How psychotic symptoms, depressive symptoms, cognitive deficits, and functional impairment may interact with one another in schizophrenia or bipolar disorder is unclear.

This study explored these interactions in a discovery sample of 339 Chinese, of whom 146 had first-episode schizophrenia and 193 had bipolar disorder. Psychotic symptoms were assessed using the Positive and Negative Symptom Scale; depressive symptoms, using the Hamilton Depression Rating Scale; cognitive deficits, using tests of processing speed, executive function, and logical memory; and functional impairment, using clinical assessments. Network models connecting the four types of variables were developed and compared between men and women and between disorders. Potential causal relationships among the variables were explored through directed acyclic graphing. The results in the discovery sample were compared to those obtained for a validation sample of 235 Chinese, of whom 138 had chronic schizophrenia and 97 had bipolar disorder.

In the discovery and validation cohorts, schizophrenia and bipolar disorder showed similar networks of associations, in which the central hubs included ‘disorganized’ symptoms, depressive symptoms, and deficits in processing speed during the digital symbol substitution test. Directed acyclic graphing suggested that disorganized symptoms were upstream drivers of cognitive impairment and functional decline, while core depressive symptoms (e.g. low mood) drove somatic and anxiety symptoms.

Our study advocates for transdiagnostic, network-informed strategies prioritizing the mitigation of disorganization and depressive symptoms to disrupt symptom cascades and improve functional outcomes in schizophrenia and bipolar disorder.

Some adolescents can achieve academic success and maintain well-being despite their engagement in video gaming. Social factors may play a role in their vulnerability to mental health problems.

This study examined the role of perceived peer support and childhood experiences of optimal parenting in the association between video-gaming duration and depressive symptoms in adolescents.

A sample of 1071 adolescents (mean age 13.62 years, s.d. = 0.95) completed a questionnaire on video-game usage. Their perceptions of parental care and support since childhood were assessed using the Parental Bonding Instrument, whereas their perceived peer friend support was assessed using the friend support subscale of the Multidimensional Scale of Perceived Social Support. Their depressive symptoms were measured using the depression subscale of the Depression Anxiety Stress Scales. Moderated mediation analysis was conducted to examine the associations of these variables. Family socioeconomic status and symptoms of attention-deficit hyperactivity disorder were included as covariates.

Longer durations of video gaming were associated with higher levels of depressive symptoms. The role of perceived peer support in this association was moderated by childhood experiences of optimal parenting. Specifically, the mediating role of perceived friend support was significant only for adolescents who lacked optimal parenting.

The relationship between frequent video gaming and depressive symptoms in adolescents is complex and may depend on the levels of peer and parental support. Lacking support from both parents and peers can increase adolescents’ risk of depression associated with frequent video gaming.

This study employs a longitudinal network approach to investigate the dynamic relationships between COVID-19-related stressors and depressive symptoms among Canadian adults and to explore any sex and age differences in these associations.

The study utilised data from the Canadian Longitudinal Study on Ageing (CLSA), a large, national, long-term study of Canadian adults aged 45 years and older. Depressive symptoms were measured using the Centre for Epidemiologic Studies Depression Scale (CES-D), and COVID-19-related stressors were evaluated using a standardised stress inventory adapted for the pandemic context. The cross-lagged panel network analysis (CLPN) was employed to examine the temporal relationships and dynamic interactions between depressive symptoms and COVID-19-related stressors.

Significant variations in network structures and strengths were identified across demographic groups. Individuals aged between 45 and 65 years and females exhibited stronger connections between COVID-19-related stressors and depressive symptoms. Central symptoms such as “feeling unhappy” were consistent across groups, while “feeling depressed” was more central among males and “increased verbal or physical conflict” among females. Additionally, health-related stressors and family separation emerged as critical bridge symptoms for males and individuals under 65 years, respectively.

Both cross-sectional and longitudinal relationships, and directionality between COVID-19-related stressors and depressive symptoms across sex and age groups were identified. The findings of the study highlight that dedicated mental health intervention and prevention efforts are warranted to ameliorate the negative impact of stressors on depressive symptoms.

