Depression and Anxiety最新文献

{"title":"Autistic Traits and Social Anxiety in Chinese College Students: The Longitudinal Mediating Role of Rumination","authors":"Lulu Hou,&nbsp;Wendian Shi","doi":"10.1155/da/6103362","DOIUrl":"https://doi.org/10.1155/da/6103362","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Autistic traits (ATs) and social anxiety (SA) are closely associated; however, few studies have investigated the potential mediating mechanism of this relationship using longitudinal data. This study examined: (1) the developmental trajectories of ATs, rumination, and SA among college students; (2) whether the baseline levels of ATs predicted the developmental trajectories of SA; and (3) whether the trajectories of rumination mediated this longitudinal association.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study enrolled 397 college students to complete Broad Autism Phenotype Questionnaire, Discriminative Response Scale, and SA Disorder Dimension three times over the course of a year. Three unconditional latent growth models (LGMs) were first used to explore the trajectories of ATs, rumination, and SA, respectively. Then, a conditional LGM was used to examine the direct longitudinal association between ATs and SA. Finally, a structural equation model was further used to examine the longitudinal mediating role of rumination between ATs and SA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For college students, ATs remained relatively stable, whereas rumination and SA declined across the study period. Furthermore, ATs positively predicted the intercept of SA (<i>β</i> = 0.66, <i>p</i> &lt; 0.001), and negatively predicted the slope of SA (<i>β</i> = −0.29, <i>p</i> &lt; 0.001). More importantly, higher baseline levels of rumination mediated ATs on the baseline value of SA (0.14, 95% confidence interval [CI] [0.08 0.22]), and slower rates of decline of rumination mediated ATs on the change in SA (−0.15, 95% CI [−0.46 −0.01]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These results indicate that college is a critical period for the abatement of rumination and SA. Furthermore, rumination might be one of the mechanisms underlying the link between ATs and SA. Interventions to prevent the negative impact of ATs might help to decrease the risk of rumination and SA in the college students.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2025 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/da/6103362","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223940","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":"Interrelationships Among Personality Traits, Depressive Symptoms, Childhood Abuse, and Social Disability","authors":"Zizhao Feng,&nbsp;Jia Zhou,&nbsp;Rui Liu,&nbsp;Le Xiao,&nbsp;Yuan Feng,&nbsp;Ruinan Li,&nbsp;Xiaoya Li,&nbsp;Xueshan Zhang,&nbsp;Jing Liu,&nbsp;Gang Wang,&nbsp;Jingjing Zhou","doi":"10.1155/da/2250192","DOIUrl":"https://doi.org/10.1155/da/2250192","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Personality traits and childhood abuse were found to be associated with depressive symptoms and with each other. However, no previous study has elucidated the directional interrelationship among those factors in a clinical population of patients with major depressive disorder (MDD). This study sought to construct networks to explicate the directional interrelationship among those factors and social disability, identify the most central factor, and explore potentially existing causality chains implied by the directed association chains.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This cross-sectional study analyzed data from 1445 patients with MDD in a national cohort. Personality traits were measured using the Eysenck Personality Questionnaire-Revised Short Scale for Chinese (EPQ-RSC). Seven dimensions of depressive symptoms were measured with various scales: depression, anxiety, insomnia, and somatic symptoms with the 17-item Hamilton Depression Rating Scale (HAMD-17), the loss of pleasure sensation with the Snaith-Hamilton Pleasure Scale (SHAPS), apathy with the Modified Apathy Evaluation Scale (MAES), and fatigue with the Chalder Fatigue Scale (CFS-11). Childhood abuse experience was measured using the Childhood Trauma Questionnaire-Short Form (CTQ-SF). Social disability was measured with the Sheehan Disability Scale (SDS). Undirected and Bayesian network analyses were used to identify central factors and explore directional interrelationships among the variables.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The loss of pleasure sensation was the most central in terms of strength and closeness. In the directed acyclic graph (DAG) derived from the Bayesian network analysis, psychoticism was positioned at the highest level in the model, suggesting its causal precedence. One key directed association chain, which implied a potentially existing causality chain, was that psychoticism predicted the loss of pleasure sensation, and this symptom predicted social disability.