Journal of affective disorders最新文献

{"title":"Synergistic effects of a body shape index and depression on mortality in individuals with low sexual frequency","authors":"Tian-Qi Teng ,&nbsp;Meng-Meng Wang ,&nbsp;De-Gang Mo ,&nbsp;Yan-you Xie ,&nbsp;Rui Chen ,&nbsp;Jia-Chao Xu ,&nbsp;Jing Liu ,&nbsp;Hai-Chu Yu","doi":"10.1016/j.jad.2025.03.129","DOIUrl":"10.1016/j.jad.2025.03.129","url":null,"abstract":"<div><h3>Background</h3><div>Individuals with low sexual frequency often experience comorbidities that exacerbate mortality. This article evaluates the predictive value of five body fat anthropometric indicators for all-cause mortality and explores the interaction between obesity and depression in mortality among young and middle-aged individuals with sexual frequency &lt;12 times per year.</div></div><div><h3>Methods</h3><div>This study included participants with a sexual frequency of &lt;12 times per year from the 2015–2016 National Health and Nutrition Examination Survey (NHANES). We assessed the impact of anthropometric indicators and depression on mortality, as well as their synergistic interactions, and further developed an accessible predictive survival model.</div></div><div><h3>Results</h3><div>A total of 4978 participants aged 20–59 were included, with 215 deaths (4.3 %) over 15 years of follow-up. A Body Shape Index (ABSI) showed the strongest association with all-cause mortality, with an AUC of 0.67. Participants with ABSI ≥0.082 had a significantly higher risk of death (HR: 1.87, 95%CI: 1.31–2.68), as did those with depression (HR: 1.86, 95%CI: 1.19–2.92). Interaction analysis revealed a synergistic effect between depression and ABSI, increasing death risk by 293 % when both were present. Significant survival differences were observed between men and women with these risk factors, with median survival rates of 76.3 % and 90.8 %, respectively. The model based on ABSI and depression provided valuable mortality predictions, with AUC of 0.78, 0.77, and 0.77 for 3-year, 5-year, and 10-year survival.</div></div><div><h3>Conclusion</h3><div>ABSI and depression are associated with all-cause mortality in individuals with low sexual frequency, potentially creating a synergistic effect on mortality risk.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"380 ","pages":"Pages 104-112"},"PeriodicalIF":4.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684565","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":"Characterizing the effects of vagus nerve stimulation on symptom improvement in markedly treatment-resistant major depressive disorder: A RECOVER trial report","authors":"Harold A. Sackeim ,&nbsp;Charles R. Conway ,&nbsp;Scott T. Aaronson ,&nbsp;Mark T. Bunker ,&nbsp;Charles Gordon ,&nbsp;Ying-Chieh (Lisa) Lee ,&nbsp;Olivia Shy ,&nbsp;Shannon Majewski ,&nbsp;Quyen Tran ,&nbsp;A. John Rush","doi":"10.1016/j.jad.2025.03.124","DOIUrl":"10.1016/j.jad.2025.03.124","url":null,"abstract":"<div><h3>Background</h3><div>The RECOVER trial randomized 493 patients with markedly treatment-resistant major depressive disorder to treatment-as-usual with or without active vagus nerve stimulation (VNS Therapy). While the primary outcome measure did not statistically separate the treatment conditions, the field may lack optimal metrics for quantifying symptom improvement in markedly treatment-resistant patients.</div></div><div><h3>Methods</h3><div>This study examined the impact of three factors on sensitivity to clinical improvement across the total RECOVER sample and to differences in the effectiveness of the randomized conditions, systematically varying outcome classification (remission, response, and partial response), observation period (3–12 months, 6–12 months, 10–12 months and last observation), and depression rating scale.</div></div><div><h3>Results</h3><div>Effect sizes for detecting therapeutic change across the total sample and the difference in effectiveness between the randomized groups were markedly higher for partial response than response or remission classifications. Longer observation periods produced larger therapeutic effects across the sample, but the effect sizes for the randomized treatment differences were substantially higher in the final 10–12 month period. The MADRS showed the least sensitivity to change across the sample and between the treatment groups. Using the partial response classification and the 10–12 month observation period, a significant difference between the groups was obtained for 3 of 4 depression scales.