Journal of affective disorders最新文献

{"title":"The association between local public health unit funding and adolescent mental health during the COVID-19 pandemic: Longitudinal findings from the Ontario public health information database (OPHID) and COMPASS studies","authors":"Stephen Hunter ,&nbsp;Brendan T. Smith ,&nbsp;Naomi Schwartz ,&nbsp;Steven Rebellato ,&nbsp;Karen A. Patte ,&nbsp;Carla Hilario ,&nbsp;Laura N. Anderson ,&nbsp;Scott T. Leatherdale ,&nbsp;Roman Pabayo","doi":"10.1016/j.jad.2025.119759","DOIUrl":"10.1016/j.jad.2025.119759","url":null,"abstract":"<div><h3>Background</h3><div>Public health units (PHU) require adequate funding to service the needs of their community. This study examined the association between PHU funding and adolescent mental health trajectories from 2018–19 to 2020–21 in Ontario, Canada.</div></div><div><h3>Methods</h3><div>Longitudinal adolescent data from the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, and Sedentary behaviour (COMPASS) study (<em>n</em> = 6043) was used. Adolescents reported on depression and anxiety symptoms via questionnaire. Data on funding from 12 PHUs was obtained from the Ontario Public Health Information Database. We used multilevel growth curve analyses to estimate whether PHU funding modified trajectories of depressive and anxiety symptoms while adjusting for student, school, and area-level covariates. We also tested for heterogeneity by gender and performed gender stratified analyses.</div></div><div><h3>Results</h3><div>PHU funding modified depression trajectories. Differences in depression scores by level of PHU funding were not significant at each time point. However, students attending schools in areas with lower PHU funding had smaller rates of growth in depression from 2018–19 to 2019–20 (Low PHU: ∂ = 0.50, 95 % CI: 0.27, 0.74; High PHU: ∂ = 1.10, 95 % CI: 0.81, 1.39), but larger rates of growth from 2019–20 to 2020–21 (Low PHU: ∂ = 1.66, 95 % CI: 1.32, 2.00; High PHU: ∂ = 0.70, 95 % CI: 0.35, 1.05). Findings were similar in female stratified models. PHU funding did not modify anxiety trajectories.</div></div><div><h3>Conclusion</h3><div>Trajectories of adolescent depression symptoms, particularly females, during the COVID-19 pandemic may have been modified by the level of PHU funding. More research over a longer period and in different jurisdictions is needed.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"390 ","pages":"Article 119759"},"PeriodicalIF":4.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496758","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":"Epigenetic Regulation of Ferroptosis by the KDM3A/BRPF1 Transcriptional Axis Confers Neuroprotection in Postpartum Depression mouse model","authors":"Jiangli Lan ,&nbsp;Yanqiong Zhou ,&nbsp;Lingyan Deng ,&nbsp;Huan Liu ,&nbsp;Wei Hong ,&nbsp;Ren Jing ,&nbsp;Jianqiu Zheng","doi":"10.1016/j.jad.2025.119690","DOIUrl":"10.1016/j.jad.2025.119690","url":null,"abstract":"<div><h3>Background</h3><div>Postpartum depression (PPD) represents a debilitating perinatal psychiatric disorder with elusive pathogenesis. While ferroptosis—an iron-dependent regulated cell death pathway—is implicated in neuropsychiatric conditions, its mechanistic role in PPD remains undefined.</div></div><div><h3>Methods</h3><div>We integrated blood-derived protein quantitative trait loci (bd-pQTL) from 35,559 Icelanders with FerrDb-curated ferroptosis genes through bidirectional Mendelian randomization (MR) to identify causal PPD regulators. Mediation MR delineated ferroptosis-related pathways validated in an ovariectomy/hormone-withdrawal mouse model simulating postpartum neuroendocrinology. Multimodal assessment combined behavioral phenotyping, ferroptotic biomarker quantification, transcriptional profiling, and pharmacological ferroptosis inhibition (Ferrostatin-1).