Journal of affective disorders最新文献

{"title":"Cost-effectiveness of brexpiprazole for the treatment of major depressive disorder in Japan","authors":"Yilong Zhang ,&nbsp;Mitsuhiro Sado ,&nbsp;Kentaro Yamato ,&nbsp;Michal Pochopien ,&nbsp;Michal Gorecki","doi":"10.1016/j.jad.2025.119532","DOIUrl":"10.1016/j.jad.2025.119532","url":null,"abstract":"<div><h3>Background</h3><div>Approximately 50 % of patients with major depressive disorder (MDD) do not respond adequately to selective serotonin reuptake inhibitors (SSRI) and serotonin and norepinephrine reuptake inhibitors (SNRI). These patients are candidates for add-on therapy with brexpiprazole.</div></div><div><h3>Methods</h3><div>A cost-utility analysis was conducted from the Japanese public healthcare payer perspective to compare brexpiprazole and placebo (no add-on) as an adjunct to SSRI/SNRI in patients with MDD and inadequate response to SSRI/SNRI monotherapy. An additional analysis compared initiation of brexpiprazole after 8 (early add-on) and 14 weeks (late add-on). The model followed a cohort of patients participating in clinical trials of brexpiprazole over a total time horizon of 67 weeks.</div></div><div><h3>Results</h3><div>Early add-on of brexpiprazole was cost-effective at the willingness to pay threshold of 5 million JPY/QALY compared with both no add-on and late add-on. Compared with no add-on, patients in the early add-on group gained 0.037 quality-adjusted life-years (QALYs) at an incremental cost of JPY 155,762, resulting in an incremental cost-effectiveness ratio (ICER) of JPY 4.3 million/QALY. Compared with late add-on, early add-on resulted in an incremental gain of 0.008 QALYs at a total cost of JPY 3663, corresponding to an ICER of JPY 0.46 million/QALY.</div></div><div><h3>Limitations</h3><div>The modelling horizon was restricted to trial duration, so that long-term benefits of brexpiprazole were not captured. There was also uncertainty around incremental QALY gains for early compared with late add-on.</div></div><div><h3>Conclusion</h3><div>Brexpiprazole, especially when initiated early, was a cost-effective adjunctive treatment for patients with MDD and a history of inadequate response to SSRI/SNRI.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"388 ","pages":"Article 119532"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182107","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":"Efficacy and safety of add-on dextromethorphan on irritability in children with ADHD treated with methylphenidate: A randomized double-blind controlled trial","authors":"Pei-Yin Pan,&nbsp;Chin-Bin Yeh","doi":"10.1016/j.jad.2025.119546","DOIUrl":"10.1016/j.jad.2025.119546","url":null,"abstract":"<div><h3>Objective</h3><div>Converging evidence suggests that childhood irritability is prospectively associated with major depressive disorder. Dextromethorphan has shown efficacious in improving depressive symptomatology in adults. This trial aimed to investigate the efficacy and safety of add-on dextromethorphan on irritability in children with attention-deficit/hyperactivity disorder (ADHD) receiving methylphenidate treatment.</div></div><div><h3>Methods</h3><div>This randomized, double-blind, parallel-group trial evaluated dextromethorphan/methylphenidate versus placebo/methylphenidate in patients 7–17 years old with ADHD and comorbid irritability, which defined by the score of the Affective Reactivity Index (ARI) parent-report form ≥6. Patients were randomly assigned to receive optimal dose of methylphenidate and either dextromethorphan or placebo, 30 mg once daily for the first 2 weeks and 60 mg once daily thereafter, for a total of 8 weeks. The primary outcome was the change from baseline to week 8 in the ARI score.</div></div><div><h3>Results</h3><div>A total of 19 patients were randomized (dextromethorphan, <em>N</em> = 8; placebo, <em>N</em> = 11), and Dextromethorphan was significantly superior to the placebo in reducing the ARI score at Week 2 (−5.82 points vs. −0.32 points; least-squares mean difference − 5.50; 95 % CI −8.13, −2.87), Week 4 (−6.49 points vs. −1.96 points; least-squares mean difference − 4.53; 95 % CI −7.13, −1.94), and Week 8 (−4.98 points vs. −2.21 points; least-squares mean difference − 2.77; 95 % CI −5.29, −0.24). The effects of treatment by time interaction were significant at week 2, week 4, and week 8 (<em>p</em> &lt; 0.001, p &lt; 0.001, and <em>p</em> = 0.015, respectively).</div></div><div><h3>Conclusions</h3><div>Adjunctive dextromethorphan might be efficacious in the treatment of irritability in children with ADHD treated with methylphenidate.