</div></div><div><h3>Limitations</h3><div>The findings derive from a retrospective assessment of alternative outcome metrics.</div></div><div><h3>Conclusion</h3><div>In a large randomized controlled trial of VNS for markedly treatment-resistant depression, the magnitude of therapeutic effects and separation of treatment groups differed as a function of outcome classification, measurement period, and rating scale.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"380 ","pages":"Pages 135-145"},"PeriodicalIF":4.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684568","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":"Uncoupling serotonin (2C) and dopamine (D2) receptor heterodimers ameliorate PTSD-like behaviors","authors":"Weifen Li ,&nbsp;Tianxiang Li ,&nbsp;Tahir Ali ,&nbsp;Shengnan Mou ,&nbsp;Qichao Gong ,&nbsp;Zhi-Jian Yu ,&nbsp;Shupeng Li","doi":"10.1016/j.jad.2025.03.127","DOIUrl":"10.1016/j.jad.2025.03.127","url":null,"abstract":"<div><h3>Background</h3><div>G-protein-coupled receptors (GPCRs), crucial for various physiological functions, can form complexes with themselves or other GPCRs, influencing their signaling and drug interactions. GPCR oligomerization remains an active area of research in neurological diseases, including Post-Traumatic Stress Disorder (PTSD). Here, we illuminated a novel serotonin and dopamine receptor heterodimerization that played an etiological role in fear conditioning behaviors associated with memory defects in the single prolonger stress (SPS) mice and reverting effects of receptors interaction interfering with peptide.</div></div><div><h3>Methods</h3><div>To assess our projected goal, we prepared a single prolonged stress (SPS) mice model followed by peptide treatment, behavior assays, and biochemical analysis.</div></div><div><h3>Results</h3><div>Our study revealed a direct interaction between dopamine D2 receptors (D2R) and serotonin 5-HT2C receptors (5-HT2CR) via the K226-L240 region in the brains of SPS mice. This D2R/5-HT2CR interaction modulated downstream PI3K-AKT signaling and contributed to cognitive deficits in a mouse model of SPS. An interfering peptide (TAT-D2R-KL) designed to disrupt D2R/5-HT2CR heterodimerization reduced the excitatory/inhibitory neuron firing frequency ratio, attenuated PI3K/AKT signaling impairment, and alleviated cognitive deficits in SPS mice. Furthermore, treatment with the PI3K inhibitor, Bisperoxovanadium Compound bpV (pic), reversed the effects of the peptide, confirming the critical role of PI3K/AKT signaling in D2R/5-HT2CR dimerization and the associated pathophysiology of SPS.</div></div><div><h3>Conclusion</h3><div>These findings revealed a causative role of D2R/5-HT2CR hetero-dimer in PTSD and could be reversed by TAT-D2R-KL treatment.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"380 ","pages":"Pages 63-77"},"PeriodicalIF":4.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684480","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":"A commentary on “internet-based therapist-supported interpersonal psychotherapy for depression: A randomized controlled trial”","authors":"Muhammad Putra Dinata Saragi ,&nbsp;Rina Suryani ,&nbsp;Annisa Arrumaisyah Daulay ,&nbsp;Rizky Andana Pohan ,&nbsp;Dika Sahputra ,&nbsp;Devi Eka Yulita Br. Tarigan ,&nbsp;Ilham Mirzaya Putra","doi":"10.1016/j.jad.2025.03.120","DOIUrl":"10.1016/j.jad.2025.03.120","url":null,"abstract":"","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"380 ","pages":"Pages 230-231"},"PeriodicalIF":4.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692200","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":"Functional brain network dynamics of brooding in depression: Insights from real-time fMRI neurofeedback","authors":"Saampras Ganesan ,&nbsp;Masaya Misaki ,&nbsp;Andrew Zalesky ,&nbsp;Aki Tsuchiyagaito","doi":"10.1016/j.jad.2025.03.121","DOIUrl":"10.1016/j.jad.2025.03.121","url":null,"abstract":"<div><h3>Background</h3><div>Brooding is a critical symptom and prognostic factor of major depressive disorder (MDD), which involves passively dwelling on self-referential dysphoria and related abstractions. The neurobiology of brooding remains under characterized. We aimed to elucidate neural dynamics underlying brooding, and explore their responses to neurofeedback intervention in MDD.