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Prior research indicates that both structural and functional networks are compromised in older adults experiencing depressive symptoms. However, the potential impact of abnormal interactions between brain structure and function remains unclear. This study investigates alterations in structural–functional connectivity coupling (SFC) among older adults with depressive symptoms, and explores how these changes differ depending on the presence of physiological comorbidities.
Methods
We used multimodal neuroimaging data (dMRI/rs-fMRI) from 415 older adults with depressive symptoms and 415 age-matched normal controls. Subgroups were established within the depressive group based on the presence of hypertension, hyperlipidemia, diabetes, cerebrovascular disease, and sleep disorders. We examined group and subgroup differences in SFC and tracked its alterations in relation to symptom progression.
Results
Older adults with depressive symptoms showed significantly increased SFC in the ventral attention network compared with normal controls. Moreover, changes in SFC within the subcortical network, especially in the left amygdala, were closely linked to symptom progression. Subgroup analyses further revealed heterogeneity in SFC changes, with certain physiological health factors, such as metabolic diseases and sleep disorders, contributing to distinct neural mechanisms underlying depressive symptoms in this population.
Conclusions
This study identifies alterations in SFC related to depressive symptoms in older adults, primarily within the ventral attention and subcortical networks. Subgroup analyses highlight the heterogeneous SFC changes associated with metabolic diseases and sleep disorders. These findings highlight SFC may serve as potential markers for more personalized interventions, ultimately improving the clinical management of depression in older adults.
Previous research has suggested bidirectional relations between depressive symptoms and both internal and external core beliefs (self-esteem and optimism, respectively) in adolescence. However, little work has examined the cultural commonality versus specificity of these developmental pathways in adolescence across diverse contexts. To address this gap, the current study traced bidirectional associations among depressive symptoms and two forms of core beliefs (self-esteem and optimism) in adolescents from 12 cultural groups in nine countries. Longitudinal data were collected from 1,090 adolescents at ages 15 and 17. Significant associations emerged between age 15 depressive symptoms and both age 17 core beliefs across all cultural groups except Sweden. No significant associations between age 15 core beliefs and age 17 depressive symptoms were found in the multigroup model. However, the pathways from core beliefs to depressive symptoms and from depressive symptoms to core beliefs did not significantly differ in strength. These findings provide cross-cultural evidence for the scar theory (depressive symptoms → core beliefs), but no clear support for the vulnerability theory (core beliefs → depressive symptoms), perhaps due to the measurement and stability of depression. These findings have implications for understanding the adolescent development of psychopathology and cognitions, such as core beliefs, across diverse cultures.
Depression runs in families, with both genetic and environmental mechanisms contributing to intergenerational continuity, though these mechanisms have often been studied separately. This study examined the interplay between genetic and environmental influences in the intergenerational continuity of depressive symptoms from parents to offspring.
Methods
Using data from the Dutch TRAILS cohort (n = 2201), a prospective, genetically informed, multiple-generation study, we examined the association between parents’ self-reported depressive symptoms (reported at mean age of 41 years) and offspring depressive symptoms, self-reported nearly two decades later, in adulthood (mean age: 29 years). We assessed the role of genetic (polygenic scores for depressive symptoms in parents and offspring) and environmental mechanisms (parental warmth during adolescence) in explaining intergenerational continuity of depressive symptoms in separate and combined models.
Results
Parents’ depressive symptoms, offspring genetic predisposition, and parental warmth were associated with an increased risk of depressive symptoms in offspring. In the combined model, parents’ genetic predisposition was linked to their own depressive symptoms, which were linked to lower parental warmth, which, in turn, was linked to higher depressive symptoms in offspring, after accounting for offspring genetic predisposition, sex, age, and socioeconomic status.
Discussion
Both genetic and environmental mechanisms contribute to the intergenerational continuity of depressive symptoms independently and in interplay. Despite a significant effect, the influence of parental warmth was modest, suggesting limited covariation between this particular parenting measure and depressive symptoms, at least when assessed with large temporal distance.
Self-harm is widespread and often occurs in the community without resulting in hospital presentation. Individuals with depressive symptoms are at elevated risk. There are limited self-harm interventions designed for community and primary care settings. The Community Outpatient Psychological Engagement Service for Self-harm (COPESS) is a brief talking therapy intervention for self-harm based in community settings.
