Depression is almost twice as prevalent in women than men. Atypical symptoms, somatic complaints, and comorbid anxiety disorders are more common in women, whereas suicide and comorbid substance use disorders are more common in men. Previous studies have also reported gender differences in the efficacy of and tolerability to specific classes of antidepressants. Various psychosocial and biological factors have been proposed to explain the gender differences in clinical characteristics of depression. The predominant theory of depression pathogenesis is the monoamine hypothesis, and consequently, monoamine neurotransmitters have been the primary target of antidepressants. In the first section of this review, study findings of clinical differences in depression by gender are summarized. Then, we provide an overview of the findings from human and rodent studies of gender differences in serotonin, norepinephrine, dopamine, and glutamate neurotransmitter systems. Total level, rate of synthesis, and receptor profiles of neurotransmitters seem to differ by gender in the euthymic state, depressed state, and in responses to stress or antidepressants. Furthermore, these neurotransmitters interact with gonadal hormones and the hypothalamic-pituitary-adrenal axis, systems that innately exhibit gender differences. Although most of the studies conducted so far are limited to animal models and results of the studies are heterogeneous, growing evidence suggests that gender differences exist in neurotransmitter systems, which possibly leads to gender differences in depression. More intensive studies in this field are needed to build gender-specific treatment strategies.
Antidepressive Agents ; Anxiety Disorders ; Biological Factors ; Depression ; Dopamine ; Female ; Glutamic Acid ; Gonadal Hormones ; Humans ; Male ; Models, Animal ; Neurotransmitter Agents ; Norepinephrine ; Rodentia ; Serotonin ; Substance-Related Disorders ; Suicide

Objectives: Recent advances in brain age prediction models reveal accelerated brain aging in major depressive disorder (MDD) patients. This review investigates the complex relationship between brain aging and biological age gap (BAG) in MDD, emphasizing the influences of clinical characteristics, treatment responses, and various neuroimaging techniques on this dynamic interplay. Methods: A systematic review of the existing literature was conducted, focusing on 18 studies that analyze brain aging patterns in MDD patients. Key factors such as age, clinical features, and lifestyle choices were examined to assess their impact on BAG and the overall neurobiological health of individuals with MDD. Results: The findings indicate that MDD patients frequently experience accelerated brain aging, particularly in elderly populations, with BAG serving as a valuable biomarker for assessing biological aging rates. The review highlights the urgent need for more granular approaches, considering variables such as age, gender, and socioeconomic status. Specific local brain aging patterns were observed in regions related to emotional regulation, suggesting that localized BAG changes may provide critical insights into the pathophysiology of MDD and its neurobiological underpinnings. Conclusions BAG is a significant biomarker for evaluating accelerated brain aging in MDD, informing personalized treatment strategies. Future research should incorporate diverse clinical characteristics and advanced neuroimaging techniques in representative samples to enhance the clinical applicability of BAG and deepen the understanding of its role in depression and biological aging.

Objectives: Recent advances in brain age prediction models reveal accelerated brain aging in major depressive disorder (MDD) patients. This review investigates the complex relationship between brain aging and biological age gap (BAG) in MDD, emphasizing the influences of clinical characteristics, treatment responses, and various neuroimaging techniques on this dynamic interplay. Methods: A systematic review of the existing literature was conducted, focusing on 18 studies that analyze brain aging patterns in MDD patients. Key factors such as age, clinical features, and lifestyle choices were examined to assess their impact on BAG and the overall neurobiological health of individuals with MDD. Results: The findings indicate that MDD patients frequently experience accelerated brain aging, particularly in elderly populations, with BAG serving as a valuable biomarker for assessing biological aging rates. The review highlights the urgent need for more granular approaches, considering variables such as age, gender, and socioeconomic status. Specific local brain aging patterns were observed in regions related to emotional regulation, suggesting that localized BAG changes may provide critical insights into the pathophysiology of MDD and its neurobiological underpinnings. Conclusions BAG is a significant biomarker for evaluating accelerated brain aging in MDD, informing personalized treatment strategies. Future research should incorporate diverse clinical characteristics and advanced neuroimaging techniques in representative samples to enhance the clinical applicability of BAG and deepen the understanding of its role in depression and biological aging.

