Background Anxious depression, defined by coexisting anxiety and depressive symptoms, has been associated with poorer treatment outcomes, though findings remain inconsistent. This study examined whether anxious depression influences antidepressant efficacy in an Asian population. Methods This multicenter, single‐blind study across five hospitals was conducted in Taiwan from May 2006 to December 2009. Patients aged 18 and older with major depressive disorder (MDD) were diagnosed and treated with either escitalopram or paroxetine. The Hamilton Rating Scale for Depression (HAM‐D) and the Beck Depression Inventory‐II (BDI‐II) assessed outcomes. Anxious depression was defined as a HAM‐D anxiety factor score ≥ 7. We assessed treatment efficacy by remission and response rates, as well as changes in depression scores. Results The study included 302 patients, of whom 193 were classified as having anxious depression and 109 as having nonanxious depression. No significant differences were observed in treatment dosage or duration between the anxious and nonanxious depression groups. HAM‐D‐defined remission rates were 40.4% and 43.1%, respectively (adjusted OR = 0.9, 95% CI = 0.6–1.5, and p = 0.651), and response rates were 62.2% and 56.9% (adjusted OR = 1.2, 95% CI = 0.7–1.9, and p = 0.517). The anxious depression group showed a greater reduction in HAM‐D scores (−13.0 vs. −10.4; adjusted mean difference = −1.9, 95% CI = −3.5 to −0.4, and p = 0.014), whereas the percentage change did not differ significantly between groups (adjusted p = 0.529). BDI‐II outcomes likewise showed no significant between‐group differences. Time to remission (log‐rank p = 0.599) and response (log‐rank p = 0.264) also did not differ significantly. Conclusions In this Taiwanese multicenter outpatient cohort, anxious depression was not significantly associated with lower remission or response rates during 8 weeks of treatment with escitalopram or paroxetine. These findings contribute to the limited evidence on antidepressant outcomes among Asian outpatients with anxious depression. However, the absence of statistically significant differences should not be interpreted as evidence of equivalence, and further prospective studies with larger and better‐balanced samples are needed to confirm these findings. Trial Registration: ClinicalTrials.gov identifier: NCT00384020
Background While peer support can alleviate depressive symptoms of college students, peers' willingness to intervene and factors associated with this willingness remain understudied. This study aims to (1) develop and validate a Bystander Intervention Willingness for Depression (BIWD) scale for Chinese college students and (2) identify key sociodemographic and sociopsychological correlates of willingness.Methods A cross-sectional study was conducted from May to June 2024. A 13-item BIWD scale based on the Bystander Intervention Model was assessed using exploratory (n = 217) and confirmatory (n = 1008) factor analyses. Linear regression models examined associations between BIWD scores and sociodemographic factors, social perceptions, and mental health indicators.Results The BIWD scale comprised four dimensions: depression-related cognition, intervention responsibility, bystander effect resistance, and self-efficacy. Older age, higher socioeconomic status, stronger personal anti-stigma attitude, greater interpersonal closeness, and stronger social support were associated with higher BIWD scores. Students with depressive or anxiety symptoms showed higher depression-related cognition, but lower intervention responsibility, self-efficacy, and higher susceptibility to bystander effects.Conclusions Findings support the BIWD scale as a useful tool for assessing peer intervention willingness. Initiatives to reduce personal stigma, family functioning enhancement, and targeted self-efficacy training, especially for students experiencing mental health symptoms, may strengthen peer-based support for depression.
Recent studies have highlighted the adverse impact of social‐media distractions on cognitive abilities, especially among individuals with anxiety who experience heightened apprehensions about providing immediate online social responses. Nevertheless, the investigation into the mechanism is scarce. In this fMRI study, 94 healthy adults completed a 2‐back working memory (WM) task under three conditions using a between‐subject design: social media‐like cue distraction (e.g., WeChat), nonsocial digital distraction (e.g., browser), and no distraction. Data were analyzed using task‐evoked activation analysis based on the general linear model (GLM) and functional network connectivity (FNC) analysis based on independent component analysis (ICA). Results showed that social media‐like cue distraction impaired WM and altered posterior cingulate cortex (PCC) activity. Crucially, under the social media‐like cue distraction condition, the brain–behavior relationship in the PCC was significantly moderated by trait social anxiety: higher social anxiety predicted a positive coupling between PCC activation and task accuracy, with decreased PCC activation associated with decreased accuracy; conversely, individuals with low social anxiety exhibited decreased PCC activation together with increased accuracy. This study is the first to demonstrate that cues resembling social media can specifically disrupt core brain regions of the default mode network (DMN; PCC) functions during WM tasks and that this neural response is influenced by individual levels of social anxiety.
Background With the increasing prevalence of internet use among younger age groups, internet addiction and its associated mental health problems, particularly depression and anxiety, have attracted increasing public attention. Although studies have revealed an association between internet addiction and mental health, there is still a lack of in‐depth understanding of the interactions among specific symptoms and differences between children and adolescents. A network analysis approach was adopted to address these issues. Methods A total of 12,779 participants aged 10–18 years completed the Internet Addiction Test (IAT), Patient Health Questionnaire‐9 (PHQ‐9), and Generalized Anxiety Disorder‐7 (GAD‐7) through an online platform. Symptom networks of internet addiction, depression, and anxiety were constructed separately for children and adolescents and compared between the two groups. Results The most central symptoms were consistent across the two groups (children and adolescents), including “ anticipation ” (IAT11), “ neglect chores to spend more time online ” (IAT2), and “ uncontrollable worrying ” (GAD2). Bridge symptoms were also similar across the two groups, including “ nervousness ” (GAD1), “ irritability ” (GAD6), and “ restlessness ” (GAD5). However, there were significant differences in network structure, with adolescents exhibiting stronger within‐community (within‐syndrome) edges and children exhibiting stronger between‐community (cross‐syndrome) edges. Conclusions This study revealed similarities and differences in the network structures of internet addiction, depression, and anxiety between children and adolescents. These findings may provide a basis for targeted intervention strategies.
Introduction Problematic pornography use (PPU) has been associated with symptoms of depression and anxiety. These associations have been studied in clinical and adolescent samples, but little attention has been paid to gender differences in international general population samples. This study examined relationships between PPU, anxiety symptoms, and depression symptoms, with a focus on potential gender differences. Method Data were obtained from the International Sex Survey (ISS), a large‐scale, cross‐sectional study conducted across 42 countries. It involved 82,243 participants (Mean age = 32.39 years, SD = 12.52; 39.6% men, 57.0% women, 3.4% gender diverse). Participants completed validated measures, including the Problematic Pornography Consumption Scale (PPCS) and the Brief Symptom Inventory’s (BSI‐18) depression and anxiety symptoms subscales. A one‐way ANOVA was used to assess gender differences, while regression analysis examined the role of gender (i.e., men, women, and gender‐diverse individuals) in the associations between psychological distress (i.e., depression and anxiety symptoms) and PPU. Results Men reported the highest PPU levels, whereas gender‐diverse participants reported the highest anxiety and depression levels, followed by women. PPU was positively correlated with anxiety and depression symptoms, with small‐to‐moderate associations ( r = 0.207 and r = 0.249, respectively). Gender significantly moderated both associations, with the steepest positive slopes among men, suggesting that they might rely more heavily on pornography as a maladaptive coping mechanism. Conclusions This study highlights differences between PPU and mental health across gender identities. While gender‐diverse individuals experience the highest levels of psychological distress, men demonstrate the strongest link between such distress and PPU. These findings highlight the need for gender‐sensitive mental‐health interventions addressing PPU and its psychological implications.
