Journal of affective disorders最新文献

{"title":"Transdiagnostic links of reward processing in obsessive-compulsive disorder and depression","authors":"Kevin M. Wagner ,&nbsp;Matti Cervin ,&nbsp;Jessica S.C. Cheng ,&nbsp;Jasmine Arriaga ,&nbsp;Vanessa Zavala Cruz ,&nbsp;Dayan Berrones ,&nbsp;Josselyn S. Muñoz ,&nbsp;Renee M. Frederick ,&nbsp;Jacey L. Anderberg ,&nbsp;Belinda E. Núñez Bracho ,&nbsp;Victor R. Adorno ,&nbsp;Leonardo F. Fontenelle ,&nbsp;Andrew D. Wiese","doi":"10.1016/j.jad.2025.119886","DOIUrl":"10.1016/j.jad.2025.119886","url":null,"abstract":"<div><h3>Objectives</h3><div>Transdiagnostic models aim to uncover shared mechanisms across mental disorders. Reward responsiveness (the ability to experience pleasure from rewarding stimuli) is a plausible, yet underexplored, transdiagnostic mechanism linking obsessive-compulsive disorder (OCD) and depression. This study used network analysis to (1) examine how key reward responsiveness domains are interlinked in individuals with OCD and (2) explore how each domain is uniquely associated with OCD and depression.</div></div><div><h3>Methods</h3><div>A total of 1345 individuals with a history of OCD symptoms (ages 18–88, 71 % women) from Latino communities in the United States (including Puerto Rico) and nine Latin American countries completed validated measures of reward responsiveness, OCD, and depression. Network analyses evaluated interrelations among reward responsiveness domains and their links to OCD and depression.</div></div><div><h3>Results</h3><div>Hobbies and social interactions were the most central domains in the reward responsiveness network. Higher OCD severity was uniquely associated with lower responsiveness to social interactions, while higher depression severity was uniquely linked to reduced responsiveness in hobbies and goal-directed behaviors.</div></div><div><h3>Conclusions</h3><div>Reward responsiveness is relevant to both OCD and depression. Interventions that enhance engagement in central domains, such as hobbies and social interactions, may improve outcomes. Future research should explore reward responsiveness in other mental disorders to inform transdiagnostic intervention strategies.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"391 ","pages":"Article 119886"},"PeriodicalIF":4.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659238","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":"The effect of virtual immersion in nature on hospitalization stress in psychiatric patients: A randomized controlled trial","authors":"Chen Gao ,&nbsp;Ruo-Yan Wu ,&nbsp;Xiu-Mei Dong ,&nbsp;Lin Li ,&nbsp;Yu-Xin Tan ,&nbsp;Chen-Ling Liu ,&nbsp;Jing Chen","doi":"10.1016/j.jad.2025.119942","DOIUrl":"10.1016/j.jad.2025.119942","url":null,"abstract":"<div><h3>Background</h3><div>Stress is not only a transdiagnostic risk factor for depressive and anxiety disorders but is also closely associated with disease relapse and treatment compliance in psychiatric care. The lack of access to nature in closed psychiatric wards may exacerbate patients' perceived stress, while virtual reality (VR)-based immersive nature technology offers an innovative solution.</div></div><div><h3>Methods</h3><div>This study aimed to evaluate the effects of a short-term, low-dose VR nature immersion protocol (10 min per day for 3 consecutive days) on hospitalized psychiatric patients in China. This study employed a randomized controlled trial design, enrolling 60 inpatients diagnosed with depressive disorder or bipolar disorder. Seven participants withdrew, leaving 27 in the VR nature group and 26 in the VR city control group. Intervention effects were measured using multidimensional indicators, including psychological scales, physiological indicators, and immediate emotion.</div></div><div><h3>Results</h3><div>The VR nature group exhibited significant reductions in perceived stress, depression, and anxiety, along with significantly increased connectedness to nature. Physiological data indicated that the VR nature group had significantly lower heart rates compared to the control group. After a single VR session, the VR nature group demonstrated a significant improvement in positive emotions and a marked reduction in negative emotions.