Horizontal equity is defined as equal care for equal needs, regardless of socioeconomic factors. This study investigated trends in horizontal equity in mental health care (MHC) utilization in Sweden from 2006 to 2022. Monitoring equity provides valuable information for healthcare system governance (e.g., planning and resource allocation) necessary for ensuring equitable provision of services.

A total of 81,650 Stockholm residents aged 18-64, who participated in the Hälsa Stockholm surveys of 2006, 2010, 2014 or 2021, were analysed. Their subsequent use of MHC (primary, in- and outpatient specialized care, and psychotropic medication) within six months after survey response was collected from registries between 2006 and 2022. Concentration index (CI) and need-standardized CI (Horizontal inequity index, HI), summative measures of inequalities, were used in this study. HI was estimated using self-reported psychological distress (measured with the General health questionnaire 12 in 2006-2014 and Kessler 6 in 2021) as the primary need indicator, with general health status and long-term limiting illness as additional need indicators. Equivalized disposable household income was used as the ranking variable, while education status, migration status, age, and sex were included as non-need variables that we controlled for in the analyses.

Lower-income individuals used MHC services more than their higher-income counterparts with comparable levels of psychological distress. These "pro-poor" inequities in the probability of MHC use increased from HI = -0.057 [95% Confidence Limits, CL: -0.079, -0.034] in 2006/2007 to HI = -0.130 [95% CL: -0.159, -0.102] in 2014/2015. By 2021/2022, the "pro-poor" inequities had decreased (HI = -0.034 [95% CL: -0.06, -0.009]), partly due to an increase in MHC use among higher-income groups but a decrease in the lowest income group. Standardizing for additional need indicators reduced the "pro-poor" inequities but maintained the observed trends. Among non-Nordic migrants, "pro-rich" inequities fell between 2006/2007 and 2014/2015 but rose in 2021/2022, with significant "pro-rich" inequities among non-European migrants in 2021/2022 (HI = 0.100 [95% CL: 0.024, 0.176]). Among patients in outpatient services, "pro-poor" inequities in visit frequency decreased over time (2006-2022).

We observed increasingly higher probability of MHC use among lower-income individuals than their higher-income peers with similar (measured) needs from 2006 to 2015. However, during the pandemic (2021/2022), potential access problems led to diminishing of "pro-poor" inequities in the total sample, and to "pro-rich" inequities among non-Nordic migrants. The Covid-19 disruption to the healthcare system-such as restrictions on in-person visits and the rapid transition to digital healthcare services-along with its impact on care-seeking, may explain the trend shifts.

Emotional stress, including depression, may contribute to increased gastroesophageal reflux disease symptoms. In this paper, we aim to evaluate the associations between depressive symptoms, depressive symptom severity, and symptom clusters with acid reflux medication use, considering the potential interaction effect of sex. Data from the 2007-2018 National Health and Nutrition Examination Survey were used. Participants aged 18 years or older were included if they responded to the depressive symptoms and prescription medication questionnaires. This study included 31,444 participants, of whom 2871 had depressive symptoms. Participants with depressive symptoms had significantly higher odds of using antacids (aOR = 1.735; p < 0.001), histamine-2 receptor antagonists (H2RAs) (aOR = 1.653; p < 0.001), and proton pump inhibitors (PPIs) (aOR = 1.723; p < 0.001). A positive association was also found between depressive symptom severity and the use of antacids (aOR = 1.054; p < 0.001), H2RAs (aOR = 1.048; p < 0.001), and PPIs (aOR = 1.053; p < 0.001). Moreover, increases in cognitive-affective and somatic scores were associated with higher odds of using antacids (aOR = 1.080 for cognitive, 1.102 for somatic; p < 0.001), H2RAs (aOR = 1.078 for cognitive, 1.083 for somatic; p < 0.001), and PPIs (aOR = 1.075 for cognitive, 1.105 for somatic; p < 0.001). No significant sex interaction effects were observed. Adjusted models demonstrated no significant associations between depressive symptoms and the duration of medication use. This study provides evidence of an association between depressive symptoms and acid reflux medication use, highlighting the need to screen for related symptoms in patients with depressive symptoms.

Public health crises like the COVID-19 pandemic have posed unprecedented challenges to both physical and mental health. To better understand related social support conversations on online support groups, and how the topics of these conversations are associated with producing conversation and with authors' mental health status, we analyzed 65,004 posts and comments on the subreddit r/COVID19_support using structural topic modeling. Among the 22 valid topics identified, those that attracted more user engagement addressed uncertainty about prospective situations, national and international news, sending condolences regarding loss, and the dangerous impact of the pandemic. More importantly, topics related to giving esteem (e.g. sending encouragement to boost others' self-efficacy, expressing appreciation) and emotional support (e.g. sending regards and condolences) were consistently and negatively associated with authors' anxiety and mental illness during the pandemic. In the same vein, providing informational support by updating situations related to the health impact and political, media, and working environment during the pandemic were also associated with reduced anxiety and mental illness. Theoretical and practical implications are discussed.

Affective disorders, such as depression, are commonly associated with the development of chronic pain, but the underlying mechanisms still remain unclear. The dopaminergic system, located in the midbrain, is considered one of the regions where algesia and emotional processing overlap. This suggests a structural basis hypothesis for the comorbidity of chronic pain and depression, highlighting the interplay between nociceptive and affective processing. But there are more and more evidences show that somatic and head/facial pain involve different neuronal overlap. In previous study, the research show that VTA dopaminergic system involved in pIONT surgery induced depressive-like behaviors in mice. But there still no evidence shows if chronic somatic pain will induce depressive-like behaviors and which neuronal circle pathway is underly. In this study, we assessed depressive-like behaviors and performed artificial interference of VTA (ventral tegmental area) dopaminergic neurons in a mouse model of chronic peripheral neuropathic pain induced by the spared nerve injury (SNI) model. After a 4-week duration of hyperalgesia and allodynia resulting from SNI surgery, social withdraw and other depressive-like behaviors were observed in the SNI group. Furthermore, the dopaminergic cells' excitability in VTA were significantly increased in SNI mice. The excitability alteration was improved play a key role in the development and modulation of the chronic peripheral neuropathic pain-induced depressive-like behaviors. It has been shown pain and affections have structural and functional circuits to interact with each other, therefore the neuroplastic changes and functional role of VTA dopaminergic neurons within these circuits may serve as potential targets for understanding and therapeutically addressing the development of depressive-like symptoms accompanied by prolonged pain syndromes in humans.

Lifestyle is a significant, common, and easily modifiable factor capable of increasing or reducing the risk of acquiring many diseases. Currently, there is a research gap as too little scientific attention has been focused on exploring the relationship between mental health and nutritional status in various populations. Moreover, the association between body composition and somatization has not been fully disclosed. Therefore, this study aimed to assess the associations of body composition with the symptomatology of somatization in an environmentally vulnerable sample of young adults.

