Are TrkB receptor agonists the right tool to fulfill the promises for a therapeutic value of the brain-derived neurotrophic factor?

Brain-derived neurotrophic factor signaling via its receptor tropomyosin receptor kinase B regulates several crucial physiological processes. It has been shown to act in the brain, promoting neuronal survival, growth, and plasticity as well as in the rest of the body where it is involved in regulating for instance aspects of the metabolism. Due to its crucial and very pleiotropic activity, reduction of brain-derived neurotrophic factor levels and alterations in the brain-derived neurotrophic factor/tropomyosin receptor kinase B signaling have been found to be associated with a wide spectrum of neurological diseases. However, because of its poor bioavailability and pharmacological properties, brain-derived neurotrophic factor itself has a very low therapeutic value. Moreover, the concomitant binding of exogenous brain-derived neurotrophic factor to the p75 neurotrophin receptor has the potential to elicit several unwanted and deleterious side effects. Therefore, developing tools and approaches to specifically promote tropomyosin receptor kinase B signaling has become an important goal of translational research. Among the newly developed tools are different categories of tropomyosin receptor kinase B receptor agonist molecules. In this review, we give a comprehensive description of the different tropomyosin receptor kinase B receptor agonist drugs developed so far and of the results of their application in animal models of several neurological diseases. Moreover, we discuss the main benefits of tropomyosin receptor kinase B receptor agonists, concentrating especially on the new tropomyosin receptor kinase B agonist antibodies. The benefits observed both in vitro and in vivo upon application of tropomyosin receptor kinase B receptor agonist drugs seem to predominantly depend on their general neuroprotective activity and their ability to promote neuronal plasticity. Moreover, tropomyosin receptor kinase B agonist antibodies have been shown to specifically bind the tropomyosin receptor kinase B receptor and not p75 neurotrophin receptor. Therefore, while, based on the current knowledge, the tropomyosin receptor kinase B receptor agonists do not seem to have the potential to reverse the disease pathology per se, promoting brain-derived neurotrophic factor/tropomyosin receptor kinase B signaling still has a very high therapeutic relevance.

Understanding the spectrum of non-motor symptoms in multiple sclerosis: insights from animal models.

Multiple sclerosis is a chronic autoimmune disease of the central nervous system and is generally considered to be a non-traumatic, physically debilitating neurological disorder. In addition to experiencing motor disability, patients with multiple sclerosis also experience a variety of non-motor symptoms, including cognitive deficits, anxiety, depression, sensory impairments, and pain. However, the pathogenesis and treatment of such non-motor symptoms in multiple sclerosis are still under research. Preclinical studies for multiple sclerosis benefit from the use of disease-appropriate animal models, including experimental autoimmune encephalomyelitis. Prior to understanding the pathophysiology and developing treatments for non-motor symptoms, it is critical to characterize the animal model in terms of its ability to replicate certain non-motor features of multiple sclerosis. As such, no single animal model can mimic the entire spectrum of symptoms. This review focuses on the non-motor symptoms that have been investigated in animal models of multiple sclerosis as well as possible underlying mechanisms. Further, we highlighted gaps in the literature to explain the non-motor aspects of multiple sclerosis in experimental animal models, which will serve as the basis for future studies.

Xiaoyaosan ameliorates CUMS-induced depressive-like and anorexia behaviors in mice via necroptosis related cellular senescence in hypothalamus.

ETHNOPHARMACOLOGICAL RELEVANCE: Depression and anorexia often co-occur and share symptoms such as low mood, lack of energy, and weight loss. Xiaoyaosan is a classic formula comprising of a combination of eight herbs, possessing definitive therapeutic effects, minimal side effects, and economical benefits. It has been extensively employed in clinical treatment of ailments and symptoms such as depression, anxiety, and appetite problems. Nonetheless, its exact pharmacological mechanism with necroptosis remains incompletely explicit. AIM OF THE STUDY: The aim of this study is to explore the potential mechanisms of anti-depressive and appetite-regulating effects of the active ingredients in Xiaoyaosan, and to investigate whether there is a correlation with necroptosis. MATERIALS AND METHODS: The network pharmacology method was conducted to identify active ingredients, which were used to predict the possible targets of Xiaoyaosan and explore the potential targets in treating depression and anorexia by overlapping with differentially expressed genes (DEGs) screened from GEO datasets (GSE125441, GSE198597, and GSE69151). Afterwards, the protein-protein interaction (PPI) network, enrichment analyses, hub gene identification, co-expression study and molecular docking were used to study the potential mechanism of Xiaoyaosan. Then, a mice model of depression was established by chronic unpredictable mild stress (CUMS) and the incidence of necroptosis in the hypothalamus of CUMS mice was investigated, while verifying the key therapeutic target of Xiaoyaosan. RESULTS: Through network pharmacology research, it had been discovered that the 145 active ingredients of the 8 herbs in the Xiaoyaosan could regulate 198 disease targets. Through PPI network analysis and functional enrichment analysis, it had been found that the pharmacological mechanism of Xiaoyaosan mainly involved biological processes such as oxidative stress, kinase activity, and DNA metabolism. It is related to various pathways such as cellular senescence, immune inflammation, and the cell cycle, and 9 hub targets had been identified. Further analysis of the 9 hub targets and the key PPI network clusters clarified the key mechanisms by which Xiaoyaosan exerts anti-depressant and appetite regulating effects, possibly related to necroptosis-mediated cellular senescence. Molecular docking of the key indicators of cellular senescence screened by bioinformatics, SIRT1, ABL1, and MYC, revealed that the key component regulating SIRT1 is 2-[3,4-dihydroxyphenyl]-5,7-dihydroxy-6-[3-methylbut-2-enyl]chromone in licorice root, Glabridin in licorice root regulates ABL1, and ß-sitosterol found in Chinese angelica, debark peony root, and fresh ginger regulates MYC. Finally, through in vivo experiments, the expression of necroptosis in the hypothalamus of CUMS mice was verified. The regulatory effects of Xiaoyaosan on key substances RIPK1, RIPK3, MLKL, and p-MLKL were determined, while regulating effects on SIRT1, ABL1, and MYC were also observed. CONCLUSION: The present study have revealed the common mechanism of Xiaoyaosan in treating depression and anorexia, indicating that the active ingredients of Xiaoyaosan may alleviate the symptoms of depression and anorexia by intervening in the pathways related to necroptosis and cellular senescence. The hub genes and common pathways identified by the study also provide new insights into the therapeutic targets of depression and anorexia, as well as the exploration of pharmacological mechanism of Xiaoyaosan.

