Journal of Affective Disorders

BackgroundThe present study analyzes the effects of each containment phase of the first COVID-19 wave on depression levels in a cohort of adults with a history of major depressive disorder (MDD). MethodsThis analysis is part of the Remote Assessment of Disease and Relapse-MDD (RADAR-MDD) study. Individuals included had a diagnosis of DSM-5 major depressive disorder (MDD), at least two episodes of major depression (MDE), one of them in the previous two years. Depression was evaluated with the Patient Health Questionnaire-8 (PHQ-8) and anxiety with the Generalized Anxiety Disorder-7 (GAD-7). A total of 121 participants recruited from Catalonia were registered from November 1, 2019, to October 16, 2020. Levels of depression were explored across the phases (pre-lockdown, lockdown, four post-lockdown phases) of the restrictions imposed by the Spanish/Catalan governments. Then, a mixed model was fitted to estimate how depression varied over the phases. ResultsA small but statistically significant rise in the depressive severity was found during the lockdown and phase 0 (early post-lockdown), as compared with the pre-lockdown phase in this sample with a history of MDD. Those with low pre-lockdown depression experienced an increase in depression levels during the "new normality". We observed a significant decrease in the depression levels during the "new normality" in those with high pre-lockdown depression, compared to the pre-lockdown period. ConclusionThese findings suggest that COVID-19 restrictions impacted on the depression of individuals diagnosed with MDD, depending on their pre-lockdown depression severity. Furthermore, these subjects worsened when the restrictions were harder, during the lockdown and the early post-lockdown.

In Low and Middle Income Countries (LMICs), adolescent depression is one of the leading mental health problems with serious implications, posing a significant public health concern. A comprehensive understanding of adolescent depression and the development of effective intervention strategies require not only an examination of its biological and psychological determinants but also a critical analysis of the social factors influencing its prevalence and impact. This scoping review, guided by Arksey and OMalleys framework, examined the social factors influencing adolescent depression. A total of 48 primary studies were included, identified through a systematic search across five databases and manual exploration of relevant literature from various LMICs. This review identified structural factors including gender, socioeconomic status, ethnicity, and family structure alongside stressors in family, school, and neighborhood settings, such as conflict, harsh parenting, maltreatment, academic pressure, peer rejection, bullying, and neighborhood violence, as key contributors to adolescent depression. Conversely, social support from family, peers and teachers was found to be a protective factor against depression. However, these studies are primarily cross-sectional, with a predominant focus on Asia and limited attention to neighborhood-level factors, often concentrating on school-going adolescents. Furthermore, the studies are largely descriptive and atomized, inadequately exploring the domains and their interplay with social structures in shaping adolescent depression.

BackgroundThe early prediction of adolescent depression recurrence poses a significant challenge in the field. This study aims to investigate and compare the abilities of two psychopathology factors, namely the general psychopathology factor (p) and the specific internalizing factor, in predicting depression recurrence over a 2-year course, as well as identifying remitted depression patients from healthy adolescents. Longitudinal changes of these two factors in different trajectory groups were also tracked to examine their sensitivity to sustained remission and relapse. MethodsWe included 255 baseline-remitted depression patients and a healthy control group (n=255) matched in age, sex, and race, sourced from the Adolescent Brain Cognitive Development Study. The Linear Mixed Model was employed to differentiate between healthy controls and remitted depression patients, predict depression recurrence, and track longitudinal changes over a subsequent 2-year course using the p factor and the specific internalizing factor respectively. ResultsThe p factor not only effectively discriminated between remitted depression patients and healthy controls, but also robustly predicted the depression recurrence over a subsequent 2-year course. The specific internalizing factor could only differentiate remitted depression patients from healthy controls. Additionally, a noteworthy longitudinal decline of the p factor in the sustained-remission group was observed. ConclusionsPsychopathology factors serve as the inherent and enduring measurement of long-term mental health aberrations. Longitudinal results indicate that the p factor is more sensitive to respond to sustained remission than the internalizing factor. The ability of the overall p factor to anticipate depression relapse, unlike the specific internalizing factor, suggests clinical interventions should monitor and mitigate the coincident symptoms across all dimensions to preempt relapse of adolescent depression, rather than an exclusive focus on internalizing symptoms.

