Major depression (MD) is a highly heterogeneous diagnostic category. Diverse symptoms such as sad mood, anhedonia, and fatigue are routinely added to an unweighted sum-score, and cutoffs are used to ...distinguish between depressed participants and healthy controls. Researchers then investigate outcome variables like MD risk factors, biomarkers, and treatment response in such samples. These practices presuppose that (1) depression is a discrete condition, and that (2) symptoms are interchangeable indicators of this latent disorder. Here I review these two assumptions, elucidate their historical roots, show how deeply engrained they are in psychological and psychiatric research, and document that they contrast with evidence. Depression is not a consistent syndrome with clearly demarcated boundaries, and depression symptoms are not interchangeable indicators of an underlying disorder. Current research practices lump individuals with very different problems into one category, which has contributed to the remarkably slow progress in key research domains such as the development of efficacious antidepressants or the identification of biomarkers for depression. The recently proposed network framework offers an alternative to the problematic assumptions. MD is not understood as a distinct condition, but as heterogeneous symptom cluster that substantially overlaps with other syndromes such as anxiety disorders. MD is not framed as an underlying disease with a number of equivalent indicators, but as a network of symptoms that have direct causal influence on each other: insomnia can cause fatigue which then triggers concentration and psychomotor problems. This approach offers new opportunities for constructing an empirically based classification system and has broad implications for future research.
Parents’ socialization beliefs have implications for the psychological adjustment of their children through their parenting behaviors; however, such pathways have rarely been established among ...Chinese American families. The present study examined how Chinese American parents’ goals for their children to take on bicultural values and behaviors (i.e., bicultural socialization beliefs) influenced their child’s level of depressive symptoms in emerging adulthood through their parenting behaviors and the level of parent–child alienation. Data came from Waves 2 (adolescence) and 3 (emerging adulthood) of a longitudinal study of 444 Chinese American families. Mothers’ reports of their bicultural socialization beliefs positively predicted adolescents’ reports of mothers’ autonomy-supporting behaviors and interdependence-focused shaming behaviors. In addition, there was a significant and negative indirect effect of mothers’ bicultural socialization beliefs on emerging adult depressive symptoms through adolescents’ reports of mothers’ autonomy-supporting behaviors and emerging adults’ reports of alienation to their parents. In contrast, there was a significant and positive indirect effect from fathers’ reports of their bicultural socialization beliefs to emerging adult depressive symptoms, through emerging adults’ reports of alienation only. Findings contribute to our understanding of bicultural processes in Chinese American families and establish that parents’ beliefs have significant implications for the psychological adjustment of Chinese American youth. (PsycInfo Database Record (c) 2024 APA, all rights reserved) (Source: journal abstract)
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CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ, UPUK
Despite the importance for understanding mechanisms of change, little is known about the order of change in daily life emotions, cognitions, and behaviors during treatment of depression. This study ...examined the within-person temporal order of emotional, cognitive, and behavioral improvements using ecological momentary assessment data.
Thirty-two individuals with diagnosed depression completed ecological momentary assessment questions on emotions (sad mood, happy mood), behaviors (social interaction, number of activities), and cognitive variables (worrying, negative self-thoughts) 5 times a day during a 4-month period in which they underwent psychotherapy for depression. Nonparametric change-point analyses were used to determine the timing of gains (i.e., improvements in the mean of each variable) for each individual. We then established whether the first (i.e., earliest) gains in emotions preceded, followed, or occurred in the same week as cognitive and behavioral gains for each individual.
Contrary to our hypotheses, first gains in behaviors did not precede first emotional gains (3 times, 8%) more often than they followed them (26 times, 70%). Cognitive gains often occurred in the same week as first emotional gains (43 times, 58%) and less often preceded (13 times, 18%) or followed emotional gains (18 times, 24%).
The first improvements in behaviors did not tend to precede the first improvements in emotions likely because fewer behavioral gains were found. The finding that cognitive variables tend to improve around the same time as sad mood may explain why many studies failed to find that cognitive change predicts later change in depressive symptoms. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ, UPUK
Major depression is one of the most prevalent and debilitating personal and public health conditions worldwide. Less appreciated is that depression's tremendous burdens are not shared equally among ...all who become depressed. Some will suffer recurrences over the rest of their lives, whereas half or more will never have a recurrence. Based on these two distinctive life course prototypes, we propose a subtype distinction for research on the origins and lifetime course of major depression. A pressing goal is to determine at the time of depression's first onset who will follow which clinical trajectory. The lack of recognition of this distinction has resulted in many obstacles, including conceptual biases, methodological oversights, and definitional dead ends. Current theories are reviewed and compared. The implications for contemporary diagnostic controversies, reevaluating research on treatment and prevention, and enhancing the predictive strength of traditionally weak indicators of recurrences and recurrent depression are discussed.