Rasch analysis of the Hospital Anxiety andDepression Scale (HADS) in patients with major depression / Análisis de Rasch de la Escala Hospitalaria de Ansiedad y Depresión (Hospital Anxiety and Depression Scale, HADS) en pacientes con depresión mayor

La Hospital Anxiety and Depression Scale (HADS) [Escala Hospitalaria de Ansiedad y Depresión] es una herramienta ampliamente utilizada para detección de la depresión y la ansiedad en pacientes con enfermedades médicas. Este estudio tuvo como objetivo explorar las propiedades psicométricas de la HADS en la detección de pacientes con depresión mayor utilizando el método de la teoría de respuesta al ítem. Un total de 460 pacientes con depresión mayor completaron el HADS. Se utilizó el análisis de Rasch para examinar la unidimensionalidad, el ajuste de los ítems, la dependencia local, la confiabilidad, el orden de las categorías, el funcionamiento diferencial de los ítems (DIF) y la focalización. La HADS mostró una construcción bidimensional. Todos los ítems se ajustaban al modelo de Rasch. Tres pares de ítems mostraron una dependencia local menor pero desconsiderada. Ambas subescalas tuvieron una confiabilidad aceptable. Ninguno de los ítems mostró categorías desordenadas o DIF. Todos los ítems estaban bien dirigidos y los participantes con niveles altos y bajos de angustia fueron menos objetivo que aquellos con niveles moderados de angustia. Finalmente, se generó una tabla de conversión para transformar las puntuaciones brutas en medidas de intervalo. El HADS demostró propiedades psicométricas adecuadas para evaluar la depresión y la ansiedad en pacientes con depresión mayor. Fue más apropiado para evaluar niveles de angustia moderados que altos o bajos. La tabla de conversión se puede utilizar para una medición más precisa. Estos resultados pueden allanar el camino para métodos eficientes y sensibles para analizar la respuesta a los síntomas de depresión en la investigación y en la práctica clínica.(AU)

The Hospital Anxiety and Depression Scale (HADS) is a widely used screening tool for depression and anxiety in patients with medical ill-nesses. This study aimed to explore the psychometric properties of the HADS in screening for patients with major depression using item response theory method.A total of 460 patients with major depression completed the HADS. Rasch analyses were used to examine unidimensionality, item fit, local dependency, reliability, ordering of categories, differential item functioning (DIF)and targeting. The HADS showed a two-dimensional construct.All items fit the Rasch model.Three pairs of items showed mi-norbut inconsiderate local dependency.Both subscales had acceptable re-liability.None of the items displayed disordered categoriesor DIF.All items werewelltargeted, and participants with high and low levels of dis-tress were less targeted than those with moderate levels of distress.Finally, a conversion table to transform the raw scores into interval measures was generated. The HADS demonstrated adequate psychometric properties in assessing depression and anxiety in patients with major depression. It was more appropriate for assessing moderate than high or low levels of dis-tress.The conversion table can be used for more precise measurement.These results may pave the way for efficient and sensitive methods of ana-lyzing depression symptom response in research and in clinical practice.(AU)

Riesgo de depresión durante el embarazo en la atención prenatal de riesgo habitual / Risk of depression during pregnancy in usual risk antenatal care / Risco de depressão na gravidez na assistência pré-natal de risco habitual