Aims
To assess the feasibility of evaluating the COPESS intervention in a community setting in relation to participant recruitment, retention, data collection and the acceptability of the intervention.
Method
We used a mixed-method approach and a single-blind randomised controlled trial design with 1:1 allocation to either COPESS plus treatment as usual or treatment as usual alone. Adults with depressive symptoms and self-harm in the past 6 months were recruited from general practices. Secondary outcome measures were assessed at baseline and 1 month, 2 months and 3 months after randomisation. The trial was pre-registered on clinicaltrials.gov (NCT04191122) on 9 December 2019.
Results
Fifty-five people were randomised (of an initial target of 60). Retention rates at follow-up assessments were high (>75%), as was attendance by all participants for all therapy sessions (93%). At 3 months, there were trends towards lower levels of self-harm urges, depressive symptoms and distress in the COPESS group compared with controls. Fidelity to the manualised COPESS therapy was moderate to high.
Conclusions
All progression criteria were met, supporting further evaluation of the intervention in a full-scale efficacy and/or cost-effectiveness trial. These findings add to the growing evidence base supporting the utility of brief psychological interventions for self-harm. COPESS has potential as a brief primary-care-based intervention for those struggling with self-harm.
An association between second-hand smoke exposure and depressive symptoms has been reported; however, further research is needed for clarity.
Aims
This 20-year prospective cohort study aimed to longitudinally explore the relationships of smoking and second-hand smoke exposure with incident depressive symptoms in community-dwelling middle-aged and older adults.
Method
Data of adults aged ≥40 years were collected from the National Institute for Longevity Sciences – Longitudinal Study of Aging database (third to ninth waves). Participants with baseline (third wave) depressive symptoms, missing data or no follow-up participation were excluded. Baseline data on current cigarette smoking and second-hand smoke exposure were collected. Depressive symptoms were defined as a Center for Epidemiologic Studies Depression Scale score ≥16. Generalised estimating equation models evaluated longitudinal relationships of smoking and second-hand smoke exposure with incident depressive symptoms.
Results
The final analysis included 1697 participants (mean (s.d.) age, 58.7 (11.2) years; mean follow-up, 12.9 years). Depressive symptom incidence ranged from 8.0% (wave 4) to 6.5% (wave 9). Compared with non-current smokers, current smokers showed no significantly higher risk of incident depressive symptoms (multivariable-adjusted odds ratio (95% CI): 1.27 (0.96−1.68)). Subgroup analysis revealed higher risks in male current smokers (adjusted odds ratio (95% CI): 1.40 (1.00−1.94)) and current smokers aged ≥65 years (adjusted odds ratio (95% CI): 1.62 (1.00−2.63)). Current smokers exposed to second-hand smoke had a higher depressive symptom risk than unexposed non-smokers (odds ratio (95% CI): 1.50 (1.05−2.14)) and greater risk (odds ratio (95% CI): 1.39 (1.00−1.94)) than unexposed current smokers.
Conclusions
Smoking, combined with second-hand smoke exposure, is associated with future depressive symptoms in community-dwelling middle-aged and older adults.
Existing evidence on the association between combined lifestyle and depressive symptoms is limited to the general population and is lacking in individuals with subthreshold depression, a high-risk group for depressive disorders. Furthermore, it remains unclear whether an overall healthy lifestyle can mitigate the association between childhood trauma (CT) and depressive symptoms, even in the general population. We aimed to explore the associations of combined lifestyle, and its interaction with CT, with depressive symptoms and their subtypes (i.e. cognitive-affective and somatic symptoms) among adults with subthreshold depression.
Methods
This dynamic cohort was initiated in Shenzhen, China in 2019, including adults aged 18–65 years with the Patient Health Questionnaire-9 (PHQ-9) score of ≥ 5 but not diagnosed with depressive disorders at baseline. CT (present or absent) was assessed with the Childhood Trauma Questionnaire-Short Form. Combined lifestyle, including no current drinking, no current smoking, regular physical exercise, optimal sleep duration and no obesity, was categorized into 0–2, 3 and 4–5 healthy lifestyles. Depressive symptoms were assessed using the PHQ-9 during follow-up. This cohort was followed every 6 months, and as of March 2023, had been followed for 3.5 years.
