Perinatal depression is a major cause of disability for individuals giving birth worldwide, with detrimental effects on short- and long-term parental and child outcomes. There is emerging evidence ...that the neuroactive steroid hormone allopregnanolone is implicated in the pathophysiology and course of perinatal mood symptoms. However, no study thus far has examined allopregnanolone levels whilst making use of longitudinal data on depressive symptom trajectories throughout the perinatal period. The present study investigated levels of allopregnanolone at gestational week 17 of 252 participants in relation to perinatal depressive symptom trajectories, with a secondary aim of exploring the role of history of depression as an effect modifier. Four perinatal depressive symptom trajectories were investigated: controls (no depressive symptoms throughout perinatal period) (N=161), antepartum (depressive symptoms prenatally with postpartum remission) (N=31), postpartum-onset (no depressive symptoms during pregnancy, development of depressive symptoms postpartum) (N=23), and persistent (depressive symptoms throughout the perinatal period) (N=37). Results show that for every one nmol/l increase in allopregnanolone, there was 7% higher odds for persistent depressive symptoms (OR 1.07, 95% CI 1.01–1.14) compared to controls. No association was seen for antepartum and postpartum-onset depressive symptoms. History of depression did not modify the association between allopregnanolone and perinatal depressive symptom trajectories. These results show the role of allopregnanolone for persistent depressive symptoms and strengthen the hypothesis of differences in pathophysiology among the trajectories.
•Higher allopregnanolone was associated with higher odds for persistent depressive symptoms.•No associations were found between allopregnanolone and APDS or PPDS.•Depression history was not an effect modifier of allopregnanolone on perinatal depression.
This study aimed to explore the relationship between flavonoids intake and the prevalence and all-cause mortality of depressive symptoms in American adults.
Analyzing 2007–2008, 2009–2010, and ...2017–2018 NHANES data, we examined the association between dietary flavonoid and depressive symptoms, including specific subclasses assessment and mortality outcomes tracking until December 31, 2019. Our methodology included weighted multivariate logistic regression, weighted cox proportional hazards regression and restricted cubic spline (RCS) models, supported by stratified and sensitivity analyses.
Among the 12,340 participants in total, 1129 exhibited depressive symptoms. The multiple logistic regression analysis showed a significant reduction in total flavonoid and subclass intake in individuals with current depressive symptoms. Adjusted odds ratios (ORs) for the highest quartiles were 0.69 for anthocyanidins and 0.63 for flavones. Interaction effects emerged in non-hypertensive, higher-income, and normal-weight groups for flavones intake. The RCS model indicated an L-shaped association between depressive symptoms and total flavonoid intake, with inflection points at 346 mg/day. During a median follow-up of 119 months, 148 deaths occurred among patients with depressive symptoms. Hazard ratios (HRs) for all-cause mortality showed a significant positive correlation between total flavonoid intake and survival in model 1 (HR = 0.56), with an optimal intake range of 45.2–948.3 mg/day according to the RCS model.
The study relied on U.S. population survey data, potentially limiting generalizability. Unmeasured confounding factors may exist, and genetic factors were not considered.
Adequate intake of flavonoids, especially anthocyanidins and flavones, is associated with reduced odds of depressive symptoms. Additionally, optimal intake ranges of flavonoid intake for mental health benefits were observed for all-cause mortality in population with depressive symptoms.
•Flavonoid intake is associated with lower depressive symptoms, particularly from anthocyanidins and flavones, and better survival.•The L-shaped link between total flavonoid intake and depressive symptoms and mortality suggests an optimal intake for mental health.•Interaction effects suggest flavones are more linked to depressive symptoms in non-hypertensive, higher-income, normal-weight individuals.
Metformin is a medication that is widely used for lowering blood sugar in patients with type 2 diabetes. Metformin was shown to have significant antidepressant effects; however, it is not clear ...whether metformin treatment improves outcomes in patients with type 2 diabetes who have concomitant depressive symptoms.
A total of 475 patients with type 2 diabetes mellitus with depressive symptoms were included in this study and divided into metformin and nonmetformin groups according to whether they were taking metformin. The DASS-21 was used to assess patients' depression and anxiety scores before and after a 24-week intervention. In addition, general information about whether the patients had developed complications from diabetes and whether they had been diagnosed with other diseases was assessed.