Objetivo: identificar el riesgo de depresión durante el embarazo en gestantes de riesgo habitual incluidas en el control prenatal y los factores asociados. Método: estudio transversal, realizado con 201 gestantes, en el consultorio de prenatal de riesgo habitual de una maternidad universitaria. Para la recolección de datos se utilizó un formulario electrónico que contenía un instrumento de caracterización y la Escala de Riesgo de Depresión del Embarazo. La variable dependiente fue el riesgo de depresión en el embarazo. El análisis estadístico se realizó mediante el cálculo de la razón de posibilidades (Odds Ratio) y utilizando las pruebas de Chi-cuadrado y exacta de Fischer. Resultados: entre las participantes, 68,2% tenían mayor riesgo de depresión durante el embarazo. Hubo asociación estadísticamente significativa entre mayor riesgo de depresión durante el embarazo y la variable ocupación (p=0,04), o sea, la ausencia del trabajo (OR = 2,00) duplicó la probabilidad de ocurrencia. Conclusión: la alta prevalencia de riesgo de depresión durante el embarazo destaca la necesidad de planificación, priorización e integración de la salud mental en los servicios de salud prenatal, especialmente en el ámbito de la Atención Primaria de Salud, por parte de los gestores de salud y de los formuladores de políticas.

Objective: to identify the risk of depression during pregnancy among pregnant women receiving routine prenatal care and the associated factors. Method: a cross-sectional study, carried out with 201 pregnant women, in a routine prenatal clinic of a university maternity hospital. Data were collected using an electronic form containing a characterization instrument and the Escala de Risco de Depressão na Gravidez (Depression during Pregnancy Scale). The dependent variable was the risk of depression during pregnancy. Statistical analysis was performed by calculating the Odds Ratio and using the Chi-square and Fischer's Exact tests. Results: among the participants, 68.2% had a higher risk of depression during pregnancy. There was a statistically significant association between a higher risk of depression during pregnancy and occupation (p=0.04), that is, unemployment (OR=2.00) doubled the risk of depression. Conclusion: the high prevalence of the risk of depression during pregnancy indicates the necessity of planning, prioritizing, and integrating mental health into prenatal health services, especially in the primary healthcare environment, by health managers and policymakers.

Objetivo: identificar o risco de depressão na gravidez entre gestantes inseridas na assistência pré-natal de risco habitual e os fatores associados. Método: estudo transversal, realizado com 201 gestantes, no ambulatório de pré-natal de risco habitual de uma maternidade universitária. A coleta de dados utilizou um formulário eletrônico contendo um instrumento de caracterização e a Escala de Risco de Depressão na Gravidez. A variável dependente foi o risco de depressão na gravidez. A análise estatística deu-se pelo cálculo da razão de chances (Odds Ratio) e pelos testes Qui-quadrado e Exato de Fischer. Resultados: entre as participantes, 68,2% apresentaram maior risco de depressão na gravidez. Houve associação estatisticamente significativa entre o maior risco de depressão na gravidez e a variável ocupação (p=0,04), ou seja, a ausência de emprego (OR = 2,00) aumentou em duas vezes a chance de ocorrência. Conclusão: a alta prevalência de risco de depressão na gravidez evidencia a necessidade de planejamento, priorização e integração da saúde mental nos serviços de saúde pré-natal, principalmente no ambiente da Atenção Primária à Saúde, por parte de gestores de saúde e formuladores de políticas.

Distrés psicológico en estudiantes de enfermería: relación con tiempo de pantalla, dieta y actividad física / Psychological distress in nursing students: relationship with screen time, diet and physical activity / Sofrimento psicológico em estudantes de enfermagem: relação com tempo de tela, alimentação e atividade física

Objetivo: determinar la prevalencia de síntomas de ansiedad y depresión, al igual que su asociación con el tiempo de pantalla, la dieta y la actividad física, en una cohorte de estudiantes de enfermería. Método: estudio descriptivo y transversal sobre una muestra de 648 estudiantes de enfermería. Se utilizaron la Hospital Anxiety and Depression Scale, la versión corta del International Physical Activity Questionnaire y el Índice de Alimentación Saludable español. Se llevaron a cabo diferentes modelos de regresión lineal múltiple para analizar la asociación entre los síntomas de ansiedad y depresión, y el tiempo de pantalla, la dieta y la actividad física. Resultados: la prevalencia de síntomas de ansiedad y depresión fue de 24,1% y 3,7%, respectivamente. El tiempo de pantalla prolongado (>6 horas por día), baja actividad física y dieta inadecuada se asociaron de manera independiente y significativa con una mayor sintomatología psicológica. Conclusión: la salud mental de los estudiantes de enfermería podría beneficiarse de implementarse iniciativas que promuevan estilos de vida saludables.

Objective: to determine the prevalence of anxiety and depression symptoms, as well as their association with screen time, diet and physical activity, in a cohort comprised by nursing students. Method: a descriptive and cross-sectional study conducted with a sample of 648 Nursing students. The instruments used were the Hospital Anxiety and Depression Scale, the short version of the International Physical Activity Questionnaire and the Spanish Healthy Eating Index (Índice de Alimentación Saludable Español, IASE). Different multiple linear regression models were performed to analyze the association between anxiety/depression symptoms and screen time, diet and physical activity. Results: the prevalence values for anxiety and depression symptoms were 24.1% and 3.7%, respectively. Prolonged screen times (>6 hours a day), low levels of physical activity and inadequate diet were independently and significantly associated with deeper psychological symptoms. Conclusion: Nursing students' mental health might benefit from the implementation of initiatives promoting healthy lifestyles.

