Journal of Affective Disorders

BackgroundChildhood maltreatment is a major risk factor for depression and may contribute to sex differences in depression prevalence. We examined sex-specific associations between childhood maltreatment and depression and estimated the proportion of depression cases attributable to specific maltreatment subtypes. MethodsWe analyzed baseline data from 159,045 participants (49.4% women; aged 19-72) in the German National Cohort (NAKO). Childhood maltreatment was assessed via the Childhood Trauma...

BackgroundAdolescents with a parental history of bipolar disorder (BD; High-Risk) are more likely to develop BD than those without such history (Low-Risk). Actigraphy studies in adults indicate that instability in sleep and rest-activity rhythms (RAR) may be associated with progression to BD. However, it remains unclear whether High-and Low-Risk adolescents are differentially affected by sleep/RAR instability and their impact on emerging mood symptoms. MethodsWe recruited 50 adolescents unaffec...

BackgroundPsychomotor retardation is characterised by slowed motor and cognitive processes. Although associated with greater illness severity in depression, its relationship with treatment response is unclear. We examined whether psychomotor retardation is associated with treatment outcomes in depression. MethodsWe conducted a secondary analysis of individual participant data from nine randomised controlled trials of pharmacological, psychological and exercise-based treatments for unipolar depr...

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...

BackgroundMany people with depression do not respond well to the first antidepressant prescribed. Treatment Resistant Depression (TRD) refers to depression which does not respond to multiple subsequent antidepressant treatments. Identifying TRD in routinely-collected health records is challenging due to limited response-related data. Previous studies have used definitions based on the number of antidepressant switches observed. However, these do not account for other features clinically indicati...

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...

BackgroundWorldwide, common mental disorders such as anxiety and depression are major contributors to disability. However, the role of diet as a risk factor for anxiety and depression remains underexplored. Therefore, we investigated the associations between food groups and major depressive disorder (MDD) and anxiety disorders, following a harmonized protocol to enable integration of studies. MethodsWe analysed data from 1,634 participants in the Netherlands Study of Depression and Anxiety to e...

ObjectiveEffective management of Major Depressive Disorder (MDD) is limited by reliance on episodic, subjective clinical scales. Passive digital phenotyping offers a potential solution for continuous, objective monitoring. We aimed to assess the concurrent validity of a novel digital biomarker--the Facial Affect Dynamics-derived Depression Severity (FADS) score--against the Patient Health Questionnaire-9 (PHQ-9). MethodsWe conducted an interim analysis of the EMC2FR study (NCT06860165), a prosp...

BackgroundThe Michigan Freshman Study on Stress and Resilience aims to identify factors that predict the emergence of depression and/or anxiety symptoms in college freshmen. We previously showed that a combination of psychiatric instruments (Affect Score) strongly predicts who will develop such symptoms during the freshman year. Here, we ask: a) Can we replicate the predictive power of the Affect Score in an independent cohort? and b) Can the neuroendocrine profile during the Trier Social Stress...

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...

BackgroundAn accelerated schedule of intermittent theta burst stimulation (aiTBS) has been shown to improve clinical efficacy of transcranial magnetic stimulation for bipolar disorder (BD) and major depressive disorder (MDD). We investigated the functional connectivity changes underpinning clinical effects of aiTBS on transdiagnostic treatment-resistant depression (TRD). MethodsData were collected from two studies: an open-label active aiTBS study for MDD and a double-blind, randomized control ...

BackgroundSuicidal ideation (SI) is a major global concern, yet its dynamic interplay with other symptoms remains poorly understood. ObjectiveTo identify symptoms that co-fluctuate with or temporally precede SI to improve warning signal detection and intervention. MethodsLongitudinal data from three Dutch psychiatric cohorts with lifetime internalizing disorders (16 waves from April 2020 until February 2022) were collected during the COVID-19 pandemic. We analyzed depressive, happiness, anxiet...

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...

BackgroundAdolescence and young adulthood are critical periods for the emergence of bipolar disorder (BD). Instability in sleep and rest-activity rhythms is associated with elevated risk for BD, yet little is known about the neural correlates of this vulnerability. White matter organization in fronto-limbic pathways, which support mood regulation and show sensitivity to sleep/rest-activity rhythm disruption, offers a promising avenue for investigation. MethodsParticipants (16-24y;N=112) recruit...

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...

ImportanceArtificial Intelligence (AI) voice applications have the potential to address the unmet treatment needs among patients with depression and anxiety, but their therapeutic utility is largely unknown. ObjectiveTo investigate the efficacy and mechanisms of an AI-driven voice-based coach, Lumen, delivering problem-solving treatment (PST) for patients with untreated, moderate depression and/or anxiety. DesignPhase 2, 3-arm randomized clinical trial. SettingA public university and affiliat...

BackgroundChallenges in correctly identifying bipolar II disorder (BD-II) during depressive states have led to poor clinical outcomes. BD-II-specific imaging investigations are lacking. This study addresses current knowledge gaps by comparing white matter (WM) integrity in BD-II and unipolar depression (UD) using fixel-based analysis. MethodFibre density (FD), fibre cross-section (FC), and the combined measure (FDC) within 72 WM tracts were compared among 33 individuals with BD-II, 50 with UD, ...

Major depressive disorder (MDD) involves dysregulated neuroimmune, metabolic, and oxidative stress (NIMETOX) pathways. Recently, it was shown that NIMETOX pathways should be evaluated in MDD patients stratified for metabolic syndrome (MetS). The current study aims to characterize the metabolic hormone and adipokine profiles of Chinese MDD patients stratified for MetS and to delineate their associations with overall severity of depression (OSOD), suicidal ideation (SI), recurrence of illness (ROI...