Journal of affective disorders最新文献

{"title":"Depressive symptoms are associated with impaired body affect recognition for neutral expressions","authors":"Lauren N. Grzelak ,&nbsp;James E. Glazer ,&nbsp;David M. Klemballa ,&nbsp;Carver B. Nabb ,&nbsp;Vijay A. Mittal ,&nbsp;Sebastian Walther ,&nbsp;Stewart A. Shankman ,&nbsp;Allison M. Letkiewicz","doi":"10.1016/j.jad.2025.119531","DOIUrl":"10.1016/j.jad.2025.119531","url":null,"abstract":"<div><div>Deficits in the recognition of emotional information may contribute to the social dysfunction that characterizes depression. Emotion recognition studies in depression, however, have predominately used facial stimuli – a notable limitation as emotion is also inferred from body movement. The present study used a large set of point-light display (PLD) videos, which are minimalistic representations of dynamic whole-body motion, to assess emotion recognition abilities in depression. First, a sample was collected via MTurk (<em>N</em> = 101) to establish normative emotion category ratings (Happy, Sad, Afraid, Angry, Neutral) for each video. A separate sample of healthy controls (<em>N</em> = 83) and lifetime MDD (<em>N</em> = 142) rated the emotion of each video. Test-retest stability of body affect ratings were also assessed for a subset of participants. There were no significant group differences on accuracy for any emotion category, but individuals with greater depressive symptoms exhibited lower accuracy for neutral body affect relative to those with lower depressive symptoms. This effect was not accounted for by co-occurring anxiety symptoms, highlighting the specificity of the effects to depression. Additionally, body affect ratings showed significant test-retest stability over six months for all emotions. In sum, individuals with greater depressive severity may misinterpret neutral body affect as representing an emotional expression. Future studies should clarify the role of impaired body affect recognition in broader social impairments and course of illness.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"387 ","pages":"Article 119531"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183631","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":"Prenatal stress and cortical morphometric similarity network in offspring: Transcriptional signatures of associated genes","authors":"Junhui Zhang,&nbsp;Yanqing Zhang,&nbsp;Yuanyuan Chen,&nbsp;Jianjun Zhu","doi":"10.1016/j.jad.2025.119519","DOIUrl":"10.1016/j.jad.2025.119519","url":null,"abstract":"<div><h3>Background</h3><div>Prenatal stress is known to disrupt neurodevelopment in offspring, heightening their risk of mental health disorders. However, its impact on the morphometric similarity network (MSN)—a framework that integrates multiple anatomical features to quantify structural similarity across brain regions in the developing offspring—remains poorly understood.</div></div><div><h3>Methods</h3><div>Using data from the Queensland Twin Adolescent Brain (QTAB) longitudinal study focusing on adolescent twins, we investigated the impact of prenatal stress on cortical MSN in 414 early adolescents (aged 9–14 years). Furthermore, we analyzed the relationship between MSN strength alterations associated with prenatal stress and anatomically organized gene expressions. Disease-related analysis and functional enrichment analysis were conducted.</div></div><div><h3>Results</h3><div>Adolescents exposed to prenatal stress exhibited smaller age-related changes in MSN strength between ages 9 and 14, particularly in regions associated with emotional regulation, cognitive control, and decision-making, despite showing greater similarity at age 9 compared to their unexposed peers. We identified cortical patterns characterized by weighted gene expression, strongly associated with group differences in MSN strength. Gene expressions linked to prenatal stress-related MSN strength changes were correlated with differential gene expression (DGE) implicated in conditions such as autism spectrum disorder (ASD) and inflammatory bowel disease (IBD).</div></div><div><h3>Conclusions</h3><div>These results enhance insights into the interplay between gene expression and structural brain changes driven by prenatal stress, highlighting a potential mechanistic link between prenatal stress and neurodevelopmental vulnerability, shedding light on the biological pathways underpinning neurodevelopmental risk factors.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"387 ","pages":"Article 119519"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168183","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":"Machine learning models of depression in middle-aged and older adults with cardiovascular metabolic diseases","authors":"Haopeng Ke ,&nbsp;Anning Xu ,&nbsp;Haofeng Zhou ,&nbsp;Junnian Chen ,&nbsp;Wenjing Wu ,&nbsp;Qian He ,&nbsp;Huanyi Cao","doi":"10.1016/j.jad.2025.119494","DOIUrl":"10.1016/j.jad.2025.119494","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of cardiovascular metabolic diseases (CMD) is increasing, and depression in CMD patients significantly impacts prognosis. Therefore, this study aimed to develop and validate a predictive model for depression in CMD patients using machine learning methods.