Objetivo: determinar a prevalência de sintomas de ansiedade e depressão e sua associação com tempo de tela, dieta e atividade física em uma coorte de estudantes de enfermagem. Método: estudo descritivo transversal com amostra de 648 estudantes de enfermagem. Utilizou-se a Hospital Anxiety and Depression Scale, a versão curta do International Physical Activity Questionnaire e o Índice Espanhol de Alimentação Saudável. Foram realizados diferentes modelos de regressão linear múltipla para analisar a associação entre sintomas de ansiedade e depressão e tempo de tela, dieta e atividade física. Resultados: a prevalência de sintomas de ansiedade e depressão foi de 24,1% e 3,7%, respectivamente. O tempo prolongado de tela (>6 horas por dia), a baixa atividade física e a dieta inadequada foram associados de forma independente e significativa ao aumento da sintomatologia psicológica. Conclusão: a saúde mental dos estudantes de enfermagem pode ser beneficiada com a implementação de iniciativas que promovam estilos de vida saudáveis.

Síntomas de depresión, ansiedad y estrés en estudiantes del área de la salud e impacto en la calidad de vida / Symptoms of depression, anxiety and stress in health students and impact on quality of life / Sintomas de depressão, ansiedade e estresse em estudantes da saúde e impacto na qualidade de vida

Objetivo: evaluar la asociación entre la calidad de vida y la presencia de síntomas de depresión, ansiedad y estrés en estudiantes universitarios del área de la salud. Método: estudio transversal que incluyó a 321 estudiantes de carreras del área de la salud. La calidad de vida se midió mediante la escala de la Organización Mundial de la Salud, versión abreviada, en los dominios físico, psicológico, relaciones sociales y ambiente, y los síntomas se evaluaron por la escala de depresión, ansiedad y estrés. Se realizó un análisis multivariante por medio de regresión lineal robusta para evaluar la asociación entre la calidad de vida y los síntomas presentados. Resultados: se observó una asociación negativa entre la calidad de vida y los síntomas de depresión en todos los dominios, mientras que los síntomas de ansiedad tuvieron una asociación negativa en el dominio ambiente, y los síntomas de estrés tuvieron una asociación negativa en el dominio psicológico. La gravedad de los síntomas se asoció desfavorablemente con la calidad de vida, es decir, cuanto mayor la gravedad de los síntomas, menores las puntuaciones medias en todos los dominios. Conclusión: los síntomas de depresión, ansiedad y estrés fueron prevalentes e impactaron negativamente en la calidad de vida de los estudiantes, especialmente en presencia de síntomas depresivos. Las puntuaciones disminuidas se asociaron significativamente con la gravedad de los síntomas.

Objective: to evaluate the association between quality of life and presence of symptoms of depression, anxiety, and stress in college students in the health area. Method: cross-sectional study that included 321 students from undergraduate courses in the health area. Quality of life was measured using the World Health Organization scale, abbreviated version, in the physical, psychological, social relations and environment domains, and symptoms were assessed by the depression, anxiety and stress scale. Multivariate analysis was performed using robust linear regression to evaluate the association between quality of life and symptoms. Results: a negative association was observed between the quality of life and depression symptoms in all domains, while anxiety symptoms showed a negative association in the environment domain, and stress symptoms had a negative association in the psychological domain. Symptom severity was unfavorably associated with quality of life, that is, the greater the symptom severity, the lower the mean scores in all domains. Conclusion: symptoms of depression, anxiety, and stress were prevalent and had a negative impact on students' quality of life, especially in the presence of depressive symptoms. The decrease in scores was significantly associated with the severity of symptoms.

Objetivo: avaliar a associação entre qualidade de vida e presença de sintomas de depressão, ansiedade e estresse em estudantes universitários da área da saúde. Método: estudo transversal que incluiu 321 estudantes de cursos de graduação da área da saúde. A qualidade de vida foi mensurada por meio da escala da Organização Mundial da Saúde, versão abreviada, nos domínios físico, psicológico, relações sociais e meio ambiente, e os sintomas avaliados pela escala de depressão, ansiedade e estresse. Foi realizada análise multivariada utilizando regressão linear robusta para avaliar a associação entre qualidade de vida e sintomas apresentados. Resultados: observou- se associação negativa entre qualidade de vida e sintomas de depressão em todos os domínios, enquanto os sintomas de ansiedade apresentaram associação negativa no domínio meio ambiente, e os sintomas de estresse tiveram associação negativa no domínio psicológico. A gravidade dos sintomas associou-se de forma desfavorável com a qualidade de vida, ou seja, quanto maior a gravidade dos sintomas, menor a média dos escores em todos os domínios. Conclusão: sintomas de depressão, ansiedade e estresse mostraram-se prevalentes e com impacto negativo na qualidade de vida dos estudantes, principalmente na presença de sintomas depressivos. A diminuição dos escores foi significativamente associada à gravidade dos sintomas.