</div></div><div><h3>Results</h3><div>Primary MR identified 159 ferroptosis-related genes, with BRPF1 exerting robust protection against PPD (IVW <em>OR</em> = 0.797, <em>P</em> = 0.009). Chromatin modifier KDM3A governed BRPF1 expression (mediation <em>β</em> = 0.336, <em>P</em> &lt; 0.0001), forming a causal hierarchy that suppressed ferroptosis. Hormone-withdrawn mice recapitulated PPD neuropathology: depression-like behaviors (FST/TST immobility ↑, OFT/LDT exploration ↓, <em>P</em> &lt; 0.0001), ferroptotic signatures (hippocampal Fe²⁺↑, GSH↓, <em>P</em> &lt; 0.001), and KDM3A/BRPF1 axis suppression (GPX4↓, SLC7A11↓, <em>P</em> &lt; 0.001). Ferrostatin-1 administration rescued behavioral deficits, normalized redox homeostasis, and restored KDM3A/BRPF1-mediated GPX4/SLC7A11 transactivation (<em>P</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>We establish an epigenetic paradigm wherein KDM3A orchestrates BRPF1-dependent transcriptional control of ferroptosis defenses (GPX4/SLC7A11), constraining PPD pathogenesis. This KDM3A/BRPF1 axis represents a druggable target, with ferroptosis inhibition demonstrating therapeutic efficacy, informing novel epigenetic-based interventions.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"388 ","pages":"Article 119690"},"PeriodicalIF":4.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480856","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":"Internal consistency, sensitivity, specificity and predictive value of the short version of the Zarit Burden Interview-7 scores: systematic review and generalization meta-analysis","authors":"Júlia Gisbert-Pérez ,&nbsp;Elena Cejalvo ,&nbsp;Manuel Martí-Vilar ,&nbsp;Laura Badenes-Ribera","doi":"10.1016/j.jad.2025.119744","DOIUrl":"10.1016/j.jad.2025.119744","url":null,"abstract":"<div><h3>Objectives</h3><div>The <em>Zarit Burden Interview (</em>ZBI) is one of the most widely used instruments for assessing caregiver burden. One of the most used short scales of the ZBI is the 7-item version. The aim of the study was to conduct a systematic review and generalization meta-analysis of the reliability and validity of the scores of the short version ZBI-7 items to determine whether they provide average values that justify their application and, secondly, to identify the characteristics of the studies that could explain the heterogeneity among the estimates.</div></div><div><h3>Methods</h3><div>Forty-eight articles were identified that applied the short version of the ZBI-7, of which only 14 reported a reliability coefficient and 7 reported sensitivity, specificity and predictive values. A random effects model was applied in the statistical analyses.</div></div><div><h3>Results</h3><div>The average Cronbach's alpha coefficient was 0.866 (95 % CI [0.835, 0.891], k = 15), with high heterogeneity (I² = 86.4 %). Mean sensitivity was 98.6 % (95 % CI [70.0 %–95.3 %], k = 3), mean specificity was 87.4 % (95 % CI [93.6 %–99.7 %], k = 3), mean positive predictive value was 93.7 % (95 % CI [81.3 %–98.1 %], k = 3), mean negative predictive value was 97.3 % (95 % CI [87.5, 99.4], k = 3).</div></div><div><h3>Conclusions</h3><div>According to psychometric theory, the ZBI-7 can be considered reliable and valid for exploratory purposes in both research and clinical practice.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"388 ","pages":"Article 119744"},"PeriodicalIF":4.9,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484471","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":"Maternal perinatal cannabis use disorder and the risk of anxiety disorders in offspring: Insights from a longitudinal data-linkage cohort study","authors":"Abay Woday Tadesse ,&nbsp;Getinet Ayano ,&nbsp;Berihun Assefa Dachew ,&nbsp;Kim Betts ,&nbsp;Rosa Alati","doi":"10.1016/j.jad.2025.119743","DOIUrl":"10.1016/j.jad.2025.119743","url":null,"abstract":"<div><h3>Background</h3><div>Cannabis use is increasing among pregnant women, but its effects on child mental health remain poorly understood. This study investigates whether maternal cannabis use disorder (CUD) during pregnancy and the postnatal period increases offspring risk of anxiety disorders.