Journal of Affective Disorders Reports

BackgroundStudies suggest that good self-management is associated with better coping with chronic mental conditions. However, an encompassing assessment of the relationship between depression and self-management competence is lacking. MethodsThis study assesses the relationship between depressiveness and self-management competence in a sample of 83 depressed in-patients. Beck Depression Inventory II (BDI-II) was used to assess depressiveness. The Self-Management Self-Test (SMST) was used to assess self-management competence. Patient surveys took place at the time of hospital admission (T1) and at the time of hospital discharge or approximately 4 to 6 weeks after (T2). ResultsSelf-management competence correlated negatively with depressiveness at T1. Four out of five specific dimensions of self-management competence correlated inversely with depressiveness at T1. Self-management competence differed depending on the severity of the depressive syndrome and was higher the lower the severity of the depressive syndrome was. In the course of clinical treatment, self-management competence increased. Change of self-management competence during clinical treatment was not dependent on the sociodemographic variables gender or age. Change of self-management competence during clinical treatment predicted the change of depressiveness between hospital admission and discharge (T2 vs. T1) as well as depressiveness at T2. LimitationsSample size was relatively small. The SMST is a relatively new psychometric instrument that has not yet found widespread use in clinical research. ConclusionOur findings offer clinical evidence that in depressed in-patients, self-management competence and depressiveness are associated constructs. These results suggest that self-management competence may be a valuable resource in the treatment of depressive disorders.

BackgroundMajor depressive disorder (MDD) with suicidality represents a significant public health concern, as suicide ranks among the leading causes of death worldwide. While electroencephalography (EEG) has shown promise in depression diagnosis, its utility in identifying suicidal risk remains underexplored. This study aims to develop and validate a Suicidal Risk Index (SR Index) using EEG biomarkers and machine learning (ML) algorithms for distinguishing between MDD patients with and without suicidality. MethodsIn this retrospective observational study, resting-state EEG data were collected using Stress EEG Assessment (SEA) system. SR Index was developed by integrating the PHQ-9 scale with EEG-derived features, including band power, coherence, and fractal dimension, optimized using ML algorithms to enhance accuracy. ResultsThe study included 268 participants (159 without suicidality, 109 with suicidality). The SR Index demonstrated robust discriminative ability with an AUC of 0.8117 (p=2.63x10-18). At the optimal cutoff value of 8, the model achieved 88.99% sensitivity, 57.23% specificity, 67.86% positive predictive value, and 78.85% negative predictive value, with a balanced accuracy of 73.11%. ConclusionsThe SR Index shows promise as an objective tool for identifying suicidality in MDD patients, potentially complementing traditional clinical assessments. This approach may enhance early detection and risk stratification in clinical settings, potentially improving suicide prevention strategies. HighlightsO_LINovel EEG- and ML-based Suicidal Risk Index distinguishes MDD patients with and without suicidality. C_LIO_LISR Index achieves 88.99% sensitivity and 73.11% balanced accuracy in identifying suicidal risk. C_LI

BackgroundThe October 7, 2023, terrorist attack in Israel led to over 1,200 civilian deaths and the abduction of 251 individuals to Gaza. While prior studies have documented the psychological toll on directly affected populations, the broader emotional impact of the ongoing hostage crisis on the general public remains unclear. This study explored how concern for the hostages relates to psychological distress and functional impairment, conceptualizing this reaction as a form of collective prolonged grief. MethodsA nationally representative sample of 515 Israeli adults completed self-report questionnaires at two timepoints: August 2023 (pre-attack) and May 2025. Measures assessed anxiety, depression, PTSD symptoms, cumulative stress, emotional burnout, and daily functioning. Concern for the hostages was rated on a 4-point scale. Prolonged Grief Disorder (PGD) symptoms were measured using an adapted PG-13 scale to reflect ambiguous loss. Multivariate analyses controlled for baseline distress and trauma exposure. ResultsHigher concern levels were significantly associated with elevated distress across all symptom domains. Nearly half (48.7%) of participants met criteria for probable PGD in relation to the hostage situation. These individuals exhibited significantly higher psychological symptoms and lower functional well-being--including poorer sleep, reduced concentration, and diminished optimism and hope. ConclusionsFindings indicate that the prolonged hostage crisis constitutes a collective psychological burden marked by ambiguous loss and unresolved national trauma. This form of distress affects even those without direct exposure. Mental health efforts must extend beyond trauma-specific care to include interventions for symbolic and collective grief. National leadership plays a critical role in recognizing this suffering and restoring societal trust.