This study aimed to develop a classification model predicting incident bipolar disorder (BD) cases in young adults within a 5-year interval, using sociodemographic and clinical features from a large cohort study. We analyzed 1,091 individuals without BD, aged 18 to 24 years at baseline, and used the XGBoost algorithm with feature selection and oversampling methods. Forty-nine individuals (4.49%) received a BD diagnosis five years later. The best model had an acceptable performance (test AUC: 0.786, 95% CI: 0.686, 0.887) and included ten features: feeling of worthlessness, sadness, current depressive episode, selfreported stress, self-confidence, lifetime cocaine use, socioeconomic status, sex frequency, romantic relationship, and tachylalia. We performed a permutation test with 10,000 permutations that showed the AUC from the built model is significantly better than random classifiers. The results provide insights into BD as a latent phenomenon, as depression is its typical initial manifestation. Future studies could monitor subjects during other developmental stages and investigate risk populations to improve BD characterization. Furthermore, the usage of digital health data, biological, and neuropsychological information and also neuroimaging can help in the rise of new predictive models.

Neuroticism is a subclinical manifestation of the phenome of depression, comprising depressive and anxiety symptoms, and suicidal behaviors. Rumination is positively associated with depression and neuroticism and may mediate the effects of neuroticism on depression. This study aims to determine whether rumination or its components, including brooding or reflection, mediate the effects of neuroticism on depression, or alternatively, whether both neuroticism and rumination are manifestations of the phenome of depression. This study recruited 74 depressed subjects and 44 healthy controls. The depression group was split into groups with high versus low brooding scores. We used partial least squares (PLS) to examine mediation effects. We found that brooding and reflection scores are significantly higher in depressed patients than in controls. Patients with higher brooding scores have increased severity of depression, anxiety, insomnia, neuroticism, and current suicidal ideation as compared with patients with lower brooding scores and controls. There is a strong positive association between rumination, and neuroticism, depression, anxiety, and lifetime and current suicidal behaviors. PLS analysis shows that brooding does not mediate the effects of neuroticism on the depression phenome, because no discriminant validity could be established between neuroticism and brooding, or between neuroticism and brooding and the depression phenome. We were able to extract one validated latent vector from brooding and neuroticism, insomnia, depression, anxiety, and current suicidal behaviors. Overall, this study supports the theory that rumination and neuroticism are manifestations of the phenome of depression, just like affective symptoms, suicidal behaviors, and insomnia.

BackgroundThere is evidence that adverse childhood experiences (ACEs) and negative life events (NLEs) are associated with major depression (MDD). PurposeTo determine whether ACEs affect all features of mild MDD, including suicidal tendencies, brooding, neuroticism, insomnia, cognitive deficits, severity of depression and anxiety, and cognitive deficits, and whether NLEs mediate these effects. Patients and methodsThis study examines a cohort of 118 academic students, namely 74 students who satisfied the DSM-5-TR criteria for MDD and 44 normal control students. We assessed brooding, neuroticism, suicidal ideation and attempts, and the severity of depression, anxiety, insomnia, and the Stroop tests. ResultsOne validated factor could be extracted from brooding, neuroticism, current suicidal behaviors, and the severity of depression, anxiety, and insomnia, labeled the phenome of depression. A large part of the variance in the phenome of depression (55.0%) was explained by the combined effects of self-, relationships, and academic-related NLEs in conjunction with ACEs, including family dysfunction and abuse and neglect (both physical and emotional). The latter ACEs significantly interacted (moderating effect) with NLEs to impact the depression phenome. Although sexual abuse did not have direct effects on the phenome, its effects were mediated by NLEs. We discovered that increased sexual abuse, physical and emotional abuse and neglect, and ACEs related to family dysfunction predicted 22.5% of the variance in NLEs. Up to 18.5% of the variance in the Stroop test scores was explained by sexual abuse and the phenome of depression. The latter mediated the effects of NLEs and abuse, neglect, and family dysfunction on the Stroop test scores. ConclusionComplex intersections between ACEs and NLEs impact the phenome of depression, which comprises neuroticism, brooding, suicidal tendencies, and the severity of insomnia, anxiety, and depression, while sexual abuse together with other ACEs and NLEs may impact cognitive interference inhibition.

