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BACKGROUND: The orbitofrontal cortex (OFC) is implicated in depression. The hypothesis investigated was whether the OFC sensitivity to reward and nonreward is related to the severity of depressive symptoms.
METHODS: Activations in the monetary incentive delay task were measured in the IMAGEN cohort at ages 14 years (n = 1877) and 19 years (n = 1140) with a longitudinal design. Clinically relevant subgroups were compared at ages 19 (high-severity group: n = 116; low-severity group: n = 206) and 14.
RESULTS: The medial OFC exhibited graded activation increases to reward, and the lateral OFC had graded activation increases to nonreward. In this general population, the medial and lateral OFC activations were associated with concurrent depressive symptoms at both ages 14 and 19 years. In a stratified high-severity depressive symptom group versus control group comparison, the lateral OFC showed greater sensitivity for the magnitudes of activations related to nonreward in the high-severity group at age 19 (p = .027), and the medial OFC showed decreased sensitivity to the reward magnitudes in the high-severity group at both ages 14 (p = .002) and 19 (p = .002). In a longitudinal design, there was greater sensitivity to nonreward of the lateral OFC at age 14 for those who exhibited high depressive symptom severity later at age 19 (p = .003).
CONCLUSIONS: Activations in the lateral OFC relate to sensitivity to not winning, were associated with high depressive symptom scores, and at age 14 predicted the depressive symptoms at ages 16 and 19. Activations in the medial OFC were related to sensitivity to winning, and reduced reward sensitivity was associated with concurrent high depressive symptom scores.
While the role of and consequences of being a bystander to face-to-face bullying has received some attention in the literature, to date, little is known about the effects of being a bystander to cyberbullying. It is also unknown how empathy might impact the negative consequences associated with being a bystander of cyberbullying. The present study focused on examining the longitudinal association between bystander of cyberbullying depression, and anxiety, and the moderating role of empathy in the relationship between bystander of cyberbullying and subsequent depression and anxiety. There were 1,090 adolescents (M-age = 12.19; 50% female) from the United States included at Time 1, and they completed questionnaires on empathy, cyberbullying roles (bystander, perpetrator, victim), depression, and anxiety. One year later, at Time 2, 1,067 adolescents (M-age = 13.76; 51% female) completed questionnaires on depression and anxiety. Results revealed a positive association between bystander of cyberbullying and depression and anxiety. Further, empathy moderated the positive relationship between bystander of cyberbullying and depression, but not for anxiety. Implications for intervention and prevention programs are discussed.
Cyber victimization research reveals various personal and contextual correlations and negative consequences associated with this experience. Despite increasing attention on cyber victimization, few studies have examined such experiences among ethnic minority adolescents. The purpose of the present study was to examine the moderating effect of ethnicity in the longitudinal associations among cyber victimization, school-belongingness, and psychological consequences (i.e., depression, loneliness, anxiety). These associations were investigated among 416 Latinx and white adolescents (46% female; M age = 13.89, SD = 0.41) from one middle school in the United States. They answered questionnaires on cyber victimization, school belongingness, depression, loneliness, and anxiety in the 7th grade (Time 1). One year later, in the 8th grade (Time 2), they completed questionnaires on depression, loneliness, and anxiety. Low levels of school-belongingness strengthened the positive relationships between cyber victimization and Time 2 depression and anxiety, especially among Latinx adolescents. The positive association between cyber victimization and Time 2 loneliness was strengthened for low levels of school-belongingness for all adolescents. These findings may indicate that cyber victimization threatens adolescents’ school-belongingness, which has implications for their emotional adjustment. Such findings underscore the importance of considering diverse populations when examining cyber victimization.