Depressive disorders are prevalent worldwide. Despite the availability of various antidepressants, treatment responses remain suboptimal, with disappointing remission rates. Recent advancements in antidepressant development have shifted focus to mechanisms beyond traditional monoamine neurotransmitters, such as serotonin and norepinephrine. Allopregnanolone, a neurosteroid, acts as a positive allosteric modulator of GABA A receptors, playing a significant role in regulating mood and anxiety. Fluctuations in allopregnanolone levels during reproductive cycles contribute to mood disorders such as premenstrual dysphoric disorder, postpartum depression (PPD), and menopausal depression. Recently, the Food and Drug Administration approved two novel antidepressants, brexanolone (IV) and zuranolone (oral). These synthetic analogs of allopregnanolone offer fast-acting relief for PPD by enhancing GABAergic inhibition. Additionally, these neurosteroid-based therapies provide new hope for patients with depression beyond PPD, due to their rapid onset of action. However, concerns regarding long-term safety and the potential for misuse remain, necessitating further research.This review explores the relationship between neurosteroids and depression, with a focus on the mechanisms and clinical applications of brexanolone and zuranolone in treating mood disorders.

Depressive disorders are prevalent worldwide. Despite the availability of various antidepressants, treatment responses remain suboptimal, with disappointing remission rates. Recent advancements in antidepressant development have shifted focus to mechanisms beyond traditional monoamine neurotransmitters, such as serotonin and norepinephrine. Allopregnanolone, a neurosteroid, acts as a positive allosteric modulator of GABA A receptors, playing a significant role in regulating mood and anxiety. Fluctuations in allopregnanolone levels during reproductive cycles contribute to mood disorders such as premenstrual dysphoric disorder, postpartum depression (PPD), and menopausal depression. Recently, the Food and Drug Administration approved two novel antidepressants, brexanolone (IV) and zuranolone (oral). These synthetic analogs of allopregnanolone offer fast-acting relief for PPD by enhancing GABAergic inhibition. Additionally, these neurosteroid-based therapies provide new hope for patients with depression beyond PPD, due to their rapid onset of action. However, concerns regarding long-term safety and the potential for misuse remain, necessitating further research.This review explores the relationship between neurosteroids and depression, with a focus on the mechanisms and clinical applications of brexanolone and zuranolone in treating mood disorders.

Objectives: Recent advances in brain age prediction models reveal accelerated brain aging in major depressive disorder (MDD) patients. This review investigates the complex relationship between brain aging and biological age gap (BAG) in MDD, emphasizing the influences of clinical characteristics, treatment responses, and various neuroimaging techniques on this dynamic interplay. Methods: A systematic review of the existing literature was conducted, focusing on 18 studies that analyze brain aging patterns in MDD patients. Key factors such as age, clinical features, and lifestyle choices were examined to assess their impact on BAG and the overall neurobiological health of individuals with MDD. Results: The findings indicate that MDD patients frequently experience accelerated brain aging, particularly in elderly populations, with BAG serving as a valuable biomarker for assessing biological aging rates. The review highlights the urgent need for more granular approaches, considering variables such as age, gender, and socioeconomic status. Specific local brain aging patterns were observed in regions related to emotional regulation, suggesting that localized BAG changes may provide critical insights into the pathophysiology of MDD and its neurobiological underpinnings. Conclusions BAG is a significant biomarker for evaluating accelerated brain aging in MDD, informing personalized treatment strategies. Future research should incorporate diverse clinical characteristics and advanced neuroimaging techniques in representative samples to enhance the clinical applicability of BAG and deepen the understanding of its role in depression and biological aging.

Depressive disorders are prevalent worldwide. Despite the availability of various antidepressants, treatment responses remain suboptimal, with disappointing remission rates. Recent advancements in antidepressant development have shifted focus to mechanisms beyond traditional monoamine neurotransmitters, such as serotonin and norepinephrine. Allopregnanolone, a neurosteroid, acts as a positive allosteric modulator of GABA A receptors, playing a significant role in regulating mood and anxiety. Fluctuations in allopregnanolone levels during reproductive cycles contribute to mood disorders such as premenstrual dysphoric disorder, postpartum depression (PPD), and menopausal depression. Recently, the Food and Drug Administration approved two novel antidepressants, brexanolone (IV) and zuranolone (oral). These synthetic analogs of allopregnanolone offer fast-acting relief for PPD by enhancing GABAergic inhibition. Additionally, these neurosteroid-based therapies provide new hope for patients with depression beyond PPD, due to their rapid onset of action. However, concerns regarding long-term safety and the potential for misuse remain, necessitating further research.This review explores the relationship between neurosteroids and depression, with a focus on the mechanisms and clinical applications of brexanolone and zuranolone in treating mood disorders.