Research suggests there are alterations in the cortisol awakening response (CAR) in patients with premenstrual dysphoric disorder (PMDD), as demonstrated by delayed cortisol peaks and flatter diurnal cortisol slopes compared to healthy controls. While inconsistent, previous work also demonstrates a relation between alterations in CAR, prefrontal serotonin transporter (5-HTT) binding and severity of depressive symptoms.

This longitudinal study explores CAR in relation to midbrain and prefrontal 5-HTT binding and depressive symptoms in patients with PMDD and in healthy controls across the menstrual cycle.

Thirty patients with PMDD and 29 controls each provided 3 saliva samples for assessment of CAR (awakening, +30 min, +60 min) and 5 to assess the diurnal cortisol slope (09.00, 12.00, 15.00, 18.00, 21.00 h) during the periovulatory and premenstrual phases. [11C]DASB positron emission tomography scans were performed to measure 5-HTT non-displaceable binding potential (BPND). Depressive symptoms were assessed using the Hamilton Depression Rating Scale. Associations between cortisol measures, 5-HTT BPND and depressive symptoms were examined using linear mixed-effects models, independent t-tests, mixed analysis of variance (ANOVA) and Spearman rank correlations.

A significant interaction effect between group and cycle phase was found for cortisol peak concentrations (estimate = 0.78, p = 0.05, d = 0.62, 95% CI: [0.01, 1.56]; and corrected for awakening cortisol concentration: estimate = 0.90, p = 0.02, d = 0.77, 95% CI: [0.15, 1.66]). Cortisol peak concentrations correlated negatively with both midbrain 5-HTT BPND (r = −0.34, p < 0.01, R2 = 0.12) and depressive symptoms (r = −0.30, p = 0.02, R2 = 0.09) during the premenstrual phase.

Patients with PMDD showed attenuated cortisol peaks in the periovulatory phase compared with healthy controls, who demonstrated plastic changes across the cycle. Results point towards an interplay between the stress and the serotonergic system, as well as to the severity of depressive symptoms during the premenstrual phase.

Everyday functional capacity in older adults is influenced by several factors, with prior studies finding that cognition mediates the relationship between depression and everyday functioning. However, these studies utilized samples with low depression severity and used only one type of functional assessment. We aimed to examine whether cognition mediates the relationship between depression and functioning in older adults with a history of treatment-resistant depression.

Data from 383 participants enrolled in the OPTIMUM Neuro study were analyzed. Participants completed a neuropsychological assessment battery, depression severity interview, self-/informant-rated functioning measures and a performance-based functioning measure. Linear regression was used to determine whether depression scores predicted cognitive domain and everyday functioning scores. Cognitive domain scores predicted by depression were then tested as mediators between depression and functioning.

Higher depression symptoms predicted poorer performance on all measures of functioning as well as the cognitive domains of attention, executive functioning, and immediate memory. Immediate memory partially mediated the relationship between depression and a performance-based measure of functioning, while attention and executive functioning partially mediated the relationship between a self-report measure of functioning and depression.

The relationship between depression severity and poorer functional performance was partially mediated by attention, executive functioning, and immediate memory, with results differing based on the measure of functioning used. Our findings suggest that there may be additional non-cognitive factors influencing this relationship and highlight the importance of using multiple methods to assess functional performance.

Prior research indicates that both structural and functional networks are compromised in older adults experiencing depressive symptoms. However, the potential impact of abnormal interactions between brain structure and function remains unclear. This study investigates alterations in structural–functional connectivity coupling (SFC) among older adults with depressive symptoms, and explores how these changes differ depending on the presence of physiological comorbidities.

We used multimodal neuroimaging data (dMRI/rs-fMRI) from 415 older adults with depressive symptoms and 415 age-matched normal controls. Subgroups were established within the depressive group based on the presence of hypertension, hyperlipidemia, diabetes, cerebrovascular disease, and sleep disorders. We examined group and subgroup differences in SFC and tracked its alterations in relation to symptom progression.

Older adults with depressive symptoms showed significantly increased SFC in the ventral attention network compared with normal controls. Moreover, changes in SFC within the subcortical network, especially in the left amygdala, were closely linked to symptom progression. Subgroup analyses further revealed heterogeneity in SFC changes, with certain physiological health factors, such as metabolic diseases and sleep disorders, contributing to distinct neural mechanisms underlying depressive symptoms in this population.