A single cross-sectional study included young non-clinical Lithuanian students (n = 1223) aged 21.7 ± 3.9. The body adiposity status of the study participants was estimated using both the body mass index (BMI) and the Body Adiposity Estimator (CUN-BAE) method. Fat-free mass was evaluated via the adjusted fat-free mass index equation (FFMIadj). The Patient Health Questionnaire (PHQ-15) was applied to assess the severity of the perceived symptoms of a somatic symptom disorder (SSD).

The CUN-BAE was considered to be a better predictor of adiposity than the BMI because 14.7% of females and 6.2% of males were interpreted as obese using the CUN-BAE, while the BMI equation identified participants as having a normal body weight. The highest rates of somatization were found in 18.6% of the cohort. Young adults with higher amounts of body fat mass (β: 0.050, 95% confidence interval (95% CI): 0.013; 0.084, p = 0.007) and lower FFMI are prone to a higher risk for developing somatization (β: -0.429, 95% CI: -0.597; -0.260, p < 0.001).

Our study revealed that body composition is significantly related to multiple somatic complaints throughout a range of measurements. However, in contrast to the CUN-BAE tool, the BMI equation underestimated the relationship between body fat and mental health outcomes in young adults. Even though nutritional status along with targeted physical load, as the mediators, are likely to play a significant role in the maintenance of optimal body composition and mental health outcomes, healthcare providers are recommended to advise individuals to lower their body fat percentage and increase fat-free mass in order to reduce the risk of somatization.

Background/Objectives: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex neuroimmunological disorder with limited treatment options. Despite the widespread use of Dietary Supplements (DSs) among ME/CFS patients to alleviate fatigue and associated symptoms, evidence remains inconclusive. This systematic review aims to provide an updated synthesis of the efficacy of DS interventions and explore possible mechanisms underlying their therapeutic effects. Methods: This systematic review was conducted according to PRISMA guidelines. Several databases (Ebsco Host, PubMed, Scopus, Google Scholar) were used for the systematic search, which was based on the broad search terms ME/CFS and DS with a focus on publications between 1994 and 2024. The primary outcome was fatigue, with additional considerations including psychological well-being, physical activity, and biochemical markers. Two independent researchers screened the studies for eligibility in a multi-stage process and assessed quality and bias using Cochrane's risk of bias tools (RoB-2, ROBINS-I). Results: Fourteen studies (N = 809) of heterogeneous designs were included, showing a high risk of bias, mostly due to missing data and selection bias. While some interventions (L-carnitine and guanidinoacetic acid, oxaloacetate, CoQ10-selenium combination, NADH and NADH-CoQ10 combination) showed significant reductions in fatigue, methodological limitations, like small sample sizes and missing data, prevent firm conclusions. Mixed results were reported for secondary outcomes like cognitive function and inflammatory markers. Six studies noted adverse effects, including nausea and insomnia. Conclusions: Though some DSs showed potential in reducing fatigue in ME/CFS, methodological limitations and inconsistent results hinder definitive conclusions. Future research should improve diagnostic criteria and include more diverse populations.

The objectives of this study were to examine the association between financial wellbeing and somatization, in addition to the mediating effect of anxiety, depression and stress. To test such hypotheses, a cross-sectional study was carried out between September and October 2021; 403 participants (264 females; age = 32.76 ± 13.24 years) were recruited. Depression mediated the association between financial wellbeing and somatization. A worse financial wellbeing was significantly associated with more depression, which was associated with more somatization. Moreover, a worse financial wellbeing was significantly and directly associated with more somatization. Our study adds to the narrow body of research revolving around the relationship between financial wellbeing and somatization in Lebanese adults. Understanding that the effects of, depression are aggravated in a country such as Lebanon would help establish more preventative guidelines and mental health awareness campaigns. Identifying the correlates of somatization can also be translated into improved interventions.

Numerous early-life risk factors are thought to significantly contribute to the development of psychological problems in toddlerhood. However, these factors have seldom been investigated concomitantly and longitudinally, and few studies include both mothers and fathers. This study examines the longitudinal impact of early environmental, parental, and child-specific risk factors on children's internalizing and externalizing symptomatology at age 4.

Families were recruited from a perinatal center at birth and completed self-report questionnaires at birth, 4 weeks postpartum, 6 months postpartum, and annually thereafter. The final population-based sample consisted of n = 560 mothers (and fathers) who gave birth after June 2015, with children who turned 4 years old before March 31, 2021. The primary outcomes, children's internalizing and externalizing symptomatology at age 4, were measured using the Strengthsand Difficulties Questionnaire. Linear mixed effect models were used to estimate growth curves for predictors between 4 weeks and 4 years postpartum, which were subsequently entered into multivariable linear regressions to predict internalizing and externalizing symptomatology at age 4.

The study identified several key risk factors: environmental (lack of social support, lower parental education, male sex), parental (poor parental mental health, increased parenting stress, parental sleep difficulties) and child-specific (children's low physical health, children's reduced sleep quality, temperament).

The findings underscore that most identified risk factors are related to children's temperament, mental and physical health of parents, their experienced stress, and families' social support networks. These insights highlight the importance of targeted interventions focusing on improving parental mental health, reducing stress, and enhancing social support to mitigate early-life psychological problems in children.

We were interested in developing a methodology for diagnosing the depression status of a focused population group, such as the Korean university student group, with higher accuracy. To this end, we proposed a method of fusing the data collected from multiple depression self-questionnaires aided by a psychiatrist's diagnosis. In particular, we found that the standard diagnostic cut-offs and factor analysis prepared for a general population by depression self-questionnaires are inadequate for a focused population with its unique cultural background. In this study, a novel approach to optimizing diagnostic cut-offs and generalizing factor analysis for the Korean university student group is presented in the fusion space of multiple self-questionnaires.

We collected the data from 30 randomly selected Korean university students, over 21 weeks, with the psychiatric evaluation as a reference, then established the optimal cut-off regions in the fused CESD - PHQ9 score space based on the statistical correlation between CES - D and PHQ - 9 and the reference diagnostics. We also re-extracted the factors in the fused CESD - PHQ9 space to expose the key factors that are behind the depression characteristics of the group.

We verified the existence of a clear correlation between CES - D and PHQ - 9 scores. However, the standard cut-offs of CES - D and PHQ - 9 are found inconsistent with the correlation. The new cut-off regions we obtained in the fused CESD - PHQ9 score space are consistent with the correlation and optimal for the psychiatrist's diagnosis with the sensitivity and specificity of 80.95% and 89.74%, respectively. Also, we identified that "socio-psychological" and "interpersonal relationship" factors are the major factors for the depression characteristics of the group.

Although the new cut-off regions we presented were based on the incorporation of clinical diagnosis into the fused CESD - PHQ9 score space, further verification with a larger scale of clinical data is helpful.

We identified optimal cut-off regions and generalized factor analysis in the fusion space, which can provide more reliable and trustworthy diagnoses. These can serve as a self-diagnostic tool for reliably identifying the depression characteristics of a focused population as well as effectively linking individuals and psychiatrists as an intermediary.

