Sleep disturbances and psychomotor retardation in the prediction of cognitive impairments in patients with major depressive disorder

BACKGROUND Symptoms of depression and comorbid anxiety are known risk factors for cognitive impairment in major depressive disorder(MDD).Understanding their relationships is crucial for developing targeted interventions to mitigate cognitive impairments in MDD patients.We expect that the severity of sleep disturbances and other depressive symptoms will be positively correlated with the degree of cognitive impairments.We also hypothesize that anxiety symptoms,especially psychic anxiety,is a key factor in predicting cognitive performance in MDD patients and may indirectly contribute to cognitive impairment by affecting sleep disturbances and other potential factors.AIM To determine which dimension of the depressive and anxiety symptoms predicts cognitive impairment during a depressive episode.METHODS A comprehensive neurocognitive test battery assessed executive function,attention,processing speed,and memory in 162 medication-free MDD patients and 142 matched healthy controls.The 24-item Hamilton Depression Rating Scale was used to assess depressive symptoms,and the 14-item Hamilton Anxiety Scale was used to assess anxiety symptoms.Linear regression analyses and mediation analyses were conducted to evaluate the impact of depressive and anxiety symptoms,as well as their interactions,on cognitive impairments.RESULTS Among the depressive symptoms,sleep disturbances were associated with poorer executive function(P=0.004),lower processing speed(P=0.047),and memory impairments(P<0.001),and psychomotor retardation(PR)was associated with lower processing speed in patients with MDD(P=0.019).Notably,PR was found to mediate the impact of sleep disturbances on the processing speed.Regarding anxiety symptoms,psychic anxiety,rather than somatic anxiety,was associated with cognitive impairments in all aspects.Sleep disturbances mediated the effect of psychic anxiety on executive function[β=-0.013,BC CI(-0.027,-0.001)]and memory[β=-0.149,BC CI(-0.237,-0.063)],while PR mediated its effect on processing speed(β=-0.023,BC CI(-0.045,-0.004)].CONCLUSION Sleep disturbances may be a key predictor of poorer executive function,lower processing speed,and memory loss,while PR is crucial for lower processing speed during a depressive episode.Psychic anxiety contributes to all aspects of cognitive impairments,mediated by sleep disturbances and PR.

Peripheral mitochondrial DNA as a neuroinflammatory biomarker for major depressive disorder

In the pathogenesis of major depressive disorder, chronic stress-related neuroinflammation hinders favorable prognosis and antidepressant response. Mitochondrial DNA may be an inflammatory trigger, after its release from stress-induced dysfunctional central nervous system mitochondria into peripheral circulation. This evidence supports the potential use of peripheral mitochondrial DNA as a neuroinflammatory biomarker for the diagnosis and treatment of major depressive disorder. Herein, we critically review the neuroinflammation theory in major depressive disorder, providing compelling evidence that mitochondrial DNA release acts as a critical biological substrate, and that it constitutes the neuroinflammatory disease pathway. After its release, mitochondrial DNA can be carried in the exosomes and transported to extracellular spaces in the central nervous system and peripheral circulation. Detectable exosomes render encaged mitochondrial DNA relatively stable. This mitochondrial DNA in peripheral circulation can thus be directly detected in clinical practice. These characteristics illustrate the potential for mitochondrial DNA to serve as an innovative clinical biomarker and molecular treatment target for major depressive disorder. This review also highlights the future potential value of clinical applications combining mitochondrial DNA with a panel of other biomarkers, to improve diagnostic precision in major depressive disorder.