Soft Drinks and Symptoms of Depression and Anxiety in Overweight Subjects: A Longitudinal Analysis of an European Cohort.

BACKGROUND: Studies about the association of carbonated/soft drinks, coffee, and tea with depression and anxiety are scarce and inconclusive and little is known about this association in European adults. Our aim was to examine the association between the consumption of these beverages and depressive and anxiety symptom severity. METHODS: A total of 941 European overweight adults (mean age, 46.8 years) with subsyndromal depression that participated in the MooDFOOD depression prevention randomized controlled trial (Clinical Trials.gov identifier: NCT2529423; date of the study: from 2014 to 2018) were analyzed. Depressive and anxiety symptom severity and beverage consumption were assessed using multilevel mixed-effects ordinal logistic regression models for each beverage consumption (carbonated/soft drink with sugar, carbonated/soft drink with non-nutritive sweeteners, coffee, and tea) with the three repeated measures of follow-up (baseline and 6 and 12 months). A case report form for participants' sociodemographic and clinical characteristics, the Food Frequency Questionnaire, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder 7-Item Scale, the MINI International Neuropsychiatric Interview 5.0, the Short Questionnaire to Assess Health-Enhancing Psychical Activity, and the Alcohol Use Disorders Identification Test were the research tools used. RESULTS: Daily consumption of carbonated/soft drinks with sugar was associated with a higher level of anxiety. Trends towards significance were found for associations between both daily consumption of carbonated/soft drinks with sugar and non-nutritive sweeteners and a higher level of depression. No relationship was found between coffee and tea consumption and the level of depression and anxiety. CONCLUSIONS: The high and regular consumption of carbonated/soft drink with sugar (amount of consumption: ≥1 unit (200 mL)/day) tended to be associated with higher level of anxiety in a multicountry sample of overweight subjects with subsyndromal depressive symptoms. It is important to point out that further research in this area is essential to provide valuable information about the intake patterns of non-alcoholic beverages and their relationship with affective disorders in the European adult population.

Impact of COVID-19 on Lifestyle Habits and Emotional State of Childhood Cancer Survivors and Their Parents.

OBJECTIVE: The COVID-19 pandemic and associated social distancing measures affected the physical and emotional state of children and parents worldwide. Survivors of childhood cancer may be particularly vulnerable to these effects. We aimed to evaluate the lifestyle habits and emotional states of childhood cancer survivors and their parents during the COVID-19 outbreak. METHODS: Lifestyle habits and emotional distress were assessed in 43 childhood cancer survivors (aged 8-21 years) and their parents before and during the COVID-19 lockdown, using the PROMIS anxiety and depression modules and the "Mabat Youth" questionnaire. RESULTS: Most parents (80.5%) reported eating more family meals during home confinement compared to their usual routine. Patients' physical activity levels did not change significantly during confinement, leisure-related screen time nearly doubled (p < 0.001), and sleep duration increased (p = 0.006). Anxiety levels of children (p = 0.045) and parents (p = 0.02) increased during confinement compared to pre-pandemic levels, with no significant changes in depression levels. CONCLUSIONS: Contrary to concerns regarding lifestyle habits during the COVID-19 lockdown, eating behaviors of childhood cancer survivors improved, sleep duration increased, and physical activity remained unchanged. Still, screen time increased significantly. Parents of childhood cancer survivors reported higher anxiety levels for themselves and their children during home confinement. Our findings may assist medical and psycho-social teams in guiding parents of cancer survivors during similar circumstances in the future.

Key Nutrients for Optimal Blood Glucose Control and Mental Health in Individuals with Diabetes: A Review of the Evidence.

Diabetes is associated with an increased risk of mental disorders, including depression, anxiety, and cognitive decline. Mental disorders can also contribute to the development of diabetes through various mechanisms including increased stress, poor self-care behaviors, and adverse effects on glucose metabolism. Consequently, individuals suffering from either of these conditions frequently experience comorbidity with the other. Nutrition plays an important role in both diabetes and mental health disorders including depression and anxiety. Deficiencies in specific nutrients such as omega-3 fatty acids, vitamin D, B vitamins, zinc, chromium, magnesium, and selenium have been implicated in the pathogenesis of both diabetes and mental disorders. While the impact of nutrition on the progression and control of diabetes and mental disorders is broadly acknowledged, there is a notable knowledge gap concerning the implications of distinct nutrients in preventing and mitigating symptoms of both conditions when they coexist. The aim of this study was to examine the role of nutrition in improving glucose homeostasis and promoting mental well-being among individuals with diabetes. Further, we evaluated the preventive or delaying effects of key nutrients on the simultaneous manifestation of these conditions when one of them is present. Our findings indicated that the use of personalized dietary interventions and targeted nutrient supplementation can improve metabolic and mental health outcomes in patients with type 2 diabetes.

