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Background: The COVID-19 pandemic created stressors to daily living, leading to increased mental health problems. It is important to assess the influence of COVID-19 pandemic on mental health, specifically anxiety., Objectives: The goal was to determine the prevalence and sociodemographic, clinical, and other correlates of likely Generalized Anxiety Disorder (GAD) among study subjects in Ghana., Design: This study employed a cross-sectional approach, using an online survey administered primarily through social media platforms. The survey questions included the GAD-7 scale, which was used to assess likely GAD in respondents. Data were analyzed using descriptive statistics, chi-square tests, and logistic regression analysis., Participants: Overall, 756 respondents completed the survey, mainly from Ashanti and Greater Accra, which were the hardest hit by COVID-19., Results: The prevalence of likely GAD in our sample was 7.6%. Gender, loss of job due to COVID-19, and seeking mental health counseling were independently associated with increased likelihood of GAD., Conclusions: The findings suggest that women, those who lost their jobs due to the COVID-19 pandemic, and those who sought mental health counseling were more likely to experience moderate to high anxiety symptoms as a result of the COVID-19 pandemic. Priority must be attached to psychological support measures for members of these groups.

According to biopsychosocial models, experiencing parental child abuse increases susceptibility to adulthood psychopathology. However, there is a paucity of studies examining potential mechanisms of the parental child abuse and adulthood psychopathology relationship. The purpose of the current study was to determine if Time 2 (T2) trait self-esteem mediated levels of Time 1 (T1) retrospectively recalled parental child abuse predicting (T3) past-year major depressive disorder (MDD), generalized anxiety disorder (GAD), panic disorder (PD), alcohol use disorder (AUD), and substance use disorder (SUD) symptoms. The 18-year Midlife Development in the United States (MIDUS) study included participants (N = 3294; T1 average age of 45.62 years) assessed at three different time points, each spaced about nine years apart. We performed structural equation mediation modeling analyses to determine how maternal and paternal child abuse at T1 would independently predict T3 MDD, GAD, PD, AUD, and SUD symptoms. We also examined whether T2 self-esteem mediated these relations while controlling for adulthood T1 psychopathology symptoms, demographics, socioeconomic status, somatic symptoms, and parental psychopathology. Consistent with our hypotheses, higher T1 maternal and paternal abuse predicted increased T3 GAD, PD, AUD, and SUD symptoms via diminished T2 self-esteem as the mediator (% proportion mediated = 33.0-100). However, childhood paternal, but not maternal, abuse predicted adulthood MDD symptoms via reduced self-esteem. Findings remained after adjusting for covariates. Our research highlights the importance of understanding retrospectively recalled parental child abuse-adulthood psychopathology relations, their potential mechanisms, and self-esteem as a malleable treatment target for adults with heightened child abuse., Competing Interests: Declaration of competing interest None of the authors have any conflict of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Psychiatric disorders, including attention-deficit hyperactivity disorder (ADHD), depression, anxiety disorders, and dementia, manifest differently across life stages, impacting cognitive, emotional, and behavioral health. Understanding the causal relationships between various types of physical activity and these disorders is crucial for developing targeted interventions., Methods: The summary level data from GWAS was utilized to conduct a two-sample Mendelian Randomization (MR) analysis. We assessed the potential causal relationships between different types of physical activity including light do it yourself (DIY) activities, heavy DIY activities, strenuous sports, and aerobic exercises/other exercises and the prevalence of psychiatric disorders (ADHD, depression, anxiety disorders, and dementia) across different life stages., Results: The MR analysis showed no causal relationship between light DIY activities and any of the psychiatric disorders studied. Heavy DIY activities showed a significant negative association with anxiety disorders but no links with ADHD, depression, or dementia. Strenuous sports did not demonstrate any causal relationship with the psychiatric disorders examined. Aerobic exercises were notably correlated with a reduced risk of depression, although no significant associations were found with ADHD, anxiety disorders, or dementia., Conclusions: The findings indicate that heavy DIY activities might contribute to reducing anxiety disorders, while aerobic exercises potentially lower the risk of depression. These results emphasize the potential benefits of promoting specific types of physical activity to improve mental health outcomes across different life stages. Future research could further investigate the mechanisms underlying these relationships and consider diverse populations and objective measures of physical activity., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The authors confirm that the content of the manuscript has not been published, or submitted for publication elsewhere., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: A diagnosis of breast cancer has a significant impact on a patient's physical and emotional health. Breast reconstruction improves quality of life and self-esteem following mastectomy. However, many patients undergo additional elective revision procedures after reconstruction., Objectives: The aim of this study was to assess the relationship between perioperative emotional well-being and elective revisions in breast reconstruction., Methods: A retrospective review was performed of patients who underwent breast reconstruction with a single surgeon between January 2007 and December 2017. Revision procedures were defined as additional operations that fall outside the index reconstructive plan. Medical records were reviewed for a history of generalized anxiety disorder (GAD) and/or major depressive disorder. Multivariate analysis was performed to identify factors associated with revision., Results: A total of 775 patients undergoing breast reconstruction were included, of whom 121 (15.6%) underwent elective revision. Overall, a history of any psychiatric history (P < .001), depression alone (P = .001%), and GAD and depression together (P = .003) were significantly associated with revision surgery. On multivariate logistic regression controlling for comorbidities and reconstruction modality, depression alone, and GAD and depression together were significantly associated with an increased likelihood of revision surgery (odds ratio, 3.20, P < .001; odds ratio, 2.63, P < .001)., Conclusions: Perioperative emotional well-being and reconstruction modality impact the rate of secondary revision surgery. An understanding of the surgical and patient-related risk factors for revision can provide more informed patient-decision making and improve surgical planning., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Aesthetic Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Anxiety and depressive symptoms are common among patients with heart failure (HF). Physical limitations, lifestyle changes, and uncertainties related to HF can result in the development or exacerbating of anxiety and depressive symptoms. However, the central and bridge symptoms of anxiety and depressive symptoms network among patients with HF remain unclear. Network analysis is a statistical method that can discover and visualize complex relationships between multiple variables. This study aimed to establish a network of anxiety and depressive symptoms and identify the central and bridge symptoms in this network among patients with HF., Methods: This study employed a cross-sectional study design and convenience sampling to recruit patients with HF. This study followed the Helsinki Declaration and was approved by the Research Ethics Committee of Hospital. The Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire (PHQ-9) were administered to evaluate anxiety and depressive symptoms among patients with HF, respectively. Network analysis of anxiety and depressive symptoms was performed using R., Results: In the anxiety and depressive symptoms network, PHQ2 (feeling down, depressed, or hopeless), PHQ7 (inability to concentrate), and GAD4 (difficulty relaxing) were the most central symptoms. Anxiety and depressive symptoms were linked by PHQ2 (feeling down, depressed, or hopeless), GAD6 (becoming easily annoyed or impatient), GAD5 (unable to sit still because of anxiety), GAD7 (feeling afraid that something terrible is about to happen), and PHQ6 (feeling bad or like a failure, or disappointing oneself or family)., Conclusions: This study identified the central and bridge symptoms in a network of anxiety and depressive symptoms. Targeting these symptoms can contribute to interventions for patients with HF at risk of-or suffering from-anxiety and depressive symptoms, which can be effective in reducing the comorbidity of anxiety and depression., Competing Interests: Declarations Ethics approval and consent to participate This study followed the Helsinki Declaration and was approved by the Medical Ethics Committee of Henan Provincial People’s Hospital (No. 2021207). Written’ informed consent was obtained from all of the participants. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Background: Among adolescents, symptoms of generalized anxiety disorder (GAD) and social anxiety disorder (SAD) are not only clinically significant but also continuingly increasing. During adolescence, individuals begin to establish distinct, self-determined lifestyle patterns. This study seeks to identify the associations between such lifestyle factors and the prevalence of GAD and SAD symptoms., Methods: The analyzable sample was based on a cross-sectional, nationally representative survey of Finnish 14-18 year old students from comprehensive schools, general upper secondary schools, and vocational institutions. The sample consisted of 60,252 boys and 71,118 girls, with the mean age of 16.05 years (standard deviation 1.06). Symptoms were identified using the GAD-7 (cutpoint of 10), the Mini-SPIN (cutpoint of 6), and the PHQ-2 (cutpoint of 3). Logistic regression models for both GAD and SAD symptoms were stratified by comorbidity group variables., Results: GAD symptoms were closely related to excessive internet use and decreased sleep duration among adolescents, regardless of comorbidity with depression or SAD. SAD symptoms were associated with excessive internet use and a lack of intense exercise, independent of comorbid depression or GAD., Conclusions: The findings underscore the importance of considering lifestyle factors when developing interventions to mitigate GAD and SAD symptoms in adolescents. Interventions and policy recommendations aiming at improving adolescents' health behaviour and mental health should take into account the intertwining of these factors., Competing Interests: Declarations Ethics approval and consent to participate Informed consent was obtained from all the participants of the study. For the participants under 18 years of age, informed consent was obtained from their respective guardians. Pupils and students fill out the survey anonymously during a school lesson. Responding to the survey is voluntary, and participants give informed consent by answering the survey. Guardians of participants under 18 years old are informed in advance, and guardians of participants under 15 years old have an option to decline their child’s participation. The study was conducted according to the guidelines of the Declaration of Helsinki. The institutional review board of the Finnish Institute for Health and Welfare has evaluated the School Health Promotion study research plan. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Background: The majority of individuals at ultra-high risk (UHR) for psychosis do not transition to a full threshold psychotic disorder. It is therefore important to understand their longer-term clinical and functional outcomes, particularly given the high prevalence of comorbid mental disorders in this population at baseline., Aims: This study investigated the prevalence of non-psychotic disorders in the UHR population at entry and long-term follow-up and their association with functional outcomes. Persistence of UHR status was also investigated., Study Design: The sample comprised 102 UHR young people from the Personal Assessment and Crisis Evaluation (PACE) Clinic who had not transitioned to psychosis by long-term follow-up (mean = 8.8 years, range = 6.8-12.1 years since baseline)., Results: Eighty-eight percent of participants at baseline were diagnosed with at least one mental disorder, the majority of which were mood disorders (78%), anxiety disorders (35%), and substance use disorders (SUDs) (18%). This pattern of disorder prevalence continued at follow-up, though prevalence was reduced, with 52% not meeting criteria for current non-psychotic mental disorder. However, 35% of participants developed a new non-psychotic mental disorder by follow-up. Presence of a continuous non-psychotic mental disorder was associated with poorer functional outcomes at follow-up. 28% of participants still met UHR criteria at follow-up., Conclusions: The study adds to the evidence base that a substantial proportion of UHR individuals who do not transition to psychosis experience persistent attenuated psychotic symptoms and persistent and incident non-psychotic disorders over the long term. Long-term treatment and re-entry into services is indicated., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.)