While the consequences of cyberbullying victimization have received some attention in the literature, to date, little is known about the multiple types of strains in adolescents’ lives, such as whether cyberbullying victimization and peer rejection increase their vulnerability to depression and anxiety. Even though some research found that adolescents with disabilities show higher risk for cyberbullying victimization, most research has focused on typically developing adolescents. Thus, the present study focused on examining the moderating effect of peer rejection in the relationships between cyberbullying victimization, depression, and anxiety among adolescents with autism spectrum disorder. There were 128 participants (89% male; ages ranging from 11–16 years old) with autism spectrum disorder in the sixth, seventh, or eighth grade at 16 middle schools in the United States. Participants completed questionnaires on cyberbullying victimization, peer rejection, depression, and anxiety. Results revealed that cyberbullying victimization was associated positively with peer rejection, anxiety, and depression among adolescents with autism spectrum disorder. Further, peer rejection was linked positively with depression and anxiety. Peer rejection moderated the positive relationship between cyberbullying victimization and depression, but not anxiety. Implications for prevention programs and future research are discussed.
The purpose of the present study was to investigate the moderating effect of perceived social support from friends in the associations between self-isolation practices during the COVID-19 pandemic and adolescents' mental health (i.e., depression, subjective health complaints, self-harm), measured six months later (Time 2). Participants were 1,567 7(th) and 8(th) graders (51% female; 51% white; M age = 13.67) from the United States. They completed questionnaires on perceived social support from friends, depression, subjective health complaints, and self-harm at Time 1, and self-isolation practices during COVID-19, depression, subjective health complaints, and self-harm at Time 2. The findings revealed that self-isolation practices during COVID-19 was related positively to Time 1 perceived social support from friends, and negatively to Time 2 depression, subjective health complaints, and self-harm, while accounting for Time 1 mental health outcomes. Higher perceived social support from friends at Time 1 buffered against the negative impacts on adolescents' mental health outcomes at Time 2 when they practiced greater self-isolation during COVID-19, while lower perceived social support at Time 1 had the opposite effects on Time 2 mental health outcomes.
Symptoms of anxiety and depression in young athletes using the hospital anxiety and depression scale
(2018)
Elite young athletes have to cope with multiple psychological demands such as training volume, mental and physical fatigue, spatial separation of family and friends or time management problems may lead to reduced mental and physical recovery. While normative data regarding symptoms of anxiety and depression for the general population is available (Hinz and Brahler, 2011), hardly any information exists for adolescents in general and young athletes in particular. Therefore, the aim of this study was to assess overall symptoms of anxiety and depression in young athletes as well as possible sex differences. The survey was carried out within the scope of the study "Resistance Training in Young Athletes" (KINGS-Study). Between August 2015 and September 2016, 326 young athletes aged (mean +/- SD) 14.3 +/- 1.6 years completed the Hospital Anxiety and Depression Scale (HAD Scale). Regarding the analysis of age on the anxiety and depression subscales, age groups were classified as follows: late childhood (12-14 years) and late adolescence (15-18 years). The participating young athletes were recruited from Olympic weight lifting, handball, judo, track and field athletics, boxing, soccer, gymnastics, ice speed skating, volleyball, and rowing. Anxiety and depression scores were (mean +/- SD) 4.3 +/- 3.0 and 2.8 +/- 2.9, respectively. In the subscale anxiety, 22 cases (6.7%) showed subclinical scores and 11 cases (3.4%) showed clinical relevant score values. When analyzing the depression subscale, 31 cases (9.5%) showed subclinical score values and 12 cases (3.7%) showed clinically important values. No significant differences were found between male and female athletes (p >= 0.05). No statistically significant differences in the HADS scores were found between male athletes of late childhood and late adolescents (p >= 0.05). To the best of our knowledge, this is the first report describing questionnaire based indicators of symptoms of anxiety and depression in young athletes. Our data implies the need for sports medical as well as sports psychiatric support for young athletes. In addition, our results demonstrated that the chronological classification concerning age did not influence HAD Scale outcomes. Future research should focus on sports medical and sports psychiatric interventional approaches with the goal to prevent anxiety and depression as well as teaching coping strategies to young athletes.
Web-based bereavement care
(2020)
Background:
Web-based interventions have been introduced as novel and effective treatments for mental disorders and, in recent years, specifically for the bereaved. However, a systematic summary of the effectiveness of online interventions for people experiencing bereavement is still missing.
Objective:
A systematic literature search was conducted by four reviewers who reviewed and meta-analytically summarized the evidence for web-based interventions for bereaved people.
