ABSTRACT Patients with vitiligo are known to have a markedly increased burden of psychological comorbidities compared with the general population. However, a comprehensive and up‐to‐date assessment of the association between vitiligo, depression, and suicidality is lacking. This study aimed to quantitatively evaluate the association between vitiligo and the risks of depression and suicidality. A systematic search of PubMed, Embase, Web of Science, and the Cochrane Library was conducted from inception to 25 July 2025. Pooled odds ratios (ORs) and standardized mean differences (SMDs) with corresponding 95% confidence intervals (CIs) were calculated. Seventy‐three studies were included. The pooled prevalence of depression among patients with vitiligo was 0.37 (95% CI, 0.30–0.45). Compared with non‐vitiligo controls, vitiligo patients exhibited significantly higher risks of depression (OR = 1.60, 95% CI [1.05, 2.43]) and suicide‐related outcomes (OR = 1.22, 95% CI [1.05, 1.41]), with suicidal ideation showing the greatest increase (OR = 2.05, 95% CI [1.08, 3.90]). However, the unadjusted preliminary analysis of continuous depression scores showed an increase, but it was not significant after publication bias correction. Female patients represented a particularly vulnerable subgroup, whereas adolescent patients showed a dual risk profile depending on the reference group: compared with age‐matched non‐vitiligo controls, adolescents with vitiligo had a significantly higher risk of depression (OR = 2.84); however, within the vitiligo patient population, adolescents showed a lower depression risk than adult patients (OR = 0.20). The risk of depression was higher than that in the general population but lower than that observed in psoriasis. Vitiligo is significantly associated with elevated risks of depression and suicidality. These findings highlight the need for heightened clinical awareness and integrated psychological care to improve patients' overall well‐being and quality of life.
ABSTRACT Despite evidence linking academic stress and depressive symptoms, cross‐sectional designs cannot reveal their developmental dynamics, and total‐scale scores obscure symptom‐level complexity and intervention targets. We applied the random intercept cross‐lagged panel model (RI‐CLPM) and cross‐lagged panel network (CLPN) analysis to 307 Chinese adolescents (58.63% female) to examine the relationship between academic stress and depressive symptoms from the aggregate to the symptom level and to identify key nodes. Results from the RI‐CLPM indicated a positive association between academic stress and depressive symptoms at the between‐person level. At the within‐person level, Time‐1 academic stress predicted a reduction in Time‐2 depressive symptoms. CLPN results revealed complex reciprocal influences: ‘People were unfriendly’ and ‘I felt hopeless about the future’ were initially vulnerable and later progressed to ‘I felt sad’ and ‘I thought my life had been a failure’. Early drivers included ‘I thought my life had been a failure’ and ‘I felt that people dislike me’, whereas over time ‘I was unhappy’ and ‘I felt hopeless about the future’ gained predictive importance. The study revealed temporal relationships between academic stress and depressive symptoms and identified potential targets, providing evidence and implications for prevention and intervention.
The study had two core aims: (1) to identify data-driven sleep-wake timing and 4-week weekend catch-up sleep ratio (WCS ratio) patterns among college students through 28-day objective monitoring; (2) to quantify the combined associations between multidimensional sleep profiles and anxiety symptoms. A two-phase design was used. We recruited 182 undergraduates (mean age = 19.3, SD = 1.09) for 28-day millimetre-wave radar sleep tracking and psychological tests. Study 1 adopted k-means and DTW time-series clustering, extracting two sleep-wake timing patterns (Post-midnight, n = 161; Pre-midnight, n = 21) and two WCS-ratio trajectories (decreasing, n = 90; increasing, n = 92), regarded as exploratory short-term behavioural patterns. Study 2 performed logistic regression, sensitivity tests, and cumulative indicator analysis. Key results: (1) Poor sleep quality (OR = 1.98, 95% CI [1.47, 2.66]), shorter weekday sleep duration (OR = 0.52, 95% CI [0.29, 0.92]), pre-midnight sleep timing (OR = 9.84, 95% CI [2.01, 48.06]), an increasing WCS-ratio pattern (OR = 3.88, 95% CI [1.14, 13.23]), and severe negative life events (OR = 6.22, 95% CI [1.24, 31.34]) predicted higher anxiety score. Sleep quality, weekday sleep duration, and life stress remained robust in sensitivity analyses; continuous sleep and WCS indicators showed no stable predictive effects. (2) Cumulative analysis found a non-linear threshold effect: symptoms of anxiety tend to rise when multiple sleep and stress factors co-occur. These findings suggest that monitoring multifaceted sleep-related behaviours, especially their long-term dynamics, may aid in identifying college students with elevated anxiety symptoms.
ABSTRACT To explore the heterogeneity of psychological resilience in adolescents with depression and suicidal ideation and to identify psychosocial factors associated with different resilience profiles. A total of 286 hospitalised adolescents diagnosed with depressive disorders and suicidal ideation were consecutively enroled. Psychological resilience was assessed using the Adolescent Resilience Scale. Latent profile analysis (LPA) was conducted to identify resilience profiles. Least absolute shrinkage and selection operator (LASSO) regression was used to select variables associated with membership in the low‐ and moderate‐resilience profiles, using the high‐resilience profile as the reference category. Bootstrap resampling was performed to assess the stability of variable selection. LPA identified three psychological resilience profiles: low resilience‐vulnerable (22.0%), moderate resilience‐cognitive advantage (66.8%), and high resilience‐tenacious (11.2%). Social support, problem‐focused coping, and emotion‐focused coping were selected in both profile‐comparison models and showed relatively high bootstrap selection frequencies. Neglectful parenting was selected only in the comparison between the low resilience‐vulnerable and high resilience‐tenacious profiles and showed comparatively lower selection stability. Psychological resilience showed substantial heterogeneity among adolescents with depression and suicidal ideation. Social support and coping strategies were consistently associated with resilience profile membership, whereas the association with neglectful parenting was less stable. These findings may inform future research on profile‐based psychological assessment and differentiated support strategies; however, longitudinal studies are needed to clarify temporal and causal relationships.
ABSTRACT Previous investigations have identified the effectiveness of breathwork on both psychological and physical health for individuals under a resting state. However, there was no study investigating the effects of breathwork under a mentally‐fatigued state. The purpose of this study was to examine the acute effects of breathwork administered after the induction of mental fatigue by a cognitive tasks on primary self‐reported outcomes including positive and negative affect and self‐reported stress indices, as well as on secondary physiological outcomes including diaphragm function and stress‐related physiological responses. This study was employed with a randomized cross‐over study design. Twenty healthy university students voluntarily participated in this study. Each of them performed a 20‐min breathwork and control (quiet bed rest) condition following the Colour‐Word Stroop Task (CWST) in a randomized sequence over two days separated at least by a week. Participants completed self‐reported questionnaires for positive and negative affect and stress indices and underwent ultrasonographic assessments of the diaphragm function, saliva collection for cortisol and IgA, and heart rate variability assessments at baseline, pre‐CWST, post‐CWST, and post‐intervention. The breathwork condition demonstrated significantly higher positive affect at post‐intervention compared to the control condition ( p = 0.021). Right hemidiaphragm excursion and left hemidiaphragm thickness at end‐inspiration significantly increased from post‐CWST to post‐intervention in the breathwork condition. The breathwork condition appeared to improve positive affect and diaphragm function even under a mentally‐fatigued state, compared to the control condition. These findings indicate that breathwork may serve as a simple, accessible, and practical strategy to enhance subjective well‐being in a stressful environment and diaphragm function regardless of mental fatigue.
