Journal of Affective Disorders Reports最新文献

{"title":"Psychometric Evaluation of the Patient Health Questionnaire-9 (PHQ-9) in a Sample of Afghan University Students","authors":"Basir Ahmad Azizi,&nbsp;Anna Bjärtå,&nbsp;Jennifer Meurling,&nbsp;Fara Tabrizi,&nbsp;Sajjad Saadat,&nbsp;Wahidh Talbian,&nbsp;Mohammad Sajjad Afsharzada","doi":"10.1016/j.jadr.2026.101189","DOIUrl":"10.1016/j.jadr.2026.101189","url":null,"abstract":"<div><h3>Background</h3><div>The Patient Health Questionnaire-9 (PHQ-9) is a brief scale designed to identify and assess the presence and severity of depressive symptoms. It is widely used in clinical and research settings and is available in numerous languages. This study aimed to evaluate the psychometric properties of an existing Dari version of the PHQ-9 in Afghan university students.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, participants were recruited at Herat University, Afghanistan, during the 2024–2025 academic year. Participants completed an online survey comprising Dari versions of the PHQ-9 and the Depression Anxiety Stress Scale–Short Form (DASS-21). A subsample of 40 participants completed the PHQ-9 again two weeks later. Internal consistency, two-week test-retest reliability, internal structure, and convergent validity were examined.</div></div><div><h3>Results</h3><div>Two hundred fifteen participants aged 18–50 years (<em>M</em> = 25.6, 52.6% females, 47.4% males) were included. The Dari PHQ-9 demonstrated good internal consistency (Cronbach’s alpha = .86) and satisfactory two-week test-retest reliability (ICC = .84, 95% CI [.72, .91]). Confirmatory factor analysis showed good fit for both unidimensional and correlated two-factor models, supporting an essentially unidimensional interpretation of the PHQ-9. Convergent validity with the DASS-21 depression subscale was satisfactory (<em>r</em> = .73, <em>p</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>The existing Dari PHQ-9 demonstrated good internal consistency, satisfactory test-retest reliability, and evidence supporting an essentially unidimensional interpretation and convergent validity in this sample. Further studies should evaluate its psychometric performance in more diverse Dari-speaking populations and settings, including clinical and community contexts.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"26 ","pages":"Article 101189"},"PeriodicalIF":3.0,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149204939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The different impact of negative affect and anhedonia in the trajectory of mental well-being: Longitudinal data of youth during an international pandemic","authors":"Alison Fang-Wei Wu,&nbsp;Iris Lavi,&nbsp;Jennifer Y.F. Lau","doi":"10.1016/j.jadr.2026.101140","DOIUrl":"10.1016/j.jadr.2026.101140","url":null,"abstract":"<div><h3>Purpose</h3><div>The preventative measures during the COVID-19 pandemic can undermine individuals’ mental health, especially among adolescents. In this study, we expected that Israeli adolescents might experience adverse impacts on their well-being and that those with existing emotional difficulties, such as high negative affect and anhedonia, would manifest worse well-being than those without. We aim to examine individual differences in well-being trajectories, as these differences link to negative affect and anhedonia.</div></div><div><h3>Methods</h3><div>We utilised a longitudinal online survey to measure 306 Israeli adolescents’ negative affect, anhedonia and well-being from May 2020 and every two weeks for wave 1 to wave 8. Demographic information, including age, gender and ethnicity was also included.</div></div><div><h3>Results</h3><div>Multilevel models showed that the effect of time on well-being was random, suggesting varied trajectories of well-being across Israeli adolescents. We also found that the initial negative affect level moderated the association between time and well-being. Those with negative affect showed low initial but increasing well-being overtime. In contrast, those with low negative affect had high initial but decreasing well-being. Both results might be due to individuals’ adaptation to the changes. On the other hand, initial anhedonia symptoms consistently predicted poor well-being over time.</div></div><div><h3>Conclusions</h3><div>Our study showed the varied well-being trajectories and the predictive roles of negative affect in the trajectory during the COVID-19 pandemic. Future research should examine whether considering these distinct emotional processes could contribute to the development of more tailored approaches to promoting young people’s mental well-being.