</div></div><div><h3>Conclusion</h3><div>This research provides evidence that short-term VR nature immersion effectively alleviates stress and emotional in hospitalized psychiatric patients. The consistent results across psychological, physiological, and immediate emotional indicators validate its efficacy. The proposed lightweight protocol is both clinically feasible and safe, offering a new pathway for stress intervention in closed psychiatric wards.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"391 ","pages":"Article 119942"},"PeriodicalIF":4.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667702","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":"Letter to the editor regarding:‘Prolonged loneliness and risk of incident cognitive decline and dementia: A two-cohort study’","authors":"Zongyu Yang ,&nbsp;Songjie Liao ,&nbsp;Liqiu Kou","doi":"10.1016/j.jad.2025.119943","DOIUrl":"10.1016/j.jad.2025.119943","url":null,"abstract":"","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"391 ","pages":"Article 119943"},"PeriodicalIF":4.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667699","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":"Evaluating psychometric validity of ecological momentary assessment for youth irritability","authors":"Eleanor G. Hansen ,&nbsp;Reut Naim ,&nbsp;Lauren M. Henry ,&nbsp;Katharina Kircanski ,&nbsp;Daniel S. Pine ,&nbsp;Melissa A. Brotman ,&nbsp;Meghan E. Byrne","doi":"10.1016/j.jad.2025.119788","DOIUrl":"10.1016/j.jad.2025.119788","url":null,"abstract":"<div><h3>Background</h3><div>Irritability is a transdiagnostic symptom in youth, leading to long-term adverse consequences. Ecological momentary assessment (EMA), or naturalistic clinical phenotyping, can quantify real-world experiences and affective dynamics of irritability in vivo and may be less contaminated by biases that impact retrospective report measures. However, to date, no research examines the psychometric properties of EMA measures of irritability.</div></div><div><h3>Methods</h3><div>The current study assesses EMA data from <em>N</em> = 49 youth receiving treatment for clinically impairing irritability (<em>M</em>age = 10.63, 36.73 % female). Analyses evaluate two irritability EMA items and one positive-affect EMA item for within and between person variability, internal consistency, test-retest reliability, and convergent and discriminant validity.</div></div><div><h3>Results</h3><div>EMA items demonstrate acceptable psychometric properties including acceptable variability, consistency, reliability, and convergent and discriminant validity. Comparisons to previous work in anxious and healthy youth are discussed.</div></div><div><h3>Limitations</h3><div>Study limitations include participants' concurrent involvement in treatment and exclusion of outburst-related EMA measures from study analyses.</div></div><div><h3>Conclusion</h3><div>These results may facilitate future research with irritability EMA items in clinical populations; future work should validate EMA items psychometrically before use in clinical trials.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"391 ","pages":"Article 119788"},"PeriodicalIF":4.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659237","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":"Towards improved specificity in mental health syndromes: projection-based clustering of depressive phenotypes","authors":"Alexander Tashevski ,&nbsp;Mathew R. Varidel ,&nbsp;Ian B. Hickie ,&nbsp;Jan Scott ,&nbsp;Jacob J. Crouse ,&nbsp;Caroline Hunt ,&nbsp;Maree Abbott ,&nbsp;Frank Iorfino","doi":"10.1016/j.jad.2025.119912","DOIUrl":"10.1016/j.jad.2025.119912","url":null,"abstract":"<div><h3>Background</h3><div>Quantitative attempts to improve syndrome specificity typically produce large heterogenous subgroupings, impacting the validity of treatment and research targets. Assessing barriers to the valid application of existing methods and examining improvements from an interpretable projection-based clustering alternative may improve the precision and reproducibility of our research targets and classification systems.</div></div><div><h3>Methods</h3><div>This exploratory, cross-sectional, study recruited 2820 participants aged 12-to-25 years, from primary-healthcare services in Australia, between November 2018 and July 2023. 