BMC Psychiatry最新文献

{"title":"Association between Weight-Adjusted Waist Index and Depression in NAFLD: the modulating roles of sex and BMI.","authors":"Jingwen Zhang, Yan Wang, Sunkui Ke, Tianyu Xie, Lijun Liu, Xiaoyu Fu, Chenhao Wang, Xiao Huang","doi":"10.1186/s12888-024-06308-8","DOIUrl":"https://doi.org/10.1186/s12888-024-06308-8","url":null,"abstract":"<p><strong>Background: </strong>The Weight-Adjusted Waist Index (WWI) is a novel indicator of obesity that accurately reflects body composition. However, the association between WWI and depression in patients with non-alcoholic fatty liver disease (NAFLD) remains unclear. This study aims to explore this relationship through a nationally representative cross-sectional analysis.</p><p><strong>Methods: </strong>This study included adult participants diagnosed with NAFLD from NHANES 2017-2020. WWI was calculated as the waist circumference (cm) divided by the square root of body weight (kg). NAFLD diagnosis relied on vibration-controlled transient elastography (VCTE) with a controlled attenuation parameter (CAP) exceeding 248 dB/m to indicate hepatic steatosis. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9), with scores ≥ 10 indicating the presence of major depression.</p><p><strong>Results: </strong>After adjusting for all covariates, a significant positive association was found between WWI and depression in NAFLD (OR = 1.725, 95% CI: 1.442-2.063, p < 0.00001), with a dose-response relationship indicated by restricted cubic spline analysis. The association was stronger in men and lean/normal weight NAFLD patients. Adjusting further for BMI did not alter these findings (OR = 1.643, 95% CI: 1.357-1.989, p < 0.00001). BMI's association with depression was negated after adjusting for WWI.</p><p><strong>Conclusions: </strong>WWI had a positive association with depression in NAFLD, independent of BMI. This association was more pronounced in men and lean/normal weight NAFLD. These findings suggest that WWI may be a novel indicator of depression in NAFLD and potentially valuable in depression prevention.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"838"},"PeriodicalIF":3.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680583","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 moderating role of COMT gene rs4680 polymorphism between maladaptive metacognitive beliefs and negative symptoms in patients with schizophrenia.","authors":"Feten Fekih-Romdhane, Georges Kerbage, Nagham Hachem, Michelle El Murr, Georges Haddad, Alexandre Andrade Loch, Rony Abou Khalil, Elissar El Hayek, Souheil Hallit","doi":"10.1186/s12888-024-06275-0","DOIUrl":"https://doi.org/10.1186/s12888-024-06275-0","url":null,"abstract":"<p><strong>Background: </strong>Although the positive association between impairments in metacognitive capacity and negative symptoms in people with schizophrenia spectrum disorders is widely evidenced in the literature, the explaining mechanisms of this association are still less known and poorly understood. This study aims to bridge this knowledge gap by testing the hypothesis that COMT rs4680 variants will act as moderators in the relationship between certain metacognitive domains and negative symptoms' severity.</p><p><strong>Method: </strong>A cross-sectional study was carried-out during the period between February and March 2024. A total of 115 biologically unrelated Arab (Lebanese) patients with schizophrenia were included.</p><p><strong>Results: </strong>After controlling for sex and duration of illness as a potential confounder, moderation analyses showed that the AG genotype of the COMT rs4680 served as a significant moderator between maladaptive metacognitive beliefs about cognitive confidence (i.e. lack of confidence in memory) and negative symptoms. In non-carriers of the COMT rs4680 AG genotype, lower cognitive confidence (i.e., more \"lack of cognitive confidence\") is significantly associated with greater negative symptoms.</p><p><strong>Conclusion: </strong>Findings suggest that metacognition may be a relevant treatment target in the management of negative symptoms particularly in non-carriers of the COMT rs4680 AG genotype. Therefore, genetic testing could potentially be used to match patients with metacognitive interventions that are more likely to be effective in supporting recovery from negative symptoms.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"831"},"PeriodicalIF":3.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680771","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":"Regional homogeneity patterns reveal the genetic and neurobiological basis of State-Trait Anxiety.","authors":"Yuanhao Li, Su Yan, Jia Li, Yuanyuan Qin, Li Li, Nanxi Shen, Yan Xie, Dong Liu, Jicheng Fang, Tian Tian, Wenzhen Zhu","doi":"10.1186/s12888-024-06291-0","DOIUrl":"https://doi.org/10.1186/s12888-024-06291-0","url":null,"abstract":"<p><strong>Objective: </strong>State anxiety and trait anxiety are differentially mapped in brain function. However, the genetic and neurobiological basis of anxiety-related functional changes remain largely unknown.