Methods:
Systematic searches (PubMed, Web of Science, PsycInfo, PsycArticles, Medline, and CINAHL) resulted in seven randomized controlled trials (N= 1,257) that addressed adults having experienced bereavement using internet-based interventions. We used random effects models to summarize treatment effects for between-group comparisons (treatmentvs.control at post) and stability over time (postvs.follow-up).
Results:
All web-based interventions were based on cognitive behavioral therapy (CBT). In comparison with control groups, the interventions showed moderate (g= .54) to large effects (g= .86) for symptoms of grief and posttraumatic stress disorder (PTSD), respectively. The effect for depression was small (g= .44). All effects were stable over time. A higher number of treatment sessions achieved higher effects for grief symptoms and more individual feedback increased effects for depression. Other moderators (i.e.dropout rate, time since loss, exposure) did not significantly reduce moderate degrees of heterogeneity between the studies.
Limitations:
The number of includable studies was low in this review resulting to lower power for moderator analyses in particular.
Conclusions:
Overall, the results of web-based bereavement interventions are promising, and its low-threshold approach might reduce barriers to bereavement care. Nonetheless, future research should further examine potential moderators and specific treatment components (e.g.exposure, feedback) and compare interventions with active controls.
Online hate speech has become a widespread problem in the daily life of adolescents. Despite growing societal and academic interest in this online risk, not much is known about the relationship between online hate speech victimization (OHSV) and adolescents' mental well-being.
In addition, potential factors influencing the magnitude of this relationship remain unclear. To address these gaps in the literature, this study investigated the relationship between OHSV and depressive symptoms and the buffering effects of resilience in this relationship. The sample consists of 1,632 adolescents (49.1% girls) between 12 and 18 years old (M-age = 13.83, SDage = 1.23), recruited from nine schools across Spain.
Self-report questionnaires were administered to assess OHSV, depressive symptoms, and resilience. Regression analyses revealed that OHSV was positively linked to depressive symptoms.
In addition, victims of online hate speech were less likely to report depressive symptoms when they reported average or high levels of resilience (i.e., social competence, personal competence, structured style, social resources, and family cohesion) compared with those with low levels of resilience.
Our findings highlight the need for the development of intervention programs and the relevance of focusing on internal and external developmental assets to mitigate negative outcomes for victims of online hate speech.
Ziel Vergleich der Erkennungsgüte von drei Depressions-Screeninginstrumenten bei Patienten mit koronarer Herzerkrankung (KHK).
Methodik 1019 KHK-Patienten erhielten den Patient Health Questionnaire (PHQ-9 und PHQ-2) und die Hospital Anxiety and Depression Scale (HADS-D) sowie ein klinisches Interview (Composite International Diagnostic Interview) als Referenzstandard.
Ergebnisse Bezüglich der Erkennungsgüte waren PHQ-9 und HADS-D dem PHQ-2 überlegen. Optimale Cut-off-Werte waren 7 (PHQ-9 und HADS-D) und 2 (PHQ-2).
Schlussfolgerung PHQ-9 und HADS-D haben eine vergleichbare Diskriminationsfähigkeit für depressive Störungen bei KHK-Patienten.
Objective:
Depression and coronary heart disease (CHD) are highly comorbid conditions. Brain-derived neurotrophic factor (BDNF) plays an important role in cardiovascular processes. Depressed patients typically show decreased BDNF concentrations. We analysed the relationship between BDNF and depression in a sample of patients with CHD and additionally distinguished between cognitive-affective and somatic depression symptoms. We also investigated whether BDNF was associated with somatic comorbidity burden, acute coronary syndrome (ACS) or congestive heart failure (CHF).
Methods:
The following variables were assessed for 225 hospitalised patients with CHD: BDNF concentrations, depression [Patient Health Questionnaire-9 (PHQ-9)], somatic comorbidity (Charlson Comorbidity Index), CHF, ACS, platelet count, smoking status and antidepressant treatment.
Results:
Regression models revealed that BDNF was not associated with severity of depression. Although depressed patients (PHQ-9 score >7) had significantly lower BDNF concentrations compared to non-depressed patients (p = 0.04), this was not statistically significant after controlling for confounders (p = 0.15). Cognitive-affective symptoms and somatic comorbidity burden each closely missed a statistically significant association with BDNF concentrations (p = 0.08, p = 0.06, respectively). BDNF was reduced in patients with CHF (p = 0.02). There was no covariate-adjusted, significant association between BDNF and ACS.