IntroductionProspective studies on mental health of students showed that young adults enroled in university are affected by poorer mental health than other working peers or adults, and this condition is responsible for a large proportion of disability-adjusted life-years MethodsWe enrolled 1388 students at the baseline (and 557 completed follow-up after six months) who reported their demographic information and completed self-report questionnaires on depressive, anxiety and obsessive-compulsive symptoms. We applied multiple regression modelling and supervised machine learning to evince associations and predict the risk factors of poorer mental health at baseline and follow-up ResultsApproximately one out of five students reported severe depressive symptoms and/or suicidal ideation. An association of economic worry with depression was evidenced at the beginning of the study (when there was a high frequency of worry OR = 3.11 [1.88 - 5.15]) and during follow-up. Supervised machine learning exhibited high accuracy in predicting the students who maintained well-being (balanced accuracy = 0.85) or absence of suicidal ideation, but its performance was almost null in identifying those whose symptoms worsened. ConclusionsStudents severe mental health problems are reaching worrying percentages, and few demographic factors can be leveraged to predict poor mental health outcomes. Further research including people with lived experience is crucial to assess students needs and improve the prediction of those at risk of developing worse symptoms.

Paternal perinatal depression negatively affects maternal mental health and child development. However, early detection remains limited, particularly in countries such as Japan, where paternal involvement in perinatal care is low. The Edinburgh Postnatal Depression Scale-Partner (EPDS-P), a maternal-rated tool for screening paternal depression, offers a feasible solution. This study longitudinally validated the diagnostic performance of the EPDS-P from the prenatal to postpartum periods and examined its independence from maternal psychological and demographic characteristics. This prospective, community-based cohort study in Towada, Japan, included couples assessed during routine visits by health nurses. Paternal depression was defined as a Center for Epidemiologic Studies Depression Scale score [≥]16. Receiver operating characteristic curves were used to evaluate diagnostic accuracy, and binomial logistic regression was used to assess the influence of maternal and paternal age, parity, gestational weeks or postpartum days, and maternal Edinburgh Postnatal Depression Scale and Mother-to-Infant Bonding Scale scores. Data from 385 prenatal and 411 postpartum couples were analyzed. The EPDS-P demonstrated fair diagnostic accuracy (area under the curve: 0.783, prenatal; 0.746, postpartum). The optimal prenatal and postpartum cut-off values (3 and 4, respectively) achieved sensitivities of 70.7% and 61.5% and specificities of 75.9% and 86.8%, respectively. The EPDS-P score was the only significant predictor of paternal depression. The EPDS-P is a valid and practical tool for indirectly screening for paternal perinatal depression, independent of maternal influences. Its integration into routine perinatal care may help identify at-risk fathers in settings with limited paternal engagement and contribute to more inclusive, family-centered mental health support. HighlightsO_LIThe EPDS-P enables maternal indirect screening of paternal perinatal depression. C_LIO_LIA cohort of 385 prenatal and 411 postpartum Japanese couples were surveyed. C_LIO_LIThe EPDS-P accuracy was fair, with AUCs of 0.783 (prenatal) and 0.746 (postpartum). C_LIO_LIThe optimal EPDS-P cutoffs were 3 (prenatal) and 4 (postpartum). C_LIO_LIEPDS-P accuracy was independent of maternal mood or bonding measures. C_LI

The present study aims to assess the association between sleep quality and the functional and cognitive impairment in subjects that recently converted to bipolar disorder (BD), subjects with past major depressive disorder (MDD) and subjects with recurrent MDD. This was a cross-sectional study corresponding to a second wave of a cohort study with a community sample. The first wave included 585 subjects diagnosed with MDD. Mood episodes were assessed through structured clinical interview. Functional and objective cognitive impairments were measured by the Functional Assessment Short Test (FAST) and Letter-number sequencing from Wechsler Adult Intelligence Scale III, respectively, and Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) was used for subjective cognition measure. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI). In PSQI, FAST and COBRA, we found significantly worse scores in the BD and recurrent MDD groups when compared to past MDD group. Our findings also showed a significant association between functioning and subjective cognition with general sleep quality in all observed groups. We reinforce the need to follow-up for maintenance of functional and cognitive impairment, notably with BD patients, who may suffer in addition to damage caused by sleep alterations, also with neuroprogression in the long term.

