1.Cognitive Function as a Predictor of Short-Term Pharmacological Treatment Response in Major Depressive Disorder: Mediating Effect of Mentalization
Seon Hee HWANG ; Myung Sun KIM ; Byung Joo HAM
Psychiatry Investigation 2025;22(5):522-530
Objective:
Deficits in social cognition (mentalization) and other cognitive deficits have been reported in patients with major depressive disorder (MDD) and may influence treatment response. This study examined the impact of cognitive function on treatment response of patients with MDD after 8 weeks of medication and whether the impact was mediated by mentalization.
Methods:
Cognitive function (memory, attention, executive function, processing speed) and mentalization were measured in 28 patients with MDD at baseline using neuropsychological tests and self-report scales. The treatment response was defined as the rate of improvement in symptom severity and global function.
Results:
Multiple regression analyses, controlling for mentalization and cognitive function, separately revealed that delayed recall was a negative predictor of functional improvement after 8 weeks of treatment, while mentalization was a positive predictor. A single mediation model using PROCESS macro showed that delayed recall and Digit Span backward indirectly affected functional improvement, mediated by mentalization. When age at onset was controlled for as a covariate, the mediating effect lost significance, and the direct effect of delayed recall on functional improvement was still significant.
Conclusion
Despite the small sample size, our results provide evidence that patients with MDD and low memory (delayed recall) at baseline may benefit more from short-term pharmacological treatments.
2.Cognitive Function as a Predictor of Short-Term Pharmacological Treatment Response in Major Depressive Disorder: Mediating Effect of Mentalization
Seon Hee HWANG ; Myung Sun KIM ; Byung Joo HAM
Psychiatry Investigation 2025;22(5):522-530
Objective:
Deficits in social cognition (mentalization) and other cognitive deficits have been reported in patients with major depressive disorder (MDD) and may influence treatment response. This study examined the impact of cognitive function on treatment response of patients with MDD after 8 weeks of medication and whether the impact was mediated by mentalization.
Methods:
Cognitive function (memory, attention, executive function, processing speed) and mentalization were measured in 28 patients with MDD at baseline using neuropsychological tests and self-report scales. The treatment response was defined as the rate of improvement in symptom severity and global function.
Results:
Multiple regression analyses, controlling for mentalization and cognitive function, separately revealed that delayed recall was a negative predictor of functional improvement after 8 weeks of treatment, while mentalization was a positive predictor. A single mediation model using PROCESS macro showed that delayed recall and Digit Span backward indirectly affected functional improvement, mediated by mentalization. When age at onset was controlled for as a covariate, the mediating effect lost significance, and the direct effect of delayed recall on functional improvement was still significant.
Conclusion
Despite the small sample size, our results provide evidence that patients with MDD and low memory (delayed recall) at baseline may benefit more from short-term pharmacological treatments.
3.Cognitive Function as a Predictor of Short-Term Pharmacological Treatment Response in Major Depressive Disorder: Mediating Effect of Mentalization
Seon Hee HWANG ; Myung Sun KIM ; Byung Joo HAM
Psychiatry Investigation 2025;22(5):522-530
Objective:
Deficits in social cognition (mentalization) and other cognitive deficits have been reported in patients with major depressive disorder (MDD) and may influence treatment response. This study examined the impact of cognitive function on treatment response of patients with MDD after 8 weeks of medication and whether the impact was mediated by mentalization.
Methods:
Cognitive function (memory, attention, executive function, processing speed) and mentalization were measured in 28 patients with MDD at baseline using neuropsychological tests and self-report scales. The treatment response was defined as the rate of improvement in symptom severity and global function.
Results:
Multiple regression analyses, controlling for mentalization and cognitive function, separately revealed that delayed recall was a negative predictor of functional improvement after 8 weeks of treatment, while mentalization was a positive predictor. A single mediation model using PROCESS macro showed that delayed recall and Digit Span backward indirectly affected functional improvement, mediated by mentalization. When age at onset was controlled for as a covariate, the mediating effect lost significance, and the direct effect of delayed recall on functional improvement was still significant.