This study identifies alterations in SFC related to depressive symptoms in older adults, primarily within the ventral attention and subcortical networks. Subgroup analyses highlight the heterogeneous SFC changes associated with metabolic diseases and sleep disorders. These findings highlight SFC may serve as potential markers for more personalized interventions, ultimately improving the clinical management of depression in older adults.

Depression runs in families, with both genetic and environmental mechanisms contributing to intergenerational continuity, though these mechanisms have often been studied separately. This study examined the interplay between genetic and environmental influences in the intergenerational continuity of depressive symptoms from parents to offspring.

Using data from the Dutch TRAILS cohort (n = 2201), a prospective, genetically informed, multiple-generation study, we examined the association between parents’ self-reported depressive symptoms (reported at mean age of 41 years) and offspring depressive symptoms, self-reported nearly two decades later, in adulthood (mean age: 29 years). We assessed the role of genetic (polygenic scores for depressive symptoms in parents and offspring) and environmental mechanisms (parental warmth during adolescence) in explaining intergenerational continuity of depressive symptoms in separate and combined models.

Parents’ depressive symptoms, offspring genetic predisposition, and parental warmth were associated with an increased risk of depressive symptoms in offspring. In the combined model, parents’ genetic predisposition was linked to their own depressive symptoms, which were linked to lower parental warmth, which, in turn, was linked to higher depressive symptoms in offspring, after accounting for offspring genetic predisposition, sex, age, and socioeconomic status.

Both genetic and environmental mechanisms contribute to the intergenerational continuity of depressive symptoms independently and in interplay. Despite a significant effect, the influence of parental warmth was modest, suggesting limited covariation between this particular parenting measure and depressive symptoms, at least when assessed with large temporal distance.

Self-harm is widespread and often occurs in the community without resulting in hospital presentation. Individuals with depressive symptoms are at elevated risk. There are limited self-harm interventions designed for community and primary care settings. The Community Outpatient Psychological Engagement Service for Self-harm (COPESS) is a brief talking therapy intervention for self-harm based in community settings.

To assess the feasibility of evaluating the COPESS intervention in a community setting in relation to participant recruitment, retention, data collection and the acceptability of the intervention.

We used a mixed-method approach and a single-blind randomised controlled trial design with 1:1 allocation to either COPESS plus treatment as usual or treatment as usual alone. Adults with depressive symptoms and self-harm in the past 6 months were recruited from general practices. Secondary outcome measures were assessed at baseline and 1 month, 2 months and 3 months after randomisation. The trial was pre-registered on clinicaltrials.gov (NCT04191122) on 9 December 2019.

Fifty-five people were randomised (of an initial target of 60). Retention rates at follow-up assessments were high (>75%), as was attendance by all participants for all therapy sessions (93%). At 3 months, there were trends towards lower levels of self-harm urges, depressive symptoms and distress in the COPESS group compared with controls. Fidelity to the manualised COPESS therapy was moderate to high.

All progression criteria were met, supporting further evaluation of the intervention in a full-scale efficacy and/or cost-effectiveness trial. These findings add to the growing evidence base supporting the utility of brief psychological interventions for self-harm. COPESS has potential as a brief primary-care-based intervention for those struggling with self-harm.

An association between second-hand smoke exposure and depressive symptoms has been reported; however, further research is needed for clarity.

This 20-year prospective cohort study aimed to longitudinally explore the relationships of smoking and second-hand smoke exposure with incident depressive symptoms in community-dwelling middle-aged and older adults.

Data of adults aged ≥40 years were collected from the National Institute for Longevity Sciences – Longitudinal Study of Aging database (third to ninth waves). Participants with baseline (third wave) depressive symptoms, missing data or no follow-up participation were excluded. Baseline data on current cigarette smoking and second-hand smoke exposure were collected. Depressive symptoms were defined as a Center for Epidemiologic Studies Depression Scale score ≥16. Generalised estimating equation models evaluated longitudinal relationships of smoking and second-hand smoke exposure with incident depressive symptoms.

