Objective To explore the changes in serum lactate dehydrogenase （LDH）， monocyte chemoattractant protein-1 （MCP-1）， and transcription factor 4 （TCF4） levels in patients with cerebral small vessel disease complicated by depression and their clinical significance. Methods According to the inclusion and exclusion criteria， 90 patients admitted to the Kailuan General Hospital between January 2022 and August 2024 were selected as the study subjects， including 27 patients diagnosed with cerebral small vessel disease complicated by depression and 63 patients with cerebral small vessel disease uncomplicated by depression. An additional 45 healthy individuals with normal head MRI findings and no mental disorders during the same period at the hospital were selected as the control group. General information was collected from the three groups， including age， body mass index， systolic blood pressure， and diastolic blood pressure.The general information and the levels of serum LDH，MCP-1，and TCF4 in the three groups were compared. The correlations of serum LDH，MCP-1，and TCF4 levels with HAMD score in patients with cerebral small vessel disease and depression were analyzed. Logistic regression was applied to analyze possible factors leading to depression in patients with cerebral small vessel disease.The receiver operating characteristic curve was applied to analyze the efficacy of serum LDH， MCP-1， and TCF4 levels in diagnosing depression in patients with cerebral small vessel disease. Results The levels of serum LDH， MCP-1，and TCF4 were significantly higher in the cerebral small vessel disease complicated by depression group than in cerebral small vessel disease uncomplicated with depression group and the control group （P<0.05）， and these levels were significantly higher in the cerebral small vessel disease uncomplicated with depression group than in the control group （P<0.05）.The serum LDH，MCP-1 and TCF4 were positively correlated with HAMD score in patients with cerebral small vessel disease complicated with depression（r=0.606，0.798，0.672，all P<0.001）.Serum LDH， MCP-1， and TCF4 were influencing factors for depression in cerebral small vessel disease（P<0.05）.The area under the receiver operating characteristic curve of LDH， MCP-1，and TCF4 in combination in the diagnosis of depression in cerebral small vessel disease was 0.917， which was superior to serum LDH， MCP-1， and TCF4 alone （ZLDH-combination=2.457，P=0.014；ZMCP-1-combination=2.384， P=0.017； ZTCF4-combination=2.317， P=0.021）. Conclusion Serum LDH， MCP-1， and TCF4 levels increased in patients with cerebral small vessel disease complicated with depression. Their combination is valuable in the diagnosis of cerebral small vessel disease complicated with depression.
Depression

Objective To investigate the changing trend of sleep disturbance in patients with hepatolenticular degeneration and the bidirectional relationship between sleep disturbance and depression through a cross-lagged regression analysis. Methods A total of 80 patients who met the diagnostic criteria for WD from January to June 2024 were enrolled in this longitudinal study and were followed up for 3 months.Pittsburgh Sleep Quality Index （PSQI） was used to assess sleep quality， and Beck Depression Inventory （BDI） was used to assess the severity of depression， at the time of enrollment （T0）， at 1 month after enrollment （T1），and at 2 months after enrollment （T3）. An unconditional growth model was used to analyze the trajectory of sleep disturbance， and a cross-lagged regression model was used to investigate the temporal relationship between sleep disturbance and depression. Results From T0 to T2， there were significant increases in PSQI and BDI scores in all WD patients（P<0.05）. The variance of the intercept factor （the initial status of sleep disturbance） was estimated at 10.83（P<0.01），and the variance of the slope factor （the rate of change in sleep disturbance） was 1.20 （P<0.01），with a significant negative correlation between the intercept and the slope （r=-0.25，P<0.01）. The correlation analysis of PSQI and BDI scores across the three time points revealed a positive correlation between PSQI and BDI scores （r∈[0.19，0.96]，P<0.01）.The cross-lagged model analysis showed that sleep disturbance significantly predicted subsequent depression （P<0.01），with standardized regression coefficients （β） of 0.392 and 0.347， respectively； meanwhile， depression also significantly predicted subsequent sleep disturbance （P<0.01）， with β of 0.273 and 0.372， respectively. These findings suggested a bidirectional predictive relationship between sleep disturbance and depression in WD patients over time. Conclusion There is a bidirectional relationship between sleep disturbance and depression in patients with WD， and depression has a more pronounced influence on sleep disturbance. Therefore， clinical interventions should focus on both sleep and psychological state， and combined management should be performed to improve the effect of disease control.
Depression