About one in four Chinese people might suffer or have already suffered from anxiety conditions, with a lifetime prevalence rate of 4.8%. However, many of those who could have benefited from psychological or pharmacological treatments fail to be recognized or treated due to the lack of timely recognition and accurate diagnosis.

This study used a topic modeling approach to explore people's anxiety-related concerns raised on a computer-mediated Chinese health platform, YOU WEN BI DA (questioning and answering), to provide implications for accurate diagnosis, targeted education, tailored intervention, and informed policy-making in the course of addressing this condition of public concern.

First, we extracted data from YOU WEN BI DA between May 2022 and February 2023. After cleaning the extracted data both using the Python text processing tool spaCy and manually, we ascertained the optimal number of topics by drawing on the coherence scores and used latent Dirichlet allocation (LDA) topic modeling to generate the most salient topics and related terms. We then categorized the topics ascertained into different classes of themes by plotting them onto a 2D plane via multidimensional scaling using the pyLDAvis visualization tool. Finally, we analyzed these topics and themes qualitatively to better understand people's anxiety-related concerns.

5 topics with different overall prevalence were ascertained through data analysis. Topic 2 (tinnitus phobia-incurred concerns, n = 639) is the most popular dominant topic, occurring in 25.1% of the 2545 collected concerns, closely followed by Topics 1 (neurosis-incurred concerns, n = 512;) and 3 (sleep, dyskinesia, bipolar, cognitive, and somatic disorders-incurred concerns, n = 619), which appeared in 20.1% and 24.3% of the 2545 concerns respectively. Topic 5 (social phobia-incurred concerns, n = 428) ranks as the fourth most popular dominant topic, showing up in 16.8% of the 2545 concerns. Topic 4 (autonomic nerve dysfunction-incurred concerns, n = 347) accounts for 13.6% of the 2545 concerns. The t-distributed Stochastic Neighbor Embedding analysis reveals partial similarities between Topics 2 and 5 as well as between Topics 4 and 5 because many concerns involved in Topics 2 and 5 pertain to people's psychological status of fear and anxiety and the relief and dispelling of such symptoms through medication, and many concerns involved in Topics 4 and 5 relate to people's worries about the negative impact on their nerves and the adjustment and conditioning of such effects through medication.

This was the first study that investigated Chinese people's anxiety-related concerns raised on YOU WEN BI DA using the topic modeling technique. The automatic text analysis and complementary manual interpretation of the collected data allowed for the discovery of the dominant topics hidden in the data and the categorization of these topics into different themes to reveal the overall status of people's anxiety-related concerns. The research findings can provide some practice implications for health and medical educators, practitioners, and policy-makers to make joint efforts to address this common public concern effectively and efficiently.

Depression is a heterogeneous syndrome that impacts an individual's emotional, social, cognitive and bodily functioning. Depression is associated with biases in emotional processing, but alterations in basic sensory processing have received less attention in depression research. Here, we measured event-related potentials (ERPs) in response to changes in the intensity of auditory stimuli and the location of somatosensory stimuli in participants with depression and in non-depressed control participants. We tested whether auditory mismatch negativity, P3a or N1 intensity dependence response or somatosensory mismatch response, P3a, P50 or N80 can dissociate depressed participants and non-depressed controls, and we also analysed the effects of depression medication and age in this sample. N1 intensity dependence response was increased in unmedicated depressed participants relative to non-depressed controls. When age was controlled for in the analysis, the effect of depression was only at a trend level. N1 intensity dependence response correlated with depression severity at the whole sample level. We did not observe any depression-related alterations in auditory mismatch negativity or P3a or somatosensory ERPs. Our results may reflect an association between the N1 intensity dependence response and altered neurotransmitter activity in depression, but this should be confirmed in future studies.

There is a lack of research on transcranial direct current stimulation (tDCS) for the treatment of somatic symptoms in major depressive disorder (MDD) and the suitable stimulating brain region. We investigated the efficacy of tDCS targeting the dorsolateral prefrontal cortex (DLPFC) versus orbitofrontal cortex (OFC) on depressive somatic symptoms and somatic anxiety in patients with MDD and aimed to identify the appropriate stimulating brain regions.

In this randomized, double-blind, sham-controlled study, a total of 70 patients diagnosed with MDD were randomly allocated into DLPFC group, OFC group, and Sham group. Subjects participated in 2 weeks of 10 primary interventions and subsequently 2-week maintenance interventions weekly (20 min, 2 mA).

The DLPFC group showed a more significant improvement in somatic symptoms compared to the Sham group at week 2. At the maintenance and follow-up stages, the DLPFC group outperformed the Sham and OFC groups, but the difference with the Sham group was not significant. Neither active group demonstrated superiority over the Sham group in improving depression and anxiety.

In conclusion, the tDCS targeting DLPFC may be a potentially effective therapeutic target for alleviating somatic symptoms in patients with MDD.

Brain signals refer to electrical signals or metabolic changes that occur as a consequence of brain cell activity. Among the various non-invasive measurement methods, electroencephalogram (EEG) stands out as a widely employed technique, providing valuable insights into brain patterns. The deviations observed in EEG reading serve as indicators of abnormal brain activity, which is associated with neurological diseases. Brain‒computer interface (BCI) systems enable the direct extraction and transmission of information from the human brain, facilitating interaction with external devices. Notably, the emergence of artificial intelligence (AI) has had a profound impact on the enhancement of precision and accuracy in BCI technology, thereby broadening the scope of research in this field. AI techniques, encompassing machine learning (ML) and deep learning (DL) models, have demonstrated remarkable success in classifying and predicting various brain diseases. This comprehensive review investigates the application of AI in EEG-based brain disease diagnosis, highlighting advancements in AI algorithms.

Depressive disorders are a critical public health concern in Chile. Nonetheless, there is a lack of evidence regarding the identification of depressive symptom clusters. The objective was to identify depressive symptom clusters among Chilean young adults and examine how demographic, and lifestyle factors as well as social support can influence and predict them.

Cross-sectional study conducted among 1,000 participants from the Limache cohort 2. A latent class analysis (LCA) was performed to identify depressive symptom clusters, using the Patient Health Questionnaire (PHQ-9). Multinomial logistic regression was then applied to explore the associations between identified classes and potential predictors. The models were adjusted by age and sex.

Three latent classes of depressive symptoms were identified: minimal (25.7%); somatic (50.7%) and severe (23.6%). In the severe class for eight out nine depressive symptoms the probabilities were above 50%, and the probability of suicidal ideation was almost a third in this class. Being female (Adjusted Odds ratio [AOR], 2.49; 95% confidence interval [CI] [1.63-3.81]), current smoker (AOR, 1.74; 95% CI [1.15-2.65]), having basic education (AOR, 3.12; 95% CI [1.30-7.53]) and obesity (AOR, 2.72; 95% CI [1.61-4.59]) significantly increased the likelihood of belonging to severe class. Higher social support decreased the odds of being in the somatic (OR, 0.96; 95% CI [0.93-0.98]) and severe (OR, 0.92; 95% CI [0.90-0.94]) classes.