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CMK, FFLJ, NUK, UL, UM, UPUK
Depressive symptomatology is manifested in greater first-person singular pronoun use (i.e., I-talk), but when and for whom this effect is most apparent, and the extent to which it is specific to ...depression or part of a broader association between negative emotionality and I-talk, remains unclear. Using pooled data from N = 4,754 participants from 6 labs across 2 countries, we examined, in a preregistered analysis, how the depression-I-talk effect varied by (a) first-person singular pronoun type (i.e., subjective, objective, and possessive), (b) the communication context in which language was generated (i.e., personal, momentary thought, identity-related, and impersonal), and (c) gender. Overall, there was a small but reliable positive correlation between depression and I-talk (r = .10, 95% CI .07, .13). The effect was present for all first-person singular pronouns except the possessive type, in all communication contexts except the impersonal one, and for both females and males with little evidence of gender differences. Importantly, a similar pattern of results emerged for negative emotionality. Further, the depression-I-talk effect was substantially reduced when controlled for negative emotionality but this was not the case when the negative emotionality-I-talk effect was controlled for depression. These results suggest that the robust empirical link between depression and I-talk largely reflects a broader association between negative emotionality and I-talk. Self-referential language using first-person singular pronouns may therefore be better construed as a linguistic marker of general distress proneness or negative emotionality rather than as a specific marker of depression.
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This meta-analysis evaluated the relation between social support and depression in youth and compared the cumulative evidence for 2 theories that have been proposed to explain this association: the ...general benefits (GB; also known as main effects) and stress-buffering (SB) models. The study included 341 articles (19% unpublished) gathered through a search in PsycINFO, PsycARTICLES, ERIC, and ProQuest, and a hand search of 11 relevant journals. Using a random effects model, the overall effect size based on k = 341 studies and N = 273,149 participants was r = .26 (95% CI .24, .28), with robust support for the GB model and support for the SB model among medically ill youth. Stress-buffering analyses suggest that different stressful contexts may not allow youth to fully draw on the benefits of social support, and we propose value in seeking to better understand both stress-buffering (effects of social support are enhanced) and reverse stress-buffering (effects of social support are dampened) processes. Key findings regarding other moderators include a different pattern of effect sizes across various sources of support. In addition, gender differences were largely absent from this study, suggesting that social support may be a more critical resource for boys than is typically acknowledged. Results also demonstrated the importance of using instruments with adequate psychometric support, with careful consideration of methodological and conceptual issues. Building upon these collective findings, we provide recommendations for theory and practice, as well as recommendations for addressing limitations in the extant literature to guide future investigations.
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Social support is the degree to which people are accepted by, cared for, and attended to by important others and is one of the most popular constructs in the psychological canon. This project ...synthesized data from 60 meta-analyses, which included over 2,700 studies and 2.1 million participants, to evaluate the association of social support with psychological adjustment. Results from a second-order meta-analysis indicated that, overall, social support yielded a robust association with psychological adjustment,
= .24, 95% CI .22, .26. Effects of social support were detectable across several outcome categories (mental health, psychological traits, educational outcomes, workplace outcomes), specific outcomes (depression, posttraumatic stress disorder, stress, burnout), and sources of support (friends, family, peers, teachers, coworkers, supervisors), and were detectable across age and cultural groups. However, perceived support was more strongly associated with psychological adjustment than received support. Furthermore, social support effects were larger when examining unhealthy samples, well-validated scales, and cross-sectional studies. Finally, effects were less pronounced in six meta-analyses that controlled for relevant covariates,
= .17, 95% CI .10, .23. Given the substantial variability of social support effects across prior meta-analyses (range = .07-.41), future study is needed to identify additional moderators of its association with psychological adjustment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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We investigated the plasma levels of MHPG, a metabolite of noradrenaline or IL-6, and the clinical response to paroxetine in major depression (MD). Twenty-eight patients who met the MD criteria as ...per DSM-5 were enrolled in this study (age 42 ± 8 years; male/female 15/13; single-/repeated-episode 12/16). The plasma levels of MHPG were not altered before or four weeks after paroxetine treatment. Plasma levels of IL-6 were significantly decreased 4 weeks after paroxetine treatment. The HAMD scores significantly decreased after paroxetine treatment. No correlation was found between changes in plasma MHPG and changes in HAMD scores before and 4 weeks after paroxetine treatment. No interaction was observed between plasma MGPH and plasma IL-6 in patients with MD treated with paroxetine.
