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.

Addressing social function in the treatment of depression:A call for holistic approaches

This article discusses the importance of addressing social functioning impairment in patients with residual depressive symptoms,as highlighted in the study by Liao et al.The authors showed that social dysfunction persists in many patients despite symptom remission.This observation calls for a shift in depression treatment strategies,with an emphasis on integrating social functioning as a key treatment goal.This article suggests targeted interventions that focus on both symptomatic relief and the restoration of social function.

Correlation between psychological,family social support,and home nursing quality for an implanted venous access port

BACKGROUND Cancer patients with an implanted venous access port(IVAP)often manage their care at home during chemotherapy intervals,including maintaining the device,monitoring complications,and following medication instructions.Home care ensures continued support after discharge.However,due to factors such as age,gender,culture,psychological status,and family support,the quality of home care varies significantly.Understanding these factors can help provide targeted guidance to improve the care of cancer patients.AIM To explore IVAP chemotherapy on home care quality and its association with mental health and family support for cancer patients.METHODS This investigative study was based on a medical records system.It investigated the relationship between psychological status,family support,and home care quality in 180 patients with cancer undergoing IVAP chemotherapy.Psychological status was assessed using the State Anxiety Inventory(S-AI);family support was assessed using the Perceived Social Support Scale(PSSS),and home care quality was evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30).Pearson’s correlation and Structural Equation Modeling were used to analyze the interplay between these factors.RESULTS The average S-AI score was 47.52±14.47,PSSS was 52.48±12.64,and EORTC QLQ-C30 was 70.09±17.32.A substantial inverse relationship was observed between the EORTC QLQ-C30 and S-AI scores(r=-0.712).A significant positive correlation was found between the EORTC QLQ-C30 and the PSSS,with a correlation coefficient of(r=0.744).The multiple linear regression analysis indicated that family social support,psychological status,and average monthly family income were the main factors influencing the variation in the quality of home care,explaining 71.9%of the variation.The Structural Equation Modeling results indicated that psychological status acted as a partial mediator in the association between family social support and home care quality of life,explaining 32.78%of the mediation effect.CONCLUSION Psychological status and family social support positively impacted cancer patients’home care quality,with psychology partially mediating this effect.

Study on Communication Effect of Food Safety Risk in Social Media:the Influence of Response Effort Level on Consumption Willingness Change

By constructing influence model for communication effect of food safety risk in social media environment,the influences of different response manners taken by relevant enterprises on consumers' cognition and purchasing intention are analyzed,and influence mechanisms of response effort level,interaction and content reliability on consumers' attitudes are revealed. Based on quasi-experimental study with three kinds of response effort levels,it is found that content reliability,interaction and effort degree of enterprise response under negative information of food safety event have significant impacts on communication effect and consumers' purchasing intention.

Mapping and measuring urban-rural inequalities in accessibility to social infrastructures

Equal access to social infrastructures is a fundamental prerequisite for sustainable development,but has long been a great challenge worldwide.Previous studies have primarily focused on the accessibility to social infras-tructures in urban areas across various scales,with less attention to rural areas,where inequality can be more severe.Particularly,few have investigated the disparities of accessibility to social infrastructures between urban and rural areas.Here,using the Changsha-Zhuzhou-Xiangtan urban agglomeration,China,as an example,we investigated the inequality of accessibility in both urban and rural areas,and further compared the urban-rural difference.Accessibility was measured by travel time of residents to infrastructures.We selected four types of social infrastructures including supermarkets,bus stops,primary schools,and health care,which were funda-mentally important to both urban and rural residents.We found large disparities in accessibility between urban and rural areas,ranging from 20 min to 2 h.Rural residents had to spend one to two more hours to bus stops than urban residents,and 20 min more to the other three types of infrastructures.Furthermore,accessibility to multiple infrastructures showed greater urban-rural differences.Rural residents in more than half of the towns had no access to any infrastructure within 15 min,while more than 60%of the urban residents could access to all infrastructures within 15 min.Our results revealed quantitative accessibility gap between urban and rural areas and underscored the necessity of social infrastructures planning to address such disparities.

