The psychological profile that structurally documents the case of a depression patient is essential for psychotherapy. Large language models can be applied to summarize the profiles from counseling speech, however, it may suffer from long-context forgetting and produce unverifiable hallucinations, due to overlong length of speech, multi-party interactions and unstructured chatting. Hereby, we propose a StreamProfile, a streaming framework that processes counseling speech incrementally, extracts evidences grounded from ASR transcriptions by storing it in a Hierarchical Evidence Memory, and then performs a Chain-of-Thought pipeline according to PM+ psychological intervention for clinical reasoning. The final profile is synthesized strictly from those evidences, making every claim traceable. Experiments on real-world teenager counseling speech have shown that the proposed StreamProfile system can accurately generate the profiles and prevent hallucination.

BackgroundChildhood trauma may not only lead to various negative outcomes during adolescence and persist into adulthood, but also extend to the next generation. However, most existing studies capture the monolithic impact, but remain limited on the granularity of which specific traumatic exposures and how they flow from parents to offspring, as well as on the association with adolescent depression and non-suicidal self-injury (NSSI) behavior.MethodsThis multi-center cross-sectional study recruited 1,380 Chinese adolescents with clinical depression and 1,532 of their parents from 9 Chinese provinces. Using Bayesian network analysis, the study first characterized the network structure to explore core associations among variables of interest, then built a directed acyclic graph model to reveal potential transmission pathways among childhood trauma subtypes, parenting, emotional regulation, socioeconomic factors and adolescent depression and NSSI frequency. The stability and robustness of the network were validated through bootstrapping and centrality stability tests.ResultsTwo types of childhood trauma that exhibited direct transmission pathways were identified from parents to adolescents: emotional neglect (β = 0.079, p<0.001) and physical abuse (β = 0.143, p<0.01). Several indirect transmission pathways bridged by parenting styles and emotion regulation strategies were also found. A positive association between childhood trauma and adolescent depression and NSSI frequency was then observed.ConclusionChildhood trauma may transmit intergenerationally in direct or indirect pathways. Positive parenting style is a key network node in breaking the transmission. Findings of this study deepens the theoretical understanding in the intergenerational effects of childhood trauma and emphasizes the central role of parenting in adolescent depression and NSSI prevention program.

BACKGROUND:Parental absence is a significant risk factor for adolescent suicidal ideation, yet the relational mechanisms and sex-specific vulnerabilities within clinical populations remain under-explored. This study investigated how different forms of parental absence relate to suicidal ideation through father-child and mother-child relationships, and whether these associations are moderated by adolescent sex. METHODS:A nationwide multi-center cross-sectional study was conducted from December 2020 to December 2023. We recruited 2467 clinically diagnosed depressed adolescents from 14 hospitals in China. A moderated mediation model was tested using Firth's penalized logistic regression to address outcome imbalance. The model explicitly disaggregated single-parent and dual-parent absence while testing sex as a moderator of direct pathways. RESULTS:A significant interaction between sex and single-parent absence emerged, indicating single-parent absence was associated with higher suicidal ideation specifically among female adolescents (B = 1.144, p = 0.011). Mediation analyses demonstrated that the father-child relationship served as a consistent mediator for both single-parent (indirect effect = 0.058, 95% CI [0.003, 0.129]) and dual-parent absence (indirect effect = 0.066, 95% CI [0.004, 0.151]). Conversely, the mother-child relationship showed no significant mediating effect after adjustment. LIMITATIONS:The cross-sectional design limits causal inferences, and certain variables were assessed using self-report single-item measures. CONCLUSIONS:Parental absence influences suicidal ideation through distinct structural and relational pathways. The father-child relationship emerged as a more robust mediator than the mother-child relationship, while sex moderated the direct impact of family disruption. These results highlight the necessity of sex-sensitive and father-inclusive clinical interventions in preventing suicide among depressed adolescents.

