Journal of affective disorders最新文献

Background: Childhood maltreatment and bullying victimization are established risk factors for adolescent depression, yet the dynamic protective role of resilience in this context remains inadequately understood. This study examines how specific resilience components dynamically mitigate depressive symptoms in the context of co-occurring childhood adversities.

Methods: A three-wave longitudinal study (6-month intervals) was conducted among 801 Chinese early adolescents (aged 10-14). Cross-sectional and cross-lagged panel network models were used to analyze multivariate relationships among five maltreatment subtypes, three bullying forms, resilience components, and depressive symptoms. Centrality and bridge centrality indices identified core and bridging nodes in the network.

Results: The cross-sectional network identified belief (expected influence = 1.426) as the most central resilience factor, while meaningfulness showed the strongest bridging protection (bridge strength = 0.030) against adversity and depression. Cross-lagged panel network models revealed bidirectional resilience dynamics: meaningfulness negatively predicted emotional neglect and reciprocally reinforced motivation across time points. Fatigue and emotional abuse emerged as key risk drivers in temporal networks.

Limitations: The sample was from a single regional school, limiting generalizability. Self-report measures and 6-month intervals may not fully capture dynamic processes or biological mechanisms.

Conclusions: Resilience protects against depression through staged mechanisms: pre-trauma belief establishment, in-crisis solitude adaptation, and post-trauma meaning reconstruction. These findings support the development of phase-specific, resilience-focused interventions for depression prevention in early adolescents exposed to cumulative adversity.

Background: The shortage of mental health resources remains a major barrier to effective and scalable interventions for perinatal depression (PND). To address this challenge, this study evaluated the effectiveness of a tiered internet-based cognitive behavioral therapy (iCBT) intervention for PND, delivered by non-specialist health care providers (HCPs) within the primary care system.

Methods: This pragmatic, non-randomized controlled trial enrolled pregnant women from two antenatal clinics in Hefei, China. Participants with an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 9 were allocated to the intervention group (N = 268) or control group (N = 160) based on their enrollment time. In addition to usual care, the intervention group received a tiered iCBT intervention (Mom's Good Mood, MGM), in which intervention intensity was matched to baseline depression symptom severity. The control group received usual care alone. The intention-to-treat principle was applied to test the significance of primary endpoints (the change in EPDS scores from baseline to 6 months postpartum) and secondary outcomes (including the proportion of women with postpartum depression (EPDS ≥9), the proportion achieving response (≥4-point EPDS reduction), changes in GAD-7 scores, the proportion with postnatal anxiety, and changes in life satisfaction scores). Linear mixed models (LMM), generalized linear mixed models (GLMM), sensitivity analyses, and a cost-effectiveness analysis were conducted.

Results: Compared with controls, the intervention group showed a significantly greater reduction in EPDS scores from baseline to postpartum (Least-squares means, LSM, -1.63, 95% CI -2.62 to -0.64), a lower risk of postpartum depression (aOR = 0.46, 95% CI 0.27 to 0.79), and a higher odds of response (≥4-point reduction on EPDS, aOR = 1.70, 95% CI 1.05 to 2.76). Similar trends were observed for anxiety outcomes. Subgroup analysis showed more pronounced benefits for moderate to severe cases (LSM, -2.79, 95% CI -5.04 to -0.54; aOR = 0.20, 95% CI 0.06 to 0.68), while no significant effect was observed for mild cases. The intervention proved to be highly cost-effective, with an incremental cost of ¥5.5 (US$0.75) per 1% increase in response rate.

Conclusions: The tiered iCBT program MGM demonstrated significant effectiveness in reducing PND. Delivered by trained non-specialist HCPs within primary care settings, it optimizes resource use while enabling scalable mental health support.

