywas positively associated with self-blame and catastrophizing. Second, the results of the mediation analy-sis have shown a significant mediation effect for the self-blamein the rela-tionship between mindfulnessand depression (a*b = -.15; BCI 95% [-.36, -.03]) and between mindfulnessand trait anxiety (a*b = -.09; BCI 95% [-.27, -.01]). Conclusions. Our results report the role of self-blame and catastrophiz-ing in BD and how these might significantly mediate between dispositional mindfulness and symptoms of depression and anxiety. These results suggest that a meditation practice focused on reducing catastrophizing and self-blame may be especially helpful for symptoms of depression and anxiety in bipolar patients.(AU)

Factores de riesgo transdiagnósticos de los trastornos emocionales en adultos: una revisión sistemática / Transdiagnostic risk factors of emotional disorders in adults: A systematic review

La comorbilidad es más la regla que la excepción en salud mental y, sobre todo, en el caso de la ansiedad y la depresión. Los modelos transdiagnósticos estudian los procesos subyacentes para mejorar el tratamiento y la comprensión de la salud mental. Objetivo: Esta revisión sistemática busca evidencias sobre los factores de riesgo transdiagnósticos para la ansiedad y la depresión en la población clínica diagnosticada de estas condiciones psicopatológicas, analizando los diferentes tipos o categorías de factores identificados. Método: Se registró una revisión sistemática en PROSPERO (número de registro CRD42022370327) y se diseñó de acuerdo con las guías PRISMA-P. La calidad del estudio fue evaluada por dos revisores independientes con conocimiento del campo para reducir el posible sesgo. Resultados: Cincuenta y tres artículos fueron examinados y las variables transdiagnósticas fueron agrupadas en tres categorías: psicológicas, biológicas y socioculturales. Conclusiones: La categoría más estudiada fue la de variables psicológicas, en especial los procesos cognitivos, afecto negativo y neuroticismo, intolerancia a la incertidumbre, sensibilidad a la ansiedad. Los factores biológicos y socioculturales requieren más estudio para sustentar su enfoque transdiagnóstico.(AU)

Comorbidity is more the rule than the exception in mental health, specifically in the case of anxiety and depression. Transdiagnostic models studied the underlying processes to improve mental health treat-ment and understating. Objective:This systematic review searchs for evi-dence on transdiagnostic risk factors for anxiety and depression in the clin-ical population diagnosed with these psychopathological conditions, by an-alysing the different types or categories of factors identified.Methods:A sys-tematic review was registered in PROSPERO (registration number CRD42022370327) and was designed according to PRISMA-P guidelines. Two independent reviewers with field knowledge assessed the study quality to reduce bias.Results: Fifty-three articles were examined, and the transdi-agnostic variables were grouped into three categories: psychological, bio-logical, and sociocultural.Conclusions:The most studied category was that of psychological variables, especially cognitive processes, negative affect, and neuroticism, intolerance of uncertainty, anxiety sensitivity. Biological and sociocultural factors require more study to support their transdiagnos-tic approach.(AU)

Burden and Predictors of Depression in Populations With Coronary Heart Disease.