Non-suicidal self-injury (NSSI) is highly prevalent among adolescents with major depressive disorder (MDD), yet the developmental and sex-related mechanisms underlying its occurrence and severity remain poorly understood. This study examined the effects of age and sex on NSSI occurrence and frequency in a large clinical cohort (N = 2,343) of Chinese adolescents diagnosed with MDD. Mediation analyses assessed self-esteem, depression, and anxiety as potential pathways linking age and sex to NSSI. Females had significantly higher NSSI prevalence (OR = 2.53) and frequency than males, while NSSI engagement decreased with age (OR = 0.808/year for NSSI occurrence). Self-esteem and depression partially mediated the effect of sex on NSSI occurrence, whereas self-esteem largely explained sex differences in NSSI frequency. Age-related declines in NSSI were mediated by self-esteem only in early adolescence, suggesting distinct developmental mechanisms across age groups. In late adolescence, age was directly protective for NSSI occurrence, independent of psychological variables. These findings highlight self-esteem as a critical factor influencing NSSI severity, with implications for sex- and age-specific intervention strategies. Future research should explore longitudinal trajectories and causal relationships to refine targeted prevention efforts for adolescents at risk of NSSI.

Adolescent depressive disorder (ADD) is a chronic and debilitating mental disorder, yet its diagnosis still relies on subjective assessment. An efficient and cost-effective diagnostic tool for ADD is urgently needed to improve clinical management. Herein, amorphous MIL-88B@nitrogen/sulfur co-doped carbon-dots (aMIL-88B@NSCDs) are designed as a dual-ion mode matrix for comprehensive metabolic profiling of ADD. The aMIL-88B@NSCDs with integrated physicochemical properties facilitate the efficient dual-ionization of metabolites, enabling the selective ionization of metabolites from bio-samples. It exhibits a 5-12-fold signal enhancement over NSCDs (a well-established dual-ion mode matrix) and shows high reproducibility with coefficients of variation ≤ 10%. Next, we directly extracted the dual-ion mode serum metabolic fingerprints (dual-SMFs) with 432 features (defined as signal-to-noise ratio (S/N) > 3, 190/242 in positive/negative ion mode) within seconds. Based on the dual-SMFs, we constructed a high-performance diagnostic model for ADD, with an area under the curve (AUC) of 0.926 (0.760/0.734 in positive/negative ion mode). This work not only contributes to the development of the dual-ion mode matrices but also provides an efficient and comprehensive strategy for the precision clinical management of ADD.

Non-suicidal self-injury (NSSI) is highly prevalent among adolescents with depressive disorder and is associated with significantly worsened clinical outcomes. Previous researches have established a link between NSSI and impairments in emotion regulation. This study aimed to quantitatively investigate the relationship between specific emotion regulation strategies and NSSI, and to develop and validate a clinically applicable nomogram for estimating the likelihood of NSSI for individual patients in this population. We recruited 1946 adolescents with depressive disorder from January 2021 to December 2021. The participants were randomly divided into a training group (70

AIM:Non-suicidal self-injury (NSSI) is a prevalent behavior among adolescents with major depressive disorder (MDD), yet the precise neural mechanisms remain unclear. This study aimed to investigate the temporal dynamics of brain connectivity associated with NSSI in adolescents with MDD using dynamic functional connectivity (dFC) analysis. METHODS:Resting-state fMRI data from 204 adolescents (154 with NSSI, 50 without) were analyzed. dFC variability within the fronto-limbic network was assessed using a seed-based dynamic conditional correlation approach. Group differences in dFC variability were examined, and a machine-learning model was used to predict NSSI based on dFC features. Mediation analysis explored the dFC's role in the relationship between depressive symptoms and NSSI. RESULTS:Adolescents with NSSI exhibited reduced dFC variability, which mediated the relationship between depressive severity and NSSI behavior (a*b = 0.144; p = 0.001). Key connections-insula, anterior cingulate cortex, orbitofrontal cortex, and hippocampus-were critical in distinguishing NSSI from non-NSSI groups. Machine learning models based on these connections achieved robust and stable performance with mean AUC of 0.84 and PR-AUC of 0.94 in predicting NSSI. CONCLUSIONS:Altered dFC within the fronto-limbic network may underlie NSSI in adolescents with MDD, identifying preliminary neural features for targeted interventions and highlighting neurobiological heterogeneity associated with NSSI in adolescents with MDD.