Comparative Analysis of Body Image Dissatisfaction, Depression, and Health-Related Quality of Life in Adults with Type 1 Diabetes: A Case-Control Study.

(1) Objective: This case-control study investigated body image dissatisfaction, depression, and health-related quality of life (HRQoL) in adults with type 1 diabetes. (2) Methods: A total of 35 adults with diabetes and an equal number of age- and gender-matched controls were included. Assessment tools used were the Body Image Disturbance Questionnaire (BIDQ), the Hospital Anxiety and Depression Scale (HADS), and the RAND 36-Item Health Survey. Both quantitative and qualitative data were analyzed. (3) Results: Body image dissatisfaction did not differ significantly between the groups. However, adults with diabetes reported higher levels of depression (p = 0.002) and lower scores for physical health (p = 0.015) and general health (p < 0.001) on the HRQoL measure. Qualitative analysis identified common themes related to physical disturbance, effect on activities, and psychosocial concerns. (4) Conclusions: Despite similar body image dissatisfaction, adults with type 1 diabetes exhibited increased depression and reduced HRQoL. These findings emphasize the need to integrate psychological well-being into type 1 diabetes management. They also support further research into the impact of body image dissatisfaction in T1D and potential interventions to address it.

Ghrelin as a Biomarker of "Immunometabolic Depression" and Its Connection with Dysbiosis.

Ghrelin, a gastrointestinal peptide, is an endogenous ligand of growth hormone secretagogue receptor 1a (GHSR1a), which is mainly produced by X/A-like cells in the intestinal mucosa. Beyond its initial description as a growth hormone (GH) secretagogue stimulator of appetite, ghrelin has been revealed to have a wide range of physiological effects, for example, the modulation of inflammation; the improvement of cardiac performance; the modulation of stress, anxiety, taste sensation, and reward-seeking behavior; and the regulation of glucose metabolism and thermogenesis. Ghrelin secretion is altered in depressive disorders and metabolic syndrome, which frequently co-occur, but it is still unknown how these modifications relate to the physiopathology of these disorders. This review highlights the increasing amount of research establishing the close relationship between ghrelin, nutrition, microbiota, and disorders such as depression and metabolic syndrome, and it evaluates the ghrelinergic system as a potential target for the development of effective pharmacotherapies.

Therapeutic Drug Monitoring in Children and Adolescents: Findings on Fluoxetine from the TDM-VIGIL Trial.

Fluoxetine is the recommended first-line antidepressant in many therapeutic guidelines for children and adolescents. However, little is known about the relationships between drug dose and serum level as well as the therapeutic serum reference range in this age group. Within a large naturalistic observational prospective multicenter clinical trial ("TDM-VIGIL"), a transdiagnostic sample of children and adolescents (n = 138; mean age, 15; range, 7-18 years; 24.6% males) was treated with fluoxetine (10-40 mg/day). Analyses of both the last timepoint and all timepoints (n = 292 observations), utilizing (multiple) linear regressions, linear mixed-effect models, and cumulative link (mixed) models, were used to test the associations between dose, serum concentration, outcome, and potential predictors. The receiver operating curve and first to third interquartile methods, respectively, were used to examine concentration cutoff and reference values for responders. A strong positive relationship was found between dose and serum concentration of fluoxetine and its metabolite. Higher body weight was associated with lower serum concentrations, and female sex was associated with lower therapeutic response. The preliminary reference ranges for the active moiety (fluoxetine+norfluoxetine) were 208-328 ng/mL (transdiagnostically) and 201.5-306 ng/mL (depression). Most patients showed marked (45.6%) or minimal (43.5%) improvements and reported no adverse effects (64.9%). This study demonstrated a clear linear dose-serum level relationship for fluoxetine in youth, with the identified reference range being within that established for adults.

Serum levels of brain-derived neurotrophic factor in remission, but not the acute phase, may predict the development from depression to dementia.

OBJECTIVES: Depression may be a risk factor or a prodromal symptom of dementia, and decreased serum levels of brain-derived neurotrophic factor (BDNF) have been observed in both depression and dementia. The aim of the present study was to determine whether serum levels of BDNF in the remitted or acute phase of depression predicted the transition from depression to dementia. METHODS: Serum levels of BDNF were measured in the acute phase of depression (n = 204) and after remission (n = 117), and we followed (mean: 24.3 months) the participants to assess the subsequent onset of dementia or mild cognitive impairment (MCI). RESULTS: Serum levels of BDNF after remission, but not those in the acute depressive phase, predicted the future development of dementia or MCI. CONCLUSIONS: Patients with low serum BDNF levels, even after depression remission, might have an increased risk of developing dementia. These findings suggest a potential association between residual low serum BDNF levels after remission and the prodromal state of dementia, or the involvement of BDNF in the transition from depression to dementia. However, given that this study is low-powered and preliminary, interpretation of the results should be approached with caution.