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Loss of pleasure sensation and psychoticism might be important for future research in MDD. The appearance of psychoticism at the beginning of the directed association chain (which implied a potentially existing causality chain) involving the central factor and the characteristics of high psychoticism implied that the social/interpersonal component of the loss of pleasure sensation may be a meaningful focus of future research and intervention of MDD.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;sec","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2025 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/da/2250192","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223941","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 Association Between Age at First Live Birth and Depression: Results From NHANES 2005–2018","authors":"Ali Kolahdooz,&nbsp;Fatemeh Movahed,&nbsp;Mohsen Yousefi,&nbsp;Amirhossein Salehi,&nbsp;Saba Goodarzi,&nbsp;Arman Shafiee","doi":"10.1155/da/6614889","DOIUrl":"https://doi.org/10.1155/da/6614889","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This cross-sectional study, utilizing National Health and Nutritional Examination Surveys (NHANESs) data from 2005 to 2018, examines the association between age at first live birth and depression among women aged 12 years or older.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data encompassed 10,399 participants, with 1260 exhibiting depressive symptoms. The 9-item Patient Health Questionnaire (PHQ-9) assessed depression. Age at first live birth was categorized as &lt;18, 18–25, and &gt;25.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Women with depressive symptoms were more likely to be single, have lower incomes and education levels, be smokers, and exhibit higher body mass indexes (BMIs) or sleep disorders. Younger age at first live birth correlated with higher depression prevalence. Univariate analysis shows decreased depression chances for women with first live births at 18–25 (47% decrease) or &gt;25 (76% decrease), with an 11% reduction for every year increase in age at first birth. Multivariate analyses confirm a significant association between age at first live birth and depression, even after adjusting for various factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study underscores the association between age at first live birth and depression, highlighting the need for considering reproductive history in mental health assessments. The findings emphasize the multifaceted nature of this relationship, demonstrating the impact of sociodemographic and lifestyle factors on mental health outcomes among women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2025 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/da/6614889","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224490","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":"Differential Anxiety–Depression–CRP Network Structures Across Insomnia Severity Levels: Evidence From UK Biobank","authors":"Xue Luo,&nbsp;Shuqiong Zheng,&nbsp;Yihong Cheng,&nbsp;Shuai Liu,&nbsp;Shufei Zeng,&nbsp;Leqin Fang,&nbsp;Shixu Du,&nbsp;Weimin Li,&nbsp;Hangyi Yang,&nbsp;Zhiting Huang,&nbsp;Bin Zhang","doi":"10.1155/da/8836588","DOIUrl":"https://doi.org/10.1155/da/8836588","url":null,"abstract":"<p><b>Background:</b> This study investigated the relationships between anxiety, depression symptoms, and C-reactive protein (CRP) across insomnia severity levels using network analysis and examined the structural differences within these networks.</p><p><b>Methods:</b> Gaussian graphical model network analysis with Least Absolute Shrinkage and Selection Operator (LASSO) regularization was conducted on UK Biobank data (<i>N</i> = 143,027). Depression and anxiety symptoms were assessed using the 9-item Patient Health Questionnaire (PHQ-9) and 7-item Generalized Anxiety Disorder Scale (GAD-7), respectively. CRP was quantified using immunoturbidimetric-high-sensitivity analysis. Participants were categorized by insomnia frequency (never/rarely, sometimes, and usually). The strength symptoms and expected influence identified core symptoms, while bridge expected influence (bridge EI) determined bridge symptoms. Network comparison tests (NCTs) were performed pairwise across the three groups to assess differences in global strength and edge weights.</p><p><b>Results:</b> Across all networks, “Depressed mood” demonstrated the highest strength centrality, while “Irritability” exhibited the highest bridge EI. “Depressed mood” had the highest expected influence centrality in the never/rarely insomnia group and “Uncontrollable worry” in other groups. NCTs revealed significant differences in global strength (<i>S</i> = 0.178, <i>p</i> &lt; 0.01) and edge weights (<i>M</i> = 0.062, <i>p</i> &lt; 0.01) between the never/rarely and usually insomnia groups, with stronger connections between depressive symptoms (energy/appetite) and CRP in the usually insomnia group (<i>p</i> &lt; 0.001).