Thyroid function and associated mood changes after COVID-19 vaccines in patients with Hashimoto thyroiditis.

Context: Severe acute respiratory syndrome-coronavirus 2 (COVID-19) vaccines may incur changes in thyroid functions followed by mood changes, and patients with Hashimoto thyroiditis (HT) were suggested to bear a higher risk. Objectives: We primarily aim to find whether COVID-19 vaccination could induce potential subsequent thyroid function and mood changes. The secondary aim was to find inflammatory biomarkers associated with risk. Methods: The retrospective, multi-center study recruited patients with HT receiving COVID-19-inactivated vaccines. C-reactive proteins (CRPs), thyroid-stimulating hormones (TSHs), and mood changes were studied before and after vaccination during a follow-up of a 6-month period. Independent association was investigated between incidence of mood state, thyroid functions, and inflammatory markers. Propensity score-matched comparisons between the vaccine and control groups were carried out to investigate the difference. Results: Final analysis included 2,765 patients with HT in the vaccine group and 1,288 patients in the control group. In the matched analysis, TSH increase and mood change incidence were both significantly higher in the vaccine group (11.9% versus 6.1% for TSH increase and 12.7% versus 8.4% for mood change incidence). An increase in CRP was associated with mood change (p< 0.01 by the Kaplan-Meier method) and severity (r = 0.75) after vaccination. Baseline CRP, TSH, and antibodies of thyroid peroxidase (anti-TPO) were found to predict incidence of mood changes. Conclusion: COVID-19 vaccination seemed to induce increased levels and incidence of TSH surge followed by mood changes in patients with HT. Higher levels of pre-vaccine serum TSH, CRP, and anti-TPO values were associated with higher incidence in the early post-vaccine phase.

Effect of Increased Depressive Feelings during the COVID-19 Pandemic on the Association between Depressive Mood and Suicidal Behavior: Using the 17th (2021) Korea Youth Risk Behavior Web-Based Survey (KYRBS).

This study investigated the impact of increased depressive feelings during the COVID-19 pandemic on the suicidal behavior of Korean high school students using the 17th Korea Youth Risk Behavior Web-Based Survey (KYRBS). We classified the independent variables into four groups ("no depressive mood and no increase in depressive feelings [group A]", "no depressive mood and increase in depressive feelings [group B]", "depressive mood and no increase in depressive feelings [group C]", and "depressive mood and increase in depressive feelings [group D]"). Compared to group A, group D showed an odds ratio of 18.30 in men and 14.87 in women for suicidal behavior after accounting for demographic and health behavioral characteristics. We found that depressive mood and a relatively short-term increase in depressive feelings had a synergistic effect, rather than an additive one, on suicidal behavior. Based on this result, we claim that an appropriate intervention method is necessary to prevent adolescents' depressive mood from developing into suicidal behavior during the pandemic.

Beta-Endorphin and Oxytocin in Patients with Alcohol Use Disorder and Comorbid Depression.

BACKGROUND: The neuropeptides ß-endorphin and oxytocin are released into the bloodstream as hormones from the pituitary gland but also have an important function as neuroregulators in the forebrain. The blood levels of both polypeptides have been shown to reflect depressive symptoms. ß-Endorphin, in particular, is also involved in abstinence from alcohol. METHODS: The serum levels of ß-endorphin and oxytocin were measured during the early withdrawal phase in patients with alcohol use disorder (AUD) with (N = 35) or without (N = 45) depressive comorbidity and compared with those in healthy volunteers (N = 23). In addition to comparing the groups, the study examined whether serum levels correlated with various psychometric measures of dependence, depression and aggression, as well as with clinical characteristics of dependence. RESULTS: Both serum levels of beta-endorphin and oxytocin were significantly lower in patients than those in healthy controls (p = 0.011 for ß-endorphin and p = 0.005 for oxytocin, Kruskal-Wallis test). In patients with depressive comorbidity, the significance was greatest (p = 0.005 for ß-endorphin and p = 0.004 for oxytocin, U-test). There was no correlation with clinical or psychometric parameters (p > 0.05, Spearman test), but beta-endorphin levels did correlate significantly with physical aggression (p = 0.026, Spearman test). CONCLUSIONS: Serum levels of ß-endorphin and oxytocin are lower in patients with AUD, particularly in those with depressive comorbidity. ß-Endorphin levels correlated with physical aggression according to the Buss-Durkee (BDHI) estimates.

