Background: To explore the impact of trait mindfulness on the quality of life (QoL) in patients with bipolar disorder (BD) and to examine the serial mediating roles of emotion dysregulation and depressive/manic symptoms. Methods: A cross-sectional study based on previous medical record data was conducted. Clinical records and scale data of 256 patients with BD who received outpatient or inpatient care at Xiamen Xianyue Hospital (Xiamen Mental Health Center) between June 2022 and June 2024 were extracted, all of whom carried a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) confirmed diagnosis. All scale assessments had been completed at the time of the index clinical visit, including the Five Facet Mindfulness Questionnaire (FFMQ), the Difficulties in Emotion Regulation Scale (DERS), the Self-Rating Depression Scale (SDS), the Bech-Rafaelsen Mania Scale (BRMS), and the Brief Quality of Life in Bipolar Disorder scale (Brief QoL.BD). Age, sex, bipolar subtype,illness duration,current mood state, and current pharmacological treatment were entered as covariates. Two separate serial mediation models (one with depressive symptoms and one with manic symptoms as the second-stage mediator) were tested using regression-based mediation analysis with bias-corrected bootstrapping (5000 resamples) under the PROCESS framework (Model 6). Results: Correlation analysis showed that trait mindfulness in patients with BD was significantly and positively correlated with QoL (r = 0.472, p < 0.001), and significantly and negatively correlated with emotion dysregulation (r =–0.523, p < 0.001), depressive symptoms (r =–0.457, p < 0.001), and manic symptoms (r =–0.406, p< 0.001). Serial mediation analysis revealed that the indirect effect of trait mindfulness on QoL through emotion dysregulation and depressive symptoms was 0.086 (95% CI [0.047, 0.132]), with a model explanatory power (adjusted R2 ) of 0.385. The indirect effect through emotion dysregulation and manic symptoms was 0.052 (95% CI [0.016, 0.091]), with a model explanatory power (adjusted R2) of 0.307. Conclusions: In this cross-sectional study based on previous medical record data, emotion dysregulation together with mood symptoms jointly served as a serial mediating chain linking trait mindfulness to QoL in patients with BD, and the depression-related chain conveyed a stronger mediating effect than the mania-related chain. Above findings suggest that a higher level of trait mindfulness may be associated with better QoL through enhanced emotion regulation and milder depressive/manic symptoms, with the depressive pathway being the most salient. The direction of these pathways still needs further verification by prospective designs.
Background: Prolonged opioid administration for pain control and to facilitate tolerance of mechanical ventilation in the intensive care unit (ICU) may lead to tolerance and physical dependence. Following opioid discontinuation, opioid withdrawal syndrome (OWS) may occur. Although this condition has been well described in pediatric populations, its incidence and associated factors in critically ill adults remain uncertain because of diagnostic heterogeneity and the frequent clinical overlap with delirium. The aim of this study was to assess the prevalence of OWS and to identify factors associated with its development in adult patients. Methods: We conducted a retrospective, descriptive, observational study including patients evaluated at the post ICU follow-up clinic of Lozano Blesa University Clinical Hospital (Zaragoza, Spain) over a 12-month period. This study investigated the association between multiple opioid medications and adjunctive medications and the occurrence of OWS. Eligible patients had an ICU stay of >7 days, received mechanical ventilation for >48 hours, and had been exposed to opioids. Demographic, clinical, and pharmaco logical variables were collected, including types of opioids, weight-adjusted cumulative dose, and use of adjuvant medications. OWS was diagnosed during the first 48 hours after opioid discontinuation using a combination of the Clinical Opiate Withdrawal Scale (COWS) and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. Receiver operating characteristic (ROC) curve analyses were performed to evaluate the impact of morphine exposure. Results: A total of 66 patients were included (mean age 59.9 ± 13.6 years; predominantly male). The leading cause of ICU admission was respiratory disease (48.5%). Mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score at admission was 17.0 ± 6.1, and median ICU length of stay was 19 days. Twenty-two patients (33.3%) developed OWS, which was mild in 90.9% and moderate in 9.1% according to the COWS. No significant differences were observed between groups in baseline characteristics or delirium occurrence. Patients who developed OWS were more likely to have received morphine (100% vs. 75%; p = 0.010) and had a higher weight-adjusted cumulative morphine dose (3.15 ± 2.33 vs. 2.21 ± 2.50 mg/kg; p = 0.047), whereas no differences were found for fentanyl exposure. In addition, they more frequently required benzodiazepines (68.2% vs. 18.2%), neuroleptics (68.2% vs. 6.8%), and dexmedetomidine (31.8% vs. 4.5%) (p <0.01 for all comparisons). Cumulative morphine dose showed modest discriminatory performance for OWS (area under the curve (AUC) 0.653; p = 0.048). Conclusions: OWS is a common complication among adult ICU survivors, although it is predominantly mild in severity. A higher cumulative dose of morphine was associated with its onset, although no association was found with the total duration of exposure. Clinical overlap with delirium and the reactive use of psychoactive medications may contribute to under-recognition of this condition, under scoring the need for structured OWS screening during ICU stay and in post-intensive care syndrome (PICS) follow-up.