</div></div><div><h3>Methods</h3><div>We investigated functional MRI (fMRI) dynamic functional network connectivity (dFNC) in 36 MDD subjects and 26 healthy controls (HCs) during rest and brooding. Rest was measured before and after fMRI neurofeedback (MDD-active/sham: <em>n</em> = 18/18, HC-active/sham: <em>n</em> = 13/13). Baseline brooding severity was recorded using Ruminative Response Scale - Brooding subscale (RRS-B).</div></div><div><h3>Results</h3><div>Four recurrent dFNC states were identified. Measures of time spent were not significantly different between MDD and HC for any of these states during brooding or rest. RRS-B scores in MDD showed significant negative correlation with measures of time spent in dFNC state 3 during brooding (<em>r</em> = −0.4, <em>p</em> = 0.002, FDR-significant). This state comprises strong connections spanning several brain systems involved in sensory, attentional and cognitive processing. Time spent in this anti-brooding dFNC state significantly increased following neurofeedback only in the MDD active group (z = −2.09, FWE-<em>p</em> = 0.034).</div></div><div><h3>Limitations</h3><div>The sample size was small and imbalanced between groups. Brooding condition was not examined post-neurofeedback.</div></div><div><h3>Conclusion</h3><div>We identified a densely connected anti-brooding dFNC brain state in MDD. MDD subjects spent significantly longer time in this state after active neurofeedback intervention, highlighting neurofeedback's potential for modulating dysfunctional brain dynamics to treat MDD.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"380 ","pages":"Pages 191-202"},"PeriodicalIF":4.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The empirical status of implicit emotion regulation in mood and anxiety disorders: A meta-analytic review","authors":"Stefan Daniel Paul Dalton ,&nbsp;Holly Cooper ,&nbsp;Ben Jennings ,&nbsp;Survjit Cheeta","doi":"10.1016/j.jad.2025.03.118","DOIUrl":"10.1016/j.jad.2025.03.118","url":null,"abstract":"<div><div>Strategies to successfully regulate negative emotions may be hindered by maladaptive implicit emotion processing tendencies. And while implicit emotion regulation is known to be impaired in many psychiatric disorders, contradictory findings exist within the empirical literature. Therefore, a meta-analysis of implicit emotion regulation in mood and anxiety disorders (major depressive disorder [MDD], bipolar disorder, generalised anxiety disorder, social anxiety disorder, panic disorder, obsessive-compulsive disorder and post-traumatic stress disorder [PTSD]) was performed. Systematic literature searches were conducted in Web of Science, PubMed/MEDLINE, Scopus, and BrainMap for articles published between 2011 and 2024, and inclusion criteria included internationally recognised diagnostic measures (i.e., DSM-5). A total of 23 clinical studies were identified, and using the Newcastle-Ottawa Scale, 21 studies were of excellent quality. Small to medium effect sizes were reported in patients across measures of accuracy (patients [<em>n</em> = 428] vs. controls [<em>n</em> = 412], standardised mean difference [SMD] -0.39, 95% CI [−0.57 to −0.21], <em>p</em> &lt; .0001) and response latency (patients [<em>n</em> = 477] vs. controls [<em>n</em> = 428], SMD 0.38, 95% CI [0.22 to 0.54], <em>p</em> &lt; .0001). The pooled effects of reduced accuracy and longer reaction times in patients were confirmed by separate sub-group analyses for mood and anxiety disorders, with MDD and PTSD reporting the largest effects. Regarding publication bias, Egger's regression test did not indicate funnel plot asymmetry. Recommendations for future research include investigation of dysfunctional implicit emotion regulation as a transdiagnostic characteristic of psychiatric disorders within the Research Domain Criteria (RDoC) framework.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"380 ","pages":"Pages 256-269"},"PeriodicalIF":4.