To test the hypothesis that surgical otologic intervention for any type of adult hearing loss decreases the odds for incident adverse life events (ALEs) and medical comorbidities (MCBs).

Retrospective cohort database study.

Electronic medical record data from the TriNetX Research Network were queried for adults (age ≥18 years) with congenital, sensorineural, conductive, and mixed hearing loss (HL). Patients were further stratified into 3 groups by presence or absence (HL-surgery) of surgical intervention at any point following diagnosis, including (1) stapes surgery (HL + stapes); (2) cochlear implantation and bone-anchored hearing aid (HL + CI); and (3) mastoidectomy alone and tympanoplasty with or without mastoidectomy (HL + TM). Primary outcomes were defined as odds for new ALEs or MCBs at any point given HL treatment status [Odds ratio with 95% confidence interval, (OR; 95% CI, P-value)]. Cohorts were balanced using propensity-score matching (PSM) based on US census-defined demographics and congenital comorbidities.

There were 2 577 153 patients included in this study. Matched analysis demonstrated that HL + stapes adults (n = 7985) had 0.37-lower odds (95% CI = 0.30-0.47, P < .0001) of experiencing any incident ALE versus HL-surgery adults (n = 2 518 409). Adults in the HL + CI cohort (n = 17 129) had 0.58-lower odds (0.52-0.66, P < .0001) of experiencing any incident MCB versus HL-surgery adults.

This study highlights the benefit of surgical intervention for adult hearing loss on social and medical phenomes. These findings represent the largest cohort study to date demonstrating this association and further support that hearing restoration improves patient socioeconomic and medical outcomes.

Type 2 diabetes mellitus (T2DM) and Major depressive disorder (MDD) act as risk factors for each other, and the comorbidity of both significantly increases the all-cause mortality rate. Therefore, studying the diagnosis and treatment of diabetes with depression (DD) is of great significance. In this study, we progressively identified hub genes associated with T2DM and depression through WGCNA analysis, PPI networks, and machine learning, and constructed ROC and nomogram to assess their diagnostic efficacy. Additionally, we validated these genes using qRT-PCR in the hippocampus of DD model mice. The results indicate that UBTD1, ANKRD9, CNN2, AKT1, and CAPZA2 are shared hub genes associated with diabetes and depression, with ANKRD9, CNN2 and UBTD1 demonstrating favorable diagnostic predictive efficacy. In the DD model, UBTD1 (p > 0.05) and ANKRD9 (p < 0.01) were downregulated, while CNN2 (p < 0.001), AKT1 (p < 0.05), and CAPZA2 (p < 0.01) were upregulated. We have discussed their mechanisms of action in the pathogenesis and therapy of DD, suggesting their therapeutic potential, and propose that these genes may serve as prospective diagnostic candidates for DD. In conclusion, this work offers new insights for future research on DD.

To examine the associations between antidiabetic medication type and a new episode of depression using 100% Texas Medicare database during 2009 and 2018.

A retrospective cohort study.

A population-based study using the Texas Medicare data.

11 common antihyperglycaemic medication types, alone and in combinations: metformin-only, five non-metformin-containing regimens (dipeptidyl peptidase-4 inhibitor (DPP4i) only, sulfonylureas (SU) only, thiazolidinediones (TZD) only, SU/DPP4i and SU/TZD) and five metformin-containing combination treatments (metformin/DPP4i, metformin/SU, metformin/TZD, metformin/SU/DPP4i and metformin/SU/TZD).

This study included 59 057 type 2 diabetes (T2D) patients from a cohort of Texas Medicare beneficiaries who were aged ≥66 years, had consistent diabetes medication intake, were not diagnosed with depression or prescribed antidepressants during the 2-year look-back period and received regular care from Medicare providers.

The main outcome was a new episode of depression, identified by a new depression diagnosis during the follow-up period.

