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BACKGROUND: The primary objective of this randomized controlled trial (RCT) is to establish the effectiveness of time-restricted eating (TRE) compared with the Mediterranean diet for people with bipolar disorder (BD) who have symptoms of sleep disorders or circadian rhythm sleep-wake disruption. This work builds on the growing evidence that TRE has benefits for improving circadian rhythms. TRE and Mediterranean diet guidance will be offered remotely using self-help materials and an app, with coaching support. METHODS: This study is an international RCT to compare the effectiveness of TRE and the Mediterranean diet. Three hundred participants will be recruited primarily via social media. Main inclusion criteria are: receiving treatment for a diagnosis of BD I or II (confirmed via DIAMOND structured diagnostic interview), endorsement of sleep or circadian problems, self-reported eating window of ≥ 12 h, and no current mood episode, acute suicidality, eating disorder, psychosis, alcohol or substance use disorder, or other health conditions that would interfere with or limit the safety of following the dietary guidance. Participants will be asked to complete baseline daily food logging for two weeks and then will be randomly allocated to follow TRE or the Mediterranean diet for 8 weeks, during which time, they will continue to complete daily food logging. Intervention content will be delivered via an app. Symptom severity interviews will be conducted at baseline; mid-intervention (4 weeks after the intervention begins); end of intervention; and at 6, 9, and 15 months post-baseline by phone or videoconference. Self-rated symptom severity and quality of life data will be gathered at those timepoints, as well as at 16 weeks post baseline. To provide a more refined index of whether TRE successfully decreases emotional lability and improves sleep, participants will be asked to complete a sleep diary (core CSD) each morning and complete six mood assessments per day for eight days at baseline and again at mid-intervention. DISCUSSION: The planned research will provide novel and important information on whether TRE is more beneficial than the Mediterranean diet for reducing mood symptoms and improving quality of life in individuals with BD who also experience sleep or circadian problems. TRIAL REGISTRATION: ClinicalTrials.gov ID NCT06188754.

Purpose: Muscle Quality Index (MQI), defined as the muscle strength per unit of muscle mass, is considered an emerging indicator of health and physical function. This study aims to explore the relationship between MQI and the risk of depression among non-elderly US adults. Methods: This cross-sectional study collected data from participants aged between 20 and 59 years old, utilizing the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014. The MQI was calculated by dividing the handgrip strength (HGS, kg) by the arm and appendicular skeletal muscle mass (ASM, kg). Depression assessments were conducted using the Patient Health Questionnaire (PHQ-9). The relationship between MQI and the risk of depression was explored by weighted logistic regression, smooth curve fitting, and subgroup analyses. Results: A total of 4773 participants were included in this study. After adjusting for confounding factors, low MQI levels were identified as an independent risk factor for depression (OR = 0.800, 95%CI:0.668–0.957, P = 0.015). Smooth curve fitting analysis indicated a nonlinear relationship. Subgroup analysis did not identify any specific populations. Conclusions: Higher MQI levels were closely associated with a lower risk of depression among non-elderly US adults. MQI could enhance our understanding of the link between muscle and depression and might serve as a simple functional measure for evaluating and predicting depression. [ABSTRACT FROM AUTHOR]

Background: We aimed to clarify the controversial relationship between levels of high-sensitivity C-reactive protein (hs-CRP) and severity of depression in men and women. Methods: Medical records were retrospectively analyzed for 1,236 inpatients at our medical center who were diagnosed with depression at discharge between January 2018 and August 2022. Depression severity was assessed during hospitalization using the 24-item Hamilton Depression Rating Scale. Potential associations between severity scores and hs-CRP levels were explored using multivariate linear regression as well as smooth curve fitting to detect non-linear patterns. Results: In male patients, hs-CRP levels between 2.00 mg/L and 10.00 mg/L showed a non-linear association with depression severity overall (fully adjusted β = 1.69, 95% CI 0.65 to 2.72), as well as with severity of specific symptoms such as hopelessness, sluggishness, and cognitive disturbance. In female patients, hs-CRP levels showed a linear association with severity of cognitive disturbance (fully adjusted β = 0.07, 95% CI 0.01 to 0.12). These results remained significant after adjusting for age, body mass index, diabetes, hypertension, history of drinking, history of smoking, and estradiol levels. Discussion: Levels of hs-CRP show sex-specific associations with depression severity, particularly levels between 2.00 and 10.00 mg/L in men. These findings may help develop personalized anti-inflammatory treatments for depression, particularly for men with hs-CRP levels of 2.00–10.00 mg/L. [ABSTRACT FROM AUTHOR]

Background: Mood disorders, including unipolar and bipolar depression, contribute significantly to the global burden of disease. Psychological therapy is considered a gold standard non-pharmacological treatment for managing these conditions; however, a growing body of evidence also supports the use of lifestyle therapies for these conditions. Despite some clinical guidelines endorsing the application of lifestyle therapies as a first-line treatment for individuals with mood disorders, there is limited evidence that this recommendation has been widely adopted into routine practice. A key obstacle is the insufficient evidence on whether lifestyle therapies match the clinical and cost effectiveness of psychological therapy, particularly for treating those with moderate to severe symptoms. The HARMON-E Trial seeks to address this gap by conducting a non-inferiority trial evaluating whether a multi-component lifestyle therapy program is non-inferior to psychological therapy on clinical and cost-effectiveness outcomes over 8-weeks for adults with major depressive disorder and bipolar affective disorder. Methods: This trial uses an individually randomised group treatment design with computer generated block randomisation (1:1). Three hundred and seventy-eight adults with clinical depression or bipolar affective disorder, a recent major depressive episode, and moderate-to-severe depressive symptoms are randomised to receive either lifestyle therapy or psychological therapy (adjunctive to any existing treatments, including pharmacotherapies). Both therapy programs are delivered remotely, via a secure online video conferencing platform. The programs comprise an individual session and six subsequent group-based sessions over 8-weeks. All program aspects (e.g. session duration, time of day, and communications between participants and facilitators) are matched except for the content and program facilitators. Lifestyle therapy is provided by a dietitian and exercise physiologist focusing on four pillars of lifestyle (diet, physical activity, sleep, and substance use), and the psychological therapy program is provided by two psychologists using a cognitive behavioural therapy approach. Data collection occurs at baseline, 8-weeks, 16-weeks, and 6 months with research assistants blinded to allocation. The primary outcome is depressive symptoms at 8 weeks, measured using the Montgomery-Åsberg Depression Rating Scale (MADRS) (minimal clinically important difference = 1.6). A pre-specified within-trial economic evaluation will also be conducted. Discussion: Should lifestyle therapy be found to be as clinically and cost effective as psychological therapy for managing mood disorders, this approach has potential to be considered as an adjunctive treatment for those with moderate to severe depressive symptoms. Trial registration: Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12622001026718, registered 22nd July 2022. Protocol version: 4.14, 26/06/2024 [ABSTRACT FROM AUTHOR]

Background: Tackling poor mental health in university students has been identified as a priority in higher education. However, there are few evidence-based prevention initiatives designed for students. Repetitive Negative Thought (RNT, e.g. worry, rumination) is elevated in university students and is a well-established vulnerability factor for anxiety and depression. Furthermore, there are now evidence-based cognitive-behavioural interventions to tackle RNT. A mobile self-help cognitive-behavioural app targeting RNT, adapted for students may therefore be an effective, scalable, and acceptable way to improve prevention in students. Methods: An online single blind, two-arm parallel-group Randomised Controlled Trial (RCT) to examine the incidence of major depression and symptoms of anxiety and depression across 12 months in university students aged over 16 who screen into the study with self-reported high levels of worry and/or rumination and no current diagnosis of major depression. Eligible participants will be randomised to the active intervention arm (usual practice plus using a self-guided mobile app targeting RNT) or to the control arm (usual practice). In total, 648 participants aged over 16, with no current major depression, bipolar disorder or psychosis will be recruited from UK universities. Assessments will take place at baseline (pre-randomisation), 3 months and 12 months post- randomisation. Primary endpoint and outcome is incidence of major depression as determined by self-reported diagnostic criteria at 12-month follow-up. Depressive symptoms, anxiety, well-being, health-related quality of life, functioning and academic outcomes are secondary outcomes. Compliance, adverse events, and potentially mediating variables will be carefully monitored. Discussion: The trial aims to provide a better understanding of the causal role of tackling RNT (worry, rumination) using a self-help mobile app with respect to preventing depression in university students. This knowledge will be used to develop and disseminate innovative evidence-based, feasible, and effective mobile-health public health strategies for preventing common mental health problems. Trial registration: https://www.isrctn.com/ISRCTN86795807 Date of registration: 27 October 2022 [ABSTRACT FROM AUTHOR]

Background: Socioeconomic status (SES) is associated with both depression and activities of daily living (ADL and IADL). However, the role of ADL as a biological mechanism in the relationship between SES and late-life depression, examined through longitudinal data, remains understudied. This study explored the longitudinal mediation effects of basic ADL or IADL on the SES-depression link in older adults. Methods: Data from the China Health and Retirement Longitudinal Study (N = 4104) were utilized. Mediation analysis was performed using parallel process latent growth curve modeling. Results: The average age of participants was 57.76 years, and 55.7% being females. Significant linear growth over time was observed in ADL, IADL, and depression. Adjusting for covariates, SES was positively linked to the initial levels (intercepts) of ADL (βiADL=-0.100[-0.143, -0.057]), IADL (βiIADL=-0.140[-0.185, -0.095]), and depression (βiDEP=-0.103[-0.158, -0.048]). However, SES showed no significant correlation with the rate of change (slopes) in ADL, IADL, or depression (P > 0.05). The intercepts of ADL (βiDEP = 0.566[0.503, 0.629]) and IADL (βiDEP = 0.607[0.544, 0.670]) were positively correlated with the depression intercept but negatively with the depression slope. Conversely, the slopes of ADL and IADL were positively associated with the depression slope. These results suggest a negative indirect relationship between SES and the initial level of depression, but a positive indirect relationship with the rate of increase in depression through ADL (or IADL) intercept. Conclusions: Higher SES is associated with a lower initial risk of depression and ADL difficulties. However, this same higher SES may relate to a faster increase in ADL difficulties and depression among middle-aged and older adults. The findings underscore the need for increased governmental healthcare funding and improved healthcare accessibility. Additionally, maintaining adequate sleep and physical activity can help prevent disability and reduce depression risk later in life, particularly among older adults with lower SES. [ABSTRACT FROM AUTHOR]