The final analysis included 1697 participants (mean (s.d.) age, 58.7 (11.2) years; mean follow-up, 12.9 years). Depressive symptom incidence ranged from 8.0% (wave 4) to 6.5% (wave 9). Compared with non-current smokers, current smokers showed no significantly higher risk of incident depressive symptoms (multivariable-adjusted odds ratio (95% CI): 1.27 (0.96−1.68)). Subgroup analysis revealed higher risks in male current smokers (adjusted odds ratio (95% CI): 1.40 (1.00−1.94)) and current smokers aged ≥65 years (adjusted odds ratio (95% CI): 1.62 (1.00−2.63)). Current smokers exposed to second-hand smoke had a higher depressive symptom risk than unexposed non-smokers (odds ratio (95% CI): 1.50 (1.05−2.14)) and greater risk (odds ratio (95% CI): 1.39 (1.00−1.94)) than unexposed current smokers.

Smoking, combined with second-hand smoke exposure, is associated with future depressive symptoms in community-dwelling middle-aged and older adults.

Existing evidence on the association between combined lifestyle and depressive symptoms is limited to the general population and is lacking in individuals with subthreshold depression, a high-risk group for depressive disorders. Furthermore, it remains unclear whether an overall healthy lifestyle can mitigate the association between childhood trauma (CT) and depressive symptoms, even in the general population. We aimed to explore the associations of combined lifestyle, and its interaction with CT, with depressive symptoms and their subtypes (i.e. cognitive-affective and somatic symptoms) among adults with subthreshold depression.

This dynamic cohort was initiated in Shenzhen, China in 2019, including adults aged 18–65 years with the Patient Health Questionnaire-9 (PHQ-9) score of ≥ 5 but not diagnosed with depressive disorders at baseline. CT (present or absent) was assessed with the Childhood Trauma Questionnaire-Short Form. Combined lifestyle, including no current drinking, no current smoking, regular physical exercise, optimal sleep duration and no obesity, was categorized into 0–2, 3 and 4–5 healthy lifestyles. Depressive symptoms were assessed using the PHQ-9 during follow-up. This cohort was followed every 6 months, and as of March 2023, had been followed for 3.5 years.

This study included 2298 participants (mean [SD] age, 40.3 [11.1] years; 37.7% male). After fully adjusting for confounders, compared with 0–2 healthy lifestyles, 3 (β coefficient, −0.619 [95% CI, −0.943, −0.294]) and 4–5 (β coefficient, −0.986 [95% CI, −1.302, −0.671]) healthy lifestyles were associated with milder depressive symptoms during follow-up. There exists a significant synergistic interaction between a healthy lifestyle and the absence of CT. The CT-stratified analysis showed that compared with 0–2 healthy lifestyles, 3 healthy lifestyles were associated with milder depressive symptoms in participants with CT, but not in those without CT, and 4–5 healthy lifestyles were associated with milder depressive symptoms in both participants with and without CT, with a stronger association in those with CT. The lifestyle-stratified analysis showed that CT was associated with more severe depressive symptoms in participants with 0–2 healthy lifestyles, but not in those with 3 or 4–5 healthy lifestyles. Cognitive-affective and somatic symptoms showed similar results.

In this 3.5-year longitudinal study of adults with subthreshold depression, an overall healthy lifestyle was associated with subsequent milder depressive symptoms and their subtypes, with a stronger association in adults with CT than those without CT. Moreover, an overall healthy lifestyle mitigated the association of CT with depressive symptoms and their subtypes.

This study aimed to examine the relationship between fibroblast growth factor 19 (FGF19) and depressive symptoms, measured by Beck’s Depression Inventory (BDI) scores and investigate the moderating role of smoking.

This study involved 156 Chinese adult males (78 smokers and 78 non-smokers) from September 2014 to January 2016. The severity of depressive symptoms was evaluated using the BDI scores. Spearman rank correlation analyses were used to investigate the relationship between cerebrospinal fluid (CSF) FGF19 levels and BDI scores. Additionally, moderation and simple slope analyses were applied to assess the moderating effect of smoking on the relationship between the two.