BackgroundNon-suicidal self-injury (NSSI) represents a growing public health concern, particularly in adolescents. Emotion dysregulation is central to prevailing NSSI models, yet it remains unclear whether acceptance-based emotion regulation (ER) and its underlying neural processes are disrupted in naturalistic, dynamic contexts. MethodsPre-registered neuroimaging trial in recently diagnosed and treatment-naive adolescents with NSSI (n=25) and healthy controls (n=25) using an ER paradigm with dynamic video clips and concomitant functional magnetic resonance imaging. Behavioral, neural activity, and connectivity indices during emotion reactivity and acceptance-based regulation were compared between groups. ResultsAdolescents with NSSI experienced elevated negative feelings during neutral clips, reflecting heightened baseline negativity. In comparison to controls, they displayed reduced temporal and ventrolateral prefrontal engagement during emotional reactivity, but increased engagement of regions implicated in both emotion reactivity (right amygdala, insula) and ER (right dlPFC, dmPFC, vlPFC) when utilizing acceptance. Higher activation in the right dlPFC was positively associated with difficulties in accessing ER strategies in everyday life. Adolescents with NSSI showed reduced functional connectivity between the right amygdala and left dlPFC. ConclusionsAdolescents with NSSI exhibited a baseline negativity bias and altered neural engagement during both negative emotional reactivity and acceptance-based regulation, characterized by increased activation and reduced amygdala-dlPFC connectivity. These findings highlight atypical emotion processing in real-life contexts in individuals with NSSI. Targeting acceptance-based regulation and prefrontal-limbic circuitry may represent a promising intervention approach for adolescents with NSSI.

The studys objective was to establish the prevalence and variables associated with post-traumatic stress disorder risk (PTSD-R) in a sample of COVID-19 survivors in Santa Marta, Colombia. A cross-sectional study was designed with a non-probabilistic sample of adult COVID-19 survivors. Participants were demographically characterized and completed scales for depression risk, insomnia risk, and PTSD-R. Three hundred and thirty COVID-19 survivors between 18 and 89 years participated; 61.52% were women. The frequency of depression risk was 49.70%; insomnia risk, 60.61%; and PTSD-R, 13.33%. Depression risk (OR = 41.43, 95% CI 5.54 - 311.63), insomnia risk (OR = 5.25, 95% CI 1.77 - 18.71), low income (OR = 3.46, 95% CI 1.38 - 8.67) and being married or free union (OR = 2.65, 95% CI 1.13 - 6.22) were associated with PTSD-R. In conclusion, two out of every fifteen COVID-19 survivors are in PTSD-R. Depression and insomnia risk are strongly associated with PTSD-R in COVID-19 survivors.

Numerous studies have shown that adults with depression have distinct oculomotor alterations during saccade tasks, but whether similar alterations occur in adolescents is largely unknown. The purpose of this study was to test if eye-tracking during a structured saccade task could distinguish a group of adolescents with depression from healthy controls. We hypothesized that, due to overlapping circuitry between depression pathology and the oculomotor system, adolescents with depression would show alterations in fixation, saccade, and pupil behaviour. 51 adolescents with depression and 66 age-matched healthy controls completed the Interleaved Pro- and Anti-Saccade Task (IPAST) and several self-reported questionnaires for psychiatric symptoms. Oculomotor outcomes included fixation acquisition, fixation breaks, correct rate, saccadic reaction time, rate of correct express-latency pro-saccades, rate of express- and regular-latency anti-saccade errors, baseline pupil size, as well as pupil constriction and dilation sizes following task instruction. In comparison to healthy controls, adolescents with depression displayed impairments acquiring fixation (p<.001), made more fixation breaks in pro- (p=.023) and anti-saccade trials (p=.005), more anti-saccade errors (p=.013), more express-latency saccades overall (ps=.016), had a smaller pupil constriction in pro-saccade trials (p=.047) and had a smaller pupil dilation in pro- (p=.011) and anti-saccade trials (p=.041). No differences were found for saccadic reaction time, rate of correct pro-saccades, rate of regular-latency anti-saccade errors, pupil constriction size during anti-saccade trials, or baseline pupil size. Patients had psychiatric comorbidities and were using psychotropic medication. While this reflected clinical reality, these factors may have influenced oculomotor behaviour. Adolescents with depression had altered fixation, saccade, and pupil behaviour during IPAST. Given that many cases of adolescent depression remain undetected, accessible and objective screening approaches are highly needed. This oculomotor phenotype may be used in the development of such a screening tool to detect those at risk.