A total of 59 057 T2D patients (mean (SD) age, 75.4 (6.4) years; 30 798 (52.1%) female) were followed up to 96 months. Of these, 22.5% patients had a new episode of depression at the 5-year follow-up. Compared with the metformin-only group, patients in the non-metformin-containing regimens had a higher risk of new episode depression (HR: 1.17, 95% CI 1.05 to 1.30 for DPP4i-only; HR: 1.06, 95% CI 1.01 to 1.12 for SU-only), but there was no significant difference among patients receiving metformin-containing combination therapy. Metformin/TZD and metformin/SU/DPP4i combination treatments had a lower risk of new episodes of depression than metformin-only (HR: 0.88, 95% CI 0.78 to 0.99 and HR: 0.83, 95% CI 0.71 to 0.98 separately). The same direction of association was observed in sensitivity analyses.

This retrospective cohort study found that T2D patients treated with metformin/TZD and metformin/SU/DPP4i had the lowest risk of new episodes of depression. These findings suggest that certain combinations of metformin with other antidiabetic medications may be associated with a reduced risk of new-onset depression. Therefore, it could be beneficial to incorporate depression risk evaluation into routine diabetes care and consider it in the decision-making process for diabetes medication types, especially when deprescribing metformin.

Elevated depressive symptoms are a risk factor for diabetes. Although depressive symptoms can remit or emerge over time, little work has considered if courses of depressive symptoms are associated with incident diabetes. The purpose of this study was to explore associations between courses of depressive symptoms and incident diabetes. Data came from the English Longitudinal Study of Ageing (n = 4,978), which is an ongoing, cohort study of adults aged 50 years and older residing in private households in England. Depressive symptoms were measured biennially from 2002 to 2008. Participants were categorized into one of six groups: no depressive symptoms, remitted depressive symptoms, incident depressive symptoms with remission, incident depressive symptoms without remission, chronic depressive symptoms, and variable course. Diabetes status was self-reported biennially from 2010 to 2018. After adjusting for covariates, remitted depressive symptoms (HR = 1.52, 95% CI [1.06, 2.22]) and variable course depressive symptoms (HR = 1.83, 95% CI [1.19, 2.81]) remained associated with incident diabetes. In sensitivity analyses, which lowered the cut-off score for depressive symptoms, variable course depressive symptoms (HR = 1.61, 95% CI [1.11, 2.33]) remained associated with incident diabetes. Specific courses of depressive symptoms, including variable course depressive symptoms, were associated with diabetes incidence. Continuing to examine the link between patterns of depressive symptoms over time and incident diabetes may lead to the development of more targeted interventions.

African American women have a disproportionate burden of disease compared to US non-Hispanic white women. Exposure to psychosocial stressors may contribute to these health disparities. Racial discrimination, a major stressor for African American women, could affect health through epigenetic mechanisms.

We conducted an epigenome-wide association study (EWAS) to examine the association of interpersonal racism (in daily life and in institutional settings) with DNA methylation in blood in 384 participants of the Black Women's Health Study (BWHS). We also evaluated whether a greater number of perceived experiences of racism was associated with epigenetic aging as measured using different methylation clocks. Models were adjusted for chronological age, body mass index, years of education, neighborhood SES, geographic region of residence, alcohol drinking, smoking, and technical covariates.

Higher scores of racism in daily life were associated with higher methylation levels at the cg04494873 site in chromosome 5 (β = 0.64%; 95% CI = 0.41%, 0.87%; P = 6.35E-08). We also replicated one CpG site, cg03317714, which was inversely associated with racial discrimination in a previous EWAS among African American women. In the BWHS, higher scores of racism in daily life were associated with lower methylation levels at that CpG site (β = -0.94%; 95% CI = -1.37%, -0.51%; P = 2.2E-05). Higher racism scores were associated with accelerated epigenetic aging in more than one methylation clock.

Exposure to discriminatory events may affect the epigenome and accelerate biological aging, which may explain in part the earlier onset of disease in African American women.

To inform the development and adaptation of lifestyle programs to prevent type 2 diabetes, we sought to identify factors associated with depressive symptoms in the early postpartum period among women with recent gestational diabetes (GDM).

Participants are from the Balance after Baby Intervention (BABI) study, a two-year randomized clinical trial of a lifestyle program for women with recent GDM conducted in Boston, MA, and Denver, CO between 2016 and 2019. The Edinburgh Postpartum Depression Scale (EPDS) and Perceived Stress Scale (PSS-10) were administered at an average of 8-weeks postpartum. We defined an EPDS score of ≥ 9 as depressive symptoms and reviewed medical records for medical history. We conducted bivariate analyses to identify predictors of postpartum depressive symptoms, then modeled the odds of postpartum depressive symptoms using multivariable logistic regression and selected the best fit model.

