This study aimed to characterise neurometabolic differences between bipolar disorder I (BD-I) and bipolar disorder II (BD-II), and to examine their associations with cognitive function. A total of 50 patients diagnosed with BD-I, 80 patients with BD-II, and 50 healthy controls (HCs) were recruited for this study. Metabolite concentrations—specifically N-acetylaspartate (NAA) and choline-containing compounds (Cho)—were measured in the prefrontal white matter (PWM), anterior cingulate cortex (ACC), and thalamus through proton magnetic resonance spectroscopy (¹H-MRS). Cognitive performance was evaluated using the MATRICS Consensus Cognitive Battery (MCCB). When compared to HCs, patients with BD-II showed significantly higher Cho/Cr ratios in the right PWM and left ACC, along with lower NAA/Cr ratios in the right thalamus; compared to BD-II patients, those with BD-I exhibited higher Cho/Cr ratios in the right PWM and lower NAA/Cr ratios in the right thalamus; among BD-I patients, the Cho/Cr ratio in the left ACC was negatively correlated with measures of information processing speed and attentional vigilance. This study demonstrates that BD-II patients exhibit greater cholinergic dysregulation in the left ACC and the right PWM, whereas BD-I patients show more pronounced neuronal dysfunction in the right thalamus. Furthermore, the left ACC Cho/Cr ratio was specifically associated with cognitive impairments in information processing speed and attentional vigilance, but only among patients with BD-I. This suggests that subtype-specific mechanisms underlie the relationship between neurometabolic abnormalities and cognitive deficits. Not applicable.

The underlying mechanism of major depressive disorder (MDD) with eating disorder (ED) remains unclear. We aim to clarify the characteristic changes of THs and brain neurometabolic alterations in ED, and to explore their relationships. The study included 28 individuals with MDD and ED, 81 individuals with MDD without ED, and 37 age-matched healthy controls (HCs). Serum TH levels were assessed, and 1H proton magnetic spectroscopy was utilized to determine the N-acetylaspartic acid to creatine (NAA/Cr) and choline-containing compounds to creatine ratios in the prefrontal cortex, anterior cingulate cortex, and thalamus. Subsequently, differential analysis, receiver operating characteristic (ROC) analysis, and correlation analysis were performed to explore their characteristics and interrelationships. In both MDD with ED and MDD without ED cohorts, free tri-iodothyronine (FT3) levels were significantly lower compared to HCs, whereas free thyroxine (FT4) and total thyroxine (TT4) levels were elevated. Significantly lower NAA/Cr ratios were observed in the right thalamus and higher NAA/Cr ratios in the left cerebellum in both MDD with ED and MDD without ED compared to HCs. Neurometabolic factors and THs levels achieved an ROC curve area of 0.830 in differentiating MDD with ED from MDD without ED. In addition, serum FT3 and TT4 levels showed a positive correlation with NAA/Cr in the eft cerebellum in cases of MDD with ED. Our findings reveal concurrent thyroid hormone irregularities and neurometabolic changes in the thalamic-cerebellum circuitry in MDD with ED, providing preliminary insights into the neurobiology of abnormal eating behaviors in depression. Given the cross-sectional design, these results are exploratory and require validation. Level of evidence Level IV, cross-sectional study.

Virtual Reality-based Eye movement desensitization and reprocessing therapy (VR-EMDR) has been proven effective in treating adults with major depressive disorder (MDD). However, its effectiveness in treating adolescents with MDD is less studied, and its underlying neuroimaging mechanism remains unknown. Sixty-eight adolescents with MDD and 29 adolescent healthy control (HC) were recruited. Adolescents with MDD were randomly allocated to the intervention group and the wait-list control group. The intervention group received 12-session of VR-EMDR, while another group received no psychotherapy. We used the Hamilton Depression Rating Scale-24 version (24-HDRS) to assess the patients’ depressive symptoms; the Das-Naglieri Cognitive Assessment System (CAS) to assess the patients’ neurocognitive performance; and the functional near-infrared spectroscopy (fNIRS) to assess the patients’ functional connectivity and small-world network attributes. After VR-EMDR, the linear mixed model (LMM) revealed significantly lower scores in 24-HDRS and average shortest path, and significantly higher scores in figure memory, successive processing, sentence repetition, sentence question, and total cognitive in the intervention group (all p < 0.05). Multiple linear regression analyses revealed that significant negative relationships can be found between average shortest path and figure memory, total cognition; a significant positive relationship can be found between global efficiency and successive processing (all p < 0.05). VR-EMDR can effectively improve depressive symptoms, neurocognitive performance, and change small-world network attributes in adolescents with MDD. Furthermore, the changes in average shortest path length and global efficiency may play potential roles in the improvement of cognitive function after VR-EMDR.