Background: Anxiety-, mood/affective-, or stress-related disorders affect up to one-third of individuals during their lives and often impact their ability to work. This study aimed to delineate trajectories of work disability (WD) among individuals diagnosed with anxiety-, mood/affective-, or stress-related disorder in primary healthcare and to examine associations between trajectory group membership and sociodemographic, clinical, and clinical-related factors. Methods: The study population included working-age individuals, aged 22–62 years, living in Stockholm County, Sweden, who experienced a new episode of any anxiety-, mood/affective, or stress-related disorder in primary healthcare in 2017 (N = 11,304). Data were obtained from Swedish national and regional registers and were linked using pseudonymised unique personal identification numbers. The primary outcome was days with WD (sum of sickness absence and disability pension days) during the three years before and three years after a diagnosis of anxiety-, mood/affective-, or stress-related disorders in primary healthcare. A zero-inflated Poisson group-based trajectory model was used to identify groups of individuals with similar patterns of WD over the study period, with a multinomial logistic regression used to examine associations of sociodemographic, clinical, and clinical-related factors with trajectory group membership. Results: Four distinct trajectory groups were found, high increasing (5.1%), with high levels, from 16 to 80 days of WD in six-monthly intervals during follow-up, peak (11.1%), with a peak in WD, up to 32 days of WD, around the time of the diagnosis, low increasing (12.8%), with an increase in days of WD from 4 to 22 during the study period, and constant low (71.1%), with almost no WD over the study period. In multinomial regression models, diagnostic category, psychotropic medication use, a diagnosis of a psychiatric disorder within secondary healthcare, age at diagnosis, and occupation were associated with WD trajectory groups. Conclusions: Around two-thirds of individuals treated for a new episode of any anxiety-, mood/affective-, or stress-related disorder in primary healthcare have an excellent prognosis regarding WD. Several sociodemographic and clinical characteristics were associated with group membership; these factors could identify individuals at risk of long-term welfare dependency and who might benefit from interventions to promote a return to work. [ABSTRACT FROM AUTHOR]

Background: Anxiety and depression often co-occur, exhibiting high comorbidity, with their trends evolving over time. However, the specific pathways through which comorbid symptoms of anxiety and depression evolve and interact remain unclear. To investigate these questions, this study employed Network Analysis (NA) and Longitudinal Network Analysis (LNA) to explore the central symptoms of anxiety and depression, as well as the temporal evolution of these central symptoms. Methods: The study focused on 606 high school students who were not in their final year in Shandong of China, with assessments conducted from March to September 2022. The bootnet package in R was used for establishing NA and LNA models, as well as for conducting accuracy analysis and node stability analysis. Results: The results of the NA indicated that adolescent highly susceptible to anxiety and depression. And uncontrollable worry was a common central symptom, while irritability emerged as a central bridging symptom across all three NAs. The LNA results revealed that suicidal ideation and worthlessness were key central symptoms in the LNA. Furthermore, worthlessness played a pivotal role in the developmental pathway of "suicidal ideation → worthlessness → anxiety and uncontrollable worry." A reduction in suicidal ideation was associated with decreased severity in other symptoms. Conclusions: The findings suggest that adolescent anxiety and depression are in a state of vulnerability, and that irritability, worthlessness, and suicidal ideation are potential targets for interventions to address adolescent anxiety and depression. [ABSTRACT FROM AUTHOR]

Background: Depression is a prevalent and serious mental health disorder that significantly impacts daily life and functioning. Neurofilament Light chain (NfL), associated with axonal neuronal damage, has been identified as a promising biomarker, potentially aiding in early diagnosis of depression, personalized treatment, and tracking disease progression. This study used meta-analysis to evaluate the potential of plasma NfL as a biomarker for depression patients. Methods: A systematic search following the PRISMA guidelines was conducted across PubMed, Web of Science, Scopus, and Google Scholar databases to find relevant studies on plasma NfL levels in patients with depression. A random effects model meta-analysis was applied to determine its potential as a biomarker for differentiating patients from controls. Results: Our meta-analysis, based on four articles with six datasets, revealed that plasma NfL levels were notably higher in individuals with depression (228 cases) compared to healthy controls (118 individuals). The weighted mean difference (WMD) was 8.78 (95% CI: 5.28, 12.28; P < 0.01), indicating a significant effect size. Given the diverse confounding factors inherent in the included observational studies, the observed variability can be attributed to these influences. Due to the observed heterogeneity (heterogeneity Chi-Square: 54.91, p < 0.05), we performed a subgroup analysis. Subgroup analyses based on depression type and analysis method consistently supported the association between NfL and depression, strengthening the evidence. Conclusion: Our meta-analysis demonstrates that elevated NfL levels may serve as a promising biomarker for diagnosing depressive disorders. Further research on diverse subtypes and longitudinal changes is needed to validate its clinical utility. [ABSTRACT FROM AUTHOR]

Background: In China, parents who have lost their only child are referred to as Shidu parents (SDPs). This study aimed to investigate the prevalence and risk factors of post-traumatic stress disorder (PTSD) and investigate the influence of depressive and anxiety symptoms on the development of PTSD. Method: Four hundred and thirty-six SDPs completed assessments of PTSD (Structured Clinical Interview for DSM-IV Disorders, SCID-IV; The Clinician-Administered PTSD Scale-IV, CAPS-IV), depression (Hamilton depression scale), and anxiety (Hamilton Anxiety Scale) via in-person interviews. Logistic regression and hierarchical multiple linear regression analyses were used to explore the association of demographic characteristics, depression, and anxiety symptoms with PTSD. Results: The prevalence of PTSD in SDPs was 14.45%. The comorbidity of depression and anxiety symptoms was 87.30% in the SDPs with PTSD. The logistic regression model, which included factors of gender, age, education, depression, and anxiety, which contributed to the development of PTSD, was significant [χ² (11) = 122.47, p < 0.001]. The hierarchical multiple linear regression analysis indicated that female gender and the severity of comorbidities (depression and anxiety) were positively associated with the severity of PTSD. Conclusion: This study found that the severity of depression and anxiety was closely related to the severity of PTSD, supporting that SDPs are highly prone to the co-occurrence of PTSD, depression, and anxiety after bereavement. Our findings may provide more insights into the development of individualized interventions for parents who have experienced the loss of their only child. [ABSTRACT FROM AUTHOR]

Background: Mental health disorders still rank as leading causes of morbidity worldwide despite increasing awareness and improvements in treatment. Notably, low- and middle-income countries like Uganda, are disproportionately affected by such disorders. The burden of depressive symptoms in these countries is particularly high among students, aggravated by poverty, malnutrition, and inadequate public health governance, yet it is clearly under-researched, making it hard to achieve several of UN Sustainability Development Goals. Current treatment options are insufficient to tackle the increased burden of depressive disease. This is more challenging for low-resource regions especially in Sub-Saharan Africa, suggesting the need for alternative treatments that can swiftly be applied if proven effective. The main aim of this randomized controlled trial (RCT) is therefore to examine if a low-cost healthy diet (based on local Ugandan foods) combined with easy-to access mindfulness cognitive therapy can reduce depressive symptoms among university students in Uganda. Methods: We will recruit female and male students at Makerere University, the largest public university in Uganda, to an open, intention-to-treat, two-armed RCT. Those who score above a predefined threshold on a self-reported assessment of depressive symptoms, measured by the Center for Epidemiological Studies – Depression score (CES-D), are eligible for study inclusion and will be randomized to either an intervention (n = 125) or a control (n = 125) group. The intervention group will receive educational group-based sessions on how to prepare a Mediterranean-type of healthy diet and how to adhere to the principles of mindfulness-based cognitive therapy. Outcome measures include self-reported depression symptoms, quality of life, and dietary intakes. In addition we will perform a cost-effectiveness analysis. The RCT intervention will last 9 months, followed by additional 15 months with regular data collections. Discussion: We here describe a novel approach to treat depressive symptoms among university students living in resource constraint settings, by combining a healthy diet with low threshold psychotherapy. If this intervention succeeds, our project can be viewed as a step towards evidence-based behavior practices for young adults with a common mental disorder (depression) that are beneficial to public mental health initiatives and management. Trial registration: The RCT is registered in ClinicalTrials.gov (ID: NCT05848973). The date of registration was August 14, 2023. [ABSTRACT FROM AUTHOR]