(1) After 24 weeks, anxiety and depression scores were significantly lower in the metformin group than in the nonmetformin group. (2) The prevalence of depressive symptoms was significantly greater in female type 2 diabetic patients than in male patients (OR = 2.039, 95 % CI = 1.160–3.568). (3) People with type 2 diabetes who develop complications from diabetes (OR = 1.794, 95 % CI = 1.015–3.171) and those diagnosed with other conditions are more likely to experience depressive symptoms.
Metformin has an ameliorative effect on type 2 diabetes. However, women, those with diabetes complications, and those with type 2 diabetes who are also diagnosed with other conditions are more likely to experience depressive symptoms.
•Metformin Intervention Improves Depressive Symptoms in Patients with Type 2 Diabetes Mellitus After 24 Weeks of Intervention.•Metformin improves anxiety in patients with T2D.•There is a significant gender difference in the distribution of depressive symptoms in patients with type 2 diabetes, with women with type 2 diabetes more likely to experience depressive symptoms.•Complications of diabetes and other diseases are also risk factors for depressive symptoms.
The Supplemental Nutrition Assistance Program (SNAP) has been established to reduce food insecurity. Limited evidence is available on SNAP participation status over time and depressive symptoms. We ...aimed to examine the associations of SNAP status over time among low-income individuals, with depressive symptoms in the U.S.
NHANES participants aged ≥20 years of low family income from 2011 to 2018 with information available on depressive symptoms and SNAP use were included in analysis. Depressive symptoms were assessed using 9-item Patient Health Questionnaire (PHQ-9), and PHQ-9 score ≥ 10 is indicative of significant depressive symptoms. Multivariable linear and logistic regressions models were conducted to examine the associations of SNAP participation status over time (never receiving SNAP, receiving SNAP prior to >12 months ago, current receiving SNAP, receiving SNAP in the last 12 months but not currently) with depressive symptoms and significant depressive symptoms.
Currently receiving SNAP (beta (β) = 0.17, 95 % CI: 0.10, 0.25; odds ratio (OR) = 1.52, 95 % confidence interval (CI): 1.16, 2.00) and receiving SNAP in the last 12 months but not currently (β = 0.24, 95 % CI: 0.04, 0.43; OR = 1.83, 95 % CI: 1.16, 2.89) were associated with higher depressive symptoms and higher prevalence of significant depressive symptoms.
The cross-sectional design precludes causal interpretation, and key variables were measured with self-report.
Receiving SNAP in the last 12 months was associated with higher levels of depressive symptoms among individuals with low family income. Improvement on diet quality may be important for reducing depressive symptoms among SNAP users.
•Recent SNAP participation is associated with higher levels of depressive symptoms among individuals with low family income.•The associations of SNAP participation status and depressive symptoms are more pronounced in certain subgroups.•Future efforts may study improving quality of diet among SNAP recipients for further prevention of health outcomes.
Celecoxib, a nonsteroidal anti-inflammatory agent, was found to be an effective add-on treatment for unipolar and bipolar depression. We investigated the potential beneficial effect of celecoxib ...monotherapy on depressive symptoms after Coronavirus disease (COVID-19).
This was a randomized, double-blind, placebo-controlled clinical trial investigating the therapeutic effects of celecoxib monotherapy in patients with moderate depressive symptoms following COVID-19 infection. Patients were randomized to receive either a celecoxib capsule (100 mg) twice daily or a placebo capsule twice daily for 6 weeks. Participants were assessed with the Hamilton Depression Rating Scale (HDRS) and the side effect checklist at baseline and weeks 3 and 6.
A total of 62 patients were included. GLM repeated-measures showed a significant effect of time × treatment (F = 12.95, df = 1.98, p < 0.001) for celecoxib, suggesting superior improvement of depressive symptoms in celecoxib compared to placebo from baseline to the study endpoint. HDRS scores in the celecoxib group showed a greater decline from baseline to both week 3 (t = 4.12, p < 0.001, Cohen's d = 1.10) and week 6 (t = 4.76, p < 0.001, Cohen's d = 1.27), compared to the placebo group. Rate of response to treatment (70% vs 9%, p < 0.001) and remission (67% vs 0%, p < 0.001) was significantly higher in celecoxib compared to the placebo group at week 6. Adverse event frequencies were not significantly different between the two groups.