Our study investigated the neuropsychological mechanisms underlying BD comorbid with BPD by examining childhood trauma and metabolic changes in the cerebellum. We found that BD & BPD patients reported higher levels of physical abuse and demonstrated distinct cerebellar metabolic profiles characterized by elevated NAA/Cr and Cho/Cr ratios in the right cerebellum compared to BD patients without BPD. Notably, these ratio changes were driven by significantly increased absolute NAA concentrations and decreased creatine levels, whereas absolute choline concentrations and NAA/Cho ratios remained unchanged. Physical abuse was inversely correlated with the right cerebellar Cho/Cr ratio. These findings suggest that childhood trauma may interact with cerebellar energy metabolic dysfunction-characterized by neuronal hypermetabolism (elevated NAA) and compromised energy buffering (reduced Cr)-in the pathophysiology of this comorbidity. This study provides new insights into the biological underpinnings linking early-life adversity and cerebellar neurochemical alterations in BD & BPD.

Backgrounds: Evidence from animal and population studies has consistently revealed that microRNA 218 (MIR218) is involved in susceptibility to depression and cognitive functions. Nevertheless, few studies have evaluated the association between MIR218 and clinical features in patients with depressed bipolar disorder (BD). Methods: A total of 66 patients with depressed BD and 49 healthy controls (HCs) were recruited for this study. MIR218 polygenic risk score (PRS) was used to assess the addictive effects of the MIR218 regulated genes. We compared the MIR218 PRS between patients with depressed BD and HCs to investigate whether it can be used to predict the risk of BD, and further explored the association between MIR218 PRS and cognitive performance as well as neurochemical metabolites among depressed BD. Results: We found that there was a significant difference in MIR218 PRS between patients with depressed BD and HCs. The correlation analysis indicated that MIR218 PRS was negative associated with the number of disease onset (r = -0.311, P = 0.033) and choline (Cho)/creatine (Cr) in right thalamus (r = -0.285, P = 0.021). Additionally, as supported by previous findings, patients with lower MIR218 PRS presented more domains of impaired cognitive function than those with higher scores. Conclusion: These findings suggested MIR218 PRS might be useful in differentiating patients with depressed BD from HCs. Moreover, depressed BD with lower MIR218 PRS showed more pronounced cognitive impairment than those with higher scores, which may be associated with disease recurrence and Cho metabolism in right thalamus.

BACKGROUND:Most patients with major depressive disorder (MDD) have working memory (WM) impairment, which can be improved by virtual reality-based working memory (VR-WM) training; however, the specific neural mechanisms remain unclear. This study aimed to clarify how VR-WM training improves WM in patients with MDD and further explore the role of the frontotemporal lobe in related neural mechanisms. METHODS:A total of 57 patients with MDD were included in a randomized controlled study to clarify the effects of 20 sessions of VR-WM training on WM in patients with MDD and to explore the role of the frontotemporal lobe in associated neural mechanisms. The Stroop color word test, 2-back task, digit task switching, and digit span test were used to measure the inhibition, updating and switching functions of WM and WM span. The functional features of the frontotemporal lobe in patients with MDD at rest were detected using functional near-infrared spectroscopy before and after training. RESULTS:After VR-WM training, patients with MDD exhibited significant improvements in the accuracy of the Stroop color word test (p = 0.013) and 2-back task (p = 0.002), the scores of digit span test (p = 0.030) and Hamilton Depression Rating Scale (HDRS) score (p = 0.006). Significant group-by-time interactions of local efficiency (p = 0.005) and clustering coefficient (p = 0.004) of the frontotemporal lobe were observed between groups. The degree of improvement in the total score of the digit span test was positively correlated with the change in the clustering coefficient (p = 0.034). CONCLUSIONS:VR-WM training effectively improved inhibition, updating and memory span in the WM of patients with MDD. Furthermore, VR-WM training was observed to enhance functional connectivity in the frontotemporal lobe, thereby improving WM performance in patients with MDD.