BackgroundDepression causes a substantial burden on a persons health and well-being. However, evidence is limited regarding whether depression of one person in a marital relationship may affect the other partners health. This study examined whether depression in one partner within a married couple is associated with the other partners mortality, also considering whether only one or both partners have depression. MethodsTo test the hypothesis that spousal depression is associated with higher mortality risk for their partner, we used a nationally representative sample of older US adults from the Health and Retirement Study. Depression was assessed in both partners using the Center for Epidemiologic Studies Depression Scale. With baseline measures in 2010, we characterized depression status for 8,442 married individuals within 4,225 couples as follows: i) no depression in either partner, ii) depression in respondent only, iii) depression in spouse only, and iv) depression in respondent and their spouse. Associations between couples depression status and individuals mortality over 11 years were estimated using Cox proportional hazards models adjusted for 22 covariates. ResultsHigher mortality hazard was observed when only the respondent had depression (hazard ratio (HR): 1.44 [95% confidence interval (CI): 1.26, 1.63]), but also when only their spouse exhibited depression (HR: 1.18 [95% CI: 1.00, 1.38]). When both partners had depression, a jointly elevated mortality hazard was observed (HR: 1.56 [95% CI: 1.30, 1.87]). ConclusionsResults suggest the harmful effects of depression could extend beyond the individual to ones partners physical health. Future studies on health effects of depression should incorporate familial contexts. Highlights- When one partner was depressed, the other partner had a higher mortality risk regardless of their own depression status. - Widowhood effect did not fully explain the effects of spousal depression on ones mortality. - Harmful effects of depression could extend beyond the individual to the partners physical health.

Background: Sleep debt and irregular sleep patterns are highly prevalent amongst adolescents. However, whether the absence of these sleep behaviours protects against subsequent depression remains unclear. Here, we examined the association of sleep debt, weekend catch-up sleep (WCS), and social jetlag (SJL) in adolescence with depression in young adulthood and identified underlying biopsychosocial mechanisms. Methods: Secondary data analyses were conducted using the Avon Longitudinal Study of Parents and Children. Bedtimes and wake-up times on school days and weekends (i.e., sleep duration) and sleep need were self-reported at 15 years. This was used to generate sleep debt (sleep need minus school day sleep duration), WCS (weekend sleep duration minus school day sleep duration), and SJL (absolute difference in the midpoint of sleep times between school days and weekends). Depression was assessed at 24 years with the Clinical Interview Schedule-Revised. Common mental health symptoms, biological, and school-related factors at 17 years were the mediators. Results: Logistic regression analyses revealed that greater WCS (adjusted odds ratio [AOR]=0.90; 95% CI=0.84-0.97; p=0.004) and lower sleep debt (AOR=1.10; 95% confidence interval [CI]=1.03-1.18; p=0.005) at age 15 reduced the likelihood of depression at 24 years. Irritability at 17 years partially mediated the relationship between sleep debt and depression (bias-corrected estimate=0.003; 95% CI=0.002-0.004; p<0.001). Conclusions: Adolescents who experience less sleep debt (i.e., less discrepancies between their actual sleep and their perceived sleep need) and those who extend their sleep duration on weekends are at reduced risk for depression in young adulthood. These findings underscore the need for greater opportunities for adolescents to obtain more hours of sleep to protect them against later poor mental health outcomes, such as depression. Keywords: Sleep; longitudinal studies; depression; ALSPAC