1843 participants completed relevant self-reported measures of depression, anxiety and mania-like experiences, and were included for analysis. Principal Component Analysis (PCA) was used to examine the distribution of within-syndrome variance. Projection-based subtypes were compared to traditional quantitative phenotyping approaches: clustering paradigms (Model-Based, Centre-Based Partition, Hierarchical), LCA, and Exploratory Factor Analysis (FA).</div></div><div><h3>Results</h3><div>Interpretable projection-based clustering improved homogeneity and qualitative distinctions between clusters were compared to all other methods. This identified 14 clusters organisable into six novel symptom profiles: sleep (n = 117; 11 %), mania (n = 125; 12 %), anxiety (n = 119; 11 %), weight/appetite gain (n = 138; 13 %), weight/appetite loss (n = 242; 23 %), and an undifferentiated type (n = 310; 29 %). The PCA identified a skewed power-law distribution underlying symptom variance, affecting standard LCA/clustering procedures. This interacted with optimisation algorithms, producing heterogenous subtypes. Within FA, it produced the nested hierarchical structure identified in HiTOP studies.</div></div><div><h3>Conclusions</h3><div>A skewed variance distribution underlying the depressive syndrome adversely impacts standard Clustering/LCA methods, and may contribute to past difficulties in identifying well-specified data-driven phenotypes. Consequently, future studies should consider the distribution's impact to their optimisation algorithms or use the better-specified projection-based clustering. Identified profiles reflect major trends in depressive symptom expression, potentially representing improved research targets.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"391 ","pages":"Article 119912"},"PeriodicalIF":4.9,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649512","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":"Do young people get the mental healthcare they need? Trajectories of depressive symptoms, correlates and care pathways in a clinical sample of young people reaching the upper age limit of their CAMHS","authors":"Larissa S. van Bodegom ,&nbsp;Suzanne E. Gerritsen ,&nbsp;Athanasios Maras ,&nbsp;Manon H.J. Hillegers ,&nbsp;Dieter Wolke ,&nbsp;Dimitris Rizopoulos ,&nbsp;Therese A.M.J. van Amelsvoort ,&nbsp;Tomislav Franić ,&nbsp;Giovanni de Girolamo ,&nbsp;Jason Madan ,&nbsp;Fiona McNicholas ,&nbsp;Moli Paul ,&nbsp;Diane Purper-Ouakil ,&nbsp;Paramala J. Santosh ,&nbsp;Ulrike Schulze ,&nbsp;Swaran P. Singh ,&nbsp;Cathy Street ,&nbsp;Sabine Tremmery ,&nbsp;Helena Tuomainen ,&nbsp;Gwendolyn C. Dieleman ,&nbsp;Mathilde M. Overbeek","doi":"10.1016/j.jad.2025.119925","DOIUrl":"10.1016/j.jad.2025.119925","url":null,"abstract":"<div><div>Identifying young service users whose depressive symptoms persist into adulthood is crucial to avert potential difficulties they may face when transitioning from Child and Adolescent Mental Healthcare Services (CAMHS) to Adult Mental Healthcare Services (AMHS). As depressive symptoms are diverse in severity and stability, it is important to objectively identify those who require continued support. A clinical cohort of 763 young people from eight European countries, reaching the upper age limit of their CAMHS, was studied to identify trajectories of self-reported depressive problems (ASEBA Youth Self-Report and Adult Self-Report) over a 24-month follow-up period, as well as associated risk factors for persistent depression and service use, using growth mixture modeling. Self-reported, parent-reported, and clinician-reported interviews and questionnaires were used to collect information on risk factors for persistent depression and service use. We identified a low, a decreasing, an increasing and a high trajectory of depressive symptoms. The high trajectory could be predicted with almost all risk factors for persistent depression (i.g. higher clinician-rated psychopathology, more suicidality, comorbidity and being a victim of bullying) and these young people were likely to transition to AMHS or require specialist mental health care at a later date. More importantly, young people whose depressive symptoms increase to similar levels as the group with persistent high-levels of depressive symptoms (the increasing trajectory) could not be properly distinguished from other young people based on risk factors, while their needed continuation of treatment (either in AMHS or CAMHS) was equally likely as the end of care.