We demonstrated that treatment with celecoxib significantly improved depression scores of patients with depressive symptoms following COVID-19 infection. Further trials with larger sample sizes and longer study periods should assess our findings before any suggestion for clinical use.
The trial was prospectively registered at the Iranian registry of clinical trials (www.irct.ir; registration number: IRCT20090117001556N142).
•COVID-19 patients are affected by depressive symptoms after acute phase.•Celecoxib significantly improved depression scores of patients with post-COVID-19•Rate of response to treatment and remission was higher in the celecoxib group•Treatment with celecoxib was safe.
This study aimed to examine the relationship between different dimensions of depressive symptoms and the presence of diabetes mellitus in hemodialysis patients. Additionally, the study sought to ...elucidate the mediating effect of physical performance on this association.OBJECTIVEThis study aimed to examine the relationship between different dimensions of depressive symptoms and the presence of diabetes mellitus in hemodialysis patients. Additionally, the study sought to elucidate the mediating effect of physical performance on this association.This was a cross-sectional multicenter study conducted between July 2020 and March 2023, involving 1024 patients from eight hemodialysis centers in Shanghai. Diabetes mellitus was based on a documented physician diagnosis and blood glucose tests. Physical performance and depressive symptoms were assessed using short-physical performance battery (SPPB) and the patient health questionnaire-9, respectively. Regression and mediation analysis were applied to statistical analysis.METHODSThis was a cross-sectional multicenter study conducted between July 2020 and March 2023, involving 1024 patients from eight hemodialysis centers in Shanghai. Diabetes mellitus was based on a documented physician diagnosis and blood glucose tests. Physical performance and depressive symptoms were assessed using short-physical performance battery (SPPB) and the patient health questionnaire-9, respectively. Regression and mediation analysis were applied to statistical analysis.Among the 1024 participants, 39.26% (n = 402) were found to have coexisting diabetes mellitus. Diminished SPPB scores (OR = 0.843, 95% CI = 0.792-0.897) and cognitive depressive symptoms (OR = 1.068, 95% CI = 1.011-1.129) exhibited significant associations with diabetes mellitus, while somatic depressive symptoms did not show a significant correlation. Notably, SPPB emerged as a complete mediator in the relationship between cognitive depressive symptoms and diabetes mellitus. The observed indirect effect of SPPB on this relationship was estimated at 0.038 (95% CI: 0.021-0.057).RESULTSAmong the 1024 participants, 39.26% (n = 402) were found to have coexisting diabetes mellitus. Diminished SPPB scores (OR = 0.843, 95% CI = 0.792-0.897) and cognitive depressive symptoms (OR = 1.068, 95% CI = 1.011-1.129) exhibited significant associations with diabetes mellitus, while somatic depressive symptoms did not show a significant correlation. Notably, SPPB emerged as a complete mediator in the relationship between cognitive depressive symptoms and diabetes mellitus. The observed indirect effect of SPPB on this relationship was estimated at 0.038 (95% CI: 0.021-0.057).This study showed an association between diabetes mellitus and cognitive depressive symptoms in patients undergoing hemodialysis, with physical performance appearing to mediate the relationship between diabetes mellitus and depressive symptoms.CONCLUSIONThis study showed an association between diabetes mellitus and cognitive depressive symptoms in patients undergoing hemodialysis, with physical performance appearing to mediate the relationship between diabetes mellitus and depressive symptoms.
•Lower emotional clarity (EC) was associated with greater concurrent depression severity.•At lower EC, inflammatory activity predicted increases in depression symptom severity.•Inflammation-by-EC ...interactions predicted specific depressive symptoms.
A growing body of work has implicated inflammation in the pathogenesis of depression. As not all individuals with heightened levels of peripheral inflammation develop symptoms of depression, additional work is needed to identify other factors that catalyze the relationship between inflammation and depressive symptoms. Given that elevated levels of inflammatory activity can induce a variety of emotional changes, the present study examined whether emotional clarity, the trait-like ability to identify, discern, and express one’s emotions, influences the strength of the association between inflammatory signaling and concurrent and prospective symptoms of depression.
Community adolescents (N = 225, Mage = 16.63 years), drawn from a larger longitudinal project investigating sex and racial differences in depression onset, provided blood samples to determine peripheral levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP) at a baseline visit, along with self-report measures of emotional clarity and depressive symptom severity. Depressive symptom severity was assessed again at a follow-up visit approximately 5-months after baseline.
