Relationship between depressive symptoms and sleep quality and cognitive inhibition ability in prenatal pregnant women.

BACKGROUND: Sleep problems and cognitive changes are typical in pregnant women with depressive symptoms. However, the relationship between sleep quality and executive dysfunction remains unclear. This study aims to explore the differences in sleep quality and cognitive inhibition between pregnant women with and without depressive symptoms in the third trimester of pregnancy and investigate the correlations between sleep quality, cognitive inhibition and depressive symptoms. METHODS: In the third trimester, 169 women without depressive symptoms and 88 women with depressive symptoms participated in the study. Edinburgh Postpartum Depression Questionnaire (EPDS) was used to assess depressive symptoms, and Pittsburgh Standard Sleep Quality Index Questionnaire (PSQI) was used to investigate sleep quality. The color-word Stroop task is used to evaluate cognitive inhibition. RESULTS: Compared with women without depressive symptoms, pregnant women with depressive symptoms showed worse sleep quality and Stroop task performances (response speed and accuracy). In addition, the speed of cognitive inhibition plays a mediating role in the relationship between sleep quality and prenatal depressive symptoms. CONCLUSION: This research emphasizes the importance of sleep quality screening and cognitive training for depression during pregnancy and childbirth in ensuring women's mental health during pregnancy and childbirth.

The reward positivity mediates the association between adverse childhood experiences and anhedonia in young adults with drug-naïve major depressive disorder.

BACKGROUND: Current clinical studies have indicated that major depressive disorder (MDD) with adverse childhood experiences (ACEs) is associated with greater anhedonia. However, little is known about whether the change in reward sensitivity among young MDD individuals with ACEs are related to anhedonia. METHODS: We evaluated anhedonia and ACEs of each patient. Then, we performed Iowa gambling task during EEG to measure the reward positivity (RewP) and its difference (ΔRewP) in 86 MDD patients (31 with no or one ACE and 55 with two or more ACEs) and 44 healthy controls (HCs). Furthermore, we constructed a mediation model to assessed whether aberrant ΔRewP could mediate the relationship between ACEs and anhedonia. RESULTS: Compared with healthy controls and MDD patients with no or one ACE, MDD patients with two or more ACEs had the most severe symptoms of anhedonia and impaired decision-making, and showed significantly reduced reward sensitivity (most blunted ΔRewP). More importantly, ΔRewP mediated relationship between ACEs and anhedonia in MDD. CONCLUSIONS: We found that the ΔRewP partially mediates the association between ACEs and anhedonia in MDD patients, which provides evidence for the neurobiological basis of abnormal changes in the reward system in MDD individuals with early adverse experiences.

Aberrant high-beta band functional connectivity during reward processing in melancholic major depressive disorder: An MEG study.

OBJECTIVE: To identify the spatial-temporal pattern variation of whole-brain functional connectivity (FC) during reward processing in melancholic major depressive disorder (MDD) patients, and to determine the clinical correlates of connectomic differences. METHODS: 61 MDD patients and 32 healthy controls were enrolled into the study. During magnetoencephalography (MEG) scanning, all participants completed the facial emotion recognition task. The MDD patients were further divided into two groups: melancholic (n = 31) and non-melancholic (n = 30), based on the Mini International Neuropsychiatric Interview (M.I.N.I.) assessment. Melancholic symptoms were examined by using the 6-item melancholia subscale from the Hamilton Depression Rating Scale (HAM-D6). The whole-brain orthogonalized power envelope connections in the high-beta band (20-35 Hz) were constructed in each period after the happy emotional stimuli (0-200 ms, 100-300 ms, 200-400 ms, 300-500 ms, and 400-600 ms). Then, the network-based statistic (NBS) was used to determine the specific abnormal connection patterns in melancholic MDD patients. RESULTS: The NBS identified a sub-network difference at the mid-late period (300-500 ms) in response to happy faces among the three groups (corrected P = 0.035). Then, the post hoc and correlation analyses found five FCs were decreased in melancholic MDD patients and were related to HAM-D6 score, including FCs of left fusiform gyrus-right orbital inferior frontal gyrus (r = -0.52, P < 0.001), left fusiform gyrus-left amygdala (r = -0.26, P = 0.049), left posterior cingulate gyrus-right precuneus (r = -0.32, P = 0.025), left precuneus-right precuneus (r = -0.27, P = 0.049), and left precuneus-left inferior occipital gyrus (r = -0.32, P = 0.025). CONCLUSION: In response to happy faces, melancholic MDD patients demonstrated a disrupted functional connective pattern (20-35 Hz, 300-500 ms), which involved brain regions in visual information processing and the limbic system. The aberrant functional connective pattern in reward processing might be a biomarker of melancholic MDD.

Neural responses to decision-making in suicide attempters with youth major depressive disorder.