BACKGROUND:Gender differences in non-suicidal self-injury (NSSI) among adolescents with major depressive episodes (MDE) may exist, but the underlying neurobiological mechanisms remain unclear. METHODS:171 unmedicated MDE adolescent patients with NSSI (NSSI group), 71 unmedicated MDE adolescent patients without NSSI (non-NSSI group), and 32 healthy controls (HC) were included. The 24-item Hamilton Depression Rating Scale (24-HDRS) was used to assess depressive symptoms. Bilateral metabolic ratios of N-acetyl aspartate (NAA) and choline-containing compounds (Cho) to creatine (Cr) in the prefrontal cortex (PFC), anterior cingulated cortex (ACC), lenticular nucleus (LN), and thalamus were obtained by proton magnetic resonance spectroscopy (1H-MRS) at 3.0 T. RESULTS:A significant interaction effect between biological sex and the group can be found in the Cho/Cr of the right thalamus, in which males with NSSI showed significantly lower Cho/Cr than those without (p = 0.01), and males had higher Cho/Cr of the right thalamus than females in the non-NSSI group (p = 0.002). A significant correlation between the risk of NSSI and the Cho/Cr of the right thalamus can only be found in male MDE adolescents (p = 0.002), instead of in females. The binary logistic regression showed a significant negative association between the Cho/Cr of the right thalamus and the risk of NSSI in males (p = 0.02). CONCLUSIONS:There is a sex-specific association between the neurochemical metabolisms and the NSSI risk. The Cho/Cr of the right thalamus may increase the risk of NSSI in MDE male adolescents, which can be a specific biomarker for NSSI risk the in MDE male adolescents.

OBJECTIVE:Eye movement desensitization and reprocessing therapy (EMDR) is effective in treating major depressive disorder (MDD) with childhood trauma, and virtual reality (VR) can further extend its application form. However, the utilization of VR-EMDR in treating MDD with childhood trauma is still in its infancy, and whether it can improve depressive symptoms and traumatic experience remains unknown. METHOD:Seventy-two MDD patients were randomly allocated to the intervention group and the wait-list control group on a 1:1 basis. The intervention group received 12-session VR-EMDR, while another group received no intervention. We used Patient Health Questionnaire-9 (PHQ-9) and Hamilton Depression Rating Scale-24 Version (24-HDRS) to assess the patient's subjective and objective depressive symptoms, the Posttraumatic Stress Disorder Check List-Civilian (PCL-C) to assess the patient's traumatic experience, the Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire, and the MATRICS Consensus Cognitive Battery to assess the patient's subjective and objective cognitive performance. RESULTS:After VR-EMDR, the linear mixed model revealed significantly lower scores in PHQ-9, 24-HDRS total and factor score (including anxiety/somatization, weight, and block), Posttraumatic Stress Disorder Check List-Civilian, and Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire and significantly higher scores in information processing speed, attention/alertness, and working memory in the intervention group (p < .05). Improvements can be maintained in the 3-month follow-up, except for 24-HDRS anxiety/somatization factor score, which showed significantly higher scores in the 3-month follow-up compared with postintervention (p < .05). CONCLUSIONS:VR-EMDR is effective in improving depressive symptoms, traumatic experience, and cognitive performance in MDD with childhood trauma. Part of the effects can be maintained 3 months after the intervention. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

BACKGROUND:Both genetic and environmental factors can influence brain function in individuals with bipolar disorder (BD). This study aimed to investigate the aberrant functional connectivity (FC) of the striatum and its relationship with the polygenic risk score (PRS) of MicroRNA-124 (MIR124) and experiences of childhood trauma. METHODS:The study recruited 80 patients with BD and 54 healthy controls (HCs). Resting-state functional magnetic resonance imaging data were collected from all participants. Six pairs of striatal subregions were selected as seeds for the FC analysis. Additionally, MIR124 PRS was calculated, and childhood trauma was assessed. Partial correlation and mediation analyses were conducted to explore these associations. RESULTS:BD exhibited higher incidence of childhood trauma and increased MIR124 PRS compared to HCs. When compared to HCs, BD showed decreased FC between the left dorsal caudate (dCa) and right thalamus, the right dCa and left medial superior frontal gyrus, and the right dlPu and right median cingulate/paracingulate gyri. Conversely, increased FC was observed between the right dorsolateral putamen (dlPu) and left precentral gyrus, the right globus pallidus (GP) and precentral gyrus. Notably, mediation analyses revealed that scores for emotional neglect (EN) and physical neglect (PN) from the Childhood Trauma Questionnaire (CTQ) mediated the relationship between MIR124 PRS and FC between the right GP and left precentral gyrus. CONCLUSIONS:These findings suggest that an elevated MIR124 PRS and experiences of childhood trauma may be associated with altered FC within corticostriatal circuits in BD, offering potential new insights into the underlying mechanisms of BD.