FGF19 levels were significantly associated with BDI scores across all participants (r = 0.26, p < 0.001). Smokers had higher CSF FGF19 levels and BDI scores compared to non-smokers (445.9 ± 272.7 pg/ml vs 229.6 ± 162.7 pg/ml, p < 0.001; 2.7 ± 3.0 vs 1.3 ± 2.4, p < 0.001). CSF FGF19 levels were positively associated with BDI scores in non-smokers (r = 0.27, p = 0.015), but no similar association was found among smokers (r = −0.11, p = 0.32). Linear regression revealed a positive correlation between FGF19 and BDI scores (β = 0.173, t = 2.161, 95% CI: 0.015–0.331, p < 0.05), which was negatively impacted by smoking (β = −0.873, t = −4.644, 95% CI: −1.244 to −0.501, p < 0.001).

These results highlight the potential role of FGF19 in individuals at risk for presence of or further development of depressive symptoms and underscore the importance of considering smoking status when examining this association.

Inequality can increase the risk of poor mental health. Objective measures explain the effects of socioeconomic disparities, but individuals may perceive inequality differently.

We aimed to investigate the association between the perception of economic inequality and depressive symptoms and suicide ideation.

We used data from the Survey of Korean Youths’ Lives, a nationally representative cross-sectional study of 14 918 young adults aged 19−34 years in South Korea. Multivariate logistic regression analysis was conducted to assess the association between perceived economic inequalities (i.e. income inequality and inequality of intergenerational mobility) and depressive symptoms/suicide ideation. Additionally, subgroup analyses were performed based on objective and subjective income levels.

Young adults with a high perception of economic inequality were more likely to experience depressive symptoms and suicide ideation. For example, those with a high perception of intergenerational mobility inequality had higher odds of depressive symptoms (odds ratio 1.82, 95% CI 1.49, 2.23) and suicide ideation (odds ratio 1.87, 95% CI 1.35, 2.60). Statistical evidence showed no interaction between the perception of inequalities and income, suggesting that a high perception of inequalities is associated with depressive symptoms and suicidal ideation, regardless of income. Nevertheless, the strongest association with poor mental health was observed in those with high perceived inequality and low income.

This study shows that the way young adults perceive economic inequality could affect their depressive symptoms and suicidal ideation. The findings highlight the importance of reducing these perceptions and addressing economic inequalities to improve mental health.

Depression is a complex mental health disorder with highly heterogeneous symptoms that vary significantly across individuals, influenced by various factors, including sex and regional contexts. Network analysis is an analytical method that provides a robust framework for evaluating the heterogeneity of depressive symptoms and identifying their potential clinical implications.

To investigate sex-specific differences in the network structures of depressive symptoms in Asian patients diagnosed with depressive disorders, using data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3, which was conducted in 2023.

A network analysis of 10 depressive symptoms defined according to the National Institute for Health and Care Excellence guidelines was performed. The sex-specific differences in the network structures of the depressive symptoms were examined using the Network Comparison Test. Subgroup analysis of the sex-specific differences in the network structures was performed according to geographical region classifications, including East Asia, Southeast Asia, and South or West Asia.

A total of 998 men and 1,915 women with depression were analysed in this study. The analyses showed that all 10 depressive symptoms were grouped into a single cluster. Low self-confidence and loss of interest emerged as the most central nodes for men and women, respectively. In addition, a significant difference in global strength invariance was observed between the networks. In the regional subgroup analysis, only East Asian men showed two distinct clustering patterns. In addition, significant differences in global strength and network structure were observed only between East Asian men and women.

The study highlights the sex-specific differences in depressive symptom networks across Asian countries. The results revealed that low self-confidence and loss of interest are the main symptoms of depression in Asian men and women, respectively. The network connections were more localised in men, whereas women showed a more diverse network. Among the Asian subgroups analysed, only East Asians exhibited significant differences in network structure. The considerable effects of neurovegetative symptoms in men may indicate potential neurobiological underpinnings of depression in the East Asian population.

Young adulthood is a transitional period between childhood and adulthood characterised by unique stressors that increase the risk of food insecurity and poor mental health. This study examined the association between food insecurity and mental health outcomes among U.S. young adults aged 18–25.

A cross-sectional survey was completed by young adults between the ages of 18 and 25 years between January and April 2022. Key measures included food insecurity, perceived stress, anxiety, depressive symptoms and insomnia. Descriptive statistics and linear regression analyses were used to determine the prevalence of and associations between food insecurity and mental health outcomes, controlling for key demographic and social factors.