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"25 ","pages":"Article 101140"},"PeriodicalIF":3.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148656100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single day intervention (SDI) for depression: An exploratory pilot study to establish acceptability, feasibility, and explore symptom change","authors":"Skye C. Napolitano,&nbsp;Nadia Kako,&nbsp;Aditya Krishnan,&nbsp;Corinne N. Carlton,&nbsp;Crystal E. Schiller,&nbsp;Flavio Frohlich","doi":"10.1016/j.jadr.2026.101132","DOIUrl":"10.1016/j.jadr.2026.101132","url":null,"abstract":"<div><div>Major depressive disorder (MDD) is characterized by significant alterations in mood, cognition, motivation, and behavior that yield suffering and disruption in daily functioning. Current depression treatments are often not fully effective and can be time intensive and costly. It is therefore critical to identify and refine effective treatments for MDD. In this exploratory pilot study, we present the findings of a single-day intervention (SDI) for treating depression termed the Carolina Accelerated Recovery from Depression (CARED) protocol, which we designed to complement future neurostimulation augmentation. The study was preregistered (NCT06590038), and focused on feasibility, acceptability, and preliminary outcome data. The psychotherapy intervention of CARED consists of principles and elements of behavioral activation and acceptance and commitment therapy to target low mood, anhedonia, and psychological rigidity. Ten adult participants with current MDD were recruited from the community to pilot the CARED psychotherapy protocol and provide feedback. Participants also completed symptom measures at baseline and two weeks after the SDI. Results indicate that overall, participants reported positive experiences with the therapy experience. Descriptive patterns suggested that 6 of 10 participants with moderate-to-severe MDD showed reductions in BDI-II scores at two week follow up, while 9 of 10 participants reported satisfaction with the intervention and willingness to return, and no adverse events were reported. While preliminary, these results support the CARED SDI as a feasible and well-tolerated platform for investigation in a larger controlled trial augmented with noninvasive brain stimulation.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"25 ","pages":"Article 101132"},"PeriodicalIF":3.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148656109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unpacking adolescent depression: A narrative review from a transdiagnostic perspective using the dimensional RDoC framework","authors":"Lane M. Bellmont-Olson,&nbsp;Madison Wright,&nbsp;Eva M. Müller-Oehring,&nbsp;Fiona C. Baker,&nbsp;Orsolya Kiss,&nbsp;Kilian M. Pohl,&nbsp;Ian H. Gotlib,&nbsp;Tilman Schulte","doi":"10.1016/j.jadr.2026.101129","DOIUrl":"10.1016/j.jadr.2026.101129","url":null,"abstract":"<div><h3>Background</h3><div>Adolescent depression is a unique presentation that is highly heterogenous, yet few studies have utilized longitudinal multimodal assessment approaches to develop a lifespan-oriented view of the etiology, course, and severity of this condition. Consequently, diagnostic criteria for mood disturbances may disadvantage adolescents by overlooking key developmental factors relevant to depression risk, delaying access to early interventions. This narrative review examines transdiagnostic factors of adolescent psychopathology, including sleep health and its effects on brain development and functioning on biological and psychosocial levels. Building on this work, a novel and dimensional framework of adolescent depression is proposed in the context of relevant Research Domain Criteria (RDoC) systems.</div></div><div><h3>Methods</h3><div>This review is based on scientific peer-reviewed publications, identified via keyword searches from Google Scholar, PubMed, ProQuest, and Connected Papers.</div></div><div><h3>Results</h3><div>There is some evidence to support a bidirectional relationship between sleep health and risk of depression development in adolescents. Furthermore, hormonal changes during adolescence and genetic risk for developing depression may specifically influence neuronal architecture and functioning underlying depressive presentations.</div></div><div><h3>Limitations</h3><div>Participant samples of chosen studies varied in terms of adolescent age ranges, with data on adolescent depression and associated factors being largely correlational.