Objective: To assess the effectiveness of Internet-based self-help interventions in treating depression in adolescents and young adults. Methods: A systematic search was conducted across six databases, including PubMed, to identify randomized controlled trials (RCTs) that satisfied the specified inclusion and exclusion criteria. The intervention measure consisted of Internet-based self-help interventions. Results: A total of 23 randomized controlled trials (RCTs) were included in this analysis. Meta-analysis indicated that Internet-based self-help therapies significantly reduced depression scores in adolescents and young adults. (OR = -0.68, 95%CI [-0.88, -0.47], P < 0.001). We examined the effects of patient recruitment from various regions, medication usage, therapist involvement, weekly intervention time, and intervention duration. Patients selected from school, primary healthcare centers, clinics and local communities had better results. Intervention lasting 30 to 60 min and 60 to180 minutes per week were effective in the short term. Conclusion: The internet-based self-help intervention can be effective in treating depression in adolescents and young adults. However, factors such as patient recruitment locations, medication usage, Therapists' involvement, weekly intervention time, and intervention duration interacted with the outcome. Subgroup analysis on potential adverse effects and gender was impossible due to insufficient data from the included studies. [ABSTRACT FROM AUTHOR]

Background: The main objective of this study was to examine the burden of schizophrenia, depression, Alzheimer's disease/dementia, and stroke on caregivers and non-caregivers in Japan. This study also aimed to provide a comparative landscape on the burden of caregiving for each disorder. Methods: The Japan National Health and Wellness Survey database, 2016 and 2018 was used in this study. Health-related quality of life (HRQoL), work productivity, and health care utilization were assessed using a self-administered, Internet-based questionnaire. The burden of caregiving experienced by each group of caregivers was compared with background-matched non-caregivers (controls) as well as with caregivers of patients with each disorder. Results: Caregivers of patients with schizophrenia, depression, Alzheimer's disease/dementia, or stroke had lower HRQoL, higher healthcare costs and work productivity impairment than non-caregivers. Furthermore, caregivers of patients with psychiatric disorders such as schizophrenia and depression had lower HRQoL and work productivity than caregivers of patients with Alzheimer's disease/dementia and stroke. In addition, according to the Caregiver Reaction Assessment (CRA), caregivers of patients with schizophrenia and depression were more inclined to perceive a loss in physical strength and financial burden to the same extent as their self-esteem. Conclusions: This study indicated a substantial caregiving burden among caregivers of patients with psychiatric and neurological diseases in Japan. The caregiver burden of psychiatric disorders (schizophrenia and depression) was greater than that of neurological disorders (Alzheimer's disease/dementia and stroke), suggesting a need to provide support to caregivers of patients with psychiatric disorders to be better able to care for their patients. Trial Registration: None. [ABSTRACT FROM AUTHOR]

Objective: Patients with Postherpetic Neuralgia (PHN) often exhibit depressive-like symptoms, significantly impacting their quality of life. Esketamine, known for its analgesic properties, has also been recognized for its rapid antidepressant effects. However, its efficacy in the treatment of PHN requires further exploration. This study aims to evaluate the impact of intravenous patient-controlled analgesia(PICA) with esketamine on depressive mood in PHN patients. Methods: This retrospective study analyzed PHN patients hospitalized and treated at the affiliated hospital of Southwest Medical University from June 2021 to March 2023. Patients were divided into the esketamine group (E group) and the sufentanil group (S group) based on their treatment regimens. Primary outcomes included pain numerical rating scale(NRS), depression patient health questionaire-9(PHQ-9), and anxiety generalized anxiety disorder-7(GAD-7) scores measured before treatment, and at 3 days, 7 days, 1 month, 2 months, and 3 months post-treatment. Results: A total of 83 patients were included in the analysis. Before treatment, there were no statistically significant differences in pain NRS, depression PHQ-9, and anxiety GAD-7 scores between the two groups (P > 0.05). Compared to before treatment, significant reductions in pain NRS scores were observed at all post-treatment time points in both groups (P < 0.05), with no differences between groups (P > 0.05). The E group exhibited significantly lower depression PHQ-9 scores than the S group at 3 days and 7 days post-treatment (P < 0.05), but no significant differences were observed at 1 month, 2 months, and 3 months (P > 0.05). Anxiety GAD-7 scores were significantly lower in the E group compared to the S group at 3 days, 7 days post-treatment (P < 0.05), with no statistical differences at 1 month, 2 months, and 3 months post-treatment (P > 0.05). Conclusion: Both PICA with esketamine and sufentanil alleviated pain equally in PHN patients. However, PICA with esketamine specifically improved early symptoms of anxiety and depression. [ABSTRACT FROM AUTHOR]

Lithium Carbonate is an effective treatment for affective disorders, but has a range of side effects. This case report highlights a rare side effect of Raynaud's phenomenon following initiation of Lithium therapy in a patient with recurrent depressive disorder. He was commenced on Lithium therapy to treat severe treatment resistant depression with psychotic symptoms when alternative treatments trialled were ineffective. He had no other risk factors or known aetiological causes for development of Raynaud's phenomenon. Symptoms resolved on discontinuation of Lithium and re-emerged on recommencement. Previous case series have shown Lithium effectively treating vasospastic disorders such as cluster headache and Raynaud's phenomenon. However, a paradoxical reaction to those previously described was induced in this case. [ABSTRACT FROM AUTHOR]

Background: Depressive disorders are among the common mental health conditions in the general outpatient setting and affect patients' load and treatment outcomes. People who suffer from depression frequently consult general practitioners and prefer to attribute their symptoms to physical illness rather than mental illness. Little is known about the magnitude and associated factors of depression among patients attending general outpatient services in Somalia. The study aimed at determining the prevalence and associated factors of depression among them. Methods: This is an institution-based cross-sectional study among randomly selected 422 patients who attended general outpatient services of two hospitals in Mogadishu. We applied three standardized instruments, such as the Somali version of the Patient Health Questionnaire (PHQ-9), the Oslo Social Support Scale (OSSS-3), and the Perceived Stress Scale-10 (PSS-10). We analyzed data using the statistical software SPSS version 29. We calculated prevalence and its 95% Confidence Interval (CI) and identified associated factors by bivariate and Multivariate analysis. We considered the association significant when p value is < 0.05. Results: The prevalence of depression symptoms was found to be 55% (95% CI 50–60%). The result also showed that 55.0% were females, 50.7% were aged between 26 and 44 years, 44.3% were single, 29.9% achieved tertiary education, and 44.3% were unemployed. Multivariate analysis established that age of between 26 and 44 years (aOR = 2.86, 95%CI:1.30–6.29, p = 0.009), being separated/divorced (aOR = 2.37, 95%CI: 1.16–4.82, p = 0.018), income level of ≤$100 (aOR = 3.71, 95% CI:1.36–10.09, p = 0.010), and high stress levels (aOR = 20.06, 95%CI:7.33–54.94, p < 0.001) were independent factors that significantly associated with depressive symptoms. Conclusion: This study found high levels of depression among patients attending outpatient clinics, with age, marital status, education level, income level, family history of psychiatry disorder, and stress level being key predictors. Regular screening among patients in outpatient clinics and proper referral are crucial in ensuring that those at high risk of depression are managed effectively. [ABSTRACT FROM AUTHOR]

Background: This study was intended to investigate the correlation between depression and suicidal ideation among Chinese college students during the COVID-19 pandemic and the potential mediating roles of chronotype and sleep quality in this relationship. Methods: A sample of 4,768 college students was selected from four institutions in Anhui Province, China, and the study was conducted during the COVID-19 pandemic (November to December 2020) using a stratified, cluster, multi-stage sampling method. This study used the two-item Patient Health Questionnaire (PHQ-2) to assess depressive symptoms, the Morningness-Eveningness Questionnaire 19 (MEQ-19) to determine individual sleep chronotypes (i.e., morning or evening preference), and the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality. Participants were asked about suicidal ideation. MPLUS 8.3 software was used to analyze the mediating effect of chronotype and sleep quality on the relationship between depression and suicidal ideation. Results: During the COVID-19 pandemic, the prevalence of suicidal ideation among Chinese college students was 5.4%. Depression was inversely correlated with chronotype (beta = − 0.346, P < 0.01) and positively correlated with sleep quality (beta = 0.846, P < 0.001), indicating that students experiencing depressive symptoms were more likely to have a later chronotype and poor sleep quality. A later chronotype (beta = − 0.019, P < 0.05) and poor sleep quality (beta = 0.066, P < 0.01) predicted suicidal ideation. Depression emerged as a direct and significant risk factor for suicidal ideation (effect value = 0.535, 95% confidence interval: 0.449 ~ 0.622). Chronotype and sleep quality were found to have potential mediating effects on the relationship between depression and suicidal ideation; however, the chain-mediating effect of chronotype and sleep quality was not statistically significant. Conclusions: Our findings suggest that during the COVID-19 pandemic, depression can precipitate suicidal ideation through its influence on sleep chronotype and quality. These compelling findings highlight the urgency of early intervention strategies intended to mitigate suicidal thoughts, particularly among students exhibiting depressive symptoms, who experience disrupted sleep patterns and poor sleep quality. [ABSTRACT FROM AUTHOR]

Background: Depression is prevalent among lung cancer patients undergoing chemotherapy, and the symptom cluster of fatigue-pain-insomnia may influence their depression. Identifying characteristics of patients with different depression trajectories can aid in developing more targeted interventions. This study aimed to identify the trajectories of depression and the fatigue-pain-insomnia symptom cluster, and to explore the predictive factors associated with the categories of depression trajectories. Methods: In this longitudinal study, 187 lung cancer patients who were undergoing chemotherapy were recruited and assessed at the first (T1), second(T2), and fourth(T3) months using the Patient Health Questionnaire-9 (PHQ-9), the Brief Pain Inventory (BPI), the Brief Fatigue Inventory (BFI), and the Athens Insomnia Scale (AIS). Growth Mixture Model (GMM) and Latent Class Analysis (LCA) were used to identify the different trajectories of the fatigue-pain-insomnia symptom cluster and depression. Binary logistic regression was utilized to analyze the predictive factors of different depressive trajectories. Results: GMM identified two depressive trajectories: a high decreasing depression trajectory (40.64%) and a low increasing depression trajectory (59.36%). LCA showed that 48.66% of patients were likely members of the high symptom cluster trajectory. Binary logistic regression analysis indicated that having a history of alcohol consumption, a higher symptom cluster burden, unemployed, and a lower monthly income predicted a high decreasing depression trajectory. Conclusions: Depression and fatigue-pain-insomnia symptom cluster in lung cancer chemotherapy patients exhibited two distinct trajectories. When managing depression in these patients, it is recommended to strengthen symptom management and pay particular attention to individuals with a history of alcohol consumption, unemployed, and a lower monthly income. [ABSTRACT FROM AUTHOR]