Meta-analysis shows that sub-clusters defined by affected domains of psychosocial functioning capture PTSD subtypes better than symptom clusters defined in the DSM-IV. This pilot study investigated the association between symptom sub-clusters and brain volume in twelve persons with PTSD (females, mean age 40.9 years). Structural magnetic resonance imaging (MRI) images were acquired, and voxel-based morphometry (VBM) was used to estimate local gray matter volume throughout the brain. Participants gray matter volume was correlated with both overall PTSD severity and sub-cluster severities. In this preliminary study examining sub-clusters and brain morphometry, we found that neuronal changes associated with sub-clusters may provide a more complete understanding of the neuroanatomical changes that occur in PTSD beyond what can be ascertained using overall disorder severity or comparisons with control subjects. The results of our study suggest that the neurobiological changes resulting from severe trauma depend on the specific sub-clusters of symptoms experienced by individuals with PTSD.

ImportanceSuicide remains a leading cause of death worldwide, underscoring the importance of identifying neurobiological markers associated with suicidal behaviors. While non-suicidal self-directed violence (NSSDV) is an established risk factor for future suicide attempts (SA), the underlying neural distinctions between these behaviors remain insufficiently understood. ObjectiveTo examine functional connectivity (FC) changes that may differentiate SA from NSSDV based on resting-state functional magnetic resonance imaging (rs-fMRI). Design, setting, and participantsIn this case-control study, cross-sectional data of participants with a history of self-directed violence (SDV) were stratified into SA (n = 579) and NSSDV (n = 491) groups based on self-reported questionnaires. Both cross-sectional data and rs-fMRI data were collected from the UK Biobank between October 2016 to January 2024. Main outcomes and measuresFC matrices across different brain regions were analyzed. A general linear regression model was employed to identify significant FC correlations with SA. An exploratory analysis examined the correlation between FC and SDV frequency and interval. ResultsA total of 1,070 participants with a history of self-directed violence (SDV) were stratified into SA and NSSDV groups. Compared to NSSDV, the SA group exhibited decreased FC in bilateral amygdala and right putamen, alongside increased FC in the right caudate. Higher frequency of SDV was correlated to increased FC between the orbitofrontal cortex (OFC) and occipital regions, whereas individuals reporting SDV within the past 12 months showed decreased FC between the OFC and both the rectus gyrus and temporal lobe. Conclusions and relevanceThis large-sample rs-fMRI study highlights distinct FC alterations associated with different dimensions of self-harm. The limbic and reward circuits appear particularly relevant in differentiating SA from NSSDV and in capturing variations tied to SDV frequency and recency. These insights advance our understanding of suicidal behaviors neurobiological underpinnings and may inform targeted risk stratification.