An improved understanding of the factors associated with suicidal attempts in youth suffering from depression is crucial for the identification and prevention of future suicide risk. However, there is limited understanding of how neural activity is modified during the process of decision-making. Our study aimed to investigate the neural responses in suicide attempters with major depressive disorder (MDD) during decision-making. Electroencephalography (EEG) was recorded from 79 individuals aged 16-25 with MDD, including 39 with past suicide attempts (SA group) and 40 without (NSA group), as well as from 40 age- and sex- matched healthy controls (HCs) during the Iowa Gambling Task (IGT). All participants completed diagnostic interviews, self-report questionnaires. Our study examined feedback processing by measuring the feedback-related negativity (FRN), ΔFN (FRN-loss minus FRN-gain), and the P300 as electrophysiological indicators of feedback evaluation. The SA group showed poorest IGT performance. SA group and NSA group, compared with HC group, exhibited specific deficits in decision-making (i.e., exhibited smaller (i.e., blunted) ΔFN). Post hoc analysis found that the SA group was the least sensitive to gains and the most sensitive to losses. In addition, we also found that the larger the value of ΔFN, the better the decision-making ability and the lower the impulsivity. Our study highlights the link between suicide attempts and impaired decision-making in individuals with major depressive disorder. These findings constitute an important step in gaining a better understanding of the specific reward-related abnormalities that could contribute to the young MDD patients with suicide attempts.

Aberrant social reward dynamics in individuals with melancholic major depressive disorder: An ERP study.

BACKGROUND: Compared to monetary rewards, depressive symptoms are specifically associated with abnormal social reward processing. In addition, individuals with melancholic depression may exhibit more significant reward-related impairments. However, there is still limited understanding of the specific alterations in social reward processing in individuals with melancholic depression. METHODS: Forty patients with melancholic major depressive disorder (MDD), forty patients with non-melancholic MDD, and fifty healthy controls participated in the social incentive delay (SID) tasks with event-related potential (ERP) recording. We measured one anticipatory ERP(cue-N2) and two consummatory ERPs (FRN, fb-P3). Furthermore, we examined correlation between FRN and consummatory anhedonia. RESULTS: Melancholic MDD patients showed less anticipation of social rewards (cue-N2). Concurrently, melancholic individuals demonstrated diminished reception of social rewards, as evidenced by reduced amplitudes of FRN. Notably, the group x condition interaction effect on FRN was significant (F (2, 127) = 4.15, p = 0.018, η2ρ = 0.061). Melancholic MDD patients had similar neural responses to both gain and neutral feedback (blunted reward positivity), whereas non-melancholic MDD patients (t (39) = 3.09, p = 0.004) and healthy participants (t (49) = 5.25, p < 0.001) had smaller FRN amplitudes when receiving gain feedback relative to neutral feedback. In addition, there was a significant correlation between FRN and consummatory anhedonia in MDD patients. CONCLUSIONS: Our findings indicated that individuals with melancholic MDD exhibit attenuated neural responses to both anticipated and consumed social rewards. This suggests that aberrant processing of social rewards could serve as a potential biomarker for melancholic MDD.

Neurophysiological activity following gains and losses among young adults with non-suicidal self-injury: An ERP study.

OBJECTIVE: Non-suicidal self-injury (NSSI) is an increasingly concerning issue that is linked to a range of mental health problems. However, little is known about the potential neurophysiological mechanisms underlying risk decision-making in Major depressive disorder (MDD) patients with NSSI-the present study aimed to fill this important literature gap. METHODS: A total of 81 MDD patients (with NSSI: n = 40, without NSSI: n = 41) and 44 matched healthy controls (HC) underwent a modified version of the Iowa Gambling Task (IGT) while an electroencephalogram was recorded. Feedback-related negativity (FRN) and P300 were examined during the feedback stage of the risky decision-making process. RESULTS: Behavioural findings revealed that individuals diagnosed with MDD displayed a greater tendency to make risky decisions compared to the control group. Furthermore, MDD patients with NSSI demonstrated a significantly more negative ΔFN (i.e., the difference in neural response to losses compared to gains) than those without NSSI. Further, NSSI patients showed a larger difference ΔFN (loss minus gain), which was associated with enhanced impulsivity. CONCLUSIONS: Collectively, the findings suggest that there is an altered processing of risky decision-making in the electrophysiology of patients with MDD who engage in NSSI. The ΔFN may serve as a psychophysiological marker indicating risk for NSSI.

Patterns of attentional bias in antenatal depression: an eye-tracking study.