Integrated ribosome and proteome analyses reveal insights into sevoflurane-induced long-term social behavior and cognitive dysfunctions through ADNP inhibition in neonatal mice

A growing number of studies have demonstrated that repeated exposure to sevoflurane during development results in persistent social abnormalities and cognitive impairment.Davunetide,an active fragment of the activity-dependent neuroprotective protein(ADNP),has been implicated in social and cognitive protection.However,the potential of davunetide to attenuate social deficits following sevoflurane exposure and the underlying developmental mechanisms remain poorly understood.In this study,ribosome and proteome profiles were analyzed to investigate the molecular basis of sevoflurane-induced social deficits in neonatal mice.The neuropathological basis was also explored using Golgi staining,morphological analysis,western blotting,electrophysiological analysis,and behavioral analysis.Results indicated that ADNP was significantly down-regulated following developmental exposure to sevoflurane.In adulthood,anterior cingulate cortex(ACC)neurons exposed to sevoflurane exhibited a decrease in dendrite number,total dendrite length,and spine density.Furthermore,the expression levels of Homer,PSD95,synaptophysin,and vglut2 were significantly reduced in the sevoflurane group.Patch-clamp recordings indicated reductions in both the frequency and amplitude of miniature excitatory postsynaptic currents(mEPSCs).Notably,davunetide significantly ameliorated the synaptic defects,social behavior deficits,and cognitive impairments induced by sevoflurane.Mechanistic analysis revealed that loss of ADNP led to dysregulation of Ca^(2+)activity via the Wnt/β-catenin signaling,resulting in decreased expression of synaptic proteins.Suppression of Wnt signaling was restored in the davunetide-treated group.Thus,ADNP was identified as a promising therapeutic target for the prevention and treatment of neurodevelopmental toxicity caused by general anesthetics.This study provides important insights into the mechanisms underlying social and cognitive disturbances caused by sevoflurane exposure in neonatal mice and elucidates the regulatory pathways involved.

Dysfunctional attitudes,social support,negative life events,and depressive symptoms in Chinese adolescents:A moderated mediation model

BACKGROUND Depression is a prevalent psychological issue in adolescents that is significantly related to negative life events(NLEs)and dysfunctional attitudes.High levels of social support can significantly buffer NLEs’effect on depression.Currently,there is limited research on how social support moderates the relationship between NLEs,dysfunctional attitudes,and depression in adolescents in China.It is imperative to investigate this moderating effect to mitigate dysfunctional attitudes in adolescent undergoing depressive mood,ultimately enhancing their overall mental health.AIM To investigate the relationship and underlying mechanisms between specific dysfunctional attitudes,social support,and depression among Chinese adolescents.METHODS This is a cross-sectional study which selected five middle schools in Shandong Province for investigation in March 2022.Participants included 795 adolescents(49.87%male,mage=15.15,SD=1.84,age range=11-18 years old).All participants completed the Dysfunctional Attitude Scale,Adolescent Life Event Scale,Beck Depression Inventory,and Social Support Rating Scale.A moderated mediation model was conducted to examine the relationship between specific dysfunctional attitudes,social support,and depression.RESULTS Results indicated that NLEs affected depression through the mediating role of specific dysfunctional attitudes(autonomy attitudesβ=0.21;perfectionismβ=0.25).Moreover,social support was found to moderate the mediating effect between NLEs,specific dysfunctional attitudes,and depressive symptoms(autonomy attitudes b2=-0.08;perfectionism b2=-0.09).CONCLUSION Dysfunctional attitudes mediated and social support moderated the relationship between NLEs and depression.Social support can buffer depression symptoms among adolescents with autonomy attitudes and perfectionism.

Comparative analyses of mitogenomes in the social bees with insights into evolution of long inverted repeats in the Meliponini

The insect mitogenome is typically a compact circular molecule with highly conserved gene contents.Nonetheless,mitogenome structural variations have been reported in specific taxa,and gene rearrangements,usually the tRNAs,occur in different lineages.Because synapomorphies of mitogenome organizations can provide information for phylogenetic inferences,comparative analyses of mitogenomes have been given increasing attention.However,most studies use a very few species to represent the whole genus,tribe,family,or even order,overlooking potential variations at lower taxonomic levels,which might lead to some incorrect inferences.To provide new insights into mitogenome organizations and their implications for phylogenetic inference,this study conducted comparative analyses for mitogenomes of three social bee tribes(Meliponini,Bombini,and Apini)based on the phylogenetic framework with denser taxonomic sampling at the species and population levels.Comparative analyses revealed that mitogenomes of Apini and Bombini are the typical type,while those of Meliponini show diverse variations in mitogenome sizes and organizations.Large inverted repeats(IRs)cause significant gene rearrangements of protein coding genes(PCGs)and rRNAs in Indo-Malay/Australian stingless bee species.Molecular evolution analyses showed that the lineage with IRs have lower dN/dS ratios for PCGs than lineages without IRs,indicating potential effects of IRs on the evolution of mitochondrial genes.The finding of IRs and different patterns of gene rearrangements suggested that Meliponini is a hotspot in mitogenome evolution.Unlike conserved PCGs and rRNAs whose rearrangements were found only in the mentioned lineages within Meliponini,tRNA rearrangements are common across all three tribes of social bees,and are significant even at the species level,indicating that comprehensive sampling is needed to fully understand the patterns of tRNA rearrangements,and their implications for phylogenetic inference.