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"387 ","pages":"Article 119546"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154662","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":"Corrigendum to “Bidirectional relationships between depression, anxiety and urinary symptoms in women: A prospective cohort study” [J. Affect. Disord. 369 (2024): 516–522]","authors":"Carol Joinson ,&nbsp;Marcus J. Drake ,&nbsp;Abigail Fraser ,&nbsp;Kate Tilling ,&nbsp;Jon Heron","doi":"10.1016/j.jad.2025.119426","DOIUrl":"10.1016/j.jad.2025.119426","url":null,"abstract":"","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"386 ","pages":"Article 119426"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138546","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":"Contagion of crisis: Associations between suicide attempts in the social network and suicidality among late adolescents","authors":"M. van der Sluijs ,&nbsp;N.G.M. de Neve-Enthoven ,&nbsp;M. Zarchev ,&nbsp;R.F.P. de Winter ,&nbsp;W.J.G. Hoogendijk ,&nbsp;N.H. Grootendorst-van Mil","doi":"10.1016/j.jad.2025.119535","DOIUrl":"10.1016/j.jad.2025.119535","url":null,"abstract":"<div><h3>Background</h3><div>Adolescence is a critical developmental period for the emergence of suicidality. Exposure to suicidal behaviour within one's social network is a known risk factor, yet evidence linking such exposure to broader adolescent suicidality, including ideation, remains limited.</div></div><div><h3>Aims</h3><div>This study investigates the relationship between adolescent suicidality and suicide attempts in their social network, additionally focusing on the type of relationship with the individual who attempted suicide and reported deaths by suicide in adolescents' social networks.</div></div><div><h3>Methods</h3><div>Data were drawn from the iBerry Study, a population-based cohort oversampled for emotional and behavioural problems in the Netherlands. The sample included 769 participants (mean age 18.1 years; 46.4% male). Suicidality and suicide attempts in the social network were assessed via self-report. Binary logistic regression models adjusted for socio-demographic (age, sex, ethnic background, household income) and clinical confounders (IQ, childhood maltreatment, social support, previous suicidality) were applied.</div></div><div><h3>Results</h3><div>Of the participants, 30.5% reported a suicide attempt in their social network, most often by a friend or romantic partner. Reported attempts were associated with increased odds of adolescent suicidality (adjusted OR= 1.69, 95% CI 1.01–2.51, <em>p</em>= 0.047). However, associations with specific relationships diminished after adjustment. No differences in suicidality were found between reported fatal versus nonfatal suicide attempts.</div></div><div><h3>Conclusion</h3><div>Adolescents that report suicide attempts within their social network may be at heightened risk for suicidality, emphasizing the need for targeted preventive measures and interventions for vulnerable youth and addressing the broader social and relational contexts of these exposures.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"388 ","pages":"Article 119535"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181364","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":"Mitigating suicide risk with a single session of virtually-delivered psychotherapy: An open-label trial of Brief Skills for Safer Living","authors":"Aleksandra Lalovic ,&nbsp;Molly Hyde ,&nbsp;Yvonne Bergmans ,&nbsp;Michael Morton ,&nbsp;Aliana Razac ,&nbsp;Gina Nicoll ,&nbsp;Dwight Syms ,&nbsp;Sidney H. Kennedy ,&nbsp;Sakina J. Rizvi","doi":"10.1016/j.jad.2025.119512","DOIUrl":"10.1016/j.jad.2025.119512","url":null,"abstract":"<div><h3>Background</h3><div>Suicide is a global challenge and suicide rates have not significantly decreased. The COVID-19 pandemic also increased suicide risk and intensified pre-existing lack of access to mental health services. To address this issue, “Brief Skills for Safer Living” (Brief-SfSL) was developed, a single-session individual psychotherapy intervention with the potential to make it easier to access care and shorten the time to access intervention. Derived from the original success of the SfSL 20-week group therapy, Brief-SfSL helps individuals understand their suicidal thoughts, build skills to manage these thoughts, and stay safer during crises. This national study tested the effectiveness of remote Brief-SfSL on suicidal ideation over 12 weeks, as well as feasibility and acceptability.