Journal of affective disorders最新文献

{"title":"The effects of exercise on episodic memory in patients with depression: a three-level meta-analysis.","authors":"Jiawen Ma, Xiaoyu Xie, Yansong Li, Xue Xia","doi":"10.1016/j.jad.2026.122418","DOIUrl":"10.1016/j.jad.2026.122418","url":null,"abstract":"<p><strong>Objective: </strong>Using a three-level meta-analysis approach, this study evaluated the effects of exercise on episodic memory in patients with depression and explored its moderating variables.</p><p><strong>Methods: </strong>A systematic search was conducted across seven databases to identify randomized controlled trials examining the effects of exercise interventions on episodic memory in patients with depression. Two researchers independently screened studies, extracted data, and assessed the risk of bias. A three-level meta-analysis was performed to calculate the pooled effect size (Hedges' g), and subgroup analyses were conducted to explore moderating variables.</p><p><strong>Results: </strong>A total of 13 randomized controlled trials (1098 participants) were included. Exercise showed a significant small-to-moderate positive effect on episodic memory in patients with depression (g = 0.210, 95% CI [0.10, 0.32]). Descriptively, significant improvements were observed for delayed recall (g = 0.213) and immediate recall (g = 0.206), whereas the effect for total learning was not significant (g = 0.243). No significant differences were found across memory indices or exercise characteristics (all ps > 0.05). Sensitivity analyses confirmed the robustness of the findings, and the certainty of evidence was rated as moderate.</p><p><strong>Conclusion: </strong>Exercise may provide small-to-moderate benefits for the episodic memory of patients with depression. No significant differences were observed among different memory indices or exercise characteristics, suggesting that these benefits are generally consistent under the conditions studied. Future research should standardize the assessment of episodic memory, extend the follow-up period, and further determine the optimal exercise prescriptions and its underlying mechanisms.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"122418"},"PeriodicalIF":5.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation and extension of a risk calculator to predict mood recurrence in young people with bipolar disorder.","authors":"Ava Avolio, John Merranko, Mary Kay Gill, Jessica C Levenson, Tina R Goldstein, Danella Hafeman, Boris Birmaher","doi":"10.1016/j.jad.2026.122402","DOIUrl":"10.1016/j.jad.2026.122402","url":null,"abstract":"<p><strong>Objective: </strong>The episodic nature of bipolar disorder (BD) and the substantial variability in mood recurrences between individuals, emphasize the need for accurate prediction tools. The original Course and Outcome of Bipolar Youth (COBY) recurrence risk calculator (RC) estimates threshold recurrence risk, but its performance for subthreshold recurrences has not been established. This study extended the COBY RC to predict both threshold and subthreshold recurrences and evaluated its performance in an independent sample.</p><p><strong>Method: </strong>Adolescents and young adults with BD-I/II (N = 51; BD-I: 38, BD-II: 13; 14-24 years old) were assessed with standard instruments at intake and during follow-up on average every 6 months for a median of 54 weeks. Model performance for predicting threshold and subthreshold recurrence was evaluated using area under the receiver operating characteristic curves (AUC), with additional assessments of calibration and variable importance.</p><p><strong>Results: </strong>The model demonstrated good discrimination of any recurrence within the next six months (threshold AUC = 0.72; subthreshold or worse AUC = 0.77). Calibration analyses indicated systematic risk overestimation in the external sample, plausibly reflecting differences in ascertainment (prospective vs. retrospective) and prior remission length. Recalibration greatly improved calibration without reducing discrimination.</p><p><strong>Conclusion: </strong>The COBY RC showed good discrimination for both threshold and subthreshold recurrences in an independent young adult cohort, extending prior youth and adult validations. These findings support its potential utility for personalized monitoring and early intervention across developmental stages and symptom severity.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"122402"},"PeriodicalIF":5.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of psychotic depression in Sweden: a nationwide register study.","authors":"Ahmed Al-Wandi, Axel Nordenskjöld","doi":"10.1016/j.jad.2026.122400","DOIUrl":"10.1016/j.jad.2026.122400","url":null,"abstract":"<p><strong>Background: </strong>Data on clinical outcomes in psychotic depression remain limited. We examined hospitalization, suicide, and treatment patterns in Swedish patients with psychotic depression.