OBJECTIVE:Perceived social support (PSS) buffers against loneliness, but family and friend support may differ in effects. This study constructed a mechanism model mediated by coping strategies to examine the pathways through which PSS, family and friend support influence loneliness. METHODS:Adolescents aged 12-18 with depressive disorder were recruited from 14 psychiatric hospitals across 9 Chinese provinces. They completed the Coping Strategies Scale for Middle School Students, the Multidimensional Scale of Perceived Social Support, and the UCLA Loneliness Scale. Path analysis explored relationships among PSS, family and friend support, loneliness, as well as the indirect effects mediated by coping strategies. RESULTS:A total of 2,343 adolescents participated. PSS negatively predicted loneliness (β=-0.46, p<0.001). Problem-focused coping mediated the relationship between PSS and loneliness (β=0.48, p<0.001), while emotion-focused coping did not (β=-0.04, p>0.05). Both family and friend support directly predicted loneliness with coefficients of -0.13 and -0.39, respectively. Problem-focused coping mediated the associations of both family support (β=0.32, p<0.001) and friend support (β=0.28, p<0.001) with loneliness. Emotion-focused coping weakly mediated the effect of family support (β=-0.09, p<0.001), but not friend support (β=0.04, p>0.05). CONCLUSION:Both family and friend support reduce loneliness by promoting problem-focused coping, with friend support showing a stronger effect. Family support also alleviates loneliness by reducing emotion-focused coping. Enhancing PSS and adaptive coping strategies may alleviate loneliness.

Non-suicidal self-injury (NSSI) is common among adolescents with depression, posing a significant public health concern. Although NSSI has been linked to heightened alexithymia—characterized by difficulties in identifying and describing emotions—the neurobiological mechanisms underlying this association remain insufficiently understood in adolescents. This study included 233 adolescents diagnosed with major depressive disorder (MDD), for whom resting-state functional magnetic resonance images were acquired. All participants completed the Toronto Alexithymia Scale (TAS) and the Functional Assessment of Self-Mutilation (FASM). We estimated intra-network functional connectivity (FC) within 17 large-scale brain sub-networks and examined associations between intra-network FC, TAS scores, and NSSI. Mediation models were then fitted to examine indirect pathways among alexithymia, intra-network FC, and NSSI. Adolescents with MDD who engaged in NSSI showed higher alexithymia than those without NSSI, and NSSI frequency was positively correlated with the difficulty of identifying feelings in the NSSI group. Lower intra-network FC within the frontoparietal control network was associated with the presence of NSSI, and higher TAS total scores were linked to reduced intra-network FC in this network. Mediation analyses further indicated that intra-network FC in the frontoparietal control network partially mediated the association between TAS total scores and NSSI. These findings suggest that alexithymia and aberrant connectivity within the frontoparietal control networks are jointly associated with NSSI in adolescent MDD. The identified neural markers and pathways offer insights into potential therapeutic targets, emphasizing the importance of addressing emotion regulation deficits and alexithymia in the treatment of NSSI.

BACKGROUND:Expressive suppression is associated with rumination, but the cortical functional connectivity (FC) patterns characterizing this relationship remain unclear in adolescents with major depressive disorder (MDD). This study examined associations among expressive suppression, rumination dimensions, and cortex-wide resting-state FC. METHODS:A total of 228 adolescents aged 12-18 years with MDD were included. Expressive suppression and rumination were assessed using questionnaires, and cortex-wide resting-state FC was examined. Partial correlations were performed with covariate adjustment and false discovery rate correction. FC links associated with both expressive suppression and brooding were evaluated in exploratory mediation analyses. Sensitivity models additionally adjusted for anxiety and depressive symptom severity and applied Bonferroni correction across eight indirect effects. RESULTS:Expressive suppression was positively associated with brooding, reflection, depressive rumination, and overall rumination. Cortex-wide analyses identified FC patterns involving prefrontal, insular, parietal, temporal, and posterior cingulate regions. Two FC links were associated with both expressive suppression and brooding: right medial prefrontal cortex (mPFC)-right posterior cingulate cortex (PCC) FC and right mPFC-left PCC FC. In sensitivity analyses, indirect effects through both FC links remained significant only for brooding after additional symptom adjustment and Bonferroni correction. CONCLUSIONS:These findings highlight brooding as the rumination dimension most consistently associated with expressive suppression and right mPFC connectivity with the right and left PCC in adolescents with MDD. They may contribute to neurocognitive models of maladaptive self-focused thinking in adolescent depression and inform future longitudinal and intervention research.