Objective: To investigate the influence of aerobic exercise on depression among the young people. Data sources: PubMed, Web of science, Embase, Cochrane, EBSCO were searched from inception to November 2023. Study selection: RCT studies, assessing the use of aerobic exercise in young people aged 6–35 years and then determining the development of depression in young people (aged 6–35 years), were selected, and mean ± SD values adjusted for the presence of baseline depression were extracted. Data extraction and synthesis: Study quality was assessed using the Review manager 5.4.1 and Cochrane 5.1 item on risk of bias and precision of observational studies. Two reviewers conducted all review stages independently. Selected data were pooled using random-effects meta-analysis. Main outcomes and measures: The included studies evaluated the relationship between aerobic exercise and depression at various time points among young individuals, and provided corresponding mean ± SD values. Depression diagnosis in the selected studies was conducted using the Depression Correlation Scale. Results: After screening 2296 articles, 163 articles were selected for full-text review, and 8 of those were further reviewed. Ultimately, 12 studies, involving 658 individuals, were included in the meta-analysis. The results of the meta-analysis indicated that aerobic exercise could effectively improve depression in young people (d = -1.33, 95%CI: -1.78 ~ -0.87, P < 0.05). Subgroup analysis demonstrated that aerobic exercise was beneficial for both depression (d = -2.68, 95%CI: -3.87 ~ -1.48, P < 0.05) and non-depression (d = -0.85, 95%CI: -1.20 ~ -0.51, P < 0.05) conditions, as well as for low intensity (d = -0.93, 95%CI: -1.29 ~ 0.58, P < 0.05) and moderate intensity (d = -2.08,95%CI:-2.88 ~ -1.27, P < 0.05) exercises. Additionally, aerobic exercise was found to significantly alleviate depression in young people when performed for 40 min or less (d = -2.00,95%CI: -2.96 ~ -1.04, P < 0.05), whereas durations exceeding 40 min showed a lesser effect (d = -0.85,95%CI:-1.47 ~ -0.24, P < 0.05). Furthermore, the duration-based analysis revealed that aerobic exercise improved depression levels in young people regardless of duration, whether it was for less than 6 weeks (d = -1.27,95%CI: 2.12 ~ 0.14, P < 0.05), 6 to 11 weeks (d = 1.55, 95% CI: 2.16 ~ 0.94, P < 0.05), or more than 12 weeks (d = 1.00, 95% CI: -1.76 ~ -0.24,P < 0.05). Overall, these findings suggest that aerobic exercise is a promising intervention for alleviating depression in young individuals. Conclusions: Both short (less than 40 min) and long (more than 40 min) periods of aerobic exercise were effective in improving depressive symptoms. However, the optimal duration of aerobic exercise may vary depending on the specific population and individual factors studied, such as age, health status, and exercise tolerance. Therefore, this study concluded that the most effective exercise regimen, 40 min of moderate-intensity aerobic exercise three times a week for 6 to 11 weeks, showed more significant improvement in depression indicators in individuals with depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: Severe fatigue is a common symptom for people with visual impairment, with a detrimental effect on emotional functioning, cognition, work capacity and activities of daily living. A previous study found that depression was one of the most important determinants of fatigue, but less is known about disease-specific factors in this patient population. This study aimed to explore the association between visual impairment severity and fatigue in adults with low vision, both directly and indirectly, with vision-specific factors and depression as potential mediators. Methods: Cross-sectional data were collected from 220 Dutch low vision service patients by telephone interviews. Fatigue was defined as a latent variable by severity and impact on daily life. Potential mediators included vision-related symptoms, adaptation to vision loss and depression. Hypothesized structural equation models were constructed in Mplus to test (in)direct effects of visual impairment severity (mild/moderate, severe, blindness) on fatigue through above mentioned variables. Results: The final model explained 60% of fatigue variance and revealed a significant total effect of visual impairment severity on fatigue. Patients with severe visual impairment (reference group) had significantly higher fatigue symptoms compared to those with mild/moderate visual impairment (β = -0.50, 95% bias-corrected confidence interval [BC CI] [-0.86, -0.16]) and those with blindness (β = -0.44, 95% BC CI [-0.80, -0.07]). Eye strain & light disturbance, depression and vision-related mobility mediated the fatigue difference between the severe and mild/moderate visual impairment categories. The fatigue difference between the severe visual impairment and blindness categories was solely explained by eye strain & light disturbance. Moreover, depressive symptoms (β = 0.65, p < 0.001) and eye strain & light disturbance (β = 0.19, p = 0.023) were directly associated with fatigue independent of visual impairment severity. Conclusions: Our findings indicate an inverted-U shaped relationship between visual impairment severity and fatigue in patients with low vision. The complexity of this relationship is likely explained by the consequences of visual impairment, in particular by strained eyes and depressive mood, rather than by severity of the disability itself. [ABSTRACT FROM AUTHOR]

Background: Doomscrolling behavior is very common among college students. The purpose of this study was to evaluate the reliability and validity of the Chinese version of the Doomscrolling Scale, thus providing a scientific basis for its application among Chinese university students. Methods: The Chinese version of Doomscrolling Scale was developed through translation and revision of the original scale, conducting item and factor analysis, and validating it with validation factor analysis. The psychometric properties of the Doomscrolling Scale were assessed in 2885 Chinese university students. Results: The internal consistency coefficients, two-month test-retest reliability, and split-half reliability of the Chinese version of the Doomscrolling Scale (including the 15-item and the 4-item short version) were high, and the mono-factorial scales fitted well to the theoretical model. Scores on the Chinese version of the Doomscrolling Scale were significantly associated with depression, anxiety, and smartphone addiction. The structural equation model indicates that doomscrolling can mediate the bidirectional relationship between insomnia disorder and depression. Conclusions: The revised Chinese version of the Doomscrolling Scale is valid and reliable, which can facilitate research in this field. The association between doomscrolling and various mental disorders has been confirmed, and further research should be conducted to investigate its mechanisms of action. [ABSTRACT FROM AUTHOR]

Abstract Background We aimed to clarify the controversial relationship between levels of high-sensitivity C-reactive protein (hs-CRP) and severity of depression in men and women. Methods Medical records were retrospectively analyzed for 1,236 inpatients at our medical center who were diagnosed with depression at discharge between January 2018 and August 2022. Depression severity was assessed during hospitalization using the 24-item Hamilton Depression Rating Scale. Potential associations between severity scores and hs-CRP levels were explored using multivariate linear regression as well as smooth curve fitting to detect non-linear patterns. Results In male patients, hs-CRP levels between 2.00 mg/L and 10.00 mg/L showed a non-linear association with depression severity overall (fully adjusted β = 1.69, 95% CI 0.65 to 2.72), as well as with severity of specific symptoms such as hopelessness, sluggishness, and cognitive disturbance. In female patients, hs-CRP levels showed a linear association with severity of cognitive disturbance (fully adjusted β = 0.07, 95% CI 0.01 to 0.12). These results remained significant after adjusting for age, body mass index, diabetes, hypertension, history of drinking, history of smoking, and estradiol levels. Discussion Levels of hs-CRP show sex-specific associations with depression severity, particularly levels between 2.00 and 10.00 mg/L in men. These findings may help develop personalized anti-inflammatory treatments for depression, particularly for men with hs-CRP levels of 2.00–10.00 mg/L.

Abstract Purpose Muscle Quality Index (MQI), defined as the muscle strength per unit of muscle mass, is considered an emerging indicator of health and physical function. This study aims to explore the relationship between MQI and the risk of depression among non-elderly US adults. Methods This cross-sectional study collected data from participants aged between 20 and 59 years old, utilizing the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014. The MQI was calculated by dividing the handgrip strength (HGS, kg) by the arm and appendicular skeletal muscle mass (ASM, kg). Depression assessments were conducted using the Patient Health Questionnaire (PHQ-9). The relationship between MQI and the risk of depression was explored by weighted logistic regression, smooth curve fitting, and subgroup analyses. Results A total of 4773 participants were included in this study. After adjusting for confounding factors, low MQI levels were identified as an independent risk factor for depression (OR = 0.800, 95%CI:0.668–0.957, P = 0.015). Smooth curve fitting analysis indicated a nonlinear relationship. Subgroup analysis did not identify any specific populations. Conclusions Higher MQI levels were closely associated with a lower risk of depression among non-elderly US adults. MQI could enhance our understanding of the link between muscle and depression and might serve as a simple functional measure for evaluating and predicting depression.