</p><p><strong>Methods: </strong>This nationwide register-based study included patients with an index diagnosis of psychotic unipolar depression during 2012-2020. Post-index psychiatric hospitalizations and suicide deaths were examined descriptively and using logistic regression adjusted for sex, age, prior admissions, psychiatric comorbidity, index care setting (inpatient or outpatient), and pharmacological treatment. For patients treated with electroconvulsive therapy (ECT) during 2012-2020, the outcomes of response and remission according to the Clinical Global Impressions Scale were assessed by logistic regression.</p><p><strong>Results: </strong>Of 8048 patients, 54.8% were women, median age was 47 years (interquartile range 30-63), and 51.8% were diagnosed in specialized outpatient care. A total of 25.1% were hospitalized and 0.8% died by suicide within 36 weeks. Index diagnosis in inpatient care, prior admissions, comorbid alcohol or substance use disorder, antipsychotic treatment, and younger age (≤25 years) were associated with increased odds of post-index hospitalization. Younger age was associated with decreased odds of suicide. Among ECT-treated patients, 89.8% achieved response and 48.4% achieved remission. Younger age and prior admissions were associated with decreased odds of remission. Age 51-75 years, compared with ≤25 years, was associated with increased odds of response.</p><p><strong>Conclusions: </strong>Psychotic depression carries a high risk of psychiatric hospitalization and suicide shortly after index diagnosis. Increased odds of hospitalization associated with antipsychotic treatment likely reflect confounding by indication. Among ECT-treated patients, response and remission rates were high.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"414 ","pages":"122400"},"PeriodicalIF":5.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood trauma and suicide ideation and attempts: Examining the mediating role of psychosocial, personality, lifestyle and biological factors.","authors":"Jasper X M Wiebenga, Lili Lokhorst, Adriaan W Hoogendoorn, Henriette D Heering, Merijn Eikelenboom, Erik J Giltay, Patricia van Oppen, Brenda W J H Penninx","doi":"10.1016/j.jad.2026.122414","DOIUrl":"10.1016/j.jad.2026.122414","url":null,"abstract":"<p><strong>Background: </strong>Childhood trauma (CT) is robustly associated with suicide ideation (SI) and attempts (SA) in individuals with depressive and/or anxiety disorders. However, pathways underlying these associations and whether they differ between suicide ideation only (SI+SA-) and suicide ideation with attempt (SI+SA+) remain unclear. Variables that may statistically account for CT-SI+SA- and CT-SI+SA+ associations were examined.</p><p><strong>Methods: </strong>Data from 1572 respondents with a 12-month depressive and/or anxiety disorder from the Netherlands Study of Depression and Anxiety were used. The NEMESIS childhood trauma interview (0-8 score) measured CT severity. Single and multiple-mediator models via generalized structural equation modeling (GSEM) were used to investigate whether psychosocial, personality, lifestyle and biological variables showed indirect associations consistent with mediation of the association between CT and suicide outcomes.</p><p><strong>Results: </strong>Higher CT scores were associated with SI+SA- (OR = 1.51, 95% CI: 1.32-1.73) and SI+SA+ (OR = 2.68, 95% CI: 2.21-3.27). In single mediator models, personality traits, insomnia, low social support and loneliness statistically accounted for a part of the association between CT and both outcomes. Interleukin-6 statistically accounted for a small portion of the CT-SI+SA+ link. In multiple-mediator models, direct effects reduced by 65.6% (SI+SA-) and 39.1% (SI+SA+) and aggression, insomnia, social support (both outcomes), neuroticism, introversion, hopelessness (SI+SA-) and locus of control (SI+SA+) remained significant.</p><p><strong>Limitations: </strong>The cross-sectional design limits causal inferences.</p><p><strong>Conclusion: </strong>Multiple personality traits, insomnia and lower social support statistically accounted for a portion of the association between CT and suicide outcomes. Especially aggression, insomnia and social support may represent actionable suicide prevention targets, pending longitudinal validation.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"122414"},"PeriodicalIF":5.