Findings
This study included 2298 participants (mean [SD] age, 40.3 [11.1] years; 37.7% male). After fully adjusting for confounders, compared with 0–2 healthy lifestyles, 3 (β coefficient, −0.619 [95% CI, −0.943, −0.294]) and 4–5 (β coefficient, −0.986 [95% CI, −1.302, −0.671]) healthy lifestyles were associated with milder depressive symptoms during follow-up. There exists a significant synergistic interaction between a healthy lifestyle and the absence of CT. The CT-stratified analysis showed that compared with 0–2 healthy lifestyles, 3 healthy lifestyles were associated with milder depressive symptoms in participants with CT, but not in those without CT, and 4–5 healthy lifestyles were associated with milder depressive symptoms in both participants with and without CT, with a stronger association in those with CT. The lifestyle-stratified analysis showed that CT was associated with more severe depressive symptoms in participants with 0–2 healthy lifestyles, but not in those with 3 or 4–5 healthy lifestyles. Cognitive-affective and somatic symptoms showed similar results.
Conclusions
In this 3.5-year longitudinal study of adults with subthreshold depression, an overall healthy lifestyle was associated with subsequent milder depressive symptoms and their subtypes, with a stronger association in adults with CT than those without CT. Moreover, an overall healthy lifestyle mitigated the association of CT with depressive symptoms and their subtypes.
This study aimed to examine the relationship between fibroblast growth factor 19 (FGF19) and depressive symptoms, measured by Beck’s Depression Inventory (BDI) scores and investigate the moderating role of smoking.
Methods:
This study involved 156 Chinese adult males (78 smokers and 78 non-smokers) from September 2014 to January 2016. The severity of depressive symptoms was evaluated using the BDI scores. Spearman rank correlation analyses were used to investigate the relationship between cerebrospinal fluid (CSF) FGF19 levels and BDI scores. Additionally, moderation and simple slope analyses were applied to assess the moderating effect of smoking on the relationship between the two.
Results:
FGF19 levels were significantly associated with BDI scores across all participants (r = 0.26, p < 0.001). Smokers had higher CSF FGF19 levels and BDI scores compared to non-smokers (445.9 ± 272.7 pg/ml vs 229.6 ± 162.7 pg/ml, p < 0.001; 2.7 ± 3.0 vs 1.3 ± 2.4, p < 0.001). CSF FGF19 levels were positively associated with BDI scores in non-smokers (r = 0.27, p = 0.015), but no similar association was found among smokers (r = −0.11, p = 0.32). Linear regression revealed a positive correlation between FGF19 and BDI scores (β = 0.173, t = 2.161, 95% CI: 0.015–0.331, p < 0.05), which was negatively impacted by smoking (β = −0.873, t = −4.644, 95% CI: −1.244 to −0.501, p < 0.001).
Conclusion:
These results highlight the potential role of FGF19 in individuals at risk for presence of or further development of depressive symptoms and underscore the importance of considering smoking status when examining this association.
Inequality can increase the risk of poor mental health. Objective measures explain the effects of socioeconomic disparities, but individuals may perceive inequality differently.
Aim
We aimed to investigate the association between the perception of economic inequality and depressive symptoms and suicide ideation.
Method
We used data from the Survey of Korean Youths’ Lives, a nationally representative cross-sectional study of 14 918 young adults aged 19−34 years in South Korea. Multivariate logistic regression analysis was conducted to assess the association between perceived economic inequalities (i.e. income inequality and inequality of intergenerational mobility) and depressive symptoms/suicide ideation. Additionally, subgroup analyses were performed based on objective and subjective income levels.
Results
Young adults with a high perception of economic inequality were more likely to experience depressive symptoms and suicide ideation. For example, those with a high perception of intergenerational mobility inequality had higher odds of depressive symptoms (odds ratio 1.82, 95% CI 1.49, 2.23) and suicide ideation (odds ratio 1.87, 95% CI 1.35, 2.60). Statistical evidence showed no interaction between the perception of inequalities and income, suggesting that a high perception of inequalities is associated with depressive symptoms and suicidal ideation, regardless of income. Nevertheless, the strongest association with poor mental health was observed in those with high perceived inequality and low income.