INTRODUCTION: Depression significantly impacts the quality of life and medical care in patients with coronary heart disease (CHD). This study assesses the burden of depression in adults aged 40 years and above with CHD and evaluates predictors of depression in this population. It has been reported that approximately 17-44% of persons with CHD have a major depression diagnosis and that nearly 27% of individuals undergoing coronary artery bypass graft operation suffer depression following the procedure.  Methods: Data from the 2022 National Health Interview Survey was used. The sample was made up of adults 40 years and above with CHD. A chi-square analysis was used to identify differences between those who were depressed and those who were not. Logistic and ordinal regression analyses were used to identify predictors of depression and severe depression, respectively. RESULTS: The proportion of adults 40 years and above with CHD who reported having depression was 863/1700 (50.5%). Among those who were ≥65, the proportion of those who reported depression and those who did not were similar (49.3% vs. 50.7%). Most women reported having depression (57.4% vs. 42.6%), while fewer men reported having depression (46.3% vs. 53.7%). The positive predictors of depression include being insured (odds ratio (OR) 1.26 (1.05-1.53), p = 0.016), college degree (OR 1.09 (1.01-1.18), p = 0.040), diabetes mellitus (OR 1.28 (1.15-1.42), p < 0.001), and hypertension (OR 1.34 (1.24-1.44), p < 0.001). The negative predictors of being depressed were age ≥65 (OR 0.74 (0.69-0.80), p < 0.001), male sex (OR 0.54 (0.50-0.58), p < 0.001), and ratio of family income (RFI) ≥1 (OR 0.68 (0.61-0.77), p < 0.001). The positive predictors of severe depression include diabetes mellitus (OR 1.38 (1.06-1.81), p = 0.019) and current cigarette use (OR 2.10 (1.44-3.07), p < 0.001). CONCLUSION: A significant proportion of adults 40 years and above with CHD have depression, and socioeconomic and cardiovascular risk factors are associated with a high likelihood of depression. Cardiovascular risk factors alone predict the likelihood of severe depression. Interventions to address depression in CHD should target specifically these high-risk individuals.

Evaluation of systemic immune inflammation index and neutrophil-to-lymphocyte ratio in schizophrenia, bipolar disorder and depression.

OBJECTIVES: Numerous studies consistently report on the frequent presence of low-grade systemic inflammation in individuals with schizophrenia, bipolar disorder (BD), and depression. Neutrophil-to-lymphocyte ratio (NLR) and a recently established marker, systemic immune inflammation index (SII), are markers used to assess systemic inflammation and immune response. In this study, NLR and SII index values were examined and compared across patients diagnosed with major psychiatric disorders and healthy controls. METHODS: The study included, totaling 129 patients, encompassed individuals who were diagnosed with schizophrenia in remission or BD in the euthymic period, and those undergoing treatment for major depressive disorder (MDD). The control group consisted of 62 healthy individuals. White blood cell (WBC), neutrophil, lymphocyte, platelet, and monocyte counts obtained retrospectively from complete blood profiles served as the basis for calculating NLR and SII values. RESULTS: In this study, higher WBC, neutrophil counts, NLR, and SII values were observed in schizophrenia and BD patients compared to the control group. In patients with MDD, no significant difference was found in terms of inflammatory blood cell markers compared to healthy controls. Higher NLR and SII values were found in patients with schizophrenia and BD compared to patients with MDD. CONCLUSION: The results of the study indicate that the significant difference in NLR and SII values persists after treatment in patients with schizophrenia and BD, and that the abnormal inflammatory response continues during the treatment process (Tab. 2, Ref. 41).

The association of the Prime Diet Quality Score (PDQS) with depression and anxiety symptoms: the Isfahan functional disorders (ISFUN) cohort study.

Background: Due to scarce epidemiologic data regarding the Prime Diet Quality Score (PDQS) and mental health disorders, this study aimed to investigate the association of PDQS with depression and anxiety symptoms in Iranian adults.Methods: This cross-sectional analysis was performed using the baseline data collected for the Isfahan functional disorders (ISFUN) cohort study. ISFUN was established in 2017 and enrolled apparently healthy adults, aged 18-65 years in Isfahan, Iran. Information on usual dietary intakes was collected using a validated Dish-based, 106-item food frequency questionnaire. The severity of depression and anxiety was assessed using a validated Iranian version of the Hospital Anxiety and Depression Scale.Results: A total number of1892 participants were enrolled in the present study. In total, 54.50% of subjects were female. In the fully adjusted model, participants with PDQS lower than median compared with those with PDQS higher than median had higher risk of depression (OR = 1.62; 95% CI: 1.11, 2.37) and anxiety (OR: 1.57; 95% CI: 1.08, 2.27). In stratified analysis by sex, males with PDQS lower than median compared with those with PDQS higher than median had greater risk for depressive (OR: 1.57) and anxiety symptoms (OR = 1.52). However, in females, no significant association was found between PDQS and odds of depression, and anxiety in the fully adjusted model.Conclusion: We found evidence indicating a significant inverse association between PDQS and depression and anxiety symptoms among Iranian adults. Further studies, in particular with prospective design, are required to confirm these findings.