</div></div><div><h3>Conclusions</h3><div>The reviewed literature provides support for a multimodal approach to characterize adolescent depression, yet few studies have utilized quantifiable, transdiagnostic constructs within the RDoC systems. Developmentally oriented methodological designs and constructs, such as pubertal timing, should be emphasized to tie underlying biological mechanisms and sleep health to adolescent risk and resilience over time.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"25 ","pages":"Article 101129"},"PeriodicalIF":3.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148640620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting final TMS outcomes from symptom trajectory during treatment","authors":"Yalun Zhang ,&nbsp;Mahdi Razafsha ,&nbsp;Lera Sterina ,&nbsp;Joshua C. Brown ,&nbsp;Shan Siddiqi","doi":"10.1016/j.jadr.2026.101110","DOIUrl":"10.1016/j.jadr.2026.101110","url":null,"abstract":"<div><h3>Background</h3><div>Symptom improvement during TMS treatment may predict treatment response, but it remains unclear if this early change is clinically useful.</div></div><div><h3>Objective</h3><div>To evaluate the predictive value of symptom improvement during TMS treatment for outcomes in patients receiving TMS for major depressive disorder who have not yet achieved response criteria.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed clinical data from 458 patients treated with Brainsway H1 coil targeting dorsolateral prefrontal cortex. Quick Inventory for Depressive Symptomatology (QIDS) was collected before treatment 10, 20, 30, and 36. Analyses included logistic regression predicting responder status by treatment end from symptom improvement during TMS treatment, linear regression predicting QIDS change at treatment end from QIDS change during treatment; and multiple regression to test whether individual symptom improvement predicts final improvement.</div></div><div><h3>Results</h3><div>Symptom improvement during TMS treatment predicted higher probability of final response, with model discrimination increasing from treatment 10 (T10) to treatment 20 (T20), but no further increase at treatment 30 (T30). In a leave-one-out cross-validation, there was strong correlation between early and final predicted percent QIDS change at treatment 36 based on early improvement at T10 (R = 0.42, p &lt; 10^–15), T20 (R = 0.59, p &lt; 10^–15), and T30 (R = 0.73, p &lt; 10^–15). Based on these data, we report a formula and a free web-app to predict final treatment response based on early response. No individual QIDS item significantly predicted final improvement after false discovery rate correction.</div></div><div><h3>Conclusions</h3><div>Symptom improvement during TMS treatment, measured as percent improvement, raw change, or empirical response rate—provides robust, clinically interpretable prediction of final TMS response in patients at our center who have not yet met early response criteria. We provide a free web app for automatically predicting final response based on early improvement (moiraitms.streamlit.app).</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"25 ","pages":"Article 101110"},"PeriodicalIF":3.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148385946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlates of the embittered mind: Radical, psychotic, and conspiracy ideations","authors":"Eva Billen,&nbsp;Margje Stokkers,&nbsp;Esmée van der Werff,&nbsp;Bram Sizoo","doi":"10.1016/j.jadr.2026.101104","DOIUrl":"10.1016/j.jadr.2026.101104","url":null,"abstract":"<div><div>Embitterment is a common response to perceived traumatic injustice. It can develop into hopelessness and a sense of having lost control. In severe forms it may lead to persistent litigation, aggression, and suicidality. Apart from these documented consequences, little is known about the associated psychological factors of the embittered affect. In a sample of 133 adults from the general population, the associations between embitterment and a) conspiracy mentality, b) radical attitudes that condone illegal action, and c) psychotic ideations in response to injustice, were explored. The results show a strong relationship between embitterment and psychotic ideation, and a weak association between embitterment, age, and radical (unlawful) attitudes. There was no statistically significant association between embitterment and conspiracy mentality. The results have practical implications but require further study. Because, if embitterment increases psychotic ideation, and to a lesser extend radical attitudes, this poses a risk on irrational and possibly violent behaviour. If, on the other hand, psychotic ideation or radical attitudes precede embitterment, more emphasis on screening for psychosis and radical attitudes could reduce the negative effects of embitterment.