Objective: Polycystic ovary syndrome (PCOS) symptoms extend beyond reproductive issues, impacting mental health significantly, with noted correlations to anxiety, depression, and suicide attempts. The objective of this study was to quantify psychiatric comorbidities among adolescent females with PCOS., Methods: Utilizing the National Inpatient Sample dataset from January 2016 to December 2018, this study examined a cohort of female adolescents aged 14-17 years diagnosed with PCOS, identified via International Classification of Diseases, Tenth Revision, Clinical Modification code E28.2, and matched 1:2 with non-PCOS individuals on demographic variables using propensity score matching. The primary outcomes included the prevalence of psychiatric disorders and were analyzed through categorical and continuous variable comparisons, employing t tests and Rao-Scott adjusted χ 2 tests, with odds ratios calculated to assess associations., Results: The study encompassed 11,985 patients, highlighting a significantly higher prevalence of mood disorders, major depressive disorder, and anxiety disorders in the PCOS cohort compared to controls ( P < .001). Specifically, mood disorders were reported in 43.6% of the PCOS group. Attention-deficit/hyperactivity disorder/conduct disorders were also more prevalent in the PCOS population. However, rates of schizophrenia and suicidal ideation/attempts did not significantly differ between groups., Conclusion: Adolescents with PCOS exhibit increased psychiatric comorbidities, highlighting the urgent need for integrated care strategies. Future research should aim to elucidate the mechanisms underlying these associations and develop effective interventions to improve outcomes in this vulnerable population., Prim Care Companion CNS Disord 2024;26(6):24m03760 ., Author affiliations are listed at the end of this article., (© Copyright 2024 Physicians Postgraduate Press, Inc.)

The ongoing war in Ukraine has significantly impacted the mental health of academic staff, with anxiety emerging as a predominant issue. This study aimed to assess the prevalence and severity of generalized anxiety disorder (GAD) among Ukrainian academic staff and determine the influence of sociodemographic factors, such as gender, age, migration status, scientific degree, and job title, on anxiety levels. The research was conducted using a cross-sectional online survey between December 2023 and February 2024. The sample included 429 participants from various Ukrainian universities, representing both male and female academic staff, holding job positions such as assistants, senior lecturers, associate professors, and full professors. The findings revealed that 44.3% of participants experienced moderately severe to severe anxiety, with migration due to the full-scale war being a significant predictor of higher anxiety levels. Notably, male academic staff exhibited higher anxiety levels than their female counterparts, contrary to typical peacetime trends, suggesting that wartime responsibilities and societal expectations may play a crucial role. The data underscore the need for targeted mental health support, particularly for displaced academic staff, and highlight the importance of developing gender-specific interventions. These insights are vital for informing policies and support programs to enhance academic staff's mental health and productivity in conflict zones, ensuring the continuity and quality of scientific research during and after the war., (© 2024. The Author(s).)

Background: Children and adolescents with language problems have poorer mental health compared with their non-language impaired peers. Less is known about mental health in adults with a history of language problems. This paper presents a systematic review and meta-analysis that addresses this gap in the literature. Specifically, it summarises the results from studies examining anxiety and depression in adults (aged 18 years and over) who were identified with language impairments or problems earlier in development., Methods & Procedures: Five electronic databases (PsycINFO, ERIC, CINAHL, EMBASE and PubMed) were searched for studies comparing anxiety and/or depression in a sample of adults with and without a history of language problems. Nine studies were found that met the inclusion criteria. From each, an odds ratio (OR) was computed measuring the relationship between childhood language problems and anxiety or depression in adulthood. The OR was computed so values > 1 which indicated anxiety/depression were associated with a history of language problems. ORs were averaged using multilevel random effects meta-analysis., Outcomes & Results: Averaging the study's findings across both anxiety and depression outcomes, we found that a history of childhood language problems was associated with poorer mental health in adulthood (OR = 1.79, p = 0.004). The association for anxiety was also significant (OR = 1.80, p = 0.012) and close to statistical significance for depression (OR = 1.60, p = 0.054)., Conclusions & Implications: This review reveals that adults with a history of language problems are more likely to experience poorer mental health outcomes compared with controls. These findings demonstrate childhood language problems affect not only communication but also mental health and well-being in the long term., What This Paper Adds: What is already known on the subject Prior research examining mental health in children and adolescents with language problems reveals a twofold increased risk of internalising problems, including anxiety and depression. However, little is known about mental health outcomes in adults with a history of language problems. What this paper adds to the existing knowledge The main finding was that childhood language problems are associated with increased risk of anxiety and depression in adulthood. What are the practical and clinical implications of this work? First, the study demonstrates childhood language problems increase the risk of poor mental health in adulthood. Second, in adult mental health settings there is a need to screen for language problems and, where applicable, adjust interventions to accommodate communicative needs for patients/clients. Solving these issues requires integration and recognition of the importance of speech-language therapy in the adult mental health system., (© 2024 The Author(s). International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.)

Gender differences have been identified in the co-occurrence of anxiety and depressive symptoms. However, the underlying mechanisms that give rise to this gender difference remain unclear, and few studies have examined the issue at the symptom level. The current study employed the 7-item Generalized Anxiety Disorder scale (GAD-7) and the 9-item Patient Health Questionnaire (PHQ-9) to assess anxiety and depressive symptoms in a national sample of early adolescents (N = 15 391). A network approach was applied to investigate the gender differences in symptom interconnectivity. Gender differences were found in the co-occurrence of anxiety and depressive symptoms. The results indicated that girls with higher global strength (p < 0.01) exhibited stronger interconnectivity between symptoms. Central symptom PHQ2 (Sad mood) was significantly stronger in girls (p < 0.01), whereas PHQ6 (Guilt) was stronger in boys (p < 0.05). GAD7 (Feeling afraid) was identified as a prominent bridge symptom in girls, while PHQ6 (Guilt) was observed to play a similar role in boys. The directed acyclic graphs (DAGs) demonstrated that one symptom of anxiety triggered a series of emotional symptoms of anxiety and depression, ultimately resulting in a depressive somatic symptom in girls, whereas leading to both depressive somatic and anxiety symptoms in boys. These findings enhance our understanding and provide insights into potential intervention targets to prevent the co-occurrence of anxiety and depressive symptoms at an early stage., Competing Interests: Declaration of competing interest The authors declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: To determine the mental health conditions of adolescents in the city of Manizales, Colombia, and explore risk regarding gender-based differences., Materials and Methods: Quantitative, nonexperimental, descriptive research with associative scope. A total of 316 adolescents were assessed using five scales to evaluate mental health conditions: the Perceived Stress Scale, Patient Health Questionnaire-9, Generalized Anxiety Disorder Scale, Penn Alcohol Craving Scale and The Substance Dependence Severity Scale. Univariate and bivariate analysis was performed, Chi square and Odds Ratio were tested., Results: The findings indicated that being female is a risk factor for high levels of perceived stress, depressive episodes and anxiety. Additionally, adolescents who are not attending school are at higher risk for dependence and abuse of psychoactive substances. Conversely, being female acts as a protective factor against dependence on psychoactive substances., Conclusions: The findings suggest a higher tendency among the participants towards experiencing depressive episodes. Regarding perceived stress, 71.5% of the participants fell into the low category, while 70.6% experienced a current episode of generalized anxiety., (© 2024 Wiley Periodicals LLC.)

