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 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.

BACKGROUND AND OBJECTIVES

Ensuring the total well-being of healthcare workers (HCWs), including their mental health and psychological well-being, is an essential aspect in the delivery of patient care and the preservation of the health workforce. This study aimed to determine the level of mental well-being and emotional state of HCWs in terms of depression, anxiety, and stress using the DASS-21 scale in a tertiary government hospital during the COVID-19 pandemic in the Philippines and to identify the job-related factors that may be associated with these outcomes.

This is an analytical, cross-sectional study among HCWs involved in direct patient care in a tertiary government hospital in the Philippines during the COVID-19 pandemic. Data collection was conducted from February to March 2022 through an online self-administered questionnaire, which included the Demand-Control-Support Questionnaire (DCSQ), and the 21-item Depression Anxiety Stress Scale (DASS-21). This was sent to doctors, nurses, and allied medical workers actively working in the clinical areas. All responses were collected and analyzed.

Three hundred sixty-four healthcare workers were included in the study. Majority were single (62.62%), living with immediate family (50.82%), and working in a COVID-designated area (62.09%). High prevalence of depression (49.18%), anxiety (61.54%), and stress (30.22%) was found among the HCWs. Work in high infection/COVID-designated areas was significantly associated with anxiety and stress, and high-job demand was significantly associated with all three mental health states compared to low job-demand.

Focus should be placed on modifying the condition of high job demand among healthcare workers working in hospitals. This includes ensuring optimum staffing levels and patient to HCW ratio which avoids HCWs from being subjected to high workloads and time pressures that subsequently increase risk for stress, anxiety, and depression.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a complex disease that is often accompanied by mental health disorders. However, the potential mechanisms underlying the heterogeneous clinical presentation of CP/CPPS remain uncertain. This study analyzed widely targeted metabolomic data of expressed prostatic secretions (EPS) and plasma to reveal the underlying pathological mechanisms of CP/CPPS. A total of 24 CP/CPPS patients from The Second Nanning People's Hospital (Nanning, China), and 35 asymptomatic control individuals from First Affiliated Hospital of Guangxi Medical University (Nanning, China) were enrolled. The indicators related to CP/CPPS and psychiatric symptoms were recorded. Differential analysis, coexpression network analysis, and correlation analysis were performed to identify metabolites that were specifically altered in patients and associated with various phenotypes of CP/CPPS. The crucial links between EPS and plasma were further investigated. The metabolomic data of EPS from CP/CPPS patients were significantly different from those from control individuals. Pathway analysis revealed dysregulation of amino acid metabolism, lipid metabolism, and the citrate cycle in EPS. The tryptophan metabolic pathway was found to be the most significantly altered pathway associated with distinct CP/CPPS phenotypes. Moreover, the dysregulation of tryptophan and tyrosine metabolism and elevation of oxidative stress-related metabolites in plasma were found to effectively elucidate the development of depression in CP/CPPS. Overall, metabolomic alterations in the EPS and plasma of patients were primarily associated with oxidative damage, energy metabolism abnormalities, neurological impairment, and immune dysregulation. These alterations may be associated with chronic pain, voiding symptoms, reduced fertility, and depression in CP/CPPS. This study provides a local-global perspective for understanding the pathological mechanisms of CP/CPPS and offers potential diagnostic and therapeutic targets.
Humans ; Male ; Prostatitis/blood* ; Adult ; Pelvic Pain/blood* ; Metabolomics ; Prostate/metabolism* ; Middle Aged ; Chronic Pain/blood* ; Metabolome ; Case-Control Studies ; Tryptophan/blood* ; Depression/blood* ; Oxidative Stress/physiology* ; Chronic Disease ; Lipid Metabolism/physiology*

OBJECTIVES: To explore the mediating role of sleep duration in the relationship between depression symptoms and myopia among middle school students. METHODS: This study was a cross-sectional research conducted using a stratified cluster random sampling method. A total of 1 728 middle school students were selected from two junior high schools and two senior high schools in certain urban areas and farms of the Xinjiang Production and Construction Corps. Questionnaire surveys and vision tests were conducted among the students. Spearman analysis was used to analyze the correlation between depression symptoms, sleep duration, and myopia. The Bootstrap method was employed to investigate the mediating effect of sleep duration between depression symptoms and myopia. RESULTS: The prevalence of myopia in the overall population was 74.02% (1 279/1 728), with an average sleep duration of (7.6±1.0) hours. The rate of insufficient sleep was 83.62% (1 445/1 728), and the proportion of students exhibiting depression symptoms was 25.29% (437/1 728). Correlation analysis showed significant negative correlations between visual acuity in both eyes and sleep duration with depressive emotions as measured by the Center for Epidemiologic Studies Depression Scale (with correlation coefficients of -0.064, -0.084, and -0.199 respectively; P<0.01), as well as with somatic symptoms and activities (with correlation coefficients of -0.104, -0.124, and -0.233 respectively; P<0.01) and interpersonal relationships (with correlation coefficients of -0.052, -0.059, and -0.071 respectively; P<0.05). The correlation coefficients for left and right eye visual acuity and sleep duration were 0.206 and 0.211 respectively (P<0.001). Sleep duration exhibited a mediating effect between depression symptoms and myopia (indirect effect=0.056, 95%CI: 0.029-0.088), with the mediating effect value for females (indirect effect=0.066, 95%CI: 0.024-0.119) being higher than that for males (indirect effect=0.042, 95%CI: 0.011-0.081). CONCLUSIONS Sleep duration serves as a partial mediator between depression symptoms and myopia in middle school students.
Humans ; Myopia/etiology* ; Male ; Female ; Depression/physiopathology* ; Cross-Sectional Studies ; Sleep ; Adolescent ; Students ; Child ; Time Factors ; Sleep Duration