Neuroticism, a personality trait, can predict major depressive disorder (MDD). The current study aims to determine whether a) neuroticism is a feature of the acute state of MDD, including suicidal behaviors (SB); and b) adverse childhood experiences (ACEs) are associated with neuroticism in MDD. This study included 133 participants, 67 normal controls and 66 MDD patients, and assessed the Big 5 Inventory (BFI), ACEs using the ACE Questionnaire, and the phenome of depression using the Hamilton Depression (HAMD) Rating Scale (HAMD), Beck Depression Inventory (BDI), The State-Trait Anxiety Inventory (STAI) and Columbia Suicide Severity Rating Scale (C-SSRS) scores to assess current SB. Neuroticism was significantly higher in MDD than controls, and it explained 64.9% of the variance in the depression phenome (a latent vector extracted from HAMD, BDI, STAI, and current SB scores). The other BFI domains had much less (extraversion, agreeableness) or no effect (openness, conscientiousness). One latent vector could be extracted from the phenome, lifetime dysthymia, lifetime anxiety disorders and neuroticism scores. Neglect (physical and emotional) and abuse (physical, neglect and sexual) account for approximately 30% of the variance in this latent vector. Partial Least Squares analysis showed that the effects of neglect on the phenome were partially mediated by neuroticism, whereas the effects of abuse were completely mediated by neuroticism. Neuroticism (trait) and the MDD phenome (state) are both manifestations of the same latent core, with neuroticism being a less severe manifestation of major depression, which in fact is a multiplicative manifestation of neuroticism.

The COVID-19 pandemic has presented a significant challenge to societal mental health. Yet, it remains unknown which factors influence the mental adaptation from lockdown to subsequent relaxation periods, particularly for vulnerable groups. This study used smartphone-based monitoring to explore how 74 individuals with major depression (MDD) and 77 healthy controls (HCs) responded to the transition from lockdown to relaxation during the first wave of the COVID-19 pandemic (March 21 to November 01, 2020) regarding interpersonal interactions, COVID-19-related fear (fear of participants own health, the health of close relatives, and the pandemics economic impact), and the feeling of isolation. Furthermore, we investigated the effect of a diagnosis of MDD and the experience of childhood maltreatment (CM) on adaptive functioning. During the transition from lockdown to relaxation, we observed an increase in direct contacts and a decrease in indirect contacts and self-perceived isolation in the study population. The diagnosis of MDD and the experience of CM moderated a maintenance of COVID-19-related fear: HCs and participants without the experience of CM showed a decrease in fear, while fear of participants with MDD and with an experience of CM did not change significantly. The finding that elevated COVID-19-related fear was sustained in vulnerable groups after lockdown measures were lifted could help guide psychosocial prevention efforts in future pandemic emergencies.

This study examines the impact of pandemic-related worries on mental health in the Indian general adult population from 2020 to 2022. Using data from the Global COVID-19 Trends and Impact Survey (N = 2,576,174 respondents aged[&ge;] 18 years in India; an average weekly sample size of around 25,000), it explores the associations between worry variables (namely financial stress, food insecurity, and COVID-19-related health worries) and self-reported symptoms of depression and nervousness. The statistical analysis was conducted using complete cases only (N = 747,996). Our analysis used survey-weighted models, focusing on the three pandemic-related worries as the exposures, while also adjusting for various other covariates, including demographics and calendar time. The study finds significant associations between these worries and mental health outcomes, with financial stress being the most significant factor affecting both depression (adjusted odds ratio: 2.36, 95% confidence interval: [2.27, 2.46]) and nervousness (adjusted odds ratio: 1.91, 95% confidence interval: [1.81, 2.01]) during the first phase of the study period (June 27, 2020, to May 19, 2021). The fully adjusted models also identify additional factors related to mental health, including age, gender, residential status, geographical region, occupation, and education. Moreover, the research highlights that males and urban residents had higher odds ratios for self-reported mental health problems regarding the worry variables than females and rural residents, respectively. Furthermore, the study reveals a rise in the prevalence of self-reported depression and nervousness and their association with COVID-19-related health worries during the lethal second wave of the pandemic in May 2021 compared to the onset of the pandemic. This study shows that social media platforms like Facebook can deploy surveys to a large number of participants globally and can be useful tools in capturing mental health trends and uncovering associations during a public health crisis.