Abstract Background Tackling poor mental health in university students has been identified as a priority in higher education. However, there are few evidence-based prevention initiatives designed for students. Repetitive Negative Thought (RNT, e.g. worry, rumination) is elevated in university students and is a well-established vulnerability factor for anxiety and depression. Furthermore, there are now evidence-based cognitive-behavioural interventions to tackle RNT. A mobile self-help cognitive-behavioural app targeting RNT, adapted for students may therefore be an effective, scalable, and acceptable way to improve prevention in students. Methods An online single blind, two-arm parallel-group Randomised Controlled Trial (RCT) to examine the incidence of major depression and symptoms of anxiety and depression across 12 months in university students aged over 16 who screen into the study with self-reported high levels of worry and/or rumination and no current diagnosis of major depression. Eligible participants will be randomised to the active intervention arm (usual practice plus using a self-guided mobile app targeting RNT) or to the control arm (usual practice). In total, 648 participants aged over 16, with no current major depression, bipolar disorder or psychosis will be recruited from UK universities. Assessments will take place at baseline (pre-randomisation), 3 months and 12 months post- randomisation. Primary endpoint and outcome is incidence of major depression as determined by self-reported diagnostic criteria at 12-month follow-up. Depressive symptoms, anxiety, well-being, health-related quality of life, functioning and academic outcomes are secondary outcomes. Compliance, adverse events, and potentially mediating variables will be carefully monitored. Discussion The trial aims to provide a better understanding of the causal role of tackling RNT (worry, rumination) using a self-help mobile app with respect to preventing depression in university students. This knowledge will be used to develop and disseminate innovative evidence-based, feasible, and effective mobile-health public health strategies for preventing common mental health problems. Trial registration https://www.isrctn.com/ISRCTN86795807 Date of registration: 27 October 2022

Abstract Background Anxiety-, mood/affective-, or stress-related disorders affect up to one-third of individuals during their lives and often impact their ability to work. This study aimed to delineate trajectories of work disability (WD) among individuals diagnosed with anxiety-, mood/affective-, or stress-related disorder in primary healthcare and to examine associations between trajectory group membership and sociodemographic, clinical, and clinical-related factors. Methods The study population included working-age individuals, aged 22–62 years, living in Stockholm County, Sweden, who experienced a new episode of any anxiety-, mood/affective, or stress-related disorder in primary healthcare in 2017 (N = 11,304). Data were obtained from Swedish national and regional registers and were linked using pseudonymised unique personal identification numbers. The primary outcome was days with WD (sum of sickness absence and disability pension days) during the three years before and three years after a diagnosis of anxiety-, mood/affective-, or stress-related disorders in primary healthcare. A zero-inflated Poisson group-based trajectory model was used to identify groups of individuals with similar patterns of WD over the study period, with a multinomial logistic regression used to examine associations of sociodemographic, clinical, and clinical-related factors with trajectory group membership. Results Four distinct trajectory groups were found, high increasing (5.1%), with high levels, from 16 to 80 days of WD in six-monthly intervals during follow-up, peak (11.1%), with a peak in WD, up to 32 days of WD, around the time of the diagnosis, low increasing (12.8%), with an increase in days of WD from 4 to 22 during the study period, and constant low (71.1%), with almost no WD over the study period. In multinomial regression models, diagnostic category, psychotropic medication use, a diagnosis of a psychiatric disorder within secondary healthcare, age at diagnosis, and occupation were associated with WD trajectory groups. Conclusions Around two-thirds of individuals treated for a new episode of any anxiety-, mood/affective-, or stress-related disorder in primary healthcare have an excellent prognosis regarding WD. Several sociodemographic and clinical characteristics were associated with group membership; these factors could identify individuals at risk of long-term welfare dependency and who might benefit from interventions to promote a return to work.

Abstract Background Anxiety and depression often co-occur, exhibiting high comorbidity, with their trends evolving over time. However, the specific pathways through which comorbid symptoms of anxiety and depression evolve and interact remain unclear. To investigate these questions, this study employed Network Analysis (NA) and Longitudinal Network Analysis (LNA) to explore the central symptoms of anxiety and depression, as well as the temporal evolution of these central symptoms. Methods The study focused on 606 high school students who were not in their final year in Shandong of China, with assessments conducted from March to September 2022. The bootnet package in R was used for establishing NA and LNA models, as well as for conducting accuracy analysis and node stability analysis. Results The results of the NA indicated that adolescent highly susceptible to anxiety and depression. And uncontrollable worry was a common central symptom, while irritability emerged as a central bridging symptom across all three NAs. The LNA results revealed that suicidal ideation and worthlessness were key central symptoms in the LNA. Furthermore, worthlessness played a pivotal role in the developmental pathway of “suicidal ideation → worthlessness → anxiety and uncontrollable worry.” A reduction in suicidal ideation was associated with decreased severity in other symptoms. Conclusions The findings suggest that adolescent anxiety and depression are in a state of vulnerability, and that irritability, worthlessness, and suicidal ideation are potential targets for interventions to address adolescent anxiety and depression.

Abstract Background Depression is a prevalent and serious mental health disorder that significantly impacts daily life and functioning. Neurofilament Light chain (NfL), associated with axonal neuronal damage, has been identified as a promising biomarker, potentially aiding in early diagnosis of depression, personalized treatment, and tracking disease progression. This study used meta-analysis to evaluate the potential of plasma NfL as a biomarker for depression patients. Methods A systematic search following the PRISMA guidelines was conducted across PubMed, Web of Science, Scopus, and Google Scholar databases to find relevant studies on plasma NfL levels in patients with depression. A random effects model meta-analysis was applied to determine its potential as a biomarker for differentiating patients from controls. Results Our meta-analysis, based on four articles with six datasets, revealed that plasma NfL levels were notably higher in individuals with depression (228 cases) compared to healthy controls (118 individuals). The weighted mean difference (WMD) was 8.78 (95% CI: 5.28, 12.28; P

Abstract Background Major Depressive Disorder (MDD) is one of the most disabling mental health problems worldwide. The Recovery Model emphasizes peer support to empower individuals with MDD, improve self-management, and patients' quality of life. Despite the demonstrated efficacy of peer-led interventions, further research is needed due to methodological limitations and variability in interventions across studies. Therefore, the objective of this trial is to evaluate the effectiveness of an adjuvant peer-led intervention for the reduction of depressive symptoms in individuals diagnosed with MDD attended in primary care mental health units. Methods A controlled, parallel, randomized clinical trial will be conducted. The intervention group (n = 35) will receive 6 weeks of peer-led sessions based on a peer support program drive whilst supervised by nurses, while the control group (n = 35) will use a mobile Health (mHealth) application for emotional wellness based on CBT for 6 weeks. Measurements will be collected at baseline, at 6 weeks, at 6 and 12 months after the intervention to evaluate post-intervention effects. The primary outcome is the reduction of depressive symptoms through the Beck Depression Inventory (BDI-II) after the intervention. Secondary outcomes will involve measures such as adherence to psychiatric treatment, quality of life, adherence to mediterranean diet, alcohol consumption and physical activity. Discussion We hypothesize that this peer-led intervention, in contrast to the mHealth, will show improvement in BDI-II score reduction of 6 points after six weeks, 6 and 12 months. Standardized peer-led programs can benefit patients and professionals in terms of efficacy and feasibility of clinical treatment of depression, healthy habits, self-care and quality of life. In addition, they can provide recovery and relapse reduction, improved psychosocial support, minimization of intensive care use, and support for patient autonomy through self-management. Trial registration The trial protocol is prospectively registered with ClinicalTrials.gov under protocol registration number NCT06398561. Date of registration: May 01, 2024. Recruitment is ongoing.

Abstract Background Retinal nerve fiber layer thickness, as a new visual indicator that may help diagnose mental disorders, is gaining attention from researchers. However, the causal relationship between retinal nerve fiber layer thickness and mental disorders is still to be effectively proved. Methods A bidirectional Two-sample Mendelian randomization analysis was utilized to analyse aggregated data from large-scale genome-wide association studies, we selected genetic loci for retinal nerve fiber layer thickness in independent retinal abnormalities and three prevalent psychiatric disorders (schizophrenia, depression, bipolar disorder) as instrumental variables. The Two-sample Mendelian randomization analysis was mainly performed by inverse variance weighting and weighted median method. The Cochran Q test and leave-one-out sensitivity were used to ensure the robustness of the results. The Mendelian random polymorphism residuals and outliers were used to detect single nucleotide polymorphism outliers, and MR-Egger intercept test was used to test single nucleotide polymorphism horizontal pleiotropy. Results IVW showed that retinal nerve fiber layer thickness was positively associated with schizophrenia (OR = 1.057, 95%CI: 1.000-1.117, P

Abstract Background Socioeconomic status (SES) is associated with both depression and activities of daily living (ADL and IADL). However, the role of ADL as a biological mechanism in the relationship between SES and late-life depression, examined through longitudinal data, remains understudied. This study explored the longitudinal mediation effects of basic ADL or IADL on the SES-depression link in older adults. Methods Data from the China Health and Retirement Longitudinal Study (N = 4104) were utilized. Mediation analysis was performed using parallel process latent growth curve modeling. Results The average age of participants was 57.76 years, and 55.7% being females. Significant linear growth over time was observed in ADL, IADL, and depression. Adjusting for covariates, SES was positively linked to the initial levels (intercepts) of ADL (β iADL=-0.100[-0.143, -0.057]), IADL (β iIADL=-0.140[-0.185, -0.095]), and depression (β iDEP=-0.103[-0.158, -0.048]). However, SES showed no significant correlation with the rate of change (slopes) in ADL, IADL, or depression (P > 0.05). The intercepts of ADL (β iDEP = 0.566[0.503, 0.629]) and IADL (β iDEP = 0.607[0.544, 0.670]) were positively correlated with the depression intercept but negatively with the depression slope. Conversely, the slopes of ADL and IADL were positively associated with the depression slope. These results suggest a negative indirect relationship between SES and the initial level of depression, but a positive indirect relationship with the rate of increase in depression through ADL (or IADL) intercept. Conclusions Higher SES is associated with a lower initial risk of depression and ADL difficulties. However, this same higher SES may relate to a faster increase in ADL difficulties and depression among middle-aged and older adults. The findings underscore the need for increased governmental healthcare funding and improved healthcare accessibility. Additionally, maintaining adequate sleep and physical activity can help prevent disability and reduce depression risk later in life, particularly among older adults with lower SES.