Fear of Missing Out (FoMO) is a salient factor influencing adolescents' mental health in the digital age. This two-wave longitudinal study examined whether self-esteem mediates the association between emotion regulation difficulties and FoMO over a five-month interval, while controlling for baseline levels of FoMO and self-esteem, as well as age and sex. A total of 1311 adolescents (57.5% female; M = 16.4, SD = 1.1) completed self-report measures of FoMO, self-esteem (RSES), and the Difficulties in Emotion Regulation Scale-Short Form (DERS-SF). Regression analyses showed that the DERS Strategies subscale, reflecting limited access to effective emotion regulation strategies, was the only dimension that uniquely predicted FoMO at follow-up after controlling for baseline levels. Structural equation modeling supported a mediation model, with a significant indirect effect of emotion regulation difficulties on FoMO at follow-up via self-esteem. The final model demonstrated good fit and explained 55% of the variance in FoMO at follow-up. Findings indicate that difficulties accessing adaptive regulation strategies may be associated with lower self-esteem over time, which in turn relates to higher FoMO. Interventions targeting emotion regulation and self-esteem may help mitigate FoMO-related distress in adolescence.

Background: Emerging evidence has highlighted the cerebellum's role in emotion and cognition through cerebello-cerebral interactions. However, the manner in which the cerebellum integrates with the cerebral triple core networks, the default mode network (DMN), central executive network (CEN), and salience network (SN), in Major Depressive Disorder (MDD) remains unclear.

Methods: Resting-state functional magnetic resonance imaging (rs-fMRI) data were acquired from 119 patients with MDD and 106 healthy control (HC) subjects. Voxel-wise functional connectivity (FC) between the cerebral cortex and cerebellum was subsequently constructed. To evaluate cerebello-cerebral functional integration based on voxel-wise FC, functional gradient analysis and independent component analysis (ICA) were performed.

Results: The cerebral triple core network components were found to map onto cerebellar motor and cognitive functional modules. In patients with MDD, reduced mapping of the cerebral DMN and SN components to the cerebellum was observed. Additionally, patients exhibited compression of the cerebello-cerebral functional gradient within both motor and cognitive modules. The triple core networks showed increased contributions to cerebellar cognitive modules, whereas the DMN demonstrated decreased contributions to cerebellar motor modules in MDD. These cerebello-cerebral interaction patterns were significantly correlated with clinical assessment measures, including scores on the Trail Making Test (TMT) and the Emotion Regulation Questionnaire (ERQ).

Conclusions: These findings indicate disrupted functional integration between the cerebral triple core networks and the cerebellum in MDD. The results further support the cerebellum's involvement in disease pathogenesis and suggest potential neurobiological markers for diagnosis and intervention.

Background: Depression remains highly prevalent among adults, and educational assortative mating may shape mental health by structuring resource allocation and gendered roles. In China, rapid educational expansion and shifting marital norms have created a context distinct from high-income settings, and it remains unclear how financial and domestic contributions, relationship quality, and subjective socioeconomic status predict depressive symptoms over time.

Methods: This study used two-wave longitudinal data from the 2020 and 2022 waves of the China Family Panel Studies (CFPS) for married or cohabiting adults in China. We estimated cross-lagged panel network models stratified by educational homogamy, hypergamy, and hypogamy and gender, linking depressive symptoms with marital satisfaction, subjective well-being, and subjective socioeconomic status.

Results: Life satisfaction bridged marital satisfaction and depressive symptoms in homogamous unions. Hypogamous wives had the lowest depressive scores, while hypergamous wives' depression was tied to financial and housework satisfaction. In hypogamous husbands, depressive symptoms predicted declines in marital satisfaction.

Limitations: Observational two-wave CLPN models preclude strong causal claims, and findings reflect contemporary Chinese marital norms.

Conclusions: Women in hypogamous unions had the lowest mean depressive symptoms, whereas women in hypergamous unions showed no clear mental-health advantage. Among men, the most distinctive feature of hypogamy was not a statistically clear elevation in mean depressive symptoms, but a stronger pattern in which depressive symptoms predicted later declines in marital satisfaction and well-being. These findings suggest that the mental-health correlates of educational pairing in China are gendered and closely tied to how couples evaluate financial, domestic, and relational arrangements.