Marital Status as a Moderator:Exploring the Relationship between Social Engagement and Depressive Symptoms in China’s Older Adult Population

Objective This study aims to explore the complex relationship between social engagement and depressive symptoms among older adults in China,focusing particularly on the moderating role of marital status.Methods This study used data from the latest Chinese Longitudinal Healthy Longevity Survey(CLHLS).The analysis used the latent class analysis to delineate personality clusters and hierarchical linear regression,supplemented by the PROCESS macro,to investigate the effects of social engagement and marital status on depressive symptoms.Results The analysis encompassed 7,789 respondents(mean age:82.53[s=11.20]years),with 54%female.The personality analysis categorized participants into four clusters,with the majority(77.60%)classified as Confident Idealists,who exhibited the lowest levels of depressive symptoms.Hierarchical linear regression analysis yielded several significant findings:Higher levels of social engagement were significantly associated with fewer depressive symptoms(t=-7.932,P<0.001,B=-0.463).Marital status was a significant factor;married individuals reported fewer depressive symptoms compared to their unmarried counterparts(t=-6.368,P<0.001,B=-0.750).There was a significant moderating effect of marital status on the relationship between social engagement and depressive symptoms(t=-2.092,P=0.037,B=-0.217).Conclusion This study demonstrates that,among Chinese older adults,both social engagement and marital status significantly influence depressive symptoms.Higher social engagement,particularly in other activities like doing household chores,gardening,reading newspapers or books,and playing cards or Mahjong,is associated with fewer depressive symptoms,especially among married individuals.

Relationship between serum neutrophil gelatinase-associated lipocalin levels and cognitive impairment, anxiety, and depressive symptoms in acute ischemic stroke

BACKGROUND Acute ischemic stroke(AIS)is a significant global health issue with increasing incidence owing to aging populations and rising cardiovascular risk factors.In addition to physical impairments,AIS frequently leads to neuropsychiatric co-mplications,such as cognitive impairment,anxiety,and depressive symptoms,which adversely affect patients’quality of life and rehabilitation.Neutrophil ge-latinase-associated lipocalin(NGAL)has emerged as a potential biomarker for various conditions,including AIS.This study investigated the association bet-ween serum NGAL levels at admission and neuropsychiatric complications in patients with AIS.neuropsychiatric complications in patients with AIS.METHODS Between January 2022 and December 2023,150 patients with AIS were enrolled.Serum NGAL levels were measured at admission using an enzyme-linked immu-nosorbent assay.Cognitive function was assessed using the Mini-Mental State Examination,while anxiety and depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale at discharge.The relationship between serum NGAL levels and cognitive impairment,anxiety,and depressive symptoms was analyzed using multivariate logistic regression,adjusted for potential con-founders of age,sex,body mass index,smoking status,hypertension,diabetes mellitus,dyslipidemia,previous stroke,and stroke severity.RESULTS The mean age of the participants was 65.4±10.2 years,and 58%were males.Prevalence rates of cognitive impairment,anxiety,and depressive symptoms at discharge were 34.7%,28.0%,and 32.0%,respectively.Serum NGAL levels were significantly higher in patients with cognitive impairment(median:5.6 ng/mL vs 3.2 ng/mL,P<0.001),anxiety(median:5.1 ng/mL vs 3.5 ng/mL,P=0.002),and depressive symptoms(median:5.4 ng/mL vs 3.3 ng/mL,P<0.001),compared to those without these conditions.Multivariate logistic regression analysis showed that higher serum NGAL levels at admission were independently associated with cognitive impairment[odds ratio(OR)=1.42,95%confidence interval(CI):1.18-1.71,P<0.001],anxiety(OR=1.28,95%CI:1.09-1.51,P=0.003),and depressive symptoms(OR=1.39,95%CI:1.16-1.67,P<0.001)after adjusting for potential confounders.CONCLUSION Elevated serum NGAL levels were independently associated with cognitive impairment,anxiety,and depressive symptoms in patients with AIS;and may function as potential biomarkers for patients at risk.

