Objective University students face significant academic, social, and career‐planning challenges. Under such stressors, deficient emotion regulation may increase vulnerability to depressive states, in which persistent symptoms could progress to clinical depression. This study investigates key risk and protective factors for depressive symptoms among university students, including negative life events, neuroticism, and social support. A longitudinal framework was further employed to assess changes in depressive symptoms before and after the COVID‐19 pandemic, with the goal of informing early identification and intervention strategies. Methods The dataset included 18 024 valid responses from baseline assessments. Follow‐up assessments conducted 1 year later included 6129 participants. The extreme gradient boosting (XGBoost) model with SHapley Additive exPlanations (SHAP) was used to quantify the relative importance of specific factors (e.g., negative life events and social support) on depressive symptoms, while a cross‐lagged panel model examined longitudinal directional associations between these factors and depressive symptoms. Results The prevalence of depressive symptoms was 15.2% among the student sample. Significant correlations were observed between symptom severity and adverse family relationships, childhood trauma, prior suicide attempts, and psychiatric history. Neuroticism and negative life events showed significant positive associations with depressive symptoms, while subjective support and support utilization demonstrated negative associations with symptom severity. Longitudinal analysis revealed an increase in both symptom severity and depression detection rates following the COVID‐19 pandemic. The cross‐lagged panel model identified neuroticism as a significant positive longitudinal predictor of depressive symptoms, whereas subjective support showed a significant negative longitudinal association with subsequent depressive symptoms. Conclusion This study identifies neuroticism as an important longitudinal risk indicator for depressive symptoms and subjective support as a protective indicator, while negative life events showed significant cross‐sectional associations with symptom severity. The findings demonstrate how integrating longitudinal designs with interpretable machine learning elucidates complex mental health dynamics in student populations, providing an evidence‐based framework for targeted interventions within campus mental health policies.
Background Epidermal differentiation disorders (EDDs) are rare, chronic skin diseases with significant psychosocial impact on patients and families. Their daily management requires complex care, placing caregivers at risk of stress and anxiety. Few studies have systematically examined anxiety and coping strategies in this group. Objectives To compare anxiety levels and coping styles between caregivers of children with syndromic or nonsyndromic EDD and caregivers of healthy children. Methods In this cross‐sectional case‐control study, 39 caregivers of children with EDD and 39 matched controls were recruited from a dermatology clinic. Anxiety was assessed with the State‐Trait Anxiety Inventory (STAI) and coping styles with the Coping Inventory for Stressful Situations (CISS). Sociodemographic and clinical data were collected. Results Caregivers of children with EDDs reported significantly higher trait anxiety than controls (79.5% vs. 53.8%; p = 0.017). Task‐oriented coping (TOC) was less frequent among EDD caregivers, with more than half showing low TOC compared with less than one‐third of controls (56.4% vs. 28.6%; p = 0.019). High avoidance‐oriented coping (AOC) was observed more often in controls (21.4% vs. 5.6%; p = 0.044). Anxiety was greater among caregivers of boys than girls (95.7% vs. 56.2%; p = 0.003). Avoidant coping was associated with greater child symptom severity, including pruritus and redness. Conclusions Caregivers of children with EDD experience high anxiety and rely less on adaptive coping strategies. These findings emphasize the need for early, family‐centered psychosocial interventions to support caregiver well‐being and improve outcomes for affected children.
