BackgroundFreshmen often experience challenges when adjusting from high school to college, which may elevate levels of depression, anxiety, and stress. This phenomenon is particularly pronounced in medical schools, where the overall academic atmosphere is widely regarded as exceptionally demanding and stressful.ObjectivesTo examine the indirect effect of sedentary behavior on the relationship between phubbing and depression anxiety stress of first-year medical students.MethodsThis study conducted a cross-sectional survey with 795 first-year medical students from Soochow University in China from October 2024 to November 2024 by using electronic questionnaire. The instruments were Depression Anxiety Stress Scale-21 (DASS-21), Generic Scale of Phubbing (GSP), and Adolescent Sedentary Activity Questionnaire (ASAQ).ResultsThe findings indicate that first-year medical students’ phubbing and sedentary behavior positively affects their depression anxiety stress (r = 0.120 ~ 0.815, both p < 0.01), and phubbing positively impacts medical students’ sedentary behavior (r = 0.128, p < 0.01). Additionally, sedentary behavior acts as a significant mediator between phubbing and depression, anxiety, and stress. The indirect effect contributes to 1.9%~2.5% of the total effect.ConclusionThese findings indicate that reducing depression anxiety stress in first-year medical students can be achieved not only through direct improvements in phubbing but also through the indirect effects of reducing sedentary behavior.
Calming Minds Study
Conditions: Anxiety; Anxiety Depression; Worry; Depression; Rumination – Thoughts
Interventions: Behavioral: Be Specific; Behavioral: Be Kind; Behavioral: Be Present; Behavioral: Break Habit; Behavioral: Psychoeducation
Sponsors: University of California, Los Angeles; University of Exeter
Not yet recruiting
Interventions: Behavioral: Be Specific; Behavioral: Be Kind; Behavioral: Be Present; Behavioral: Break Habit; Behavioral: Psychoeducation
Sponsors: University of California, Los Angeles; University of Exeter
Not yet recruiting
Phenotype, Genetics, and Interpretation: Further Considerations on Atypical Depression
We read with great interest the recent article by Shin et al. (1). The authors leveraged the substantial Australian Genetics of Depression Study (AGDS) cohort to provide compelling evidence for the clinical and biological validity of the atypical depression subtype. Their integrative analysis of clinical features, polygenic scores (PGSs) for mental, metabolic, and circadian traits, and self-reported treatment outcomes is a significant contribution to the field. The particularly robust finding of an association between a genetic predisposition for eveningness (lower-chronotype PGS) and atypical depression, which persisted after adjustment for body mass index (BMI), is noteworthy and points to a potentially core, BMI-independent pathway.
Reply to: Phenotype, Genetics, and Interpretation: Further Considerations on Atypical Depression
We thank Li and Chen for their thoughtful and constructive engagement with our work (1). They raise three important conceptual and methodological points concerning the operationalization of phenotypes, interpretation of body mass index (BMI)–adjusted sensitivity analyses, and future analytical directions, which we discuss below.
Comorbidity alters the genetic relationship between anxiety disorders and major depression
The extensive genetic overlap between anxiety disorders (ANX) and major depression (MD) may partly reflect inclusion of comorbid cases in genome-wide association studies (GWAS). We investigated this genetic relationship between ANX and MD with and without mutual comorbidity.
<![CDATA[Psilocybin therapy shows fast, lasting relief for depression; clinicians discuss trial hurdles and emerging promise for PTSD and addiction in this podcast.]]>
Computer-based tree drawing test in adolescents and adults with depression
ObjectiveTo evaluate the value of the computer-based Tree Drawing Test in the auxiliary diagnosis of depressive disorders and to analyze the differences in the performance of adolescent and adult depression patients in the Tree Drawing Projection Test.MethodsThis study was conducted at Guo Yang County People’s Hospital in Anhui, China, and involved a total of 184 participants: 43 adults with depression, 82 adolescents with depression, and 59 healthy controls. The Tree Drawing Test and scale assessments were administered to patients with depressive disorders (adult group and adolescent group) and a control group. Computer image recognition and calculation techniques were used to analyze the results statistically.ResultsSignificant differences were observed between the adult depression group and the control group in terms of crown area, trunk area, total area, and HDRS scores (p < 0.001). Statistically significant differences were also found between the adult depression group and the adolescent depression group in terms of trunk area (p < 0.01), total area (p < 0.001), HDRS scores (p < 0.001), and HAMA scores (p < 0.01). The crown area (r = -0.261, p < 0.001), trunk area (r = -0.154, p = 0.037), total area (r = -0.285, p < 0.001), and HDRS scores in the Tree Drawing Test were significantly correlated.ConclusionThe computer-based Tree Drawing Test has certain value in the auxiliary diagnosis of depression. Future research should include larger sample sizes and participants from different regions and cultural backgrounds to further validate the generalizability and cultural adaptability of the Tree Drawing Test for depression assessment.