Multimodal abnormalities of brain structures in adolescents and young adults with major depressive disorder:An activation likelihood estimation meta-analysis

BACKGROUND Major depressive disorder(MDD)in adolescents and young adults contributes significantly to global morbidity,with inconsistent findings on brain structural changes from structural magnetic resonance imaging studies.Activation likeli-hood estimation(ALE)offers a method to synthesize these diverse findings and identify consistent brain anomalies.METHODS We performed a comprehensive literature search in PubMed,Web of Science,Embase,and Chinese National Knowledge Infrastructure databases for neuroi-maging studies on MDD among adolescents and young adults published up to November 19,2023.Two independent researchers performed the study selection,quality assessment,and data extraction.The ALE technique was employed to synthesize findings on localized brain function anomalies in MDD patients,which was supplemented by sensitivity analyses.RESULTS Twenty-two studies comprising fourteen diffusion tensor imaging(DTI)studies and eight voxel-based morphome-try(VBM)studies,and involving 451 MDD patients and 465 healthy controls(HCs)for DTI and 664 MDD patients and 946 HCs for VBM,were included.DTI-based ALE demonstrated significant reductions in fractional anisotropy(FA)values in the right caudate head,right insula,and right lentiform nucleus putamen in adolescents and young adults with MDD compared to HCs,with no regions exhibiting increased FA values.VBM-based ALE did not demonstrate significant alterations in gray matter volume.Sensitivity analyses highlighted consistent findings in the right caudate head(11 of 14 analyses),right insula(10 of 14 analyses),and right lentiform nucleus putamen(11 of 14 analyses).CONCLUSION Structural alterations in the right caudate head,right insula,and right lentiform nucleus putamen in young MDD patients may contribute to its recurrent nature,offering insights for targeted therapies.

Major depressive disorder is associated with mitochondrial ND6 T14502C mutation in two Han Chinese families

BACKGROUND Globally,the World Health Organization ranks major depressive disorder(MDD)as the leading cause of disability.However,MDD molecular etiology is still poorly understood.AIM To explore the possible association between mitochondrial ND6 T14502C mutation and MDD.METHODS Clinical data were collected from two pedigrees,and detailed mitochondrial genomes were obtained for the two proband members.The assessment of the resulting variants included an evaluation of their evolutionary conservation,allelic frequencies,as well as their structural and functional consequences.Detailed mitochondrial whole genome analysis,phylogenetic,and haplotype analysis were performed on the probands.RESULTS Herein,we reported the clinical,genetic,and molecular profiling of two Chinese families afflicted with MDD.These Chinese families exhibited not only a range of onset and severity ages in their depression but also extremely low penetrances to MDD.Sequence analyses of mitochondrial genomes from these pedigrees have resulted in the identification of a homoplasmic T14502C(I58V)mutation.The polymorphism is located at a highly conserved isoleucine at position 58 of ND6 and distinct mitochondrial DNA(mtDNA)polymorphisms originating from haplogroups M10 and H2.CONCLUSION Identifying the T14502C mutation in two individuals with no genetic relation who exhibit symptoms of depression provides compelling evidence that this mutation may be implicated in MDD development.Nonetheless,the two Chinese pedigrees that carried the T14502C mutation did not exhibit any functionally significant mutations in their mtDNA.Therefore,the phenotypic expression of the T14502C mutation related to MDD may be influenced by the nuclear modifier gene(s)or environmental factors.

Resting-state functional magnetic resonance imaging and support vector machines for the diagnosis of major depressive disorder in adolescents