Growing work underscores the importance of understanding disturbances in positive valence or emotional processes in psychopathology. Despite evidence that substance use disorders, such as cannabis misuse, are associated with positive emotion processes, few studies have examined associations between cannabis use and clinically relevant disorders that centrally feature positive emotions (such as bipolar spectrum disorders) and associated positive emotion processes. The present study investigates associations between self-reported cannabis use and bipolar spectrum disorder (BSD) risk and mood severity, as well as three well-studied positive valence processes (i.e., positive emotion experience, reward responsiveness, and positive emotion valuation). Emerging adult college students who endorsed cannabis use (N = 968) were recruited from nine North American universities. Higher self-reported BSD risk was associated with greater cannabis-related interference with daily life, but not cannabis use frequency or difficulty stopping. Furthermore, higher positive emotion experience was associated with lower cannabis frequency, interference with life, and difficulty stopping. Greater reward responsiveness was associated with decreased cannabis interference in daily life. These findings highlight the importance of clinically relevant and basic positive emotion-relevant processes in understanding cannabis use.

Background: Anhedonia is a core transdiagnostic symptom across diverse psychiatric disorders, yet its neural mechanisms across multiple biological scales remain unclear. In this study, we aim to explore the neural circuit patterns and molecular genetic foundations of anhedonia by integrating multimodal neuroimaging and transcriptomic data.

Methods: We used publicly available resting-state fMRI data from a transdiagnostic cohort (N = 213; comprising healthy controls and patients with diverse affective and psychotic disorders), with anhedonia assessed using the Temporal Experience of Pleasure Scale (TEPS). First, we applied connectome-based predictive modeling (CPM) to derive macroscale functional network patterns predictive of distinct anhedonia dimensions (anticipatory vs. consummatory). Next, the predictive performance and generalizability of these models were evaluated in an independent transdiagnostic cohort (N = 247). Finally, we linked the anhedonia-related connectome pattern (ARCP) to PET-derived neurotransmitter receptor/transporter maps and AHBA gene-expression profiles via spatial correspondence analyses.

Results: CPM robustly predicted anhedonia across diagnostic categories, supporting the "neurobiological continuum" hypothesis of anhedonia. ARCP were distributed across the default mode (DMN), salience (SN), sensorimotor (Som/Mot), and limbic networks. At the edge level, cross-network connections between DMN and Som/Mot constituted the core transdiagnostic feature. Spatial correspondence analyses linked to DRD2 receptor density and gene expression profiles enriched in dopaminergic signaling and autophagy pathways.

Conclusions: We establish a multi-level framework for transdiagnostic anhedonia by linking macroscale connectome aberrations to genetic and receptor-level disruptions. Together, these multi-scale insights advance the transdiagnostic continuum model and offer a promising neurobiological basis for precision psychiatry.

Background: Anxiety and depression are leading contributors to the global mental health burden, often clustering in urban areas where sociodemographic vulnerabilities and environmental stressors accumulate. Evidence on their joint and distinct spatial patterns in high-income urban contexts remains limited.

Methods: We analyzed longitudinal data from 2023 to 2025 collected in the population-based Specchio study in Geneva (N = 6057), Switzerland. Prevalence and distribution of anxiety (GAD-2 ≥ 3) and depression (PHQ-2 ≥ 3) were assessed. Spatial clustering was examined using Spatial and Spatiotemporal Relative Risk (sparr). Generalized estimating equations evaluated sociodemographic, psychosocial, and environmental determinants.

Results: Overall, 6057 participants were included, 59% female, mean age (51.8 ± 14.0). The prevalence of anxiety was 13.5%, 14.1%, 12.1% and depression 9.9%, 9.4%, 8.1% in 2023, 2024 and 2025 respectively. Spatial high-risk clusters for anxiety and depression were identified and overlapped in central Geneva. These clusters persisted between 2023 and 2025. Depression clusters decreased slightly after adjustment for age, sex, and education, and anxiety clusters remained the same. High-risk clusters were associated with lower income, more one-person households, higher levels of air pollution, urban heat, and reduced greenness compared with the rest of the canton. Findings were consistent when restricting analyses to individuals who participated in all three years.

Conclusion: Areas with greater socioeconomic disadvantage and higher environmental stress were characterized by higher prevalence of anxiety and depressive symptoms in an urban area in Switzerland. These findings underscore the need for targeted public health interventions that integrate social and environmental approaches for mental health issues in urban settings.