</div></div><div><h3>Methods</h3><div>The study utilized data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) for model derivation and internal validation, and data from the China Health and Retirement Longitudinal Study (CHARLS) for external validation. Logistic Regression, K-nearest neighbors, Support Vector Machine, Random Forest, Gradient Boosting Machine (GBM), and Light Gradient Boosting Machine were used to construct depression prediction models. The model performance was assessed mainly using area under the receiver operator characteristic curve (AUC), brier score, calibration plots and decision curve analysis (DCA). Model interpretations were generated using the Shapley additive explanations (SHAP) method.</div></div><div><h3>Results</h3><div>Among the 14,884 participants in SHARE and 1128 in CHARLS, 5456 and 474 had depression, respectively. The Gradient Boosting Machine (GBM) model demonstrated the best performance in terms of discrimination and calibration, with an AUC of 0.823 in the external validation cohort, and the DCA also verified that the GBM model had the best clinical practicality. The SHAP method revealed that trouble sleep, life satisfaction and loneliness were the top 3 predictors of depression. For the convenience of clinicians, we developed a clinical support system based on GBM model.</div></div><div><h3>Conclusions</h3><div>We integrated the GBM model into a clinical support system which could assist clinicians in early identifying CMD patients at high risk for depression.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"387 ","pages":"Article 119494"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179967","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 network-based approach reveals higher plasticity levels in bipolar than major depressive disorder","authors":"Aurelia Viglione ,&nbsp;Claudia Delli Colli ,&nbsp;Silvia Poggini ,&nbsp;Melika Mobasher ,&nbsp;Benedetta Vai ,&nbsp;Sara Poletti ,&nbsp;Francesco Benedetti ,&nbsp;Igor Branchi","doi":"10.1016/j.jad.2025.119549","DOIUrl":"10.1016/j.jad.2025.119549","url":null,"abstract":"<div><h3>Background</h3><div>Bipolar disorder (BD) and major depressive disorder (MDD) are often misdiagnosed due to overlapping symptomatology, leading to inappropriate treatments and poor outcomes. Thus, novel approaches for effective early differential diagnosis are warranted. Plasticity – the ability to modify brain functioning and mental state – is increasingly recognized as a crucial process in psychiatry, as it underlies transitions from psychopathology to wellbeing. Accordingly, enhanced plasticity is reported to increase mental state transitions. Since BD patients experience transitioning between depression and mania, we hypothesized this disorder to be characterized by higher plasticity levels than MDD.</div></div><div><h3>Methods</h3><div>We leveraged a recent network-based approach to measure plasticity, operationalizing it as the inverse of the connectivity strength among network symptoms. We analyzed 211 BD and 136 MDD patients undergoing a major depressive episode. Symptoms were employed to generate unregularized networks via Gaussian Graphical Model, with Spearman's Rank correlation estimating the input matrix. Connectivity strength was compared between disorders using the Network Comparison Test function.</div></div><div><h3>Results</h3><div>BD patients exhibit higher plasticity levels than MDD patients, as demonstrated by weaker symptom connectivity, despite both groups having comparable depressive symptom severity (<em>p</em> = 0.008). Within the BD group, type I patients showed also higher plasticity compared to type II (<em>p</em> = 0.04), further corroborating the association between high plasticity and mood instability.</div></div><div><h3>Conclusions</h3><div>Our findings support the hypothesis that plasticity levels differ across psychopathological conditions based on their likelihood of mental transitions. Consequently, measuring of plasticity through symptom network dynamics holds promise for the early differential diagnosis of BD and MDD.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"387 ","pages":"Article 119549"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181550","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":"Depression is associated with treatment response trajectories in adults with Prolonged Grief Disorder: A machine learning analysis","authors":"Adam Calderon ,&nbsp;Matthew Irwin ,&nbsp;Naomi M. Simon ,&nbsp;M. Katherine Shear ,&nbsp;Christine Mauro ,&nbsp;Sidney Zisook ,&nbsp;Charles F. Reynolds III ,&nbsp;Matteo Malgaroli","doi":"10.1016/j.jad.2025.119536","DOIUrl":"10.1016/j.jad.2025.119536","url":null,"abstract":"<div><h3>Background</h3><div>Although evidence-based Prolonged Grief Disorder treatments (PGDT) exist, pretreatment characteristics associated with differential improvement remain unidentified. To identify clinical factors relevant to optimizing PGDT outcomes, we used unsupervised and supervised machine learning to study treatment effects from a double-blinded, placebo-controlled, randomized clinical trial.