Individuals with bipolar disorders (BDs) with depressive symptoms exhibit poorer cognitive performance and are often excluded from procognitive interventions and cognitive research. Threshold values on depression severity scales, based on cutoffs defining depressive episodes, have traditionally been used to exclude patients suspected of having depression‐associated cognitive impairment. Identifying a threshold value for depression‐associated cognitive impairment on these scales could help guide patient selection and treatment. We assessed neuropsychological performance in outpatients with BD with varying levels of depressive symptom severity measured by the Montgomery–Åsberg Depression Rating Scale (MADRS). The sample was divided based on the total MADRS score or subscores in MADRS theoretical domains. We then compared average cognitive performance between groups while adjusting for relevant covariates to determine a MADRS score above which cognition is significantly impaired. We included 2532 individuals with BD. The composite cognitive score was significantly lower in individuals with a MADRS score ≥ 12 than in those with a score ≤ 1 but did not differ from that of individuals with scores between 2 and 11. Symptoms of detachment and sadness were more strongly associated with cognitive impairment than other symptoms. Individuals with type I BD with MADRS detachment subscores higher than 4 and individuals with type II BD with nonzero sadness subscores had significant cognitive impairment compared to individuals with lower subscores. Excluding individuals with BD whose cognition may be affected by depressive symptoms would require omitting those with MADRS detachment subscores higher than 4 or nonzero sadness subscores. Our findings question the existence of a total depression severity threshold for cognitive impairment, as specific depressive symptoms seem more strongly associated with cognitive impairment than total symptom severity.
Depression is a common comorbidity in patients with heart failure with preserved ejection fraction (HFpEF), suggesting potential epidemiological and pathophysiological connections between these two age‐related chronic diseases. Extensive clinical evidence demonstrates that depression is closely associated with both the incidence and prognosis of HFpEF. It is currently believed that depression may contribute to the pathogenesis of HFpEF through various interconnected mechanisms, including intestinal dysfunction, endothelial dysfunction, disturbances in fat and energy metabolism, autonomic nervous system dysfunction, hypothalamic–pituitary–adrenal (HPA) axis imbalance, and sex differences. Both conditions often share common comorbidities and genetic predispositions. Notably, inflammation is implicated in all these mechanisms and processes, playing a key role at different stages and facilitating the interaction between the two diseases during their onset and progression. However, the connections between depression and HFpEF have not yet been systematically and thoroughly elucidated. This review aims to comprehensively summarize the associations between depression and HFpEF, focusing particularly on elucidating their interplay in pathogenesis from an inflammation perspective, with special emphasis on the adverse effects of depression on the development of HFpEF. Additionally, we evaluate the management approaches for patients with comorbid depression and HFpEF, which include both pharmacological and nonpharmacological treatments, highlighting that personalized and integrated interventions may offer significant benefits. The review underscores the importance of increased attention and early identification of patients with comorbid depression and HFpEF and is expected to provide valuable insights and guidance for the clinical management of this significant patient population.
Purpose Vision‐threatening diabetic retinopathy (VTDR) poses significant blindness risks and the study aimed to identify the impact of psychological factors on its ocular outcomes. Methods This retrospective cohort study enrolled 782 VTDR patients from three ophthalmological centers (2018–2021). DR severity was graded using ETDRS criteria. Primary outcomes included tractional retinal detachment (TRD) involving the fovea, neovascular glaucoma (NVG), final best‐corrected visual acuity (BCVA) <0.3, and recurrent vitreous hemorrhage (VH). Anxiety and depression were assessed via the hospital anxiety and depression scale (HADS). Univariable and multivariable logistic regression evaluated the associations between HADS scores and ocular outcomes. Results After a median follow‐up of 24.8 months, depressive symptoms (HADS‐D ≥8) were associated with higher rates of BCVA <0.3 (67.8% vs. 57.2%, p = 0.033) and NVG (13.6% vs. 6.9%, p = 0.020). Recurrent VH was more frequent in patients with anxiety (21.0% vs. 10.6%, p = 0.031) or depression (20.3% vs. 10.7%, p = 0.045). Multivariable logistic analysis revealed that each 1‐point increase in HADS‐D score significantly increased adjusted odds of TRD (aOR = 1.06, 95% CI: 1.01−1.11), BCVA <0.3 (aOR = 1.07, 95% CI: 1.02−1.11), recurrent VH (aOR = 1.09, 95% CI: 1.02−1.17), and NVG (aOR = 1.10, 95% CI: 1.03−1.17; all p < 0.05). There was a consistent positive gradient between HADS severity and adverse outcomes. Conclusion Depressive symptoms are independently associated with worse ocular prognoses in VTDR patients. Systematic psychological screening and intervention is essential to mitigate vision deterioration risk in this population.