Conclusion
Despite the small sample size, our results provide evidence that patients with MDD and low memory (delayed recall) at baseline may benefit more from short-term pharmacological treatments.
4.Cognitive Function as a Predictor of Short-Term Pharmacological Treatment Response in Major Depressive Disorder: Mediating Effect of Mentalization
Seon Hee HWANG ; Myung Sun KIM ; Byung Joo HAM
Psychiatry Investigation 2025;22(5):522-530
Objective:
Deficits in social cognition (mentalization) and other cognitive deficits have been reported in patients with major depressive disorder (MDD) and may influence treatment response. This study examined the impact of cognitive function on treatment response of patients with MDD after 8 weeks of medication and whether the impact was mediated by mentalization.
Methods:
Cognitive function (memory, attention, executive function, processing speed) and mentalization were measured in 28 patients with MDD at baseline using neuropsychological tests and self-report scales. The treatment response was defined as the rate of improvement in symptom severity and global function.
Results:
Multiple regression analyses, controlling for mentalization and cognitive function, separately revealed that delayed recall was a negative predictor of functional improvement after 8 weeks of treatment, while mentalization was a positive predictor. A single mediation model using PROCESS macro showed that delayed recall and Digit Span backward indirectly affected functional improvement, mediated by mentalization. When age at onset was controlled for as a covariate, the mediating effect lost significance, and the direct effect of delayed recall on functional improvement was still significant.
Conclusion
Despite the small sample size, our results provide evidence that patients with MDD and low memory (delayed recall) at baseline may benefit more from short-term pharmacological treatments.
5.Cognitive Function as a Predictor of Short-Term Pharmacological Treatment Response in Major Depressive Disorder: Mediating Effect of Mentalization
Seon Hee HWANG ; Myung Sun KIM ; Byung Joo HAM
Psychiatry Investigation 2025;22(5):522-530
Objective:
Deficits in social cognition (mentalization) and other cognitive deficits have been reported in patients with major depressive disorder (MDD) and may influence treatment response. This study examined the impact of cognitive function on treatment response of patients with MDD after 8 weeks of medication and whether the impact was mediated by mentalization.
Methods:
Cognitive function (memory, attention, executive function, processing speed) and mentalization were measured in 28 patients with MDD at baseline using neuropsychological tests and self-report scales. The treatment response was defined as the rate of improvement in symptom severity and global function.
Results:
Multiple regression analyses, controlling for mentalization and cognitive function, separately revealed that delayed recall was a negative predictor of functional improvement after 8 weeks of treatment, while mentalization was a positive predictor. A single mediation model using PROCESS macro showed that delayed recall and Digit Span backward indirectly affected functional improvement, mediated by mentalization. When age at onset was controlled for as a covariate, the mediating effect lost significance, and the direct effect of delayed recall on functional improvement was still significant.
Conclusion
Despite the small sample size, our results provide evidence that patients with MDD and low memory (delayed recall) at baseline may benefit more from short-term pharmacological treatments.
6.Graph Machine Learning With Systematic Hyper-Parameter Selection on Hidden Networks and Mental Health Conditions in the Middle-Aged and Old
Psychiatry Investigation 2024;21(12):1382-1390
Objective:
It takes significant time and energy to collect data on explicit networks. This study used graph machine learning to identify hidden networks and predict mental health conditions in the middle-aged and old.
Methods:
Data came from the Korean Longitudinal Study of Ageing (2016–2018), with 2,000 participants aged 56 or more. The dependent variable was mental disease (no vs. yes) in 2018. Twenty-eight predictors in 2016 were included. Graph machine learning with systematic hyper-parameter selection was conducted.
