Background and AimsAnxiety and depression symptoms are common among autistic youth, yet little is known about the pattern and relationship of their trajectories from childhood into adolescence, a period of increasing social and academic demands.MethodsThis study used parallel process latent growth curve models to examine joint trajectories, including initial levels and rate of change in caregiver-reported depression and anxiety symptoms across age 7–16 within an inception cohort of autistic youth with varied communication abilities. We also examined autistic traits, sex assigned at birth, emotional reactivity and communication ability as potential predictors. Child anxiety and depression symptoms were estimated from Child Behavior Checklist Anxiety and Affective Problems subscales, completed by caregivers approximately annually.ResultsWhereas anxiety symptoms were relatively stable from childhood into adolescence, depression symptoms increased on average; significant heterogeneity of individual trajectories underlaid these overall trends. Findings indicated cross-sectional and longitudinal co-occurrence of anxiety and depression symptoms. Greater autistic traits and emotional reactivity correlated with greater initial anxiety and depression symptoms, but not their trajectories. Stronger communication ability correlated with more initial anxiety, but decreasing anxiety symptoms over time.ConclusionsFindings indicate group-level changes in depression symptoms and synchronous evolution of anxiety and depression symptoms in autistic youth across childhood and adolescence. This indicates the importance of joint monitoring of anxiety and depression symptoms in this period, with changes being potentially informative for early detection and intervention. Considering how anxiety symptom presentation may evolve across development may be a helpful next step to identifying at-risk subgroups.
Retrospective evaluation of transcranial magnetic stimulation for enhancing arousal in patients with minimally conscious state: a single-centre study in Inner Mongolia, China
ObjectiveThis study aimed to investigate the effect of high-frequency transcranial magnetic stimulation (TMS) targeting multiple brain regions on the recovery of consciousness in patients with minimally conscious state (MCS).MethodsA retrospective analysis was conducted on MCS patients between August 2022 and March 2024. Some patients received only conventional rehabilitation treatment, while others received additional TMS therapy. Clinical outcomes were assessed using the Glasgow Coma Scale (GCS) and the Coma Recovery Scale-Revised (CRS-R) at three time points: before treatment (T0), two weeks post-treatment (T1), and one month post-treatment (T2). Additional assessments included electroencephalogram (EEG), brainstem auditory evoked potential (BAEP), somatosensory evoked potentials (SEP), and serum levels of brain-derived neurotrophic factor (BDNF) and neuron-specific enolase (NSE).ResultsA total of 30 patients were included and divided equally into two groups. The GCS and CRS-R scores of the 15 patients who received TMS therapy demonstrated significant improvements at T1 and T2. Furthermore, these patients exhibited significant enhancements in EEG and BAEP grading at T1.ConclusionThe findings suggest that adjunctive multi-target high-frequency repetitive TMS may promote recovery of consciousness in MCS patients. These results underscore the potential of repetitive TMS as a therapeutic intervention for MCS and warrant further investigation in future studies.