Bipolar disorder (BD) is highly comorbid with obsessive-compulsive disorder (OCD), leading to poor treatment outcome and prognosis. However, the neurobiological mechanisms underlying BD comorbid with OCD remain poorly understood. To address it, we recruited 69 untreated patients with bipolar II depression, including 35 comorbid with OCD (BD-II-Depression-OCD) and 34 without OCD (BD-II-Depression-nonOCD), and 38 healthy controls (HC). Serum thyroid hormones levels and neurometabolic ratios, including N-acetyl aspartate (NAA), choline-containing compounds (Cho), and creatine (Cr), were detected to explore the neuroendocrine and neurometabolic mechanisms of BD-II-Depression-OCD comorbidity. Multivariate logistic regression and restricted cubic spline analyses were performed to identify influential factors for comorbidity and their nonlinear relationships with symptom severity. Our results revealed that patients with BD-II-Depression-OCD demonstrated reduced thyroid-stimulating hormone (TSH) levels, decreased NAA/Cr in the left prefrontal white matter (PWM), and increased Cho/Cr in the right PWM compared to patients without comorbidity. These parameters demonstrated diagnostic potential for distinguishing BD-II-Depression-OCD comorbidity. Furthermore, nonlinear associations were observed between obsessive-compulsive symptom severity and both serum TSH levels and right PWM Cho/Cr ratios among patients with comorbidity. In conclusion, BD-II-Depression-OCD comorbidity is characterized by distinct thyroid dysfunction and neurometabolic alterations. Disruptions in serum TSH levels and bilateral PWM neurometabolism may represent potential mechanisms underlying BD-II-Depression-OCD comorbidity.

Background: It is widely known that sex differences have a significant impact on patients with major depressive disorder (MDD). This study aims to evaluate the sex-related connection between serum trace elements and changes in neurometabolism in the anterior cingulate cortex (ACC) of MDD patients. Methods: 109 untreated MDD patients and 59 healthy controls underwent proton magnetic resonance spectroscopy ( 1 H-MRS) under resting conditions. We measured metabolic ratios in the ACC from both sides. Additionally, venous blood samples were taken from all participants to detect calcium (Ca), phosphorus, magnesium (Mg), copper (Cu), ceruloplasmin (CER), zinc (Zn), and iron (Fe) levels. We performed association and interaction analyses to explore the connections between the disease and gender. Results: In individuals with MDD, the Cu/Zn ratio increased, while the levels of Mg, CER, Zn and Fe decreased. Male MDD patients had lower Cu levels, while female patients had an increased Cu/Zn ratio. We observed significant gender differences in Cu, CER and the Cu/Zn ratio in MDD. Male patients showed a reduced N -acetyl aspartate (NAA)/phosphocreatine + creatine (PCr + Cr) ratio in the left ACC. The NAA/PCr + Cr ratio decreased in the right ACC in patients with MDD. In the left ACC of male MDD patients, the Cu/Zn ratio was inversely related to the NAA/PCr + Cr ratio, and Fe levels were negatively associated with the GPC + PC/PCr + Cr ratio. Conclusions: Our findings highlight gender-specific changes in Cu homeostasis among male MDD patients. The Cu/Zn ratio and Fe levels in male MDD patients were significantly linked to neurometabolic alterations in the ACC.