Introduction: One of the most common mental disorders in the perinatal period is depression, which is associated with impaired emotional functioning due to alterations in different cognitive aspects including thought and facial emotion recognition. These functional impairment may affect emerging maternal sensitivity and have lasting consequences for the dyadic relationship. The current study aimed to investigate the impact of depressive symptoms on the attention bias of infant stimuli during pregnancy. Methods: Eighty-six pregnant women completed the Edinburgh Postnatal Depression Scale and an eye-tracking task comprising infant-related emotion images. All participants showed biased attention to infant-related images. Results: First, compared to healthy pregnant women, pregnant women with depression symptoms initially directed their attention to infant-related stimuli more quickly (F (1, 84) = 6.175, p = 0.015, η2 = 0.068). Second, the two groups of pregnant women paid attention to the positive infant stimuli faster than the neutral infant stimuli, and the first fixation latency bias score was significantly smaller than that of the infant-related negative stimulus (p = 0.007). Third, compared with the neutral stimulus, the non-depression group showed a longer first gaze duration to the negative stimulus of infants (p = 0.019), while the depressive symptoms group did not show this difference. Conclusion: We speculate that structural and functional changes in affective motivation and cognitive-attention brain areas may induce these attentional bias patterns. These results provide suggestions for the implementation of clinical intervention programs to correct the attention bias of antenatal depressed women.

Trajectories and Depressive Symptoms During the Perinatal Period: A Longitudinal Population-Based Study in China.

Most women in the perinatal period face sleep issues, which can affect their mental health. Only a few studies have focused on sleep trajectories and depressive symptoms of women during the perinatal period in China. This study aims to explore the development trajectory of sleep quality by classifying pregnant women according to the changes in their sleep quality during pregnancy and postpartum and investigate the correlation between different sleep quality trajectory groups and depressive symptoms. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality, and the Edinburgh Postnatal Depression Scale (EPDS) was used to assess the symptoms of depression. Participants (n = 412) completed the assessment of sleep quality, depressive symptoms, and some sociodemographic and obstetric data at 36 weeks of gestation, 1 week after delivery, and 6 weeks after delivery. The group-based trajectory model (GBTM) was used to complete the trajectory classification, and logistic regression was used to analyze the predictive factors of postpartum depressive symptoms. Four different sleep quality trajectories were determined: "stable-good," "worsening," "improving," and "stable-poor" groups. The results demonstrate that poor sleep trajectories, social support and parenting experience during the perinatal period are related to postpartum depression. Screening for prenatal sleep problems is crucial for identifying the onset of perinatal depressive symptoms.

Poor Sleep and Decision-Making Disturbance Are Associated With Suicidal Ideation in Pre-natal Depression.

Although many risk factors for suicidal ideation have been identified, few studies have focused on suicidal ideation and pre-natal depression. The purpose was to investigate the relationship between decision-making (DM) dysfunction and sleep disturbance on suicidal ideation in pre-natal depression. Participants included 100 women in the third trimester of pregnancy, including pregnant women with pre-natal depression who had recent suicidal ideation (n = 30), pre-natal depression without SI (n = 35) and healthy controls (n = 35). The Iowa Gambling Task (IGT) was used to evaluate the DM function and the Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep index. The Edinburgh Post-natal Depression Scale (EPDS) was used to assess suicidal ideation and the seriousness of depression. Overall, the two groups with pre-natal depression showed worse sleep quality and decreased DM function compared with healthy controls. The pre-natal depression with suicidal ideation group showed a significantly higher score in subjective sleep quality and a lower score in block 5 of IGT than the pre-natal depression without suicidal ideation group. Further correlation analysis showed that suicidal ideation positively correlated with subjective sleep quality, sleep duration, and daytime function, and negatively correlated with IGT scores. Sleep disturbance and impaired DM function may be risk factors for suicidal ideation in pre-natal depression.

Depressive Symptoms in Late Pregnancy Disrupt Attentional Processing of Negative-Positive Emotion: An Eye-Movement Study.

This study investigated biases for negative-positive information in component processes of visual attention (initial shift vs. maintenance of gaze) among women in late pregnancy with or without depressive symptoms. Eye movements were recorded while participants viewed a series of picture pairs depicting negative, positive, and neutral scenes. Initial orienting (latency and percentage of first fixation) and gaze duration were computed. Compared with neutral pictures, the group with major depressive symptoms (MDS) were less able to sense the positive emotion-related pictures and were over-responsive to negative emotion-related pictures. The group with suspicious depressive symptoms (SDS) had an attention bias toward both positive and negative emotion-related pictures. The group with no depressive symptoms (NDS) had an attention bias toward positive emotion-related pictures and had an initial attention avoidance tendency for negative emotion-related pictures. The initial gaze direction bias score for negative emotion-related pictures was positively correlated with the severity of depressive symptoms. Therefore, women with a risk of perinatal depression have a significant bias toward negative stimuli. Hypervigilant emotion processing during pregnancy may increase a woman's susceptibility to depression during late pregnancy. Attention away from negative information or attention toward positive information may provide a way of buffering emotional responses.