Journal of Affective Disorders

ObjectiveGiven the episodic nature of bipolar disorder (BD) and the variability in mood episode recurrence across individuals, accurate recurrence prediction is critical. The original COBY recurrence risk calculator (RC) was developed in a longitudinal youth cohort to estimate threshold recurrence risk. However, its accuracy for predicting subthreshold recurrences had not been fully evaluated. The objective of this study was to extend the previously developed COBY mood recurrence RC to predict b...

BackgroundSuicidal ideation (SI) fluctuates over time, yet traditional static risk factors poorly align with its dynamics over time. Understanding dynamic symptom patterns may advance knowledge of the temporal interplay between SI and co-occurring symptoms in adults with depressive and anxiety disorders. Materials and methodsWe analyzed six waves (at baseline, and after 2, 4, 6, 9, and 13 years of follow-up) of the Netherlands Study of Depression and Anxiety (NESDA; n = 305, mean age 40.8 years...

BackgroundSleep disturbance is a core feature of bipolar disorder (BD) and often precedes mood recurrence, particularly in youth. Although actigraphy provides objective sleep measurement, it is limited by cost and monitoring duration. Passive smartphone-based mobile sensing offers a scalable alternative, but its validity in youths with BD is unclear. MethodsAnalyses included adolescents and young adults (ages 14-25) with BD-I/II from the PROMPT-BD study with at least four days of concurrent act...

BackgroundWhile commonly accepted depressive subtypes reflect phenotypic differences, there has been minimal progress in identifying discrete pathophysiological pathways, biomarkers or differential therapeutic approaches which effectively guide clinical management. AimsTo test the biological validity and clinical utility of a circadian subtype of depression on the basis of clinical course, differential medication response (self-reported) and genetic risk profile. MethodsCross-sectional data we...

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...

ObjectivesElectroconvulsive Therapy (ECT) is an effective treatment for bipolar disorder, particularly in severe acute cases or for illness resistant to pharmacotherapy. However, the risk of relapse following ECT is high, necessitating intervention to reduce this risk. Based on findings from ECT studies in unipolar depression and its well-known mood-stabilizing properties, it is likely that lithium treatment may reduce the risk of relapse of bipolar disorder following ECT. Therefore, we conduct...

ObjectiveAlthough mental health and healthy lifestyle interventions are associated with functional outcomes in adolescence, the extent to which particular lifestyle factors explain relationships between mental health and outcome are unclear. Here we examined mediating effects of lifestyle factors on relationships between mental health and two functional outcomes measured 2-3 years later as well as the moderating effect of environmental risk factors on mediation strength in early adolescence. Me...

BackgroundThe COVID-19 pandemic, coupled with concurrent social instabilities, has raised concerns about the long-term impact on the population mental health. While existing studies have primarily focused on the acute phase, less is known about how anxiety and depression symptoms have evolved throughout prolonged societal disruption. This study aimed to identify distinct anxiety and depression symptom trajectories and to determine the individual, relational, and societal protective and risk fact...

Digital therapeutics for mental health often face low patient engagement, which limits their clinical impact. Interventions that deliver treatment using a video game medium may improve engagement and therapeutic efficacy, but the putative emergence of gaming-related problems remains a concern among clinical stakeholders. We examined whether long-term engagement with Meliora, a video game therapeutic for adult major depressive disorder, was associated with changes in gaming-related problems in a ...

BackgroundWhile growing evidence implicates sleep-wake and circadian rhythm disturbances (SCRDs) in the onset and course of mood and psychotic disorders, longitudinal studies using objective measures are limited. This clinical cohort study examined whether actigraphy-derived SCRDs (sleep duration, timing, and efficiency) predicted transition to (i) any full-threshold mental disorders; and then specifically: (ii) full-threshold bipolar or psychotic disorders or (iii) other full-threshold (i.e. de...