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"391 ","pages":"Article 119925"},"PeriodicalIF":4.9,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659236","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":"Suicidal obsessions from suicidal ideation: A first-person suicide image pilot study","authors":"Elizabeth F. Mattera ,&nbsp;Keila Sandoval ,&nbsp;Carly Sipper ,&nbsp;Madison Fitzpatrick ,&nbsp;Ana Allen ,&nbsp;Jayson Pease ,&nbsp;Samantha Schild ,&nbsp;Yealie Ulaba-Samura ,&nbsp;Christine Cha ,&nbsp;Christopher Pittenger ,&nbsp;Brian A. Zaboski","doi":"10.1016/j.jad.2025.119916","DOIUrl":"10.1016/j.jad.2025.119916","url":null,"abstract":"<div><div>Individuals with obsessive-compulsive disorder (OCD) experience unwanted and intrusive thoughts that cause anxiety and/or distress. The content of these thoughts can vary widely. Suicidal obsessions (SOs) are unwanted, intrusive, and distressing thoughts about suicide, death, or self-harm. Their clinical presentation differs markedly from that of suicidal ideation (SI), yet most suicide risk assessments fail to distinguish between the two phenomena. The distinction is critical, as SOs and SI differ in their clinical risk and require different treatments. This pilot study compares the self-reported affective ratings of first-person suicide images (FPSIs) by individuals with OCD presenting suicidal obsessions to ratings by individuals with OCD with suicidal ideation. Compared with those with SI, those with SOs found the images less pleasant, more threatening, more arousing, less aligned with behaviors they could imagine themselves engaging in, and less aligned with their sense of self. The difference in imagined behavioral engagement was statistically significant. After controlling for depressive and OCD symptom severity, regression models indicated a large negative effect for arousal (β = −1.05), medium effects for ego syntonicity (β = 0.64), behavioral relatedness (β = 0.58), and a sense of threat (β = −0.68, <em>p</em> = 0.55), and a small positive effect for pleasantness ratings (β = 0.33). These effects did not individually reach statistical significance in this pilot study but serve to guide future work. Differentiating between SI and SOs is clinically imperative as it frames treatment planning. The use of FPSIs may supplement traditional suicide measures and functional assessment in making this key distinction.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"391 ","pages":"Article 119916"},"PeriodicalIF":4.9,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653063","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":"Comment on “Depressive symptoms trajectories and cardiovascular disease in Chinese middle - aged and older adults: A longitudinal cohort study”","authors":"Xinyue Yang ,&nbsp;Fan Zhang ,&nbsp;Heng Yang","doi":"10.1016/j.jad.2025.119934","DOIUrl":"10.1016/j.jad.2025.119934","url":null,"abstract":"","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"390 ","pages":"Article 119934"},"PeriodicalIF":4.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144634039","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":"The relationship between household economic shocks, depression, and elevated stress-responsive biomarkers among adolescent girls and young women in rural South Africa (HPTN 068)","authors":"Nivedita L. Bhushan ,&nbsp;Gabriel Madson ,&nbsp;Nicole K. Kelly ,&nbsp;Kathleen Kahn ,&nbsp;F. Xavier Gomez-Olive ,&nbsp;Allison E. Aiello ,&nbsp;Laura Danielle Wagner ,&nbsp;Audrey E. Pettifor ,&nbsp;Marie C.D. Stoner","doi":"10.1016/j.jad.2025.119924","DOIUrl":"10.1016/j.jad.2025.119924","url":null,"abstract":"<div><h3>Background</h3><div>Common mental health disorders (CMDs) significantly contribute to the global burden of disease among adolescent girls and young women (AGYW). In South Africa, the high proportion of AGYW experiencing CMDs in part reflects adversity in early life and resulting chronic stress, particularly through exposure to poor economic conditions such as frequent household economic shocks. Yet, longitudinal evidence for the relationship between household economic shocks, CMDs, and chronic stress among AGYW is limited.