Conclusions
This study shows that the way young adults perceive economic inequality could affect their depressive symptoms and suicidal ideation. The findings highlight the importance of reducing these perceptions and addressing economic inequalities to improve mental health.
There has been substantial research undertaken on the role of a health-promoting diet in depression. Yet, the evidence of the relationship between the Nordic diet and the risk of depression is scarce. This cross-sectional study aimed to assess whether a healthy Nordic diet is associated with depressive symptoms. In total, 2603 men aged 42–60 years from the Kuopio Ischaemic Heart Disease Risk Factor Study were included. Diet quality was evaluated with a healthy Nordic diet score derived from the 4-day food diaries and depressive symptoms with the self-reported Human Population Laboratory (HPL) depression scale. Quade ANCOVA was used to examine the mean values of HPL scores in quartiles of a healthy Nordic diet score. Participants’ mean age was 53 years and BMI 26·8 kg/m2; 31·7 % were current smokers, and 86·9 % were married or living as a couple. The mean healthy Nordic diet score was 12·8 (sd 4·0, range 2–25), and the mean HPL depression score was 1·9 (sd 2·1, range 0–13). The findings suggested that lower adherence to a healthy Nordic diet was associated with higher HPL depression scores after adjusting for age, examination year, daily energy intake, leisure-time physical activity, adulthood socio-economic status, smoking and marital status (extreme quartile difference: 0·33 points, 95 % CI 0·10, 0·56, P for trend across the quartiles = 0·003). The results support the hypothesis that a lower-quality diet increases the odds of having depressive symptoms. However, prospective studies are needed to confirm the association.
Depression is a complex mental health disorder with highly heterogeneous symptoms that vary significantly across individuals, influenced by various factors, including sex and regional contexts. Network analysis is an analytical method that provides a robust framework for evaluating the heterogeneity of depressive symptoms and identifying their potential clinical implications.
Objective:
To investigate sex-specific differences in the network structures of depressive symptoms in Asian patients diagnosed with depressive disorders, using data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3, which was conducted in 2023.
Methods:
A network analysis of 10 depressive symptoms defined according to the National Institute for Health and Care Excellence guidelines was performed. The sex-specific differences in the network structures of the depressive symptoms were examined using the Network Comparison Test. Subgroup analysis of the sex-specific differences in the network structures was performed according to geographical region classifications, including East Asia, Southeast Asia, and South or West Asia.
Results:
A total of 998 men and 1,915 women with depression were analysed in this study. The analyses showed that all 10 depressive symptoms were grouped into a single cluster. Low self-confidence and loss of interest emerged as the most central nodes for men and women, respectively. In addition, a significant difference in global strength invariance was observed between the networks. In the regional subgroup analysis, only East Asian men showed two distinct clustering patterns. In addition, significant differences in global strength and network structure were observed only between East Asian men and women.
Conclusion:
The study highlights the sex-specific differences in depressive symptom networks across Asian countries. The results revealed that low self-confidence and loss of interest are the main symptoms of depression in Asian men and women, respectively. The network connections were more localised in men, whereas women showed a more diverse network. Among the Asian subgroups analysed, only East Asians exhibited significant differences in network structure. The considerable effects of neurovegetative symptoms in men may indicate potential neurobiological underpinnings of depression in the East Asian population.
Young adulthood is a transitional period between childhood and adulthood characterised by unique stressors that increase the risk of food insecurity and poor mental health. This study examined the association between food insecurity and mental health outcomes among U.S. young adults aged 18–25.
Design:
A cross-sectional survey was completed by young adults between the ages of 18 and 25 years between January and April 2022. Key measures included food insecurity, perceived stress, anxiety, depressive symptoms and insomnia. Descriptive statistics and linear regression analyses were used to determine the prevalence of and associations between food insecurity and mental health outcomes, controlling for key demographic and social factors.
Setting:
Online survey.
Participants:
1630 U.S. young adults.
Results:
Among the analytic sample of 1041 young adults, nearly 70 % of participants identified as being food insecure in the last year. Participants reported moderate to high levels of perceived stress, anxiety, depressive symptoms and insomnia. Food insecurity was positively associated with each mental health outcome including perceived stress (β = 2·28, P< 0·01), anxiety (β = 2·84, P< 0·01), depressive symptoms (β = 2·74, P< 0·01) and insomnia (β = 1·28, P< 0·01) after controlling for all other factors.
