Displaying publications 1 - 20 of 28 in total

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  1. Motevalli S, Salahshour HM, Bailey RP
    J Affect Disord, 2023 Oct 15;339:676-682.
    PMID: 37479040 DOI: 10.1016/j.jad.2023.07.043
    INTRODUCTION: This study aimed to examine the mediating role of cognitive flexibility in the relationship between cognitive emotion regulation strategies and mindfulness in patients with type 2 diabetes.

    METHODS: The research was conducted by correlation method) using Structural Equation Modeling). The statistical population consisted of all women and men with type 2 diabetes. Two hundred fifty-three samples were selected by convenience sampling method. The participants responded to the Cognitive Emotion Regulation Questionnaire, the Kentucky inventory of mindfulness skills, and the Cognitive Flexibility Inventory.

    RESULTS: The results showed that the total path coefficient between the adaptive cognitive emotion regulation strategies and mindfulness (β = 0.243, P = 0.005) was positive and significant, and the total path coefficient between the maladaptive cognitive emotion regulation strategies and mindfulness (β = -0.453, P = 0.001) was negative and significant. The path coefficient between cognitive flexibility and mindfulness (β = 0.273, P = 0.009) was positive and significant. The indirect path coefficient between the adaptive cognitive emotion regulation strategies and mindfulness (β = 0.094, P = 0.007) was positive and significant, and the indirect path coefficient between the maladaptive cognitive emotion regulation strategies and mindfulness (β = -0.117, P = 0.009) was negative and significant.

    CONCLUSION: Improving emotion regulation skills increases cognitive flexibility and mindfulness in patients with type 2 diabetes.

  2. Srisurapanont M, Likhitsathian S, Chua HC, Udomratn P, Chang S, Maneeton N, et al.
    J Affect Disord, 2015 Nov 1;186:26-31.
    PMID: 26226430 DOI: 10.1016/j.jad.2015.06.032
    BACKGROUND: Little has been known regarding the correlates of severe insomnia in major depressive disorder (MDD). This post-hoc analysis aimed to examine the sociodemographic and clinical correlates of severe insomnia in psychotropic drug-free, Asian adult outpatients with MDD.
    METHODS: Participants were psychotropic drug-free patients with MDD, aged 18-65 years. By using the Symptom Checklist-90 Items, Revised (SCL-90-R), a score of 4 (severe distress) on any one of three insomnia items was defined as severe insomnia. Other measures included the Montgomery-Asberg Depression Rating Scale (MADRS), the Fatigue Severity Scale (FSS), the nine psychopathology subscales of SCL-90-R, the Physical and Mental Component Summaries of Short Form Health Survey (SF-36 PCS and SF-36 MCS), and the Sheehan Disability Scale (SDS).
    RESULTS: Of 528 participants, their mean age being 39.5 (SD=13.26) years, 64.2% were females, and 239 (45.3%) had severe insomnia. The logistic regression model revealed that low educational qualifications (less than secondary school completion), high SCL-90-R Depression scores, high SCL-90-R Anxiety scores, and low SF-36 PCS scores were independently correlated with severe insomnia (p's
  3. Ramzi NH, Auvinen J, Veijola J, Miettunen J, Ala-Mursula L, Sebert S, et al.
    J Affect Disord, 2023 Jun 15;331:1-7.
    PMID: 36933669 DOI: 10.1016/j.jad.2023.03.026
    BACKGROUND: The fact that a complex relationship exists between alexithymia and body mass index (BMI) is well established, but the underlying mechanisms remain poorly understood. Here, we explore the relationship between alexithymia and depressive symptoms in relation to adiposity measures, including the direct and indirect effect of alexithymia and depressive symptoms on obesity over a 15-year time-period, in the Northern Finland Birth Cohort 1966 (NFBC1966).