BackgroundAs digital communication becomes central to daily life, psychotherapy increasingly has access to patients electronic media data. While digital phenotyping has been widely studied, less is known about whether incorporating personal communication data, such as text messages, improves clinical outcomes in psychotherapy. ObjectiveTo determine whether integrating personalized text message data into psychotherapy improves depression, anxiety, health related quality of life, and therapeutic ...

Depression is a common and clinically significant mental health condition among university students, particularly those experiencing academic failure and course repetition, and is associated with adverse effects on cognitive functioning, emotional regulation, and academic performance. This study evaluated the efficacy of an internet-based cognitive behavioural therapy (iCBT) intervention, MoodGYM, in reducing depressive symptoms among repeating undergraduate students at the University of Zambia ...

Depression is a heterogeneous disorder, often diagnosed based on symptom co-occurrence. However, individuals may present with markedly different symptom profiles, potentially reflecting distinct underlying mechanisms. Identifying common patterns of symptoms using data-driven approaches could help clarify the heterogeneity of depression. Furthermore, examining the sociodemographic and lifestyle characteristics, health status, and polygenic scores of individuals with specific symptom profiles may ...

BackgroundLight plays a critical role in mental health, as the primary input to the circadian system, which regulates mood, energy, and the sleep-wake cycle. Altered light sensitivity is a potential mechanism in circadian-associated mental disorders. MethodsActigraphy-derived sleep, physical activity, and circadian rhythm correlates of the pupillary light reflex were explored in young people with emerging mental disorders. Participants were 27 healthy controls (Mean age=25.67 {+/-} 2.83, 52% fe...

BackgroundMajor depressive disorder (MDD) involves immune-metabolic dysregulation, psychosocial adversity, and multidomain cognitive disturbances, yet single cognitive indices often show small and inconsistent effects. We derived a multivariate Cambridge Neuropsychological Test Automated Battery (CANTAB)-based cognitive phenotype ("cognitype") and tested whether it adds explanatory value beyond adverse childhood experiences (ACEs) and an acute-phase protein (APP) index in acute-phase MDD. Metho...

BackgroundIn 2020, Oregon became the first U.S. state to establish a regulated framework for adults to access psilocybin services using naturally-derived mushroom products. No studies have examined mental health outcomes among individuals receiving psilocybin in this context. AimsTo evaluate changes in self-reported symptoms of depression, anxiety, and well-being 30-days post-psilocybin session under the Oregon state-regulated model , and document session-related adverse events and doses consum...

Evidence-based psychotherapies are first-line treatments for psychiatric disorders, yet response rates remain suboptimal. Noninvasive brain stimulation (NIBS) may augment psychotherapy by modulating treatment-engaged circuits. We conducted a systematic review and meta-analysis of randomized controlled trials comparing active NIBS plus evidence-based psychotherapy versus sham NIBS plus psychotherapy. Following Cochrane methods, we searched six databases through February 2025, screening 1,017 reco...

Objective: Posttraumatic stress disorder (PTSD) after a traumatic birth is a serious but overlooked maternal morbidity, affecting ~20% of women following medically complicated deliveries. PTSD can undermine maternal caregiving. Rapid screening tools suited to busy obstetric settings are lacking. We developed and evaluated a brief screener, derived from the 20-item PTSD Checklist for DSM-5 (PCL-5), to identify PTSD related to childbirth. Study Design: We enrolled 107 women with traumatic childbir...

PurposeTo address high levels of depression and anxiety among college students, innovative, feasible, and effective treatment approaches with high potential for dissemination in university counseling centers are needed. This pilot study aimed to develop a toolkit and training intervention to support implementation of nature-based physical activity into group therapy in a university counseling center, and to evaluate the feasibility, acceptability, and preliminary effectiveness of the interventio...

ObjectiveDigital cognitive behavioral therapy for insomnia (CBT-I) is an effective and scalable treatment for chronic insomnia. However, treatment outcomes are typically evaluated using aggregated symptom scores, which obscure differential effects on individual symptoms and limit insights into underlying mechanisms. This study applied network intervention analysis (NIA) to investigate how somnovia, a self-guided digital CBT-I intervention, is associated with changes in individual symptoms of ins...