BACKGROUND Research has found that the amygdala plays a significant role in underlying pathology of major depressive disorder(MDD).However,few studies have explored machine learning-assisted diagnostic biomarkers based on amygdala functional connectivity(FC).AIM To investigate the analysis of neuroimaging biomarkers as a streamlined approach for the diagnosis of MDD in adolescents.METHODS Forty-four adolescents diagnosed with MDD and 43 healthy controls were enrolled in the study.Using resting-state functional magnetic resonance imaging,the FC was compared between the adolescents with MDD and the healthy controls,with the bilateral amygdala serving as the seed point,followed by statistical analysis of the results.The support vector machine(SVM)method was then applied to classify functional connections in various brain regions and to evaluate the neurophysiological characteristics associated with MDD.RESULTS Compared to the controls and using the bilateral amygdala as the region of interest,patients with MDD showed significantly lower FC values in the left inferior temporal gyrus,bilateral calcarine,right lingual gyrus,and left superior occipital gyrus.However,there was an increase in the FC value in Vermis-10.The SVM analysis revealed that the reduction in the FC value in the right lingual gyrus could effectively differentiate patients with MDD from healthy controls,achieving a diagnostic accuracy of 83.91%,sensitivity of 79.55%,specificity of 88.37%,and an area under the curve of 67.65%.CONCLUSION The results showed that an abnormal FC value in the right lingual gyrus was effective as a neuroimaging biomarker to distinguish patients with MDD from healthy controls.

Repetitive transcranial magnetic stimulation enhanced by neuronavigation in the treatment of depressive disorder and schizophrenia

This editorial assesses the advancements in neuronavigation enhanced repetitive transcranial magnetic stimulation for depressive disorder and schizophrenia treatment.Conventional repetitive transcranial magnetic stimulation faces challenges due to the intricacies of brain anatomy and patient variability.Neuronavigation offers innovative solutions by integrating neuroimaging with three-dimensional localization to pinpoint brain regions and refine therapeutic targeting.This systematic review of recent literature underscores the enhanced efficacy of neuronavigation in improving treatment outcomes for these disorders.This editorial highlights the pivotal role of neuronavigation in advancing psychiatric care.

The Effects of Childhood Trauma on College Students’Depressive Symptoms:The Mediation Role of Subjective Well-Being and the Moderation Role of Resilience

Background:The enduring and detrimental impact of childhood trauma on later health and well-being is now well established.However,research on the relationship between childhood trauma and depressive symptoms,along with the potential risk and protective factors,is insufficient in the context of Chinese college student population.Methods:Data on childhood trauma,depressive symptoms,resilience,and subjective well-being were collected through surveys conducted with 367 Chinese university students.The data collected in this study were analyzed using SPSS 26.0 and PROCESS 3.5.Results:The results revealed that subjective well-being mediated the relationship between childhood trauma and depressive symptoms among college students,with direct and indirect effects accounting for 59.46%and 40.54%of the total effect,respectively.The pathway process between subjective well-being and depressive symptoms was moderated by resilience,whereby an increase in resilience levels corresponded to a gradual escalation in the predictive power of subjective well-being on depressive symptoms.Conclusion:The study indicates that childhood trauma significantly and positively predicts depressive symptoms among college students,and it can also directly predict depressive symptoms through the mediating effect of subjective well-being.Elevating levels of psychological resilience and subjective well-being among college students can mitigate depression and promote psychological well-being.From the perspective of positive psychology,the present study provides a new perspective for the prevention and intervention of depressive symptoms among college students.

Vulnerable brain regions in adolescent major depressive disorder:A resting-state functional magnetic resonance imaging activation likelihood estimation meta-analysis

BACKGROUND Adolescent major depressive disorder(MDD)is a significant mental health concern that often leads to recurrent depression in adulthood.Resting-state functional magnetic resonance imaging(rs-fMRI)offers unique insights into the neural mechanisms underlying this condition.However,despite previous research,the specific vulnerable brain regions affected in adolescent MDD patients have not been fully elucidated.AIM To identify consistent vulnerable brain regions in adolescent MDD patients using rs-fMRI and activation likelihood estimation(ALE)meta-analysis.METHODS We performed a comprehensive literature search through July 12,2023,for studies investigating brain functional changes in adolescent MDD patients.We utilized regional homogeneity(ReHo),amplitude of low-frequency fluctuations(ALFF)and fractional ALFF(fALFF)analyses.We compared the regions of aberrant spontaneous neural activity in adolescents with MDD vs healthy controls(HCs)using ALE.RESULTS Ten studies(369 adolescent MDD patients and 313 HCs)were included.Combining the ReHo and ALFF/fALFF data,the results revealed that the activity in the right cuneus and left precuneus was lower in the adolescent MDD patients than in the HCs(voxel size:648 mm3,P<0.05),and no brain region exhibited increased activity.Based on the ALFF data,we found decreased activity in the right cuneus and left precuneus in adolescent MDD patients(voxel size:736 mm3,P<0.05),with no regions exhibiting increased activity.CONCLUSION Through ALE meta-analysis,we consistently identified the right cuneus and left precuneus as vulnerable brain regions in adolescent MDD patients,increasing our understanding of the neuropathology of affected adolescents.