    METHODS: The study included individuals from the Northern Finland Birth Cohort 1966 (NFBC1966) who had available data for adiposity measures (body mass index and waist-to-hip ratio), alexithymia (measured by the 20-Item Toronto Alexithymia Scale: TAS-20), depressive symptoms (measured by the 13-item depression subscale of Hopkins Symptom Checklist: HSCL-13) at age of 31 years (n = 4773) and 46 years (n = 4431). Pearson's (r) correlation, and multiple linear regression were used to investigate the relationships between alexithymia, depressive symptoms, and adiposity measures. The potential mediating role of depressive symptoms was examined via Hayes' procedure (PROCESS).

    RESULTS: Positive correlations were confirmed between adiposity measures (BMI and WHR) and the TAS-20 score (and its subscale), but not between obesity and HSCL-13 score. The strongest correlation was between the DIF (difficulty identifying feelings) subscale of the TAS-20 and HSCL-13 at both time points (31 y: r(3013) = 0.41, p 

  4. Quintana GR, Ponce FP, Escudero-Pastén JI, Santibáñez-Palma JF, Nagy L, Koós M, et al.
    J Affect Disord, 2024 Apr 01;350:991-1006.
    PMID: 38244805 DOI: 10.1016/j.jad.2024.01.127
    BACKGROUND: Depression and anxiety are among the most prevalent mental health issues experienced worldwide. However, whereas cross-cultural studies utilize psychometrically valid and reliable scales, fewer can meaningfully compare these conditions across different groups. To address this gap, the current study aimed to psychometrically assess the Brief Symptomatology Index (BSI) in 42 countries.

    METHODS: Using data from the International Sex Survey (N = 82,243; Mage = 32.39; SDage = 12.52; women: n = 46,874; 57 %), we examined the reliability of depression and anxiety symptom scores of the BSI-18, as well as evaluated evidence of construct, invariance, and criterion-related validity in predicting clinically relevant variables across countries, languages, genders, and sexual orientations.

    RESULTS: Results corroborated an invariant, two-factor structure across all groups tested, exhibiting excellent reliability estimates for both subscales. The 'caseness' criterion effectively discriminated among those at low and high risk of depression and anxiety, yielding differential effects on the clinical criteria examined.

    LIMITATIONS: The predictive validation was not made against a clinical diagnosis, and the full BSI-18 scale was not examined (excluding the somatization sub-dimension), limiting the validation scope of the BSI-18. Finally, the study was conducted online, mainly by advertisements through social media, ultimately skewing our sample towards women, younger, and highly educated populations.

    CONCLUSIONS: The results support that the BSI-12 is a valid and reliable assessment tool for assessing depression and anxiety symptoms across countries, languages, genders, and sexual orientations. Further, its caseness criterion can discriminate well between participants at high and low risk of depression and anxiety.