These findings highlight the importance of individualized intervention strategies for depression management. Also, the study suggests that nutritional status and social support should be considered when addressing depression in this population.

Alexithymia is a multi-faceted personality trait, which is the inability to recognize and describe emotions. It is associated with a multitude of mental health problems, and its implication for the diagnosis and treatment of depression remains unclear. The current study explored the nuances of the relationship between alexithymia and depression in a sample of 210 patients with depression. We assessed alexithymia with the 20-Item Toronto Alexithymia Scale (TAS-20) and depression with the Beck Depression Inventory (BDI-I). The mean TAS-20 score was 57.47 ± 10.63, and the mean BDI-I score was 49.33±9.24. We explored the network structure of alexithymia and depression. Items related to difficulties in identifying, describing, and expressing feelings were prominent in the alexithymia network. Joy, guilt, and self-dislike stand out in the depression network. In our analysis, we were able to show the crescent relationship between depression and alexithymia, with an inflection point at a TAS-20 score of 53. Although the correlation-concordance index was moderate (0.41; 95 %CI: 0.29-0.51), both scales greatly overlap. In the joint network of alexithymia and depression, we could identify bridge (i.e., connecting) items between alexithymia and depression. These were difficulties understanding and relating feelings to physical and body sensations on the alexithymia side, and self-dislike, crying, and somatic concern on the depression side. Taken together, they point to the pivotal role of alexithymia in the somatization/embodiment of emotions and feelings in depression.

Studies have revealed that somatization symptoms are associated with emotional memory in adolescents with depressive disorders. This study investigated somatization symptoms and emotional memory among adolescents with depressive disorders using low-frequency amplitude fluctuations (ALFF). Participants were categorized into the somatization symptoms (FSS) group, non-FSS group and healthy control group (HC). The correctness of negative picture re-recognition was higher in the FFS and HC group than in the non-FSS group. The right superior occipital gyrus and right inferior temporal gyrus were significantly larger in the FSS group than those in the non-FSS and HC groups. Additionally, the ALFF in the superior occipital and inferior temporal gyrus were positively correlated with CSI score. Furthermore, the ALFF values in the temporal region positively correlated with correct negative image re-recognition. The negative image re-recognition rate was positively correlated with the ALFF in the left and right middle occipital gyri. These findings indicated that somatization symptoms in adolescent depression are associated with the superior occipital gyrus and inferior temporal gyrus. Notably, somatization symptoms play a role in memory bias within depressive disorders, with middle occipital and inferior temporal gyri potentially serving as significant brain regions.

The prevalence of and factors associated with musculoskeletal (MSK) symptoms in patients with hidradenitis suppurativa (HS) have yet to be elucidated. Given the association between HS and inflammatory comorbidities, understanding the burden of MSK symptoms in patients with HS is crucial for patient-centered care. Our objective was to describe the prevalence of and factors associated with MSK symptoms in patients with HS. A cross-sectional study of 78 consecutive patients recruited between November 2021 and February 2023 with a dermatology-confirmed diagnosis of HS, irrespective of MSK symptoms, was performed. The average age of participants (n=78) was 37 (SD 12.2) years, and the average age at symptom onset was 23 (SD 12.1) years; 54% (n=42) of participants identified as women, and 46% (n=36) as men. The most common comorbidities included depression (n=17, 22%) and preexisting arthritis (n=12, 16%). Approximately 24% (n=18) of participants reported prolonged morning stiffness. In a multivariate regression, depression was significantly associated with morning stiffness (odds ratio [OR] 6.1, 95% CI 1.4-26.1; P=.02), while female sex was significantly associated with arthralgia (OR 19.1, 95% CI 1.6-235.2; P=.02). Every patient with depression reported arthralgia. We highlight the high prevalence of MSK symptoms among patients with HS and note the interplay between depression and MSK symptoms, with each one potentially contributing to the other.

Both depression and constipation are universal disorders that seriously affect quality of life. But the phenotypic relationship and causality between depression and constipation are still unclear.

We first assessed phenotypic relationships by logistic regression analysis using large-scale data extracted from the National Health and Nutrition Examination Survey (N = 11,585). We then evaluated causality by bidirectional two-sample mendelian randomization (MR) analysis using Genome-wide association study (GWAS) data (depression: N = 807,553; constipation: N = 377,277). To investigate whether depression severity affects the causal relationship between depression and constipation, we conducted a further MR study on GWAS data of major depression (N = 480,359).

About 11.31 % of the participants in the constipation group suffered from depression, which was significantly higher than the normal bowel group (6.09 %). The observational study showed a positive correlation between depression and constipation (OR = 1.968, 95%CI = 1.530-2.532). Besides, the risk of constipation was higher in participants with severe depression (OR = 2.294, 95%CI = 1.538-3.422) than in participants with mild depression (OR = 1.549, 95%CI = 1.242-1.932). Bidirectional MR analysis revealed an obviously causal effect of depression on constipation, but no causal effect of constipation on depression. In addition, the MR analysis also revealed a causal relationship between major depression and constipation.

The exact mechanism by which depression affects constipation is still unclear.

This study reveals a positive correlation between depression and constipation and the causal effect of depression on constipation. Clinicians should keep the risk of constipation in mind when treating patients with depression.

Painful physical symptoms (PPS) are highly prevalent in patients with major depressive disorder (MDD). Presence of PPS in depressed patients are potentially associated with poorer antidepressant treatment outcome. We aimed to evaluate the association of baseline pain levels and antidepressant treatment outcomes.

We searched PubMed, Embase and Cochrane Library databases from inception through February 2023 based on a pre-registered protocol (PROSPERO: CRD42022381349). We included original studies that reported pretreatment pain measures in antidepressant treatment responder/remitter and non-responder/non-remitter among patients with MDD. Data extraction and quality assessment were performed following the Preferred Reporting Items for Systematic Reviews and Meta-analyses by two reviewers independently. The primary outcome was the difference of the pretreatment pain levels between antidepressant treatment responder/remitter and non-responder/non-remitter. Random-effects meta-analysis was used to calculate effect sizes (Hedge's g) and subgroup and meta-regression analyses were used to explore sources of heterogeneity.

A total of 20 studies were included. Six studies reported significantly higher baseline pain severity levels in MDD treatment non-responders (Hedge's g = 0.32; 95% CI, 0.13-0.51; P = 0.0008). Six studies reported the presence of PPS (measured using a pain severity scale) was significantly associated with poor treatment response (OR = 1.46; 95% CI, 1.04-2.04; P = 0.028). Five studies reported significant higher baseline pain interference levels in non-responders (Hedge's g = 0.46; 95% CI, 0.32-0.61; P < 0.0001). Four studies found significantly higher baseline pain severity levels in non-remitters (Hedge's g = 0.27; 95% CI, 0.14-0.40; P < 0.0001). Eight studies reported the presence of PPS significantly associated with treatment non-remission (OR = 1.70; 95% CI, 1.24-2.32; P = 0.0009).