OBJECTIVES: To systematically evaluate the prevalence of depressive symptoms among children and adolescents in China. METHODS: A comprehensive search was conducted in PubMed, Embase, Cochrane Library, Web of Science, Wanfang Data, China Biomedical Literature Database, China National Knowledge Infrastructure, and VIP Database for literature published from January 2015 to May 2024 regarding the prevalence of depressive symptoms among Chinese children and adolescents. Stata 16.0 software was used for Meta analysis, and Egger's test and funnel plot analysis were performed to assess publication bias. RESULTS: A total of 53 studies were included, encompassing 314 867 children and adolescents, with 65 324 exhibiting depressive symptoms, resulting in a prevalence rate of 23.3% (95%CI: 21.4%-25.1%). Subgroup analysis revealed higher prevalence rates among females, those in rural areas, vocational high school students, individuals from the eastern region, those assessed using the Depression Self-Rating Scale for Children, and during the COVID-19 pandemic, with rates of 24.9%, 29.5%, 28.1%, 25.6%, 27.2%, and 27.7%, respectively. The distribution of studies in the funnel plot was roughly symmetrical, but Egger's test indicated potential publication bias (P<0.001). CONCLUSIONS The prevalence of depressive symptoms among children and adolescents in China is relatively high, particularly among females, those in rural areas, vocational high school students, and those in the eastern regions. Additionally, the COVID-19 pandemic may have impacted the incidence of depressive symptoms in this population.
Humans ; Adolescent ; Child ; China/epidemiology* ; Prevalence ; Depression/epidemiology* ; Female ; Male ; COVID-19

The prevalence of adolescent depressive symptoms has been rising, and maternal depression is a key predictor. This review synthesizes evidence on mechanisms of influence and on intervention research. The intergenerational transmission of risk from maternal depression appears more pronounced than that associated with paternal depression. At the biological level, genetic susceptibility and neurodevelopmental alterations underpin intergenerational transmission; at the social level, negative parenting practices and stressful family environments create a vicious cycle; at the psychological level, deficits in emotion regulation and insecure attachment amplify vulnerability to depression. Family-based interventions, including cognitive-behavioral therapy and family systems therapy, can mitigate intergenerational transmission. However, more longitudinal research is needed, and future work may integrate digital technologies to develop structured intervention protocols.
Humans ; Female ; Adolescent ; Depression/psychology* ; Family Therapy ; Mothers/psychology*

OBJECTIVES: To investigate the association between maternal depressive symptoms and adolescent suicidal ideation, and to examine the chain mediating roles of childhood trauma and ineffectiveness. METHODS: A cross-sectional online survey was administered by school psychologists to 4 157 mother-adolescent pairs from middle schools in Shanghai and Henan, China. Measures included the Center for Epidemiological Studies Depression Scale, the Childhood Trauma Questionnaire, and the Children's Depression Inventory. Using Bootstrap method to examine the chain mediating effect of childhood trauma and ineffectiveness on the relationship between maternal depression symptoms and adolescent suicidal ideation. RESULTS: The prevalence of maternal depressive symptoms was 17.68% (735/4 157); among adolescents, the prevalence of depressive symptoms was 15.49% (644/4 157), and suicidal ideation was 28.19% (1 172/4 157). Adolescent depressive symptoms and suicidal ideation were positively correlated with maternal depressive symptoms, childhood trauma, and ineffectiveness (all P<0.01). Childhood trauma significantly mediated the association between maternal and adolescent depressive symptoms (95%CI: 0.046 9-0.077 2). The chain mediation of childhood trauma and ineffectiveness in the association between maternal depressive symptoms and adolescent suicidal ideation was also significant (95%CI: 0.000 7-0.001 3). CONCLUSIONS Higher maternal depressive symptom levels are associated with a greater likelihood of adolescents' exposure to childhood trauma, which increases adolescents' ineffectiveness and, in turn, is associated with suicidal ideation. This chain effect has important implications for social interventions targeting adolescent depression.
Humans ; Suicidal Ideation ; Adolescent ; Female ; Depression/etiology* ; Cross-Sectional Studies ; Mothers/psychology* ; Male ; Child ; Adult