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Day-to-day dynamics of facial emotion expressions in posttraumatic stress disorder","authors":"Whitney R. Ringwald ,&nbsp;Scott Feltman ,&nbsp;H. Andrew Schwartz ,&nbsp;Dimitris Samaras ,&nbsp;Christopher Khudari ,&nbsp;Benjamin J. Luft ,&nbsp;Roman Kotov","doi":"10.1016/j.jad.2025.03.109","DOIUrl":"10.1016/j.jad.2025.03.109","url":null,"abstract":"<div><div>Facial expressions are an essential component of emotions that may reveal mechanisms maintaining posttraumatic stress disorder (PTSD). However, most research on emotions in PTSD has relied on self-reports, which only capture subjective affect. The few studies on outward emotion expressions have been hampered by methodological limitations, including low ecological validity and failure to capture the dynamic nature of emotions and symptoms. Our study addresses these limitations with an approach that has not been applied to psychopathology: person-specific models of day-to-day facial emotion expression and PTSD symptom dynamics. We studied a sample of World Trade Center responders (<em>N</em> = 112) with elevated PTSD pathology who recorded a daily video diary and self-reported symptoms for 90 days (8953 videos altogether). Facial expressions were detected from video recordings with a facial emotion recognition model. In data-driven, idiographic network models, most participants (80 %) had at least one, reliable expression-symptom link. Six expression-symptom dynamics were significant for &gt;10 % of the sample. Each of these dynamics had statistically meaningful heterogeneity, with some people's symptoms related to over-expressivity and others to under-expressivity. Our results provide the foundation for a more complete understanding of emotions in PTSD that not only includes subjective feelings but also outward emotion expressions.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"380 ","pages":"Pages 331-339"},"PeriodicalIF":4.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692204","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":"Children and adolescents' demand for psychiatric services: Insight from the a nine-year-period visits population change in Nanjing, China","authors":"Zenghe Yue ,&nbsp;Tianming Guo ,&nbsp;Jianhong Gu ,&nbsp;Luyang Guan ,&nbsp;Anqi Huang ,&nbsp;Kaiyan Gan ,&nbsp;Qian Li ,&nbsp;Lan Lin ,&nbsp;Xiaoyan Ke","doi":"10.1016/j.jad.2025.03.117","DOIUrl":"10.1016/j.jad.2025.03.117","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence of mental health issues among children and adolescents has been increasing. The objective of this study is to delineate the evolving characteristics of psychiatric visits among this demographic, including sex differences in service utilization, and to evaluate the capacity of existing medical resources to meet their needs for such visits.</div></div><div><h3>Methods</h3><div>The data were sourced from Nanjing Brain Hospital and retrieved from outpatient and inpatient records of individuals aged 18 and below who visited the psychiatric department between the dates of July 2015 and June 2024. A descriptive analysis of the temporal changes in clinical features and general data was conducted, and an ETS time series model was employed to forecast whether visit demands are being met.</div></div><div><h3>Results</h3><div>A total of 594,510 visits were recorded across both outpatient and inpatient systems. The overall number of visits increased year by year, with the fastest growth rate among patients with mood disorders. Furthermore, the growth rate of boys was significantly slower than that of girls (outpatient: OR = 0.93, <em>P</em> &lt; 0.001; inpatient: OR = 0.91, <em>P</em> &lt; 0.001). The ETS time series analysis indicated that future visit trends are expected to stabilize, with a significant proportion of children and adolescents still requiring N-CAP visits (outpatient: 31 %; inpatient: 44 %). In the inpatient system, the majority of this population is concentrated in the 17–18 age group (73 %).</div></div><div><h3>Conclusion</h3><div>The number of psychiatric visits for children and adolescents has been increasing on an annual basis. The current medical resources are insufficient to meet the growing demand.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"380 ","pages":"Pages 37-44"},"PeriodicalIF":4.