This study was performed to ascertain whether a) a valid precision model and valid Research and Diagnostic Algorithmic Rules (RADAR) scores can be computed in patients experiencing first-episode depression; and b) adverse childhood experiences (ACEs) and negative life events (NLEs) are associated with suicidal behavior (SBs), cognitive impairment, and phenome RADAR scores. This study recruited 90 patients with major depressive disorder (MDD) in an acute phase, of whom 71 showed a first-episode MDD (FEM), and 40 controls. We constructed RADAR scores for ACEs, NLEs encountered the last year, SBs and severity of depression, anxiety, chronic fatigue and physiosomatic symptoms using the Hamilton Depression and Anxiety Rating scales and the Fibro-Fatigue scale. Partial least squares analysis showed that in FEM, one latent vector (labelled the phenome of FEM) could be extracted from depressive, anxiety, fatigue, physiosomatic, melancholia, and insomnia symptoms, SBs, and cognitive impairments. The latter were conceptualized as a latent vector extracted from the Verbal Fluency Test, Mini Mental State Examination, and ratings of memory and judgment, indicating a generalized cognitive decline (G-CoDe). We found that 60.8% of the variance in the FEM phenome was explained by the cumulative effects of NLEs and ACEs, in particular emotional neglect and, to a lesser extent, physical abuse, and by the interaction between ACEs and physical abuse, whereby the latter attenuates the effects of NLEs. In conclusion, not the binary diagnosis of MDD (DSM/ICD) should be used in research and clinical settings but the RADAR scores and plots constructed here.

Recent increases in the prevalence rates of anxiety, depression, and suicidal ideation, especially in student populations, present an urgent need to develop targeted diagnostic and treatment tools. Given the substantial evidence of variation in mental health symptomatology, efforts to develop prevention and intervention strategies may benefit from machine learning based investigations of individual and group variability in predictors of anxiety, depression, and suicidal ideation. The present study investigated the use of random forest classifiers (RFC) in predicting anxiety and depression screening scores and suicidal ideation in 9th grade students from a Massachusetts public school district (n = 274). Our highly accurate (80-95%) predictive analyses identified a strong inverse relationship between academic performance and depression and anxiety and substantial gender and race based variation in specific academic and symptom level predictors of anxiety, depression, and suicidal ideation. These findings illustrate the need for personalized clinically relevant data collection and analyses to inform mental health programming, preventative measures, and interventions.

Background: Personality traits are consistently associated with bipolar disorder (BD). However, their features across BD diagnostic subtypes and their modulation by demographic and health-related factors remain largely unexplored. This study aimed to characterize Big Five personality domains in individuals with BD compared to controls, and to examine differences between BD type I (BD-I) and BD type II (BD-II). Methods: We analyzed 833 participants from the MadManic cohort (300 BD subjects and 533 controls) with available Big Five Inventory-2 (BFI-2) data. Linear regression models were used to assess associations between personality traits and BD diagnosis, adjusting for relevant covariates. Additional comparisons were conducted across sex, age, and Body Mass Index (BMI), and between BD-I and BD-II patients. Results: BD was associated with higher Negative Emotionality (NE) and lower Extraversion and Conscientiousness. Conscientiousness was also inversely associated with BMI. Within the BD group, individuals with BD-I exhibited lower NE compared to those with BD-II. Stratified analyses indicated that elevated NE in BD was the most consistent domain across sex, age, and BMI subgroups, whereas differences in Extraversion and Conscientiousness varied depending on subgroup features. Conclusions: BD is characterized by a distinct personality profile marked by elevated NE and reduced Extraversion and Conscientiousness. NE emerged as the most robust domain associated with BD, which may also differentiate between subtypes, with higher levels observed in BD-II than BD-I. These findings highlight the relevance for considering demographic and health-related factors, particularly BMI, when interpreting personality patterns in BD, supporting the role of personality dimensions to examine clinical heterogeneity.