Conclusion:
Food insecurity is associated with mental health problems among young adults. Future efforts should explore the directionality of this relationship to determine if food insecurity initiates or exacerbates poor mental health outcomes or if poor mental health contributes to food insecurity. Interventions to improve food security status may also help support mental health among young adults.
The relationship between emotional symptoms and cognitive impairments in major depressive disorder (MDD) is key to understanding cognitive dysfunction and optimizing recovery strategies. This study investigates the relationship between subjective and objective cognitive functions and emotional symptoms in MDD and evaluates their contributions to social functioning recovery.
Methods
The Prospective Cohort Study of Depression in China (PROUD) involved 1,376 MDD patients, who underwent 8 weeks of antidepressant monotherapy with assessments at baseline, week 8, and week 52. Measures included the Hamilton Depression Rating Scale (HAMD-17), Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR16), Chinese Brief Cognitive Test (C-BCT), Perceived Deficits Questionnaire for Depression-5 (PDQ-D5), and Sheehan Disability Scale (SDS). Cross-lagged panel modeling (CLPM) was used to analyze temporal relationships.
Results
Depressive symptoms and cognitive measures demonstrated significant improvement over 8 weeks (p < 0.001). Baseline subjective cognitive dysfunction predicted depressive symptoms at week 8 (HAMD-17: β = 0.190, 95% CI: 0.108–0.271; QIDS-SR16: β = 0.217, 95% CI: 0.126–0.308). Meanwhile, baseline depressive symptoms (QIDS-SR16) also predicted subsequent subjective cognitive dysfunction (β = 0.090, 95% CI: 0.003-0.177). Recovery of social functioning was driven by improvements in depressive symptoms (β = 0.384, p < 0.0001) and subjective cognition (β = 0.551, p < 0.0001), with subjective cognition contributing more substantially (R2 = 0.196 vs. 0.075).
Conclusions
Subjective cognitive dysfunction is more strongly associated with depressive symptoms and plays a significant role in social functioning recovery, highlighting the need for targeted interventions addressing subjective cognitive deficits in MDD.
Despite advances in antiretroviral treatment (ART), human immunodeficiency virus (HIV) can detrimentally affect everyday functioning. Neurocognitive impairment (NCI) and current depression are common in people with HIV (PWH) and can contribute to poor functional outcomes, but potential synergies between the two conditions are less understood. Thus, the present study aimed to compare the independent and combined effects of NCI and depression on everyday functioning in PWH. We predicted worse functional outcomes with comorbid NCI and depression than either condition alone.
Methods:
PWH enrolled at the UCSD HIV Neurobehavioral Research Program were assessed for neuropsychological performance, depression severity (≤minimal, mild, moderate, or severe; Beck Depression Inventory-II), and self-reported everyday functioning.
Results:
Participants were 1,973 PWH (79% male; 66% racial/ethnic minority; Age: M = 48.6; Education: M = 13.0, 66% AIDS; 82% on ART; 42% with NCI; 35% BDI>13). ANCOVA models found effects of NCI and depression symptom severity on all functional outcomes (ps < .0001). With NCI and depression severity included in the same model, both remained significant (ps < .0001), although the effects of each were attenuated, and yielded better model fit parameters (i.e., lower AIC values) than models with only NCI or only depression.
Conclusions:
Consistent with prior literature, NCI and depression had independent effects on everyday functioning in PWH. There was also evidence for combined effects of NCI and depression, such that their comorbidity had a greater impact on functioning than either alone. Our results have implications for informing future interventions to target common, comorbid NCI and depressed mood in PWH and thus reduce HIV-related health disparities.
Insufficient sleep’s impact on cognitive and emotional function is well-documented, but its effects on social functioning remain understudied. This research investigates the influence of depressive symptoms on the relationship between sleep deprivation (SD) and social decision-making. Forty-two young adults were randomly assigned to either the SD or sleep control (SC) group. The SD group stayed awake in the laboratory, while the SC group had a normal night’s sleep at home. During the subsequent morning, participants completed a Trust Game (TG) in which a higher monetary offer distributed by them indicated more trust toward their partners. They also completed an Ultimatum Game (UG) in which a higher acceptance rate indicated more rational decision-making. The results revealed that depressive symptoms significantly moderated the effect of SD on trust in the TG. However, there was no interaction between group and depressive symptoms found in predicting acceptance rates in the UG. This study demonstrates that individuals with higher levels of depressive symptoms display less trust after SD, highlighting the role of depressive symptoms in modulating the impact of SD on social decision-making. Future research should explore sleep-related interventions targeting the psychosocial dysfunctions of individuals with depression.