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Altered local functional synchronization in night-shift nurses: Associations with peripheral metabolic variation and depressive symptoms.","authors":"Yafei Kang, Fangxue Yang, Caihong Zhao, Meihong Gao, Gang Wang, Youming Zhang","doi":"10.1016/j.jad.2026.122393","DOIUrl":"10.1016/j.jad.2026.122393","url":null,"abstract":"<p><strong>Background: </strong>Night-shift work in nurses is associated with circadian disruption, sleep disturbance, and increased vulnerability to affective symptoms. However, the neural and metabolic correlates of these alterations remain insufficiently understood.</p><p><strong>Methods: </strong>A total of 121 female nurses, including 59 day-shift nurses (DSN) and 62 night-shift nurses (NSN), underwent resting-state functional MRI. Regional homogeneity (ReHo) was calculated to assess local functional synchronization. Between-group ReHo differences were examined, followed by transcriptomic and neurotransmitter decoding analyses. Untargeted serum metabolomics was performed to assess peripheral metabolic differences and their associations with ReHo.</p><p><strong>Results: </strong>Compared with DSN, NSN showed decreased ReHo in the left superior temporal cortex and left anterior hippocampus, and increased ReHo in the right medial amygdala and right superior parietal lobule. The cortical ReHo pattern was associated with gene expression profiles enriched for cellular responses to stress, protein phosphorylation, and mitochondrion organization, and showed spatial correspondence with dopamine D1 receptor distribution. Serum metabolomics revealed widespread between-group metabolic differences. In NSN, metabolite PC1 was positively associated with right medial amygdala ReHo, and an exploratory indirect association between metabolite PC1 and Beck Depression Inventory scores through right medial amygdala ReHo was observed.</p><p><strong>Conclusions: </strong>Night-shift work in nurses is associated with alterations in peripheral metabolism, local functional synchronization, and depressive symptoms. Right medial amygdala ReHo may represent a neural correlate associated with peripheral metabolic variation and affective symptom burden.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"122393"},"PeriodicalIF":5.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty transitions, depressive symptoms, and incident dementia: findings from four longitudinal studies.","authors":"Jia Fang, Wencan Cheng, Huiyuan Li, Kayan Ho, Chen Yang, Yiheng Zhang, Ni Zhang, Ye Zhang, Fangjia Shen, Xiaodan Wu, Meifen Zhang","doi":"10.1016/j.jad.2026.122381","DOIUrl":"10.1016/j.jad.2026.122381","url":null,"abstract":"<p><strong>Background: </strong>Frailty is a potentially reversible risk factor for dementia. Whether frailty reversal actively reduces dementia risk across diverse populations, and the extent to which depressive symptoms mediate this pathway, remains unclear.</p><p><strong>Methods: </strong>We included 59,331 adults aged ≥50 from the Health and Retirement Study (HRS), the China Health and Retirement Longitudinal Study (CHARLS), the Survey of Health, Ageing and Retirement in Europe (SHARE), and the English Longitudinal Study of Ageing (ELSA). A harmonized 25-item FI defined frailty (FI ≥ 0.25). Primary exposures were baseline frailty status and frailty transitions between the first two waves, evaluated within baseline strata as worsening versus stable non-frail status and improvement versus stable frail status. Mean FI and FI change were also examined.</p><p><strong>Results: </strong>Over 7.51 ± 2.09 years, 5629 participants (9.49%) developed dementia. Baseline frailty was associated with higher risk (HRs, 1.35-2.23), as was frailty worsening (HRs, 1.43-2.53). Frailty reversal was associated with lower risk in SHARE (HR, 0.55) and CHARLS (HR, 0.70); associations in ELSA and HRS were not statistically significant. Estimated mediation proportions for depressive symptoms ranged from 29.29% to 44.78%. CLPN analyses showed cross-lagged associations in three cohorts for walking limitations, difficulty managing finances, and psychiatric problems.</p><p><strong>Conclusion: </strong>Frailty worsening was associated with higher dementia risk, whereas frailty improvement was associated with lower risk in some cohorts. Depressive symptoms showed indirect associations with incident dementia for both baseline frailty and frailty worsening. However, whether interventions targeting frailty and depressive symptoms can reduce dementia incidence remains to be determined in future interventional studies.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"122381"},"PeriodicalIF":5.