Performance Evaluation of a Voice-Based Depression Assessment System Considering the Number and Type of Input Utterances.

It is empirically known that mood changes affect facial expressions and voices. In this study, the authors have focused on the voice to develop a method for estimating depression in individuals from their voices. A short input voice is ideal for applying the proposed method to a wide range of applications. Therefore, we evaluated this method using multiple input utterances while assuming a unit utterance input. The experimental results revealed that depressive states could be estimated with sufficient accuracy using the smallest number of utterances when positive utterances were included in three to four input utterances.

Mood versus energy/activity symptoms in bipolar disorder: which cluster of Hamilton Depression Rating Scale better distinguishes between mania, depression, and euthymia? / Sintomas de humor versus sintomas de energia/atividade no transtorno bipolar: qual grupo da Escala de Depressão de Hamilton distingue melhor entre mania, depressão e eutimia?

Abstract Introduction Although bipolar disorder (BD) is traditionally included among mood disorders, some authors believe that changes in energy and motor activity, rather than mood changes, represent the true cardinal symptoms in mania and depression. The aim of the current study was to identify which cluster of the Hamilton Depression Rating Scale (HAM-D) better distinguishes between mania, depression and euthymia. Method A group of 106 patients with BD were followed for 13 years and repeatedly assessed with the HAM-D as well as with other clinical scales. To perform a comparison, HAM-D items were classified according to clinical criteria into three clusters: energy/activity symptoms, mood symptoms, and other symptoms. Item response theory (IRT) analyses were performed to provide a test information curve for those three clusters. We measured the prevalence of one cluster of symptoms over the other two throughout the latent trait. Results Considering HAM-D items individually, the IRT analysis revealed that there was a mixture of mood and energy/activity symptoms among the most discriminative items, both in depression and in euthymia. However, in mania, only energy/activity symptoms - i.e., general somatic symptoms and retardation - were among the most informative items. Considering the classification of items, both in depression as in mania, the energy/activity cluster was more informative than the mood cluster according to the IRT analysis. Conclusion Our data reinforce the view of hyperactivity and motor retardation as cardinal changes of mania and depression, respectively.

Resumo Introdução Embora o transtorno bipolar (TB) seja tradicionalmente incluído entre os transtornos do humor, alguns autores acreditam que as alterações na energia e na atividade motora, em vez das alterações no humor, representam os verdadeiros sintomas cardinais na mania e na depressão. O objetivo do presente estudo foi identificar qual grupo da Escala de Depressão de Hamilton (HAM-D) distingue melhor entre mania, depressão e eutimia. Método Um grupo de 106 pacientes com TB foram acompanhados por 13 anos e avaliados repetidamente com a HAM-D e com outras escalas clínicas. Para realizar uma comparação, os itens da HAM-D foram classificados de acordo com critérios clínicos em três grupos: sintomas de energia/atividade, sintomas de humor e outros sintomas. Foram realizadas análises da teoria da resposta ao item (TRI) para fornecer uma curva de informações de teste para esses três grupos. Medimos a prevalência de um grupo de sintomas em comparação aos outros dois através do traço latente. Resultados Considerando os itens da HAM-D individualmente, a análise da TRI revelou que havia uma mistura de sintomas de humor e de energia/atividade entre os itens mais discriminativos, tanto na depressão quanto na eutimia. No entanto, na mania, apenas os sintomas de energia/atividade - ou seja, sintomas somáticos gerais e retardo - estavam entre os itens mais informativos. Considerando a classificação dos itens, tanto na depressão quanto na mania, o grupo energia/atividade foi mais informativo que o grupo humor, de acordo com a análise da TRI. Conclusão Nossos dados reforçam a visão da hiperatividade e do retardo motor como as alterações cardinais de mania e depressão, respectivamente.

Using Computer Tablets to Improve Moods for Older Adults With Dementia and Interactions With Their Caregivers: Pilot Intervention Study.