This study suggests that PPS are negatively associated with the antidepressant treatment outcome in patients with MDD. It is possible that better management in pain conditions when treating depression can benefit the therapeutic effects of antidepressant medication in depressed patients.

Interoception refers to the sensation and perception of internal bodily sensations, and may be related to depressive symptoms. Schemata concerning the body vary across different cultures and may influence interoception and symptom presentations of depression. This study explored the relationship between interoception, depressive symptoms, and schema of somatic focus in Chinese people with subsyndromal depression. Thirty-nine individuals with subsyndromal depression (SD) and 40 healthy controls (HCs) were assessed at baseline and after 3 months. Participants completed the self-report questionnaires for assessing interoceptive sensibility, somatic and psychological symptoms of depression, and somatization tendency. They also completed the heartbeat perception behavioral task for estimating interoceptive accuracy. The results showed that both the SD and the HC groups showed similar interoceptive accuracy, although the SD group showed heightened interoceptive sensibility. The discrepancy between interoceptive sensibility and interoceptive accuracy is termed the interoceptive trait prediction error (ITPE). The ITPE was positive in SD participants but was negative in HCs. In the entire sample, interoceptive sensibility and the ITPE were correlated with somatic symptoms rather than with psychological symptoms of depression. Interoceptive sensibility partially mediated the relationship between somatization tendency and somatic symptoms, after controlling for psychological symptoms of depression. These results remained stable after 3 months. The shortcomings of the present study were a lack of clinical interview to ascertain diagnosis and a short follow-up duration. In conclusion, our study suggests that altered interoception occurs in subsyndromal depression. Interoception is related to somatic symptoms of depression. The schema of body was related to depressive symptoms, partially through interoception, in Chinese people with subsyndromal depression.

The "Patient Health Questionnaire (PHQ)" is a screening instrument, designed for time-efficient detection and severity assessment of depression, anxiety, and other syndromes in medical settings. Besides the questions on psychological symptoms, there are items on psychosocial functioning, on stressors and critical life events. However, for the stress items there are no psychometric properties available until now. The present study is thought to investigate item characteristics, internal consistency as well as factorial and construct validity of the stress scale of the PHQ. A representative sample of the general population of Germany was collected by a demography consulting company (USUMA, Berlin). Per random-route procedure, households and members of the households were selected. The sample was representative for the German community regarding age, gender, and education. In this investigation the following questionnaires were administered: PHQ-Stress, Questions on Life Satisfaction Modules (FLZ-M), Type-D Scale-14 (DS14). The sample included N = 2396 participants with mean age of 48.50 (SD = 17.75; range = 14 to 92) and 55.2 % being female. Reliability of the PHQ stress scale was acceptable (ω = 0.776), but some factor loadings were comparatively low. Model fit indices showed mixed results, some indicating unacceptable and some indicating acceptable fit of the 10-item stress scale of the PHQ. Correlations with related constructs demonstrated the scale's convergent validity. The results of this validation study indicate that the PHQ stress scale, which provides a one-dimensional total stress score, is a valid, good practical and reliable self-report instrument for assessing the severity of psychosocial stress.

Approximately 9% of US adults experience major depression each year, with a lifetime prevalence of approximately 17% for men and 30% for women.

Major depression is defined by depressed mood, loss of interest in activities, and associated psychological and somatic symptoms lasting at least 2 weeks. Evaluation should include structured assessment of severity as well as risk of self-harm, suspected bipolar disorder, psychotic symptoms, substance use, and co-occurring anxiety disorder. First-line treatments include specific psychotherapies and antidepressant medications. A network meta-analysis of randomized clinical trials reported cognitive therapy, behavioral activation, problem-solving therapy, interpersonal therapy, brief psychodynamic therapy, and mindfulness-based psychotherapy all had at least medium-sized effects in symptom improvement over usual care without psychotherapy (standardized mean difference [SMD] ranging from 0.50 [95% CI, 0.20-0.81] to 0.73 [95% CI, 0.52-0.95]). A network meta-analysis of randomized clinical trials reported 21 antidepressant medications all had small- to medium-sized effects in symptom improvement over placebo (SMD ranging from 0.23 [95% CI, 0.19-0.28] for fluoxetine to 0.48 [95% CI, 0.41-0.55] for amitriptyline). Psychotherapy combined with antidepressant medication may be preferred, especially for more severe or chronic depression. A network meta-analysis of randomized clinical trials reported greater symptom improvement with combined treatment than with psychotherapy alone (SMD, 0.30 [95% CI, 0.14-0.45]) or medication alone (SMD, 0.33 [95% CI, 0.20-0.47]). When initial antidepressant medication is not effective, second-line medication treatment includes changing antidepressant medication, adding a second antidepressant, or augmenting with a nonantidepressant medication, which have approximately equal likelihood of success based on a network meta-analysis. Collaborative care programs, including systematic follow-up and outcome assessment, improve treatment effectiveness, with 1 meta-analysis reporting significantly greater symptom improvement compared with usual care (SMD, 0.42 [95% CI, 0.23-0.61]).

Effective first-line depression treatments include specific forms of psychotherapy and more than 20 antidepressant medications. Close monitoring significantly improves the likelihood of treatment success.

Major depressive disorder (MDD) is often marked by impaired motivation and reward processing, known as anhedonia. Many patients do not respond to first-line treatments, and improvements in motivation can be slow, creating an urgent need for rapid interventions. Recently, we demonstrated that transcutaneous auricular vagus nerve stimulation (taVNS) acutely boosts effort invigoration in healthy participants, but its effects on depression remain unclear.

To assess the impact of taVNS on effort invigoration and maintenance in a sample that includes patients with MDD, evaluating the generalizability of our findings.

We used a single-blind, randomized crossover design in 30 patients with MDD and 29 matched (age, sex, and BMI) healthy control participants (HCP).

Consistent with prior findings, taVNS increased effort invigoration for rewards in both groups during Session 1 (p = .040), particularly for less wanted rewards in HCP (pboot < 0.001). However, invigoration remained elevated in all participants, and no acute changes were observed in Session 2 (Δinvigoration = 3.3, p = .12). Crucially, throughout Session 1, we found taVNS-induced increases in effort invigoration (pboot = 0.008) and wanting (pboot = 0.010) in patients with MDD, with gains in wanting maintained across sessions (Δwanting = 0.06, p = .97).

Our study replicates the invigorating effects of taVNS in Session 1 and reveals its generalizability to depression. Furthermore, we expand upon previous research by showing taVNS-induced conditioning effects on invigoration and wanting within Session 1 in patients that were largely sustained. While enduring motivational improvements present challenges for crossover designs, they are highly desirable in interventions and warrant further follow-up research.