Background: Lower limb amputation can lead to psychological problems.There is a lack of data to evaluate the psychological problems and associated factors in lower limb amputees., Aim: Prevalence and factors associated with psychological disorder and phantom limb pain in lower limb amputees METHODS: It was a cross-sectional study with a consecutive sampling technique. Patients were assessed on the Hospital Anxiety and Depression Scale (HADS) for the presence of depression and anxiety disorder. DSM-5 diagnostic criteria for substance use disorder were used, andphantom limb pain was diagnosed as defined by Pare., Results: 103 patients were included in the present study with a mean age of37.7 ± 14.5 yrs. The majorityof patients were males (87.4 %), married (69.9 %), on paid employment (95.1 %), and were of middle socioeconomic status (83.5 %). Most of the patients presented with roadside accident injuries (83.5 %)and had below-knee amputation (58.3 %). As per DSM-5, 38.8 % had a substance use disorder, out of which 35.9 % and 24.3 % had alcohol and tobacco use disorders, respectively. On HADS, 48.5 % had a presence of depressive disorder, and 30.1 % had anxiety disorder. The majority of patients (97.1 %) had phantom limb pain. Those from rural areas reported significantly more frequency of anxiety (x 2 -5.501; p-0.019) and depressive disorder (x 2 -7.009; p-0.008). Lower incomehad a significant positive association with depression (r-0.228; p-0.021) and phantom limb pain (U-22.500; p-0.008)., Conclusion: The prevalence of psychiatric morbidity in lower-limb amputeeswas very high. The most common psychological morbidity was depression,followed by anxiety disorder and substance use disorders.Our findings reflect that we would benefit by including mental health professionals asintegral members of the multidisciplinary team to do an early psychological assessment and intervention, which would help prevent psychological illnesses and improve quality of life., Competing Interests: Declaration of competing interest We authorise that we do not have any competing interest for the article titled “Prevalence and Factors Associated with Psychological Morbidity, Phantom Limb Pain in Lower Limb Amputees” submitted in the prestigious journal., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Purpose: Since the onset of the COVID-19 pandemic, most research has focused on the management of the acute symptoms of the disease. Yet some people tend to experience symptoms beyond the acute phase, defined as Post-COVID-19 Condition (PCC). This study aims to assess the impact of COVID-19 and PCC on anxiety and depression., Methods: This is a prospective longitudinal cohort study among the Belgian adult population with recent SARS-CoV-2 infection for which contact tracing was initiated. A total of 3127 people were followed-up just after their infection and three months later (from April 2021 to January 2022). Anxiety and depression were assessed at the two stages using the GAD-7 (Generalized Anxiety Disorder) and the PHQ-9 (Patient Health Questionnaire)., Results: Three months after infection, participants with PCC (50%) had an increased probability of having both anxiety and depressive symptoms (p < 0.001). The proportion with anxiety and depressive symptoms at three months were significantly higher in people with PCC (11% and 19%) compared to people without persistent COVID symptoms (3.8% and 4.2%) and to a matched sub-sample not infected with SARS-CoV-2 (6.5% and 4.3%). Having at least one acute COVID-19 symptom (p < 0.001), experiencing financial loss following the infection (p < 0.001), and different PCC symptoms were associated with anxiety and depressive symptoms worsening over time., Conclusions: This study showed that three months after a SARS-CoV-2 infection, one in two people suffer from PCC with significant consequences for their mental health. Follow-up on mental health must therefore have an important place in people suffering from PCC., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Background: Women with menopausal transition (MT) have an elevated risk of experiencing common mental health diagnoses (CMHD: depression or anxiety). There is no recent data comparing the rate, and treatment, of CMHD between men and women., Methods: In this population-based study, incidence rates (IR) per 100 person-years-at-risk (PYAR) for men and women ≥45 years registered with an UK primary care practice between 2010 and 2021 were estimated. Incidence rate ratios (IRR) with 95 % confidence intervals (CIs) of CMHD were estimated using men as a reference. We measured first prescriptions for psychotropic medications received within 12 months after CMHD. For selective serotonin reuptake inhibitors (SSRIs) /selective norepinephrine reuptake inhibitors (SNRIs), we measured the IR of prescribing per 100 PYAR, by 10-year bands. Proportion of SSRIs/SNRIs prescribing was estimated per 100 persons., Results: Rates of anxiety and depressive disorders were 1.68 and 1.69 per 100 PYAR in women aged 45-54 years-old compared to 0.91 and 1.20 per 100 PYAR in men, with IRR of 1.84 (95 % CI 1.72-1.97) and 1.44 (1.35-1.53) respectively. SSRIs/SNRIs were the most prescribed medication; in 2021, IRs for SSRIs/SNRIs were 13.4 per 100 PYAR in both sexes. In 2021, the proportion of SSRIs/SNRIs prescribing was 50.67 per 100 women and 41.91 per 100 men., Limitations: MT is assumed based on women's age as menopause onset is rarely recorded in primary care databases., Conclusions: Women ≥45 years experienced more CMHD compared to men, especially 45-54 years-olds, which coincides with MT. The proportion of SSRIs/SNRIs prescribing was higher in women., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dana Alsugeir reports financial support was provided by Saudi Arabian Cultural Bureau. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Transgender/non-binary (TNB) adolescents are at increased risk for mental health concerns, and caregiver awareness is important to facilitate access to care. Yet, limited research has examined caregiver awareness of TNB mental health. Thus, we examined (1) the prevalence of internalizing symptoms (depression, generalized anxiety, separation anxiety, social anxiety) among TNB adolescents and (2) associations between adolescent and caregiver reports of adolescent mental health symptoms. TNB adolescents (N = 75) aged 12-18 and a caregiver were recruited from a multidisciplinary gender clinic in Ohio. Adolescents self-reported their mental health symptoms via the CDI and SCARED. Caregivers reported their perceptions of the adolescent's mental health symptoms via the CASI-5. Descriptive statistics assessed participant characteristics, adolescent self-reported mental health symptoms, and caregiver proxy reports of adolescent mental health symptoms. Pearson's correlations and scatterplots were used to compare adolescent and caregiver reports and McNemar tests assessed if the differences were statistically significant. Most TNB adolescents reported elevated symptoms of depression (59%), generalized anxiety (75%), separation anxiety (52%), and social anxiety (78%). Caregiver and adolescent reports were significantly correlated for depression (r = .36, p = .002), separation anxiety (r = .39, p < .001), and social anxiety (r = .47, p < .001). Caregiver and adolescent reports of generalized anxiety were not significantly correlated (r = .21, p = .08). McNemar tests were significant (all p < .001), such that adolescents' reports met clinical cutoffs far more than their caregivers' reports., Conclusions: Though adolescent and caregiver reports were low to moderately correlated, youth reports were consistently higher, suggesting the importance of interventions to increase caregiver understanding of TNB adolescent mental health., What Is Known: • Transgender/non-binary adolescents are at high risk for mental health concerns and caregivers are essential to coordinate care., What Is New: • This study expands the diagnostic mental health sub-categories examined in transgender/non-binary adolescents, noting elevated symptoms of separation and social anxiety. • Transgender/non-binary adolescents reported more symptoms of depression, generalized anxiety, separation anxiety, and social anxiety than caregivers., (© 2024. The Author(s).)

Importance: Research suggests that low-grade, nonresolving inflammation may predate adult mental and physical illness. However, evidence to date is largely cross-sectional or focuses on single disorder outcomes., Objectives: To examine trajectories of inflammation as measured by C-reactive protein (CRP) levels in a large sample of children and adolescents, and to explore associations between different identified trajectories and mental and related cardiometabolic health outcomes in early adulthood., Design, Setting, and Participants: In a longitudinal cohort study using data from the large UK-based Avon Longitudinal Study of Parents and Children (ALSPAC), latent class growth analysis (LCGA) was used to explore different trajectories of inflammation, with logistic regression exploring association with mental and physical health outcomes. Participants with measurable CRP data and associated mental and cardiometabolic health outcomes recorded were included in the analysis. Data analysis was performed from May 1, 2023, to March 30, 2024., Exposures: Inflammation was assessed via CRP levels at ages 9, 15, and 17 years. LCGA was used to identify different trajectories of inflammation., Main Outcomes and Measures: Outcomes assessed at age 24 years included psychotic disorders, depressive disorders, anxiety disorders, hypomania, and, as a measure of insulin resistance, Homeostasis Model Assessment (HOMA2) score., Results: A total of 6556 participants (3303 [50.4%] female) were included. Three classes of inflammation were identified: persistently low CRP levels (reference class, n = 6109); persistently raised CRP levels, peaking at age 9 years (early peak, n = 197); and persistently raised CRP levels, peaking at age 17 years (late peak, n = 250). Participants in the early peak group were associated with a higher risk of psychotic disorder (odds ratio [OR], 4.60; 95% CI, 1.81-11.70; P = .008), a higher risk of severe depression (OR, 4.37; 95% CI, 1.64-11.63; P = .02), and higher HOMA2 scores (β = 0.05; 95% CI, 0.01-0.62, P = .04) compared with participants with persistently low CRP. The late peak group was not associated with any outcomes at age 24 years., Conclusions and Relevance: Low-grade systemic inflammation peaking in midchildhood was associated with specific mental and cardiometabolic disorders in young adulthood. These findings suggest that low-grade persistent inflammation in early life may be an important shared common factor for mental-physical comorbidity and so could be relevant to future efforts of patient stratification and risk profiling.

Aims: To estimate the strength of association between psychiatric disorders and substance use disorders (SUD), and cannabis use and cannabis use disorder (CUD) during early pregnancy., Design: Observational study., Setting: Kaiser Permanente Northern California, USA., Participants: 299 496 pregnancies from 227 555 individuals screened for cannabis use by self-report and a urine toxicology test at entrance to prenatal care in Kaiser Permanente Northern California during January 2011-December 2021 (excepting year 2020). The sample was 62.5% non-White, with a mean (standard deviation) age of 31.1 (5.5) years; 6.8% used cannabis; 0.2% had a CUD., Measurements: Exposure variables included electronic health record-based psychiatric diagnoses of attention deficit hyperactivity, anxiety, bipolar, depressive, personality, posttraumatic stress and psychotic disorders; and alcohol, opioid, stimulant and tobacco use disorders, during the two years prior to pregnancy up to the day before the prenatal substance use screening date. Outcome variables were any cannabis use, frequency of self-reported cannabis use and CUD during early pregnancy., Findings: Psychiatric disorder prevalence ranged from 0.2% (psychotic) to 14.3% (anxiety), and SUD ranged from 0.3% (stimulant/opioid) to 3.8% (tobacco). Psychiatric disorders were associated with cannabis use and CUD, with the strongest association for any use found for bipolar disorder (adjusted odds ratio [aOR] = 2.83; 95% confidence interval [CI] = 2.53-3.17) and the strongest association for CUD found for psychotic disorders (aOR = 10.01, 95% CI = 6.52-15.37). SUDs were associated with cannabis use and CUD, with the strongest association for any use found for tobacco use disorder (aOR = 4.03, 95% CI = 3.82-4.24) and the strongest association for CUD found for stimulant use disorder (aOR = 21.99, 95% CI = 16.53-29.26). Anxiety, bipolar, depressive disorders and tobacco use disorder were associated with greater odds of daily than monthly or less cannabis use., Conclusions: Psychiatric disorders and substance use disorders appear to be associated with elevated odds of any and frequent cannabis use as well as cannabis use disorder during early pregnancy. In most cases, the associations with cannabis outcomes were stronger for substance use disorders than other psychiatric disorders., (© 2024 Society for the Study of Addiction.)

Objectives: This study aimed to examine the frequency of anxiety disorder, coronavirus anxiety and health anxiety in tinnitus patients during the pandemic and also, determined the psychophysiological impact of COVID-19 on tinnitus., Methods: This cross-sectional study was conducted in a tertiary central pandemic hospital from 15 July 2021 to 15 December 2022. In total, 124 patients with tinnitus and 77 healthy controls participated in the study. The sociodemographic data, a set of valid and reliable assessment instruments were used to measure outcomes of anxiety disorder, coronavirus anxiety, health anxiety and severity of tinnitus., Results: Patients with tinnitus were found to experience higher levels of coronavirus anxiety, health anxiety and anxiety disorder than controls (p < 0.05). In tinnitus patients, the frequency of coronavirus anxiety was 22.6% and anxiety disorder was 18.5%. Notably, the levels of tinnitus severity were moderate to severe in more than half of the patients (51.6%) and also most of them (81.3%) reported that the severity of tinnitus during the pandemic was higher compared with the pre-pandemic., Conclusion: Tinnitus patients had high levels of anxiety disorder, coronavirus anxiety and health anxiety. In line with these findings, it was evaluated that there was a relationship between the COVID-19 pandemic with psychological problems and tinnitus. Therefore, the predominance of tinnitus symptoms at presentation should not lead the clinician to neglect the underlying psychopathological problems in these patients., (© 2024 The Author(s). Clinical Otolaryngology published by John Wiley & Sons Ltd.)