BACKGROUND: Persons living with dementia represent a significant and growing segment of the older adult (aged 65 years and older) population. They are often challenged expressively and may experience difficulties with sharing their feelings or moods. Availability of, and easy access to, tablets facilitates the use of information and communication technologies (ICTs) as a delivery mechanism for nonpharmacological interventions, especially for persons living with dementia. Evidence of the impact of ICTs in different community settings on mood with older adults and the impact of engagement on their caregivers is needed to promote broader adoption and sustainment of these technologies in the United States. OBJECTIVE: This study aimed to determine the extent of the effects of tablets on positive mood change and examine the effects of study variables on care recipients' mood changes and caregivers' daily interactions. METHODS: The tablet intervention was developed and evaluated in five programs. The primary outcome was caregivers' assessment of care recipients' mood (n=1089) before and after a tablet engagement session using an eight-point mood visual analog scale. Session influence on caregivers' daily activities was captured for a subsample of participants (n=542). Frequency distributions were computed for each study variables. Chi-square tests of association were calculated to determine the association of the variables on mood changes for all care recipients, as well as those being treated in skilled nursing facilities and in-home, and then for those that affected caregivers' daily activities. RESULTS: The study sample comprised 1089 care recipient and caregiver engagement sessions. Cumulatively, 50.78% (553/1089) of care recipients showed a transition from negative to positive moods, whereas another 41.78% (455/1089) maintained an already-positive mood after the caregiver engagement session. Chi-square analyses demonstrated that positive mood changes resulted from using music (χ210=72.9; P<.001), using YouTube as the sole app (χ212=64.5; P<.001), using multiple engagement strategies (χ22=42.8; P<.001), and when cared for in a skilled nursing facility (χ24=236.8; P<.001) across the entire care recipient sample. In addition, although many features of the engagement session positively influenced the caregivers' day, the largest effect was observed when care recipients' mood was considered to have improved following the session (χ24=234.7; P<.001). CONCLUSIONS: The study is one of the first in the United States to explore the impact of ICTs, in particular managed tablets and Web-based video services that can be used on a tablet through an app, on improving mood in persons living with dementia, and enhancing caregivers' perceptions about their care recipient interactions. Importantly, these pilot data substantiate ICTs as part of a personalized engagement approach, as beneficial alternatives to pharmaceutical interventions for mood enhancement. However, a more comprehensive study that explores the ICT's impact on additional clinical outcomes is needed to confirm these preliminary findings.

Emotion suppression and food intake in the context of a couple discussion: A dyadic analysis.

Using dyadic analysis, this study examined whether emotion suppression is a valid mediator in the relationship between mood change following a stressful couple discussion and subsequent food intake among cohabiting couples. In a laboratory setting, 80 heterosexual couples were presented with a bogus taste test immediately after discussing aspects that they would like each other to change. Mood change, emotion suppression and appetite perceptions were self-reported using visual analogue scales, and BMI was calculated based on objective measures. The moderated-mediation Actor-Partner Interdependence Model revealed a significant indirect conditional effect, showing that mood worsening was significantly associated with higher emotion suppression and that emotion suppression was significantly associated with more food intake among spouses with a high BMI. For spouses with a low BMI, the reverse effect was found, i.e., mood worsening was significantly associated with less food intake through the indirect effect of emotion suppression. Furthermore, an indirect partner effect was observed regardless of BMI, i.e., mood worsening was related to more food intake, which was mediated by the partner's emotion suppression. These results highlight the key role of emotion suppression in the relationship between mood change and food intake in the context of a stressful couple discussion.

Loss of sexual interest and premenstrual mood change in women with postpartum versus non-postpartum depression: A nationwide community sample of Korean adults.