Burnout syndrome among preschool teachers in Serbia.

Pedagogical work, especially with preschool children, is one of the most stressful professions, and the incidence of stress-related illnesses among preschool teachers is higher than in the general population. The aim of this cross-sectional study, conducted between October 2018 and April 2019, was to examine the prevalence of the burnout syndrome in a representative sample of 482 preschool teachers in Serbia and the factors associated with it. For this purpose, the participants completed a questionnaire composed of six sections: the socio-demographic and socio-economic characteristics, health and lifestyle characteristics, workplace and employment characteristics; Copenhagen Burnout Inventory (CBI); Beck Depression Inventory (BDI), and the Zung Self-Rating Anxiety Scale (SAS). The frequency of the total burnout was 27.1 %. The frequency of burnout on the CBI was 25.4 % for personal burnout, 27.0 % for work-related burnout, and 23.4 % for client-related burnout. Multivariate logistic regression analysis with total burnout as an outcome variable showed that being single (OR: 0.18; 95 % CI: 0.05-0.58), having poor (OR: 6.05; 95 % CI: 1.05-34.91), or average (OR: 3.60; 95 % CI: 1.57-8.25) self-rated health, not having didactic/play tools (OR: 2.71; 95 % CI: 1.21-6.04), having a higher score on the BDI (OR: 1.19; 95 % CI: 1.09-1.29) or SAS (OR: 1.10; 95 % CI: 1.03-1.18) was significantly associated with the total burnout among our participants. Our study shows the worryingly high prevalence of the burnout syndrome among preschool teachers in Serbia and points to its association with mental health issues, depression, and anxiety.

Reward positivity moderates the association between pubertal status and social anxiety symptoms in nine-to-12-year-old youths.

The transition to adolescence is characterized by rapid development of puberty, reward processing, and internalizing psychopathology (i.e., depression and anxiety). More advanced pubertal status and altered reward processing are both known to be associated with elevated internalizing symptoms. However, it was unclear to what extent pubertal status and reward processing interacted with each other in predicting internalizing psychopathology. We examined how the puberty-psychopathology association was moderated by the reward processing indexed by ERPs, including the reward positivity (RewP) and the late positive potential (LPP). A-hundred-and-fifteen nine-to-12-year-old typically developing youths (66 girls; Mean age/SD =10.98/1.18 years) reported their pubertal status and symptoms of depression and social anxiety and completed an EEG Doors task that assessed monetary reward feedback processing. A principal component analysis of the ERP data identified a RewP, an anterior LPP, and a posterior LPP, elicited by the win and loss feedback of the task. The puberty-social anxiety relationship was moderated by the RewP, an identified neural marker of reward sensitivity. Specifically, more advanced puberty was associated with heightened social anxiety symptoms in the presence of a larger, but not smaller, RewP. We did not observe any moderating effect of the LPPs. Our study provided novel evidence that a hypersensitivity toward the reward stimuli (indexed by an enlarged RewP) further exacerbated the risks associated with more advanced pubertal status for social anxiety.

Effects of subchronic and mild social defeat stress on the intestinal microbiota and fecal bile acid composition in mice.

The gut microbiota plays a crucial role in both the pathogenesis and alleviation of host depression by modulating the brain-gut axis. We have developed a murine model of human depression called the subchronic and mild social defeat stress (sCSDS) model, which impacts not only behavior but also the host gut microbiota and gut metabolites, including bile acids. In this study, we utilized liquid chromatography/mass spectrometry (LC/MS) to explore the effects of sCSDS on the mouse fecal bile acid profile. sCSDS mice exhibited significantly elevated levels of deoxycholic acid (DCA) and lithocholic acid (LCA) in fecal extracts, leading to a notable increase in total bile acids and 7α-dehydroxylated secondary bile acids. Consequently, a noteworthy negative correlation was identified between the abundances of DCA and LCA and the social interaction score, an indicator of susceptibility in stressed mice. Furthermore, analysis of the colonic microbiome unveiled a negative correlation between the abundance of CDCA and Turicibacter. Additionally, DCA and LCA exhibited positive correlations with Oscillospiraceae and Lachnospiraceae but negative correlations with the Eubacterium coprostanoligenes group. These findings suggest that sCSDS impacts the bidirectional interaction between the gut microbiota and bile acids and is associated with reduced social interaction, a behavioral indicator of susceptibility in stressed mice.