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploratory non-randomized clinical trial of subcutaneous esketamine in treatment-resistant depression: Effects of ketamine-assisted psychotherapy.","authors":"Yves Martins Varela, Patricia Cavalcanti-Ribeiro, Geovan Menezes de Sousa, Marcelo Falchi-Carvalho, Juliana Dos Santos Fernandes Barbalho, Raynara Bolcont de Oliveira Gomes, Melanie Moura Medina Gurgel, Bruno Carvalho Pereira, Pâmela Milena de Lima Souza, Kaike Thiê da Costa Gonçalves, Mariana Muniz, Victor Rocha Nóbrega de Almeida, Luiz Felipe Dantas Pereira, David Cavalcante Barbosa, Bruna Santos de Carvalho, Eduardo Igor Torquato Cardoso Lopes, Ariadne Cruz de Oliveira, Draulio Barros de Araujo, Fernanda Palhano-Fontes, Gisele Fernandes-Osterhold, Nicole Galvão-Coelho","doi":"10.1016/j.jad.2026.122369","DOIUrl":"10.1016/j.jad.2026.122369","url":null,"abstract":"<p><strong>Background: </strong>Ketamine is an effective rapid-acting treatment for treatment-resistant depression (TRD), producing antidepressant effects within hours of administration. Because it induces states of heightened neuroplasticity and psychological openness, psychotherapy may enhance its therapeutic effects.</p><p><strong>Methods: </strong>This exploratory, nonrandomized, open-label clinical trial evaluated the adjunctive effects of ketamine-assisted psychotherapy (KAP) in an outpatient setting. Forty-six patients with TRD received eight weekly sessions of subcutaneous esketamine (0.5-1.0 mg/kg) and were sequentially allocated to esketamine alone (KET, n = 23) or esketamine plus KAP (n = 23). Depressive symptoms were assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Beck Depression Inventory-II (BDI-II) during treatment and at follow-up assessments up to six months after protocol completion.</p><p><strong>Results: </strong>Both groups showed significant reductions in depressive symptoms. MADRS scores were significantly lower in the KAP group at the seventh and eighth sessions (p = 0.015 and p = 0.041). At treatment completion, response and remission rates were 52.2% and 34.8% in the KET group versus 78.3% and 78.3% in the KAP group; the between-group difference was significant only for remission (p = 0.007). BDI-II scores also indicated earlier subjective improvement in the KAP group. No significant between-group differences were observed during the six-month follow-up.</p><p><strong>Conclusions: </strong>These findings suggest that structured psychotherapeutic support may accelerate symptomatic improvement and increase remission rates during subcutaneous esketamine treatment for TRD, without improving the durability of response. Randomized controlled trials are needed to clarify the specific contribution of psychotherapy, investigate the mechanisms underlying this interaction, and optimize integrated treatment approaches.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"122369"},"PeriodicalIF":5.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotional processing biases in the longitudinal course of major depressive disorder.","authors":"Katharina Hierl, Liane Wollweber, Hannah Lemke, Leonie Esser, Cécile Abati, Dominik Grotegerd, Katharina Dohm, Anna Kraus, Elisabeth J Leehr, Hanne L Kjærstad, Philipp Kanske, Udo Dannlowski, Katharina Förster","doi":"10.1016/j.jad.2026.122362","DOIUrl":"10.1016/j.jad.2026.122362","url":null,"abstract":"<p><p>Negative biases in emotional processing are central to cognitive models of Major Depressive Disorder (MDD), yet it remains unclear whether negatively biased valence attribution covaries with depressive symptoms or represents a more stable vulnerability. In this longitudinal study, we examined emotional valence ratings during a subliminal affective priming task in n = 232 MDD patients and n = 496 healthy controls (HC's) across multiple follow-up assessments, yielding 1395 observations. Multilevel models tested effects of depressive symptom severity, diagnostic group (MDD vs. HC), affective prime (happy, sad, neutral), and their interactions. To separate within-person fluctuations from between-person differences, depressive symptom severity was decomposed (Mundlak within-between specification). Exploratory analyses examined whether long-term symptom trajectory clusters were associated with emotional bias. Greater depressive symptom severity was associated with more negative valence ratings. Within-between analyses indicated that this association was primarily driven by within-person symptom fluctuations, indicating more negative ratings when symptom severity exceeded individual average. In contrast, diagnostic group, prime condition, and symptom severity × prime interactions did not significantly predict valence ratings, and no group differences emerged between HC's and remitted MDD patients. Exploratory trajectory analyses suggested that patients with recurrent symptom patterns may show more negative valence ratings, although cluster stability was limited and findings should be interpreted cautiously. Overall, the results suggest that negative valence attribution in MDD is more closely linked to current depressive symptom severity than to diagnostic status alone. Longitudinal approaches separating within- and between-person processes may help clarify when negative biases emerge and persist during depression progression.