Adolescence is a critical period for the onset of major depressive disorder (MDD), during which emotional symptoms frequently co-occur with environmental adversity and maladaptive behavioral coping. In China, these processes may be further shaped by left-behind experience (LBE) — a prevalent structural vulnerability in which children grow up separated from migrating parents. To clarify these relationships, we applied network analysis in a clinical sample of 2341 adolescents (Mage = 14.99 years,77.92

BACKGROUND:Depression is a major global public health concern, often co-occurring with Non-Suicidal Self-Injury (NSSI). Focused on Depressive adolescents, this study aimed to quantify the importance of factors in predicting NSSI and compare them between the only child and non-only child groups, enriching knowledge to leverage tailored intervention strategies. METHODS:A large multicenter survey was conducted in China. 2510 adolescents diagnosed with Major Depressive Disorder (MDD) volunteered for the study. 36 factors were included to train random forest models for NSSI prediction in only child and non-only child groups, respectively. The SHapley Additive exPlanations (SHAP) method was utilized to compute the relative importance of each factor in two groups. RESULTS:Adolescents with MDD exhibited a rather high prevalence of NSSI (52.0 %), among them 66.9 % were non-only children. Self-esteem was the most significant factor for both groups, while critical disparities of factors were also found. In the only child group, factors like family support, parental overprotection, drinking alcohol, sleep conditions and romantic relationship involvement showed greater importance, while higher depression degree, anxiety level and emotional abuse were more important factors for non-only children. LIMITATIONS:The use of cross-sectional data from Chinese adolescents may limit deeper analysis of NSSI mechanisms and the generalizability to Western cultures. CONCLUSIONS:Only and non-only child family structures may have different influence on factors related with NSSI occurrence of adolescents with MDD. Only children were more susceptible to vulnerable family environments, alcohol abuse and romantic experience, while non-only children were more disturbed by abnormal mental states.

Background:Non-suicidal self-injury (NSSI) is common among adolescents with depressive disorders, yet the role of peer victimization and gender differences remains understudied. This study examines how different types of peer victimization (physical, verbal, social, property) relate to NSSI, focusing on gender as a moderator. Methods:A cross-sectional study of 2,343 adolescents with depressive disorders (517 males, 1,826 females) was conducted across 14 medical institutions in China. Peer victimization and NSSI were measured using the PVQ and C-FASM, respectively. Gender-stratified multiple linear regressions examined predictors of NSSI and its functions. Results:NSSI was more prevalent in females (80.18%) than males (61.51%) (χ 2 = 77.094, p < 0.001), with higher scores for emotion regulation (β = 12.33 vs. 9.85, p < 0.001). Regression analyses revealed gender-specific predictors: in males, social victimization (β = 1.213, p = 0.036) and verbal victimization (β = 1.764, p = 0.031) significantly predicted NSSI related to emotion regulation; in females, physical victimization (β = 0.768, p = 0.005) and social victimization (β = 0.873, p < 0.001) were the primary predictors. For attention-seeking functions, physical, social, and verbal victimization were significant predictors in both genders, with higher coefficients observed in males. It is noteworthy that property victimization was significantly associated with social avoidance-driven NSSI only in females (β = 0.564, p = 0.001), highlighting the gender-specific impact of victimization on NSSI functions. Conclusion:Peer victimization is a significant predictor of NSSI, with clear gender-specific patterns. Gender-sensitive assessments and interventions tailored to victimization type are essential for early prevention.

Depression affects emotional expression and perception. As a non-invasive and privacy-preserving method, speech is widely used for automatic depression detection. However, existing models often focus only on depressive features in speech, ignoring the differential emotion expression patterns across different emotion-inducing tasks. To address this, we propose an emotion-guided graph attention network (emoGAT) for depression detection. By collecting speech-text data from depressed individuals and healthy controls during emotion-inducing tasks, we construct graph embeddings using sentiment cues from both speech and text. Experimental results show our method reduces the standard deviation by 1.8% and improves accuracy by 4.36%. Graph attention visualization also reveals depression-specific characteristics, such as flattened prosody in neutral picture description tasks and cognitive biases toward negative information, offering deeper insights into emotional relational expressions.