Abstract Background Mental health disorders still rank as leading causes of morbidity worldwide despite increasing awareness and improvements in treatment. Notably, low- and middle-income countries like Uganda, are disproportionately affected by such disorders. The burden of depressive symptoms in these countries is particularly high among students, aggravated by poverty, malnutrition, and inadequate public health governance, yet it is clearly under-researched, making it hard to achieve several of UN Sustainability Development Goals. Current treatment options are insufficient to tackle the increased burden of depressive disease. This is more challenging for low-resource regions especially in Sub-Saharan Africa, suggesting the need for alternative treatments that can swiftly be applied if proven effective. The main aim of this randomized controlled trial (RCT) is therefore to examine if a low-cost healthy diet (based on local Ugandan foods) combined with easy-to access mindfulness cognitive therapy can reduce depressive symptoms among university students in Uganda. Methods We will recruit female and male students at Makerere University, the largest public university in Uganda, to an open, intention-to-treat, two-armed RCT. Those who score above a predefined threshold on a self-reported assessment of depressive symptoms, measured by the Center for Epidemiological Studies – Depression score (CES-D), are eligible for study inclusion and will be randomized to either an intervention (n = 125) or a control (n = 125) group. The intervention group will receive educational group-based sessions on how to prepare a Mediterranean-type of healthy diet and how to adhere to the principles of mindfulness-based cognitive therapy. Outcome measures include self-reported depression symptoms, quality of life, and dietary intakes. In addition we will perform a cost-effectiveness analysis. The RCT intervention will last 9 months, followed by additional 15 months with regular data collections. Discussion We here describe a novel approach to treat depressive symptoms among university students living in resource constraint settings, by combining a healthy diet with low threshold psychotherapy. If this intervention succeeds, our project can be viewed as a step towards evidence-based behavior practices for young adults with a common mental disorder (depression) that are beneficial to public mental health initiatives and management. Trial registration The RCT is registered in ClinicalTrials.gov (ID: NCT05848973). The date of registration was August 14, 2023.

Abstract Background In China, parents who have lost their only child are referred to as Shidu parents (SDPs). This study aimed to investigate the prevalence and risk factors of post-traumatic stress disorder (PTSD) and investigate the influence of depressive and anxiety symptoms on the development of PTSD. Method Four hundred and thirty-six SDPs completed assessments of PTSD (Structured Clinical Interview for DSM-IV Disorders, SCID-IV; The Clinician-Administered PTSD Scale-IV, CAPS-IV), depression (Hamilton depression scale), and anxiety (Hamilton Anxiety Scale) via in-person interviews. Logistic regression and hierarchical multiple linear regression analyses were used to explore the association of demographic characteristics, depression, and anxiety symptoms with PTSD. Results The prevalence of PTSD in SDPs was 14.45%. The comorbidity of depression and anxiety symptoms was 87.30% in the SDPs with PTSD. The logistic regression model, which included factors of gender, age, education, depression, and anxiety, which contributed to the development of PTSD, was significant [χ² (11) = 122.47, p

Abstract Background The main objective of this study was to examine the burden of schizophrenia, depression, Alzheimer’s disease/dementia, and stroke on caregivers and non-caregivers in Japan. This study also aimed to provide a comparative landscape on the burden of caregiving for each disorder. Methods The Japan National Health and Wellness Survey database, 2016 and 2018 was used in this study. Health-related quality of life (HRQoL), work productivity, and health care utilization were assessed using a self-administered, Internet-based questionnaire. The burden of caregiving experienced by each group of caregivers was compared with background-matched non-caregivers (controls) as well as with caregivers of patients with each disorder. Results Caregivers of patients with schizophrenia, depression, Alzheimer’s disease/dementia, or stroke had lower HRQoL, higher healthcare costs and work productivity impairment than non-caregivers. Furthermore, caregivers of patients with psychiatric disorders such as schizophrenia and depression had lower HRQoL and work productivity than caregivers of patients with Alzheimer’s disease/dementia and stroke. In addition, according to the Caregiver Reaction Assessment (CRA), caregivers of patients with schizophrenia and depression were more inclined to perceive a loss in physical strength and financial burden to the same extent as their self-esteem. Conclusions This study indicated a substantial caregiving burden among caregivers of patients with psychiatric and neurological diseases in Japan. The caregiver burden of psychiatric disorders (schizophrenia and depression) was greater than that of neurological disorders (Alzheimer’s disease/dementia and stroke), suggesting a need to provide support to caregivers of patients with psychiatric disorders to be better able to care for their patients. Trial Registration None.

Abstract Objective To assess the effectiveness of Internet-based self-help interventions in treating depression in adolescents and young adults. Methods A systematic search was conducted across six databases, including PubMed, to identify randomized controlled trials (RCTs) that satisfied the specified inclusion and exclusion criteria. The intervention measure consisted of Internet-based self-help interventions. Results A total of 23 randomized controlled trials (RCTs) were included in this analysis. Meta-analysis indicated that Internet-based self-help therapies significantly reduced depression scores in adolescents and young adults. (OR = -0.68, 95%CI [-0.88, -0.47], P

Abstract Background Depression is a highly prevalent and often recurrent condition; however, treatment is not always accessible or effective in addressing abnormalities in emotional processing. Given the high prevalence of depression worldwide, identifying and mapping out effective and sustainable interventions is crucial. Emotion dysregulation in depression is not readily amenable to improvement due to the complex, time-dynamic nature of emotion; however, systematic planning frameworks for programs addressing behavioral changes can provide guidelines for the development of a rational intervention that tackles these difficulties. This study proposes an empirical and theoretical art-based emotion regulation (ER) intervention using an integrated approach that combines intervention mapping (IM) with participatory action research (PAR). Methods We used the IM protocol to identify strategies and develop an intervention for patients with major depressive disorder (MDD). As applied in this study, IM comprises six steps: (a) determining the need for new treatments and determinants of risk; (b) identifying changeable determinants and assigning specific intervention targets; (c) selecting strategies to improve ER across relevant theories and research disciplines; (d) creating a treatment program and refining it based on consultations with an advisory group; (e) developing the implementation plan and conducting a PAR study to pilot-test it; and (f) planning evaluation strategies and conducting a PAR study for feedback on the initial testing. Results Following the steps of IM, we developed two frameworks for an art-based ER intervention: an individual and an integrative framework. The programs include four theory- and evidence-based ER strategies aimed mainly at decreasing depressive symptoms and improving ER in patients with MDD. We also developed a plan for evaluating the proposed intervention. Based on our preliminary PAR studies, the intervention was feasible and acceptable for adoption and implementation in primary care settings. Conclusion The application of IM incorporated with PAR has resulted in an intervention for improving ER in depression. While changing behavior is perceived as a challenging and elaborate task, this method can be useful in offering a clear structure for developing rational interventions. Further refinement is necessary through rigorous research.

Abstract Background This study was intended to investigate the correlation between depression and suicidal ideation among Chinese college students during the COVID-19 pandemic and the potential mediating roles of chronotype and sleep quality in this relationship . Methods A sample of 4,768 college students was selected from four institutions in Anhui Province, China, and the study was conducted during the COVID-19 pandemic (November to December 2020) using a stratified, cluster, multi-stage sampling method. This study used the two-item Patient Health Questionnaire (PHQ-2) to assess depressive symptoms, the Morningness-Eveningness Questionnaire 19 (MEQ-19) to determine individual sleep chronotypes (i.e., morning or evening preference), and the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality. Participants were asked about suicidal ideation. MPLUS 8.3 software was used to analyze the mediating effect of chronotype and sleep quality on the relationship between depression and suicidal ideation. Results During the COVID-19 pandemic, the prevalence of suicidal ideation among Chinese college students was 5.4%. Depression was inversely correlated with chronotype (beta = − 0.346, P

Abstract Lithium Carbonate is an effective treatment for affective disorders, but has a range of side effects. This case report highlights a rare side effect of Raynaud’s phenomenon following initiation of Lithium therapy in a patient with recurrent depressive disorder. He was commenced on Lithium therapy to treat severe treatment resistant depression with psychotic symptoms when alternative treatments trialled were ineffective. He had no other risk factors or known aetiological causes for development of Raynaud’s phenomenon. Symptoms resolved on discontinuation of Lithium and re-emerged on recommencement. Previous case series have shown Lithium effectively treating vasospastic disorders such as cluster headache and Raynaud’s phenomenon. However, a paradoxical reaction to those previously described was induced in this case.