Purpose: Few longitudinal studies have investigated the mediating role of inflammation during childhood in associations between prenatal maternal stress and adolescent mental health. The objective of this study was to examine the associations between prenatal maternal stress, concentrations of immune markers at age 9, and symptoms of generalized anxiety disorder (GAD) and depression during adolescence., Methods: This study included 3723 mother-child pairs from the Avon Longitudinal Study of Parents and Children (ALSPAC). Prenatal maternal stress was examined using 55 items measured during pregnancy. Inflammation was assessed using serum concentrations of interleukin-6 (IL-6) and C-reactive protein (CRP) when children were 9 years old. GAD and depression were assessed when children were 16 and 18 years of age, respectively. Analyses comprised of structural equation models., Results: Prenatal maternal stress was associated with higher concentrations of IL-6 in childhood, and with greater symptoms of depression and GAD in adolescence. However, we did not observe associations between prenatal maternal stress and CRP; also, CRP and IL-6 were not associated with depression and GAD. There was no evidence that CRP and IL-6 mediated the associations between prenatal maternal stress and either GAD or depression., Conclusions: Prenatal maternal stress is associated with IL-6 levels in childhood, and with GAD and depression during adolescence. Future studies should examine immune activity at multiple points during development in relation to mental health into adulthood to determine whether inflammation at different points during development could increase risk for mental health problems among children whose mothers experienced significant stressors during pregnancy., Competing Interests: Declaration of Competing Interest No conflict, (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: COVID-19 pandemic had devastating socio-economic and health effects, including mental health. This study examines the intersectionality between gender and mental health outcomes among Kenyan adults in informal settlements of Nairobi, Kisumu, and Kilifi Counties during the COVID-19 crisis. This is necessary to inform mental health response in case of another pandemic., Methods: We analyzed data collected in a longitudinal survey between July 2020 (fourth round) and February 2021 (fifth round). The data covered COVID-19-related effects on job loss, food insecurity, access to health services, and mental health. Participants were randomly sampled from existing cohorts at the Population Council. The outcomes of interest were depressive and anxiety disorders, combined into a binary composite outcome variable. Descriptive statistics included means for continuous variables and frequencies and proportions for categorical variables. Chi-square tests were used to examine the differences between groups. The relationship between the gendered COVID-19 socio-economic effects and participants' mental health was examined using modified Poisson regression., Results: A total of 4,050 participants were interviewed, 66% female and median age 38 [interquartile range (IQR): 29-46]. Complete income loss was strongly associated with negative mental health outcomes in multiple intersections with varied magnitudes. The association was larger among older females (≥50 years) (PR = 1.33, 95% CI = 1.17-1.51, p  < 0.001) than older males (PR = 1.22, 95% CI = 1.17-1.27, p  < 0.001). Partial loss of income was protective against negative mental health outcomes among young males (18-29 years) (PR = 0.81, 95% CI = 0.76-0.87, p  < 0.001) but linked to negative outcomes among middle-aged males (30-49 years old) (PR = 1.14, 95% CI = 1.12-1.16, p  < 0.001). Skipping meals was associated with negative mental health outcomes for both genders particularly the married (married male: PR = 1.49, 95% CI = 1.22-1.83, p  < 0.001; married female: PR = 1.42, 95% CI = 1.26-1.60, p  < 0.001)., Conclusion: We observed significant gender differences in the prevalence of depressive symptoms and anxiety disorders during the COVID-19 pandemic, underscoring the importance of socio-economic factors and health services access in shaping mental health outcomes. Interventions targeting pandemic-related mental health issues should be gender-sensitive and address economic vulnerabilities such as job losses and food insecurity. Policies to mitigate these effects, especially for at-risk groups are crucial for reducing mental health burden in future crises., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Mwanga, Odero, Kadengye, Odunga, Muluve, Mugotitsa, Wafubwa, Austrian and Kiwuwa-Muyingo.)

Background: Major depressive disorder (MDD) is a serious and disabling condition characterized by abnormal mood changes. Clinical guidelines for depression treatment recommend antidepressant medications, with benzodiazepines acting as short-term synergists. However, little is currently known about the prevalence and associated clinical risk factors of benzodiazepine use among Chinese patients with MDD. This study aimed to explore the prevalence and clinical risk factors associated with benzodiazepine use in this population., Methods: A total of 2742 patients with MDD (males/females = 816/1926, aged 14-60 years) participated in this cross-sectional observational study. General information and psychosis assessments were collected online. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), anxiety symptoms using the Generalized Anxiety Disorder-7 (GAD-7), and sleep problems and suicidal tendencies using the third and ninth items of the PHQ-9. Multivariable logistic regression analysis models were employed to identify factors associated with benzodiazepine use., Results: The prevalence of benzodiazepine use among patients with MDD was 42.9 %. Among these patients, 99.6 % used a single benzodiazepine, with oxazepam being the most frequently prescribed. Age, severity of sleep problems, depressive symptoms, and anxiety symptoms were significantly correlated with benzodiazepine use (all P < 0.001)., Limitations: The cross-sectional design of this study precludes establishing causal relationships., Conclusion: Our findings indicate a high prevalence of benzodiazepine use among Chinese patients with MDD. Factors such as severe depressive symptoms, anxiety symptoms, age, and sleep problems appear to be associated with benzodiazepine use. These results underscore the importance of vigilance regarding benzodiazepine use in patients with MDD., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts with any financial interests., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Objective: To assess the long-term impact of the age of onset (AOO) of the first major depressive episode (MDE) according to 3 age groups and considering gender., Methods: Data were extracted from NESARC III, a representative U.S., Sample: We included 8053 participants with an MDE history in a cross-sectional and retrospective cohort study. We defined 3 AOO groups: childhood-onset (< 13 yo), adolescence-onset (13-18 yo), and adult-onset (> 18 yo). We compared sociodemographic characteristics, lifetime psychiatric disorders per DSM-5 criteria, and health-related quality of life (HRQOL) in each group and performed gender-stratified analyses., Results: Prevalence of childhood-onset MDE was 10.03 %, adolescence-onset was 14.12 %, and adult-onset was 75.85 %. Suicide attempts (AOR = 3.61; 95 % CI 2.90-4.50), anxiety disorders (AOR = 1.92; 95 % CI 1.62-2.27), and personality disorders (AOR = 3.08; 95 % CI 2.56-3.71) were more frequent in the childhood-onset than in the adult-onset one. Adolescence-onset group showed similar results. Physical Disability scale (p < 0.001) and Mental Disability scale (p < 0.001) were significantly lower in the childhood-onset group. Results were more nuanced in the adolescence-onset group. Women in childhood-onset and adolescence-onset groups had poorer outcomes than the adult-onset group. Differences were less pronounced in men., Limitations: Recall and classification biases inherent to survey design., Conclusion: Individuals, particularly women, who experienced their first MDE during childhood or adolescence exhibit higher lifetime psychiatric disorder prevalence and poorer HRQOL than those with adult-onset MDE. These findings highlight the importance of preventive measures, early diagnosis, and treatment of youth depression., Competing Interests: Declaration of competing interest None of the authors have any competing interests., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Exposure to traumatic events is a frequent source of distress, provoking isolated symptoms such as distressing memories (DM) to full-blown post-traumatic stress disorder (PTSD). We aimed to assess the continuum theory using DM as an isolated symptom, and to examine trauma consequences in a exposed to traumatic events., Methods: Using data from the National Epidemiologic Study of Alcohol and Related Conditions III, we assessed the prevalence of DM in a trauma exposed sample, and examined their sociodemographic and lifetime psychiatric correlates, comparing three groups: (i) controls (no DM, no PTSD); (ii) participants with isolated DM without PTSD; (iii) participants with PTSD. We estimated the sensitivity and specificity of DM for PTSD diagnosis., Results: In our sample of 17,505 participants exposed to trauma, 13 % had PTSD and 42 % had DM without PTSD. The sensitivity of DM for the diagnosis of PTSD was 95.14 %, specificity was 51.91 %. Participants with DM and those with PTSD shared the same socio-demographic correlates. Participants with DM reported more lifetime psychiatric disorders (mood disorders - mainly depressive disorders and bipolar type 1 disorder; anxiety disorders - mainly social anxiety disorder, substance use disorders - mainly opioid use disorder and cannabis disorder; eating disorders - mainly binge eating disorder; personality disorders - mainly borderline personality disorder- and suicidality) than controls, but less than participants with PTSD., Conclusion: DM represent an intermediate state between well-being and post-traumatic stress disorder; DM is also associated with other psychiatric disorders. It should be considered as a transdiagnostic psychiatric symptom useful for clinicians in identifying psychiatric vulnerability., Competing Interests: Declaration of competing interest None., (Copyright © 2024. Published by Elsevier B.V.)