Association between the triglyceride glucose index and depression: a meta-analysis.

Background: Obesity and diabetes have been associated with depressive symptoms. The aim of this systematic review and meta-analysis was to evaluate the association between the triglyceride glucose index (TyG index) a novel indicator of insulin resistance (IR) and depression in the adult population. Methods: Relevant observational studies were acquired through comprehensive searches of the Medline, Web of Science, Embase, Wanfang, and China National Knowledge Internet databases. To account for heterogeneity, a random-effects model was employed to combine the findings. Additionally, multiple subgroup analyses were conducted to assess the impact of various study characteristics on the outcome. Results: The meta-analysis comprised eight datasets from six cross-sectional studies, encompassing a total of 28,973 adults. The pooled findings suggested that subjects with a high TyG index, compared to those with a low TyG index, were associated with a higher prevalence of depression (odds ratio [OR]: 1.41, 95% confidence interval (CI): 1.28-1.56, p<0.001; I2 = 19%). Sensitivity analyses, by omitting one dataset at a time, showed consistent results (OR: 1.39-1.45, p<0.05). Further subgroup analyses showed consistent results in participants aged <50 years old and in those aged ≥50 years old, in men and in women, in studies with different cutoff values for the TyG index, and in studies with different methods for the diagnosis of depression (for each subgroup difference, p>0.05). Conclusion: A high TyG index may be associated with a higher prevalence of depression in the adult population.

Strict association between development of psychological conditions and hypertension incidence: A cross-sectional study.

Background/Aims: Previous studies indicated a significant association between mental disorders and cardiovascular diseases, including heart failure (HF) and coronary artery disease (CAD) with comorbidity hypertension (HTN), and vice versa, leading to a challenge in the final decision. To resolve this issue, we aimed to exclude comorbidities and further assessed to better find any association between mental disorders and cardiovascular diseases (CVD). Methods: The cross-sectional study involved 300 participants: 100 with HTN (without HF or CAD), 100 with HF (without HTN or CAD), 100 with CAD (without HTN or HF), and 100 healthy individuals as a control group. To evaluate depression, anxiety, and stress levels, the Depression, Anxiety, and Stress Scale - 21 (DASS-21) was applied. For further analysis, the SPSS ver.20 was used. Results: The analysis showed that the score of depression, anxiety, and stress was higher in the HTN patients compared to the control (p < 0.001), CAD (p < 0.001), and HF (p < 0.001) groups, respectively. However, no significant differences were observed between the other study groups. Notably, patients with HF and CAD without concurrent HTN had similar psychological distress levels to healthy participants. Conclusion: The present study emphasized the higher prevalence of psychological distress in HTN patients and suggests a requirement for further research regarding the etiology involved in this association.

Immediate and long-term electrophysiological biomarkers of antidepressant-like behavioral effects after subanesthetic ketamine and medial prefrontal cortex deep brain stimulation treatment.