</div></div><div><h3>Methods</h3><div>This was a single-arm trial of virtually-delivered Brief-SfSL in 77 adults with suicidal ideation across Canada with follow-up at 1, 4 and 12 weeks. The primary outcome was the Beck Scale for Suicide Ideation, and secondary measures assessed depression, anxiety, social connectedness, and life functioning.</div></div><div><h3>Results</h3><div>The results demonstrated that Brief-SfSL is an effective, feasible, acceptable, and safe intervention for suicide risk.</div></div><div><h3>Conclusions</h3><div>These data support the utility of Brief-SfSL as a single-session targeted suicide intervention that can increase accessibility due to the flexibility in delivery format and minimal resources required. They also underscore that remote suicide intervention can be conducted with a suicide safety protocol in place. Future studies will investigate Brief-SfSL in a randomized controlled trial and the long-term impact of Brief-SfSL on suicide risk, healthcare system utilization, and health economics.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"388 ","pages":"Article 119512"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182187","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":"Surface-based functional brain imaging analysis of major depressive disorder after electroconvulsive therapy","authors":"Rui Qian ,&nbsp;Nanxue Duan ,&nbsp;Min Wang ,&nbsp;Siyu Fan ,&nbsp;Yang Ji ,&nbsp;Yue Yu ,&nbsp;Hao Zheng ,&nbsp;Xingqi Wu ,&nbsp;Yanghua Tian","doi":"10.1016/j.jad.2025.119492","DOIUrl":"10.1016/j.jad.2025.119492","url":null,"abstract":"<div><h3>Background</h3><div>The neural mechanisms underlying electroconvulsive therapy (ECT) in treating major depressive disorder (MDD) remain unclear. Previous neuroimaging studies have primarily employed voxel-based methods, which report only 35 % of the spatial localization of surface-based methods. This study aimed to investigate the antidepressant mechanisms of ECT using surface-based analyses.</div></div><div><h3>Method</h3><div>Longitudinal resting-state functional magnetic resonance imaging data were collected from 46 MDD patients undergoing ECT. Surface-based analyses were performed to investigate alterations in the amplitude of low-frequency fluctuations (ALFF) and functional connectivity. Correlation analyses explored relationships between ALFF, functional connectivity, and depressive symptoms. Support vector regression (SVR) was used to assess whether baseline functional connectivity could predict treatment response. A second independent cohort of 38 MDD patients was used for validation analyses.</div></div><div><h3>Result</h3><div>ECT increased ALFF in the left dorsolateral prefrontal cortex, left orbitofrontal cortex (OFC), and left inferior frontal cortex (IFC). Functional connectivity within the default mode network (DMN) and between the frontoparietal network and DMN also increased. Elevated IFC-OFC functional connectivity was strongly associated with depression remission, and baseline functional connectivity predicted symptom improvement. Similar changes in brain network functional connectivity were observed in the validation cohort, consistent with findings from the primary cohort.</div></div><div><h3>Conclusion</h3><div>This study advances understanding of the antidepressant effects of ECT through surface-based analysis and identifies potential predictive markers for assessing ECT efficacy in treating MDD.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"388 ","pages":"Article 119492"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182799","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":"Serum HDL mediates the association between inflammatory predictors and depression risk after the COVID-19 pandemic","authors":"Wen Li,&nbsp;Xiaoxia Meng,&nbsp;Huaman Liu,&nbsp;Siqi Liu","doi":"10.1016/j.jad.2025.119525","DOIUrl":"10.1016/j.jad.2025.119525","url":null,"abstract":"<div><h3>Background</h3><div>This study investigated whether HDL cholesterol mediates the relationship between inflammatory indicators and depression, using post-pandemic data in the context of metabolic disturbances and immune system impairment potentially caused by COVID-19.