Results:
The area under the curve was similar across different models in different scenarios. However, sensitivity (93%) was highest for the graph random forest in the scenario of 2,000 participants and the centrality requirement of life satisfaction 90. Based on the graph random forest, top-10 determinants of mental disease were mental disease in previous period (2016), age, income, life satisfaction–health, life satisfaction–overall, subjective health, body mass index, life satisfaction–economic, children alive and health insurance. Especially, life satisfaction–overall was a top-5 determinant in the graph random forest, which considers life satisfaction as an emotional connection and a group interaction.
Conclusion
Improving an individual’s life satisfaction as a personal condition is expected to strengthen the individual’s emotional connection as a group interaction, which would reduce the risk of the individual’s mental disease in the end. This would bring an important clinical implication for highlighting the importance of a patient’s life satisfaction and emotional connection regarding the diagnosis and management of the patient’s mental disease.
7.The Effect of Forkhead Box O1 Single Nucleotide Polymorphisms on Cortical Thickness and White Matter Integrity in High Suicide Risk Patients
Daun SHIN ; Youbin KANG ; Aram KIM ; Woo Suk TAE ; Mi-Ryung HAN ; Kyu-Man HAN ; Byung-Joo HAM
Psychiatry Investigation 2024;21(11):1238-1250
Objective:
Neuroinflammation’s role is increasingly emphasized in the pathology of major depressive disorder (MDD), and its close association with the risk of suicide is being reported. The Forkhead Box O1 (FoxO1) gene is known to play a role in regulating mood and emotion and is associated with susceptibility to suicidality in relation to environmental stress. This research aims to explore the relationship between FoxO1 and the risk of suicide in individuals with MDD.
Methods:
We enrolled 127 healthy controls (HC) and 231 patients diagnosed with MDD, including 119 individuals with high suicide risk (HSR). All participants underwent the Hamilton Rating Scale for Depression Assessment and magnetic resonance imaging. Cortical thickness and white matter integrity were evaluated.
Results:
In the HSR group, cortical thinning was observed in the left triangular part of the inferior frontal gyrus and right transverse frontopolar gyrus compared to HC. Additionally, fractional anisotropy (FA) values were decreased in the left posterior thalamic radiation, sagittal stratum, and uncinate fasciculus. Although no differences were observed based on allele variations for the two FoxO1 single nucleotide polymorphisms (SNPs), those with the minor allele of FoxO1 rs34733279, especially in the HSR group, displayed increased cortical thinning and reduced FA values in the left cingulum.
Conclusion
Our study reveals close association between the minor allele of the FoxO1 gene rs34733279 and suicide risk in the left cingulum highlights the potential key role of the FoxO1 gene rs34733279 in the context of suicidal vulnerability. Further investigations are warranted to elucidate the underlying biological mechanisms.
8.Is There such a Thing as Post-Viral Depression?: Implications for Precision Medicine
Eun-Sook PARK ; Chan Young SHIN ; Se Jin JEON ; Byung-Joo HAM
Biomolecules & Therapeutics 2024;32(6):659-684
Viral infections are increasingly recognized as triggers for depressive disorders, particularly following the SARS-CoV-2 pandemic and the rise of long COVID. Viruses such as Herpes Simplex Virus (HSV), Epstein-Barr Virus (EBV), Cytomegalovirus (CMV), and Human Immunodeficiency Virus (HIV) are linked to depression through complex neurobiological mechanisms. These include immune system dysregulation, chronic inflammation, and neurotransmitter imbalances that affect brain function and mood regulation. Viral activation of the immune system leads to the release of pro-inflammatory cytokines, resulting in neuroinflammation and associated depressive symptoms. Furthermore, specific viruses can disrupt neurotransmitter systems, including serotonin, dopamine, and glutamate, all of which are essential for mood stabilization. The unique interactions of different viruses with these systems underscore the need for virus-specific therapeutic approaches. Current broad-spectrum treatments often overlook the precise neurobiological pathways involved in post-viral depression, reducing their efficacy. This review emphasizes the need to understand these virus-specific interactions to create tailored interventions that directly address the neurobiological effects induced by each type of virus. These interventions may include immunomodulatory treatments that target persistent inflammation, antiviral therapies to reduce the viral load, or neuroprotective strategies that restore neurotransmitter balance. Precision medicine offers promising avenues for the effective management of virus-induced depression, providing patient-specific approaches that address the specific biological mechanisms involved. By focusing on the development of these targeted treatments, this review aims to pave the way for a new era in psychiatric care that fully addresses the root causes of depression induced by viral infections.