Adaptation of behavioural activation for adolescents with mild to moderate intellectual disabilities and depression
IntroductionAdolescents with intellectual disabilities are at increased risk for mental health problems and depression. Despite this, there is currently no evidence for effective psychological interventions for treating low mood and depression in this population. Behavioural activation has been identified as an effective intervention for treating depression in autistic adolescents and for adults with intellectual disabilities and may therefore also be suitable for use with adolescents with intellectual disabilities.MethodThe current paper describes an approach taken to adapting an existing behavioural activation intervention used with adults with intellectual disabilities (Beat-It) to be suitable for adolescents, named Beat-Depression (Beat-D). An iterative, three-phase approach was adopted for the adaptation process. The first phase involved review of the Beat-It manual and proposed adaptations by the project team, followed by a second phase consisting of consultations with parents of adolescents with intellectual disabilities and professionals with experience in the field.ResultsThe outcomes from phases one and two were incorporated into a final adapted manual for the Beat-D intervention. The intervention is described following the principles of the Template for Intervention Description and Replication (TIDieR) checklist.DiscussionImplications for using this adaptation approach more broadly to ensure psychological interventions used with adolescents with intellectual disabilities are suitable and accessible are discussed along with future plans for the evaluation of Beat-D.
Barriers and Facilitators in the Implementation of the Systematic Medical Appraisal, Referral, and Treatment (SMART) Mental Health Digital Intervention in Rural India: Mixed Methods Process Evaluation Study
<strong>Background:</strong> An estimated 150 million people have mental health care needs in India, but only 15% are able to access care. Depression and anxiety contribute to a large proportion of mental morbidity. The Systematic Medical Appraisal, Referral, and Treatment (SMART) Mental Health trial used a mobile-based clinical decision support system for primary care doctors and community health workers (CHWs) to identify and treat people at risk of depression, anxiety disorders, and self-harm. A community-based antistigma campaign was also delivered. The intervention led to improved remission rates for depression and anxiety and lower stigma scores. <strong>Objective:</strong> A process evaluation assessed (1) implementation fidelity, barriers, and facilitators; (2) perceptions of doctors and CHWs on the use of SMART Mental Health; and (3) the causal pathways that led to trial outcomes. <strong>Methods:</strong> A mixed methods evaluation combining backend program data and qualitative data was conducted. A total of 38 focus group discussions and 37 key informant interviews were conducted with primary doctors, CHWs, government officials, local community leaders, and research project staff. The data were coded and analyzed using a framework analysis approach based on the UK Medical Research Council guidance on process evaluations and the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. <strong>Results:</strong> The intervention had high implementation fidelity. Across clusters, the median proportion of participants with at least 1 CHW follow-up was 98% (IQR 96.6%-100%). The referral rate for a psychiatrist was low (224/1697, 13.2%), and only 23.6% (53/224) of those referred visited the psychiatrist. The median exposure to antistigma audiovisual content was 84% (IQR 65.7%-95.9%). At the community level, key implementation barriers included cultural inhibitions in seeking mental health care and the unavailability of patients due to competing demands. Proximity and tight social connections between CHWs and their communities were important facilitators in seeking medical help. Doctor and CHW training, mentoring, and feedback provided by program staff were important facilitators to support the use of the digital health components by the health workforce. <strong>Conclusions:</strong> A complex intervention that included both community-based antistigma and clinical digital health interventions achieved high implementation fidelity. Key areas to consider for maintenance of such interventions include (1) the need for sustained community-based strategies to address stigma and other cultural barriers; (2) health workforce strengthening policies, including supportive supervision for CHWs and doctors to increase capability in the use of mental health digital health tools; and (3) strategies to improve access to specialist care for those with more complex care needs. <strong>Trial Registration:</strong> Clinical Trial Registry India CTRI/2018/08/015355; https://tinyurl.com/5r63suxp
<![CDATA[Online tool personalizes antidepressant choice in primary care, cutting dropouts and improving 24-week depression and anxiety scores.]]>