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684549","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":"Exposure to childhood parental bereavement and risk of school bullying victimization","authors":"Hailiang Ran ,&nbsp;Jin Lu ,&nbsp;Qiongxian Li ,&nbsp;Yuanyu Shi ,&nbsp;Guiqing Zheng ,&nbsp;Yandie He ,&nbsp;Shuqing Liu ,&nbsp;Yi Xiang ,&nbsp;William Y. Xuan ,&nbsp;Yuanyuan Xiao ,&nbsp;Ziming Xuan","doi":"10.1016/j.jad.2025.03.105","DOIUrl":"10.1016/j.jad.2025.03.105","url":null,"abstract":"<div><h3>Objective</h3><div>Parental bereavement is detrimental to youth mental health, yet its potential impact on youth bullying remains unknown. We aimed to examine the association of early exposure to parental death with school bullying victimization, and further assess whether youth's age when bereavement occurred, sex, and urbanicity modify the association.</div></div><div><h3>Method</h3><div>This study used a large multi-site sample (N = 21,489 youth aged 10–17) from the Mental Health Survey for Children and Adolescents in Yunnan Province, China, 2019 to 2021. Childhood parental bereavement data were based on self-report of any parental bereavement. Current bullying victimization was measured using the Olweus Questionnaire. Logistic regression model accounting for the survey design was used to estimate the association.</div></div><div><h3>Results</h3><div>597 participants (2.8 %) experienced a parental death. 3283 individuals (15.3 %) reported current bullying victimization in the school. Youth's parental bereavement was associated with greater likelihood of bullying victimization (aOR 1.42 [95 % CI 1.12–1.81]) and frequent victimization (aOR = 1.44 [95 % CI 1.08–1.90]). Maternal death, girls, youth from rural areas, and those who experienced bereavement at older ages were more likely to experience bullying victimization. Maternal death was associated with elevated risk of bullying victimization among youth with parental death at older ages, boys, and youth from urban areas.</div></div><div><h3>Conclusions</h3><div>Early exposure to parental bereavement increased the risk of school bullying victimization and frequent victimization. The sex of the deceased parent, age when bereavement occurred, sex of youth participant, and urban-rural residence modified the observed association. Tailored interventions for youth who experienced parental bereavement could consider in addressing school bullying.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"380 ","pages":"Pages 87-93"},"PeriodicalIF":4.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684567","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":"Association between hikikomori (social withdrawal) and depression in Korean young adults.","authors":"Su Min Park, Min Jeong Joo, Jae Hyeok Lim, Suk-Yong Jang, Eun-Cheol Park, Min Jin Ha","doi":"10.1016/j.jad.2025.03.125","DOIUrl":"https://doi.org/10.1016/j.jad.2025.03.125","url":null,"abstract":"<p><strong>Background: </strong>Major depressive disorder (MDD) is a prevalent mental illness, particularly affecting women. The World Health Organization projects that by 2030, MDD will be the leading cause of disease burden. The phenomenon of hikikomori-initially observed in Japan-is increasingly associated with depression, a key risk factor for which is social isolation. This study analyzed the impact of social withdrawal on depression among South Korean young adults, focusing on (1) the relation between withdrawal duration and causes, and (2) its effect on depression severity.</p><p><strong>Methods: </strong>Data from the 2022 Korean Youth Survey, including 14,966 participants aged 19-34, were used. Depression levels were assessed using the Patient Health Questionnaire-9 (PHQ-9), and multiple logistic regression was conducted to examine the association between hikikomori behavior and depression.</p><p><strong>Results: </strong>The reference group for all analyses was youth who were not socially withdrawn. The association between hikikomori and depression was statistically significant for the two sexes (males: OR: 2.25, 95 % CI: 1.60-3.19; females: OR: 2.34, 95 % CI: 1.63-3.36). Household size influenced depression risk among hikikomori, and sex differences were observed in social withdrawal's effect on suicide risk.</p><p><strong>Conclusion: </strong>This study highlights the link between hikikomori and depression in South Korean youth, with sex-specific differences in depression and suicide risk, suggesting the need for tailored mental health programs. Future research should explore the long-term effects of prolonged social withdrawal through longitudinal studies and conduct cross-cultural comparisons of hikikomori.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692201","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}