Background: Early life environments can have long-lasting impacts on future health and wellbeing. Maternal health during pregnancy, including experiencing stress or mood disorders, has been associated with psychopathology in later life. Anxiety disorders are one of the most prevalent mental health conditions, affecting approximately 7 % of children and adolescents globally, with a lifetime prevalence of 15-20 %. Identifying prenatal risk factors can support future and current public health interventions and maternity care., Methods: Data were obtained from the Growing Up in New Zealand longitudinal study of child development. Prenatally, mothers provided sociodemographic information as well as data on their mental health, potential teratogens, and lifestyle factors such as supplement intake and exercise levels. At 8-years old, 4922 children self-completed the PROMIS-SF anxiety measure. Bivariate analyses and backward stepwise regression were used to determine the best multivariable model., Results: Significant prenatal predictors of anxiety symptoms at 8-years old included elevated maternal depression symptoms, body mass index in the overweight/obese range, exercise patterns, and paracetamol, anti-inflammatory and alcohol intake., Limitations: Sample attrition from baseline to 8-year may have affected statistical power. To further untangle the effect of timing and duration of the exposures reported in this study, larger sample sizes would be required., Conclusions: Prenatal mental health and wellbeing was significantly associated with child anxiety symptoms at 8-years of age. This study highlights the importance of supporting expectant mothers' health and wellbeing during pregnancy to ensure children have the best opportunity to have good mental health., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Karen Waldie reports financial support was provided by Royal Society of New Zealand Marsden Fund. Caroline Walker reports financial support was provided by Royal Society of New Zealand Marsden Fund. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Introduction: Youth with a family history of bipolar disorder (At-Risk) have a higher risk of developing psychiatric disorders and experiencing environmental stressors than youth without such family history (Control). We studied the differential associations of familial and environmental factors on developing psychiatric diagnoses and symptoms, in At-Risk and Control youth., Methods: At-Risk and Control youth (N = 466, ages 9-22) were systematically assessed for severity of symptoms, psychiatric diagnoses, and self-reported measures of stress and social support. We tested the association of family history and measures of stress or support with symptom severity and diagnoses., Results: At-Risk youth had higher symptom severity scores and were more frequently diagnosed with psychiatric disorders (all p values < 0.001). When predicting mood symptom severity, family history had an interaction effect with stressful life events (p < 0.001) and number of distinct traumatic events (p = 0.001). In multivariate models, At-Risk status predicted anxiety disorders (OR = 2.7, CI 1.3-5.4, p = 0.005) and anxiety severity (Coefficient = 0.4, CI 0.2-0.7, p < 0.001) but not mood or behavioral disorder diagnoses or severity., Limitations: Measures of stress and social support were based on self-report. Not all participants had passed through the period of risk for developing the outcomes under study and the follow up period was variable. We could not fully study the differential impact of physical or sexual abuse due to low frequency of occurrence in controls., Conclusion: At-Risk youth exhibit more severe mood symptoms compared to Controls when exposed to similar levels of stress or trauma. At-Risk youth are also more prone to develop anxiety which may be a precursor for bipolar disorder., Competing Interests: Declaration of competing interest Masoud Kamali has nothing to disclose. Emma K. Stapp has nothing to disclose. Janice M. Fullerton has received honoraria from Illumina for contribution to a Speakers Bureau in 2023 and had flight and accommodations paid for by Novo Nordisk Fonden to attend the Familial High Risk Summit. Neera Ghaziuddin has nothing to disclose. Leslie Hulvershorn has nothing to disclose. Melvin G. McInnis has received research support from Janssen Pharmaceuticals. Philip B. Mitchell has received remuneration from Janssen (Australia) for lectures and advisory board membership in the last 3 years. Gloria Roberts has nothing to disclose. Holly C. Wilcox has nothing to disclose. John I. Nurnberger Jr. has nothing to disclose., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: We considered the suggestion that mental health is the product of two intersecting continua: psychological distress and mental wellbeing., Objectives: To understand prevalences of low mental wellbeing, depression and anxiety, and examine associations between them and with sociodemographic variables., Methods: In a cross-sectional survey in informal settlements, 4906 women aged 18-49 years answered questions on mental wellbeing (Short Warwick-Edinburgh Mental Wellbeing Scale: SWEMWBS) and symptoms of depression (Patient Health Questionnaire: PHQ-9) and anxiety (Generalised Anxiety Disorder: GAD-7). We used regression models to examine associations of lower mental wellbeing with symptoms suggesting moderate-to-severe depression and anxiety, and with sociodemographic characteristics., Results: About 15% of women reported symptoms of low wellbeing, 9% symptoms of moderate-to-severe depression, and 6% symptoms of moderate-to-severe anxiety. Women with low wellbeing did not necessarily report symptoms suggesting anxiety or depression, and women with anxiety or depression did not necessarily report low wellbeing. In adjusted models, poorer and less educated women were more likely to report low wellbeing. Symptoms of anxiety or depression were more likely to be reported by widowed, separated, or divorced women, women who were in paid employment, and women who used drugs or alcohol themselves or whose partners did. Women with low wellbeing had at least double the odds of reporting symptoms of moderate-to-severe depression or anxiety than women who reported greater wellbeing., Conclusion: The findings support the idea of two continua of mental health. How individual women cope with mental illness and nevertheless enjoy a state of wellbeing deserves more study., (© 2024. The Author(s).)

Background: Anxiety disorders are a significant global mental health concern, contributing to substantial disability-adjusted life years (DALYs) and imposing considerable social and economic burdens. Understanding the epidemiology of anxiety disorders within the BRICS nations (Brazil, Russian Federation, India, China, and South Africa) is essential due to their unique socio-economic landscapes and ongoing transformations., Methods: This study utilized data from the Global Burden of Disease (GBD) 2021 database to evaluate anxiety disorder incidence trends in BRICS countries from 1992 to 2021. The Age-Period-Cohort (APC) model with an intrinsic estimator (IE) algorithm was employed to disentangle the effects of age, period, and cohort on incidence rates. Data were categorized into 5-year age groups, and 95% uncertainty intervals (UIs) were calculated to account for data variability., Results: From 1992 to 2021, the global number of anxiety disorders cases increased by 73.44%, with age-standardized incidence rates rising by 21.17%. Among BRICS nations, India experienced the largest increase in cases (113.30%), while China had the smallest increase (2.79%). Globally, young (15-49 years) and oldest (80-94 years) age groups showed predominantly positive local drift values, indicating rising incidence rates. Brazil and India mirrored this trend, while China and South Africa mostly exhibited negative local drift values. Russia Federation had mixed trends with younger groups showing negative and older groups positive local drift values. The incidence of anxiety disorders exhibited an "M-shaped" age pattern with peaks at 10-14 and 35-39 years. Period effects were stable globally but varied in BRICS countries, with Brazil showing a decline and India an increase. Cohort effects were stable globally but showed increasing trends in Brazil and India post-1955-1959 cohort., Conclusion: This study highlights a significant increase in anxiety disorders incidence globally and within BRICS nations over the past three decades, with marked variations across countries. The distinct trends observed in age, period, and cohort effects call for age-specific and gender-sensitive mental health policies. Continuous monitoring, research, and tailored public health strategies are essential to address the rising burden of anxiety disorders and improve mental health outcomes in these rapidly evolving regions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Liu, Luo, Huang, Tan, Cheng and Wu.)

Objective: Generalized Anxiety Disorder is an international mental health problem. Prevalence for anxiety disorders reported in perinatal period is high and related with adverse parental and child outcomes. Thus, the objective of this study was to investigate the psychometric properties and factorial validity of General Anxiety Disorder-7 questionnaire (GAD-7) in the context of postpartum mothers., Methods: In this cross-sectional study, 278 mothers (mean age 31.09; SD = 4.42) were recruited at the Neonatology, Gynecology, and Obstetrics Ward. Generalized Anxiety Disorder was assessed with GAD-7, stress with Parental Stress Scale (PSS), while risk of depression with Edinburgh Postpartum Depression Scale (EPDS). Confirmatory factor analysis (CFA) was used to verify factor structure of GAD-7 and the internal consistency was evaluated using reliability coefficients: Cronbach's Alpha and McDonald's Omega., Results: The internal consistency of the GAD-7 was high (Cronbach's Alpha = 0.90 and MacDonald's Omega = 0.91). GAD-7 had significant correlations with the variables examined for construct validity, stress (PSS; r = 0.35, p < 0.01) and risk of depression (EPDS; r = 0.76, p < 0.01). The Confirmatory Factor Analysis results supported a good fit of the data to the model: χ²(df) = 14.19 (14), p = 0.44; Comparative Fit Index (CFI) = 0.99; Tucker-Lewis Index (TLI) = 0.99; Root Mean Square Error of Approximation (RMSEA) = 0.007 (90% C.I. 0.000; 0.059)., Conclusion: GAD-7 has satisfactory psychometric properties. GAD-7 had significant correlations with the variables examined for construct validity with PSS and EPDS. GAD-7 is a reliable instrument for screening anxiety symptoms in perinatal period in research and clinical setting., (© 2024. The Author(s).)

Background: Major depressive disorder and anxiety disorders are highly prevalent and comorbid during the perinatal period. Although research and clinicians agree that emotion regulation (ER) is an important transdiagnostic factor underlying both disorders in the general population, ER during the perinatal period has received less research attention. The aim of this systematic review was to assess the literature regarding the role of ten commonly studied ER strategies in the onset and maintenance of perinatal depression and anxiety in pregnant women and young mothers, using the Process Model of Gross (1998) as a theoretical framework., Methods: We searched four electronic databases with variations of the following key words: women; emotion regulation (i.e., behavioral approach, behavioral avoidance, problem solving, support seeking, distraction, rumination, reappraisal, acceptance, expressive suppression, and expressive engagement); perinatal period; and psychopathology. The aim was to identify peer-reviewed, and quantitative studies published between January 1999 and January 2023. Six articles were selected for analysis., Results: Similar ER strategies emerged as risk and protective factors in perinatal depression and anxiety. Overall, behavioral avoidance, distraction, rumination, and expressive engagement appeared as risk factors, while problem solving, emotional and instrumental support seeking, cognitive reappraisal, and acceptance, emerged as protective factors in the onset and maintenance of perinatal depression and anxiety. These findings align with previous research in perinatal community samples, as well as in non-perinatal clinical samples., Conclusions: Our results support the role of ER as a transdiagnostic factor underlying both perinatal depression and anxiety. Clinicians are encouraged to implement ER strategies into the screening, prevention, and treatment of perinatal depression and anxiety. Further research is needed to strengthen these findings and to examine the role of emotion regulation during antenatal depression and anxiety more closely., (© 2024. The Author(s).)

Background: People with mental health conditions were potentially more vulnerable than others to the neuropsychiatric effects of the COVID-19 pandemic and the global efforts taken to contain it. The aim of this multinational study was to examine the changes in psychotropic drug prescribing during the pandemic among people with depressive and anxiety disorders., Methods: This study included electronic medical records and claims data from nine databases in six countries (France, Germany, Italy, the UK, South Korea, and the USA) of patients with a diagnosis of depressive or anxiety disorders between 2016 and 2021. The outcomes were monthly prevalence rates of antidepressant, antipsychotic, and anxiolytic drug prescribing. The associations between the pandemic and psychotropic drug prescribing were examined with interrupted time series analyses for the total sample and stratified by sex and age group. People with lived experience were not involved in the research and writing process., Findings: Between Jan 1, 2016 and Dec 31, 2020, an average of 16 567 914 patients with depressive disorders (10 820 956 females [65·31%] and 5 746 958 males [34·69%]) and 15 988 451 patients with anxiety disorders (10 688 788 females [66·85%] and 5 299 663 males [33·15%]) were identified annually. Most patients with depressive disorders and anxiety disorders were aged 45-64 years. Ethnicity data were not available. Two distinct trends in prescribing rates were identified. The first pattern shows an initial surge at the start of the pandemic (eg, antipsychotics among patients with depressive disorders in MDCD&#95;US (rate ratio [RR] 1·077, 95% CI 1·055-1·100), followed by a gradual decline towards the counterfactual level (RR 0·990, 95% CI 0·988-0·992). The second pattern, observed in four databases for anxiolytics among patients with depressive disorders and two for antipsychotics among patients with anxiety disorders, shows an immediate increase (eg, antipsychotics among patients with anxiety disorders in IQVIA&#95;UK: RR 1·467, 95% CI 1·282-1·675) without a subsequent change in slope (RR 0·985, 95% CI 0·969-1·003). In MDCD&#95;US and IQVIA&#95;US, the anxiolytic prescribing rate continued to increase among patients younger than 25 years for both disorders., Interpretation: The study reveals persistently elevated rates of psychotropic drug prescriptions beyond the initial phase of the pandemic. These findings underscore the importance of enhanced mental health support and emphasise the need for regular review of psychotropic drug use among this patient group in the post-pandemic era., Funding: University Grants Committee, Research Grants Council, The Government of the Hong Kong Special Administrative Region., Competing Interests: Declaration of interests HL reports grants from Research Grants Council of Hong Kong, outside the submitted work. WCYL reports research grants from AIR@InnoHK administered by Innovation and Technology Commission, outside the submitted work. JH reports grants from UKRI, Consultancy Fees from Wellcome Trust and Juli Health, and patents pending and stock from Juli Health, outside the submitted work. COT reports stock or stock options and other financial or non-financial interests from Roche Pharmaceutical as an employee, outside the submitted work. XL reports grants from IQVIA, outside the submitted work. SF and DMK report stock or stock options and other financial or non-financial interests from Johnson and Johnson as employees, outside the submitted work. JL reports stock or stock options and other financial or non-financial interests from IQVIA as an employee, outside the submitted work. KKCM reports grants from the CW Maplethorpe Fellowship, National Institute of Health Research, UK, Hong Kong Research Grant Council, and the European Commission Horizon 2020 Framework, outside the submitted work. ICKW reports grants from Amgen, Bristol-Myers Squibb, Pfizer, Janssen, Bayer, GSK and Novartis, the Hong Kong RGC, and the Hong Kong Health and Medical Research Fund, National Institute for Health Research in England, European Commission, and National Health and Medical Research Council in Australia, consulting fees from IQVIA, payment for expert testimony and a role as an independent non-executive director of Jacobson Medical, Hong Kong, outside of the submitted work. All other authors declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)