</p><p><b>Conclusions:</b> The central roles of depressed mood, uncontrollable worry, and irritability in the anxiety–depression–CRP network across all insomnia severity groups suggest that these symptoms represent potential targets for future intervention research. Notably, network structure differed across insomnia severity; the strengthened associations between depressive symptoms and CRP in the usually insomnia group suggest that insomnia severity may be an important factor to consider in understanding the relationships between affective and inflammatory processes.</p>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2025 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/da/8836588","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146763","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":"Development and Validation of the Schedule for the Assessment of Insight in Anxiety Disorders (SAI-A)","authors":"Asala Halaj,&nbsp;Jonathan D. Huppert,&nbsp;George Konstantakopoulos,&nbsp;Anthony S. David","doi":"10.1155/da/8843975","DOIUrl":"https://doi.org/10.1155/da/8843975","url":null,"abstract":"<p>There is a growing interest in understanding insight or illness awareness in anxiety; however, most assessment instruments were designed for psychosis. The unique features of anxiety highlight the need for tailored measures to accurately evaluate insight. The aim of this study was to develop and validate the Schedule for the Assessment of Insight in Anxiety (SAI-A), a clinician-rated scale for assessing insight in anxiety disorders. We interviewed 46 participants diagnosed with anxiety disorders, conducted SAI-A interviews, and administered self-report measures. Using correlation and principal component analysis (PCA), we identified and assessed scale components, ensuring their reliability and consistency. The SAI-A demonstrated acceptable psychometric properties, including convergent validity with an established self-report measure (<i>r</i> = −0.39, <i>p</i> = 0.008) and internal consistency (Cronbach’s α = 0.70). It showed moderate to strong agreement, interrater reliability (weighted kappa = 0.53, intraclass correlation coefficient [ICC] = 0.67), and test–retest reliability (ICC = 0.65). Two distinct insight components emerged: awareness of disorder and need for treatment. Higher overall SAI-A scores correlated with symptom severity and impairment (<i>r</i> = 0.56, <i>r</i> = 0.51, <i>p</i> &lt; 0.001, respectively) and medication usage. The SAI-A is a valid and reliable assessment tool, providing a comprehensive framework for understanding and addressing insight in the context of anxiety disorders.</p>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2025 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/da/8843975","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146405","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":"Layer-Wise Relevance Propagation Approach for Diagnosis of Drug-Naïve Men With Major Depressive Disorder Using Resting-State Electroencephalography","authors":"Eun-Gyoung Yi,&nbsp;Miseon Shim,&nbsp;Seung-Hwan Lee,&nbsp;Han-Jeong Hwang","doi":"10.1155/da/5512539","DOIUrl":"https://doi.org/10.1155/da/5512539","url":null,"abstract":"<p>The advancement of artificial intelligence (AI) tools utilizing electroencephalography (EEG) for diagnosing major depressive disorder (MDD) has shown significant progress. However, the practical implementation of these tools is often impeded by the large amount of EEG data required for training AI models and the lack of explanations for the MDD diagnoses. This study aims to develop an interpretable deep-learning-based computer-aided diagnostic system for diagnosing male MDD patients using explainable AI (XAI) algorithms. The CAD system was designed to facilitate the diagnostic process by using a reduced number of EEG channels and data length while enhancing understanding of the neurophysiological characteristics of male MDD. Resting-state EEG data were collected from 40 male MDD patients (20–63 years) and 41 gender-matched healthy controls (HCs, 19–61 years). A shallow convolutional neural network (CNN; Shallow ConvNet) model was utilized to distinguish between MDD patients and HCs. Relevance scores were extracted by the layer-wise relevance propagation (LRP) method, integrated with the Shallow ConvNet, to interpret the outcomes of the deep-learning-based CAD system. Additionally, changes in diagnostic performance were assessed by progressively reducing the number of channels using an LRP-based channel selection method, as well as EEG data length. Our XAI-based CAD system showed a high diagnostic performance of 100% when using the whole 62 channels with 180-s EEG data. A relatively high diagnostic performance over 90% was retained with only five channels with 60-s EEG data. Neurophysiologically meaningful brain areas, such as fronto-central, centro-parietal, and occipital areas, also revealed significant differences in relevance scores extracted by the LRP-method between the two groups. This study successfully developed a high performance and practical XAI-based CAD system for male MDD patients. Our developed CAD system not only achieves high diagnostic accuracy but also provides meaningful neurophysiological biomarkers for male MDD patients.