Real-world use of brexpiprazole during inpatient treatment for schizophrenia: continuation, discontinuation, and concomitant psychotropics
IntroductionIn the treatment of schizophrenia, antipsychotics used during acute inpatient care must control acute symptoms while remaining sufficiently tolerable to support treatment beyond the acute phase. Brexpiprazole, a serotonin-dopamine activity modulator may be one such option; however, its real-world use and short-term continuation in acute inpatient settings remain insufficiently characterized.MethodsWe conducted a retrospective observational study of inpatients with DSM-5 schizophrenia treated with brexpiprazole at a university hospital in Japan between June 2018 and July 2024. The index date (week 0) was defined as the date of brexpiprazole initiation during the index hospitalization. The primary outcome was brexpiprazole continuation at week 8. We compared baseline demographic and treatment-related variables between the continuation and discontinuation groups and summarized reasons for discontinuation from electronic medical records. As a secondary exploratory analysis, we examined longitudinal changes in Clinical Global Impressions–Severity scale (CGI-S) and Brief Psychiatric Rating Scale (BPRS) total scores (weeks 0/4/8) in the continuation group using a linear mixed-effects model including time, concomitant psychotropic medication status, and their interaction.ResultsSixty-seven patients were included. Baseline illness severity was substantial (median CGI-S 5.0 [IQR 5.0–6.0]; mean BPRS total 58.5 ± 9.6). Concomitant psychotropic medications were common. Thirty-six patients continued brexpiprazole to week 8 (53.7%). In unadjusted exploratory comparisons, continuation was associated with the female sex (p = 0.036), lower prior chlorpromazine-equivalent dose (p = 0.015), and shorter duration of untreated psychosis (p = 0.003), with a trend toward shorter duration since onset (p = 0.073). The most frequent reason for discontinuation was adverse events (n = 10, 32.3%), most commonly akathisia (n = 6), followed by insufficient efficacy (n = 9, 29.0%) and patient preference/refusal (n = 7, 22.6%). In exploratory mixed-effects analyses within the continuation group, CGI-S and BPRS total scores decreased over time, with significant group-by-time interactions by concomitant medication status. However, between-group differences should be interpreted cautiously.DiscussionThis study describes 8-week continuation and reasons for discontinuation of brexpiprazole in acute inpatient schizophrenia care. Given the retrospective single-center design and potential selection/information bias and unmeasured confounding, further studies are warranted to clarify its clinical positioning in real-world practice.
Neural Correlates of Suicidal Behavior in Youth
Conditions: Suicidal Ideation; Suicide Attempt; Suicidal Behavior; Depression / Major Depressive Disorder; Hopelessness; Neurobiological
Interventions: Behavioral: CAMS
Sponsors: The Cleveland Clinic; MQ Mental Health Research
Not yet recruiting
Interventions: Behavioral: CAMS
Sponsors: The Cleveland Clinic; MQ Mental Health Research
Not yet recruiting
Group Retreat Psilocybin Therapy for Healthcare Clinicians With Loss of Meaning in Their Work and Symptoms of Depression
Conditions: Depression; Anxiety
Interventions: Drug: Psilocybin
Sponsors: University of Washington
Not yet recruiting
Interventions: Drug: Psilocybin
Sponsors: University of Washington
Not yet recruiting
Coaching as an Adjunct to Ketamine Therapy for Treatment-Resistant Depression
Conditions: Treatment Resistant Depression (TRD)
Interventions: Behavioral: Psychedelic Integration Coaching
Sponsors: Massachusetts General Hospital; Fireside Project
Recruiting
Interventions: Behavioral: Psychedelic Integration Coaching
Sponsors: Massachusetts General Hospital; Fireside Project
Recruiting
Group PACBT for Depression
Conditions: Depression – Major Depressive Disorder; Psilocybin; Cognitive Behavioral Therapy
Interventions: Drug: Psilocybin (drug); Behavioral: Group Cognitive Behavioral Therapy
Sponsors: University of California, Los Angeles
Not yet recruiting
Interventions: Drug: Psilocybin (drug); Behavioral: Group Cognitive Behavioral Therapy
Sponsors: University of California, Los Angeles
Not yet recruiting
Curiosity in a Novel Virtual Reality Scenario and Its Association With Symptoms of Depression: Observational Pilot Investigation
Background: Curiosity plays a fundamental role in human learning, development, and motivation, and emerging evidence suggests that reduced curiosity is linked to poorer mental health outcomes, including depressive symptoms (DS). However, to date, the majority of curiosity research relies on self-report assessments and thus risks biased reporting. Virtual reality (VR), a novel tool increasingly used within mental health research and treatment, might represent a potent tool for offering ecologically valid insights into curiosity-driven behaviors while circumventing issues related to self-report assessments, including demand characteristics and recall bias. Objective: The study aimed to enhance the assessment of curiosity by using a novel VR environment and to examine its relevance to DS. Specifically, we tested 2 hypotheses using a novel VR environment: first, that curiosity, as assessed through spontaneous exploratory interactions and behaviors in VR, positively correlates with self-reported curiosity, and second, that VR-based curiosity is inversely associated with DS. Methods: This exploratory study used an observational design that included 100 volunteers. All participants completed self-reported assessments of DS and curiosity before engaging in a novel VR scenario. Although progression in the virtual environment required solving cognitive tasks, these were embedded as structural elements rather than framed as the primary objective. Instead, participants’ free explorations and interactions with objects formed the basis for the 4 curiosity metrics used in this study. After VR exposure, participants completed a questionnaire assessing cybersickness symptoms. Results: Hypothesis 1 was not supported, as only one curiosity metric, namely object interactions, was positively associated with one aspect of curiosity relating to motivation to seek new knowledge and experiences. Further, diminishing significance after correction for multiple testing warranted caution. Results relating to hypothesis 2 indicated partial support, in that object interaction was significantly associated with DS while controlling for age, sex, and cybersickness levels. Sensitivity analyses showed no associations between object interactions and self-reported anxiety and stress symptoms. Conclusions: VR may be a potent tool for assessing exploratory behaviors in a controlled, yet ecologically valid, environment that avoids issues related to self-report. However, whether such motivations translate to established curiosity constructs warrants further research. This study also provided preliminary insights into how assessing exploratory interactions in VR may be a promising avenue that could enhance the understanding of the etiology and assessment of DS—particularly its early stages.