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"25 ","pages":"Article 101104"},"PeriodicalIF":3.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148582579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment resistance in bipolar disorder is associated with intrinsic network power","authors":"Shir Dahan,&nbsp;Mia Casburn,&nbsp;Andrea Fernandes,&nbsp;Jacqueline Quirke,&nbsp;Emma Corley,&nbsp;Pilib Ó Broin,&nbsp;Lijun Zhang,&nbsp;Keming Gao,&nbsp;Dara M Cannon,&nbsp;Jennifer Sweet","doi":"10.1016/j.jadr.2026.101107","DOIUrl":"10.1016/j.jadr.2026.101107","url":null,"abstract":"<div><h3>Background</h3><div>Treatment for bipolar disorder (BD) is often suboptimal, with over 50% of patients becoming treatment refractory. To better understand the neural mechanisms underlying treatment response, we investigated the functional magnetic resonance imaging (fMRI) signal of resting-state networks (RSNs) and compared network connectivity and spectral power across treatment-refractory BD, remitted BD, and psychiatrically healthy control groups.</div></div><div><h3>Methods</h3><div>Resting-state fMRI time series underwent group independent component analysis. Signal components were anatomically assigned to intrinsic RSNs. Time-course spectral power and spatial map intensity were compared across groups, adjusting for age, sex, and mood state.</div></div><div><h3>Results</h3><div>Group differences in power spectra were found across several RSNs. The central executive network (CEN) differed across all groups in the superior parietal lobule and left middle frontal gyrus, and between both BD groups and the control group (n = 13) in the frontal pole and supramarginal gyrus. The default mode network (DMN) differed between refractory (n = 12) and remitted (n = 13) groups in the frontal cortex. The salience network (SN) showed differences between the refractory and control groups in the cingulate, insular, frontal operculum, and middle frontal gyrus. Lastly, the lateral visual network differed between the remitters and control groups.</div></div><div><h3>Conclusion</h3><div>Resting state oscillations in the CEN, DMN, and SN, networks previously implicated in BD and treatment-resistant major depressive disorder, may be a signature of treatment response in BD. Frequency-specific alterations, particularly in frontal and cingulate regions, align with prior structural findings, suggesting entrenched neural disruptions and possible functional reorganization in treatment-refractory BD, highlighting potential targets for future interventions.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"25 ","pages":"Article 101107"},"PeriodicalIF":3.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148582582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Academic burnout and its mental health correlates among veterinary nursing students in Ghana: A cross-sectional study","authors":"Godwin Dogbey,&nbsp;Adriana-Maria Hiller,&nbsp;Axel C. Carlsson,&nbsp;Johanna Wallensten,&nbsp;Kweku Asare-Dompreh,&nbsp;Anthony Amison Agbolosu,&nbsp;Seth Atta Baiden,&nbsp;Abebayehu N. Yilma,&nbsp;Marta A. Kisiel","doi":"10.1016/j.jadr.2026.101113","DOIUrl":"10.1016/j.jadr.2026.101113","url":null,"abstract":"<div><div>This study explored the prevalence and risk factors of academic burnout among veterinary nursing students in Ghana.</div><div>A cross-sectional online survey was conducted among students in the veterinary nursing program. Burnout was assessed using a student-adapted 22-item Maslach Burnout Inventory Educational Survey (MBI-ES), comprising emotional exhaustion, depersonalization, and personal accomplishment. Mental health was measured with the Hospital Anxiety and Depression Scale and the Generalized Anxiety Disorder Scale. Logistic regression analyses produced age- and sex-adjusted odds ratios (aORs) with 95% confidence intervals (CIs).</div><div>Of 204 students, 183 responded (19% women). High emotional exhaustion was observed in 35% of students, high depersonalization in 13%, and low personal accomplishment in 51%; 7% met criteria for overall burnout. Emotional exhaustion was associated with perceived stress (aOR 3.45, 95% CI 1.64–7.26), discrimination (aOR 2.28, 95% CI 1.10–4.73), and elevated anxiety (aOR 4.06, 95% CI 2.13–7.75), and depressive symptoms with reduced personal accomplishment (aOR 2.01, 95% CI 1.10–3.67). Factors protecting from burnout included studying &gt;2 hours daily, choosing the program voluntarily, and having a better financial situation.</div><div>Decreased personal accomplishment and emotional exhaustion were common, but overall burnout was relatively low. Absence of financial difficulties was associated with lower odds of burnout.