Abstract Background Depressive disorders are among the common mental health conditions in the general outpatient setting and affect patients’ load and treatment outcomes. People who suffer from depression frequently consult general practitioners and prefer to attribute their symptoms to physical illness rather than mental illness. Little is known about the magnitude and associated factors of depression among patients attending general outpatient services in Somalia. The study aimed at determining the prevalence and associated factors of depression among them. Methods This is an institution-based cross-sectional study among randomly selected 422 patients who attended general outpatient services of two hospitals in Mogadishu. We applied three standardized instruments, such as the Somali version of the Patient Health Questionnaire (PHQ-9), the Oslo Social Support Scale (OSSS-3), and the Perceived Stress Scale-10 (PSS-10). We analyzed data using the statistical software SPSS version 29. We calculated prevalence and its 95% Confidence Interval (CI) and identified associated factors by bivariate and Multivariate analysis. We considered the association significant when p value is

Abstract Objective Patients with Postherpetic Neuralgia (PHN) often exhibit depressive-like symptoms, significantly impacting their quality of life. Esketamine, known for its analgesic properties, has also been recognized for its rapid antidepressant effects. However, its efficacy in the treatment of PHN requires further exploration. This study aims to evaluate the impact of intravenous patient-controlled analgesia(PICA) with esketamine on depressive mood in PHN patients. Methods This retrospective study analyzed PHN patients hospitalized and treated at the affiliated hospital of Southwest Medical University from June 2021 to March 2023. Patients were divided into the esketamine group (E group) and the sufentanil group (S group) based on their treatment regimens. Primary outcomes included pain numerical rating scale(NRS), depression patient health questionaire-9(PHQ-9), and anxiety generalized anxiety disorder-7(GAD-7) scores measured before treatment, and at 3 days, 7 days, 1 month, 2 months, and 3 months post-treatment. Results A total of 83 patients were included in the analysis. Before treatment, there were no statistically significant differences in pain NRS, depression PHQ-9, and anxiety GAD-7 scores between the two groups (P > 0.05). Compared to before treatment, significant reductions in pain NRS scores were observed at all post-treatment time points in both groups (P 0.05). The E group exhibited significantly lower depression PHQ-9 scores than the S group at 3 days and 7 days post-treatment (P 0.05). Anxiety GAD-7 scores were significantly lower in the E group compared to the S group at 3 days, 7 days post-treatment (P 0.05). Conclusion Both PICA with esketamine and sufentanil alleviated pain equally in PHN patients. However, PICA with esketamine specifically improved early symptoms of anxiety and depression.

Abstract Background Severe fatigue is a common symptom for people with visual impairment, with a detrimental effect on emotional functioning, cognition, work capacity and activities of daily living. A previous study found that depression was one of the most important determinants of fatigue, but less is known about disease-specific factors in this patient population. This study aimed to explore the association between visual impairment severity and fatigue in adults with low vision, both directly and indirectly, with vision-specific factors and depression as potential mediators. Methods Cross-sectional data were collected from 220 Dutch low vision service patients by telephone interviews. Fatigue was defined as a latent variable by severity and impact on daily life. Potential mediators included vision-related symptoms, adaptation to vision loss and depression. Hypothesized structural equation models were constructed in Mplus to test (in)direct effects of visual impairment severity (mild/moderate, severe, blindness) on fatigue through above mentioned variables. Results The final model explained 60% of fatigue variance and revealed a significant total effect of visual impairment severity on fatigue. Patients with severe visual impairment (reference group) had significantly higher fatigue symptoms compared to those with mild/moderate visual impairment (β = -0.50, 95% bias-corrected confidence interval [BC CI] [-0.86, -0.16]) and those with blindness (β = -0.44, 95% BC CI [-0.80, -0.07]). Eye strain & light disturbance, depression and vision-related mobility mediated the fatigue difference between the severe and mild/moderate visual impairment categories. The fatigue difference between the severe visual impairment and blindness categories was solely explained by eye strain & light disturbance. Moreover, depressive symptoms (β = 0.65, p

Abstract Background Doomscrolling behavior is very common among college students. The purpose of this study was to evaluate the reliability and validity of the Chinese version of the Doomscrolling Scale, thus providing a scientific basis for its application among Chinese university students. Methods The Chinese version of Doomscrolling Scale was developed through translation and revision of the original scale, conducting item and factor analysis, and validating it with validation factor analysis. The psychometric properties of the Doomscrolling Scale were assessed in 2885 Chinese university students. Results The internal consistency coefficients, two-month test-retest reliability, and split-half reliability of the Chinese version of the Doomscrolling Scale (including the 15-item and the 4-item short version) were high, and the mono-factorial scales fitted well to the theoretical model. Scores on the Chinese version of the Doomscrolling Scale were significantly associated with depression, anxiety, and smartphone addiction. The structural equation model indicates that doomscrolling can mediate the bidirectional relationship between insomnia disorder and depression. Conclusions The revised Chinese version of the Doomscrolling Scale is valid and reliable, which can facilitate research in this field. The association between doomscrolling and various mental disorders has been confirmed, and further research should be conducted to investigate its mechanisms of action.

Abstract Background Depression is prevalent among lung cancer patients undergoing chemotherapy, and the symptom cluster of fatigue-pain-insomnia may influence their depression. Identifying characteristics of patients with different depression trajectories can aid in developing more targeted interventions. This study aimed to identify the trajectories of depression and the fatigue-pain-insomnia symptom cluster, and to explore the predictive factors associated with the categories of depression trajectories. Methods In this longitudinal study, 187 lung cancer patients who were undergoing chemotherapy were recruited and assessed at the first (T1), second(T2), and fourth(T3) months using the Patient Health Questionnaire-9 (PHQ-9), the Brief Pain Inventory (BPI), the Brief Fatigue Inventory (BFI), and the Athens Insomnia Scale (AIS). Growth Mixture Model (GMM) and Latent Class Analysis (LCA) were used to identify the different trajectories of the fatigue-pain-insomnia symptom cluster and depression. Binary logistic regression was utilized to analyze the predictive factors of different depressive trajectories. Results GMM identified two depressive trajectories: a high decreasing depression trajectory (40.64%) and a low increasing depression trajectory (59.36%). LCA showed that 48.66% of patients were likely members of the high symptom cluster trajectory. Binary logistic regression analysis indicated that having a history of alcohol consumption, a higher symptom cluster burden, unemployed, and a lower monthly income predicted a high decreasing depression trajectory. Conclusions Depression and fatigue-pain-insomnia symptom cluster in lung cancer chemotherapy patients exhibited two distinct trajectories. When managing depression in these patients, it is recommended to strengthen symptom management and pay particular attention to individuals with a history of alcohol consumption, unemployed, and a lower monthly income.

Abstract Objective To investigate the influence of aerobic exercise on depression among the young people. Data sources PubMed, Web of science, Embase, Cochrane, EBSCO were searched from inception to November 2023. Study selection RCT studies, assessing the use of aerobic exercise in young people aged 6–35 years and then determining the development of depression in young people (aged 6–35 years), were selected, and mean ± SD values adjusted for the presence of baseline depression were extracted. Data extraction and synthesis Study quality was assessed using the Review manager 5.4.1 and Cochrane 5.1 item on risk of bias and precision of observational studies. Two reviewers conducted all review stages independently. Selected data were pooled using random-effects meta-analysis. Main outcomes and measures The included studies evaluated the relationship between aerobic exercise and depression at various time points among young individuals, and provided corresponding mean ± SD values. Depression diagnosis in the selected studies was conducted using the Depression Correlation Scale. Results After screening 2296 articles, 163 articles were selected for full-text review, and 8 of those were further reviewed. Ultimately, 12 studies, involving 658 individuals, were included in the meta-analysis. The results of the meta-analysis indicated that aerobic exercise could effectively improve depression in young people (d = -1.33, 95%CI: -1.78 ~ -0.87, P

Abstract Background The prevalence of sleep disorders among medical students was high during the COVID-19 pandemic. However, fewer studies have been conducted on sleep disorders among medical students after the COVID-19 pandemic. This study investigated the prevalence and factors influencing sleep disorders among Chinese medical students after COVID-19. Methods A total of 1,194 Chinese medical students were included in this study from 9th to 12th July 2023. We used the Self-administered Chinese scale to collect the demographic characteristics. In addition, we used the Chinese versions of the Self-rating Depression Scale (SDS), the Self-rating Anxiety Scale (SAS), and the Pittsburgh Sleep Quality Index (PSQI) to assess subjects’ depression, anxiety, and sleep disorders, respectively. The chi-square test and binary logistic regression were used to identify factors influencing sleep disorders. The receiver operating characteristic (ROC) curve was utilized to assess the predictive value of relevant variables for sleep disorders. Results We found the prevalence of sleep disorders among medical students after COVID-19 was 82.3%. According to logistic regression results, medical students with depression were 1.151 times more likely to have sleep disorders than those without depression (OR = 1.151, 95% CI 1.114 to 1.188). Doctoral students were 1.908 times more likely to have sleep disorders than graduate and undergraduate students (OR = 1.908, 95% CI 1.264 to 2.880). Conclusion The prevalence of sleep disorders among medical students is high after COVID-19. In addition, high academic levels and depression are risk factors for sleep disorders. Therefore, medical colleges and administrators should pay more attention to sleep disorders in medical students after the COVID-19 pandemic. Regular assessment of sleep disorders and depression is essential.

Abstract Background Anxiety and depression are psychiatric disorders that often coexist and share some features. Developing a simple and cost-effective tool to assess anxiety and depression in the Arabic-speaking population, predominantly residing in low- and middle-income nations where research can be arduous, would be immensely beneficial. The study aimed to translate the four-item composite Patient Health Questionnaire – 4 (PHQ-4) into Arabic and evaluate its psychometric properties, including internal reliability, sex invariance, composite reliability, and correlation with measures of psychological distress. Methods 587 Arabic-speaking adults were recruited between February and March 2023. An anonymous self-administered Google Forms link was distributed via social media networks. We utilized the FACTOR software to explore the factor structure of the Arabic PHQ-4. Results Confirmatory factor analysis (CFA) indicated that fit of the two-factor model of the PHQ-4 scores was modest (χ 2/df = .13/1 = .13, RMSEA = .001, SRMR = .002, CFI = 1.005, TLI = 1.000). Internal reliability was excellent (McDonald’s omega = .86; Cronbach’s alpha = .86). Indices suggested that configural, metric, and scalar invariance were supported across sex. No significant difference was found between males and females in terms of the PHQ-4 total scores, PHQ-4 anxiety scores, and PHQ-4 depression scores. The total score of the PHQ-4 and its depression and anxiety scores were significantly and moderately-to-strongly associated with lower wellbeing and higher Depression Anxiety and Stress Scale (DASS) total and subscales scores. Conclusion The PHQ-4 proves to be a reliable, valid, and cost-effective tool for assessing symptoms related to depression and anxiety. To evaluate the practical effectiveness of the Arabic PHQ-4 and to further enhance the data on its construct validity, future studies should assess the measure in diverse contexts and among specific populations.