</p>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2025 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/da/5512539","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172014","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":"Bidirectional Association Between Internet Use and Depressive Symptoms Among Middle-Aged and Older Adults in China: A Cross-Lagged Model of Proactive Health Behavior as the Mediating Role","authors":"Zhibin Li,&nbsp;Huijun Liu","doi":"10.1155/da/9391682","DOIUrl":"https://doi.org/10.1155/da/9391682","url":null,"abstract":"<p><b>Objectives:</b> The present study aimed to examine the bidirectional relationship between internet use and depressive symptoms among middle-aged and older adults. Moreover, it explored whether proactive health behavior mediates the association between internet use and depressive symptoms.</p><p><b>Methods:</b> We used the latest three-wave data (2015, 2018, and 2020) from the China Health and Retirement Longitudinal Study (CHARLS), which included 11,332 participants aged 45 years and older. The bidirectional relationship between internet use and depressive symptoms was examined using a cross-lagged model. The mediating role of proactive health behavior was also investigated using a cross-lagged mediation model.</p><p><b>Results:</b> Cross-lagged models indicated reciprocal effects between depressive symptoms and internet use. Internet use had a greater impact on subsequent depressive symptoms than vice versa. Mediation analyses further revealed that proactive health behavior significantly mediated the path from internet use to depressive symptoms. Furthermore, subgroup analyses showed these effects were not significantly heterogeneous in subgroups by age and chronic disease status.</p><p><b>Conclusions:</b> This study sheds light on the direction of the association between internet use and depressive symptoms. Internet use could reduce depressive symptoms among middle-aged and older adults by enhancing proactive health behavior.</p>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2025 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/da/9391682","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111342","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":"Extent of Anxiety Among Married Women in Bangladesh and its Potential Predictors: A Nation-Wide Cross-Sectional Study","authors":"Mortuja Mahamud Tohan,&nbsp;Sayeeda Zaman,&nbsp;Paumpy Paul,&nbsp;Nasrin Sultana,&nbsp;Abu Sadat Nurullah,&nbsp;Md. Ashfikur Rahman","doi":"10.1155/da/7415491","DOIUrl":"https://doi.org/10.1155/da/7415491","url":null,"abstract":"<p>Anxiety is a significant mental health challenge for women of reproductive age worldwide, often contributing to broader psychological issues. However, research on anxiety prevalence among this demographic, particularly in Bangladesh, remains limited. This study addresses this gap by identifying potential predictors of anxiety among married women in Bangladesh. Using data from the nationally representative Bangladesh Demographic and Health Survey (BDHS) 2022, the generalized anxiety disorder (GAD-7) scale was employed to assess anxiety levels. Descriptive and inferential statistical analyses, including one-way ANOVA and stepwise multiple regression, were conducted to identify key predictors. The findings reveal that 25.8% of married women in Bangladesh experience mild to severe anxiety, with 4.1% reporting moderate to severe anxiety. A six-factor model derived from stepwise multiple regression explained 17.3% of the variance in anxiety levels. The most significant predictor was a history of terminated pregnancy, accounting for 6.8% of the variance (<i>R</i>² change = 0.068; <i>p</i> ≤ 0.001). Other notable predictors included pressure from spouses or family members (<i>R</i>² change = 0.038; <i>p</i> ≤ 0.001), educational status (<i>R</i>² change = 0.028; <i>p</i> &lt; 0.001), religion (<i>R</i>² change = 0.019.; <i>p</i> = 0.018), continuation of education after marriage (<i>R</i>² change = 0.012; <i>p</i> = 0.030), and husband’s educational attainment (<i>R</i>² change = 0.007; <i>p</i> = 0.033). Additional factors such as employment after marriage, age at first sexual intercourse, and wealth status also played significant roles. The study highlights the substantial prevalence of anxiety among married women in Bangladesh, emphasizing the influence of socioeconomic along with other potential factors. Further research is needed to develop targeted interventions addressing socioeconomic and behavioral determinants, ensuring the mental well-being of married women.