  5. Norhayati MN, Hazlina NH, Asrenee AR, Emilin WM
    J Affect Disord, 2015 Apr 1;175:34-52.
    PMID: 25590764 DOI: 10.1016/j.jad.2014.12.041
    BACKGROUND: The prevalence of postpartum depression worldwide varies from 0.5% to 60.8% in the first 12 months postpartum using self-reported questionnaire. This review aims to update the current magnitude of postpartum depression based on self-reported questionnaire and clinical interview and explore its associated factors in developed and developing countries.
    METHODS: A literature search conducted between 2005 and 2014 identified 203 studies, of which 191 used self-reported questionnaire in 42 countries and 21 used structured clinical interview in 15 countries. Nine studies used a combination of self-reported questionnaire and clinical interview.
    RESULT: The prevalence of postpartum depression varies from 1.9% to 82.1% in developing countries and from 5.2% to 74.0% in developed countries using self-reported questionnaire. Structured clinical interview shows a much lower prevalence range from 0.1% in Finland to 26.3% in India. Antenatal depression and anxiety, previous psychiatric illness, poor marital relationship, stressful life events, negative attitude towards pregnancy, and lack of social support are significant contributors to postpartum depression.
    LIMITATION: All studies are included irrespective of the methodological quality, such as small sample size and their inclusion could affect the generalizability of the results.
    CONCLUSION: The current prevalence of postpartum depression is much higher than that previously reported, and similar risk factors are documented. A culturally sensitive cut-off score with adequate psychometric properties of the screening instruments should be available. In future studies, examining the physical, biological, and cultural factors in qualitative studies and in those with adequate methodological qualities is recommended.
    KEYWORDS:Epidemiology; Postpartum depression; Prevalence; Risk factors
  6. Srisurapanont M, Bautista D, Chen CH, Wang G, Udomratn P, Eurviriyanukul K
    J Affect Disord, 2015 Jan 15;171:105-10.
    PMID: 25303026 DOI: 10.1016/j.jad.2014.09.007
    BACKGROUND: Subjective cognitive impairment (SCI) in major depressive disorder (MDD) is prevalent and correlated with disability. This study aimed to examine the prevalence rates and correlates of subjective memory deficit (SMD) and subjective concentration deficit (SCD) in medication-free, non-elderly Asians with MDD.
    METHODS: The SMD and SCD were assessed by using two items of the Symptom Checklist-90-Revised (SCL-90-R). Other measurements of interest included the Montgomery-Asberg Depression Rating Scale (MADRS), the Fatigue Severity Scale (FSS), the Sheehan Disability Scale (SDS), and the Short Form Health Survey (SF-36). Adjusted odds ratios with 95% confidence intervals were calculated.
    RESULTS: Of 515 participants from China, Korea, Malaysia, Singapore, Taiwan, and Thailand, 347 (67.4%) and 377 (73.2%) had SMD and SCD, respectively. In total, 420 participants (81.6%) had SMD alone, SCD alone, and both deficits. Severe depression and poor mental health were significant correlates of SMD. Severe depression, clinically significant disability, poor physical health, and poor mental health were significantly independent correlates of SCD. Compared with young adults (18-34 years), older adults aged 50-65 years had a significantly lower risk of SCD (OR=.33, 95% CI: .19-.57).
    LIMITATIONS: Only two SCL-90-R items were used to assess the SMD and SCD. The exclusion of MDD patients treated with psychotropic medications eliminated many patients commonly seen in typical clinic settings.
    CONCLUSION: SMD and SCD are prevalent in medication-free, non-elderly Asians with MDD. Both deficits are correlated with depression and mental health status. The independent correlation between SCD and disability underscores the crucial role of SCI in MDD.
    KEYWORDS: Asian; Cognitive impairment; Depressive disorders; SCL-90-R; Subjective
  7. Nicolosi A, Moreira ED, Villa M, Glasser DB
    J Affect Disord, 2004 Oct 15;82(2):235-43.
    PMID: 15488252 DOI: 10.1016/j.jad.2003.12.008
    BACKGROUND:
    Depression and erectile dysfunction (ED) have a complex and bi-directional relationship. We examined the relationships between erectile dysfunction and depressive symptoms or diagnosed depression, sexual activity and sexual satisfaction.

    METHODS:
    A population survey of men aged 40-70 years was carried out in Brazil, Italy, Japan and Malaysia in 1997-1998. A questionnaire was used to collect life style, sexual behaviors and medical data. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. ED was classified as moderate or complete if the men reported they were "sometimes" or "never" able to achieve and maintain an erection satisfactory for sexual intercourse. Only men with a sexual partner and not taking psychoactive drugs were considered.

    RESULTS:
    Diagnosed depression was reported by 2.0% of the men, depressive symptoms by 21.0%. The prevalence of moderate or complete ED was 17.8%. Sexual satisfaction related to the frequency of sexual intercourse and inversely related to depressive symptoms. Depressive symptoms were positively associated with being single (odds ratio [OR] 1.7), widowed, separated or divorced (OR 2.2), moderate or complete ED (1.8), heart disease (1.6) and smoking (1.6), and negatively associated with age, physical activity and frequency of sexual intercourse.