Conclusion:
Serum BDNF concentrations are associated with cardiovascular dysfunction. Somatic comorbidities should be considered when investigating the relationship between depression and BDNF.
Background
This cluster-randomised monocentric controlled trial focuses on improving the uptake symptoms of mental health care in adolescents with chronic medical conditions who have been identified by screening to have depression or anxiety. The study aims to determine the efficacy of motivational interviewing (MI) delivered by trained physicians to increase 12- to 20-year-old adolescents’ utilisation of psychological health care for symptoms of anxiety or depression.
Methods/design
In this single-centre approach, n = 1,000 adolescents will be screened (using PHQ-9 and GAD-7), and adolescents with results indicative of anxiety or depressive symptoms (n = 162) will be advised to seek psychological health care in clusters from treating physicians in specialised outpatient departments. Participants who screen positive will receive either two sessions of MI or treatment as usual (TAU; regarded as the typical daily clinical practice), which is focused on recommending them to seek psychological health care for further evaluation. MI efficacy will be compared to the current TAU as the control condition. The primary outcome is the utilisation rate of psychological health care after counselling by an MI-trained physician vs. an untrained physician. Additionally, reasons for not claiming psychological support and changes in disease-related parameters will be evaluated in a 6-month follow-up session.
Discussion
This trial will evaluate the feasibility of MI as a way to improve the utilisation of mental health-care services by adolescents who need further support other than that provided by standard care for chronic diseases. Physicians offering MI to adolescents may serve as a model for optimising health-care management in daily clinical practice, which may improve adolescents’ long-term well-being by improving adherence to medical treatment and preventing negative lifelong consequences into adulthood.
Sedentarism is a risk factor for depression and anxiety. People living with the human immunodeficiency virus (PLWH) have a higher prevalence of anxiety and depression compared to HIV-negative individuals. This cross-sectional study (n = 450, median age 44 (19-75), 7.3% females) evaluates the prevalence rates and prevalence ratio (PR) of anxiety and/or depression in PLWH associated with recreational exercise. A decreased likelihood of having anxiety (PR=0.57; 0.36-0.91; p = 0.01), depression (PR=0.41; 0.36-0.94; p=0.01), and comorbid anxiety and depression (PR = 0,43; 0.24-0.75; p=0.002) was found in exercising compared to non-exercising PLWH. Recreational exercise is associated with a lower risk for anxiety and/or depression. Further prospective studies are needed to provide insights on the direction of this association.
Publication Bias in meta-analyses of the efficacy of psychotherapeutic interventions for depression
(2013)
Objective: The aim of this study was to assess whether systematic reviews investigating psychotherapeutic interventions for depression are affected by publication bias. Only homogeneous data sets were included, as heterogeneous data sets can distort statistical tests of publication bias. Method: We applied Begg and Mazumdar's adjusted rank correlation test, Egger's regression analysis, and the trim and fill procedure to assess the presence and magnitude of publication bias in all homogeneous data sets of systematic reviews published up to September 2010. Results: Thirty-one data sets reported in 19 meta-analyses fulfilled our inclusion criteria. Significant bias was detected in 5 (16.13%; rank correlation test) and 6 (19.35%; Egger's regression analysis) of these data sets. Applying the trim and fill procedure to amend presumably missing studies rarely changed the assessment of the efficacy of therapeutic interventions, with 2 exceptions. In 1 data set psychotherapy was no longer found to be significantly more efficacious than pharmacotherapy in reducing dropout at posttreatment when publication bias was taken into account. In the 2nd data set, after correcting for publication bias, there was no longer evidence that depressed patients without comorbid personality disorder profited more from psychotherapy and pharmacotherapy than patients with comorbid personality disorder. Conclusions: The results suggest that taken together, psychotherapy research for depression is only marginally affected by the selective reporting of positive outcomes. With 2 notable exceptions, correcting for publication bias did not change the evaluation of the efficacy of psychotherapeutic interventions.