BackgroundSuicidal ideation (SI) and suicidal behavior (SB) may have different etiological pathways, particularly related to feedback processing. Identifying ERP components related to these suicide states may help researchers localize and understand these differences. Objective. Our primary purpose was to utilize time-frequency decomposition techniques to assess neurophysiological correlates of SI and SB during positive and negative feedback processing. Methods271 subjects (55.7% female; mean age=35.75, SD=16.07; 30.6% veterans) completed a questionnaire battery and a multi-task protocol, including a gambling feedback task (Gehring & Willoughby, 2002), while electroencephalography (EEG) was collected using a 96-channel EEG system. Exploratory factor analysis (EFA) was conducted across 20 self-report suicide items selected to index SI and SB from several suicide-relevant questionnaires. EFA results produced 2 factors, corresponding to SI and SB. Time-frequency principal component analyses produced measures across all frequency bands (i.e., delta-FN/P3, delta-SW, theta-FN, alpha, beta-1, beta-2, and gamma). ResultsExcepting alpha amplitude, all measured frequencies were related to SB, and not SI (across loss and gain, with some loss-gain differences). Alpha, uniquely, showed a relationship to SI and not to SB (across loss and gain, no loss-gain differences). Robust regressions confirmed that the delta, theta, and high-frequency (HF; beta-1, beta-2, and gamma as combined HF loss, gain, and loss-gain difference factors) measures were each independently related to SB. DiscussionBroadly, the results indicate that individuals with SB showed heightened neurophysiological response across multiple ERP components (except alpha) to gambling feedback, with significantly greater increases to loss stimuli relative to gain stimuli. General Scientific SummaryThis study, using time-frequency EEG/ERP measures from a gambling feedback task, supports the theoretical framework that suicidal behavior and suicidal ideation can be indexed separately. Generally, stronger reactivity to all feedback (i.e., loss and gain feedback during a gambling task) is seen in those with suicidal behavior and not in those with suicidal ideation, but with a small separate effect related to suicidal ideation.

Major depressive disorder (MDD) exhibits psychomotor retardation which concerns abnormal slowness of both thoughts and movements. In the current study, we investigated whether such psychomotor disturbance also disrupts the MDD subjects ability to synchronize their movements to a rhythmic tone sequence. We found that the timing between finger taps and tones is altered for MDD subjects (N=38), compared with healthy controls (N=65), mainly when tones are presented at a low frequency below 1 Hz. No differences, however, are observed in terms of the tapping speed, tapping stability, and tapping interval. Auditory-motor desynchronization in the low frequency range (< 1Hz) is associated with depression severity as well as with the degrees of both psychomotor anhedonia and vegetative symptoms (using the Beck Depression Inventory). In sum, our study demonstrates a frequency-specific auditory-motor synchronization deficit in MDD which also relates to psychomotor retardation. This suggests disruption of the cognitive capacity of temporal prediction for low-frequency auditory-motor synchronization in MDD. That supports a cognitive and therefore psychomotor over a motor view of psychomotor retardation in MDD.

BackgroundTo investigate the mediating role of family poverty income ratio (PIR) in the association between depression and mortality risk, including all-cause and cardiovascular disease mortality, using data from the National Health and Nutrition Examination Survey (NHANES). MethodsThe study included a cohort of participants from seven NHANES cycles (2005-2018) with available depressive assessments and family PIR data. The primary endpoint was all-cause mortality, and the secondary endpoint was cardiovascular mortality, ascertained from National Center for Health Statistics (NCHS) mortality follow-up data. To evaluate the relationship between depression and mortality, we employed restricted cubic splines (RCS), Cox proportional hazards regression models. After adjusting for covariates such as age, sex, education, and marital status, mediation analysis was conducted to assess the mediating effects of the family PIR on these associations. ResultsThe prevalence of depressive symptoms among the 33,132 participants was 8.64%, with a mean age of 47.62 {+/-} 18.69 years. After adjusting for multiple confounders, higher Patient Health Questionnaire-9(PHQ-9) scores were significantly associated with an increased risk of all-cause mortality (HR = 1.050, 95% CI: 1.042-1.058, P < 0.0001) and cardiovascular mortality (HR = 1.035, 95% CI: 1.019-1.050, P < 0.00001). Mediation analysis revealed that 14.51% and 5.82% of the effects of depression on all-cause and cardiovascular mortality, respectively, were mediated through family PIR. ConclusionThe family PIR plays a partial mediating role in the relationship between depressive and mortality risk, highlighting the importance of socioeconomic factors in understanding and reducing depression-related mortality. Interventions targeting both mental health and socioeconomic support are essential to improve overall survival among individuals with depression.