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a debilitating illness medically unexplained, affecting approximately 1% of the global population. Due to the subjective complaint, assessing the exact severity of fatigue is a clinical challenge, thus, this study aimed to produce comprehensive features of fatigue severity in ME/CFS patients.

We systematically extracted the data for fatigue levels of participants in randomized controlled trials (RCTs) targeting ME/CFS from PubMed, Cochrane Library, Web of Science, and CINAHL throughout January 31, 2024. We normalized each different measurement to a maximum 100-point scale and performed a meta-analysis to assess fatigue severity by subgroups of age, fatigue domain, intervention, case definition, and assessment tool, respectively.

Among the total of 497 relevant studies, 60 RCTs finally met our eligibility criteria, which included a total of 7088 ME/CFS patients (males 1815, females 4532, and no information 741). The fatigue severity of the whole 7,088 patients was 77.9 (95% CI 74.7-81.0), showing 77.7 (95% CI 74.3-81.0) from 54 RCTs in 6,706 adults and 79.6 (95% CI 69.8-89.3) from 6 RCTs in 382 adolescents. Regarding the domain of fatigue, 'cognitive' (74.2, 95% CI 65.4-83.0) and 'physical' fatigue (74.3, 95% CI 68.3-80.3) were a little higher than 'mental' fatigue (70.1, 95% CI 64.4-75.8). The ME/CFS participants for non-pharmacological intervention (79.1, 95% CI 75.2-83.0) showed a higher fatigue level than those for pharmacological intervention (75.5, 95% CI 70.0-81.0). The fatigue levels of ME/CFS patients varied according to diagnostic criteria and assessment tools adapted in RCTs, likely from 54.2 by ICC (International Consensus Criteria) to 83.6 by Canadian criteria and 54.2 by MFS (Mental Fatigue Scale) to 88.6 by CIS (Checklist Individual Strength), respectively.

This systematic review firstly produced comprehensive features of fatigue severity in patients with ME/CFS. Our data will provide insights for clinicians in diagnosis, therapeutic assessment, and patient management, as well as for researchers in fatigue-related investigations.

We introduce the bias and equivalence framework to highlight how concepts, methods, and tools from cultural psychology can contribute to successful cultural adaptation and implementation of behavioral interventions. To situate our contribution, we provide a review of recent cultural adaptation research and existing frameworks. We identified 68 different frameworks that have been cited when reporting cultural adaptations and highlight three major adaptation dimensions that can be used to differentiate adaptations. Regarding effectiveness, we found an average effect size of zr = 0.24 (95%CI 0.20, 0.29) in 24 meta-analyses published since 2014, but also substantive differences across domains and unclear effects of the extent of cultural adaptations. To advance cultural adaptation efforts, we outline a framework that integrates key steps from previous cultural adaptation frameworks and highlight how cultural bias and equivalence considerations in conjunction with community engagement help a) in the diagnosis of behavioral or psychological problems, b) identification of possible interventions, c) the selection of specific mechanisms of behavior change, d) the specification and documentation of dose effects and thresholds for diagnosis, e) entry and exit points within intervention programs, and f) cost-benefit-sustainability discussions. We provide guiding questions that may help researchers when adapting interventions to novel cultural contexts.

Major depressive disorder (MDD) is one of the leading causes of disability. We aimed to report the MDD-attributable prevalence, incidence and years lived with disability (YLDs) in the Middle East and North Africa (MENA) region from 1990 to 2019 by age, sex and socio-demographic index (SDI).

Publicly available data on the burden of MDD were retrieved from the Global Burden of Disease (GBD) study 2019 for the 21 countries in MENA. The counts and age-standardised rates (per 100,000) were presented, along with their corresponding 95% uncertainty intervals.

In 2019, MDD had an age-standardised point prevalence of 3322.1 and an incidence rate of 4921.7 per 100,000 population in MENA. Furthermore, there were 4.1 million YLDs in 2019. However, there were no substantial changes in the MDD burden over the period 1990-2019. In 2019, Palestine had the highest burden of MDD. The highest prevalence, incidence and YLDs attributable to MDD were found in the 35-39 age group. In 2019, the YLD rate in MENA was higher than the global rate for almost all age groups. Furthermore, there was a broadly negative association between the YLD rate and SDI.

The study highlights the need to prevent the disorder using a multidisciplinary approach and for the provision of cost-effective treatments for those affected, in order to increase their quality of life.

Despite their acknowledged value, patient-reported outcome measures (PROMs) are infrequently used in psychosis, particularly in low-and middle-income countries. We compared ratings on two single-item PROMs, Self-Rated Health (SRH) and Self-Rated Mental Health (SRMH), of persons receiving similar early psychosis services in Chennai, India and Montreal, Canada. We hypothesized greater improvements in SRH and SRMH in the Chennai (compared to the Montreal) sample.

Participants (Chennai N = 159/168 who participated in the larger study; Montreal N = 74/165 who participated in the larger study) completed the SRH and SRMH during at least two out of three timepoints (entry, months 12 and 24). Repeated measures proportional odds logistic regressions examined the effects of time (baseline to month 24), site, and relevant baseline (e.g., gender) and time-varying covariates (i.e., symptoms) on SRH and SRMH scores.

SRH (but not SRMH) scores significantly differed between the sites at baseline, with Chennai patients reporting poorer health (OR: 0.33; CI: 0.18, 0.63). While Chennai patients reported similar significant improvements in their SRH (OR: 7.03; CI: 3.13; 15.78) and SRMH (OR: 2.29, CI: 1.03, 5.11) over time, Montreal patients only reported significant improvements in their SRMH. Women in Chennai (but not Montreal) reported lower mental health than men. Higher anxiety and longer durations of untreated psychosis were associated with poorer SRH and SRMH, while negative symptoms were associated with SRH.

As hypothesized, Chennai patients reported greater improvements in health and mental health. The marked differences between health and mental health in Montreal, in contrast to the overlap between the two in Chennai, aligns with previous findings of clearer distinctions between mind and body in Western societies. Cross-context (e.g., anxiety) and context-specific (e.g., gender) factors influence patients' health perceptions. Our results highlight the value of integrating simple PROMs in early psychosis.

Chronic pain often leads to the development of sleep disturbances. However, the precise neural circuit mechanisms responsible for sleep disorders in chronic pain have remained largely unknown. Here, we present compelling evidence that hyperactivity of pyramidal neurons (PNs) in the anterior cingulate cortex (ACC) drives insomnia in a mouse model of nerve-injury-induced chronic pain. After nerve injury, ACC PNs displayed spontaneous hyperactivity selectively in periods of insomnia. We then show that ACC PNs were both necessary for developing chronic-pain-induced insomnia and sufficient to mimic sleep loss in naive mice. Importantly, combining optogenetics and electrophysiological recordings, we found that the ACC projection to the dorsal medial striatum (DMS) underlies chronic-pain-induced insomnia through enhanced activity and plasticity of ACC-DMS dopamine D1R neuron synapses. Our findings shed light on the pivotal role of ACC PNs in developing chronic-pain-induced sleep disorders.