</div></div><div><h3>Methods</h3><div>This cross-sectional study, using data from the National Health and Nutrition Examination Survey (NHANES), included 5731 participants aged 20 years or older from August 2021 to August 2023. The Patient Health Questionnaire-9 (PHQ-9) assessed depressive symptoms. Multivariable logistic regression, Pearson correlation, and mediation analyses were conducted to evaluate odds ratios and associations between inflammatory indicators and depression.</div></div><div><h3>Results</h3><div>Correlation analysis revealed significant negative associations between four inflammatory indicators (CRP, C-reactive protein; PC, platelet count; SII, systemic immune-inflammation index; PPN, product of platelet count and neutrophil count) and HDL cholesterol, as well as between HDL cholesterol and depression, while the inflammatory indicators were significantly positively correlated with depression (all <em>p</em> &lt; 0.05). Furthermore, multivariable logistic regression models, adjusted for covariates, demonstrated that elevated levels of these four inflammatory indicators (CRP: adjusted OR = 1.011, CI = 1.003–1.025; PC: OR = 1.002, CI = 1.001–1.004; SII: OR = 1.002, CI = 1.001–1.003; PPN: OR = 1.002, CI = 1.001–1.004) were significantly associated with an increased risk of depression in the total study population. Finally, mediation analysis indicated that HDL cholesterol mediated the presumed causal associations between CRP (6.7–13.2 %), PC (4.5–12.8 %), PPN (4.8–14.9 %), and depression, whereas SII was identified as an independent predictor of depression development.</div></div><div><h3>Conclusions</h3><div>Targeting HDL cholesterol and inflammatory indicators such as CRP, PC, SII and PPN may provide potential interventions for mitigating depression risk.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"387 ","pages":"Article 119525"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178564","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":"Gastrointestinal adverse events associated with SNRIs: A FAERS-based pharmacovigilance study","authors":"Jiayi Lin ,&nbsp;Sijia Wei ,&nbsp;Ying Peng ,&nbsp;Chuoyi Liang ,&nbsp;Wenli Jiao ,&nbsp;Yelin Ji ,&nbsp;Yanfang Deng ,&nbsp;Fengxia Yan ,&nbsp;Xi Jing","doi":"10.1016/j.jad.2025.119484","DOIUrl":"10.1016/j.jad.2025.119484","url":null,"abstract":"<div><div>Major depressive disorder is a prevalent mental illness, with SNRIs constituting a mainstay of the psychopharmacological approach to its clinical management. Despite their impact on adherence, efficacy, and relapse risk, gastrointestinal adverse events (AEs) linked to SNRIs remain under-explored. This study systematically evaluated gastrointestinal adverse events associated with SNRIs by leveraging the FDA Adverse Event Reporting System (FAERS) database. A retrospective analysis of FAERS data from 2004 to 2024 identified 114,148 reports involving five SNRI drugs (venlafaxine, desvenlafaxine, milnacipran, levomilnacipran, and duloxetine). Gastrointestinal adverse events ranked among the top ten System Organ Classes for all five drugs. At the pharmacovigilance level, we identified 18 positive signals, with significant risks for five specific adverse events: constipation, dry mouth, oral hypoaesthesia, nausea, and vomiting. Descriptive analyses revealed that middle-aged (45–64 years) and elderly (65–74 years) patients were more susceptible to gastrointestinal adverse events compared to younger age groups, although the specific effects varied across different drugs and age groups. These findings highlight the significant risks of gastrointestinal AEs associated with SNRIs, underscoring the need for individualized drug selection, close monitoring, and further research into underlying mechanisms and long-term impacts.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"387 ","pages":"Article 119484"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167794","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 semi-structured interview for bipolar at-risk states (SIBARS): psychometric properties and validation","authors":"Riccardo Stefanelli ,&nbsp;Andrés Estradé ,&nbsp;Matilda Azis ,&nbsp;Alberto Stefana ,&nbsp;Ilaria Bonoldi ,&nbsp;Stefano Damiani ,&nbsp;Andrea De Micheli ,&nbsp;Valentina Floris ,&nbsp;Umberto Provenzani ,&nbsp;Luca Ballan ,&nbsp;Sameer Jauhar ,&nbsp;Silia Vitoratou ,&nbsp;Daniel Stahl ,&nbsp;Marco Solmi ,&nbsp;Christoph U. Correll ,&nbsp;Andrea Pfennig ,&nbsp;Allan H. Young ,&nbsp;Paolo Fusar-Poli","doi":"10.1016/j.jad.2025.119529","DOIUrl":"10.1016/j.jad.2025.119529","url":null,"abstract":"<div><h3>Background</h3><div>Established psychometric instruments to detect individuals at high-risk of bipolar disorders (BD) are essential to advance preventive approaches.