Objective Observational studies have shown an association between Parkinson disease （PD） and mental illness， but further studies are needed to explore the causal relationship between them. This study aims to investigate such causal relationship using the method of two-sample Mendelian randomization （MR）. Methods Related data were extracted from GWAS， and summary statistics associated with PD， depression， sleep disorders， and anxiety phenotype-variants were obtained. Single nucleotide polymorphisms （SNPs） for PD were selected as instrumental variables， and MR-PRESSO was used to exclude outliers. Inverse variance weighting was used as the main method to assess causal effect estimates， and MR Egger， weighted median， simple mode， and weighted mode were used to verify the robustness of the findings. A sensitivity analysis was used to validate the reliability of the results， including the Cochran Q test， the MR-Egger intercept test， funnel plots， and the leave-one-out method. Results A total of 21 SNPs associated with PD were identified. The MR analysis showed that PD had a causal relationship with depression （OR=0.974，95%CI 0.934‒1.015， P=0.210）， sleep disorders （OR=1.056， 95%CI 0.970-1.149， P=0.211）， and anxiety （OR=0.998， 95%CI 0.996‒1.001， P=0.118）， with no statistical significance. Different MR analyses and sensitivity analyses showed that PD did not directly contribute to the development of mental illness. Conclusion There is no direct causal relationship between PD and depression/sleep disorders/anxiety. In clinical practice， healthcare professionals should pay attention to the mental health of patients with PD. Randomized controlled studies should be conducted in the future to further validate the results of this study.
Depression ; Anxiety

BACKGROUND

Osteoarthritis (OA) is a leading cause of pain and disability among older adults, often accompanied by mental health issues like depression. Understanding the impact of clinico-sociodemographic factors on OA and depression is essential for improving patient outcomes.

This study aimed to examine the association between osteoarthritis, clinico-sociodemographic factors and depression among elderly patients in a tertiary hospital setting.

A cross-sectional study was conducted on elderly patients with osteoarthritis to explore the correlation between clinico-sociodemographic factors and the severity of depression. Data were collected and analyzed using Microsoft Excel 2018, with descriptive and inferential statistics, including Chi-square tests and correlation analyses (Spearman’s Rank for WOMAC scores and Geriatric Depression Scale, Pearson’s for socio-demographic factors and comorbidities).

Despite most participants (48.15%) having normal depression scores, a significant number (37.04%) had mild depression and 14.81% had moderate depression. Knee pain was the most common affected area (56.79%), and 62.96% had one comorbidity. Albeit having no statistically significant correlations, positive weak relationships were identified between socio-demographic factors, clinical status and depression.

This study identified weak associations between osteoarthritis-related pain and depression, especially among individuals with comorbidities and higher pain levels. While socio-demographic factors may influence the severity of both osteoarthritis and depression, further research is necessary to explore these relationships more thoroughly and to consider additional contributing factors. These findings underscore the importance of integrated care approaches that address both the physical and mental health needs of elderly patients with osteoarthritis.

BACKGROUND

Hypertension is a significant global health issue linked to high mortality and morbidity rates. It contributes not only to organ damage but also to psychological disorders such as anxiety and depression. Despite the rise in hypertensive patients experiencing these mental health issues, evidence remains insufficient.

This systematic review and meta-analysis aimed to assess the prevalence of anxiety and depression among hypertensive patients.

Observational studies published between 2020 and 2024 were sourced from PubMed, The Cochrane Library, and Google Scholar. The Newcastle-Ottawa Scale, adapted for cross-sectional studies, was utilized to evaluate study quality. A random-effects model was employed for meta-analysis to estimate the prevalence rates of anxiety and depression, alongside subgroup and sensitivity analyses to identify sources of heterogeneity.

Fifteen studies were included, with 14 eligible for quantitative analysis. The findings indicated a prevalence rate of 35% for depression (95% CI: 26%-44%) and 41% for anxiety (95% CI: 4%-78%) among hypertensive patients. Significant heterogeneity was observed in the studies (I²=98.3% for depression, I²=99.9% for anxiety). Subgroup analyses highlighted variability in assessment scales (p < 0.001), but not by region or population source. No publication bias was identified (p = 0.663 for depression, p = 0.710 for anxiety). Factors associated with depression included uncontrolled hypertension, female gender, marital status, and social support, while anxiety was linked to similar factors plus concerns about hypertension complications.