Background: Non-suicidal self-injury (NSSI) may be related to serious cognitive impairment in patients with major depressive disorder (MDD), but the specific mechanism is still unclear. This study attempts to identify the neurobiological process alterations of cognitive impairment in MDD patients with NSSI by examining the functional connectivity of the frontotemporal cortex in MDD patients with or without NSSI. Method: Thirty MDD patients with NSSI, 36 MDD patients without NSSI, and 35 healthy controls (HC) were included in the study. The MATRICS Consensus Cognitive Battery (MCCB) was used to comprehensively assess the cognitive function of the subjects and functional near-infrared spectroscopy (fNIRS) was used to detect the functional connectivity of the frontotemporal cortex and its brain regions of interest. Results: MDD patients with or without NSSI had multi-domain cognitive impairments. MDD patients with NSSI showed the lowest score in performance of attention/alertness and the weakest functional connectivity of frontotemporal when compared with the MDD patients without NSSI and the HC. In addition, the functional connectivity of the bilateral frontotemporal cortex was positively correlated with verbal learning and working memory in MDD patients with NSSI. Conclusion: In MDD patients, the appearance of NSSI is often accompanied by further impairment of attention/ alertness and a decline in functional connectivity of the frontotemporal cortex. The impairment of verbal learning and working memory was associated with decreased functional connectivity of the frontotemporal cortex in MDD patients with NSSI.

Abstract Background Recent evidences have shown sex-differential cognitive deficits in bipolar disorder (BD) and differences in cognitions across BD subtypes. However, the sex-specific effect on cognitive impairment in BD subtype II (BD-II) remains obscure. The aim of the current study was to examine whether cognitive deficits differ by gender in youth with BD-II depression. Method This cross-sectional study recruited 125 unmedicated youths with BD-II depression and 140 age-, sex-, and education-matched healthy controls (HCs). The Chinese version of the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) was used to assess cognitive functions. Mood state was assessed using the 24-item Hamilton Depression Rating Scale (24-HDRS) and the Young Mania Rating Scale (YMRS). Multivariate analysis of covariance (MANCOVA) was conducted. Result ​Compared with HCs, patients with BD-II depression had lower scores on MCCB composite and its seven cognitive domains (all p < 0.001). After controlling for age and education, MANCOVA revealed significant gender-by-group interaction on attention/vigilance (F = 6.224, df = 1, p = 0.013), verbal learning (F = 9.847, df = 1, p = 0.002), visual learning (F = 4.242, df = 1, p = 0.040), and composite (F = 8.819, df = 1, p = 0.003). Post hoc analyses suggested that males performed worse in the above-mentioned MCCB tests than females in BD-II depression. Conclusion Our study demonstrated generalized cognitive deficits in unmedicated youths with BD-II depression. Male patients performed more serious cognitive impairment on attention/vigilance, verbal learning, and visual learning compared to female patients.

BACKGROUND:The clinical characteristics of major depressive disorder (MDD) in adolescents show notable gender-related differences, but the cause of these differences is still not understood. The current research concentrates on the changes in neurometabolism and neuroendocrine function, aiming to identify differences in endocrine function and brain metabolism between male and female adolescents with MDD. METHODS:A total of 121 teenagers diagnosed with MDD (43 males and 78 females) were enlisted as participants. Measurement was conducted on levels of endocrine hormones, which included free tri-iodothyronine (FT3), total tri-iodothyronine (TT3), free thyroxin (FT4), total thyroxin (TT4), thyroid-stimulating hormone (TSH), cortisol, and adrenocorticotropic hormone (ACTH). Obtained through 1H-MRS, the N-acetyl aspartate (NAA) and choline containing compounds (Cho) to creatine (Cr) ratios were acquired for the prefrontal whiter matter (PWM), anterior cingulate cortex (ACC), basal ganglia (BG), thalamus, and cerebellum. RESULT:After adjusting for multiple comparisons, female adolescents with MDD showed lower ACTH levels compared to their male counterparts. An increased lateralization index (LI) was observed in female patients for both the thalamic Cho/Cr ratio and the basal ganglia NAA/Cr ratio. Additionally, an intriguing finding was that in male adolescent patients, TT4 levels were significantly correlated with the Cho/Cr ratio in the left cerebellum. However, no such correlation between hormones and brain metabolism was found in females. CONCLUSIONS:Gender differences in endocrine and neurometabolic abnormalities may contribute to the gender-specific pathophysiology of MDD in adolescent patients. Metabolic abnormalities and lateralization changes are observed in different brain regions for male and female MDD patients.