</div></div><div><h3>Methods</h3><div>Patients were randomized into four treatment groups for 20 weeks: citalopram with grief-informed clinical management, citalopram with PGDT, pill placebo with PGDT, or pill placebo with clinical management. The trial included 333 PGD patients aged 18–95 years (<em>M</em> = 53.9; <em>SD</em> <em>=</em> 14.4). Symptom trajectories were assessed using latent growth mixture modeling based on Inventory for Complicated Grief scores collected every 4 weeks. The relationship between patient-level characteristics and assigned trajectories was examined using logistic regression with elastic net regularization based on the administration of citalopram, PGDT, and risk factors for developing PGD.</div></div><div><h3>Results</h3><div>Three response trajectories were identified: lesser severity responders (60 %, <em>n</em> = 200), greater severity responders (18.02 %, <em>n</em> = 60), and non-responders (21.92 %, <em>n</em> = 73). Significant differences between greater severity responders and non-responders emerged by Week 8, persisting through the 6-month follow-up assessment. The elastic net model (AUC = 0.702; F1 = 0.777) indicated that higher baseline depression severity, grief-related functional impairment, and not receiving PGDT were associated with a decreased probability of response.</div></div><div><h3>Limitations</h3><div>An independent validation cohort of PGDT patients is needed to further study generalizability of findings.</div></div><div><h3>Conclusions</h3><div>Differential PGDT courses and the role of depression severity and grief-related functional impairment in treatment non-response were identified. These findings underscore the importance of determining clinical factors relevant to optimizing individual treatment strategies.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"388 ","pages":"Article 119536"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181527","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":"Six-country psychometric comparison of women responses to the Depression Anxiety Stress Scale (DASS) and the Child and Adolescent Behaviour Inventory (CABI) across cultures and time","authors":"Francisco Antonio Calderón Alfaro ,&nbsp;Jamie Lachman ,&nbsp;Catherine L. Ward ,&nbsp;Qing Han ,&nbsp;Rosanne Jocson ,&nbsp;Ivo Kunovski ,&nbsp;Stephanie Eagling-Peche ,&nbsp;Rumaya Juhari ,&nbsp;Kufre Okop ,&nbsp;Jennel Reyes ,&nbsp;Viorel Babii ,&nbsp;Lucie Cluver ,&nbsp;Liane Peña Alampay ,&nbsp;Marija Raleva ,&nbsp;Frances Gardner","doi":"10.1016/j.jad.2025.119524","DOIUrl":"10.1016/j.jad.2025.119524","url":null,"abstract":"<div><h3>Background</h3><div>The Depression Anxiety Stress Scale (DASS) and the Child and Adolescent Behaviour Inventory (CABI) are freely accessible tools used to assess depression and externalizing symptoms, respectively. There is limited psychometric evidence on how these scales hold over time and across cultures. This study aims to evaluate the internal structure of both scales and their invariance across six countries and over two timepoints.</div></div><div><h3>Methods</h3><div>Data from the ParentChat Pilot Study included information from 566 adults (85.51 % female) with children aged 2 to 17. Only female data from North Macedonia, Malaysia, Moldova, Montenegro, Philippines, and South Africa were used. Confirmatory factor analysis was employed to assess invariance of each construct.</div></div><div><h3>Results</h3><div>At baseline, the DASS depression subscale achieved scalar invariance across five countries (CFI = 0.973, TLI = 0.956, RMSEA = 0.060, SRMR = 0.069) and across timepoints (CFI = 0.990, TLI = 0.979, RMSE = 0.037, SRMR = 0.034). The CABI extract achieved scalar invariance across two countries (CFI = 0.968, TLI = 0.963, RMSEA = 0.068, SRMR = 0.085) and across timepoints (CFI = 0.983, TLI = 0.980, RMSEA = 0.044, SRMR = 0.067).</div></div><div><h3>Limitations</h3><div>Small sample sizes, disproportionate female sample, and use of subscales or item extracts may limit generalizability. The scales were also not validated for all age groups used.</div></div><div><h3>Conclusions</h3><div>The study provides evidence of validity for the internal structure of the DASS and CABI extracts across cultures and over time. These findings support the use of these open-access tools in resource-limited settings to promote local research.