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"25 ","pages":"Article 101113"},"PeriodicalIF":3.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148582587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global burden, risk assessment, and burden prediction of adolescents depressive disorders from 1991 to 2021: A population-based study","authors":"Feiyang Ling,&nbsp;Ying Wu,&nbsp;Yunen Dong,&nbsp;Rui Zhong,&nbsp;Hongyu Liu,&nbsp;Yuemei Yang,&nbsp;Jianfeng Gao","doi":"10.1016/j.jadr.2026.101143","DOIUrl":"10.1016/j.jadr.2026.101143","url":null,"abstract":"<div><h3>Background</h3><div>Adolescent depressive disorders (ADD) pose a critical global public health challenge, yet comprehensive assessments of their long-term burden, key risk factors, and future trajectories remain limited.</div></div><div><h3>Objectives</h3><div>This study aimed to quantify the global incidence, disability-adjusted life years (DALYs), and attributable risk factors for ADD from 1991 to 2021, and to project future burden trends to 2039.</div></div><div><h3>Method</h3><div>We conducted a population-based analysis using data from the Global Burden of Disease Study 2021 across 204 countries and territories. Analyses included joinpoint regression for trend analysis, comparative risk assessment for risk factors (bullying victimization, intimate partner violence, childhood sexual abuse), and Bayesian age-period-cohort modeling for burden prediction.</div></div><div><h3>Results</h3><div>From 1991 to 2021, global ADD incidence increased significantly. The rise was more pronounced in males and the 10–14-year age group. East Asia saw a decline, while high-income North America experienced a sharp increase. DALYs attributable to violence and bullying rose, particularly in high-SDI regions. Projections indicate a continued global increase and a widening gender gap, with females disproportionately affected.</div></div><div><h3>Conclusions</h3><div>The global burden of ADD is escalating, with distinct patterns by sex, age, and region. Violence and bullying are key drivers. These findings underscore an urgent need for targeted, gender-sensitive, and region-specific mental health interventions for adolescents.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"25 ","pages":"Article 101143"},"PeriodicalIF":3.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148640548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maudsley Staging Method for measuring treatment-resistant depression in patients with major depressive disorder: An adaptation to Danish national registers","authors":"Mathilde Werborg Birkholm,&nbsp;Aleksander Søltoft-Jensen,&nbsp;Sean Jonas Valdemar Marker,&nbsp;Maj Vinberg,&nbsp;Jesper Riise,&nbsp;Kasper Koldby,&nbsp;Frederikke Hørdam Gronemann,&nbsp;Merete Osler,&nbsp;Janne Petersen","doi":"10.1016/j.jadr.2026.101144","DOIUrl":"10.1016/j.jadr.2026.101144","url":null,"abstract":"<div><div>A substantial proportion of patients with major depressive disorder (MDD) develop treatment-resistant depression (TRD), defined by an insufficient response to adequate antidepressant treatment. The Maudsley Staging Method (MSM) is one of several approaches used to characterize TRD severity, staging resistance from mild to severe based on illness duration, symptom severity, and treatment history. However, its applicability in register-based research has not been fully established.</div><div>We therefore adapted the MSM for use in nationwide Danish register data and examined MSM’s association with clinically diagnosed depression severity and a binary TRD measure defined as failure to respond to more than two adequate treatment attempts (TRD_&gt;2AT). We included 105,808 adults (≥18 years) diagnosed with MDD in Danish hospital settings between 2015 and 2022. MSM stage, TRD_&gt;2AT status, and depression severity were derived from hospital and primary care contacts, as well as prescription and hospital medication records.</div><div>According to the adapted MSM, most patients were classified as having moderate TRD (63.4%). The MSM classification closely aligned with TRD_&gt;2AT, as 0.6% of patients with mild MSM scores and 86.7% of patients with severe MSM scores fulfilled the TRD_&gt;2AT criterion. In contrast, the association between MSM and depression severity was less pronounced.</div><div>These findings indicate that the MSM is feasible to adapt for Danish register data. However, predictive validation of the register adaptation against clinical outcomes remains a necessary next step.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"25 ","pages":"Article 101144"},"PeriodicalIF":3.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148737733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}