</div></div><div><h3>Methods</h3><div>We used linked administrative health data from New South Wales, Australia, covering 223,068 live births from January 2003 to December 2005. Maternal CUD and child anxiety disorders, including generalized anxiety disorder (GAD), phobic anxiety disorder (PAD), posttraumatic stress disorder (PTSD), separation and social anxiety disorders, were identified using ICD-10 codes. Generalized linear models (GLMs) with log-binomial regression estimated adjusted risk ratios (aRRs). Mediation and propensity score matching (PSM) analyses were also conducted to test the robustness of findings.</div></div><div><h3>Results</h3><div>After adjusting for covariates, offspring prenatally exposed to maternal CUD had a 79% increased risk of any anxiety disorder [adjusted risk ratio (aRR) = 1.79 (95 % CI 1.40, 2.26)]; specifically PTSD [aRR = 2.46 (95 % CI 1.78, 3.33)], GAD [aRR = 2.18 (95 % CI 1.03, 4.60)], and CADs [aRR = 1.91 (95 % CI 1.05, 4.60)], compared to non-exposed offspring. Postnatal CUD exposure was also associated with an increased risk of any anxiety disorder [aRR = 2.02 (95 % CI 1.22, 3.14)] and PTSD [aRR = 2.97 (95 % CI 1.56, 5.17)]. These associations remained significant in mediation and PSM analyses.</div></div><div><h3>Conclusion</h3><div>Maternal CUD during pregnancy and the postnatal period is associated with elevated risks of anxiety disorders in offspring. These findings highlight the need for targeted interventions, including perinatal counselling, to reduce anxiety risks in offspring.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"389 ","pages":"Article 119743"},"PeriodicalIF":4.9,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484473","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":"Extensive microstructural changes in association and commissural fibers in adults with childhood maltreatment: An automated fiber quantification study","authors":"Yanxuan Du ,&nbsp;Huiyuan Huang ,&nbsp;Yidan Qiu ,&nbsp;Taihan Chen ,&nbsp;Xia Liu ,&nbsp;Liujie Su ,&nbsp;Xinrui Li ,&nbsp;Ruiwang Huang","doi":"10.1016/j.jad.2025.119746","DOIUrl":"10.1016/j.jad.2025.119746","url":null,"abstract":"<div><h3>Background</h3><div>Childhood maltreatment (CM) is a pervasive global issue with heightened risk of both emotion dysregulation and reward dependence related behavioral problems and significantly affects microstructure of brain white matter (WM). Yet the specific alterations of WM microstructure alterations in CM individuals remain unclear.</div></div><div><h3>Methods</h3><div>We explored fine-grained WM microstructure alterations using automatic fiber quantification and assessed their correlation with emotion dysregulation and reward dependence. Childhood Trauma Questionnaire-Short Form (CTQ-SF) scores were collected from 1000 subjects. From these, 21 subjects with CTQ-SF ≥ 38 were selected as the CM group, and 22 subjects with 25 ≤ CTQ-SF ≤ 37 and scores of all subscales not exceeding the thresholds as the no CM group. Support vector regression models were utilized to explore the relationship between the fine-grained diffusion tensor images parameters and emotion dysregulation or reward dependence.</div></div><div><h3>Results</h3><div>The CM group exhibited alterations in the nodes of several association and commissural fibers, including uncinate, arcuate, inferior fronto-occipital, callosal forceps minor, and inferior longitudinal fasciculus. Remarkably, radial diffusivity in frontoparietal segment of left arcuate fasciculus were significant negatively correlated with reward dependence in the CM group. Mean diffusivity of left inferior fronto-occipital fasciculus and CM subtypes experiences could be used as predictors for emotion dysregulation.</div></div><div><h3>Limitations</h3><div>This cross-sectional study did not allow the establishment of a causal relationship unequivocally.</div></div><div><h3>Conclusions</h3><div>Understanding the neurobiological alterations associated with childhood maltreatment provides a clue for potentially increasing the urgency of early screening for risk of behavioral problems related to emotion dysregulation and reward dependence.