</p><p><strong>Methods: </strong>Participants aged 18-30 from the community underwent resting-state fMRI and were assessed with the State-Trait Anxiety Inventory. Using a general linear regression model, we analyzed the effects of state and trait anxiety, as well as their sum and difference (delta), on regional homogeneity (ReHo) in cortical areas. ReHo patterns denote the spatial distribution of ReHo associated with anxiety scores. We further explored the spatial correlations between ReHo patterns and neuromaps, including gene expression, neurotransmitter receptor density, myelination, and functional connectivity gradients, to elucidate the genetic and molecular substrates of these ReHo patterns.</p><p><strong>Results: </strong>Our findings demonstrated robust spatial correlations between whole-brain ReHo patterns for state and trait anxiety, with trait anxiety and the delta value exhibiting stronger network correlations, notably in the dorsal attention, salience, visual, and sensorimotor networks. Genes highly correlated with ReHo patterns exhibited unique spatiotemporal expression patterns, involvement in oxidative stress, metabolism, and response to stimuli, and were expressed in specific cell types. Furthermore, ReHo patterns significantly correlated with neuromaps of neurotransmitter receptor density, myelination, and functional connectivity gradients.</p><p><strong>Conclusions: </strong>The ReHo patterns associated with anxiety may be driven by genetic and neurobiological traits. Our findings contribute to a deeper understanding of the pathogenesis of anxiety from a genetic and molecular perspective.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"837"},"PeriodicalIF":3.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680767","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":"Differences of regional homogeneity and cognitive function between psychotic depression and drug-naïve schizophrenia.","authors":"Wensheng Chen, Caixia Xu, Weibin Wu, Wenxuan Li, Wei Huang, Zhijian Li, Xiaoling Li, Guojun Xie, Xuesong Li, Chunguo Zhang, Jiaquan Liang","doi":"10.1186/s12888-024-06283-0","DOIUrl":"https://doi.org/10.1186/s12888-024-06283-0","url":null,"abstract":"<p><strong>Background: </strong>Psychotic depression (PD) and schizophrenia (SCZ) share overlapping symptoms yet differ in etiology, progression, and treatment approaches. Differentiating these disorders through symptom-based diagnosis is challenging, emphasizing the need for a clearer understanding of their distinct cognitive and neural mechanisms.</p><p><strong>Aim: </strong>This study aims to compare cognitive impairments and brain functional activities in PD and SCZ to pinpoint distinguishing characteristics of each disorder.</p><p><strong>Methods: </strong>We evaluated cognitive function in 42 PD and 30 SCZ patients using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and resting-state functional magnetic resonance imaging (rs-fMRI). Regional homogeneity (ReHo) values were derived from rs-fMRI data, and group differences in RBANS scores were analyzed. Additionally, Pearson correlation analysis was performed to assess the relationship between cognitive domains and brain functional metrics.</p><p><strong>Results: </strong>(1) The SCZ group showed significantly lower RBANS scores than the PD group across all cognitive domains, particularly in visuospatial/constructional ability and delayed memory (p < 0.05); (2) The SCZ group exhibited a significantly higher ReHo value in the left precuneus compared to the PD group (p < 0.05); (3) A negative correlation was observed between visuospatial construction, delayed memory scores, and the ReHo value of the left precuneus.</p><p><strong>Conclusion: </strong>Cognitive impairment is more pronounced in SCZ than in PD, with marked deficits in visuospatial and memory domains. Enhanced left precuneus activity further differentiates SCZ from PD and correlates with cognitive impairments in both disorders, providing neuroimaging-based evidence to aid differential diagnosis and insights into cognitive dysfunction mechanisms, while also paving a clearer path for psychiatric research.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"835"},"PeriodicalIF":3.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between alcohol drinking frequency and depression among adults in the United States: a cross-sectional study.","authors":"Peng Qi, Mengjie Huang, Haiyan Zhu","doi":"10.1186/s12888-024-06296-9","DOIUrl":"https://doi.org/10.1186/s12888-024-06296-9","url":null,"abstract":"<p><strong>Background: </strong>Depression is a major contributor to the global burden of diseases, and alcohol intake is often considered to be associated with depression. However, the relationship between alcohol drinking frequency and depression remains unclear. This study aims to explore the association between alcohol drinking frequency and depression.