Adolescent suicide risk factors and the integration of socialemotional skills in school-based prevention programs

Adolescents are considered one of the most vulnerable groups affected by suicide.Rapid changes in adolescents’physical and mental states,as well as in their lives,significantly and undeniably increase the risk of suicide.Psychological,social,family,individual,and environmental factors are important risk factors for suicidal behavior among teenagers and may contribute to suicide risk through various direct,indirect,or combined pathways.Social-emotional learning is considered a powerful intervention measure for addressing the crisis of adolescent suicide.When deliberately cultivated,fostered,and enhanced,selfawareness,self-management,social awareness,interpersonal skills,and responsible decision-making,as the five core competencies of social-emotional learning,can be used to effectively target various risk factors for adolescent suicide and provide necessary mental and interpersonal support.Among numerous suicide intervention methods,school-based interventions based on social-emotional competence have shown great potential in preventing and addressing suicide risk factors in adolescents.The characteristics of school-based interventions based on social-emotional competence,including their appropriateness,necessity,cost-effectiveness,comprehensiveness,and effectiveness,make these interventions an important means of addressing the crisis of adolescent suicide.To further determine the potential of school-based interventions based on social-emotional competence and better address the issue of adolescent suicide,additional financial support should be provided,the combination of socialemotional learning and other suicide prevention programs within schools should be fully leveraged,and cooperation between schools and families,society,and other environments should be maximized.These efforts should be considered future research directions.

Validity,Reliability,and Measurement Invariance of the Thai Smartphone Application-Based Addiction Scale and Bergen Social Media Addiction Scale

Background:In recent years,there has been increased research interest in both smartphone addiction and social media addiction as well as the development of psychometric instruments to assess these constructs.However,there is a lack of psychometric evaluation for instruments assessing smartphone addiction and social media addiction in Thailand.The present study evaluated the psychometric properties and gender measurement invariance of the Thai version of the Smartphone Application-Based Addiction Scale(SABAS)and Bergen Social Media Addiction Scale(BSMAS).Method:A total of 801 Thai university students participated in an online survey from January 2022 to July 2022 which included demographic information,SABAS,BSMAS,and the Internet Gaming Disorder Scale-Short Form(IGDS9-SF).Results:Confirmatory Factor Analyses(CFAs)found that both the SABAS and BSMAS had a one-factor structure.Findings demonstrated adequate psychometric properties of both instruments and also supported measurement invariance across genders.Moreover,scores on the SABAS and BSMAS were correlated with scores on the IGDS9-SF.Conclusion:The results indicated that the SABAS and BSMAS are useful psychometric instruments for assessing the risk of smartphone addiction and social media addiction among Thai young adults.

Intervention Effects on the Willingness to Stop Smoking and Social Nicotine Dependence Based on Single-Session Group Therapy with Frequent Use of Role Play Targeting Smokers with Mental Disorders

Objective: We devised a “Smoking-Cessation Motivation Program” as a community welfare service aimed at making short-term improvements in social nicotine dependence and enhancing the willingness to stop smoking among people with mental disorders. Method: The study conducted a controlled trial to empirically examine the effects of the program on the willingness to stop smoking and social nicotine dependence among 26 smokers with mental disorders in the intervention group, who were compared with a control group of 16 individuals. Results: Results demonstrated the program’s effectiveness in reducing social nicotine dependence, and a variance analysis with age as the covariate evidenced a mutual interaction between social nicotine dependence and the willingness to stop smoking, confidence to stop smoking, and resisting the temptation to smoke. Conclusion: Future studies should examine longer-term program results, the impact of program duration, and other factors that influence the program’s effectiveness.