Numerous studies suggest that subjects suffering from a mental health condition before the COVID-19 pandemic were at higher risk of contagion, but mostly are cross-sectional or retrospective. The BIOVAL-D-COVID-19 is a longitudinal cohort study design with 922 subjects who full filled two evaluations from an online survey of Spanish residents before and during the pandemic. Mental health conditions assessed were: Major Depressive Episode (MDE), Generalised Anxiety Disorder (GAD), Suicidal Thoughts and Behaviours (STB) and subthreshold of panic and bipolar disorder (BD). Mental health screening instruments used were: the Spanish version of the Composite International Diagnostic Interview (CIDI) version 3.0 for the evaluation of MDE, the GAD-7 scale to evaluate GAD; STB was evaluated with four items from the CIDI questionnaire. Panic Disorder and BD were screened from a modified and self-reported version of the CIDI. A bivariate plus five logistic regression models were developed for each mental health condition adjusted by socio-demographic variables; employment status; general and physical health; comorbidity; and including all previous variables and the other mental health conditions. We found in bivariate model that MDE; GAD and STB were statistically significant risk factors of contagion of COVID-19. The logistic regression models developed reveal that having a previous GAD (aOR 3.30 1.31-8.31) or STB (aOR 2.16 CI 95% 1.01-4.62) was statistically significant associated with COVID-19 contagion, independently of all variables included. MDE was not a risk factor of contagion when it was adjusted by comorbidity (aOR 0.99 CI 95% 0.47-2.09). It is recommended to detect those subjects with previous GAD or STB as vulnerable groups of infection to reduce contagion rates., (© 2024 John Wiley & Sons Ltd.)

Data on the chronicity of mental disorder in children with chronic physical illness (CPI) are limited. We examined the prevalence and predictors of homotypic and heterotypic continuity of mental disorder in children with CPI. A sample of 263 children aged 2-16 years with physician-diagnosed CPI were recruited from outpatient clinics (e.g., dermatology, respiratory) at a Canadian pediatric academic hospital and followed for 24 months. Parent and child-reported mental disorders (mood, anxiety, behavioral, attention-deficit hyperactivity disorder [ADHD]) were assessed using the Mini International Neuropsychiatric Interview for Children and Adolescents at baseline, 6, 12, and 24 months. Marginal regression models were computed to identify clinical, parent, and demographic factors associated with mental comorbidity over time. Mental disorder was observed in 24-27% of children with CPI based on child reports and 35-39% based on parent reports. Parent-reported models revealed significant homotypic continuity for all mental disorders (ORs = 4.2-9.5), and heterotypic continuity between mood and anxiety disorders (OR = 2.2), ADHD and behavioral disorders (OR = 5.1), and behavioral and each mental disorder (ORs = 6.7-8.4). Child-reported models revealed significant homotypic continuity for mood (OR = 8.8) and anxiety disorder (OR = 6.0), and heterotypic continuity between anxiety and mood disorders (OR = 12.4). Child disability (ORs = 1.3-1.5) and parent psychopathology (ORs = 1.2-1.8) were the most consistent predictors of both child- and parent-reported mental disorder over time. Mental comorbidity was prevalent and persistent in children with CPI with homotypic and heterotypic continuity common across informants. Child disability and parent psychopathology may be priority targets within integrated family-centered models of care to prevent mental comorbidity in children with CPI., Competing Interests: Declarations Ethical approval This study was conducted according to the guidelines of the Declaration of Helsinki and was approved by the University of Waterloo Human Research Ethics Board (#31010). Consent to participate Informed consent was obtained from all individual participants included in the study. Competing interests The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Objective: Knowing the prevalence of mental health difficulties in young children is critical for early identification and intervention. In the current study, we examine the agreement among three different data sources estimating the prevalence of diagnoses for attention deficit hyperactivity disorder (ADHD) and emotional disorders (i.e., anxiety or mood disorder) for children between birth and 9 years of age., Methods: Data from a prospective pregnancy cohort was linked with provincial administrative health data for children in Alberta, Canada. We report the positive agreement, negative agreement, and Cohen's Kappa of parent-reported child diagnoses provided by a health professional ("parent report"), exceeding a clinical cut-off on a standardized questionnaire completed by parents (the Behavior Assessment System for Children, 3rd edition ["BASC-3"]), and cumulative inpatient, outpatient, or physician claims diagnoses ("administrative data")., Results: Positive and negative agreement for administrative data and parent-reported ADHD diagnoses were 70.8% and 95.6%, respectively, and 30.5% and 94.9% for administrative data and the BASC-3, respectively. For emotional disorders, administrative data and parent-reported diagnoses had a positive agreement of 35.7% and negative agreement of 96.30%. Positive and negative agreement for emotional disorders using administrative data and the BASC-3 were 20.0% and 87.4%, respectively. Kappa coefficients were generally low, indicating poor chance-corrected agreement between these data sources., Conclusions: The data sources highlighted in this study provide disparate agreement for the prevalence of ADHD and emotional disorder diagnoses in young children. Low Kappa coefficients suggest that parent-reported diagnoses, clinically elevated symptoms using a standardized questionnaire, and diagnoses from administrative data serve different purposes and provide discrete estimates of mental health difficulties in early childhood., Plain Language Title: Prevalence of child mental health disorders according to different data sources in Canada., Competing Interests: Data AccessThe datasets generated and analyzed during the current study are from the All Our Families Study and Alberta Health/Alberta Health Services. All Our Families data can be made available from the Study Lead, Dr. Suzanne Tough, via http://allourfamiliesstudy.com/. Administrative data may be requested through Alberta Health/ Alberta Health Services. Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: The systematic review evaluated the association of subclinical hypothyroidism (SCH) with metabolic syndrome (MetS) and specific MetS components in people with major psychiatric disorders., Methods: A systematic review and meta-analysis was conducted to evaluate the association of SCH with MetS and its components in people with major psychiatric conditions., Results: Five studies incorporating 24,158 participants met the inclusion criteria. All five studies comprised patients with depression and/or anxiety. Three studies incorporating 3365 participants were suitable for the meta-analysis. The pooled Odds Ratio (OR) of MetS was 3.46 (95% Confidence Interval/CI = 1.39-8.62) in major depressive disorder (MDD) and anxiety disorders patients with concurrent SCH compared to those without SCH. Meta-analysis showed a significant positive association between SCH and high body mass index (OR = 2.58, 95%CI = 1.33-5.01), high fasting plasma glucose (OR = 3.05, 95%CI = 1.79-5.18) and low high-density lipoprotein cholesterol (OR = 2.30, 95%CI = 1.82-2.92)., Conclusions: These findings suggest a significant positive association between MetS and SCH in people with MDD and anxiety disorders. This review informed the clinical implications of MetS in MDD with comorbid SCH and the importance of early diagnosis and treatment for SCH and MetS in psychiatric patients., Competing Interests: DisclosureThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: The purpose of this study was to assess the trajectory of women's depressive symptoms during the first six months postpartum, identify risk factors (sociodemographic, obstetric and personality) associated with classes, and examine associations between classes and postpartum PTSD at two months and bonding at six months., Methods: The final sample included 212 women who gave birth in the maternity wards of a large tertiary health center that were approached at 1-3 days, two months, and six months postpartum and completed a demographic questionnaire and measures of neuroticism (BFI) and postpartum depression (EPDS), postpartum PTSD (City Birth Trauma Scale) and bonding (PBQ). Obstetric data were taken from the medical files., Results: Cluster analysis revealed three distinctive clusters: "stable-low" (64.2%), "transient-decreasing" (25.9%), and "stable-high" (9.9%). Neuroticism, general-related PTSD symptoms, and bonding were associated with differences between all trajectories. Birth-related PTSD symptoms were associated with differences between both stable-high and transient-decreasing trajectories and the stable-low trajectory. No obstetric or demographic variables were associated with differences between trajectories., Conclusion: We suggest that screening women for vulnerabilities such as high levels of neuroticism and offering treatment can alleviate the possible deleterious effects of high-symptom depression trajectories that may be associated with their vulnerability., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Background: The coronavirus disease 2019 (COVID-19) pandemic, a global health crisis, profoundly impacted all aspects of daily life. Adolescence, a pivotal stage of psychological and social development, is heavily influenced by the psychosocial and socio-cultural context. Hence, it is imperative to thoroughly understand the psychosocial changes adolescents experienced during the pandemic and implement effective management initiatives., Data Sources: We examined the incidence rates of depressive and anxiety disorders among adolescents aged 10-19 years globally and regionally. We utilized data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 to compare pre-pandemic (2018-2019) and pandemic (2020-2021) periods. Our investigation covered 204 countries and territories across the six World Health Organization regions. We conducted a comprehensive literature search using databases including PubMed/MEDLINE, Scopus, and Google Scholar, employing search terms such as "psychosocial", "adolescent", "youth", "risk factors", "COVID-19 pandemic", "prevention", and "intervention"., Results: During the pandemic, the mental health outcomes of adolescents deteriorated, particularly in terms of depressive and anxiety disorders. According to GBD 2021, the incidence rate of anxiety disorders increased from 720.26 [95% uncertainty intervals (UI) = 548.90-929.19] before the COVID-19 pandemic (2018-2019) to 880.87 per 100,000 people (95% UI = 670.43-1132.58) during the COVID-19 pandemic (2020-2021). Similarly, the incidence rate of major depressive disorder increased from 2333.91 (95% UI = 1626.92-3138.55) before the COVID-19 pandemic to 3030.49 per 100,000 people (95% UI = 2096.73-4077.73) during the COVID-19 pandemic. This worsening was notably pronounced in high-income countries (HICs). Rapid environmental changes, including heightened social anxiety, school closures, economic crises, and exacerbated racism, have been shown to adversely affect the mental well-being of adolescents., Conclusions: The abrupt shift to remote learning and the absence of in-person social interactions heightened feelings of loneliness, anxiety, sadness, and stress among adolescents. This change magnified existing socioeconomic disparities, posing additional challenges. These complexities profoundly impact adolescents' well-being, especially vulnerable groups like those from HICs, females, and minorities. Acknowledging the underreporting bias in low- to middle-income countries highlights the importance of addressing these mental health alterations in assessments and interventions within these regions as well. Urgent interventions are crucial as the pandemic-induced mental stress may have lasting effects on adolescents' mental health., (© 2024. Children's Hospital, Zhejiang University School of Medicine.)