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"122362"},"PeriodicalIF":5.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evening meal timing irregularity is associated with higher depressive symptoms in Iranian adults: A cross-sectional study.","authors":"Vida Dankoob, Amirreza Ostevari, Bahareh Jabbarzadeh-Ganjeh, Amin Mirrafiei, Reyhane Norouziasl, Shadi Ghaemi, Negar Bafkar, Mahsa Firouzi, Aliyu Tijani Jibril, Amirreza Aghvamiamoli, Kurosh Djafarian, Alireza Bahrami, Sakineh Shab-Bidar","doi":"10.1016/j.jad.2026.122404","DOIUrl":"10.1016/j.jad.2026.122404","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to examine the association between irregular meal timing and symptoms of depression, anxiety, and stress among Iranian adults.</p><p><strong>Methods: </strong>This cross-sectional study included 450 apparently healthy adults (aged 20-59 years; 53.8% female) recruited via convenience sampling. Dietary data were collected using three non-consecutive 24-h recalls to assess meal timing irregularity, defined as day-to-day variability and deviation from participants' habitual meal timing, using composite phase deviation (CPD) scores for breakfast, lunch, and dinner. Mental health outcomes were measured with the Depression Anxiety Stress Scales short form. Covariates included sleep quality (Pittsburgh Sleep Quality Index), chronotype (Morningness-Eveningness Questionnaire), physical activity (International Physical Activity Questionnaire), anthropometrics, and sociodemographics. Associations were examined using multivariable logistic regression for binary outcomes and linear regression for continuous scores, adjusting for confounders. Linear regression analyses included participants with complete data for all model variables (n = 404).</p><p><strong>Results: </strong>No significant associations emerged between meal timing irregularity tertiles and binary mental health outcomes (all adjusted P-trend>0.05). However, in linear regression models, dinner irregularity was independently associated with higher depressive symptom scores (B = 1.08, 95% CI 0.32-1.85, P = 0.006), but not stress (P = 0.336) and anxiety (P = 0.388). Breakfast and lunch irregularities showed no significant associations.</p><p><strong>Conclusions: </strong>Dinner timing irregularity may be associated with higher depressive symptom scores in this sample of Iranian adults. Future prospective and intervention studies are needed to clarify temporality and underlying mechanisms.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"122404"},"PeriodicalIF":5.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remission outcomes with bupropion versus selective serotonin reuptake inhibitors in major depressive disorder with comorbid obesity: A propensity-matched cohort analysis.","authors":"Farah Khorassani, Justin Schneider, Jonathan Prunean, Gemma Espejo","doi":"10.1016/j.jad.2026.122398","DOIUrl":"10.1016/j.jad.2026.122398","url":null,"abstract":"<p><p>Observational and secondary analyses of clinical trials evaluating efficacy of antidepressants suggest that medications with noradrenergic and dopaminergic mechanisms of action may be more effective in managing symptoms of major depressive disorder (MDD) in obese patients than medications that are purely serotonergic. The purpose of this study is to compare the efficacy of bupropion versus SSRIs in patients without a documented antidepressant trial with comorbid MDD and obesity. This was a retrospective, propensity-score matched, observational study utilizing a global cohort within the TriNetX database. Adults aged 18 or over with a major depressive episode and obesity were grouped into two cohorts: 1) exposure to bupropion and 2) exposure to SSRIs. Patients with antidepressant exposure prior to the index event were excluded. Both cohorts were propensity matched based on 16 covariates. The primary outcome was remission of a major depressive episode. Secondary outcomes included evaluating socioeconomic and psychosocial differences between the groups. Each cohort yielded 165,629 patients. The primary endpoint analysis indicated a small but statistically significant difference in MDD remission rates in favor of bupropion with an absolute risk rate of 8.5% compared to 7.9% in the SSRI group (Risk Ratio [RR] 1.07, 95% CI 1.05-1.10, p < 0.0001). Binary outcomes were summarized using risk differences and risk ratios and compared between cohorts using chi-square tests. Our findings suggest bupropion monotherapy was associated with a small but statistically significant higher remission rate compared with SSRIs but further prospective studies using objective remission indicators are needed.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"122398"},"PeriodicalIF":5.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}