To date, few studies have focused on perceived overprotection from the perspective of people with dementia (PwD). In the present examination, the association of perceived overprotection in PwD is examined as an autonomy-restricting factor and thus negative for their mental well-being. Cross-sectional data from the prospective DYADEM study of 82 patient/partner dyads (mean age = 74.26) were used to investigate the association between overprotection, perceived stress, depression, and quality of life (QoL). The analyses show that an overprotective contact style with PwD has a significant positive association with stress and depression, and has a negative association with QoL. The results emphasize the importance of avoiding an overprotective care style and supporting patient autonomy.
To provide further insight into stress generation patterns in boys and girls around puberty, this study investigated longitudinal reciprocal relations between depressive symptoms, dysfunctional attitudes, and stress generation, the process by which individuals contribute to the occurrence of stress in interpersonal contexts (e.g., problematic social interactions) or in noninterpersonal contexts (e.g., achievement problems). A community sample of N = 924 German children and early adolescents (51.8% male) completed depressive symptoms and dysfunctional attitudes measures at T1 and again 20 months later (T2). Stressful life events were reported at T2. Dysfunctional attitudes were unrelated to stress generation. Interpersonal, but not noninterpersonal, dependent stress partially mediated the relationship between initial and later depressive symptoms, with girls being more likely to generate interpersonal stress in response to depressive symptoms. Findings underscore the role of interpersonal stress generation in the early development of depressive symptomatology, and in the gender difference in depression prevalence emerging around puberty.
Background:
Several standards have been developed to assess methodological quality of systematic reviews (SR). One widely used tool is the AMSTAR. A recent update -AMSTAR 2 -is a 16 item evaluation tool that enables a detailed assessment of SR that include randomised (RCT) or non-randomised studies (NRS) of healthcare interventions.
Methods:
A cross-sectional study of SR on pharmacological or psychological interventions in major depression in adults was conducted. SR published during 2012-2017 were sampled from MEDLINE, EMBASE and the Cochrane Database of SR. Methodological quality was assessed using AMSTAR 2. Potential predictive factors associated with quality were examined.
Results:
In rating overall confidence in the results of 60 SR four reviews were rated "high", two were "moderate", one was "low" and 53 were "critically low". The mean AMSTAR 2 percentage score was 45.3% (standard deviation 22.6%) in a wide range from 7.1% to 93.8%. Predictors of higher quality were: type of review (higher quality in Cochrane Reviews), SR including only randomized trials and higher journal impact factor.
Limitations:
AMSTAR 2 is not intended to be used for the generation of a percentage score.
Conclusions:
According to AMSTAR 2 the overall methodological quality of SR on the treatment of adult major depression needs improvement. Although there is a high need for summarized information in the field of mental health, this work demonstrates the need to critically assess SR before using their findings. Better adherence to established reporting guidelines for SR is needed.
Objectives: To investigate the efficacy of animal-assisted therapy (AAT) on symptoms of agitation/aggression and depression in nursing home residents with dementia in a randomized controlled trial. Previous studies have indicated that AAT has beneficial effects on neuropsychiatric symptoms in various psychiatric disorders but few studies have investigated the efficacy of AAT in patients suffering from dementia. Methods: Of 65 nursing home residents with dementia (mean [standard deviation] age: 81.8 [9.2] years; mean Mini-Mental State Examination score: 7.1 [0.7]), 27 matched pairs (N = 54) were randomly assigned to either treatment as usual or treatment as usual combined with AAT, administered over 10 weekly sessions. Blinded raters assessed cognitive impairment with the Mini-Mental State Examination, presence of agitation/aggression with the Cohen-Mansfield Agitation Inventory, and depression with the Dementia Mood Assessment Scale at baseline and during a period of 4 weeks after AAT intervention. Results: In the control group, symptoms of agitation/aggression and depression significantly increased over 10 weeks; in the intervention group, patients receiving combined treatment displayed constant frequency and severity of symptoms of agitation/aggression (F-1,F-48 = 6.43; p <0.05) and depression (F-1,F-48 = 26.54; p <0.001). Symptom amelioration did not occur in either group. Conclusions: AAT is a promising option for the treatment of agitation/aggression and depression in patients with dementia. Our results suggest that AAT may delay progression of neuropsychiatric symptoms in demented nursing home residents. Further research is needed to determine its long-time effects.