Depression, anxiety, psychological distress and associated factors among students attending Nemelifen Secondary and Preparatory School, Afar regional state, Ethiopia: a cross-sectional study.

OBJECTIVES: This study aimed to assess the magnitude of depression, anxiety, psychological distress and associated factors in Nemelifen Secondary and Preparatory School at Awash 7 Kilo, zone 3, Afar, Ethiopia. DESIGN: An institutional-based cross-sectional study design was implemented. SETTING: This research was conducted in Afar regional state, zone 3, Awash 7 Kilo town. PARTICIPANTS: A pretested, structured, self-administered questionnaire was used to gather information from 392 study participants. For the purpose of identifying risk variables for depression, anxiety and psychological distress, bivariate and multivariate binary logistic regression analyses were used. OUTCOME MEASURES: The primary outcome of the study was magnitude of depression, anxiety and psychological distress and the secondary outcome was factors associated with depression, anxiety and psychological distress. RESULTS: Overall, 109 study participants showed symptoms of depression (28.91%; 95% CI: 24.3%, 33.2%), 85 had symptoms of anxiety disorder (22.55%; 95% CI: 18.7%, 27.3%) and 168 had symptoms of psychological distress (44.56%; 95% CI: 39.6%, 49.6%). While anxiety was linked to ever drinking alcohol (adjusted OR (AOR)=2.87; 95% CI: 1.13, 7.28) and suicidal ideation (AOR=3.23; 95% CI: 1.80, 5.79), depression was significantly associated with having very good relationships with classmates (AOR=0.22; 95% CI: 0.09, 0.55) and suicidal ideation (AOR=2.26; 95% CI: 1.29, 3.94). The level of education (being in the ninth grade) and suicidal ideation (AOR=2.86; 95% CI: 1.49, 4.86) were also related to psychological distress. CONCLUSION: High levels of depression, anxiety and psychological distress were discovered. Very positive relationships with classmates were significantly linked to depression, while ever drinking was linked to anxiety. Likewise, the level of educational was related to psychological distress. All three of the dependent variables were linked to suicidal ideation. Above all, there was a connection among psychological distress, anxiety and depression.

Mitochondria of intestinal epithelial cells in depression: Are they at a crossroads of gut-brain communication?

The role of gut dysbiosis in depression is well established. However, recent studies have shown that gut microbiota is regulated by intestinal epithelial cell (IEC) mitochondria, which has yet to receive much attention. This review summarizes the recent developments about the critical role of IEC mitochondria in actively maintaining gut microbiota, intestinal metabolism, and immune homeostasis. We propose that IEC mitochondrial dysfunction alters gut microbiota composition, participates in cell fate, mediates oxidative stress, activates the peripheral immune system, causes peripheral inflammation, and transmits peripheral signals through the vagus and enteric nervous systems. These pathological alterations lead to brain inflammation, disruption of the blood-brain barrier, activation of the hypothalamic-pituitary-adrenal axis, activation of microglia and astrocytes, induction of neuronal loss, and ultimately depression. Furthermore, we highlight the prospect of treating depression through the mitochondria of IECs. These new findings suggest that the mitochondria of IECs may be a newly found important factor in the pathogenesis of depression and represent a potential new strategy for treating depression.

Trajectories of cognitive reactivity and its predictive value on postpartum depression in Chinese women: a latent class growth modeling analysis.

Many women are experiencing postpartum depression (PPD) after giving birth. How to recognize and intervene in high-risk PPD women early and effectively remains unknown. Our objective is to describe the latent trajectory groups of cognitive reactivity (CR) in perinatal women, and their relationship to demographic and disease-related factors, as well as investigate the associations with PPD. Data from 321 perinatal women who were evaluated in urban tertiary hospitals in China at three-time points: 32-35 weeks of pregnancy, 1 week postpartum, and 6 weeks postpartum. Latent class growth modeling was used to identify the trajectory patterns of CR and logistic regression was used to explore the association between demographic and disease-related factors, CR trajectories, and depression. Three trajectory groups were identified: the continuing deterioration group (17.2%), the postpartum deterioration group (22.1%), and the consistent resilient group (60.7%). Participants with a bachelor's degree or higher and with gestational diabetes diagnosis were more likely to be in the continuing deterioration group. Those who were from only-child families were more likely to be in the postpartum deterioration group. Women in the continuing deterioration group and postpartum deterioration group were more likely to experience PPD. Targeted interventions should be developed based on trajectory group of CR.

Predictors of postpartum depression and its association with sleep quality among mothers in Qassim, Saudi Arabia: A descriptive cross-sectional study.