Aims. Parental postpartum depressive symptoms have been extensively studied, but the combined longitudinal depression trajectories of parents and their long-term development beyond the postpartum period remain largely underexplored. We identified dyadic longitudinal depressive symptom trajectories in new parents, followed over an 11-year period, and compared parental characteristics, as well as child temperament and mental health factors, across different parental trajectory classes.
Methods. A prenatal cohort of 5,518 couples was studied. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale at eight time points: in the prenatal stage, in the newborn stage, and at 6 months, 18 months, 3 years, 5 years, 7 years and 11 years after the birth of the child.
Results. Dyadic Latent Class Growth Modelling identified five classes of couples: (1) mother has elevated depressive symptoms, father is non-depressed (24%); (2) both mother and father have elevated depressive symptoms (20%); (3) both mother and father are constantly non-depressed (42%); (4) both mother and father are constantly depressed (5%); and (5) mother is constantly depressed, father has elevated depressive symptoms (9%). Relationship maintenance (particularly being married or separated) was the most strongly associated with the classes. Socio-economic resources, emotional well-being, health, obstetric history and parental background also served as meaningful covariates. Child temperament and mental health showed weak correlations with parental trajectory classes.
Conclusions. Parents with postpartum depressive symptoms often experience depressive symptoms long-term. Separated parents are particularly vulnerable to adverse depressive trajectories. Our findings underscore the importance of dyadic methods in estimating unique combinations of parental depression trajectories.
Mothers living in low-income families are more likely to experience depressive symptoms and parenting stress which in turn can undermine mother–child interactions adversely influencing child outcomes. Previous studies demonstrate that social support is beneficial for low-income mothers to fulfill caregiving responsibilities and promote positive child outcomes. However, the longitudinal application of the Family Stress Model with protective factors remains unexplored in the literature. Thus, we examined the association between parenting stress and depressive symptoms at year 1 with harsh and responsive parenting at year 3. Then, we examined whether parenting practices at year 3 predicted child outcomes at year 5 and the main and moderating effects of social support at year 1 and year 3 on parenting and child outcomes. The sample included 1,968 mothers from the Future of Families and Child Wellbeing Study. Results showed that parenting stress significantly predicted harsh parenting. Harsh parenting was associated with more internalizing behavior problems and decreased adaptive social behavior. Responsive parenting was associated only with fewer internalizing behavior problems. The main effects of social support on responsive and harsh parenting and child outcomes were significant. Specific intervention programs targeted at reducing parenting stress, enhancing parenting skills, and improving the social support network should be designed to support mothers in the context of economic adversity.
Depression affects twice as many women as men. Risk factors for depression certainly impact this difference, but their strong interconnectedness challenges the assessment of standalone contributions. Network models allow the identification of systematic independent relationships between individual symptoms and risk factors. This study aimed to evaluate whether the extended networks of depressive symptoms, cognitive functions, and leisure activities in like-sex twins differ depending on gender or zygosity.
Methods
Twins, including 2,040 women (918 monozygotic and 1,122 dizygotic) and 1,712 men (730 monozygotic and 982 dizygotic), were selected from the Danish Twin Registry for having, along with their like-sex co-twin, completed measures of depressive symptoms, cognition, and leisure activities (physical, intellectual, and social). Network models were estimated and compared at three levels: co-twins to each other within groups defined by gender and zygosity; monozygotic to dizygotic twins within the same gender, and between genders.
Results
No significant differences were observed when co-twins were compared to each other, regardless of the pair’s zygosity or gender, nor when monozygotic twins were compared to dizygotic twins within gender. However, the gendered networks differed significantly in global strength, structure, and partial correlations between specific depressive symptoms and risk factors, all indicating stronger connectedness in women relative to men.