Association between 5-HTR1A gene C-1019G polymorphism and antidepressant response in patients with major depressive disorder:A meta-analysis

BACKGROUND Major depressive disorder(MDD)is a substantial global health concern,and its treatment is complicated by the variability in individual response to antide-pressants.AIM To consolidate research and clarify the impact of genetic variation on MDD treatment outcomes.METHODS Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines,a systematic search across PubMed,EMBASE,Web of Science,and the Cochrane Library was conducted without date restrictions,utilizing key terms related to MDD,serotonin 1A receptor polymorphism(5-HTR1A),C-1019G polymorphism,and antidepressant response.Studies meeting inclusion criteria were thoroughly screened,and quality assessed using the Newcastle-Ottawa Scale.Statistical analyses,includingχ2 and I²values,were used to evaluate heterogeneity and fixed-effect or random-effect models were applied accordingly.RESULTS The initial search yielded 1216 articles,with 11 studies meeting criteria for inclusion.Analysis of various genetic models showed no significant association between the 5-HTR1A C-1019G polymorphism and antidepressant efficacy.The heterogeneity was low to moderate,and no publication bias was detected through funnel plot symmetry and Egger's and Begg's tests.CONCLUSION This meta-analysis does not support a significant association between the 5-HTR1A C-1019G polymorphism and the efficacy of antidepressant treatment in MDD.The findings call for further research with larger cohorts to substantiate these results and enhance the understanding of antidepressant pharmacogenetics.

Impact of comorbid subthreshold depressive symptoms on cancerrelated fatigue and complications in adults with leukemia

BACKGROUND Patients not only experience symptoms caused by cancer but also suffer from the accompanying psychological pain.Therefore,these patients do not have high quality of life.According to the World Health Organization,the incidence of leukemia in China in 2020 was 5.1/100000,the mortality rate was 3.3/100000,and the prevalence rate was 16.7/100000.Therefore,it is important to examine the influence of comorbid subthreshold depressive symptoms on leukemia patients.AIM To determine the impact of comorbid subthreshold depressive symptoms on cancer-related fatigue and complications in leukemia patients,thereby providing a basis for early diagnosis and treatment in clinical practice.METHODS A questionnaire survey was conducted among leukemia patients admitted to a tertiary hospital in Xi'an,Shaanxi Province,China,from August 2022 to December 2023.Patients with a score>16 on the Chinese Classification of Mental Disorders(CCMD-3)and a Hamilton Depression Rating Scale score of 8-17 were classified as the subthreshold depressive group(n=95),while 100 leukemia patients admitted during the same period were classified as the control group.Data were collected using Epidata 3.1 software,and comparisons were made between the two groups regarding general clinical data,the Piper Fatigue Scale(PFS),the Pittsburgh Sleep Quality Index(PSQI),the Numeric Rating Scale for pain assessment,laboratory indicators,and the occurrence of complications.RESULTS In this survey,120 leukemia patients with depression were preliminarily screened,95 patients with subthreshold depression were ultimately selected as the subthreshold depression group,and 100 leukemia patients admitted during the same period were enrolled as the normal group.Comparison of basic clinical data between the two groups revealed no significant differences in age,sex,body mass index,cognitive function,or comorbidity with other chronic diseases.However,there were statistically significant differences in the use of radiotherapy and regular exercise between the two groups(P<0.05).Comparisons of scales and laboratory indicators revealed no significant differences in albumin or PSQI scores between the two groups,but there were statistically significant differences in pain scores,PSQI scores,PFS scores,hemoglobin levels,and C-reactive protein levels(P<0.05).Spearman’s correlation analysis indicated that cancer-related fatigue was correlated with age,hemoglobin levels,C-reactive protein levels,pain,and regular exercise among leukemia patients with subthreshold depression.Multivariate regression analysis revealed that advanced age,combined radiotherapy,pain,and low hemoglobin levels were risk factors for cancer-related fatigue in leukemia patients with comorbid subthreshold depression,while regular exercise was a protective factor against cancer-related fatigue.Follow-up comparisons revealed a significantly lower overall incidence of complications in the control group(4%)than in the depressive group(24.21%;P<0.001).CONCLUSION Leukemia patients with comorbid subthreshold depressive symptoms experience more severe cancer-related fatigue and a higher incidence of complications.These findings may be related to advanced age,combined radiotherapy,pain,and low hemoglobin levels,while regular exercise may effectively alleviate symptoms.