    LIMITATIONS:
    Cross-sectional studies cannot establish a temporal cause-effect relationship. However, the confirmation of known associations reassures about the validity of the original findings.

    CONCLUSIONS:
    The findings suggest that depressive symptoms are linked to ED by the mediation of decreased sexual activity and the dissatisfaction generated by the inability to have a healthy sexual life.
  8. Ho SC, Chong HY, Chaiyakunapruk N, Tangiisuran B, Jacob SA
    J Affect Disord, 2016 Mar 15;193:1-10.
    PMID: 26748881 DOI: 10.1016/j.jad.2015.12.029
    Medication non-adherence is one of the major challenges in treating patients with depression. This systematic review aims to determine the clinical and economic outcomes of non-adherence in depression.
  9. Srisurapanont M, Mok YM, Yang YK, Chan HN, Della CD, Zainal NZ, et al.
    J Affect Disord, 2018 05;232:237-242.
    PMID: 29499506 DOI: 10.1016/j.jad.2018.02.014
    BACKGROUND: Several studies have described the presence of perceived cognitive dysfunction amongst Asian patients with major depressive disorder (MDD). To date, no study has been conducted investigating the predictors of perceived cognitive dysfunction amongst Asian MDD patients.

    METHODS: This was a post-hoc analysis of the Cognitive Dysfunction in Asian patients with Depression (CogDAD) study. Descriptive statistics were used to describe the most common cognitive complaints by patients. Univariate and multivariate analyses were performed to determine variables associated with perceived cognitive dysfunction (Perceived Deficit Questionnaire-Depression, PDQ-D).

    RESULTS: The CogDAD study population is comprised of MDD patients with mild-to-moderate depression (Patient Health Questionnaire 9-item [PHQ-9]: 11.3 ± 6.9) who reported perceived cognitive dysfunction (PDQ-D = 22.6 ± 16.2). The most common cognitive complaints were: mind drifting (42.3%), trouble making decision (39.6%) and trouble concentrating (38.0%). Predictors of perceived cognitive dysfunction were: being Southeast Asians (vs. Taiwanese) (p 

  10. Halbreich U, Karkun S
    J Affect Disord, 2006 Apr;91(2-3):97-111.
    PMID: 16466664 DOI: 10.1016/j.jad.2005.12.051
    BACKGROUND:
    The prevalence of postpartum depression (PPD) is currently considered to be 10-15%. Most studies were performed with a brief unidimensional instruments (mostly the Edinburgh Postnatal Depression Scale-EPDS) with focus on depression and not on other symptoms and disorders. Most cited studies were conducted in Western economically developed countries.

    METHODS:
    We reviewed the literature on prevalence of postpartum depression and depressive symptoms in a wide range of countries.

    RESULTS:
    143 studies were identified reporting prevalence in 40 countries. It is demonstrated that there is a wide range of reported prevalence of PPD ranging from almost 0% to almost 60%. In some countries like Singapore, Malta, Malaysia, Austria and Denmark there are very few reports of PPD or postpartum depressive symptoms, whereas in other countries (e.g. Brazil, Guyana, Costa Rica, Italy, Chile, South Africa, Taiwan and Korea) reported postpartum depressive symptoms are very prevalent.

    CONCLUSIONS:
    We believe that the widely cited mean prevalence of PPD-10-15% is not representative of the actual global prevalence and magnitude of the problem, due to the wide range of reports. The variability in reported PPD might be due to cross-cultural variables, reporting style, differences in perception of mental health and its stigma, differences in socio-economic environments (e.g. poverty, levels of social support or its perception, nutrition, stress), and biological vulnerability factors. The elucidation of the underlying processes of this variability as well as the diversity of postpartum normal versus abnormal expressions of symptoms may contribute to better understanding of the diversified ante, peri- and postpartum phenomena.
  11. Eskin M, Baydar N, Harlak H, Hamdan M, Mechri A, Isayeva U, et al.
    J Affect Disord, 2021 11 01;294:366-374.
    PMID: 34315098 DOI: 10.1016/j.jad.2021.07.050
    BACKGROUND: Research on suicidality in low to middle-income countries is scarce. We addressed this issue by investigating suicidality in a cross-national college student samples from 11 predominantly low to middle-income majority Muslim countries.