Während Frauen in der Allgemeinbevölkerung ein höheres Depressionsrisiko aufweisen als Männer, ist die Forschungslage zu Geschlechterunterschieden nach Schlaganfall heterogen. Die vorliegende Längsschnittstudie untersucht Geschlechterunterschiede in der Häufigkeit von depressiven Störungen und Symptomen nach Schlaganfall. An zwei deutschen Rehabilitationszentren wurden N = 174 Schlaganfallpatienten und -patientinnen1 (n = 72 weiblich) rekrutiert und etablierte Risikofaktoren erfasst. Nacherhebungen fanden nach acht und 15 Monaten statt. Depressive Störungen und Symptome waren häufiger bei Frauen (48.2 %) als bei Männern (28.3 %) während der stationären Rehabilitation, jedoch nicht in den Folgeuntersuchungen. Etablierte Risikofaktoren beeinflussten geschlechtsunabhängig die Ausprägung depressiver Symptomatik. In Übereinstimmung mit aktuellen Meta-Analysen zeigten sich keine dauerhaften Geschlechterunterschiede bei Depression nach Schlaganfall. In der klinischen Praxis sollte die Affektlage von Schlaganfallpatienten geschlechtsunabhängig betrachtet werden.
Longitudinal pathways of sexual victimization, sexual self-esteem, and depression in women and men
(2017)
Objective: This article presents a longitudinal analysis of the links between sexual assault victimization, depression, and sexual self-esteem by examining their cross-lagged paths among both men and women. Method: Male and female college students (N = 2,425) in Germany participated in the study that comprised 3 data waves in their first, second, and third year of university, separated by 12-month intervals. Sexual assault victimization was assessed at Time 1 (T1) since the age of 14 and at Time 2 (T2) and Time 3 (T3) for the last 12 months. Depression and sexual self-esteem were measured at each wave. Results: Random-intercept cross-lagged panel analyses, controlling for individual differences in depression and sexual self-esteem, showed that sexual assault at T1 predicted depression and lower sexual self-esteem at T2, and depression and lower self-esteem at T2 predicted sexual assault victimization at T3. In addition, significant paths were found from T1 depression to T2 sexual assault victimization and from T2 sexual assault victimization to depression at T3. Sexual victimization at T1 was indirectly linked to sexual victimization at T3 via depression at T2. Both depression and sexual self-esteem at T1 were indirectly linked to sexual victimization at T3. The paths did not differ significantly between men and women. Conclusion: Sexual assault victimization was shown to be a risk factor for both depression as a general mental health indicator and lowered sexual self-esteem as a specific outcome in the domain of sexuality. Moreover, depression and sexual self-esteem increased the vulnerability for sexual assault victimization, which has implications for prevention and intervention efforts. This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
Objective: To estimate the prevalence and the type of antidepressant medication prescribed by German psychiatrists to patients with depression and cardiovascular diseases (CVD). Methods: This study was a retrospective database analysis in Germany using the Disease Analyzer Database (IMS Health, Germany). The study population included 2,288 CVD patients between 40 and 90 years of age from 175 psychiatric practices. The observation period was between 2004 and 2013. Follow-up lasted up to 12 months and ended in April 2015. Also included were 2,288 non-CVD controls matched (1 : 1) to CVD cases on the basis of age, gender, health insurance coverage, depression severity, and diagnosing physician. Results: Mean age was 68.6 years. 46.2% of patients were men, and 5.9% had private health insurance coverage. Mild, moderate, or severe depression was present in 18.7%, 60.7%, and 20.6% of patients, respectively. Most patients had treatment within a year, many of them immediately after depression diagnosis. Patients with moderate and severe depression were more likely to receive treatment than patients with mild depression. There was no difference between CVD and non-CVD in the proportion of patients treated. Nonetheless, CVD patients received selective serotonin reuptake inhibitors / serotonin-noradrenaline reuptake inhibitors (SSRIs/SNRIs) significantly more frequently. Conversely, patients without CVD were more often treated with TCA. Conclusion: There was no association between CVD and the initiation of depression treatment. Furthermore, CVD patients received SSRIs/SNRIs more frequently.