BackgroundDepression is a common mental disorder that significantly influences mental health outcomes and increases the risk of all-cause mortality. However, the dose-response relationship between depression and all-cause mortality remains unclear. MethodsA total of 36,193 participants from the National Health and Nutrition Examination Survey (NHANES) 2005-2018 were included in this study. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) scale, and all-cause mortality data were obtained from the National Death Index. Weighted Cox regression models were applied to evaluate the association between depression and all-cause mortality, with special attention to non-linear relationships. ResultsAmong the study population, 8.74% were identified as having depression. The mean follow-up duration was 90.53 months, during which 9.87% of participants died from all causes. A significant non-linear association was observed between PHQ-9 scores and all-cause mortality. All-cause mortality increased markedly with depression scores [&le;] 7 (HR: 1.068, 95% CI: 1.042-1.095, P < 0.0001) and plateaued when scores approached 7. ConclusionsElevated depressive symptoms, even at mild levels, are associated with a substantial increase in all-cause mortality. These findings underline the necessity for early identification and intervention for depressive symptoms to reduce long-term adverse health outcomes. This research provides critical evidence to inform public health strategies targeting the reduction of depression-related mortality.

Background: Childhood adversity (CA) is recognized as a distal risk-factor for suicide attempts (SA) in individuals with psychiatric disorders. However, not all individuals with experiences of CA will engage in SA. Contributing to this relationship may be proximal factors such as impulsivity, inward anger and self-aggression. However, these factors are often conceptually blended and measured in different samples. We sought to clarify association among CA and personality factors in persons with SA. Methods: Participants from two studies comprised individuals with a diagnosed psychiatric disorder and history of SA (n= 139) and individuals with depressive disorder (clinical controls, CC; n= 24). We investigated self-reported levels of CA, impulsivity, inward anger, and self-aggression between the SA and CC (pcorr< .012). We tested the relationship among the factors using regression (pcorr<.017) and mediation model (indirect effects, p<.05) within the SA group. Sensitivity models were run controlling for age, gender, symptom severity, trait anger, and externally oriented aggression. Results: SA group had higher impulsivity (pcorr=.067) in a model controlled for age and gender. Other factors did not differ among groups. Within the SA group the analyses revealed positive association among CA and personality factors (pcorr<.06) in basic and model with age and gender, however the association was not specific for internally (self) oriented factors (coefficient comparison, p<.07). Parallel mediation model indicated that CA had indirect effect on self-aggression through impulsivity (p=.001) and to a lesser extent through inward anger (p=.066). Generally, models controlling for cognitive depression symptoms showed less prominent effects (pcorr>.1). Limitations: The study was cross-sectional and did not include behavioral tasks (state) measures of proximal factors. Conclusions: CA and personality factors showed similar severity levels among the SA and CC groups suggesting they may relate to broader psychopathologies, rather than specifically to SA. The association of CA with anger and aggression was unspecific to internally oriented factors indicating the need for more precise measuring instruments developed specifically for individuals with SA. Overall, the study highlights personality factors as being associated with risk in broader vulnerable populations.

BackgroundAnhedonia, the diminished capacity to experience pleasure, is a transdiagnostic symptom increasingly studied in various psychiatric conditions. While recognized in obsessive-compulsive disorder (OCD), its unique relationship with OCD severity, independent of comorbid depression, remains unclear. This study aimed to investigate the prevalence of anhedonia in individuals with OCD, its association with OCD symptom severity, and whether this association persists after controlling for depressive symptoms. Methods227 adult participants with a primary or co-primary OCD diagnosis completed self-report measures for anhedonia, OCD severity, and depressive symptoms. Hypothesis-driven and exploratory analyses included descriptive statistics, hierarchical multiple linear regression, and group comparisons. ResultsClinically significant anhedonia was found in 14.5% of the sample, though mean anhedonia levels were generally low (M = 0.96, SD = 1.79). A significant positive correlation was initially observed between anhedonia and OCD severity (r = .148, p = .027). However, in a hierarchical regression model, while depressive symptoms significantly predicted OCD severity ({beta} = 0.602, p < .001), anhedonia did not explain unique variance ({Delta}R{superscript 2} < .001, p = .931) after controlling for depression. ConclusionsGeneral anhedonia is present in a subset of individuals with OCD and shows an initial correlation with OCD severity. However, this relationship appears to be largely accounted for by comorbid depressive symptoms. These findings underscore the critical importance of controlling for depression when researching OCD, as well as targeting depression when delivering evidence-based interventions for OCD.