    METHODS: The sample consisted of 7427 college students (56% female) who reported to be affiliated with Islam. Data on self-construal, social support, negative life-events, acceptability of suicide, suicidal ideation, and suicide attempts were collected with self-administered questionnaires.

    RESULTS: Acceptability of suicide and the experience of negative life-events were positively, and perceived social support was negatively associated with suicidal ideation. Interdependent self-construal was negatively related to the acceptability of suicide and positively associated with perceived social support, implying a negative indirect effect on suicidal ideation although its direct effect was positive. The number of negative life-events was the strongest positive predictor of ever attempting suicide. The interdependent self-construal moderated the association of negative life-events with suicide attempts.

    LIMITATIONS: Cross-sectional and self-report nature of the study were its major limitations. Participants may have suppressed their responses about suicide because of religious and legal reasons.

    CONCLUSION: Remarkable similarities across 11 country samples emerged in the linkages between cultural and interpersonal factors with suicidality. Our findings highlight the value of a nuanced approach to suicidality, that can recognize the differences in the processes associated with suicidal ideation and suicide attempts, as well as the need to consider the interplay of a broad range of personal, interpersonal, and cultural influences.

  12. Song Y, Bai W, Wang M, Liu X, Zhang L, Yu W, et al.
    J Affect Disord, 2019 12 01;259:195-200.
    PMID: 31446380 DOI: 10.1016/j.jad.2019.08.042
    BACKGROUND: Suicide is a major global mental health problem among college students. The aim of the current study was to explore the association between the psychological strains of the strain theory of suicide and suicidal behaviors among college students.

    METHODS: Participants comprised 1912 college students (16-28 years old, 47.2% female) from three universities in Jilin Province, China, who completed the self-report assessments of psychological strains (40 items Psychological Strains Scale) and suicidal behaviors (Suicidal Behaviors Questionnaire-Revised). The demographic characteristics included four variables: health status, psychological status, academic status and economic status.

    RESULTS: Approximately 15.0% (286/1912) of participants were classified as having suicide risk, based on the cut-off scores of the SBQ-R. The prevalence of suicidal behaviors among males and females was 11.9% (120/1009) and 18.4% (166/903), respectively. Value strain (OR = 1.075, 95%CI: 1.057-1.094), aspiration strain (OR = 1.082, 95%CI: 1.064-1.101), deprivation strain (OR = 1.073, 95%CI: 1.052-1.093), and coping strain (OR = 1.095, 95%CI: 1.075-1.116) were risk factors for suicidality in college students. Coping strain (OR = 1.050, 95%CI: 1.023-1.077) was still positively associated with suicide risk in multivariate logistic regression. Logistic regression analysis indicated that coping strain had the highest correlation with suicidal behaviors.

    LIMITATIONS: The directionality of the relationships cannot be deduced because this study is cross-sectional.

    CONCLUSION: This study confirms a strong association between psychological strains and suicidal behaviors in college students. Some measures can be taken to reduce psychological strains to mitigate suicide risk among college students. More studies investigating coping strain among college students are warranted.

  13. Han Q, Jocson R, Kunovski I, Raleva M, Juhari R, Okop K, et al.
    J Affect Disord, 2024 Jun 01;354:302-308.
    PMID: 38479502 DOI: 10.1016/j.jad.2024.03.063
    BACKGROUND: Parenting stress has long been proposed as a major risk factor for child maltreatment. However, there is a lack of evidence from existing studies on the temporal sequence to establish a causal relationship. This study aims to examine bidirectional temporal relationships between parenting stress and child maltreatment.