9.Graph Machine Learning With Systematic Hyper-Parameter Selection on Hidden Networks and Mental Health Conditions in the Middle-Aged and Old
Psychiatry Investigation 2024;21(12):1382-1390
Objective:
It takes significant time and energy to collect data on explicit networks. This study used graph machine learning to identify hidden networks and predict mental health conditions in the middle-aged and old.
Methods:
Data came from the Korean Longitudinal Study of Ageing (2016–2018), with 2,000 participants aged 56 or more. The dependent variable was mental disease (no vs. yes) in 2018. Twenty-eight predictors in 2016 were included. Graph machine learning with systematic hyper-parameter selection was conducted.
Results:
The area under the curve was similar across different models in different scenarios. However, sensitivity (93%) was highest for the graph random forest in the scenario of 2,000 participants and the centrality requirement of life satisfaction 90. Based on the graph random forest, top-10 determinants of mental disease were mental disease in previous period (2016), age, income, life satisfaction–health, life satisfaction–overall, subjective health, body mass index, life satisfaction–economic, children alive and health insurance. Especially, life satisfaction–overall was a top-5 determinant in the graph random forest, which considers life satisfaction as an emotional connection and a group interaction.
Conclusion
Improving an individual’s life satisfaction as a personal condition is expected to strengthen the individual’s emotional connection as a group interaction, which would reduce the risk of the individual’s mental disease in the end. This would bring an important clinical implication for highlighting the importance of a patient’s life satisfaction and emotional connection regarding the diagnosis and management of the patient’s mental disease.
10.The Effect of Forkhead Box O1 Single Nucleotide Polymorphisms on Cortical Thickness and White Matter Integrity in High Suicide Risk Patients
Daun SHIN ; Youbin KANG ; Aram KIM ; Woo Suk TAE ; Mi-Ryung HAN ; Kyu-Man HAN ; Byung-Joo HAM
Psychiatry Investigation 2024;21(11):1238-1250
Objective:
Neuroinflammation’s role is increasingly emphasized in the pathology of major depressive disorder (MDD), and its close association with the risk of suicide is being reported. The Forkhead Box O1 (FoxO1) gene is known to play a role in regulating mood and emotion and is associated with susceptibility to suicidality in relation to environmental stress. This research aims to explore the relationship between FoxO1 and the risk of suicide in individuals with MDD.
Methods:
We enrolled 127 healthy controls (HC) and 231 patients diagnosed with MDD, including 119 individuals with high suicide risk (HSR). All participants underwent the Hamilton Rating Scale for Depression Assessment and magnetic resonance imaging. Cortical thickness and white matter integrity were evaluated.
Results:
In the HSR group, cortical thinning was observed in the left triangular part of the inferior frontal gyrus and right transverse frontopolar gyrus compared to HC. Additionally, fractional anisotropy (FA) values were decreased in the left posterior thalamic radiation, sagittal stratum, and uncinate fasciculus. Although no differences were observed based on allele variations for the two FoxO1 single nucleotide polymorphisms (SNPs), those with the minor allele of FoxO1 rs34733279, especially in the HSR group, displayed increased cortical thinning and reduced FA values in the left cingulum.
Conclusion
Our study reveals close association between the minor allele of the FoxO1 gene rs34733279 and suicide risk in the left cingulum highlights the potential key role of the FoxO1 gene rs34733279 in the context of suicidal vulnerability. Further investigations are warranted to elucidate the underlying biological mechanisms.

Result Analysis
Print
Save
E-mail