Brain region-specific roles of brain-derived neurotrophic factor in social stress-induced depressive-like behavior

Brain-derived neurotrophic factor is a key factor in stress adaptation and avoidance of a social stress behavioral response.Recent studies have shown that brain-derived neurotrophic factor expression in stressed mice is brain region–specific,particularly involving the corticolimbic system,including the ventral tegmental area,nucleus accumbens,prefrontal cortex,amygdala,and hippocampus.Determining how brain-derived neurotrophic factor participates in stress processing in different brain regions will deepen our understanding of social stress psychopathology.In this review,we discuss the expression and regulation of brain-derived neurotrophic factor in stress-sensitive brain regions closely related to the pathophysiology of depression.We focused on associated molecular pathways and neural circuits,with special attention to the brain-derived neurotrophic factor–tropomyosin receptor kinase B signaling pathway and the ventral tegmental area–nucleus accumbens dopamine circuit.We determined that stress-induced alterations in brain-derived neurotrophic factor levels are likely related to the nature,severity,and duration of stress,especially in the above-mentioned brain regions of the corticolimbic system.Therefore,BDNF might be a biological indicator regulating stress-related processes in various brain regions.

Depressive semantic awareness from vlog facial and vocal streams via spatio-temporal transformer

With the rapid growth of information transmission via the Internet,efforts have been made to reduce network load to promote efficiency.One such application is semantic computing,which can extract and process semantic communication.Social media has enabled users to share their current emotions,opinions,and life events through their mobile devices.Notably,people suffering from mental health problems are more willing to share their feelings on social networks.Therefore,it is necessary to extract semantic information from social media(vlog data)to identify abnormal emotional states to facilitate early identification and intervention.Most studies do not consider spatio-temporal information when fusing multimodal information to identify abnormal emotional states such as depression.To solve this problem,this paper proposes a spatio-temporal squeeze transformer method for the extraction of semantic features of depression.First,a module with spatio-temporal data is embedded into the transformer encoder,which is utilized to obtain a representation of spatio-temporal features.Second,a classifier with a voting mechanism is designed to encourage the model to classify depression and non-depression effec-tively.Experiments are conducted on the D-Vlog dataset.The results show that the method is effective,and the accuracy rate can reach 70.70%.This work provides scaffolding for future work in the detection of affect recognition in semantic communication based on social media vlog data.

Systemic low-grade inflammation associated with specific depressive symptoms:insights from network analyses of five independent NHANES samples

To the editor:Major depressive disorder(MDD)is a heterogeneous disorder with varying symptom presentations and underlying biological mechanisms.1 The mainstream neurobiological hypotheses of depression involve monoamine neurotransmitters,hypothalamic-pituitary-adrenal axis,immune-inflammation and the glutamate system.