    METHODS: Longitudinal data from two different sources were analysed: a pre-post study of an online parenting programme conducted across six countries - the ePLH Evaluation Study, and a prospective cohort study in the United States - LONGSCAN. Cross-lagged panel model on parenting stress and child maltreatment was used in each dataset.

    RESULTS: Based on repeatedly measured data of 484 caregivers in the ePLH study across five time points (every two weeks), we found that parenting stress at an earlier time point predicted later child maltreatment (IRR = 1.14, 95 % CI: 1.10,1.18). In addition, the occurrence of child maltreatment was associated with higher subsequent short-term parenting stress (IRR = 1.04, 95 % CI: 1.01,1.08) and thus could form a vicious circle. In the LONGSCAN analysis with 772 caregivers who were followed up from child age of 6 to child age of 16, we also found parenting stress at an earlier time point predicted later child maltreatment (β = 0.11, 95 % CI: 0.01,0.20), but did not observe an association between child maltreatment and subsequent long-term parenting stress.

    LIMITATIONS: Potential information bias on the measurements.

    CONCLUSIONS: This study provides evidence for a bidirectional temporal relationship between parenting stress and child maltreatment, which should be considered in parenting intervention programmes.

  14. Balakrishnan V, Ng KS, Kaur W, Govaichelvan K, Lee ZL
    J Affect Disord, 2022 Feb 01;298(Pt B):47-56.
    PMID: 34801606 DOI: 10.1016/j.jad.2021.11.048
    BACKGROUND: This systematic review and meta-analysis aim to synthesize the extant literature reporting the effects of COVID-19 pandemic based on the pooled prevalence of depression among affected populations in Asia Pacific, as well as its risk factors.

    METHOD: A systematic review and meta-analysis approach was adopted as per the PRISMA guidelines, targeting articles published in PubMed, Google Scholar and Scopus from January 2021 to March 30, 2021. The screening resulted in 82 papers.

    RESULTS: The overall pooled depression prevalence among 201,953 respondents was 34% (95%CI, 29-38, 99.7%), with no significant differences observed between the cohorts, timelines, and regions (p > 0.05). Dominant risk factors found were fear of COVID-19 infection (13%), gender (i.e., females; 12%) and deterioration of underlying medical conditions (8.3%), regardless of the sub-groups. Specifically, fear of COVID-19 infection was the most reported risk factor among general population (k = 14) and healthcare workers (k = 8). Gender (k = 7) and increased workload (k = 7) were reported among healthcare workers whereas education disruption among students (k = 7).

    LIMITATION: The review is limited to articles published in three electronic databases. Conclusion The pandemic has caused depression among the populations across Asia Pacific, specifically among the general population, healthcare workers and students. Immediate attention and interventions from the concerned authorities are needed in addressing this issue.

  15. Zhang J, Huen JMY, Lew B, Chistopolskaya K, Talib MA, Siau CS, et al.
    J Affect Disord, 2020 06 15;271:279-285.
    PMID: 32479327 DOI: 10.1016/j.jad.2020.03.076
    BACKGROUND: The etiological factors of mood disorders and psychopathologies are understudied. In this paper, we explored whether social psychological strains are related to depression, anxiety, and stress in non-clinical populations.

    METHODS: 6,305 college students (39.3% men; 60.7% women) from six Chinese provincial-level jurisdictions completed a paper-and-pencil survey with Psychological Strain Scales (PSS-40) and Depression, Anxiety, and Stress Scales-21 (DASS-21), both validated in Chinese populations.

    RESULTS: Both PSS-40 and DASS-21 have high internal consistency reliabilities, and are highly correlated with each other. Hence, Chinese college students with greater psychological strains (value, aspiration, deprivation, or coping) have greater depression, anxiety, and stress. These results still held after controlling for relevant socio-demographic variables in the multiple regression models.

