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Background: This study aimed to assess the prevalence and the gender-specific risk factors of alcohol abuse/dependence among medical undergraduates during the post-COVID‑19 pandemic period in China. Method: The Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) was used to identify respondents with alcohol abuse/dependence. A questionnaire on basic demographics and mental distresses (learning burnout, depression symptoms, anxiety symptoms, excessive daytime sleepiness, and history of mental disorders) was used. The logistic regression model was used to explore the associations between the above characteristics and alcohol abuse/dependence. Results: A total of 3,412 medical undergraduates were included in the analysis. Males showed a higher prevalence of alcohol abuse/dependence than females (16.6% vs 7.4%, p < 0.001). Alcohol abuse/dependence was associated with learning burnout (OR: 2.168, p < 0.001) and having a partner (OR: 1.788 p = 0.001) among female medical undergraduates. Among male medical undergraduates, excessive daytime sleepiness (OR: 1.788 p = 0.001) and older age (OR: 1.788, p = 0.001) were independently associated with alcohol abuse/dependence. Conclusion: Alcohol abuse/dependence was common among medical undergraduates during the post-COVID‑19 pandemic period. Substantial gender differences in the prevalence and risk factors of alcohol abuse/dependence were found among medical undergraduates in this study, which highlighted the need for timely gender-specific screening and interventions. However, the cross-sectional design adopted in this study has limited the examination of causality, thus further longitudinal studies are warranted. [ABSTRACT FROM AUTHOR]

Major depressive disorder (MDD) with comorbid anxiety is very common and is associated with worse clinical outcomes. MDD patients at different ages of onset may have different clinical features and associated factors. The aim of this study was to investigate the prevalence of anxiety and related factors in MDD patients at different ages of onset. A total of 1718 first-episode and drug-naïve (FEDN) MDD patients were recruited. The cutoff point for early-adulthood onset (EAO) and mid-adulthood onset (MAO) was the first depressive episode before or after age 45 years. Clinical features (depressive, anxiety and psychiatric symptoms) and some metabolic parameters were collected. There was no significant difference in the prevalence of anxiety between EAO patients (50.7 %) and MAO patients (55.7 %). For EAO patients, regression analysis showed that TSH levels, TgAb levels, and TC levels were significantly associated with anxiety. For MAO patients, regression analysis showed that anxiety was associated with HDL-c levels and impaired glucose metabolism. Furthermore, suicide attempts, psychotic symptoms, and depression severity were correlated with anxiety in both groups. Our cross-sectional study cannot explain the causal relationship between anxiety and related factors in MDD patients at different ages of onset. This study revealed that the clinical characteristics and factors associated with anxiety in MDD patients differed according to age of onset, and therefore age of onset needs to be considered while treating anxiety. • Anxiety was common in major depressive disorder patients of different ages of onset. • Anxiety was associated with TSH levels in early-adulthood onset patients. • Anxiety was associated with glucose metabolism in mid-adulthood onset patients. [ABSTRACT FROM AUTHOR]

Background: Anxiety frequently occurs with major depressive disorder (MDD) but to a different extent in the various subtypes. Psychotic major depression (PMD) is a severe subtype of MDD that is under-identified and under-studied. We investigated the prevalence and related risk factors of anxiety in PMD patients.Methods: A total of 1718 first episode and drug naïve MDD patients were recruited. Measures included the Hamilton Depression Scale (HAMD), Clinical Global Impression-Severity scale (CGI-S), Hamilton Anxiety Scale (HAMA), and positive symptom scale of the Positive and Negative Syndrome Scale (PANSS), thyroid hormone levels, and metabolic parameters.Results: 171 of the entire MDD study sample met the criteria for the PMD subtype. The prevalence of severe anxiety was much higher in PMD patients (22.8 %) than in non-PMD patients (0.4 %) (χ2 = 294.69, P < 0.001, OR = 75.88, 95 % CI = 31.55-182.52). Compared to PMD patients without severe anxiety, PMD patients with severe anxiety had higher HAMD score, CGI-S score, positive symptom subscale score, suicide attempts, blood pressure, thyroid-stimulating hormone (TSH), anti-thyroglobulin (TgAb), and thyroid peroxidases antibody (TPOAb) levels. Furthermore, logistic regression analysis indicated that HAMD score and TSH levels were associated with severe anxiety in PMD patients.Limitations: Our cross-sectional study cannot explain the causal relationship between anxiety severity and risk factors in PMD patients.Conclusions: Our results suggest that PMD patients are more likely to experience severe anxiety than non-PMD patients. The severity of depression and TSH levels are independent risk factors for anxiety in PMD patients. [ABSTRACT FROM AUTHOR]