Introduction: Both ketamine (KET) and medial prefrontal cortex (mPFC) deep brain stimulation (DBS) are emerging therapies for treatment-resistant depression, yet our understanding of their electrophysiological mechanisms and biomarkers is incomplete. This study investigates aperiodic and periodic spectral parameters, and the signal complexity measure sample entropy, within mPFC local field potentials (LFP) in a chronic corticosterone (CORT) depression model after ketamine and/or mPFC DBS. Methods: Male rats were intraperitoneally administered CORT or vehicle for 21 days. Over the last 7 days, animals receiving CORT were treated with mPFC DBS, KET, both, or neither; then tested across an array of behavioral tasks for 9 days. Results: We found that the depression-like behavioral and weight effects of CORT correlated with a decrease in aperiodic-adjusted theta power (5-10 Hz) and an increase in sample entropy during the administration phase, and an increase in theta peak frequency and a decrease in the aperiodic exponent once the depression-like phenotype had been induced. The remission-like behavioral effects of ketamine alone correlated with a post-treatment increase in the offset and exponent, and decrease in sample entropy, both immediately and up to eight days post-treatment. The remission-like behavioral effects of mPFC DBS alone correlated with an immediate decrease in sample entropy, an immediate and sustained increase in low gamma (20-50 Hz) peak width and aperiodic offset, and sustained improvements in cognitive function. Failure to fully induce remission-like behavior in the combinatorial treatment group correlated with a failure to suppress an increase in sample entropy immediately after treatment. Conclusion: Our findings therefore support the potential of periodic theta parameters as biomarkers of depression-severity; and periodic low gamma parameters and cognitive measures as biomarkers of mPFC DBS treatment efficacy. They also support sample entropy and the aperiodic spectral parameters as potential cross-modal biomarkers of depression severity and the therapeutic efficacy of mPFC DBS and/or ketamine. Study of these biomarkers is important as objective measures of disease severity and predictive measures of therapeutic efficacy can be used to personalize care and promote the translatability of research across studies, modalities, and species.

Psychometric validation of the Montgomery-åsberg Depression Rating Scale - Youth (MADRS-Y) in a clinical sample.

BACKGROUND: Depression in adolescence is a serious major global health problem with increasing rates of prevalence. Measures of depression that are valid for young people are clearly needed in clinical contexts. METHODS: The study included 577 patients from child and adolescent psychiatry (n = 471) and primary care (n = 106) aged 12-22 years in Sweden (Mage=16.7 years; 76% female). The reliability and validity for Montgomery-Åsberg Depression Rating Scale - Youth (MADRS-Y) were investigated. To confirm the latent structure, we used a single-factor confirmatory factor analysis (CFA). A Kruskal-Wallis test was performed to test total score differences between diagnostic groups. Using Spearman's rho correlations, we examine whether single items in the MADRS-Y correlate with suicidal ideation measured by The Suicidal Ideation Questionnaire-JR (SIQ-JR). RESULTS: The internal consistency using McDonald's coefficient omega was excellent. The CFA of the 12-item MADRS-Y supported a one factor structure. Evidence of convergent and discriminant validity was shown. There was a significant difference in MADRS-Y scores across diagnostic groups, with higher results for depressive disorders. A strong correlation with suicidal ideation was found for two items. CONCLUSIONS: The results support MADRS-Y as a brief, reliable, and valid self-report questionnaire of depressive symptoms for young patients in a clinical setting.

The Association Between Depressive Symptoms and the Weekly Duration of Physical Activity Subset by Intensity and Domain: Population-Based, Cross-Sectional Analysis of the National Health and Nutrition Examination Survey From 2007 to 2018.