Making the case for the evolving role of social media in health professions education and a literature review on the application of some in ophthalmology

Background and Objective:Social media(SoMe)has emerged as a tool in health professions education(HPE),particularly amidst the challenges posed by the coronavirus disease 2019(COVID-19)pandemic.Despite the academia’s initial skepticism SoMe has been gaining traction in supporting learning communities,and offering opportunities for innovation in HPE.Our study aims to explore the integration of SoMe in HPE.Four key components were outlined as necessary for a successful integration,and include designing learning experiences,defining educator roles,selecting appropriate platforms,and establishing educational objectives.Methods:This article stemmed from the online Teaching Skills Series module on SoMe in education from the Ophthalmology Foundation,and drew upon evidence supporting learning theories relevant to SoMe integration and models of education.Additionally,we conducted a literature review considering Englishlanguage articles on the application of SoMe in ophthalmology from PubMed over the past decade.Key Content and Findings:Early adopters of SoMe platforms in HPE have leveraged these tools to enhance learning experiences through interaction,dialogue,content sharing,and active learning strategies.By integrating SoMe into educational programs,both online and in-person,educators can overcome time and geographical constraints,fostering more diverse and inclusive learning communities.Careful consideration is,however,necessary to address potential limitations within HPE.Conclusions:This article lays groundwork for expanding SoMe integration in HPE design,emphasizing the supportive scaffold of various learning theories,and the need of furthering robust research on examining its advantages over traditional educational formats.Our literature review underscores an ongoing multifaceted,random application of SoMe platforms in ophthalmology education.We advocate for an effective incorporation of SoMe in HPE education,with the need to comply with good educational practice.

Study on the Influence of Farmer Social Capital on Cooperative Supply Willingness of Agricultural Disaster Reduction Public Goods——Based on the Investigation on 515 Farmers

Based on social capital theory,related factors of three dimensions( structure dimension,cognition dimension and relation dimension) of farmer social capital are taken as independent variables,and famer's willingness to cooperatively supply agricultural disaster reduction public goods is taken as dependent variable. Taking 515 farmers in 27 villages of Hubei Province as investigation objects,the influence of farmer social capital on cooperative supply willingness of agricultural disaster reduction public goods is explored by Logistic regression model. Research results show that social solidarity,common value concept,social trust and reciprocal content have positive impact on farmer's willingness of cooperative supply,while annual household income,number of agricultural disaster reduction public goods and social network have negative impact on farmer's willingness of cooperative supply.

Spatiotemporal dynamics of the social structure of Indo-Pacific humpback dolphins(Sousa chinensis)in Xiamen waters from 2007 to 2019

As highly social animals,Indo-Pacific humpback dolphins(Sousa chinensis)exhibit community differentiation.Nevertheless,our understanding of the external and internal factors influencing these dynamics,as well as their spatiotemporal variations,is still limited.In the present study,variations in the social structure of an endangered Indo-Pacific humpback dolphin population in Xiamen Bay,China,were monitored over two distinct periods(2007–2010 and 2017–2019)to analyze the effects of habitat utilization and the composition of individuals within the population.In both periods,the population demonstrated a strikingly similar pattern of social differentiation,characterized by the division of individuals into two main clusters and one small cluster.Spatially,the two primary clusters occupied the eastern and western waters,respectively,although the core distribution area of the eastern cluster shifted further eastward between the two periods.Despite this distribution shift,the temporal stability of the social structure and inter-associations within the eastern cluster remained unaffected.A subset of 16individuals observed in both periods,comprising 51.6%and 43.2%of the population in each respective period,emerged as a foundational element of the social structure and may be responsible for sustaining social structure stability,especially during the 2007–2010 period.These observations suggest that the composition of dominant individuals,an internal factor,had a more substantial influence on the formation of the social network than changes in habitat use,an external factor.Consequently,the study proposes distinct conservation measures tailored to each of the two main clusters.

Female zebra finches are more vulnerable to social isolation stress than males:Involvement of the nonapeptide system

In group-living animals,chronic juvenile social isolation stress(SIS)can profoundly affect behavior and neuroendocrine regulation.However,its impact on social behavior in avian species,particularly regarding sexspecific neural circuit differences,remains underexplored.This study focused on zebra finches,a species known for its social clustering and cognitive abilities,to elucidate these influences.Results indicated that SIS significantly increased plasma corticosterone levels in females but not in males,suggesting a heightened stress response and susceptibility in females.Additionally,SIS disrupted sociality and flocking behavior in both sexes,with more severe impairments in social recognition observed in females.Mesotocin(MT)levels in the lateral septum of both sexes and in the ventromedial hypothalamus of females were found to mediate the SIS effect,while vasotocin(VT)levels within the social behavior network remained unchanged.Pharmacological interventions confirmed the critical role of MT in reversing SIS-induced impairments in sociality,flocking behavior,and social recognition,particularly in females.These findings highlight unique nucleus-and sex-dependent variations in MT and VT regulation,providing novel insights into the mechanisms governing avian social behavior.This study advances our understanding of the independent evolutionary pathways of neural circuits and neuroendocrine systems that modulate social behaviors across different taxonomic groups.