</div></div><div><h3>Methods</h3><div>Data are from the HIV Prevention Trials Network (HPTN) 068 study in rural South Africa (2012–2019). AGYW, 13–20 at baseline, were followed annually for up to 6 years. Exposures included experience of any shock, type of shock (illness/death, agricultural, wealth), and number of shocks (0, 1, ≥2). We calculated risk ratios for the association between exposures and depressive symptoms (CESD–10 &gt; 16)), stratified by grant receipt, and odds ratios for the association between exposures and stress-responsive biomarkers (C-reactive protein (CRP), cytomegalovirus (CMV), herpes simplex virus type-1 (HSV-1)) and HIV infection.</div></div><div><h3>Results</h3><div>Among 1892 AGYW, unadjusted analyses suggested a relationship between experiencing any shock (RR: 1.10, 95 % CI: 1.00–1.22), or increased shocks (RR: 1.05, 95 % CI: 1.00–1.11), and depressive symptoms. In adjusted analyses, experiencing any shock (OR: 1.21, 95 % CI: 1.04–1.34), increased shocks (OR: 1.19, 95 % CI: 1.03–1.38), and wealth shocks (OR: 1.20, 95 % CI: 1.03–1.29) were associated with increased CRP. We found no relationship between shocks and HIV acquisition.</div></div><div><h3>Conclusion</h3><div>AGYW experiencing economic adversity in early adolescence are at increased risk for depressive symptoms and elevated stress-biomarker levels during the transition to adulthood.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"391 ","pages":"Article 119924"},"PeriodicalIF":4.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649510","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":"The effect of cognition and age on the efficacy of psychotherapy in late-life depression","authors":"Bettina Bewernick ,&nbsp;Julijana Buschmann ,&nbsp;Kathrin Heser ,&nbsp;Luca Kleineidam ,&nbsp;Katharina Domschke ,&nbsp;Moritz Elsaesser ,&nbsp;Nadine Zehender ,&nbsp;Melanie Luppa ,&nbsp;Martin Hellmich ,&nbsp;Oliver Peters ,&nbsp;Lutz Froelich ,&nbsp;Steffi Riedel-Heller ,&nbsp;Elisabeth Schramm ,&nbsp;Martin Hautzinger ,&nbsp;Frank Jessen ,&nbsp;Forugh S. Dafsari ,&nbsp;Michael Wagner","doi":"10.1016/j.jad.2025.119881","DOIUrl":"10.1016/j.jad.2025.119881","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive impairment is prevalent in older age and in patients with depression, which may limit the efficacy of psychotherapy for late-life depression (LLD). We analyzed the effect of age and baseline cognition on the efficacy of psychotherapy in LLD.</div></div><div><h3>Methods</h3><div>This secondary analysis of a randomized controlled multicenter study included 213 participants (60–92 years) with moderate to severe depression who had received either supportive psychotherapy (SUI) or an LLD-specific cognitive behavioral therapy (LLD-CBT), both of which led to a substantial reduction in depressive symptoms. We examined the influence of age and baseline cognition, assessed with the CERAD-plus neuropsychological battery, on changes in the Geriatric Depression Scale (GDS) at the end of treatment and at 6-month follow-up. Trial registration at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (<span><span>NCT03735576</span><svg><path></path></svg></span>) and DRKS (DRKS00013769).</div></div><div><h3>Findings</h3><div>Baseline cognition was slightly below norms (&lt;1SD), with 15 % of patients meeting criteria for Mild Cognitive Impairment (MCI). GDS change at the end of treatment was not significantly associated with baseline cognition or MCI status, although additional interaction analyses suggest that, in the SUI group, lower baseline cognitive performance was associated with reduced treatment efficacy at follow-up only. Additionally, we found that higher age predicted a smaller reduction in GDS scores both at end-of-treatment and at follow-up in both treatment groups.</div></div><div><h3>Interpretation</h3><div>Higher age, but not lower cognitive performance, was associated with reduced psychotherapy efficacy. Thus, age-related factors should be considered in psychotherapy.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"391 ","pages":"Article 119881"},"PeriodicalIF":4.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649552","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}