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"387 ","pages":"Article 119524"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180368","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":"Barriers to mental health in post-partum women in India: A systematic review and meta-analysis","authors":"Bhupesh Gupta ,&nbsp;Kirtika Gupta ,&nbsp;Ramita Goel ,&nbsp;Vimal Satodiya ,&nbsp;Anshu Mittal","doi":"10.1016/j.jad.2025.119528","DOIUrl":"10.1016/j.jad.2025.119528","url":null,"abstract":"<div><h3>Objectives</h3><div>This study uses an exhaustive meta-analysis of descriptive epidemiological studies to determine the prevalence of major depression in post-partum women and its associated risk factors, across all ages in India.</div></div><div><h3>Data sources</h3><div>Using the PRISMA criteria as a guide, we searched databases such as PubMed, Scopus, Web of Science, and Embase to locate research articles released between 2020 and 2024. This study was registered by the International Prospective Register of Systematic Reviews PROSPERO (CRD42024513914).</div></div><div><h3>Study selection</h3><div>The eligible studies included all the English-language observational full-text articles reporting the percentage or frequency of the prevalence of depression in perinatal women in India.</div></div><div><h3>Data extraction and synthesis</h3><div>Pooled prevalence with a 95 % confidence interval was calculated using version 4.3.0 of the R software to conduct the meta-analysis, and the JBI score was used to evaluate the quality. A pooled odds ratio with a 95 % confidence interval was used to find out the association of risk factors with postpartum depression. We assessed heterogeneity with the Q and I² statistics. Egger's regression test and a funnel plot were used to evaluate publication bias.</div></div><div><h3>Results</h3><div>Utilizing a random effects model, the results of 59 publications were used to estimate the prevalence of post-partum depression in India from 2020 to 2024 to be 19 % (CI = 95: 15–23 %). Meta-regression analysis found that older age post-partum women had a higher prevalence of post-partum depression as compared to younger ones. Heterogeneity for prevalence was found to be 97 %. The sub-group analysis found a higher prevalence of post-partum depression in Southern India (22 %; 95 % CI: 15–31), studies conducted in community settings (19 %; 95 % CI: 12–28), urban areas (19 %; 95 % CI: 15–24), studies using study instruments other than EPDS scale (22 %; 95%CI: 11–39), and publication year 2024 (25 %; 95 % CI: 17–36).</div></div><div><h3>Conclusion</h3><div>Effective measures need to be taken to control all the risk factors found in this study to control post-partum depression in India.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"387 ","pages":"Article 119528"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178622","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":"Latent profile analysis of adolescent antisocial behavior: The role of situational factors with physical activity as a moderator","authors":"Xinmeng Guo ,&nbsp;Xiangren Yi ,&nbsp;Xiaosheng Dong","doi":"10.1016/j.jad.2025.119482","DOIUrl":"10.1016/j.jad.2025.119482","url":null,"abstract":"<div><h3>Objective</h3><div>This study used Latent Profile Analysis (LPA) to identify distinct antisocial behavior (ASB) profiles among Chinese adolescents and examined the influence of family characteristics, health risk behaviors (HRBs), quality of life (QoL), and physical activity (PA) levels on these profiles.</div></div><div><h3>Methods</h3><div>A cross-sectional study of 18,397 adolescents was conducted using self-reported measures of ASB, family characteristics, HRBs, QoL, and PA levels. LPA was used to classify adolescents into ASB categories. Multivariate logistic regression and subgroup analyses compared differences across profiles.</div></div><div><h3>Results</h3><div>Profiles were differentiated by the severity of ASB rather than specific types of problematic behaviors. Factors such as non-only child status, parental conflict, sedentary behavior, and alcohol consumption were significantly associated with higher ASB levels. Physical activity subgroups displayed distinct patterns, with males in high-PA subgroups and females in low-PA subgroups showing differing ASB profiles.</div></div><div><h3>Conclusions</h3><div>Targeted interventions should address specific ASB types within defined populations. Group-based physical activities fostering peer communication are recommended to mitigate ASB risks, especially among adolescents with lower PA levels. Future research should explore causal mechanisms to refine public health strategies.