Depression and anxiety prevalence among hypertensive patients ranges from 30-42%. Uncontrolled hypertension and social support significantly impact mental health, with major barriers to psychiatric care compliance including economic constraints, lack of education, and comorbidities.

BACKGROUND

Hypertensive patients have a high risk of developing mental health conditions such as anxiety and depression. Conflicting studies are available regarding the association of blood pressure control among hypertensive patients diagnosed with comorbid anxiety and/or depression.

This study aimed to determine the association of hypertension control with anxiety and depression symptoms among patients in a tertiary hospital in La Union.

A cross-sectional analytical study was conducted among 382 hypertensive patients at the outpatient department of Ilocos Training and Regional Medical Center. A validated Filipino translation of the Hospital Anxiety and Depression Scale questionnaire was used to measure depression and anxiety symptoms. Descriptive statistics, such as frequency, percentages, mean, and standard deviation were used. The chi-square test and t-test were applied to compare anxiety and depression with socio-demographic profiles and blood pressure control through odds ratios.

Out of the 382 participants, 23% have anxiety symptoms, 7.3% have depression symptoms, and 4.2% have both conditions. Age and low income were significantly associated with depression symptoms while living alone was statistically associated with anxiety symptoms. Low educational attainment was significantly associated with both depression and anxiety symptoms. While no association was found between depression symptoms and blood pressure control, the presence of anxiety symptoms increases the likelihood of poor blood pressure control.

Hypertensive patients may experience depression and anxiety symptoms. In addition, the presence of anxiety symptoms contributes to poor BP control. Hence, early detection and regular screening of mental health conditions should be implemented to improve health outcomes and reduce the burden of disease in this population.

BACKGROUND/INTRODUCTION

Depression affects millions worldwide and is a major public health concern. Its prevalence is influenced by multiple factors, including sociodemographic elements such as age, gender, and income. In the Philippines, depression affects a significant portion of the population, particularly in rural areas. The Region 2 Trauma Medical Center (R2TMC) in Nueva Vizcaya plays a critical role in addressing mental health issues in the Cagayan Valley Region, with a notable rise in depression cases during the COVID-19 pandemic. This study aimed to explore the correlation between sociodemographic factors and depression in patients at R2TMC.

This study aimed to assess the relationship between depression and various sociodemographic factors (age, sex, marital status, income, education, etc.) among patients seeking mental health services at R2TMC. The goal is to identify the prevalence of depression within these subgroups and evaluate how sociodemographic characteristics correlate with depression.

A retrospective correlational study was conducted from June 2022 to June 2024, analyzing patient records from R2TMC’s Mental Health Outpatient Department. The sample included patients diagnosed with depression based on DSM-V criteria. Descriptive statistics and multiple logistic regression were employed to analyze the data, with ethical approval obtained from the Institutional Review Board. There were 432 participants and data were analyzed using IBM SPSS.

Findings showed varying depression prevalence across sociodemographic categories. The 19-59 age group exhibited the highest depression rates, particularly among females, single individuals, and those in lower-income classes. Unemployed respondents and those with lower educational attainment had higher depression prevalence. These patterns highlight the need for targeted mental health interventions.

The study suggests that depression interventions should be tailored to address the unique vulnerabilities of different sociodemographic groups. Policymakers and healthcare providers should consider these factors to improve mental health care accessibility and effectiveness.

BACKGROUND AND OBJECTIVES

Climate anxiety is an emerging concept defined as increased anxiety about climate change and has been linked to negative mental health outcomes. As a relatively new concept, only a few have characterized it and its relationship with mental health, especially in the Global South populations. This study aimed to investigate the relationship between climate anxiety and depressive symptoms among undergraduate students from a college in a higher education institution in Manila, Philippines. Specifically, it aimed to (1) determine the proportion of undergraduate students who reported high levels of climate anxiety and depressive symptoms; and (2) determine the association between climate anxiety and depressive symptoms.

Using a cross-sectional design and a convenience sampling method, the investigators collected data through an online survey to assess levels of climate anxiety and depressive symptoms using the Climate Change Anxiety Scale (CCAS) and the Patient Health Questionnaire 9 (PHQ-9), respectively. Data was analyzed using multiple logistic regression.