Interoception, the perception of internal bodily signals, is thought to play a key role in health behavior. Interoceptive domains (e.g., accuracy and attention) are associated with mental disorders in various ways, underscoring the need for specific measures for different interoceptive domains. To allow for studying interoceptive domains in the Dutch population, the current study aimed to investigate the reliability and validity of Dutch translations of the Interoceptive Accuracy Scale (IAS-D) and Interoceptive Attention Scale (IATS-D). In a sample of 779 participants (mean age 52.98 {+/-} 16.47, 49.6% female), the IAS-D showed good internal consistency ( = 0.89) with a four-factor structure according to the confirmatory factor analysis (CFI = 0.816, TLI = 0.788, RMSEA = 0.084). The IAS-D had significant negative relations to the Interoceptive Confusion Questionnaire ({beta} = -0.638, p < 0.001), depression ({beta} = -0.298, p < 0.001), and alexithymia ({beta} = 0.528, p < 0.001). The IATS-D showed good internal consistency ( = 0.94) with a three-factor structure according to the confirmatory factor analysis (CFI = 0.852, TLI = 0.833, RMSEA = 0.100). The IATS-D had significant positive relations with the Interoceptive Confusion Questionnaire ({beta} = 0.481, p < 0.001), Body Perception Questionnaire ({beta} = 0.207, p < 0.001), depression ({beta} = 0.377, p < 0.001), and alexithymia ({beta} = 0.528, p < 0.001). The IAS-D and IATS-D are considered reliable and valid instruments for assessing self-reported interoceptive accuracy and attention in Dutch-speaking populations, supporting public health research on the role of interoception in health behavior. HighlightsO_LIInteroceptive domains associate with mental disorders in various ways C_LIO_LISpecific measures for interoceptive domains are needed C_LIO_LIIAS-D and IATS-D are reliable and valid instruments C_LIO_LIIAS-D and IATS-D can distinguish between interoceptive domains C_LI

BackgroundFatigue is a central symptom of major depressive disorder (MDD). Research in healthy individuals has shown that heightened feelings of fatigue are associated with a reduced willingness to exert effort. However, it remains unclear how fatigue affects effort-based decision-making in individuals with MDD. In this study, we explore how cognitive effort is traded for rewards in MDD and how feelings of fatigue and depressed mood symptoms influence this decision-making process. MethodsHealthy participants (n = 26) and individuals with MDD (n = 18) took part in a forced-choice paradigm, where they decided to perform either a low-effort cognitive effort task for a small reward or a more cognitively effortful task for a larger reward. Participants also completed the Beck Depression Inventory and the Modified Fatigue Impact Scale, which were used in a factor analysis to generate combined scores for depressed mood and fatigue for each participant. These factor scores were then incorporated into hierarchical mixed-effects models of choice data to explain behavioral differences between participants with MDD. ResultsOur findings reveal that individuals with MDD exhibited significantly higher preferences for low-effort/low-reward options compared to their healthy counterparts. This difference was linked to increased feelings of fatigue, which raised the perceived cost of cognitive effort. Variations in fatigue questionnaire scores showed stronger associations with effort-based choice behavior than those from questionnaires assessing depressive mood, indicating that fatigue is a key symptom with specific ties to effort in MDD. ConclusionsThese findings illuminate how fatigue might lead to decreases in goal-directed behavior in MDD, thereby deepening our understanding of diminished motivation in MDD and suggesting potential pathways for more effective treatment.