BACKGROUND:Non-suicidal self-injury (NSSI) is a high-risk behavior frequently observed in adolescents with depression, where emotional dysregulation plays a crucial role in its emergence. The Late Positive Potential (LPP), as an event-related potential component linked to emotional processing, holds potential in elucidating neurophysiological mechanisms; however, its specific significance remains unclear. This study aims to explore abnormal neural responses to emotional stimuli in adolescents with depression (with and without NSSI) through LPP analysis. METHODS:EEG signals were recorded from 106 adolescents diagnosed with depression, both with NSSI (DN+, n = 67) and without NSSI (DN-, n = 39), during exposure to emotional images representing physical and social pain. A two-factor mixed-effects analysis of variance is conducted on LPP data of participants in each group to investigate the abnormal neural representations associated with NSSI. RESULTS:Compared with the DN- group, the DN+ group exhibits significantly reduced late LPP amplitudes in the temporal and occipital regions in response to painful image stimuli. Moreover, both groups show higher early and middle LPP amplitudes in the central-parietal region when viewing physical pain images as opposed to social pain stimuli. CONCLUSION:These findings suggest significant emotional processing patterns in adolescents with and without NSSI. The LPP may serve as a potential neurophysiological marker for identifying and preventing NSSI behavior among adolescents with depression.

OBJECT:Adolescent depression is highly co-occurring with non-suicidal self-injury (NSSI). Exploring the relationship between NSSI and facial emotion recognition is crucial for early intervention in adolescents with depression. METHODS:This study used a multi-center cross-sectional design (14 psychiatric hospitals in 9 provinces of China). The Patient Health Questionnaire-9 (PHQ-9) and Functional Assessment of Self-Mutilation (FASM) were used to evaluate depression and NSSI respectively. Six emotions including neutral, angry, disgusted, fearful, happy, sad and surprised were used for testing. Spearman correlation analysis and binary logistic regression analysis were used to explore the relationship between NSSI and emotion recognition. RESULTS:This study recruited 1644 adolescent depression patients, of whom 76.2 % (1252/1644) reported NSSI behavior and had significantly higher PHQ-9 scores than adolescents without NSSI behavior (p < 0.001). "Cut or carved on your skin" was more common in the choice of method (87.6 %). The age curve showed that girls have more NSSI in each age group, and the peak incidence of NSSI in girls was higher than that in boys. Compared with the non-NSSI group, the NSSI group exhibited higher accuracy in recognizing aversive emotions. In addition, PHQ-9 scores were significantly correlated with the recognition of neutral(P < 0.001), angry(P = 0.011), and happy(P = 0.008). Furthermore, PHQ-9 scores (P < 0.001) and Surprised facial emotion recognition scores (P = 0.026) showed significant correlations with NSSI behavior. CONCLUSION:NSSI is common in adolescents with depression, and the emotional recognition ability of NSSI patients has decreased, especially in identifying neutral, happy, and angry emotions. Similarly, depression further exacerbates the risk of NSSI.

Challenges in the ability of older adults to comprehend vocal emotion have been documented. However, limited research has investigated the combined effects of aging and age-related hearing loss. The present study aimed to bridge this research gap by comparing the performance of three participant groups (younger adults with normal hearing, older adults with hearing loss, and older adults without hearing loss) in identification of "happy" and "sad" emotions via prosodic and semantic channels. We conducted regression models to investigate the relationship between age, hearing threshold, cognitive abilities and overall emotion perception performance. Results of emotion identification accuracy demonstrated that older adults with hearing loss performed worse than other two normal hearing groups in both channels. Additionally, only older adults with hearing loss showed lower accuracy in the emotional prosody than semantics, indicating only this group is influenced by channel. As for response time, both older listener groups responded more slowly than younger listeners in both channels. They also exhibited faster responses to "happy" compared to "sad", supporting the positivity effect on emotion perception in older participants. Moreover, the regression models indicated that age, hearing threshold and working memory (measured by Digit Span test) were predictive of participants' overall identification accuracy, and selective attention (measured by Stroop test) was predictive of participants' overall reaction time. These findings suggest that the degraded emotion perception among older adults is attributed to complex underlying mechanisms, which can be reasonably explained by not only aging but also the decline in hearing sensitivity and cognitive functions.