</p><p><strong>Methods: </strong>This study collected NHANES data from 2009 to 2016, involving 17,466 participants. Depression was diagnosed based on the Patient Health Questionnaire-9 (PHQ-9), and alcohol drinking frequency was collected through questionnaire surveys. Multifactorial logistic regression models, subgroup analysis, smooth curve fitting, and threshold effect analysis were used to investigate the relationship between alcohol drinking frequency and depression.</p><p><strong>Results: </strong>We divided the alcohol drinking frequency into five groups on average. After adjusting for all covariates, the Q3 group had the lowest odds of depression (OR = 0.68; 95% CI: 0.56 ~ 0.82; p < 0.05). Through smooth curve fitting, we found an \"M-shaped\" relationship between alcohol drinking frequency and depression. Further threshold effect analysis revealed that the most significant inflection points were 80 and 150.</p><p><strong>Conclusion: </strong>In this cross-sectional study of American adults, we found an \"M-shaped\" relationship between alcohol drinking frequency and depression, which may partially explain the different effects of moderate alcohol consumption on depression.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"836"},"PeriodicalIF":3.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680579","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 relationship between climate change and mental health: a systematic review of the association between eco-anxiety, psychological distress, and symptoms of major affective disorders.","authors":"Suzanne M Cosh, Rosie Ryan, Kaii Fallander, Kylie Robinson, Josephine Tognela, Phillip J Tully, Amy D Lykins","doi":"10.1186/s12888-024-06274-1","DOIUrl":"https://doi.org/10.1186/s12888-024-06274-1","url":null,"abstract":"<p><strong>Background and objectives: </strong>The adverse impacts of climate change on mental health is a burgeoning area, although findings are inconsistent. The emerging concept of eco-anxiety represents distress in relation to climate change and may be related to mental health. The aim of this study was to explore the relationship between eco-anxiety with validated mental health outcomes, specifically psychological distress and symptoms of major affective disorders.</p><p><strong>Design: </strong>Systematic review.</p><p><strong>Methods: </strong>EBSCO, ProQuest, and Web of Science databases were searched to February 2024 for studies of adult samples quantifying eco-anxiety (exposure, i.e. fear, worry or anxiety in relation to climate change) and symptoms of psychological distress and major affective disorders (outcomes), as assessed by validated measures.</p><p><strong>Results: </strong>Full text review of 83 studies was performed, and k = 35 studies were included in the review (N = 45 667, 61% female, M_age 31.2 years). Consistently, eco-anxiety showed small to large positive correlations with mental health outcomes of psychological distress, depression symptoms, anxiety symptoms, and stress symptoms. However, results regarding post-traumatic stress disorder symptoms and pathological worry were mixed. Stronger associations were observed where eco-anxiety was operationalised as 'anxiety' rather than 'worry'.</p><p><strong>Conclusions: </strong>Findings underscore that eco-anxiety is related to psychological burden. Greater consideration of eco-anxiety in assessment and treatment is needed in clinical practice and further policy development is warranted at the intersection of climate and health to address the mental health challenges posed by climate change.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"833"},"PeriodicalIF":3.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680773","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 cross-section study of the comparison of plasma inflammatory cytokines and short-chain fatty acid in patients with depression and schizophrenia.","authors":"Huan Yu, Rui Li, Xue-Jun Liang, Wen-Mao Yang, Lin Guo, Ling Liu, Qing-Rong R Tan, Zheng-Wu Peng","doi":"10.1186/s12888-024-06277-y","DOIUrl":"https://doi.org/10.1186/s12888-024-06277-y","url":null,"abstract":"<p><strong>Background: </strong>Major depressive disorder (MDD) and schizophrenia (SCH) are common and severe mental disorders that are mainly diagnosed depending on the subjective identification by psychiatrists. Finding potential objective biomarkers that can distinguish these two diseases is still meaningful.</p><p><strong>Methods: </strong>In the present study, we investigate the differences in plasma inflammatory cytokines and short-chain fatty acids (SCFAs) among patients with MDD (n = 24) and SCH (n = 24), and gender- and age-matched healthy controls (HC, n = 27) and identify potential plasma biomarkers.