Importance: Medical debt is common in the US and may hinder timely access to care for mental disorders., Objective: To estimate the prevalence of medical debt among US adults with depression and anxiety and its association with delayed and forgone mental health care., Design, Setting, and Participants: Cross-sectional, nationally representative survey study of US adult participants in the 2022 National Health Interview Survey who had current or lifetime diagnoses of depression or anxiety., Exposures: Self-reported lifetime clinical diagnoses of depression and anxiety; moderate to severe symptoms of current depression (Patient Health Questionnaire-8 score ≥10) and anxiety (Generalized Anxiety Disorder-7 score ≥10) irrespective of lifetime diagnoses; and past-year medical debt., Main Outcomes and Measures: Self-reported delaying and forgoing mental health care because of cost in the past year., Results: Among 27 651 adults (15 050 [54.4%] female; mean [SD] age, 52.9 [18.4] years), 5186 (18.2%) reported lifetime depression, 1948 (7.3%) reported current depression, 4834 (17.7%) reported lifetime anxiety, and 1689 (6.6%) reported current anxiety. Medical debt was more common among adults with lifetime depression (19.9% vs 8.6%; adjusted prevalence ratio [aPR], 1.97; 95% CI, 1.96-1.98), lifetime anxiety (19.4% vs 8.8%; aPR, 1.91; 95% CI, 1.91-1.92), current depression (27.3% vs 9.4%; aPR, 2.34; 95% CI, 2.34-2.36), and current anxiety (26.2% vs 9.6%; aPR, 2.24; 95% CI, 2.24-2.26) compared with adults without the respective mental disorders. Medical debt was associated with delayed health care among adults with lifetime depression (29.0% vs 11.6%; aPR, 2.68; 95% CI, 2.62-2.74), lifetime anxiety (28.0% vs 11.5%; aPR, 2.45; 95% CI, 2.40-2.50), current depression (36.9% vs 17.4%; aPR, 2.25; 95% CI, 2.13-2.38), and current anxiety (38.4% vs 16.9%; aPR, 2.48; 95% CI, 2.35-2.66) compared with those without these diagnoses. Medical debt was associated with forgone health care among adults with lifetime depression (29.4% vs 10.6%; aPR, 2.66; 95% CI, 2.61-2.71), lifetime anxiety (28.2% vs 10.7%; aPR, 2.63; 95% CI, 2.57-2.68), current depression (38.0% vs 17.2%; aPR, 2.35; 95% CI, 2.23-2.48), and current anxiety (40.8% vs 17.1%; aPR, 2.57; 95% CI, 2.43-2.75) compared with those without the diagnoses., Conclusions and Relevance: Medical debt is prevalent among adults with depression and anxiety and may contribute to the mental health treatment gap. In the absence of structural reform, new policies are warranted to protect against this financial barrier to mental health care.

Purpose: This study analyzes the trajectory of youth emergency department or inpatient hospital visits for depression or anxiety in Illinois before and during the COVID-19 pandemic., Methods: We analyze emergency department (ED) outpatient visits, direct admissions, and ED admissions by patients ages 5-19 years coded for depression or anxiety disorders from 2016 through June 2023 with data from the Illinois Hospital Association COMPdata database. We analyze changes in visit rates by patient sociodemographic and clinical characteristics, hospital volume and type, and census zip code measures of poverty and social vulnerability. Interrupted times series analysis was used to test the significance of differences in level and trends between 51 pre-pandemic months and 39 during-pandemic months., Results: There were 250,648 visits to 232 Illinois hospitals. After large immediate pandemic decreases there was an estimated -12.0 per-month (p = 0.003, 95% CI -19.8-4.1) decrease in male visits and a - 13.1 (p = 0.07, 95% CI -27 -1) per-month decrease in female visits in the during-pandemic relative to the pre-pandemic period. The reduction was greatest for outpatient ED visits, for males, for age 5-9 and 15-19 years patients, for smaller community hospitals, and for patients from the poorest and most vulnerable zip code areas., Conclusions: llinois youth depression and anxiety hospital visit rates declined significantly after the pandemic shutdown and remained stable into 2023 at levels below 2016-2019 rates. Further progress will require both clinical innovations and effective prevention grounded in a better understanding of the cultural roots of youth mental health., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: The aim was to investigate psychological risk profiles of cardiovascular disease (CVD). Depression and anxiety have been linked to CVD, but research has not incorporated personality and sex-specific analyses are warranted. In this study, we examine the role of sex, neuroticism, extraversion, anxiety and depression on the risk of CVD., Method: Using data from the HUNT-study and the mortality register, 32,383 (57.10% men) participants were followed for an average of 10.48 years. During this time, 142 died of myocardial infarction (MI) and 111 of stroke., Results: Cox regression showed that depression (HR = 1.07, 95% CI = [1.00, 1.14]) and neuroticism (1.23 [1.08, 1.40]) were significantly related to an increased risk of MI. One standard unit increase in depression and neuroticism was associated with 1.22 [CI 1.01, 1.47] increase and 1.43 [CI 1.14, 0.78] increase in the risk of MI respectively. For stroke, there was no significant effect of anxiety, depression or personality. However, we found a significant interaction effect between sex and extraversion where higher extraversion was associated with greater risk of stroke for women only., Conclusions: Both neuroticism and depression were related to MI. We observed an interaction between extraversion and sex with stroke, but the effect size was small. The role of extroversion as a risk factor for CVD remains inconclusive.

Introduction: In South Africa, there is limited mental health infrastructure and resources. Valid screening tools are needed to facilitate identification and linkage to care. We evaluated the performance of Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Primary Care Post Traumatic Stress Disorder Screen for DSM-5 (PC-PTSD-5), and the Columbia Suicide Severity Rating Scale (C-SSRS) among adults in South Africa against a diagnostic gold standard., Methods: Adults present at healthcare facilities were screened with the PHQ-9, GAD-7, PC-PTSD-5, and the C-SSRS. Nurses used a structured diagnostic interview to identify depression, anxiety, panic disorder, PTSD and elevated suicide risk. We assessed the internal consistency, criterion validity, and the sensitivity and specificity of these tools., Results: Of the 1885 participants, the prevalence of common mental disorders and suicide risk was 24.4 % and 14.9 %, respectively. The PHQ-9, GAD-7, and PC-PTSD-5 showed good internal consistency (0.80-0.89). All screeners demonstrated good criterion validity. For depression, a cut-off of ≥5 on the PHQ-9 yielded sensitivity of 84.24 %, while ≥10 yielded sensitivity of 48.77 %. For anxiety, the GAD-7 performed similarly. A cut-off of ≥4 on the PC-PTSD yielded sensitivity of 61.96 %. The C-SSRS yielded lower sensitivity than expected., Limitations: The prevalence data is not generalizable to the larger South African adult population given the use of a targeted, healthcare facility-based sampling and recruitment strategy., Conclusions: The performance of the PHQ-9, GAD-7, and PC-PTSD-5 demonstrated good internal consistency and criterion validity, though sensitivity and specificity trade-offs were enhanced with lower cut-offs. Further research into suicide risk screening is warranted., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Introduction: The aim of the study was to investigate longitudinal trajectories of change in anxiety and depression symptoms in Polish adolescents during the second year of the COVID-19 pandemic and after the outbreak of the war in Ukraine. Additionally, we aimed to identify risk/protective factors and outcomes associated with these trajectories., Method: We collected data in three waves between November 2021 and May 2022. Adolescents ( N = 281 in the first wave) completed the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, the Filial Responsibility Scale for Youth, and questions related to the COVID-19 pandemic and war in Ukraine., Results: We identified three trajectories of depressive symptoms: resilient with low, stable symptoms (71% of participants), chronically elevated symptoms (11%), and acute symptoms followed by recovery (18%). We distinguished two trajectories of anxiety symptoms: resilient (75%) and chronic (25%). Non-resilient trajectories were predicted by higher levels of familial unfairness (perceived lack of equality and reciprocity in the family), relationship difficulties at school and at home, older age, and poor socioeconomic status. Chronic depressive and anxiety symptoms were associated with higher war-related concerns., Discussion: These findings can inform preventive and therapeutic interventions for at-risk adolescents to reduce negative long-term outcomes of social crises.