Objectives: Recent advances in brain age prediction models reveal accelerated brain aging in major depressive disorder (MDD) patients. This review investigates the complex relationship between brain aging and biological age gap (BAG) in MDD, emphasizing the influences of clinical characteristics, treatment responses, and various neuroimaging techniques on this dynamic interplay. Methods: A systematic review of the existing literature was conducted, focusing on 18 studies that analyze brain aging patterns in MDD patients. Key factors such as age, clinical features, and lifestyle choices were examined to assess their impact on BAG and the overall neurobiological health of individuals with MDD. Results: The findings indicate that MDD patients frequently experience accelerated brain aging, particularly in elderly populations, with BAG serving as a valuable biomarker for assessing biological aging rates. The review highlights the urgent need for more granular approaches, considering variables such as age, gender, and socioeconomic status. Specific local brain aging patterns were observed in regions related to emotional regulation, suggesting that localized BAG changes may provide critical insights into the pathophysiology of MDD and its neurobiological underpinnings. Conclusions BAG is a significant biomarker for evaluating accelerated brain aging in MDD, informing personalized treatment strategies. Future research should incorporate diverse clinical characteristics and advanced neuroimaging techniques in representative samples to enhance the clinical applicability of BAG and deepen the understanding of its role in depression and biological aging.

Purpose: This study aimed to develop a Hybrid Clinical Practicum Environment Scale for Nursing Students (HCPES-NS) and verify its validity and reliability. Methods: The HCPES-NS was constructed following the DeVellis guidelines. The initial items were written based on a literature review and individual in-depth interviews. Content validity was verified through an expert panel review. To confirm the validity and reliability of the scale, a survey was conducted with 449 nursing students enrolled in 12 nursing colleges. Data were analyzed using item analysis, exploratory factor analysis, confirmatory factor analysis, concurrent validity, and reliability tests. Results: Factor analysis showed that the HCPES-NS consists of 15 items on five subdomains: clinical site atmosphere, interpersonal relationship, alternative online practicum contents, provision of learning information, and clinical performance facilitation. A higher score indicated a more positive perception of the clinical practicum environment. The concurrent validity of the HCPES-NS was confirmed by its positive correlation with the Clinical Learning Environment Scale (r = .77). The Cronbach’s α reliability of the HCPES-NS was .84. Conclusion The HCPES-NS is both valid and reliable. This scale reflects the clinical practicum environment and includes an online practicum factor. It may be used effectively by faculty members and educators to evaluate nursing students’ perceptions of clinical practicum environments.

Objective: Despite lower depression rates in men than in women, men’s suicide rates are significantly higher, suggesting potential gaps in depression screening. Rutz et al. developed the Gotland Male Depression Scale (GMDS), which includes symptoms commonly associated with male depression. This study was conducted to validate the Korean version of the GMDS (K-GMDS). Methods: The K-GMDS, Patient Health Questionnaire-9 (PHQ-9), and outpatient records of 233 new patients at the outpatient psychiatry department of Catholic University Hospital in Daegu from February and May 2022 were retrospectively reviewed. Internal consistency was measured using Cronbach’s α, and external validity was tested by analyzing the scale’s correlation with the PHQ-9. The screening capacity of the K-GMDS was tested based on the receiver operating characteristic (ROC) curve, sensitivity, specificity, and overall accuracy. Results: Of 233 patients, 42.6% (n=98) were classified to the depression group. Cronbach’s α was 0.92, and external validity was established with a Pearson’s correlation coefficient of 0.83 between the total score of the K-GMDS and the PHQ-9. While there were no significant differences in the area under the ROC curve between the K-GMDS and the PHQ-9, the K-GMDS had better sensitivity, specificity, and overall accuracy in screening depressive symptoms among men compared to the PHQ-9. Conclusion The K-GMDS exhibits satisfactory reliability and validity in psychiatric outpatient settings and outperforms the PHQ-9 in screening for depression among men. This study will be useful in developing male depression scales that are currently unavailable in South Korea.