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"389 ","pages":"Article 119746"},"PeriodicalIF":4.9,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470255","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":"Mediation analysis of anxiety and depression between alexithymia and frequency of headache attacks and impact on suicidal ideation in primary headache","authors":"Sara Guidotti ,&nbsp;Paola Torelli ,&nbsp;Giordano Ambiveri ,&nbsp;Alice Fiduccia ,&nbsp;Daniele Chirco ,&nbsp;Carlo Pruneti","doi":"10.1016/j.jad.2025.119716","DOIUrl":"10.1016/j.jad.2025.119716","url":null,"abstract":"<div><h3>Objective</h3><div>Considering the constellation of psychopathological symptoms that characterize primary headaches, the present study aimed to describe the relationship between specific psychopathological symptoms (i.e., anxiety, depression, and suicidal ideation), psychological variables (i.e., alexithymia), and their impact on headache frequency.</div></div><div><h3>Methods</h3><div>Socio-demographic data (gender, age, occupation, marital status, and educational level) and psychological variables (alexithymia, anxiety, depression, and suicidal ideation) of 70 people with headache (the experimental group was composed of 33 with migraine, 23 with tension-type headache, and 14 with mixed tension migraine) were compared to those of 62 age-matched control subjects. First, participants underwent a neurological examination to make the diagnosis and define the frequency of headache attacks in a month. Consequently, all participants completed the Toronto Alexithymia Scale-20, the Symptom Questionnaire, and the Symptom Checklist 90-Revised.</div></div><div><h3>Results</h3><div>The Headache group reported significantly higher levels of alexithymia, anxiety, depression, and suicidal ideation compared to controls. The mediation analysis, conducted within the patient group alone, proved that anxiety and depression fully mediated the relationship between alexithymia and monthly headache frequency, even controlling for gender and age. Additionally, the frequency of headache attacks predicted suicidal ideation.</div></div><div><h3>Discussions</h3><div>Our results highlight the importance of conducting a psychological evaluation in headache patients because some factors can increase the clinical manifestations of the disease.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"388 ","pages":"Article 119716"},"PeriodicalIF":4.9,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480858","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":"Staying in unhappy marriages and mental health of children and adolescents: A large-scale cross-sectional study in China.","authors":"Juan Wang, Yuqian He, Xuemei Li, Ziqian Wei, Xiaopeng Du, Yinzhe Wang, Tingting Lei, Dan Zhu, Xinyu Zhou","doi":"10.1016/j.jad.2025.119725","DOIUrl":"https://doi.org/10.1016/j.jad.2025.119725","url":null,"abstract":"<p><strong>Background: </strong>Some couples remain married despite being unhappy, for the sake of their children and adolescents. However, children and adolescents in families with unhappy marriages may be chronically expose to parental conflict, potentially increasing the risk of mental health problems more than divorce itself. Although plausible, this hypothesis has rarely been empirically tested using representative data.</p><p><strong>Methods: </strong>This large-scale cross-sectional study involved 96,431 parent-child dyads in Chongqing, China. Participants were divided into seven groups based on parental marital status and interparental relationships. Mental health problems, including depressive and anxiety symptoms, non-suicidal self-injury (NSSI) and suicide risk, was evaluated within dyads. Multivariate logistic regression was conducted to compare the risk of mental health problems among different groups.</p><p><strong>Results: </strong>About 34.56 % to 41.56 % of parents in unhappy relationships continue their marriage. Children and adolescents in the unhappy-relationship-not-divorced parents group had higher odds of depressive and anxiety symptoms, NSSI and suicide risk compared to their peers in other groups, including those with divorced parents across different levels of interparental relationships. These findings were consistent regardless of whether the interparental relationship was reported by children and adolescents or the parents.