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Biomarker of Epigenetic Aging Could Signal Depression
Research led by New York University suggests a marker of epigenetic aging could be linked to depression.
The team found that accelerated aging of a type of white blood cell called a monocyte was significantly associated with the psychological and cognitive expressions of depression in a group of women with and without HIV.
“Depression is not a one-size-fits-all disorder—it can look really different from person to person, which is why it’s so important to consider varied presentations and not just a clinical label,” said lead researcher Nicole Beaulieu Perez, PhD, assistant professor at NYU Rory Meyers College of Nursing, in a press statement.
“Our study reveals unique biological underpinnings of mental health that are often obscured by broad diagnostic categories.”
As reported in The Journals of Gerontology Series A, the researchers analyzed blood samples and depression scores from 440 women, 261 living with HIV and 179 without, from the Women’s Interagency HIV Study. They tested women with HIV as people with this disease and others affecting the immune system are at greater risk of depression than the general public.
The team looked at biological aging using two epigenetic clocks: a broad multi-tissue clock and a monocyte-specific clock that measures chemical modifications to DNA in these cells.
Depression was measured using the CES-D questionnaire, which separates physical, bodily expressions of depression such as fatigue, appetite loss, and agitation from psychological and cognitive expressions of the disorder such as hopelessness, anhedonia, and feelings of failure.
Accelerated monocyte aging was significantly associated with the psychological and cognitive expressions of depression and with anhedonia specifically, even after adjusting for HIV status, race, and ethnicity. The broader multi-tissue Horvath clock showed no association with any depression domain, suggesting it is the monocyte-specific aging signal, not generalized biological aging, that tracks with mood and cognitive symptoms.
Diagnosis of depression relies largely on self-reported symptoms and not a specific physiological test. The finding that monocyte aging maps onto cognitive and mood symptoms rather than physical ones is counterintuitive, since monocytes are inflammatory cells that one might expect to track physical, inflammation-driven complaints like fatigue.
The study is small and cross-sectional, so causality cannot yet be established, but if the claims of the study were validated it could help to personalize treatment for depression in the future.
“The dynamics of monocyte aging and depression warrant further study to clarify mechanistic links,” conclude the authors.
“Our findings bring us a step closer to this goal of precision mental health care, especially for high-risk populations, by providing a biological framework that could guide future diagnosis and treatment,” adds Beaulieu Perez.
The post Biomarker of Epigenetic Aging Could Signal Depression appeared first on Inside Precision Medicine.
Depressive Symptoms Are Associated with Altered Development of Amygdala-Ventrolateral Prefrontal Connectivity During Implicit Emotion Regulation Across Adolescence
Adolescence is characterized by extensive development in neural circuits that support emotion processing and regulation, and by increased risk for depression. While altered frontolimbic functioning during emotion processing has been implicated in youth with depression relative to healthy controls, the directions of the associations have been inconsistent.