    LIMITATIONS: This was a cross-sectional study, and the sample only included several provinces in mainland China, not a representative sample of all of them.

    CONCLUSIONS: Mood disorders and psychopathologies are linked to suicidal thoughts and behaviors. The results of this study extend the Strain Theory of Suicide from explaining the risk factors of suicidality to mood disorders and psychopathologies. Hence, these findings can inform prevention measures among college students, and possibly the general population.

  16. Zhao S, Zhang J, Liu Y, Ji H, Lew B
    J Affect Disord, 2020 01 01;260:105-110.
    PMID: 31494361 DOI: 10.1016/j.jad.2019.09.006
    BACKGROUND: Previous research on the relationship between life satisfaction and its influencing factors has mainly focused on the work domain. Psychological strains, which result from these stress-related outcomes, have not been paid enough attention to explain how it correlates negatively with life satisfaction.

    METHOD: A cross-sectional study was conducted, using questionnaires sent to selected medical staff in a public hospital in Shandong, China (N = 1012). Multiple regression analysis was used to investigate how psychological strains influencing life satisfactions among medical staff.

    RESULTS: The findings indicate that aspiration strain and deprivation strain have significantly negative impact on medical staff's life satisfaction even with other variables controlled for. Weekly working hour was a significant predictor for life satisfaction. Family factors, such as marital status and kids in the family as well as social support were important factors in influencing individuals' life satisfaction.

    CONCLUSION: The current study highlights the negative associations between aspiration strain, deprivation strain and life satisfaction. The result underlines the importance of actions taken to prevent and combat psychological strains. It also provides some evidence for policy makers to improve the work environment for medical staff, such as reduce weekly working hours and enhance social support in order to increase medical staff's life satisfaction.

  17. He L, Soh KL, Huang F, Khaza'ai H, Geok SK, Vorasiha P, et al.
    J Affect Disord, 2023 Jan 15;321:304-319.
    PMID: 36374719 DOI: 10.1016/j.jad.2022.10.026
    BACKGROUND: No meta-analysis has analyzed the effect of physical activity level, period of physical activity intervention, and duration of intervention, on perinatal depression. This study was to evaluate the impact of physical activity intensity, dose, period, and duration on perinatal depression.

    METHODS: The literature was searched via the PubMed, Embase, Cochrane Library, and Web of Science databases. Weighted mean difference (WMD) or the risk ratio (RR) was used as the effect indicator, and the effect size was represented by the 95 % confidence interval (CI). Subgroup analysis based on the perinatal stage, physical activity intensity, physical activity equivalent, and intervention duration was performed.

    RESULTS: Totally, 35 studies including 5084 women were included. Physical activity could reduce the incidence and severity of depression in perinatal women. Among depressed women with prenatal depression, low-intensity physical activity, with metabolic equivalents (METs)-min/week being <450, was associated with lower levels of depression. In the general population, the risk of postpartum depression was lower in the physical activity group when the duration of intervention was ≥12 weeks, being II, III stage, and ≥450 METs-min/week. Both low and moderate-intensity physical activity were beneficial to an improved depression severity among depressed women with postpartum depression, and moderate exercise intervention could decrease the risk of postpartum depression in general pregnant women.

    LIMITATIONS: Different types of physical activities may affect the effectiveness of interventions.

    CONCLUSION: Our study indicated physical activity specifically targeted at pregnant women could reduce depression risk and severity.

  18. Saravanan C, Alias A, Mohamad M
    J Affect Disord, 2017 10 01;220:108-116.
    PMID: 28618312 DOI: 10.1016/j.jad.2017.05.037
    BACKGROUND: Students who go to other countries for higher education face various psychological problems, particularly homesickness and depression. The objectives of this study were to: (a) identify differences between students who did and did not receive brief individual cognitive behavioural therapy (CBT) for depression to reduce homesickness; (b) identify whether brief individual CBT for depression reduces the level of homesickness in students between pre-, post- and follow-up assessment; and (c) compare the scores of students experiencing only homesickness and those experiencing both homesickness and depression.