OBJECTIVE: This cross-sectional study aims to examine the prevalence of postpartum depression (PPD) and sleep problems, their relationship, and the characteristics associated with depression/insomnia in Qassim, Saudi Arabia. METHODS: An online survey was administered to a convenience sample of 395 mothers who had given birth within the preceding year. The survey comprised demographic characteristics, pregnancy and childbirth characteristics, depression (via the Edinburgh Postnatal Depression Scale; EPDS), and sleep quality (via the Pittsburgh Sleep Quality Index; PSQI). RESULTS: Nearly two-thirds of respondents (62.3%) had PPD, while 92.2% experienced poor sleep quality. Both scales demonstrated a statistically significant positive correlation. Participants with previous PPD, peripartum depression, a personal or family history of other depression, those bottle-feeding their infants, or who had a change in sleep pattern scored significantly higher on the EPDS and had poorer PSQI scores. Respondents with a history of mental illness, pregnancy or delivery complications, those who lacked support, or gave birth to unhealthy newborns also had significantly higher EPDS scores. CONCLUSIONS: PPD and poor sleep quality were highly prevalent among mothers living in the Qassim region of Saudi Arabia. Not surprisingly, PPD was strongly correlated with poor sleep quality. Postpartum counseling for mothers during the first year after delivery is necessary to decrease the risk of developing depressive symptoms and poor sleep quality. Screening for sleep-related difficulties and depression in prenatal and postnatal programs may help prevent the development of depressive disorder among postpartum women in this region of Saudi Arabia (or other areas of the Middle East).

Risks & Protective Factors for Depression & Suicide Among Hawai'i Agricultural Producers.

Studies have consistently shown that agricultural producers in the continental United States have disproportionately high rates of depression and suicide as compared to other occupations. It is not known whether this is true in Hawai'i, which is both geographically distinct and ethnically diverse. To examine rates of depression and suicide as well as potential risk and protective factors, a state-wide mental health needs assessment was conducted from November 2021 to September 2022. We conducted a survey with a nonprobability-based convenience sample targeting agricultural producers across Hawai'i, and performed descriptive statistics and logistic regression analyses. In a sample of 408 respondents, 35% (n = 143) had clinical depression symptomatology, and 8% (n = 33) had suicidal ideation based on the Patient Health Questionnaire-9. Older age was slightly protective in that every year of increase in age was associated with 0.98 times (95% CI: 0.96, 0.99) reduced odds of depression symptomatology, and 0.96 times (95% CI:0.94, 0.98) reduced odds of suicidal ideation. Identifying as East Asian had 2.04 times (95% CI: 1.16, 3.61) higher odds of depression symptomatology, and Southeast Asian had 3.04 times odds (95% CI:1.15, 8.00) of suicidal ideation. However, in the presence of stress and coping variables, the demographic factors became statistically non-significant. Instead, feeling stressed, uncertainty as the stressor, and media-focused coping were significant risk factors in increasing two to eight times the odds of depressive symptoms. For suicidal ideation, depression symptomatology increased odds by 31.95 (95% CI: 5.60-182.32), using media-focused coping increased 5.20 odds (95% CI: 1.66, 16.27), but problem-focused coping decreased 0.32 times odds (0.10, 0.99). Culturally specific prevention and intervention measures should be tailored for Hawai'i agricultural producers with an emphasis toward younger, East, and Southeast Asian producers and attention toward providing skillful coping strategies for effective stress regulation and management.

Preferred treatment focus among college students with eating disorders and comorbid mental health problems in a digital cognitive-behavioral guided self-help program.

OBJECTIVE: To examine the mental health problems that college students with eating disorders (EDs) and comorbid depression and/or anxiety disorders preferred to target first in a digital treatment program and explore correlates of preferred treatment focus. METHODS: Four hundred and eighty nine college student users of a digital cognitive-behavioral guided self-help program targeting common mental health problems (76.7% female, Mage = 20.4 ± 4.4, 64.8% White) screened positive for an ED and ≥one other clinical mental health problem (i.e., depression, generalized anxiety disorder, social phobia, and/or panic disorder). Students also reported on insomnia, post-traumatic stress, alcohol use, and suicide risk. Before treatment, they indicated the mental health problem that they preferred to target first in treatment. Preferred treatment focus was characterized by diagnostic profile (i.e., ED + Depression, ED + Anxiety, ED + Depression + Anxiety), symptom severity, and demographics. RESULTS: 58% of students with ED + Anxiety, 47% of those with ED + Depression, and 27% of those with ED + Depression + Anxiety chose to target EDs first. Across diagnostic profiles, those who chose to target EDs first had more severe ED symptoms than those who chose to target anxiety or depression (ps < .05). Among students with ED + Depression + Anxiety, those who chose to target EDs first had lower depression symptoms than those who chose to target depression, lower generalized anxiety than those who chose to target anxiety, and lower suicidality than those who chose to target anxiety or depression (ps < .01). CONCLUSIONS: Students with EDs and comorbid depression and/or anxiety disorders showed variable preferred treatment focus across diagnostic profiles. Research should explore specific symptom presentations associated with preferred treatment focus. PUBLIC SIGNIFICANCE: Findings indicate that a sizable percentage of college students with depression/anxiety who also have EDs prefer to target EDs first in treatment, highlighting the importance of increasing availability of ED interventions to college students. Students with EDs and comorbid depression and/or anxiety disorders showed variable preferred treatment focus across diagnostic profiles, and preference to target EDs was associated with greater ED psychopathology across diagnostic profiles.