Trajectories of depressive symptoms and risk of cardiovascular disease,cancer and mortality:a prospective cohort study

Background Depressive symptoms are established risk factors for various health outcomes.However,previous studies assessed depressive symptoms at a single time point,neglecting individual variations over time.Aims To identify depressive symptoms trajectories through repeated measures and examine their associations with cardiovascular disease(CVD),cancer and mortality.Methods This study included 20634 UK Biobank participants free of CVD and cancer at baseline with two or more assessments of depressive symptoms during 2006-2016.Group-based trajectory modelling identified depressive symptoms trajectories.Incident CVD,cancer and mortality were followed up until 2021 through linked registries.Results Six depressive symptoms trajectories were identified:no symptoms(n=6407),mild-stable(n=11539),moderate-stable(n=2183),severe-decreasing(n=206),moderate-increasing(n=177)and severe-stable(n=122).During a median follow-up of 5.5 years,1471 CVD cases,1275 cancer cases and 503 deaths were documented.Compared with the no symptoms trajectory,the mildstable,moderate-stable and severe-stable trajectories exhibited higher CVD risk,with hazard ratios(HRs)(95%CIs)of 1.19(1.06 to 1.34),1.32(1.08 to 1.34)and 2.99(1.85 to 4.84),respectively.Moderate-increasing and severe-stable trajectories were associated with higher mortality risks,with HRs(95%CIs)of 2.27(1.04 to 4.93)and 3.26(1.55 to 6.88),respectively.However,the severedecreasing trajectory was not associated with higher risks of adverse outcomes.We did not find significant associations between any trajectory and cancer.Conclusions Trajectories related to stable and increasing depressive symptoms,but not the trajectory associated with severe depressive symptoms at the initial assessment but decreasing at the follow-up,were associated with higher risks of CVD and mortality.Alleviating severe depressive symptoms at the initial onset may mitigate CVD and mortality risks.

Current trends and hotspots of depressive disorders with colorectal cancer:A bibliometric and visual study

BACKGROUND Depression is strongly associated with colorectal cancer(CRC).Few bibliometric analyses have systematically summarized the research focus and recent progress in this field.AIM To determine the research status and hotspots by bibliometric analysis of relevant publications on the relationship between CRC and depression.METHODS Articles on depression in CRC patients were collected from the Web of Science Core Collection.CiteSpace and VOSviewer software were used to visualize bibliometric networks.RESULTS From 2001 to 2022,Supportive Care in Cancer,the United States,Tilburg University,and Mols were the most productive and influential journal,country,institution,and author name.Co-occurrence cluster analysis of keywords placed quality of life,anxiety,and psychological stress in the center of the visual network diagram.Further clustering was performed for the clusters with studies of the relevant mechanism of action,which showed that:(1)Cytokines have a role essential for the occurrence and development of depressive disorders in CRC;(2)MicroRNAs have a role essential for the development of depressive disorders in CRC;(3)Some anticancer drugs have pro-depressant activity;and(4)Selective serotonin reuptake inhibitors have both antitumor and antidepressant activity.CONCLUSION Life quality and psychological nursing of the cancer population were key topics.The roles of cytokines and microRNAs,the pro-depression activity of anticancer drugs and their antitumor properties deserve in-depth study.

Addison's disease caused by adrenal tuberculosis may lead to misdiagnosis of major depressive disorder: A case report

BACKGROUND Addison’s disease(AD)is a rare but potentially fatal disease in Western countries,which can easily be misdiagnosed at an early stage.Severe adrenal tuberculosis(TB)may lead to depression in patients.CASE SUMMARY We report a case of primary adrenal insufficiency secondary to adrenal TB with TB in the lungs and skin in a 48-year-old woman.The patient was misdiagnosed with depression because of her depressed mood.She had hyperpigmentation of the skin,nails,mouth,and lips.The final diagnosis was adrenal TB that resulted in the insufficient secretion of adrenocortical hormone.Adrenocortical hormone test,skin biopsy,T cell spot test of TB,and adrenal computed tomography scan were used to confirm the diagnosis.The patient’s condition improved after hormone replacement therapy and TB treatment.CONCLUSION Given the current status of TB in high-burden countries,outpatient doctors should be aware of and pay attention to TB and understand the early symptoms of AD.