BACKGROUND: Prior literature suggests a dose-response relationship between physical activity (PA) and depressive symptoms. The intensity and domain of PA are suggested to be critical to its protective effect against depression; however, existing literature has shown mixed results. OBJECTIVE: The purpose of this population-based study is to examine the associations between depressive symptoms and weekly duration of (1) total PA and (2) PA subset by intensity, domain, or both. METHODS: A cross-sectional analysis of National Health and Nutrition Examination Survey data from 2007 to 2018 was conducted using multivariable logistic and linear regression models and survey weights. Participants (N=29,730) were 20 years and older and completed the Physical Activity Questionnaire and Depression Screener. The primary outcome was the presence of depressive symptoms, and the secondary outcomes were cognitive-affective and somatic symptoms of depression. RESULTS: Participants (N=29,730) had a weighted mean age of 47.62 (SD 16.99) years, and 15,133 (51.34%) were female. On average, participants without depressive symptoms engaged in 10.87 hours of total PA per week, whereas participants with depressive symptoms engaged in 8.82 hours (P<.001). No significant associations were seen between the weekly duration of total PA and depressive symptom odds, somatic, or cognitive-affective symptoms (all P>.05). Participants with an increased weekly duration of recreational PA had decreases in depressive symptom odds (adjusted odds ratio [aOR] 0.965, 95% CI 0.944-0.986) and in somatic (adjusted coefficient [aß]=-0.016, 95% CI -0.022 to -0.009) and cognitive-affective (aß=-0.015, 95% CI -0.023 to -0.007) symptoms. When recreational PA was subset by intensity, participants with an increased weekly duration of vigorous-intensity recreational PA had decreases in depressive symptom odds (aOR 0.926, 95% CI 0.883-0.972) and in somatic (aß=-0.021, 95% CI -0.032 to -0.010) and cognitive-affective (aß=-0.022, 95% CI -0.035 to -0.009) symptoms. However, significant associations were not seen for the weekly duration of work-related, moderate- or vigorous-intensity PAs (all P>.05). CONCLUSIONS: Findings suggest that recreational, not work-related PA is associated with reduced symptoms of depression. Future studies should explore the impact of the different types and contexts of PA on depressive symptomatology.

Network analysis of the urban-rural differences in depressive symptoms among older adults with multiple chronic conditions: Evidence from a national survey.

BACKGROUND: Evidence on the differences in depressive symptoms among older adults with multiple chronic conditions (MCCs) in urban and rural areas is limited. METHODS: Measures of depressive symptoms (Center for Epidemiologic Studies Depression Scale-10) and demographic factors (age, gender, and urban-rural distribution) were used. RESULTS: A total of 4021 older adults with MCCs were included in this study. Significant differences were observed in both network global strength (Urban: 3.989 vs. Rural: 3.703, S = 0.286, p = 0.003) and network structure (M = 0.139, p = 0.002) between urban and rural residents. CONCLUSIONS: The study highlights the need for region-specific approaches to understanding and addressing depression and holds the potential to enhance understanding of the psychological health status of older adults with MCCs in urban and rural settings.

Predictors of treatment outcome of psychological therapies for common mental health problems (CMHP) in older adults: A systematic literature review.

Identifying factors that impact psychological treatment outcomes in older people with common mental health problems (CMHP) has important implications for supporting healthier and longer lives. The aim of the present study was to synthesise the evidence on predictors of psychological treatment outcomes in older people (aged 65+). PubMed, Scopus, Web of Science and PsycINFO were searched and 3929 articles were identified and screened, with 42 studies (N = 7978, M age = 68.9, SD age = 2.85) included: depression: k = 21, anxiety: k = 11, panic disorder: k = 3, mixed anxiety & depression: k = 3, PTSD: k = 2, various CMHP: k = 2, with CBT being the most common treatment (71%). The review identified 28 factors reported as significant predictors of treatment outcome in at least one study, across different domains: psychosocial (n = 9), clinical (n = 6), treatment-related (n = 6), socio-demographic (n = 4), neurobiological (n = 3). Homework completion was the most consistent predictor of positive treatment outcome. Baseline symptom severity was the most frequently studied significant predictor and across all conditions, with higher baseline symptom severity largely linked to worse treatment outcomes. No significant effects on treatment outcome were reported for gender, income and physical comorbidities. For a large majority of factors evidence was mixed or inconclusive. Further studies are required to identify factors affecting psychological treatment outcomes, which will be important for the development of personalised treatment approaches.

Cross-sectional and longitudinal associations between late-life depressive symptoms and cognitive deficits: 20-year follow-up of the Kuakini Honolulu-Asia aging study.