</p>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2025 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/da/7415491","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111363","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":"A Systematic Review of Factors Associated With Treatment Engagement and Outcome for Women in the Perinatal Period Receiving Individual Cognitive Behavioral Therapy (CBT) for Depression, Anxiety, and Trauma-Related Disorders","authors":"Natalie A. Simon,&nbsp;Jenna Evans,&nbsp;Darcy Bispham,&nbsp;Ffion Williams,&nbsp;Jonathan Jones,&nbsp;Neil P. Roberts,&nbsp;Cerith S. Waters","doi":"10.1155/da/3698331","DOIUrl":"https://doi.org/10.1155/da/3698331","url":null,"abstract":"<p>Depression, anxiety, and trauma-related disorders commonly occur in the perinatal period, with high rates of comorbidity, and potentially adverse outcomes for women and children. Cognitive behavioral therapy (CBT) is an effective treatment, however less than half of new mothers experiencing symptoms seek treatment. This review was focused on factors affecting treatment engagement and outcome in a clinical perinatal population. A mixed-methods systematic review was conducted according to Cochrane Collaboration Guidelines. We included randomized controlled trials (RCTs) of individual CBT where at least 70% of women met diagnostic criteria for depression, anxiety, or trauma-related disorders during the perinatal period. Information on, and factors associated with treatment engagement, satisfaction, therapeutic alliance were examined as risk ratios (RRs). Twenty-eight studies relating to 19 RCTs, with 2557 participants were reviewed. Most studies examined CBT adapted to the perinatal context. Engagement was good overall, and high levels of satisfaction and therapeutic alliance were reported. A relationship was demonstrated between engagement and outcome in three studies. Dropout did not differ for studies of CBT compared to treatment as usual (TAU), but there was greater dropout for CBT across four studies where the guiding therapist/coach had a minimal level of psychological therapy training and qualifications (<i>k</i> = 4; <i>n</i> = 675; RR 2.38; CI 1.17–4.83). Findings indicate the importance of engagement, which may be optimized by adapting CBT to be relevant to the unique challenges faced by women in the perinatal period, and through therapeutic provision from therapists with at least a moderate amount of psychological therapy training and qualifications.</p>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2025 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/da/3698331","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145101799","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":"Pathways Linking Parental Social Support and Decision-Making Participation to Medication Adherence in Children With Epilepsy: The Moderating Role of Parental Anxiety","authors":"Chunsong Yang,&nbsp;Rui Huang,&nbsp;Qiuji Tao,&nbsp;Zilong Hao,&nbsp;Li Zhao,&nbsp;Lingli Zhang","doi":"10.1155/da/7159579","DOIUrl":"https://doi.org/10.1155/da/7159579","url":null,"abstract":"<p><b>Background:</b> Medication adherence among pediatric epilepsy patients is frequently suboptimal, and the complex interplay between parental social support, decision-making participation, treatment satisfaction, and parental anxiety in influencing medication adherence remains underexplored. This study investigates both the direct and indirect pathways linking these factors to medication adherence and examines the mediating role of treatment satisfaction and the moderating role of parental anxiety.</p><p><b>Methods:</b> A cross-sectional study was conducted at three medical institutions between January 2020 and June 2024. Data on patient demographics and standardized scales measuring medication adherence, social support, communication and decision-making participation, treatment satisfaction, and parental anxiety were collected. Relationships among these variables were analyzed using structural equation modeling (SEM) and moderation analysis.</p><p><b>Results:</b> A total of 1056 patients were included in the study, with a mean age of 8.86 ± 3.99 years; 51.7% were male. Path analysis showed that parental social support (STD = 0.344, <i>p</i>  &lt; 0.001), communication and decision-making participation (STD = 0.392, <i>p</i>  &lt; 0.001), and treatment satisfaction (STD = 0.090, <i>p</i>  &lt; 0.05) had significant positive effects on medication adherence. Parental social support (STD = 0.483, <i>p</i>  &lt; 0.001) and communication and decision-making participation (STD = 0.203, <i>p</i>  &lt; 0.001) also strongly influenced treatment satisfaction. The indirect effects of social support and decision-making participation on medication adherence, mediated through treatment satisfaction, were statistically significant (<i>p</i>  &lt; 0.05). Parental anxiety, as a moderating factor, weakened the positive effects of social support, decision-making participation, and treatment satisfaction on medication adherence (<i>p</i>  &lt; 0.05).</p><p><b>Conclusion:</b> This study systematically develops an integrated model linking parental social support, communication and decision-making participation, treatment satisfaction, and anxiety to medication adherence in pediatric epilepsy. It highlights the mediating role of treatment satisfaction and the moderating role of parental anxiety. Enhancing parental social support and communication, improving treatment satisfaction, and addressing parental anxiety are key strategies to promote medication adherence.</p>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2025 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/da/7159579","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145101693","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}