BackgroundMajor depressive disorder (MDD) is associated with maladaptive self-reported interoception, i.e., abnormal bodily self-experience. Although diminished body trusting predicts suicidal ideation, interoceptive measures have not been considered in depressed inpatients, whose suicide risk regularly peaks post-discharge. This study aims to explore interoceptive characteristics at admission that help identify inpatients at risk for suicidal ideation at discharge, thereby preventing fatal outcomes. MethodsThe observational study included 87 depressed inpatients providing self-ratings at both hospital admission (T0) and discharge (T1) on the following scales: Multidimensional Assessment of Interoceptive Awareness (MAIA-2); Beck Depression Inventory-II (BDI-II). A hierarchical logistic regression analysis estimated the longitudinal association between self-reported interoception (T0) and suicidal ideation (T1). The optimal cutpoints for predicting suicidal ideation were calculated using ROC curve analysis. ResultsSuicidal ideation was found in 17.24% patients at discharge, who reported lower baseline MAIA-2 Trusting scores than non-ideators (p=0.01). Diminished body trusting (OR=0.19), somatic comorbidity (OR=16.77), and baseline suicidal ideation (OR=24.01) significantly predicted suicidal ideation (T1). For body trusting, we estimated an optimal classification of subsequent suicidal ideation for the cutpoint[&le;]2.33 (AUC=0.70 [95% CI 0.57, 0.83], sensitivity=0.87, specificity=0.44, positive predictive value=0.25, negative predictive value=0.94). LimitationsDue to the exploratory nature of the study, the findings should be replicated in pre-registered trials with larger sample sizes. ConclusionsDiminished body trusting is, with acceptable sensitivity, a significant predictor for post-treatment suicidal ideation in depressed inpatients. This finding emphasizes the importance of incorporating body-centered approaches into multimodal treatment strategies especially in inpatients under risk to prevent suicidal incidents.

Background and ObjectivesThe goals of depression screening, which is universally recommended in primary care settings in the U.S., are to identify adolescents with depression and connect them to treatment. However, little is known about how depression screening affects the likelihood of being diagnosed with a mental disorder or accessing mental health care over time. MethodsThis longitudinal cohort study used insurance claims data from 57,732 adolescents who had at least one routine well-visit between 2014 and 2017. Using propensity score matching, we compared adolescents who were screened for depression to similar adolescents who were not screened for depression during the well-visit. Diagnostic and treatment-related outcomes were examined over 6-month follow-up and included depression diagnoses, mood-related diagnoses, antidepressant prescriptions, any mental health-related prescriptions, and psychotherapy. We also examined heterogeneity of associations by sex. ResultsCompared to adolescents who were not screened for depression, adolescents screened for depression were 30% more likely to be diagnosed with depression (RR=1.30, 95% CI=1.11-1.52) and 17% more likely to receive a mood-related diagnosis (RR=1.17, 95% CI=1.08-1.27), but were not more likely to be treated with an antidepressant prescription (RR=1.11, 95% CI=0.82-1.51), any mental health prescription (RR=1.15, 95% CI=0.87-1.53), or psychotherapy (RR=1.13, 95% CI=0.98-1.31). In general, associations were stronger among females. ConclusionsAdolescents who were screened for depression during a well-visit were more likely to receive a diagnosis of depression or a mood-related disorder in the six months following screening. Future research should explore methods for increasing access to treatment and treatment uptake following screening. Clinical Trial Registration (if any)N/A Table of Contents SummaryInsurance claims data were used to explore associations between depression screening during routine well-visits and depression diagnoses, psychiatric prescriptions, and psychotherapy among adolescents. Whats Known on This SubjectDepression screening is increasingly viewed as a key strategy for addressing depression among adolescents. To inform clinical guidelines, the United States Preventive Services Task Force has called for research to examine the diagnostic and treatment-related outcomes of depression screening. What This Study AddsIn a sample of 57,732 adolescents, adolescents who were screened for depression during a well-visit were more likely to receive a depression or mood-related diagnosis over 6-month follow-up, but were not more likely to be treated with medication or psychotherapy.

The present study focuses on the role of amygdala reactivity to negative facial expressions in major depressive disorder (MDD). A number of studies have found amygdala hyperreactivity in depressed patients compared with control subjects. This has been interpreted in terms of a negative depressive bias in attention and memory, given the amygdalas role in attending to and remembering negatively valenced stimuli. However, failure to find amygdala hyperreactivity in depression is not uncommon, and a recent failure to replicate the effect with an extremely well-powered analysis of UK Biobank data led many to conclude that amygdala reactivity plays no role in depression. In the present study, the same UK Biobank sample is used to evaluate an alternative hypothesis about the relation between MDD and amygdala reactivity, namely that people who are vulnerable to MDD, whether or not they are currently depressed, will show elevated amygdala activity. Depression history was used as a proxy for vulnerability and regression analyses assessed the strength of the relation between three MDD history measures and amygdala reactivity. Two of three assessments of depression history showed highly significant relations with amygdala reactivity, the third showing a combination of significant and nonsignificant trends depending on the analysis.