BACKGROUND: Postpartum depression (PPD) is a type of clinical depression that can affect women after childbirth. Few previous studies have explored the association of depressive and physical symptoms among women with PPD in a nationwide community study. METHOD: A total of 18,807 adults, randomly selected, completed a face-to-face interview using the Korean version of Composite International Diagnostic Interview (K-CIDI) (response rate 80.2%). PPD was defined as a major depressive episode that began within 4 weeks after delivery. RESULTS: Of 679 female subjects with major depressive disorder (MDD), 14.0% (n=95) experienced PPD. Subjects with PPD were significantly more likely to have higher income, education, and reside in an urban area, compared to those with non-PPD. No significant differences were found in number of children. Multiple logistic regression revealed that the loss of sexual interest was the only symptom among 23 depressive symptoms that was significantly associated with depressive episodes among individuals with PPD (AOR=1.91, 95% CI 1.01-3.60) when compared with non-PPD. Loss of sexual interest was also significantly associated with the subjects with lifetime PPD regardless of depressive episode (AOR=1.93, 95% CI 1.12-3.31). Conversely, loss of confidence and loss of pleasure were less frequent in subjects with PPD. Premenstrual mood change (χ(2)=5.57, p=0.0036) and comorbid alcohol use disorder (χ(2)=5.11, p=0.031) showed a valid association with PPD. CONCLUSIONS: Loss of sexual interest and premenstrual mood change were associated with women with PPD, whereas those with non-PPD were not, thereby suggesting the possible link between sexual hormones and PPD.

Common Factor Mechanisms in Clinical Practice and Their Relationship with Outcome.

UNLABELLED: This study investigates three common factor mechanisms that could affect outcome in clinical practice: response expectancy, the affective expectation model and motivational concordance. Clients attending a gestalt therapy clinic (30 clients), a sophrology (therapeutic technique) clinic (33 clients) and a homeopathy clinic (31 clients) completed measures of expectancy and the Positive Affect and Negative Affect Schedule (PANAS) before their first session. After 1 month, they completed PANAS and measures of intrinsic motivation, perceived effort and empowerment. Expectancy was not associated with better outcome and was no different between treatments. Although some of the 54 clients who endorsed highest expectations showed substantial improvement, others did not: 19 had no change or deteriorated in positive affect, and 18 had the same result for negative affect. Intrinsic motivation independently predicted changes in negative affect (ß = -0.23). Intrinsic motivation (ß = 0.24), effort (ß = 0.23) and empowerment (ß = 0.20) independently predicted positive affect change. Expectancy (ß = -0.17) negatively affected changes in positive affect. Clients found gestalt and sophrology to be more intrinsically motivating, empowering and effortful compared with homeopathy. Greater improvement in mood was found for sophrology and gestalt than for homeopathy clients. These findings are inconsistent with response expectancy as a common factor mechanism in clinical practice. The results support motivational concordance (outcome influenced by the intrinsic enjoyment of the therapy) and the affective expectation model (high expectations can lead for some clients to worse outcome). When expectancy correlates with outcome in some other studies, this may be due to confound between expectancy and intrinsic enjoyment. KEY PRACTITIONER MESSAGE: Common factors play an important role in outcome. Intrinsic enjoyment of a therapeutic treatment is associated with better outcome. Active engagement with a therapeutic treatment improves outcome. Unrealistic expectations about a therapeutic treatment can have a negative impact on outcome.

Increased energy/activity, not mood changes, is the core feature of mania.

BACKGROUND: In the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, the occurrence of increased energy/activity and elation of mood or irritability became necessary symptoms for the diagnosis of an episode of mania or hypomania. OBJECTIVE: To evaluate whether increases in energy/activity or mood changes represent the core feature of the manic syndrome. METHODS: The symptomatology of 117 hospitalized patients with bipolar mania was evaluated using the Schedule for Affective Disorders and Schizophrenia-Changed version (SADS-C). Based on six items of the SADS-S related to mania, a Confirmatory Factor Analysis (CFA) was performed. An Item Response Theory (IRT) analysis was used to identify how much each symptom informs about the different levels of severity of the syndrome. RESULTS: According to the CFA, the item "increased energy" was the symptom with the highest factorial loadings, which was confirmed by the IRT analysis. Thus, increased energy was the alteration most correlated with the total severity of manic symptoms. Additionally, the analysis of the Item Information Function revealed that increased energy was correlated with the larger amplitude of severity levels compared with the other symptoms of mania. LIMITATIONS: Only six manic symptoms were considered. The sample might not be representative because the patients were evaluated while presenting peak symptom severity. CONCLUSIONS: Increased energy/activity is a more important symptom for a diagnosis of mania than mood changes and represents the core feature of this syndrome.