Background: Cognitive training is effective in treating neuropsychological impairment in patients with major depressive disorder (MDD), and virtual reality (VR) is a promising tool to provide such training. However, studies using VR-based working memory (WM) training in treating depressed patients' cognitive impairment are extremely scarce and how it affects cognitive performance remains unclear. Therefore, we aimed to determine the efficacy of VR-WM training in acute and remitted depressed patients and try to investigate its potential mechanisms. Methods: Forty-two patients with MDD (22 acute patients and 20 remitted patients) received 20-session VR-WM training, while 22 healthy controls (HC) received no intervention. WM and other cognitive domains' performance were assessed by the Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire (CPFQ) and the MATRICS Consensus Cognitive Battery (MCCB) before and after the intervention. Depressive symptoms were assessed by the 24-item Hamilton Depression Rating Scale (24-HDRS) at the same time points.Results: Acute and remitted MDD patients both exhibited significant improvements from pre-to post-training in WM, processing speed, visual learning, reasoning and problem-solving, and total cognition (all p < 0.05). Sig-nificant groups-by-time interactions were observed for the 24-HDRS score (p < 0.05). Mediation analysis showed that 24-HDRS score partially mediated the association between the effect of VR-WM training on WM and total cognition performance in total depressive samples.Conclusions: VR-WM training effectively improved WM and other cognitive domains' performance in both acute and remitted MDD patients. Besides, VR-WM training improves WM and total cognition performance in MDD patients partially via the enhancement of depressive symptoms.

Objective: Vortioxetine has been shown to improve cognitive performance in people with depression. This study will look at the changes in neurobiochemical metabolites that occur when vortioxetine improves cognitive performance in MDD patients, with the goal of determining the neuroimaging mechanism through which vortioxetine improves cognitive function. Methods: 30 depressed patients and 30 demographically matched healthy controls (HC) underwent MCCB cognitive assessment and 1H-MRS. After 8 weeks of vortioxetine medication, MCCB and 1H-MRS tests were retested in the MDD group. Before and after therapy, changes in cognitive performance, NAA/Cr, and Cho/Cr were examined in the MDD group. Results: Compared with the HC group, the MDD group had significant reduced in verbal learning, social cognition, and total cognition (all p < 0.05). And the MDD group had lower NAA/Cr in Right thalamus and Left PFC; the Cho/Cr in Right thalamus was lower than HC; the Cho/Cr in Left ACC had significantly increase (all p < 0.05). The MDD group showed significant improvements in the areas of verbal learning, attention/alertness, and total cognitive function before and after Vortioxetine treatment (all p < 0.05). The NAA/Cr ratio of the right PFC before and after treatment (t = 2.338, p = 0.026) showed significant changes. Conclusions: Vortioxetine can enhance not just the depression symptoms of MDD patients in the initial period, but also their verbal learning, social cognition, and general cognitive capacities after 8 weeks of treatment. Furthermore, vortioxetine has been shown to enhance cognitive function in MDD patients by altering NAA/Cr and Cho/Cr levels in the frontal-thalamic-ACC.

Cognitive impairment is a common symptom in depression, yet few intervention strategies target adolescents. This study investigated the effects of an attention and working memory cognitive training system based on virtual reality (VRCT) in adolescents with mild to moderate depressive episodes. Adolescents with depression were randomized into a VR training group (VRG, n = 47) or a waitlist control group (WT, n = 46). The VR training consisted of three 10-min tasks per session, conducted three sessions per week for 20 sessions over 7 weeks. Forty-four healthy adolescents participated as a comparison group for baseline cognitive assessment. Cognitive functions and depressive symptoms were assessed using the Das-Naglieri cognitive assessment system, driven by the Planning, Attention, Simultaneous, and Successive (PASS) processing theory, and the Hamilton Depression Rating Scale-24 at pre- and post-intervention. Baseline results indicated significantly lower cognitive scores in patients compared to healthy adolescents. Post-intervention, the VRG demonstrated significant improvements in all four cognitive scales (effect sizes 0.56 to 0.76) and a significant reduction in depressive symptoms compared to the WT. These findings suggest that VRCT holds potential for improving cognitive impairments and alleviating depressive symptoms in adolescents with depression. Further large-scale and follow-up studies are necessary to confirm long-term benefits.

