Mood disorders, including bipolar disorder (BD) and major depressive disorder (MDD), are serious and often-recurring psychiatric conditions that commonly first manifest during childhood or adolescence (1, 2). Youth with mood disorders are four times more likely to attempt suicide (32% vs. 8% in the general population) (3), are at elevated risk for developing co-occurring psychiatric disorders (4), and frequently experience family maladjustment and exposure to significant early-life stress (5, 6).

Depression, together with insulin resistance, is increasingly prevalent among youth. These conditions have traditionally been compartmentalized, but recent evidence suggests that a shared brain motivational network underlies their co-occurrence. We posit that, in the context of depressive symptoms, insulin resistance is associated with aberrant structure and functional connectivity in the Anterior Cingulate Cortex (ACC) and hippocampus. This motivational neural circuit underlies dysfunctional behavioral responses and increased sensitivity to rewarding aspects of ingesting high calorie food that lead to disinhibition of eating even when satiated. To investigate this shared mechanism, we evaluated a sample of forty-two depressed and overweight (BMI > 85th %) youth aged 9 to 17. Using ACC and hippocampus structural and seed-based regions of interest, we investigated associations between insulin resistance, depression, structure (ACC thickness, and ACC and hippocampal area), and resting-state functional connectivity (RSFC). We predicted that aberrant associations among these neural and behavioral characteristics would be stronger in insulin resistant compared to insulin sensitive youth. We found that youth with greater insulin resistance had higher levels of anhedonia and more food seeking behaviors, reduced hippocampal and ACC volumes, and greater levels of ACC and hippocampal dysconnectivity to fronto-limbic reward networks at rest. For youth with high levels of insulin resistance, thinner ACC and smaller hippocampal volumes were associated with more severe depressive symptoms, whereas the opposite was true for youth with low levels of insulin resistance. The ACC-hippocampal motivational network that subserves depression and insulin resistance separately, may represent a critical neural interaction that link these syndromes together.

OBJECTIVESTo assess pre-/post-transplantation changes in autonomic tone, as measured by heart rate variability (HRV), among patients undergoing hematopoietic cell transplantation (HCT) and to look at those changes as they relate to post-transplantation survival rates. 
.SAMPLE & SETTINGData were derived from a sample of 27 English-speaking patients undergoing allogeneic or autologous HCT at Stanford University. 
.METHODS & VARIABLESA survival analysis using the Kaplan-Meier estimator was employed to explore whether increased HRV would enhance survival probabilities over time among patients undergoing HCT.
.RESULTSAn increased probability of survival was significantly related to increases in two HRV indexes.IMPLICATIONS FOR NURSINGHRV may be a useful predictor of mortality among patients undergoing HCT. Interventions deliverable by nurses could be used to enhance HRV for patients identified as being at risk for early mortality.

Patients with cancers frequently experience sleep and circadian dysfunction. To date, only a few studies have used both a questionnaire and actigraphy for concomitant evaluation of sleep and circadian function in patients with cancer. We sought to evaluate objective sleep and circadian parameters in metastatic colon cancer (MCC) patients and their associations with symptoms and quality of life (QOL).