</p><p><strong>Results: </strong>We found that the concentrations of pro-inflammatory cytokines were increased, whereas the anti-inflammatory cytokines were decreased in both MDD and SCH. Meanwhile, except for an increase in 4-Methylvaleric acid, other SCFAs with statistical differences were reduced in both MDD and SCH. Moreover, potential biomarker panels were developed that can effectively discriminate MDD from HC (AUC = 0.997), SCH from HC (AUC = 0.999), and from each other (MDD from SCH, AUC = 0.983).</p><p><strong>Conclusions: </strong>These data suggest that alterations in plasma cytokines and SCFAs might be one of the potential features for distinguishing MDD and SCH.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry: ChiCTR2100051243, registration date: 2021/09/16.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"834"},"PeriodicalIF":3.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680575","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":"Improvement of persistent impairments in executive functions and attention following electroconvulsive therapy in a case control longitudinal follow up study.","authors":"Åsa Hammar, Eivind Haga Ronold, Malene Alden Spurkeland, Rita Ueland, Ute Kessler, Ketil J Oedegaard, Leif Oltedal","doi":"10.1186/s12888-024-06270-5","DOIUrl":"https://doi.org/10.1186/s12888-024-06270-5","url":null,"abstract":"<p><strong>Background: </strong>How cognition is influenced by electroconvulsive treatment (ECT) and major depressive disorder (MDD) is still debated. The development and etiology of neurocognitive impairment in MDD were examined by investigating the cognitive profile following ECT related to the state, scar, and trait perspectives, with the former predicting improvements parallel with depressive symptoms, while the two latter expected persisting impairments. Executive functions (EF) and attention are central to cognition and alterations in these functions could influence other domains like memory. The main aims of the present study were to examine the short and long-term effects of ECT on EF and attention in patients with major depressive disorder by exploiting the rapid antidepressant effect of this treatment.</p><p><strong>Methods: </strong>A case-control longitudinal follow-up design was used to investigate the effects of unilateral brief-pulse ECT on EF and attention in patients with depression (n = 36) compared to untreated healthy controls (n = 16). EF and attention were measured pre-treatment, approximately two weeks, and six months post-treatment.</p><p><strong>Results: </strong>The patient group showed significantly worse performance on most tests compared to healthy controls pre-treatment, and no short- or long-term worsening of EF and attention following ECT was found. Significant improvement was identified in patients' attention, processing speed and inhibition after ECT.</p><p><strong>Conclusions: </strong>The present study showed that there was no cognitive worsening after ECT treatment. An improvement in several of the tests measuring inhibition, attention, and processing speed was parallel to symptom reduction, with the former showing associations to symptom change, suggesting state-related effects from improved mood. Still, the patient group performed significantly worse on most measures both pre-treatment and at the short and long-term follow-ups, indicating prevailing trait or scar effects on cognitive functions and potential lack of practice effects.</p><p><strong>Clinical trial number: </strong>NCT04348825 (14.04.20).</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"832"},"PeriodicalIF":3.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680760","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":"Addressing psychological resilience and its determinants among university students during the COVID-19 pandemic: a three-wave longitudinal study in Shandong Province, China.","authors":"Lutong Pan, Jingjing Zhao, Mingli Pang, Jieru Wang, Yue Zhou, Rui Chen, Hui Liu, Xixing Xu, Baochen Su, Limei Nie, Jiajia Zhao, Shixue Li, Jiajia Li, Hexian Li, Fanlei Kong","doi":"10.1186/s12888-024-06175-3","DOIUrl":"10.1186/s12888-024-06175-3","url":null,"abstract":"<p><strong>Background: </strong>The relationship between public health emergencies and psychological distress had been well known, yet none research had been conducted on the trend in psychological resilience and its longitudinal determinants during the pandemic. This study aimed to explore the changes of psychological resilience of university students during COVID-19 pandemic, and further clarify the longitudinal relationship between family factors, mental health, social mentality and psychological resilience.</p><p><strong>Methods: </strong>Questionnaires were distributed to students from five universities in Shandong Province, China during the COVID-19. A total of 1635 students were finally included in this three-wave follow-up study using stratified random sampling method. Mental health was assessed by Depression Anxiety Stress Scale, social mentality was measured by the Bi-Dimensional Structure Questionnaire of Social Mentality, psychological resilience was evaluated by the Chinese version of the Psychological Resilience Scale. Repeated-measures analysis of variance was used to analyze the longitudinal changes of psychological resilience, generalized estimating equation (GEE) was conducted to estimate the determinants of psychological resilience.