Enhancing Data Forwarding Efficiency in SIoT with Multidimensional Social Relations

Effective data communication is a crucial aspect of the Social Internet of Things(SIoT)and continues to be a significant research focus.This paper proposes a data forwarding algorithm based on Multidimensional Social Relations(MSRR)in SIoT to solve this problem.The proposed algorithm separates message forwarding into intra-and cross-community forwarding by analyzing interest traits and social connections among nodes.Three new metrics are defined:the intensity of node social relationships,node activity,and community connectivity.Within the community,messages are sent by determining which node is most similar to the sender by weighing the strength of social connections and node activity.When a node performs cross-community forwarding,the message is forwarded to the most reasonable relay community by measuring the node activity and the connection between communities.The proposed algorithm was compared to three existing routing algorithms in simulation experiments.Results indicate that the proposed algorithmsubstantially improves message delivery efficiency while lessening network overhead and enhancing connectivity and coordination in the SIoT context.

Predicting Users’ Latent Suicidal Risk in Social Media: An Ensemble Model Based on Social Network Relationships

Suicide has become a critical concern,necessitating the development of effective preventative strategies.Social media platforms offer a valuable resource for identifying signs of suicidal ideation.Despite progress in detecting suicidal ideation on social media,accurately identifying individuals who express suicidal thoughts less openly or infrequently poses a significant challenge.To tackle this,we have developed a dataset focused on Chinese suicide narratives from Weibo’s Tree Hole feature and introduced an ensemble model named Text Convolutional Neural Network based on Social Network relationships(TCNN-SN).This model enhances predictive performance by leveraging social network relationship features and applying correction factors within a weighted linear fusion framework.It is specifically designed to identify key individuals who can help uncover hidden suicidal users and clusters.Our model,assessed using the bespoke dataset and benchmarked against alternative classification approaches,demonstrates superior accuracy,F1-score and AUC metrics,achieving 88.57%,88.75%and 94.25%,respectively,outperforming traditional TextCNN models by 12.18%,10.84%and 10.85%.We assert that our methodology offers a significant advancement in the predictive identification of individuals at risk,thereby contributing to the prevention and reduction of suicide incidences.

Effects of individual heterogeneity on social contagions

Despite having significant effects on social contagions,individual heterogeneity has frequently been overlooked in earlier studies.To better understand the complexity of social contagions,a non-Markovian model incorporating heterogeneous social influence and adoption thresholds is introduced.For theoretical analysis,a generalized edge-based compartmental theory which considers the heterogeneities of social influence and adoption thresholds is developed.Focusing on the final adoption size,the critical propagation probability,and the phase transition type,social contagions for adoption thresholds that follow normal distributions with various standard deviations,follow various distributions,and correlate with degrees are investigated.When thresholds follow normal distributions,a larger standard deviation results in a larger final adoption size when the information propagation probability is relatively low.However,when the information propagation probability is relatively high,a larger standard deviation results in a smaller final adoption size.When thresholds follow various distributions,crossover phenomena in phase transition are observed when investigating the relationship of the final adoption size versus the average adoption threshold for some threshold distributions.When thresholds are correlated with degrees,similar crossover phenomena occur when investigating the relationship of the final adoption size versus the degree correlation index.Additionally,we find that increasing the heterogeneity of social influence suppresses the effects of adoption threshold heterogeneity on social contagions in three cases.Our theory predictions agree well with the simulation results.

Social Robot Detection Method with Improved Graph Neural Networks

Social robot accounts controlled by artificial intelligence or humans are active in social networks,bringing negative impacts to network security and social life.Existing social robot detection methods based on graph neural networks suffer from the problem of many social network nodes and complex relationships,which makes it difficult to accurately describe the difference between the topological relations of nodes,resulting in low detection accuracy of social robots.This paper proposes a social robot detection method with the use of an improved neural network.First,social relationship subgraphs are constructed by leveraging the user’s social network to disentangle intricate social relationships effectively.Then,a linear modulated graph attention residual network model is devised to extract the node and network topology features of the social relation subgraph,thereby generating comprehensive social relation subgraph features,and the feature-wise linear modulation module of the model can better learn the differences between the nodes.Next,user text content and behavioral gene sequences are extracted to construct social behavioral features combined with the social relationship subgraph features.Finally,social robots can be more accurately identified by combining user behavioral and relationship features.By carrying out experimental studies based on the publicly available datasets TwiBot-20 and Cresci-15,the suggested method’s detection accuracies can achieve 86.73%and 97.86%,respectively.Compared with the existing mainstream approaches,the accuracy of the proposed method is 2.2%and 1.35%higher on the two datasets.The results show that the method proposed in this paper can effectively detect social robots and maintain a healthy ecological environment of social networks.

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.