</p><p><strong>Conclusions: </strong>Public awareness should be raised that divorce may not be the worst option when parents are in an unhappy relationship, at least when considering the potential association with their child and adolescent mental health.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"119725"},"PeriodicalIF":4.9,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484474","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":"Magnetic resonance spectroscopy studies in children and adolescents with depression: A systematic review and meta-analysis.","authors":"Hong Zhou, Yao Gao, Tao Dong, Jie Wang, Zhi-Fen Liu","doi":"10.1016/j.jad.2025.119747","DOIUrl":"10.1016/j.jad.2025.119747","url":null,"abstract":"<p><strong>Background: </strong>Numerous studies have focused on the levels of brain metabolites in patients with depression. However, there are relatively few studies on magnetic resonance spectroscopy (MRS) of adolescent depression and the related neurobiological mechanisms lack consistent conclusions. To summarize the nature of brain metabolite changes in adolescents with depression, we conducted meta-analyses of metabolite levels in proton magnetic resonance spectroscopy (¹H-MRS) studies.</p><p><strong>Methods: </strong>We searched the PubMed, Cochrane Library, Scopus, Embase, and Web of Science databases from January 1965 to December 2023. Heterogeneity across studies was evaluated using the Q and I² tests, and the random-effects model was used for analysis. Subgroup analyses were also conducted to explore potential sources of inconsistency.</p><p><strong>Results: </strong>A total of 26 studies involving 465 adolescent patients with depression and 409 healthy controls (HC) were included in this systematic review. N-acetyl aspartate (NAA) levels (SMD: -0.20, 95%CI: -0.34 to -0.05) were decreased in adolescents with depression when all brain areas were combined. In the dorsolateral prefrontal cortex white matter region, right-sided NAA (SMD: -0.76, 95 % CI: -1.36 to -0.15) and left-sided choline (Cho) levels (SMD: -0.54, 95 % CI: -0.96 to -0.12) were decreased. The levels of NAA (SMD: -0.35, 95 % CI: -0.65 to -0.05), Cho (SMD: -0.34, 95 % CI: -0.67 to -0.00) and creatine (Cr) (SMD: -0.50, 95 % CI: -0.96 to -0.03) in the anterior cingulate cortex (ACC) are reduced. The NAA/Cr levels (SMD: -1.67, 95 % CI: -3.29 to -0.05) in the left prefrontal cortex (PFC) are decreased.</p><p><strong>Conclusions: </strong>Our results suggest that the reduction in NAA levels throughout the brain regions, especially in the prefrontal cortex, among adolescent patients with depression may be due to neuronal loss. The decrease in Cr concentration indicates that using relative creatine concentration may affect the study results. The PFC and ACC may play an important role in adolescent depression.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"119747"},"PeriodicalIF":4.9,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484472","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":"Bidirectional relationships between cognitive decline and depression: A study of middle-aged and older adults using cross-lagged panel network analysis","authors":"Xu Ma ,&nbsp;Xingyu Zhou ,&nbsp;Yuran Qiu","doi":"10.1016/j.jad.2025.119741","DOIUrl":"10.1016/j.jad.2025.119741","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive decline and depressive symptoms are common in middle-aged and older adults. Two competing theories—Scar Theory and Vulnerability Theory—offer insights into this relationship. Scar Theory suggests depression causes cognitive impairments, while Vulnerability Theory posits cognitive deficits predispose individuals to depression. Understanding these mechanisms is crucial for developing effective interventions, especially in underrepresented regions like China.</div></div><div><h3>Methods</h3><div>We applied cross-lagged panel network (CLPN) analysis to three waves (2015, 2018, 2020) of data from the China Health and Retirement Longitudinal Study (CHARLS), comprising 14,961 participants aged ≥45 years. Cognitive functions were assessed using the MMSE subscales, and depressive symptoms using the CESD-10. Analyses were conducted separately for males and females, and network centrality metrics were used to identify key bridge symptoms.