</p><p><strong>Results: </strong>Psychological resilience changed from 28.37 in Wave 1, 29.10 in Wave 2, and 29.15 in Wave 3 among the university students. The students who majored in Art (β = 0.872, P = 0.032), parents (mother β = 0.546, P = 0.035; father β = 0.718, P = 0.012) had a greater influence on children's personality, and positive social mentality (β = 5.725, P < 0.001) were more likely to report a higher psychological resilience. Being female (β=-0.932, P < 0.001), not being a student leader (β=-0.911, P < 0.001), being anxious (β=-1.845, P < 0.001) and depressed (β=-1.846, P < 0.001), and negative social mentality (β=-0.803, P < 0.001) were less likely to report a higher psychological resilience.</p><p><strong>Conclusions: </strong>The psychological resilience of the university students in Shandong Province, China increased significantly from Wave 1 to Wave 3 during the COVID-19 pandemic. Majoring in Art, parents having a greater influence on children's personality, better mental health, positive social mentality were more likely to report a higher psychological resilience, while female, not student leader, worse mental health, and negative social mentality were less likely to report a higher the psychological resilience.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"823"},"PeriodicalIF":3.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675012","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 personal sensing technology enabled service versus a digital psychoeducation control for primary care patients with depression and anxiety: a pilot randomized controlled trial.","authors":"Colleen Stiles-Shields, Karen M Reyes, Tanvi Lakhtakia, Shannon R Smith, Olga E Barnas, Elizabeth L Gray, Charles J Krause, Kaylee P Kruzan, Mary J Kwasny, Zara Mir, Sameer Panjwani, Steven K Rothschild, Lisa Sánchez-Johnsen, Nathan W Winquist, Emily G Lattie, Nicholas B Allen, Madhu Reddy, David C Mohr","doi":"10.1186/s12888-024-06284-z","DOIUrl":"10.1186/s12888-024-06284-z","url":null,"abstract":"<p><strong>Background: </strong>Technology-enabled services (TES; clinical services that include both technology-driven [e.g., personal sensing technologies] and person-powered support elements) may address gaps in depression and anxiety treatments in healthcare settings. The current study: (1) developed a TES tailored for Primary Care patients with depression and/or anxiety, and (2) conducted a pilot randomized controlled trial to assess the efficacy of the TES compared to a digital psychoeducation control app.</p><p><strong>Methods: </strong>Participants were randomized to either: (1) TES: the \"Vira\" smartphone app (Ksana Health Inc.), informed by behavioral activation and using passive sensing technology to provide behavioral \"insights\" and target behaviors associated with mental health symptoms, alongside lay-provider coaching, or (2) Control: the Mood Education mobile app (ME), containing static psychoeducational resources designed to target mental health symptoms. Both apps collected usage data. Participants completed assessments on depression (PHQ-9), anxiety (GAD-7), health-related quality of life (PedsQL), and engagement (TWEETs) at baseline, mid-treatment (week 4), end-of-treatment (week 8), and post-treatment (week 12).</p><p><strong>Results: </strong>Participants (N = 130) were randomized to receive either the TES (Vira; M_age= 30) or ME (M_age= 33). Linear mixed-effects models determined significant improvements in PHQ-9 and GAD-7 scores for participants across both conditions (ps < 0.001). There was no interactive effect of intervention and time for the PHQ-9 (p = .90) nor the GAD-7 (p = .49). Adjusting for baseline differences and randomization strata, TES participants reported a greater change in a quality of life rating of Physical Functioning (PedsQL) across time (p = .018). TES participants also reported higher levels of engagement and demonstrated higher app usage. However, adjusting for baseline symptom severity, neither app usage nor coach interaction frequency moderated outcomes (ps ≥ 0.2).</p><p><strong>Conclusions: </strong>While the TES demonstrated superior engagement, improvements in depressive and anxious symptoms for both conditions speak to the potential benefit of both TES and low-intensity psychoeducation treatments in care settings. Future research is needed to better understand which patients might differentially benefit from TESs and broader personal sensing technologies over low-intensity treatments.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05406791.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"24 1","pages":"828"},"PeriodicalIF":3.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675010","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}