Conclusions
Environmental factors appear to best explain between-gender network differences. Women’s networks showed significantly stronger associations both among depressive symptoms and between depressive symptoms and risk factors (i.e., decreased cognition and leisure activities). Longitudinal research is needed to determine the causality and directionality of these relationships.
This study aims to empirically test whether family has a unique significance for the self that cannot be captured by the social self alone. Specifically, it examines whether family self-concept, compared to social self-concept, is more closely related to family-specific indicators (i.e., parent–child communication and family functioning) as well as to indicators of emotional maladjustment like mental health deterioration (i.e., psychological distress and depressive symptoms). The sample comprised 4,953 Mexican adolescents, including 2,551 men (51.5%) and 2,402 women, aged 14–17 years (M = 15.60, SD = 0.92). Confirmatory factor analysis was applied to evaluate the proposed big five-dimensional self-concept model. Cohen’s d confidence intervals, derived from the shared variance of Pearson’s r correlations, were analyzed to relate self-concept dimensions to parent–child communication, family functioning, and mental health deterioration. Results from factorial confirmatory analysis showed that the five-dimensional oblique model (i.e., academic, social, emotional, physical, and family, as different from social) provided a better fit than competing unidimensional and orthogonal models. Correlation analyses showed that family self-concept was significantly associated with both parent–child communication and family functioning, as well as with psychological distress (d = −1.10, confidence interval [CI] −1.21 to −1.02) and depressive symptoms (d = −1.24, CI −1.31 to −1.22). These findings add evidence that family is not accurately represented within the social self-concept. Furthermore, perceiving oneself as unloved and undervalued at home (i.e., low family self-concept) is strongly associated not only with dysfunctional family processes but also with mental health deterioration.
Schools are central places for adolescent social lives, which is a major factor greatly affecting adolescent mental health; school climate (i.e. quality of the school social environments) can be a proximal social determinant for adolescent mental health. Supportive school environments may serve as a protective factor during crises like COVID-19, which disrupt social lives and worsen adolescent mental health. This is the first study examining whether the pandemic effects differed based on the levels of school climate on depressive symptoms (DS) and psychotic experiences (PEs) among adolescents.
Methods
School climate (score range: 0–28), DS (0–26), and PEs (0–5) were self-reported in a population-based cohort (Tokyo Teen Cohort; N = 3171) at four timepoints (10y, 12y, 14y, and 16y) before and during COVID-19. COVID-19 occurred midway through the 16y survey, allowing us to examine its impact and interaction effect with school climate while accounting for within-person changes over time using mixed-effects models.
Results
Significant interaction effects were found on DS (unstandardized coefficient [B] = −0.166, 95% confidence interval [CI] −0.225 to −0.107) and PEs (B = −0.020, 95% CI −0.028 to −0.012). The pandemic effects were not significant for adolescents with high school climate scores (around the 80th percentile or higher), although the pandemic significantly worsened these outcomes among the overall sample.
Conclusions
The negative mental health effects of the pandemic were significantly mitigated among adolescents experiencing a supportive school climate. A positive school climate can protect adolescent mental health during challenging social conditions, such as pandemics.
This study aimed to assess the relationship between COVID-19 infection-related conditions and depressive symptoms among medical staff after easing the zero-COVID policy in China, and to further examine the mediating role of professional burnout.
Methods
A total of 1716 medical staff from all levels of health care institutions in 16 administrative districts of Beijing, China, were recruited to participate at the end of 2022 in this cross-sectional study. Several multiple linear regressions and mediating effects tests were performed to analyze the data.
Results
At the beginning of the end of the zero-COVID policy in China, 91.84% of respondents reported infection with COVID-19. After adjusting for potential confounding variables, the severity of infection symptoms was significantly positively associated with high levels of depressive symptoms (β = 0.06, P < 0.001), and this association was partially mediated by professional burnout. Specifically, emotional exhaustion (95% CI, 0.131, 0.251) and depersonalization (95% CI, 0.009, 0.043) significantly mediated the association between the severity of infection symptoms and depressive symptoms.
Conclusions
The mental health of medical staff with more severe symptoms of COVID-19 infection should be closely monitored. Also, interventions aimed at reducing emotional exhaustion and depersonalization may effectively reduce their risk of developing depressive symptoms.