</div></div><div><h3>Methods</h3><div>The Semi-structured Interview for Bipolar At-Risk States (SIBARS)’s psychometric properties were evaluated through: (i) dimensionality (confirmatory factor analysis, CFA); (ii) reliability (internal/inter-rater reliability); and (iii) validity in terms of convergent validity (Hamilton Depression Rating Scale, HAM-D, Mini-International Neuropsychiatric Interview, MINI; Temperament Evaluation of Memphis, Pisa, and San Diego Autoquestionnaire, TEMPS-A; Young Mania Rating Scale, YMRS), divergent validity (Comprehensive Assessment of At-Risk Mental States, CAARMS; Hamilton Anxiety Rating Scale, HAM-A), concurrent criterion validity (Bipolar Prodrome Symptom Interview and Scale–Abbreviated Screen for Patients, BPSS-AS-P).</div></div><div><h3>Results</h3><div>A total of 193 participants were included. The CFA for depression plus mania showed excellent data fit (Root Mean Square Error Approximation = 0.02). Internal (Cronbach's α = 0.90; McDonald's ω = 0.96) and inter-rater (Intra-class Correlation Coefficient = 0.97) reliability were excellent. Convergent validity was confirmed by moderate-to-strong associations between the SIBARS mania scale and the YMRS (<em>β</em> = 0.49, <em>p</em> &lt; 0.001), the SIBARS depression scale and the HAM-D (<em>β</em> = 0.54, p &lt; 0.001), and the SIBARS cyclothymic temperament scale and the TEMPS-A (<em>β</em> = 0.69 p &lt; 0.001). Divergent validity was evidenced by very weak associations between SIBARS and CAARMS' outcomes (<em>χ</em>² = 4.14, <em>p</em> = 0.042, phi = 0.15) or the HAM-A (<em>r</em> = 0.16, <em>p</em> = 0.025). Concurrent validity was indexed by a significant association of SIBARS' researcher-based ratings and BPSS-AS-P participant-based ratings (<em>r</em> = 0.23, <em>p</em> = 0.001).</div></div><div><h3>Conclusions</h3><div>There is convincing psychometric evidence supporting the SIBARS as a reliable and valid instrument for detecting individuals at clinical high-risk of BD. The cross-sectional design of the study, however, did not allow to test the SIBARS' predictive validity.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"387 ","pages":"Article 119529"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167797","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 of the Chinese version of patient health Questionnaire-4 among Chinese adolescents","authors":"Hao Xu ,&nbsp;Chenhe Zhang ,&nbsp;Hong Guo ,&nbsp;Tingting Luo ,&nbsp;Jiaqi Song ,&nbsp;Qing Shen ,&nbsp;Yiran Chen ,&nbsp;Jiahua Xu ,&nbsp;Shuping Tan ,&nbsp;Ronghuan Jiang","doi":"10.1016/j.jad.2025.119505","DOIUrl":"10.1016/j.jad.2025.119505","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of mental health issues among adolescents, particularly anxiety and depression, is increasing in China. Given the large adolescent population and their increasing prevalence, there is an urgent need for a reliable screening tool. This study aimed to validate the Chinese version of the Patient Health Questionnaire (PHQ-4) among Chinese adolescents.</div></div><div><h3>Methods</h3><div>From September 2022 to March 2024, a cross-sectional study was conducted at four middle schools in Jiangxi Province and Beijing, China, involving 8778 participants. The sample was split into exploratory factor analysis (EFA) and confirmatory factor analyses (CFA). A subset of 159 participants was used for test–re-test reliability, assessed using the intraclass correlation coefficient (ICC). Receiver operating characteristic (ROC) curve analysis was performed to determine this threshold.</div></div><div><h3>Results</h3><div>The Chinese PHQ-4 showed good overall reliability, with Cronbach's α of 0.84 and McDonald's ω of 0.86. The EFA identified two factors, depression and anxiety, with factor loadings between 0.61 and 0.81. The CFA indicated an excellent model fit. The ICC was 0.87, indicating a strong test-retest reliability. The AUC was 0.940, with a 95 % CI of 0.936–0.945, demonstrating high discriminative ability. The optimal screening threshold was determined as 3.</div></div><div><h3>Limitation</h3><div>As a cross-sectional study, causal inferences are limited.</div></div><div><h3>Conclusion</h3><div>The Chinese PHQ-4 is a reliable and valid tool for screening anxiety and depression in Chinese adolescents, with a recommended cutoff score of 3.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"387 ","pages":"Article 119505"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167800","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}