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"387 ","pages":"Article 119482"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167256","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 efficacy of lithium in the treatment of suicidal ideation, behavior and suicide: An updated systematic review and meta-analysis of randomized controlled trials","authors":"James Xiaolong Wang ,&nbsp;Gia Han Le ,&nbsp;Sabrina Wong ,&nbsp;Kayla M. Teopiz ,&nbsp;Angela T.H. Kwan ,&nbsp;Joshua D. Rosenblat ,&nbsp;Taeho Greg Rhee ,&nbsp;Roger Ho ,&nbsp;Heidi Ka Ying Lo ,&nbsp;Joseph F. Goldberg ,&nbsp;Maj Vinberg ,&nbsp;Iria Grande ,&nbsp;Rodrigo Mansur ,&nbsp;Jonathan M. Meyer ,&nbsp;Roger S. McIntyre","doi":"10.1016/j.jad.2025.119487","DOIUrl":"10.1016/j.jad.2025.119487","url":null,"abstract":"<div><h3>Objectives</h3><div>Lithium is a first-line treatment for bipolar disorder, especially BD-I. In addition to efficacy in treating acute mania and recurrence prevention in bipolar disorder, lithium's anti-suicide effects have been documented in studies showing reduced rates of completed suicide and serious attempts. To update current knowledge on the topic, we conducted a systematic review and meta-analysis of lithium's impact in randomized controlled trials on suicidality (i.e., suicidal ideation, attempts, and suicide).</div></div><div><h3>Methods</h3><div>Herein we followed Cochrane protocols and PRISMA guidelines to search OVID databases (Embase, MedLine, PsychINFO) from January 2013 to July 2024 for randomized trials evaluating lithium's effect on suicidality, specifically reporting suicidal ideation, attempts, or related mortality outcomes. We identified earlier studies from manual reference searching. Two reviewers independently extracted data and assessed quality.</div></div><div><h3>Results</h3><div>From 1793 articles, 15 studies (eight placebo-controlled, <em>n</em> = 1698; seven open-label, <em>n</em> = 1338) met eligibility criteria. Lithium was associated with nonsignificant reductions in suicide attempts (OR = 0.73; 95 % CI = [0.41, 1.31]; 25 in the lithium cohort vs. 63 on placebo) and completed suicide (OR = 0.61; 95 % CI = [0.25, 1.48]; lithium 4 vs. 13 placebo). Heterogeneity in methods and measures used to quantify suicidal ideation prevented quantitative analysis.</div></div><div><h3>Conclusions</h3><div>Methodological limitations affect assay sensitivity for suicidality measures, notably small sample sizes, diagnostic heterogeneity, inadequate treatment fidelity, subtherapeutic lithium levels, and intersubject differences in prior suicidality. Failure to reach statistical significance likely results from type II error, yet lithium's beneficial effects on suicide attempts and completed suicide align with observational studies.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"387 ","pages":"Article 119487"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167795","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":"Optimal dose of aerobic exercise for reducing depressive symptoms in children and adolescents: A meta-analysis of randomized controlled trials and dose-response analysis","authors":"Junyu Wang ,&nbsp;Lanzhi Chen ,&nbsp;Yixin Liang ,&nbsp;Tianle Chen ,&nbsp;Yuan Yuan ,&nbsp;Yong Yang ,&nbsp;Hui Fang ,&nbsp;Ting Xie ,&nbsp;Jie Zhuang","doi":"10.1016/j.jad.2025.119501","DOIUrl":"10.1016/j.jad.2025.119501","url":null,"abstract":"<div><h3>Purpose</h3><div>To identify the most effective aerobic exercise regimen and explore the dose-response relationship for improving depressive symptoms.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in PubMed, MEDLINE, Embase, CENTRAL, and Web of Science, covering studies up to September 2024. Randomized controlled trials (RCTs) evaluating the impact of aerobic exercise on depressive symptoms in children and adolescents (6–19 years) were included. Subgroup analyses were performed based on age, depression status, and exercise characteristics. Outcome measures were standardized mean differences (SMD) with 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>Eighteen RCTs with 1540 participants were included. Aerobic exercise significantly reduced depressive symptoms post-intervention (SMD: −0.37, 95 % CI: −0.59 to −0.15) and during follow-up (SMD: −0.51, 95 % CI: −0.85 to −0.18). Effects were stronger in adolescents and those with clinically diagnosed depression. Moderate-intensity exercise (4.0–5.9 METs), 30–45 min per session, 3–4 times per week, over 6–10 weeks was most effective. Dose-response analysis found an optimal dose of 590 METs-min/week (SMD: −0.46, 95 % CrI: −0.78 to −0.10), with an effective range of 360–780 METs-min/week.</div></div><div><h3>Conclusion</h3><div>Aerobic exercise significantly reduces depressive symptoms in adolescents, particularly in those with diagnosed depression. Moderate-intensity exercise (4.0–5.9 METs), 30–45 min per session, 3–4 times per week, over 6–10 weeks, is most effective. The optimal dose is 590 METs-min/week. These findings offer practical insights for designing targeted interventions.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"387 ","pages":"Article 119501"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167799","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}