BackgroundDepression is a common cause of mortality and morbidity worldwide. To detect depression, we compared Beck Depression Inventory scoring as a valid tool with participants self-reporting depression. MethodologyThis cross-sectional study aimed to explore the diagnostic values of self-reporting in patients with depression comparing to Beck Depression Inventory scoring in Mazandaran Persian cohort study, with a total of 1300 samples. The sample size was determined to include 155 participants through the census method. In order to increase the test power, 310 healthy participants were included in the study through random selection. In order to evaluate the diagnostic value of self-reporting, BDI-II was completed by blind interviewing to the case group as well as to another group who reported that they were not depressed, as control. ResultsSensitivity, specificity, accuracy, false positive, false negative, positive and negative predictive values of self-reporting was calculated 58.4%, 79.1%,73.4%, 20.8%, 41.6%, 51.8%, and 83.2% for the total population respectively, as well as, sensitivity, specificity, accuracy, positive and negative predictive values of self-report in males were 83.3%, 77.2%, 77.1%, 43.8% and 95.6% and 53.7%, 78.1%, 71.2%, 49.2%, and 81.1% for females, respectively. ConclusionThe positive predictive value and sensitivity of self-reporting are insufficient in total population and females, and therefore self-reporting cannot detect depressed patients, but regarding to its average positive predictive value, perhaps, it can be used to identify non-depressant individuals.

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.

ObjectivesCombined oral contraceptive (COC) use is linked to increased depression risk, potentially via serotonergic pathways. This study examined whether serotonin 2A/2C receptor (5-HT2AR/5-HT2CR) brain binding differs between healthy women using COCs and non-users. Methods71 healthy women had been scanned with either [18F]Altanserin (17 COC users, 22 non-users) or [11C]Cimbi-36 Positron Emission Tomography (17 COC users, 15 non-users). Multiple linear regression and latent variable models were used to assess associations between COC use and neocortical 5-HT2AR and subcortical-HT2AR/5-HT2CR binding, respectively.. Analyses were performed on data pooled across both radiotracers and on each tracer, separately. ResultsIn pooled analyses across both tracers, COC use was not significantly associated with 5-HT2AR binding in the neocortex (-7.7%, 95% CI [-18.9;5.2], p=0.22), nor with 5-HT2AR/5-HT2CR in subcortical regions (-7.8, 95% CI [-21.7;7.7], p=0.31). In [11C]Cimbi-36-only analyses, COC use was associated with -12.6% (95% CI [-22.1;-1.9], p=0.02) lower 5-HT2AR binding in neocortex and -23.5% lower 5-HT2AR/5-HT2CR binding in subcortical regions (95% CI [-35.6;-9.1], p=0.002). No significant differences were observed in the [18F]Altanserin-only analyses. ConclusionThe [11C]Cimbi-36 data indicated lower cortical 5-HT2AR and subcortical 5-HT2AR/5-HT2CR binding in COC users compared to non-users, but this was not observed in the [18F]Altanserin data. This may reflect better signal-to-noise properties of [11C]Cimbi-36 and the fact that it binds more selectively to the high-affinity, biologically active receptor state. These results offer potential mechanistic insights into the depression risk associated with COC use and may have implications for treatments targeting 5-HT2AR/5-HT2CR, underscoring the need for replication and further investigation. Highlights1) COC use was associated with lower 5-HT2AR/CR brain binding in Cimbi-36 PET data 2) COC use was not associated with 5-HT2AR brain binding in [18F]Altanserin PET data 3) We speculate if lower 5-HT2AR/CR levels may affect treatments targeting 5-HT2AR/CR

Levels and distributions of depression symptoms 8-10 months after the onset of the COVID-19 pandemic are reported in a population of faculty, staff, and students at Duke University who faced minimal infection and economic disruption due to the pandemic. Almost 5,000 respondents age 18-81 years who completed the 20-item Center for Epidemiological Studies-Depression (CES-D) battery reported high rates of depression symptoms with more than 40% reporting levels that indicate risk of moderate depression and 25% indicating risk of severe depression. There is a very steep age gradient with the highest levels reported by the youngest respondents of whom over 40% are at risk of severe depression. Symptoms are worse among those who report the demands of work often interfere with family responsibilities but these pressures neither explain the high reported rates nor the steep age gradient. Severe depression risks are highest among students. High levels of depression symptoms during the pandemic appear to be persistent and not confined to those at greatest risk of infection or economic insecurity.