During the height of the COVID-19 pandemic, the Korean government temporarily allowed full scale telehealth care for safety and usability. However, limited studies have evaluated the impact of telehealth by analyzing the physical and/or mental health data of patients with COVID-19 diagnosis collected through telehealth targeting Korean population.

This study aimed to identify subgroup of depressive symptom trajectories in patients with clinically mild COVID-19 using collected longitudinal data from a telehealth-based contactless clinical trial.

A total of 199 patients with COVID-19 were accrued for contactless clinical trial using telehealth from March 23 to July 20, 2022. Depressive symptoms were measured using the patient health questionnaire-9 on the start day of quarantine, on the final day of quarantine, and 1 month after release from quarantine. Additionally, acute COVID-19 symptoms were assessed every day during quarantine. This study used a latent class mixed model to differentiate subgroups of depressive symptom trajectories and a logistic regression model with Firth's correction to identify associations between acute COVID-19 symptoms and the subgroups.

Two latent classes were identified: class 1 with declining linearity at a slow rate and class 2 with increasing linearity. Among COVID-19 symptoms, fever, chest pain, and brain fog 1 month after release from quarantine showed strong associations with class 2 (fever: OR, 19.43, 95% CI, 2.30-165.42; chest pain: OR, 6.55, 95% CI, 1.15-34.61; brain fog: OR, 7.03, 95% CI 2.57-20.95). Sleeping difficulty and gastrointestinal symptoms were also associated with class 2 (gastrointestinal symptoms: OR, 4.76, 95% CI, 1.71-14.21; sleeping difficulty: OR, 3.12, 95% CI, 1.71-14.21).

These findings emphasize the need for the early detection of depressive symptoms in patients in the acute phase of COVID-19 using telemedicine. Active intervention, including digital therapeutics, may help patients with aggravated depressive symptoms.

Help-seeking for depression and anxiety disorders from primary care physicians in Western countries is at three times the rate of China. Western help-seeking models for common mental disorders have limitations in the Chinese settings. This article argues that an adapted model based on Andersen's Behavioral Model of Health Services Use could be an appropriate tool to better understand patients' help-seeking behaviors and improve outcomes. We applied a narrative review approach to integrate research findings from China into Andersen's model to generate a model that fits the Chinese context. We found 39 relevant articles in PubMed, MEDLINE, and Chinese journal databases from 1999 to 2022. Findings were mapped onto predisposing, enabling, and need factors of the model. This model emphasizes that predisposing factors including demographics, social norms, and health beliefs influence help-seeking preferences. Mental health service users in China tend to be older and female. Chinese generally have high concern about psychotropic medications, and social norms that consider psychological distress a personal weakness may discourage help-seeking. However, help-seeking can be enhanced by enabling factors in the health system, including training of primary care physicians, longer consultation time, and continuity of care. Need factors for treatment increase with the severity of distress symptoms, and doctor's skills and attitudes in recognizing psychosomatic symptoms. While predisposing factors are relatively hard to change, enabling factors in the health system and need factors for treatment can be targeted by enhancing the role of family doctors and training in mental health.

Patients with chronic heart failure (CHF) frequently suffer from depressive comorbidity. CHF and depressive comorbidity can cause somatic symptoms. The correct attribution of somatic symptoms is important. Thus, we aimed to assess potential differences in somatic symptom severity between CHF patients with and without depressive comorbidity.

We evaluated depressive comorbidity using the Patient Health Questionnaire-9 (PHQ-9), somatic symptom severity with the Patient Health Questionnaire-15 (PHQ-15), and sociodemographic and medical variables in 308 CHF outpatients. To compare somatic symptom severity between CHF patients with and without depressive comorbidity, we conducted item-level analyses of covariance.

Of the 308 participating patients, 93 (30.3%) met the PHQ-9 criteria for depressive comorbidity. These patients did not differ from those without depressive comorbidity with regard to age, sex, left ventricular function, and multimorbidity. Patients with depressive comorbidity scored significantly higher on ten out of thirteen PHQ-15 items than patients without depressive comorbidity. The largest effect sizes (0.71-0.80) were shown for symptoms of headache, chest pain, shortness of breath, and palpitations, and the latter three were potentially attributable to heart failure.

Among patients with CHF, somatic symptoms are more pronounced in those with depressive comorbidity than those without depressive comorbidity. This finding is especially true for cardiac symptoms independent of CHF severity. The potential interpretation of somatic symptoms as correlates of depressive comorbidity must be recognized in clinical practice.

The prevalence of depression is high worldwide, and somatic symptoms are known to be one of the most debilitating aspects of depression. However, clinicians often face challenges in accurately assessing this comorbidity. To address this issue, the Depression and Somatic Symptoms Scale (DSSS) was developed as a self-administered scale that can diagnose both depression and somatic symptoms. The objective of this study is to evaluate the validity and reliability of the Arabic-translated version of the DSSS (A-DSSS) in a sample of Lebanese adults, as well as to explore its associated factors. A cross-sectional study was conducted over a period of one month, from February to March 2023, and involved a sample of 422 participants who were aged 18 years or older. Participants completed a questionnaire that included various measures, including demographic characteristics, alcohol and smoking habits, physical activity history, as well as two scales: the Patient Health Questionnaire-9 (PHQ9) scale and the A-DSSS scale. The A-DSSS showed high internal consistency (Cronbach's alpha = 0.936), strong test-retest reliability (ICC of 0.988 with CI 0.976-0.994; p < 0.001), and a three-factor structure consistent with previous research. Convergent validity was supported by a significant correlation with the PHQ-9. Stepwise linear regression revealed that engaging in physical activity and increasing calorie consumption (as measured by MET-min/week score) were associated with a significant decrease in the A-DSSS total score and subscales. However, a significant increase in the A-DSSS total score was seen in the female gender in comparison for male gender. The A-DSSS revealed good psychometric properties and may be a useful tool for assessing depression and somatic symptoms in this population. The study also identified potential factors associated with depression and somatic symptoms, such as physical activity, calorie consumption, and gender, which may have implications in addressing depression and somatic symptoms for future interventions and clinical practice.

Survival is a fundamental physiological drive, and neural circuits have evolved to prioritize actions that meet the energy demands of the body. This fine-tuning of goal-directed actions based on metabolic states ('allostasis') is deeply rooted in our brain, and hindbrain nuclei orchestrate the vital communication between the brain and body through the vagus nerve. Despite mounting evidence for vagal control of allostatic behavior in animals, its broader function in humans is still contested. Based on stimulation studies, we propose that the vagal afferent pathway supports transitions between survival modes by gating the integration of ascending bodily signals, thereby regulating reward-seeking. By reconceptualizing vagal signals as catalysts for goal-directed behavior, our perspective opens new avenues for theory-driven translational work in mental disorders.

There is not yet a valid and evidence-based system to classify patients with MDD into more homogeneous subtypes based on their clinical features. This study aims to identify symptom-based subtypes of MDD and investigate whether the treatment outcomes of those subtypes would be different.