Effect of quantitative consciousness index on seizure parameters during electroconvulsive therapy in patients with major depressive disorder

BACKGROUND Electroconvulsive therapy(ECT)is both an effective treatment for patients with major depressive disorder(MDD)and a noxious stimulus.Although some studies have explored the effect of sedation depth on seizure parameters in ECT,there is little research on the noxious stimulation response to ECT.In this study,we used two electroencephalography(EEG)-derived indices,the quantitative consci-ousness(qCON)index and quantitative nociceptive(qNOX)index,to monitor sedation,hypnosis,and noxious stimulation response in patients with MDD undergoing acute ECT.METHODS Patients with MDD(n=24)underwent acute bilateral temporal ECT under propofol anesthesia.Before ECT,the patients were randomly divided into three groups according to qCON scores(qCON60-70,qCON50-60,and qCON40-50).Continuous qCON monitoring was performed 3 minutes before and during ECT,and the qCON,qNOX,vital signs,EEG seizure parameters,and complications during the recovery period were recorded.The 24-item Hamilton Rating Scale for Depression,Zung’s Self-rating Depression Scale,and Montreal Cognitive Asse-ssment scores were evaluated before the first ECT session,after the fourth ECT session,and after the full course of ECT.RESULTS A total of 193 ECT sessions were performed on 24 participants.The qCON index significantly affected the EEG seizure duration,peak mid-ictal amplitude,and maximum heart rate during ECT(P<0.05).The qNOX index significantly affected the post-ictal suppression index(P<0.05).Age,number of ECT sessions,and anesthetic-ECT time intervals also had a significant effect on EEG seizure parameters(P<0.05).However,there were no significant differences in complications,24-item Hamilton Rating Scale for Depression scores,Zung’s Self-rating Depression Scale scores,or Montreal Cognitive Assessment scores among the three groups(P>0.05).CONCLUSION Electrical stimulation at a qCON index of 60-70 resulted in better EEG seizure parameters without increasing complications in patients with MDD undergoing bilateral temporal ECT under propofol anesthesia.

Interoception mediates the association between social support and sociability in patients with major depressive disorder

BACKGROUND Interoception dysfunction has an important impact on the onset and development of major depressive disorder(MDD).Social support serves as a protective factor against MDD,and sociability also plays a significant role in this condition.These interconnected constructs-social support and sociability-play pivotal roles in MDD.However,no research on the mechanisms underlying the associations be-tween social support and sociability,particularly the potential role of interocep-tion,have been reported.ception,social support,and sociability,respectively.A mediation analysis model for the eight dimensions of intero-ception(noticing,not distracting,not worrying,attention regulation,emotional awareness,self-regulation,body listening,and trust),social support,and sociability were established to evaluate the mediating effects.RESULTS A partial correlation analysis of eight dimensions of the MAIA-2,SSRS,and TSBI scores,with demographic data as control variables,revealed pairwise correlations between the SSRS score and both the MAIA-2 score and TSBI score.In the major depression(MD)group,the SSRS score had a positive direct effect on the TSBI score,while the scores for body listening,emotional awareness,self-regulation,and trust in the MAIA-2C had indirect effects on the TSBI score.In the HC group,the SSRS score had a positive direct effect on the TSBI score,and the scores for attention regulation,emotional awareness,self-regulation,and trust in the MAIA-2C had indirect effects on the TSBI score.The proportion of mediators in the MD group was lower than that in the HC group.CONCLUSION Interoceptive awareness is a mediating factor in the association between social support and sociability in both HCs and depressed patients.Training in interoceptive awareness might not only help improve emotional regulation in depressed patients but also enhance their social skills and support networks.