OBJECTIVE: To examine depressed affect, somatic complaints, and positive affect as longitudinal predictors of fluid, crystallized and global cognitive performance in the Kuakini Honolulu-Asia Aging Study (HAAS), a large prospective cohort study of Japanese-American men. METHODS: We assessed 3,088 dementia-free Kuakini-HAAS participants aged 71-93 (77.1 ± 4.2) years at baseline (1991-1993). Depressive symptoms were evaluated by the Center for Epidemiologic Studies Depression (CES-D) Scale. Baseline CES-D depression subscales (depressed and positive affects; somatic complaints) were computed. The Cognitive Abilities Screening Instrument (CASI) measured cognitive performance on a 100-point scale; fluid and crystallized cognitive abilities were derived from CASI factor analysis. Cognition was also evaluated at 4 follow-up examinations over a 20-year period. Multiple regression assessed baseline CES-D subscales as predictors of cognitive change. The baseline covariates analyzed were CASI, age, education, prevalent stroke, APOE ε4 presence, and the longevity-associated FOXO3 genotype. RESULTS: Cross-sectionally, baseline CES-D subscales were related to cognitive measures; e.g., higher depressed affect was associated with lower crystallized ability (ß = -0.058, p ≤ 0.01), and somatic complaints were linked to poorer fluid ability (ß = -0.045, p ≤ 0.05) and to worse global cognitive function as measured by total CASI score (ß = -0.038, p ≤ 0.05). However, depression subscales did not significantly or consistently predict fluid ability, crystallized ability, or global cognitive performance over time. CONCLUSION: Psychological and physical well-being were associated with contemporaneous but not subsequent cognitive functioning. Assessment of depressive symptoms may identify individuals who are likely to benefit from interventions to improve mood and somatic health and thereby maintain or enhance cognition.

Self-reported suicidal ideation among individuals with first episode psychosis and healthy controls: Findings from the international multicentre EU-GEI study.

INTRODUCTION: Suicidal ideation is common among individuals with first episode psychosis (FEP), with prevalence estimates up to 56.5 %. Despite its high prevalence, relatively little is known about how sociodemographic, clinical and/or developmental characteristics contribute to the experience of suicidal ideation in individuals with FEP. METHODS: In this cross-sectional study (FEP n = 551 and controls n = 857), univariate logistic regression analyses were performed to study the associations of sociodemographic, clinical, and developmental factors with suicidal ideation in individuals with FEP as well as controls. Suicidal ideation was assessed using the Community Assessment of Psychic Experiences (CAPE). In addition, multivariate logistic regression analyses were conducted based on a stepwise approach. RESULTS: In FEP, only depressive symptoms remained significantly associated with suicidal ideation when all correlates were integrated into one model. In the multivariate model in controls, depressive symptoms, positive symptoms, and traumatic childhood experiences were significantly associated with suicidal ideation. CONCLUSIONS: This study showed that depressive symptoms are an important factor relating to suicidal ideation in individuals with FEP, over and above other clinical, sociodemographic, and developmental factors. This underscores the relevance of screening for suicidal ideation in individuals with FEP, and highlights the need for a better understanding of the diagnostic uncertainty and course of mood symptoms in early psychosis. LIMITATIONS: Cross-sectional study design, self-reported questionnaires.

Should rTMS be considered a first-line treatment for major depressive episodes in adults?

Treatment-resistant depression (TRD) is an epidemic with rising social, economic, and political costs. In a patient whose major depressive episode (MDE) persists through an adequate antidepressant trial, insurance companies often cover alternative treatments which may include repetitive transcranial magnetic stimulation (rTMS). RTMS is an FDA-cleared neuromodulation technique for TRD which is safe, efficacious, noninvasive, and well-tolerated. Recent developments in the optimization of rTMS algorithms and targeting have increased the efficacy of rTMS in treating depression, improved the clinical convenience of these treatments, and decreased the cost of a course of rTMS. In this opinion paper, we make a case for why conventional FDA-cleared rTMS should be considered as a first-line treatment for all adult MDEs. RTMS is compared to other first-line treatments including psychotherapy and SSRIs. These observations suggest that rTMS has similar efficacy, fewer side-effects, lower risk of serious adverse events, comparable compliance, the potential for more rapid relief, and cost-effectiveness. This suggestion, however, would be strengthened by further research with an emphasis on treatment-naive subjects in their first depressive episode, and trials directly contrasting rTMS with SSRIs or psychotherapy.