Background: Maternal depression during the perinatal and postpartum periods constitutes a relevant risk factor for early child development. This systmatic review aim to synthesize empirical evidence on the association between maternal depression and child development in children aged 0 to 36 months, considering symptom severity, chronicity, and trajectories, as well as potential relational and contextual mechanisms. Methods: A systematic review was conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines. Searches were performed in PsycINFO, SciELO, PubMed, Web of Science, and Google Scholar. Quantitative, peer-reviewed empirical studies were included if they assessed maternal depression using standardized instruments and reported outcomes related to cognitive, language, motor, or socioemotional development in early childhood. Of 141 recordsidentified, 10 studies met the eligibility criteria and were included in the qualitative synthesis. Results: The evidence indicates that maternal depression is not necessarily associated with global developmental delay, but rather with alterations in specific domains, including language, communication, problem solving, motor development, and socioemotional functioning. Symptom severity, persistence, and chronicity emerged as central predictors. Available studies suggested that the association may be partly explained by reduced maternal responsiveness, lower cognitive stimulation, difficulties in motherchild interaction, and adverse socioeconomic conditions. Conclusions: Maternal depression appears to be an important risk factor for child development during early childhood, particularly when symptoms are persistent or severe. The magnitude of these associations may vary according to caregiving environments and broader contextual factors.
Background: To observe the effects of childhood trauma and psychological resilience on depression in vocational college students, as well as their additive and interactive effects. Methods: From November 2023 to November 2024, 992 college students from a higher vocational and technical college in Shaoxing were selected using cluster sampling. An online survey was conducted using the Center for Epidemiologic Studies Depression Scale (CES-D), the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and the Childhood Trauma Questionnaire-Short Form (CTQ-SF). According to the presence or absence of depressive symptoms, the students were divided into a depressive symptom group and a non-depressive group. CTQ-SF scores, CD RISC-10 scores, and general characteristics of were compared between the two groups to analyse factors associated with depressive symptoms among higher vocational college students. The additive interaction between CTQ-SF and CD-RISC-10 scores in relation to depressive symptoms was also analysed. Results: Among the 992 vocational college students, the incidence of depressive symptoms was 19.86% (197/992). The CTQ-SF score was higher in the depressive symptom group than in the non-depressive group (p < 0.05), and the CD-RISC-10 score was lower in the depressive symptom group than in the non-depressive group (p< 0.05). The depressive symptom group was older than the non-depressive symptom group and had higher proportions of students with monthly living expenses <1000 yuan, average or poor relationships with classmates, and divorced or widowed parents (p < 0.05). Multivariable logistic regression analysis showed that age (odds ratio (OR) = 1.179, 95% confidence interval (CI): 1.072–1.295), average or poor relationships with classmates (OR =3.197, 95% CI: 2.038–5.015), and having divorced or widowed parents (OR = 3.208, 95% CI: 1.788–5.756) were risk factors for depressive symptoms among vocational college students (p < 0.05). Monthly living expenses (OR = 0.264, 95% CI: 0.168–0.416), sexual orientation (OR = 0.740, 95% CI: 0.551–0.993), and CD-RISC-10 score (OR = 0.306, 95% CI: 0.187–0.502) were protective factors for depression symptoms among vocational college students (p < 0.05). The additive interaction analysis yielded relative excess risk due to interaction (RERI) =–0.001, attributable proportion due to interaction (AP) =–0.002, and synergy index (S) = 1.003, indicating no additive interaction between CTQ-SF and CD-RISC-10 scores in relation to depressive symptoms among vocational college students. Conclusions: CTQ-SF and CD-RISC-10 scores showed no additive interaction in relation to depressive symptoms among vocational college students.
Background: Peripheral biomarkers for major depressive disorder are accessible but correspond poorly to central nervous system processes, a point the evidence base can address only if its record registers the compartment in which each marker was measured. To determine, by meta research rather than evidence synthesis, whether the indexed record of recent depression biomarker research registersthe peripheral-central distinction, separating omission by indexers from absence mandated by the controlled vocabulary. That peripheral markers are imperfect proxies for central processes is established prior knowledge; the question here concerns the bibliographic infrastructure through which that literature is retrieved. Methods: PubMed records published between 1 January 2024 and 30 June 2026 matching a title/abstract query for depression and biomarker terms were retrieved (Tier 1, n = 1166); the MEDLINE-indexed subset formed the analysable corpus (Tier 2, n = 825). We extracted marker-level descriptors and site qualifiers, determined from the 2026 MeSH descriptor file whether /blood and /cerebrospinal fluid are allowable per descriptor, and stratified by publication type. Results: Of 1166 retrieved records, 341 (29.2%) carried no MeSH descriptor; in the closed year 2024, 70 of 317 (22.1%) remained unindexed, so roughly one article in five is permanently absent from the structured record. Within the 825 indexed records, 494 (59.9%) carried no markerlevel descriptor and 658 (79.8%) no site qualifier. Of 1211 distinct descriptors, 681 (56.2%) do not permit /blood at all, most of them terms for which a sampling compartment would carry no meaning; restricted to the 243 markerlevel and class-level descriptors, 30 (12.3%) are barred, C-reactive protein among them, the most frequent marker descriptor in the corpus (26 records), though the same descriptors can receive /cerebrospinal fluid. Primary studies recorded a compartment three times more often than reviews (38.8% vs 14.8%; χ 2 = 52.1, p < 0.001), but recording tracked qualifier eligibility more closely than study design, rising from 5.0% to 59.4% with the number of /bloodeligible descriptors a record carried. Conclusions: The controlled-vocabulary layer cannot reliably recover the sampling compartment of depression biomarker research, for two structural reasons: the peripheral compartment is unrecordable for an entire marker class, and recording depends on how many of a record’s descriptors the vocabulary permits to carry the qualifier at all. A distinction that cannot be recorded cannot be aggregated, audited or contested. The inflammatory endotype literature of difficult-to-treat depression is thereby constrained by a blind spot at the level of retrieval rather than biology.