•Plasma levels of IL-6 were significantly decreased 4 weeks after paroxetine treatment. The HAMD scores significantly decreased after paroxetine treatment.•No correlation was found between changes in plasma MHPG or IL-6 and changes in the HAMD scores before and 4 weeks after paroxetine treatment.•No interaction was observed between plasma MGPH and plasma IL-6 in patients with MD treated with paroxetine.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
People with severe mental illness (SMI) – schizophrenia, bipolar disorder and major depressive disorder – appear at risk for cardiovascular disease (CVD), but a comprehensive meta‐analysis is ...lacking. We conducted a large‐scale meta‐analysis assessing the prevalence and incidence of CVD; coronary heart disease; stroke, transient ischemic attack or cerebrovascular disease; congestive heart failure; peripheral vascular disease; and CVD‐related death in SMI patients (N=3,211,768) versus controls (N=113,383,368) (92 studies). The pooled CVD prevalence in SMI patients (mean age 50 years) was 9.9% (95% CI: 7.4‐13.3). Adjusting for a median of seven confounders, patients had significantly higher odds of CVD versus controls in cross‐sectional studies (odds ratio, OR=1.53, 95% CI: 1.27‐1.83; 11 studies), and higher odds of coronary heart disease (OR=1.51, 95% CI: 1.47‐1.55) and cerebrovascular disease (OR=1.42, 95% CI: 1.21‐1.66). People with major depressive disorder were at increased risk for coronary heart disease, while those with schizophrenia were at increased risk for coronary heart disease, cerebrovascular disease and congestive heart failure. Cumulative CVD incidence in SMI patients was 3.6% (95% CI: 2.7‐5.3) during a median follow‐up of 8.4 years (range 1.8‐30.0). Adjusting for a median of six confounders, SMI patients had significantly higher CVD incidence than controls in longitudinal studies (hazard ratio, HR=1.78, 95% CI: 1.60‐1.98; 31 studies). The incidence was also higher for coronary heart disease (HR=1.54, 95% CI: 1.30‐1.82), cerebrovascular disease (HR=1.64, 95% CI: 1.26‐2.14), congestive heart failure (HR=2.10, 95% CI: 1.64‐2.70), and CVD‐related death (HR=1.85, 95% CI: 1.53‐2.24). People with major depressive disorder, bipolar disorder and schizophrenia were all at increased risk of CVD‐related death versus controls. CVD incidence increased with antipsychotic use (p=0.008), higher body mass index (p=0.008) and higher baseline CVD prevalence (p=0.03) in patients vs. controls. Moreover, CVD prevalence (p=0.007), but not CVD incidence (p=0.21), increased in more recently conducted studies. This large‐scale meta‐analysis confirms that SMI patients have significantly increased risk of CVD and CVD‐related mortality, and that elevated body mass index, antipsychotic use, and CVD screening and management require urgent clinical attention.
•Substance use disorders (SUDs) are highly prevalent in major depression.•The pooled prevalence of any SUD in major depressive disorder (MDD) was 0.250.•Alcohol use disorder (AUD) had the highest ...pooled prevalence of 0.208.•Males had higher rates of alcohol use compared to females.•Rates of AUD were found to be equally high in MDD and dysthymic disorder.•Comorbid rates of SUD and MDD have changed little over the last three decades.
Comorbidity between Substance Use Disorders (SUDs) and major depression is highly prevalent. This systematic review and meta-analysis aimed to estimate the prevalence of SUDs in subjects diagnosed with a major depressive disorder (MDD) in community, inpatient and outpatient settings.
A comprehensive literature search of Medline, EMBASE, PsycINFO and CINAHL databases was conducted from 1990 to 2019. Prevalence of co-morbid SUDs and MDD were extracted and odds ratios (ORs) were calculated using random effects meta-analysis.
There were 48 articles identified by electronic searches with a total sample size of 348,550 subjects that yielded 14 unique epidemiological studies, 2 national case registry studies, 7 large cohort studies and 20 clinical studies using in- or out-patients. The prevalence of any SUD in individuals with MDD was 0.250. Maximum prevalence was found with alcohol use disorder (0.208), followed by illicit drug use disorder (0.118) and cannabis use disorder (0.117). Meta-analysis showed the pooled variance of any AUD in men with MDD was 36%, which was significantly higher than that for females with MDD (19%, OR 2.628 95% CI 2.502, 2.760).
Few studies were published over the last decade so current prevalence rates of SUD in MDD are needed. Meta-analysis revealed that SUDs in MDD are highly prevalent and rates have not changed over time. The persistently high prevalence suggests there is an urgent need for more informative studies to help develop better prevention and treatment options for reducing prevalence of SUDs in persons with major depression and co-morbid disorders.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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