OBJECTIVE:This double-blind randomized controlled trial aimed to investigate the effects of high-definition transcranial direct current stimulation (HD-tDCS) on degree centrality (DC) in the cerebellum and empathy in patients with schizophrenia. METHODS:Forty-five patients with schizophrenia were randomly assigned to either active stimulation group (n=24) or sham stimulation group (n=21). Both groups underwent HD-tDCS targeting the left dorsolateral prefrontal cortex (DLPFC). Resting-state fMRI scan, the Positive and Negative Syndrome Scale (PANSS) and Chinese version of the Interpersonal Reactivity Index (IRI-C) were applied at baseline and post-intervention. Degree centrality (DC) analysis and functional connectivity (FC) analysis were performed to identify changes in brain. Correlations between neural and behavioral alterations were examined. RESULTS:After intervention, the active stimulation group showed a significant increase in DC in the right posterior cerebellum compared with their own baseline, whereas no such change was observed in the sham group. Exploratory analysis revealed enhanced FC between the right posterior cerebellum and right hippocampus in the active group post-intervention. Clinically, the active group exhibited significant reductions in total PANSS scores and positive symptom scores relative to baseline. A potential positive correlation was noted between the increased right posterior cerebellar DC and improved empathetic concern in the active group. CONCLUSION:HD-tDCS over the left DLPFC emerges as a promising targeted intervention for schizophrenia, capable of modulating cerebellar functional integration (as reflected by improved DC) and alleviating clinical symptoms.

Non-suicidal self-injury (NSSI) is a serious threat to the physical and mental health of adolescents, significantly increasing the risk of suicide and attracting widespread public concern. Electroencephalography (EEG), as an objective tool for identifying brain disorders, holds great promise. However, extracting meaningful and reliable features from high-dimensional EEG data, especially by integrating spatiotemporal brain dynamics into informative representations, remains a major challenge. In this study, we introduce an advanced semi-supervised adversarial network, NSSI-Net, to effectively model EEG features related to NSSI. NSSI-Net consists of two key modules: a spatial-temporal feature extraction module and a multi-concept discriminator. In the spatial-temporal feature extraction module, an integrated 2D convolutional neural network (2D-CNN) and a bi-directional Gated Recurrent Unit (BiGRU) are used to capture both spatial and temporal dynamics in EEG data. In the multi-concept discriminator, signal, gender, domain, and disease levels are fully explored to extract meaningful EEG features, considering individual, demographic, disease variations across a diverse population. Based on self-collected NSSI data (n=114), the model's effectiveness and reliability are demonstrated, with a 5.44% improvement in performance compared to existing machine learning and deep learning methods. This study advances the understanding and early diagnosis of NSSI in adolescents with depression, enabling timely intervention.

Nonsuicidal self-injury (NSSI) is increasingly conceptualized as an addiction-like behaviour characterized by dysregulated emotional and cognitive processes. Guided by the I-PACE model, this study investigated how person-level vulnerabilities interact with affective, mental and executive functioning to maintain NSSI in clinically depressed adolescents (N = 167, aged 12-18, M = 15.37 ± 1.75 years). Results revealed strong addiction-like patterns. Childhood trauma, depression and rumination demonstrated significant associations with NSSI frequency (r = 0.59-0.61), while resilience and self-esteem served as protective factors (r = -0.53 to -0.55). A hierarchical regression model explained 69% of variance, with trauma (OR = 1.12), depressive severity (OR = 1.11), rumination (OR = 1.11) and resilience (OR = 0.90) emerging as key predictors. Mediation analyses demonstrated how these factors operate in the addictive chain. Childhood trauma and borderline traits lead to affective dysregulation, which drives cognitive deficits that ultimately undermine resilience and increase NSSI risk (β = -0.28 and -0.24). These findings support the use of an addiction framework to conceptualize NSSI, while highlighting resilience-focused interventions as critical for breaking these maladaptive cycles.