</div></div><div><h3>Results</h3><div>The results show that cognitive functions (particularly memory and orientation) predicted depressive symptoms at earlier stage, while hopelessness and low energy subsequently contributed to cognitive decline. Centrality analysis found memory and hopelessness emerged as key bridge symptoms. Sex-specific patterns were also observed: cognitive-to-depressive pathways were more prominent in females, whereas depressive-to-cognitive effects were more pronounced in males.</div></div><div><h3>Limitation</h3><div>Causal inference is limited by the observational design. COVID-19 in the 2020 wave may have introduced external confounders.</div></div><div><h3>Conclusions</h3><div>These findings provide empirical support for both the scar and vulnerability hypotheses and underscore the importance of early, symptom-specific interventions—particularly those targeting memory and hopelessness—in mitigating the reciprocal risks of depression and cognitive decline in Chinese aging populations.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"389 ","pages":"Article 119741"},"PeriodicalIF":4.9,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144469999","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":"Initiating antidepressant treatment in pregnancy: Timing, intensity, and influential maternal and familial factors.","authors":"Alexis Carson, Nhung T H Trinh, Hedvig Nordeng, Xiaoqin Liu, Trine Munk-Olsen, Malin Eberhard-Gran, Per Magnus, Angela Lupattelli","doi":"10.1016/j.jad.2025.119726","DOIUrl":"https://doi.org/10.1016/j.jad.2025.119726","url":null,"abstract":"<p><strong>Objective: </strong>To describe the timing and intensity of antidepressant initiation in pregnancy using longitudinal trajectories of antidepressant prescription fills to identify associated sociodemographic, lifestyle, somatic, mental health, pregnancy, and paternal factors.</p><p><strong>Methods: </strong>This population-based cohort within the Norwegian Mother, Father and Child Cohort study linked to MoBa Genetics and the Prescribed Drug Registry included 1879 women with a new episode of self-reported depression/anxiety during pregnancy. Antidepressants were measured by week and average daily dose.</p><p><strong>Results: </strong>There were 87 initiators, from which we identified three prescription fill trajectories: Early-pregnancy initiators with rapid discontinuation (n = 41, 47.1 %), Early-pregnancy initiators with mid-pregnancy discontinuation (n = 30, 34.5 %), and Early-mid pregnancy initiators with continuation (n = 16, 18.4 %) and three dose trajectories: Low dose with discontinuation (n = 45, 51.7 %), High dose with discontinuation (n = 26, 29.9 %), and Medium dose with continuation (n = 16, 18.4 %). Thyroid disorder was associated with Early initiators with rapid discontinuation (adjusted relative risk ratios (aRRR): 4.15, 95 % CI: 1.56-11.03) compared to Unmedicated. Other psychotropics pre-pregnancy increased the likelihood of being Early initiators with mid-pregnancy discontinuation and High dose discontinuers compared to Unmedicated. Higher maternal genetic liability for depression was strongly associated with Early initiators with mid-pregnancy discontinuation (aRRR = 8.57, 95 % CI: 3.09-23.74), High dose discontinuers and Medium dose continuers across comparisons. Adverse reproductive history, immigration and alcohol pre-pregnancy emerged as important factors.</p><p><strong>Conclusions: </strong>Approximately 5 out of 100 women with a new episode of depression/anxiety initiated an antidepressant during pregnancy, predominantly in early pregnancy, with most discontinuing early to mid-pregnancy. Identified factors can be utilized by clinicians to provide personalized treatment guidance.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"119726"},"PeriodicalIF":4.9,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475338","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}