The cohort was established at 12 densely populated cities of China. A total of 1487 patients were enrolled. All participants were 18-65 years old and diagnosed with MDD. Participants were followed up at baseline, weeks 4, 8, and 12, and months 4 and 6. K-means algorithm was used to cluster patients with MDD according to clinical symptoms. The network analysis was adopted to characterize and compare the symptom patterns in the clusters. We also examined the associations between the clusters and the clinical outcomes.

The optimal number of the clusters was determined to be 2. Each cluster's maximum Jaccard Co-efficient was calculated to be >0.5 (cluster1 = 0.53, cluster 2 = 0.67). The symptom "depressed mood" and some other affective symptoms were the most prominent in cluster 1. Somatic symptoms, such as weight loss and general somatic symptoms, had the greatest expected influence in cluster 2. Compared with the response rates of the patients in the "somatic cluster", those of the patients in the "affective cluster" were significantly higher (P < 0.05).

Patients with MDD might be classified into two symptom-based subtypes featured with affective symptoms or somatic symptoms. The treatment efficacy and prognosis of the subtype featured with somatic symptoms may be worse.

Background  The COVID-19 pandemic has been difficult for all healthcare providers. Nurses in Indian hospitals are at risk for mental health consequences of COVID-19-related stress. The study aimed to evaluate the mental health responses of Indian nurses working during the COVID-19 pandemic.  Method The study was carried out during the COVID-19 pandemic from November 2020 to February 2021. Frontline nurses (n=387) working in both government and private sectors were recruited from four hospital centers across Mangalore, India. Nurses were selected based on specific inclusion criteria, including active duty within wards and intensive care units designated for COVID-19 care or suspected cases of SARS-CoV-2 infection. Recruitment and data collection were facilitated by medical residents using a mix of physical and electronic survey methods. Results Nurses within the private sector with low personal protective equipment (PPE) security experienced heightened anxiety. Somatic symptoms were incrementally related to mental health depending on the workplace setting; private sector staff reported greater depression symptoms compared to those in government-run hospitals. Self-efficacy buffered against depression outcomes only in nurses within the private sector working within non-COVID units. Conclusions This study's findings showed differential responses to the stress of COVID-19 based on the setting. Future studies should further explore the factors associated with such differences. Somatic symptoms can be indicators of mental health adversity. Early detection and supportive interventions need to be taken into account.

To investigate the impact of baseline painful physical symptoms (PPS) on subsequent first-episode major depressive disorder (MDD) in adults with subthreshold depressive symptoms, including subgroup analyses to assess whether the associations differ in individuals with and without physical diseases.

A total of 2343 adults with subthreshold depressive symptoms were recruited at 34 primary health care centers. PPS were measured at baseline. First-episode MDD during follow-up was diagnosed by professional psychiatrists using the Mini-International Neuropsychiatric Interview.

Baseline PPS showed independent impacts on first-episode MDD in adults with subthreshold depressive symptoms without physical diseases, but not in those with physical diseases. A non-linear association (P < 0.001) was observed between PPS burden and the risk of first-episode MDD. The HRs for first-episode MDD exhibited a rapidly increasing trend between PPS burden scores of 10-16, and maintained consistently high when scores exceeded 16. The analyses for specific PPS revealed that headache, neck pain, and heart or chest pain were independently associated with first-episode MDD in participants without physical diseases, the HRs were 1.57 (1.15-2.36), 1.53 (1.02-2.30), and 1.69 (1.14-2.50), respectively. Further network analysis demonstrated that heart or chest pain serves as a bridge symptom among the seven specific PPS and first-episode MDD in those without physical diseases.

PPS burden and heart or chest pain may be significant indicators for first-episode MDD in adults with subthreshold depressive symptoms without physical diseases. Future studies should investigate whether interventions targeting PPS can prevent episode MDD in this subthreshold population.

Neuropathic pain often leads to negative emotions, which in turn can enhance the sensation of pain. This study aimed to investigate the molecular mechanisms mediating neuropathic pain and negative emotions. Chronic constriction injury (CCI) rats were used as model animals and behavioral tests were conducted to assess pain and negative emotions. Then, the rat anterior cingulate cortex (ACC) was analyzed using UPLC-MS/MS and subsequently integrated with our previously published transcriptome data. Metabolomics analysis revealed that 68 differentially expressed metabolites (DEMs) were identified, mainly in amino acid metabolites and fatty acyls. Combined with our previously published transcriptome data, we predicted two genes that potentially exhibited associations with these metabolites, respectively Apolipoprotein L domain containing 1 (Apold1) and WAP four-disulfide core domain 1 (Wfdc1). Taken together, our results indicated that peripheral nerve injury contributing to neuropathic pain and pain-related depression may be associated with these metabolites and genes. This research provides new insights into the molecular regulatory mechanism, which could serve as a reference for the treatment of neuropathic pain and pain-related depression.

Research has shown a protective association between social support and depression, depression among stroke patients, and health impacts of depression. Despite this, not much is known about the effect of social support on depression among stroke patients. This review aims to summarize the current research examining the association between social support and depression among stroke patients. A literature search was performed in PubMed to find original peer-reviewed journal articles from 2016 to 12 March 2023 that examined the association between social support and depression among stroke patients. The search terms were depression and "social support" and stroke, which lead to 172 articles. After abstract review, seven observational studies that studied the target association among stroke patients were selected. One additional study was found using PsycINFO as a complementary source with the same search strategy and criteria. Overall, a negative association was found between social support and depression among stroke patients in eight studies, with more social support leading to lower rates of depression post-stroke. The other study did not find a statistically significant association. Overall, the results of recent studies suggest that social support is negatively associated with depression among stroke patients. In most studies, this association was statistically significant. The findings suggest the importance of improving social support perceived by stroke patients in the prevention of depression after the occurrence of stroke.

Chronic pain is a frequent, distressing and poorly understood health problem. Plasticity of synaptic transmission in the nociceptive pathways after inflammation or injury is assumed to be an important cellular basis for chronic, pathological pain. Glutamate serves as the main excitatory neurotransmitter at key synapses in the somatosensory nociceptive pathways, in which it acts on both ionotropic and metabotropic glutamate receptors. Although conventionally postsynaptic, compelling anatomical and physiological evidence demonstrates the presence of presynaptic glutamate receptors in the nociceptive pathways. Presynaptic glutamate receptors play crucial roles in nociceptive synaptic transmission and plasticity. They modulate presynaptic neurotransmitter release and synaptic plasticity, which in turn regulates pain sensitization. In this review, we summarize the latest understanding of the expression of presynaptic glutamate receptors in the nociceptive pathways, and how they contribute to nociceptive information processing and pain hypersensitivity associated with inflammation / injury. We uncover the cellular and molecular mechanisms of presynaptic glutamate receptors in shaping synaptic transmission and plasticity to mediate pain chronicity, which may provide therapeutic approaches for treatment of chronic pain.