Among the 148 respondents (N=325), 14.86% had high climate anxiety (i.e., CCAS score >= 3) and 62.84% had high depressive symptoms (i.e., PHQ-9 score >= 10). Regression analysis showed that the odds of those having high climate anxiety reporting high depressive symptoms are higher than those with low climate anxiety, though this is not significant (OR = 2.53, p=0.144).

The study verifies the existence of climate anxiety among undergraduate students and reflects an alarming mental health situation in the selected college. It is recommended that wide-scope investigations on the current state of climate anxiety and mental health among the youth be done to verify their impacts, along with inter-sectoral efforts such as increasing awareness through health education interventions to improve the youths’ mental health literacy and resilience to the effects of climate change, and promoting climate change-responsive mental health services to address these as pressing threats to youth health.

INTRODUCTION: Adolescent depression is prevalent, and teen suicide rates are on the rise locally. A systemic review to understand associated risk and protective factors is important to strengthen measures for the prevention and early detection of adolescent depression and suicide in Singapore. This systematic review aims to identify the factors associated with adolescent depression in Singapore. METHODS: A systematic search on the following databases was performed on 21 May 2020: PubMed, EMBASE and PsycINFO. Full texts were reviewed for eligibility, and the included studies were appraised for quality using the Newcastle Ottawa Scale. Narrative synthesis of the finalised articles was performed through thematic analysis. RESULTS: In total, eight studies were included in this review. The four factors associated with adolescent depression identified were: (1) sociodemographic factors (gender, ethnicity); (2) psychological factors, including childhood maltreatment exposure and psychological constructs (hope, optimism); (3) coexisting chronic medical conditions (asthma); and (4) lifestyle factors (sleep inadequacy, excessive internet use and pathological gaming). CONCLUSION The identified factors were largely similar to those reported in the global literature, except for sleep inadequacy along with conspicuously absent factors such as academic stress and strict parenting, which should prompt further research in these areas. Further research should focus on current and prospective interventions to improve mental health literacy, targeting sleep duration, internet use and gaming, and mitigating the risk of depression in patients with chronic disease in the primary care and community setting.
Humans ; Singapore/epidemiology* ; Adolescent ; Risk Factors ; Depression/etiology* ; Protective Factors ; Male ; Female ; Life Style ; Suicide

INTRODUCTION: In the early phase of the coronavirus disease 2019 (COVID-19) pandemic, children with COVID-19 in Singapore required hospital isolation. We aimed to explore the psychological experiences of children and their caregivers isolated in a tertiary university hospital due to COVID-19. METHODS: A prospective mixed-methods design was used to evaluate the psychological status of hospitalised family units with one or more children aged <18 years who had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Patient medical records were reviewed for demographic and clinical information. Parents and children ≥7 years of age underwent a psychologist-administered telephone-based interview. Self-reported, age-appropriate instruments, Short Mood and Feelings Questionnaire, and Screen for Adult/Child Anxiety-Related Disorders, were used to assess anxiety and depression, respectively. Participants were also interviewed qualitatively. RESULTS: Fifteen family units were hospitalised between March 2020 and May 2020. Of these, 13 (73%) family units were recruited. The median age of the children and median hospitalisation duration were 57 months and 21 days, respectively. Median number of COVID-19 polymerase chain reaction swabs performed for each child was eight. All children had asymptomatic to mild SARS-CoV-2 disease. The criteria indicative of anxiety disorder were met by 40% of adults and 80% of children, while the criteria indicative of separation anxiety were met by 60% of parents and 100% of children. One child met the criteria indicative of depression. Uncertainty, separation, prolonged hospitalisation and frequent swabs caused significant reported anxiety. CONCLUSIONS Families, especially children, had heightened anxiety while in hospital isolation. Therefore, home-based recovery from COVID-19 and psychological support for children and their families, with focus on early recognition of anxiety disorders, are recommended. We support review of paediatric isolation policy as the pandemic evolves.
Humans ; COVID-19/epidemiology* ; Male ; Child ; Female ; Singapore/epidemiology* ; Anxiety/etiology* ; Prospective Studies ; Adolescent ; Hospitalization ; SARS-CoV-2 ; Adult ; Child, Preschool ; Pandemics ; Parents/psychology* ; Caregivers/psychology* ; Family/psychology* ; Depression ; Patient Isolation/psychology* ; Surveys and Questionnaires