Objective:To investigate the differences in personality characteristics and cognitive functions in depression patients with and without obsessive-compulsive.Methods:From October 2020 to October 2021, 31 patients diagnosed as major depressive disorder(MDD) with obsessive-compulsive symptoms(OCS), totally 29 patients diagnosed as MDD without OCS, and 30 healthy controls(HC group) were recruited.The personality characteristics of all subjects were assessed with Eysenck personality questionnaire(EPQ), personality diagnostic questionnaire-4(PDQ-4) and Minnesota multiphasic personality inventory(MMPI), while cognitive functions were assessed with measurement and treatment research to improve cognition in schizophrenia(MATRICS)consensus cognitive battery(MCCB). SPSS 25.0 software was used for data processing, and univariate analysis of variance and simple effect analysis were used to compare the differences in personality characteristics and cognitive functions among the three groups of subjects.Results:The comparison of EPQ scores showed that the psychoticism scores of the group with and without OCS((50.32±10.08), (49.83±11.69)) were significantly lower than that of the HC group(59.47±10.41)( P=0.004, 0.003), while the neuroticism scores((61.94±12.36), (63.10±10.56)) were significantly higher than that of the HC group(46.13±8.33)(both P<0.05). The comparison of PDQ-4 scores showed that the schizoid score of the group with OCS(5.00(2.00, 7.00)) was significantly higher than that of the group without OCS(3.00(1.00, 5.00))( P=0.024). The comparison of MMPI scores showed that except for the two dimensions of masculinity-femininity and hypomania, the scores of the other eight dimensions in the group with and without OCS were significantly higher than those in the HC group(all P<0.01). The comparison of MCCB scores showed that the attention/alertness and visual learning scores of the group with OCS were significantly lower than those of the HC group( P=0.042, 0.004), meanwhile there was no difference of the all dimension scores of MCCB between the MDD patients with and without OCS. Conclusion:There are differences in personality and cognitive function between MDD patients with and without OCS and healthy controls.There is no difference in score of schizotypal personality traits between MDD patients with OCS and MDD patients without OCS, however the related cognitive function of MDD patients without OCS is not significantly different from that of MDD patients with OCS.It is suggested that MDD patients with OCS may have more deviated personality characteristics than those without OCS.Further research is needed to investigated the differences in cognitive impairment.

BackgroundResearch on depression has largely focused on negative intrusive memories with little research on general involuntary memories as they occur in everyday life. In addition, all studies have been conducted on Western participants, and there are no studies on general involuntary memory in Eastern patients with depression.MethodsThirty Chinese patients with depression and 30 healthy controls completed a memory diary in which they recorded a total of 10 involuntary and 10 voluntary memories. They were requested to fill out corresponding questionnaires of involuntary and voluntary memories as well.ResultsBoth patients with depression and healthy controls reported involuntary memories that had a more negative impact, were more specific, and were associated with more maladaptive emotion regulation when compared to voluntary memories. For both retrieval modes, patients with depression reported more negative and fewer positive memories, more negative and less positive mood impact, more avoidance, rumination, worry, negative interpretation, and less positive interpretation in response to the memories. Patients with depression rated their memories as more central, less specific, and rehearsed more frequently. Negative mood impact and maladaptive emotion regulation associated with involuntary memories were amplified in depression.ConclusionsThese findings support the view that general involuntary memories could be a potential target to promote the treatment for depression.

Abstract Background Mounting evidence showed that insula contributed to the neurobiological mechanism of suicidal behaviors in bipolar disorder (BD). However, no studies have analyzed the dynamic functional connectivity (dFC) of insular Mubregions and its association with personality traits in BD with suicidal behaviors. Therefore, we investigated the alterations of dFC variability in insular subregions and personality characteristics in BD patients with a recent suicide attempt (SA). Methods Thirty unmedicated BD patients with SA, 38 patients without SA (NSA) and 35 demographically matched healthy controls (HCs) were included. The sliding-window analysis was used to evaluate whole-brain dFC for each insular subregion seed. We assessed between-group differences of psychological characteristics on the Minnesota Multiphasic Personality Inventory-2. Finally, a multivariate regression model was adopted to predict the severity of suicidality. Results Compared to NSA and HCs, the SA group exhibited decreased dFC variability values between the left dorsal anterior insula and the left anterior cerebellum. These dFC variability values could also be utilized to predict the severity of suicidality (r = 0.456, p = 0.031), while static functional connectivity values were not appropriate for this prediction. Besides, the SA group scored significantly higher on the schizophrenia clinical scales (p < 0.001) compared with the NSA group. Conclusions Our findings indicated that the dysfunction of insula–cerebellum connectivity may underlie the neural basis of SA in BD patients, and highlighted the dFC variability values could be considered a neuromarker for predictive models of the severity of suicidality. Moreover, the psychiatric features may increase the vulnerability of suicidal behavior.