Abstract Background Serum neurofilament light chain (sNfL) has been identified as a biomarker for neurologic diseases. However, sNfL remains unknown to be responsible for depression. Aims The aim of this research was to explore the relationship between sNfL levels and depression in US adults. Methods In this cross-sectional survey of the general population, we investigated representative data involving 10,175 participants from the 2013–2014 cycle of the National Health and Nutrition Examination Survey (NHANES). Depression was diagnosed using the Patient Health Questionnaire-9 (PHQ-9). The effect of related factors on depression was analyzed by conducting a univariate analysis. Stratified analysis was utilized to detect the stability and sensitivity of the relationship. After adjusting for race, education, marital status, smoking status, body mass index (BMI), sleep duration, income, and a history of hypertension, sedentary behavior and stroke, multivariable linear regression was performed to demonstrate the correlation between sNfL and depression. Results A total of 1301 individuals between the ages of 20 and 75 were involved in this investigation, of which 108 (8.3%) were diagnosed with depression. A significant positive correlation between sNfL and depression among adults in the US was observed by conducting univariable analyses. After adjusting for confounding factors, the multivariate analyses indicated that elevated sNfL levels might play a pivotal role in the development of depression (odds ratio (OR) = 3.0; 95% confidence interval (CI): (1.5, 6.1), P = 0.002). Conclusion These results indicated that sNfL is closely linked to depression in a nationally representative individual. However, further studies are needed to confirm the biological mechanism as well as the clinical implications of sNfL and depression.

Abstract Background Adverse events (AEs) are commonly reported in clinical studies using the Medical Dictionary for Regulatory Activities (MedDRA), an international standard for drug safety monitoring. However, the technical language of MedDRA makes it challenging for patients and clinicians to share understanding and therefore to make shared decisions about medical interventions. In this project, people with lived experience of depression and antidepressant treatment worked with clinicians and researchers to co-design an online dictionary of AEs associated with antidepressants, taking into account its ease of use and applicability to real-world settings. Methods Through a pre-defined literature search, we identified MedDRA-coded AEs from randomised controlled trials of antidepressants used in the treatment of depression. In collaboration with the McPin Foundation, four co-design workshops with a lived experience advisory panel (LEAP) and one independent focus group (FG) were conducted to produce user-friendly translations of AE terms. Guiding principles for translation were co-designed with McPin/LEAP members and defined before the finalisation of Clinical Codes (CCs, or non-technical terms to represent specific AE concepts). FG results were thematically analysed using the Framework Method. Results Starting from 522 trials identified by the search, 736 MedDRA-coded AE terms were translated into 187 CCs, which balanced key factors identified as important to the LEAP and FG (namely, breadth, specificity, generalisability, patient-understandability and acceptability). Work with the LEAP showed that a user-friendly language of AEs should aim to mitigate stigma, acknowledge the multiple levels of comprehension in ‘lay’ language and balance the need for semantic accuracy with user-friendliness. Guided by these principles, an online dictionary of AEs was co-designed and made freely available ( https://thesymptomglossary.com ). The digital tool was perceived by the LEAP and FG as a resource which could feasibly improve antidepressant treatment by facilitating the accurate, meaningful expression of preferences about potential harms through a shared decision-making process. Conclusions This dictionary was developed in English around AEs from antidepressants in depression but it can be adapted to different languages and cultural contexts, and can also become a model for other interventions and disorders (i.e., antipsychotics in schizophrenia). Co-designed digital resources may improve the patient experience by helping to deliver personalised information on potential benefits and harms in an evidence-based, preference-sensitive way.

Abstract Background Depression is a common mental disorder with a much higher prevalence in women than in men. Although there has been a gradual increase in research on the association between reproductive health and depression, there is still some inconsistency in the evidence of the relationship between pregnancy loss and depression. This study aimed to investigate the relationship between pregnancy loss and depressive symptoms. Methods We analyzed data from the 2007–2020 National Health and Nutrition Examination Survey (NHANES), which included female participants aged 20 to 80 years. Pregnancy loss was determined based on participants’ self-reported number of pregnancies and pregnancy outcomes. Depressive symptoms were measured using the Patient Health Questionnaire (PHQ-9, score ≥ 10). Multivariate logistic regression, smoothed curve fitting, and generalized additive modeling were used to examine the association between pregnancy loss and depression. We also performed sensitivity analyses and subgroup analyses to verify the robustness and specificity of the findings. Results A total of 12,873 female participants were included in our study, of which 1,595 (12.39%) were categorized as depressed. Multivariate logistic regression results indicated that experiencing a pregnancy loss increased the risk of prevalence of depression in women (for 1 loss: OR = 1.31, 95% CI 1.15,1.50; for 2 or more losses: OR = 1.58, 95% CI 1.38, 1.81). When sensitivity analyses were performed, an association between pregnancy loss and depression was found in both multivariate linear regressions with PHQ-9 scores as a continuous variable and multivariate logistic regressions with a threshold of 5 PHQ-9 scores. The association between pregnancy loss and depression remained stable across subgroups. Conclusion Pregnancy loss correlated with elevated PHQ-9 scores and a heightened risk of depression in adult women across the United States. Focusing on the incidence of adverse pregnancy events in the female population may help prevent or early recognize the onset of depression.

Abstract Background Depression can be associated with increased mortality and morbidity, but no studies have investigated the specific causes of death based on autopsy reports. Autopsy studies can yield valuable and detailed information on pathological ailments or underreported conditions. This study aimed to compare autopsy-confirmed causes of death (CoD) between individuals diagnosed with major depressive disorder (MDD) and matched controls. We also analyzed subgroups within our MDD sample, including late-life depression and recurrent depression. We further investigated whether machine learning (ML) algorithms could distinguish MDD and each subgroup from controls based on their CoD. Methods We conducted a comprehensive analysis of CoD in individuals who died from nontraumatic causes. The diagnosis of lifetime MDD was ascertained based on the DSM-5 criteria using information from a structured interview with a knowledgeable informant. Eleven established ML algorithms were used to differentiate MDD individuals from controls by simultaneously analyzing different disease category groups to account for multiple tests. The McNemar test was further used to compare paired nominal data. Results The initial dataset included records of 1,102 individuals, among whom 232 (21.1%) had a lifetime diagnosis of MDD. Each MDD individual was strictly paired with a control non-psychiatric counterpart. In the MDD group, the most common CoD were circulatory (67.2%), respiratory (13.4%), digestive (6.0%), and cancer (5.6%). Despite employing a range of ML models, we could not find distinctive CoD patterns that could reliably distinguish individuals with MDD from individuals in the control group (average accuracy: 50.6%; accuracy range: 39-59%). These findings were consistent even when considering factors within the MDD group, such as late-life or recurrent MDD. When comparing groups with paired nominal tests, no differences were found for circulatory (p=0.450), respiratory (p=0.790), digestive (p=1.000), or cancer (p=0.855) CoD. Conclusions Our analysis revealed that autopsy-confirmed CoD exhibited remarkable similarity between individuals with depression and their matched controls, underscoring the existing heterogeneity in the literature. Future research should prioritize more severe manifestations of depression and larger sample sizes, particularly in the context of CoD related to cancer.

Abstract Background Studies have confirmed the rapid antidepressant action of ketamine in depressive episodes. Nevertheless, a standardized procedure for the delivery of ketamine infusion in individuals suffering from treatment-resistant depression, particularly in terms of infusion frequency and total dosage, remains undetermined. In addition, an efficacious ketamine regimen for persistent pain management involved a continuous 10-day infusion period with no notable adverse effects. Consequently, the primary objective of this study was to evaluate the antidepressant capacity of consecutive ketamine infusions spanning over three successive days, the duration of therapeutic response, and the overall safety profile of the treatment. Methods In this randomized controlled trial, participants aged 18–64 with treatment-resistant depression were randomized to receive either intravenous ketamine or midazolam (used as an active placebo) for 40 min daily over three consecutive days. Statistical analysis using repeated measures ANOVA was employed to assess the changes in the total score of the Montgomery–Åsberg Depression Rating Scale (MADRS) and the clinical global impression-Severity from the initial assessment to 10 and 31 days post-infusion. Additionally, the duration of response and remission was evaluated using Kaplan–Meier survival analysis. Results Out of 33 randomized participants, 20 underwent the treatment as planned. By day 10th, the ketamine group had a mean reduction in MADRS score of 12.55 (95% CI = 6.70–18.09), whereas the midazolam group had a decrease of 17.22 (95% CI = 11.09–23.36). This pattern continued to day 31, with ketamine showing a mean score decrease of 13.73 (95% CI = 7.54–19.91) and midazolam a fall of 12.44 (95% CI = 5.61–19.28). Both treatments were well tolerated, with dissociative symptoms in the ketamine group being temporary and ceasing by the end of each infusion. Conclusion Intravenous ketamine given for three consecutive days did not show a notable antidepressant advantage when compared to the active placebo midazolam, highlighting the need for further research into effective treatments schedules for treatment-resistant depression. Trial registration NCT05026203, ClinicalTrials.gov, registered on 24/08/2021.