Hierarchical multiple regressions detected a significant interaction between inflammatory markers and emotional clarity on future depression severity, controlling for baseline depressive symptoms. Specifically, among adolescents with low levels of emotional clarity, higher levels of IL-6, CRP, and inflammatory composite scores were significantly associated with greater future depression severity.
These results indicate that low emotional clarity and high inflammatory signaling may jointly confer risk for prospective depressive symptom severity among adolescents. Therapeutic interventions that improve emotional clarity may reduce risk of depressive symptoms among adolescents with low-grade peripheral inflammation.
Elevated Depressive symptoms (DS) and low back pain (LBP) pose significant and growing public health challenges, and China is no exception. This study innovatively examined the relationship between ...specific DS and distinct patterns of DS and incident LBP.
This study extracted data from 4713 participants aged 45+ years from the China and Health Retirement Longitudinal Study (CHARLS), followed-up for incidence LBP (June 2011–September 2020). DS was assessed by the 10-item Center for Epidemiological Studies Depression Scale (CESD-10). The incident LBP was determined by self-reported. Latent class analysis (LCA) was employed to categorize patterns of DS. Cox proportional hazards regression models were used to examine the association between DS and incident LBP.
Over the 9.25-year follow-up period, 2234 incident LBP cases were identified. There was a significant independent association between positive DS and incident LBP with an HR of 1.73 (95 % CI = 1.55–1.94). Of the 10-item DS, difficulty concentrating (adjusted HR = 1.16, 95 % CI = 1.03–1.31), effortfulness (adjusted HR = 1.32, 95 % CI = 1.18–1.49), hopelessness (adjusted HR = 1.13, 95 % CI = 1.02–1.25), restless sleep (adjusted HR = 1.17, 95 % CI = 1.06–1.30), and loneliness (adjusted HR = 1.18, 95 % CI = 1.02–1.36), each independently associated with incident LBP. Regarding patterns of DS, compared to the “healthy” pattern of DS, four patterns showed significant association with incident LBP, especially the cumulative pattern of DS.
DS and LBP were assessed based on self-reported.
In middle-aged and older Chinese adults, 5 specific DS (difficulty concentrating, effortfulness, hopelessness, restless sleep, and loneliness) and distinct patterns of DS indicate varied risks of developing LBP.
•Latent class analysis was employed to categorize patterns of depressive symptoms.•Five specific depressive symptoms were significantly associated with incident low back pain.•Cumulative or highlighted patterns of depressive symptoms were associated with a higher risk of incident low back pain.•Identifying specific symptoms and patterns may provide more accurate intervention and treatment strategies for low back pain.
Objetivo: Identificar la asociación entre las conductas del estilo de vida y síntomas de depresión en personas adultas mayores entre septiembre de 2021 y marzo de 2022 en Mexicali, Baja California ...(México). Materiales y métodos: Diseño de tipo transversal. Participaron 103 personas adultas mayores seleccionadas por un muestreo no probabilístico. Se aplicaron instrumentos para evaluar síntomas de depresión, el estado nutricional, actividad física, consumo de tabaco, consumo de alcohol y la presencia de problemas para dormir. Para el análisis de datos se empleó estadística descriptiva e inferencial. Se construyó un modelo con las conductas del estilo de vida. La investigación se desarrolló con base en la reglamentación vigente. Resultados: El 34 % presenta riesgo de desnutrición; 92.2 % tiene baja actividad física; 9.7 % consume tabaco; 15 % consume alcohol; 38.8 % reportó presentar problemas para dormir, y 31.1 % presentó síntomas de depresión. Respecto a las conductas del estilo de vida, se encontró que las personas adultas mayores con riesgo de malnutrición o malnutrición tienen 3.182 (p ? .5) más riesgo de desarrollar síntomas de depresión en comparación con quienes tienen un estado de peso adecuado. Conclusiones: El riesgo de malnutrición o malnutrición, así como el resto de conductas del estilo de vida, son factores modificables que pueden ser intervenidos por los profesionales de la salud a través de intervenciones multicomponentes, en las que se sumen esfuerzos para establecer programas de atención que apoyen a mejorar la salud física y mental de las personas adultas mayores.
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