Online survey.

1630 U.S. young adults.

Among the analytic sample of 1041 young adults, nearly 70 % of participants identified as being food insecure in the last year. Participants reported moderate to high levels of perceived stress, anxiety, depressive symptoms and insomnia. Food insecurity was positively associated with each mental health outcome including perceived stress (β = 2·28, P< 0·01), anxiety (β = 2·84, P< 0·01), depressive symptoms (β = 2·74, P< 0·01) and insomnia (β = 1·28, P< 0·01) after controlling for all other factors.

Food insecurity is associated with mental health problems among young adults. Future efforts should explore the directionality of this relationship to determine if food insecurity initiates or exacerbates poor mental health outcomes or if poor mental health contributes to food insecurity. Interventions to improve food security status may also help support mental health among young adults.

The relationship between emotional symptoms and cognitive impairments in major depressive disorder (MDD) is key to understanding cognitive dysfunction and optimizing recovery strategies. This study investigates the relationship between subjective and objective cognitive functions and emotional symptoms in MDD and evaluates their contributions to social functioning recovery.

The Prospective Cohort Study of Depression in China (PROUD) involved 1,376 MDD patients, who underwent 8 weeks of antidepressant monotherapy with assessments at baseline, week 8, and week 52. Measures included the Hamilton Depression Rating Scale (HAMD-17), Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR16), Chinese Brief Cognitive Test (C-BCT), Perceived Deficits Questionnaire for Depression-5 (PDQ-D5), and Sheehan Disability Scale (SDS). Cross-lagged panel modeling (CLPM) was used to analyze temporal relationships.

Depressive symptoms and cognitive measures demonstrated significant improvement over 8 weeks (p < 0.001). Baseline subjective cognitive dysfunction predicted depressive symptoms at week 8 (HAMD-17: β = 0.190, 95% CI: 0.108–0.271; QIDS-SR16: β = 0.217, 95% CI: 0.126–0.308). Meanwhile, baseline depressive symptoms (QIDS-SR16) also predicted subsequent subjective cognitive dysfunction (β = 0.090, 95% CI: 0.003-0.177). Recovery of social functioning was driven by improvements in depressive symptoms (β = 0.384, p < 0.0001) and subjective cognition (β = 0.551, p < 0.0001), with subjective cognition contributing more substantially (R2 = 0.196 vs. 0.075).

Subjective cognitive dysfunction is more strongly associated with depressive symptoms and plays a significant role in social functioning recovery, highlighting the need for targeted interventions addressing subjective cognitive deficits in MDD.

Despite advances in antiretroviral treatment (ART), human immunodeficiency virus (HIV) can detrimentally affect everyday functioning. Neurocognitive impairment (NCI) and current depression are common in people with HIV (PWH) and can contribute to poor functional outcomes, but potential synergies between the two conditions are less understood. Thus, the present study aimed to compare the independent and combined effects of NCI and depression on everyday functioning in PWH. We predicted worse functional outcomes with comorbid NCI and depression than either condition alone.

PWH enrolled at the UCSD HIV Neurobehavioral Research Program were assessed for neuropsychological performance, depression severity (≤minimal, mild, moderate, or severe; Beck Depression Inventory-II), and self-reported everyday functioning.

Participants were 1,973 PWH (79% male; 66% racial/ethnic minority; Age: M = 48.6; Education: M = 13.0, 66% AIDS; 82% on ART; 42% with NCI; 35% BDI>13). ANCOVA models found effects of NCI and depression symptom severity on all functional outcomes (ps < .0001). With NCI and depression severity included in the same model, both remained significant (ps < .0001), although the effects of each were attenuated, and yielded better model fit parameters (i.e., lower AIC values) than models with only NCI or only depression.

Consistent with prior literature, NCI and depression had independent effects on everyday functioning in PWH. There was also evidence for combined effects of NCI and depression, such that their comorbidity had a greater impact on functioning than either alone. Our results have implications for informing future interventions to target common, comorbid NCI and depressed mood in PWH and thus reduce HIV-related health disparities.