Backgrounds: Thyroid dysfunction was reported to be associated with depression; however, its role in suicide risk in patients with major depressive disorder (MDD) remains unclear. The objective of this study was to compare thyroid function between suicide attempters and non-suicide attempters in a large sample of first episode drug naïve (FEDN) MDD patients, which received little systemic investigation.Methods: A total of 1718 outpatients with diagnosis of MDD at their first episode were recruited. Their socio-demographic, clinical data and thyroid function parameters were collected. The positive subscale of the Positive and Negative Syndrome Scale (PANSS), Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) were measured for psychotic, anxiety and depressive symptoms, respectively.Results: Our results showed that compared with non-suicide attempters, suicide attempters had greater scores on HAMD, HAMA and PANSS psychotic symptoms and higher serum levels in thyroid stimulating hormone (TSH), anti-thyroglobulin (TgAb) and thyroid peroxidases antibody (TPOAb) (all p < 0.001). Further logistic regression analysis indicated that suicide attempts were associated with severe anxiety with an adjusted odds ratio (OR) of 2.704 and TPOAb with an adjusted OR of 2.188.Limitations: No causal relationship could be drawn due to the cross-sectional design.Conclusions: Our results indicate TSH, TgAb and TPOAb may be promising biomarkers of suicide risk in MDD, suggesting the importance of regular assessment of thyroid function parameters for suicide prevention, and possible treatment for impaired thyroid function for intervention of suicide in MDD patients. [ABSTRACT FROM AUTHOR]

• Serum levels of thyroid stimulating hormone (TSH), anti-thyroglobulin (TgAb), and thyroid peroxidases antibody (TPOAb) were higher in first-episode drug-naïve major depressive disorder (FEND MDD) patients with psychotic depression (PD) than those without. • The presence of subclinical hypothyroidism increased the risk of PD by 9-fold. • TSH, HAMA scores, and HAMD scores were independently associated with PD. • The combination of TSH, HAMA scores, and HAMD scores excellently distinguished PD patients from non-PD patients. Thyroid dysfunction is common in major depressive disorder (MDD) patients; however, its relationship with psychotic depression (PD) remains unclear. We aimed to assess thyroid hormones in 1718 first episode drug naïve (FEND) MDD patients and to determine their association with PD. The positive subscale of the Positive and Negative Symptom Scale (PANSS-P), Hamilton Anxiety Rating Scale (HAMA), and Hamilton Depression Rating Scale (HAMD) were used to detect clinical symptoms. The serum levels of free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), anti-thyroglobulin (TgAb), and thyroid peroxidases antibody (TPOAb) were assessed. The logistic regression model was conducted to determine risk factors for PD, and the Area Under the Curve (AUC) was used to test the performance of this model. 171 (10%) patients were identified as having PD. Serum levels of TSH, TgAb, and TPOAb displayed small-to-moderate associations with PANSS-P. HAMA score, HAMD score, and TSH levels were independently associated with PD. The regression model had excellent power to distinguish PD patients from non-PD patients with an AUC value of 0.93. Our study suggests TSH levels and severity of depression and anxiety symptoms were independent risk factors for PD. Regular thyroid function tests may help early detect PD. [ABSTRACT FROM AUTHOR]