    METHOD: The sample consisted of 520 first-year undergraduate international students. The experimental group contained students who were diagnosed with depression and homesickness and received seven sessions of brief individual CBT for depression to reduce homesickness. The control group contained students who were diagnosed with depression and homesickness and received one session of advice and suggestions. The comparison group contained students who experienced only homesickness and did not receive any interventions. The study used the comparison group to determine if an interaction effect existed between students experiencing only homesickness and students experiencing both homesickness and depression.

    RESULTS: Students who received brief individual CBT displayed a significant reduction in their homesickness and depression scores compared to the scores of students in the control group. Students who experienced only homesickness exhibited a significant reduction in the scores on homesickness in the post-assessment compared to the control group's post-assessment homesickness scores.

    LIMITATION: The results of this study cannot be generalized as data were collected from three universities in Malaysia. The follow-up assessment was conducted six months after the post-assessment, which also limits generalizability beyond six months.

    CONCLUSION: Overall, homesickness is considered a normal reaction. Brief individual CBT for depression is effective in reducing homesickness and depression among international students.

  19. Hasanah CI, Khan UA, Musalmah M, Razali SM
    J Affect Disord, 1997 Nov;46(2):95-9.
    PMID: 9479613
    Forty-five hospitalised patients with DSM-III-R diagnosis of mania, were found to have a mean red-cell folate level of 193 nmol/l, as compared to 896 nmol/l in the control group (P < 0.00001). Assessment of serum folate in both groups showed no significant differences in the levels. Furthermore the manic patients and the controls were matched by the socio-economic status. This indicated that the reduced red-cell folate in mania is associated with the illness and not due to reduced absorption or dietary deficiency of folate. Considering previous studies that showed reduced red-cell folate in depression, our findings suggest that reduced red-cell folate occurred in both phases of bipolar disorders.
  20. Fountoulakis KN, Vrublevska J, Abraham S, Adorjan K, Ahmed HU, Alarcón RD, et al.
    J Affect Disord, 2024 Feb 19.
    PMID: 38382816 DOI: 10.1016/j.jad.2024.02.050
    BACKGROUND: The COVID-19 pandemic has brought significant mental health challenges, particularly for vulnerable populations, including non-binary gender individuals. The COMET international study aimed to investigate specific risk factors for clinical depression or distress during the pandemic, also in these special populations.

    METHODS: Chi-square tests were used for initial screening to select only those variables which would show an initial significance. Risk Ratios (RR) were calculated, and a Multiple Backward Stepwise Linear Regression Analysis (MBSLRA) was followed with those variables given significant results at screening and with the presence of distress or depression or the lack of both of them.

    RESULTS: The most important risk factors for depression were female (RR = 1.59-5.49) and non-binary gender (RR = 1.56-7.41), unemployment (RR = 1.41-6.57), not working during lockdowns (RR = 1.43-5.79), bad general health (RR = 2.74-9.98), chronic somatic disorder (RR = 1.22-5.57), history of mental disorders (depression RR = 2.31-9.47; suicide attempt RR = 2.33-9.75; psychosis RR = 2.14-10.08; Bipolar disorder RR = 2.75-12.86), smoking status (RR = 1.15-5.31) and substance use (RR = 1.77-8.01). The risk factors for distress or depression that survived MBSLRA were younger age, being widowed, living alone, bad general health, being a carer, chronic somatic disorder, not working during lockdowns, being single, self-reported history of depression, bipolar disorder, self-harm, suicide attempts and of other mental disorders, smoking, alcohol, and substance use.

    CONCLUSIONS: Targeted preventive interventions are crucial to safeguard the mental health of vulnerable groups, emphasizing the importance of diverse samples in future research.

    LIMITATIONS: Online data collection may have resulted in the underrepresentation of certain population groups.

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