Background: Anxious depression is a prevalent subtype of depression associated with adverse outcomes such as higher depression severity and higher rates of suicidality. This study leveraged a state-wide research registry of depressed and/or suicidal youth to compare the prevalence, clinical correlates, and symptom patterns of those with versus without anxious depression., Methods: We included baseline data from 797 participants (ages 8-20) with a diagnosis of a depressive disorder. A score on the Generalized Anxiety Disorder Scale (GAD-7) ≥ 10 was used to define individuals with and without anxious depression. A structured battery was used to capture psychiatric diagnostic status, depression/anxiety severity, suicide risk, history of trauma, functioning, and resilience., Results: The prevalence of anxious depression among youth with depressive disorders was 59.5 % (n = 474). Youth with anxious depression had greater depression severity and anxiety symptoms, higher suicidality, and a higher prevalence of comorbid anxiety disorders than those without. Youth with anxious depression had greater impairment in functioning defined as worse pain interference, pain severity, fatigue, and social relationships compared to those without anxious depression. Youth with anxious depression also reported higher rates of depressive symptoms such as irritable mood, feelings of guilt, and psychomotor agitation compared to those without anxious depression., Conclusion: Anxious depression is associated with worse depression severity, higher suicidality, and lower functioning. Longitudinal work is needed to examine long-term courses of anxious depression to explore its stability as a diagnostic subcategory., Competing Interests: Declaration of competing interest Drs. Ayvaci, Nandy, Minhajuddin, Riddle, Hettema, and Slater and Ms. Gorman report no conflicts of interest. Dr. Storch reports receiving research funding to his institution from the Ream Foundation, International OCD Foundation, and NIH. He was formerly a consultant for Brainsway and Biohaven Pharmaceuticals in the past 12 months. He owns stock less than $5000 in NView. He receives book royalties from Elsevier, Wiley, Oxford, American Psychological Association, Guildford, Springer, Routledge, and Jessica Kingsley. Dr. Soutullo has been in the past 3 years a Consultant / Advisory Board member of: NeuroTech Solutions Ltd., Limbix Health & Big Health (DSMB) and Innosphere (ad hoc). He has served on the Speaker bureau of Bial, Medice, Rubio and Tecnofarma/Adium. He has received Departmental (non-personal) research funds from the Vivian L. Smith Foundation and the Favrot Fund, in support of the Child & Adolescent Mood Disorders Program (ChAMP Clinic). He receives book and Master courses royalties from Editorial Medica Panamericana. He is a full-time employee of The University of Texas (UT Health) Houston since 9/2019, where he is John S. Dunn Endowed Professor of Psychiatry and Behavioral Sciences since 3/2023. Dr. Wakefield serves as an Executive Committee Member of the Texas Child Mental Health Care Consortium. Dr. Trivedi has provided consulting services to Acadia Pharmaceuticals, Alkermes Inc., Alto Neuroscience Inc, Axsome Therapeutics, BasePoint Health management LLC, Biogen MA Inc, Cerebral Inc., Circular Genomics Inc., Compass Pathfinder Limited, Daiichi Sankyo Inc., GH Research, GreenLight VitalSign6 Inc, Heading Health, Janssen Pharmaceutical, Legion Health, Merck Sharp & Dohme Corp., Mind Medicine Inc., Myriad Neuroscience, Naki Health Ltd, Neurocrine Biosciences Inc., Noema Pharma AG, Orexo US Inc., Otsuka America Pharmaceutical Inc., Otsuka Europe LTD, Otsuka Pharmaceutical Development & Commercialization Inc., Praxis Precision Medicines Inc, PureTech LYT Inc, Relmada Therapeutics Inc., SAGE Therapeutics, Signant Health, Sparian Biosciences, Titan Pharmaceuticals, Takeda Pharmaceuticals Inc, WebMD. He has received grant/research funding from NIMH, NIDA, NCATS, American Foundation for Suicide Prevention, Patient-Centered Outcomes Research Institute (PCORI), Blue Cross Blue Shield of Texas, SAMHSA, and the DoD. Additionally, he has received editorial compensation from Elsevier and Oxford University Press., (Copyright © 2024 Elsevier B.V. All rights reserved.)

This study examined the relationships between current anxiety problems and school engagement, community service or volunteer work, and paid work among U.S. adolescents. The 2018-2019 National Survey of Children's Health (NSCH) dataset was analyzed and included 24,609 adolescents ages 12-17 years. We conducted unadjusted and adjusted logistic regression analyzes. A total of 12.6% of adolescents had healthcare provider-confirmed current anxiety problems. Adolescents with current anxiety were at decreased odds of engaging in school (aOR = 0.35, 95%CI = 0.29, 0.41) and participating in community service or volunteer work (aOR = 0.72, 95%CI = 0.59, 0.86) compared to adolescents without current anxiety. Adolescents with current anxiety were at increased odds of participating in paid work (OR = 1.18, 95%CI = 1.01, 1.38). This study reports that U.S. adolescents with anxiety were less likely to engage in school and participate in community service or volunteer work, but were more likely to participate in paid work compared to their peers without anxiety. Results should inform future interventions targeting adolescents., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Provisional Tic Disorder (PTD) is common in childhood. The received wisdom among clinicians is that PTD is short-lived and mild, with at most a few tics, and rarely includes complex tics, premonitory phenomena or comorbid illnesses. However, such conclusions come from clinical experience, with biased ascertainment and limited follow-up., Methods: Prospective study of 89 children with tics starting 0-9 months ago (median 4 months), fewer than half from clinical sources. Follow-up at 12 (± 24, 36, 48) months after the first tic., Results: At study entry, many children had ADHD (39), an anxiety disorder (27), OCD (9) or enuresis (17). All had at least two current tics, with a mean total since onset of 6.9 motor and 2.0 phonic tics. Forty-one had experienced a complex tic, and 69 could suppress some tics. Tics were clinically meaningful: 64 had tics severe enough for a clinical trial, and 76 families sought medical attention for the tics. At 12 months, 79 returned, and 78 still had tics. Of these, 29 manifested no tics during history and extended examination, but only via audio-visual monitoring when the child was seated alone. Only 12/70 now had plans to see a doctor for tics. Most who returned at 2-4 years still had tics known to the child and family, but medical impact was low., Conclusions: Our results do not contradict previous data, but overturn clinical lore. The data strongly argue against the longstanding but arbitrary tradition of separating tic disorders into recent-onset versus chronic., Competing Interests: Declaration of competing interest No relevant conflicts., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Globally, the rise in single-person households poses a potential risk to mental health, with generalized anxiety disorder (GAD) being a prominent concern. The proliferation of single-person households may exacerbate social isolation and foster loneliness and anxiety. Notably, research investigating the association between single-person households and GAD remains limited. Therefore, this study aimed to investigate the association between single-person households and GAD across sexes in Korea., Methods: We utilized data from the Korea National Health and Nutrition Examination Survey conducted in 2021 and 2022, comprising a sample of 9936 participants aged 19 or older. The Generalized Anxiety Disorder Screening Tool (GAD-7) was employed to assess anxiety levels in adults. Multiple logistic regression analysis was conducted to investigate the correlation between single-person households and GAD., Results: The reference variable used in the analysis was multi-person households (consisting of two or more individuals). The association between single-person households and GAD was statistically significant across sexes (male: odds ratio [OR]: 1.92, 95 % CI: 1.15-3.20; female: OR: 1.56, 95 % CI: 1.03-2.36). Participants in single-person households exhibited higher scores on the GAD-7 compared with those in multi-person households. Notably, marital status and education level displayed disparate effects based on sex, whereas physical activity demonstrated consistent effects irrespective of sex., Limitations: Given the use of cross-sectional data, only correlations could be established., Conclusion: The findings indicate an elevated risk of GAD in single-person households compared with multi-person households. Furthermore, promoting physical activity emerged as a potential strategy for mitigating GAD in single-person households., Competing Interests: Declaration of competing interest This manuscript has not been published or presented elsewhere in part or in entirety and is not under consideration by another journal. All study participants provided informed consent. We have read and understood your journal’s policies, and we believe that neither the manuscript nor the study violates any of these., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Introduction: Female infertility is a global issue that impacts on public health seriously and many mental disorders are observed in infertility groups., Methods: To investigate the casual relationship between those, genome-wide association studies summary data of anxiety disorder (n=9,897), broad depression (n=322,580), major depressive disorder (n=480,359 and n=500,199), bipolar disorder (n=51,710), insomnia (n= 462,341), and female infertility (n=126,342) were extracted from the existing datasets and was analyzed through the two-sample mendelian randomization study. The following heterogeneity and sensitivity test were applied to ensure the robustness of results., Results: Based on inverse variance weighted results, major depressive disorder was associated with female infertility (P = 0.0001, odds ratio 1.396, 95 % confidence interval 1.175-1.658). No causal relationship was identified between the other four mental disorders and infertility. was found. Additionally, reverse mendelian randomization did not indicate a causal relationship among these disorders., Discussion: The early identification and management of anxiety symptoms in women of reproductive age, in conjunction with the effective treatment of major depressive disorder, may be crucial for preserving female fertility., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Mao, Lin and Li.)

Background: Left undiagnosed and untreated, the association between multiple sclerosis and mental health difficulties significantly increases the multimorbidity risk in these patients. Hence, the purpose of this systematic review and meta-analysis was to estimate the prevalence of neuroticism, depression, and anxiety in MS and to explore the cumulative impact of these psychological factors on the disease expression., Methods: A literature search was conducted on PubMed, Web of Science, Scopus, and Google Scholar databases, according to the PRISMA guidelines. Also, the potential risk of bias was assessed using the AXIS tool., Result: After a rigorous full-text examination, among the 756 identified studies, 22 investigations were considered for the systematic review, and 10 studies were selected for the meta-analysis. The prevalence of neuroticism in the studied population was 24.06% (95% CI: 16.79-33.34), of depression 20.77% (95% CI: 7.67-33.88), while the presence of anxiety was found in 23.94% (95% CI: 6.21-40.36)., Conclusions: The main finding of this research confirms that psychiatric disorders often co-occur with MS, impacting the clinical symptoms and life quality of patients living with this illness. For a better understanding of the interaction between personality, depression, anxiety, and the disease symptoms, future research should consider conducting comparisons on more homogenous studies.

Background: This research aims to unravel the prevalence of postnatal emotional disorders with a focus on how postnatal anxiety remained under-estimated and often embroiled in postnatal depression., Methods: Out of 600 postnatal women invited to take part in this study from two prominent primary care clinics in Khartoum, 468 women agreed to participate in this study. Three questionnaires were utilized in this study, a Personal Information Questionnaire (PIQ), Hospital Anxiety and Depression Scale (HADS), and Beck depression Inventory (BDI). Multiple linear regression analysis applied to gauge risk factors with postnatal anxiety and depression., Results: More than half (52.50%) of women showed evidence of both anxiety and depression using HADS, while only (20.9%) of cases were detected by BDI, showing evidence of moderate depressive disorder. A substantial proportion (28.4%) showed high levels of comorbidity of anxiety and depression in the category of moderate to severe symptoms. Main risks factors for postnatal disorders were past psychiatric illness (β = 0.25, p = 0.001), a family history of psychiatric illness (β = 0.15, p = 0.002), and stress due to the number of children (β = 0.32, p = 0.001)., Conclusion: This study advances our understanding of postnatal emotional disorders, particularly highlighting the prevalence as well as correlates of postpartum anxiety. More importantly, this study highlights the importance of routine screen for emotional distress in postnatal women., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Osman, Osman, Osman and Hagar.)