Our analysis included 181 women. Thirty-five (19%) scored ≥ 9 on the EPDS. While both perceived stress and whether this was the first pregnancy complicated by GDM were significant in the bivariate analysis, only perceived stress remained a significant predictor of postpartum depressive symptoms in the multivariate regression model (OR 4.34, 95% CI [2.58-7.31]). The effect of first GDM pregnancy was no longer significant in the multivariate model (OR 2.00, 95% CI [0.63-6.33]). Additionally, a mediation model determined that perceived stress fully mediated the effect of first GDM pregnancy on depressive symptoms (Effect ratio, 0.5507/1.5377 = 0.358, p = 0.036).

Perceived stress was predictive of postpartum depressive symptoms in women with recent GDM and was found to mediate the relationship between first pregnancy complicated by GDM and postpartum depressive symptoms. Addressing perceived stress in the early postpartum period may be an important target for future lifestyle programs to maximize diabetes prevention efforts.

Background: This study investigates the impact of Type 2 diabetes mellitus (T2DM) and depressive symptoms on the health-related quality of life (HRQoL) among patients at the Agricultural General Hospital in Hanoi, Vietnam. The research explores the interconnections between chronic physical conditions and mental health within a resource-constrained healthcare environment. Methods: A cross-sectional survey was conducted with 516 T2DM patients using the SF-36 to assess HRQoL and the PHQ-9 to measure depressive symptoms. The study examined the prevalence of depressive symptoms and their correlation with various HRQoL components. Results: Among the participants, 45.2% exhibited depressive symptoms from mild to severe levels. Significant disparities in HRQoL scores were observed, particularly in physical composite and overall quality of life scores between T2DM with and without depressive symptoms. Statistical analysis highlighted that depressive symptoms significantly diminish HRQoL, with the PHQ-9 scores serving as a robust predictor. Conclusion: The findings underscore the critical need for integrated care approaches that include mental health support for T2DM patients. Routine screening for depressive symptoms should be a component of diabetes management protocols to improve overall patient outcomes. Further longitudinal research is needed to confirm these findings and develop effective interventions.

The aim was to assess the clinical and radiographic peri-implant status among type-2 diabetic and non-diabetic individuals with major depressive disorders (MDD). Participants were divided into four groups; Group-1: patients with type-2 diabetes; Group-2: patients with MDD; Group-3: patients with type-2 diabetes and MDD; Group-4: healthy controls. Demographic data was collected, and medical history including most recent hemoglobin A1c (HbA1c) levels were retrieved from healthcare records. Peri-implant modified plaque and gingival indices (MPI and mGI) and peri-implant probing depth (PPD) were recorded; and crestal bone loss (CBL) was measured. Sample-size was estimated using data from a pilot investigation. Statistical analysis was performed using one way-analysis of variance and Bonferroni Post-hoc adjustment tests. P-vales below 0.05 were considered statistically significant. Thirty, 30, 30 and 30 individuals were included in groups 1, 2, 3 and 4. Mean HbA1c levels were higher in groups 1, 2 and 3 compared with Group-4 (P < 0.05). Thirty-seven, 40, 43 and 36 implants were present in groups 1, 2, 3 and 4, respectively. In groups 1, 2, 3 and 4, the implants were in function for a mean duration of 4.7 ± 2.4, 4.9 ± 1.8, 5.05 ± 1.7 and 10.6 ± 2.2 years, respectively. The mPI, mGI, PPD and CBL were significantly higher in groups 1, 2 and 3 than individuals in Group-4 (P < 0.05). There was significant correlation between peri-implant PD and HbA1c levels among individuals in Group-1 (P < 0.05). Peri-implant soft tissue and osseous statuses are compromised among patients with type-2 DM, and MDD regardless of whether these conditions occur individually or in combination. Clinical relevance: Peri-implant soft tissue and osseous statuses are compromised among patients with type-2 DM, and MDD regardless of whether these conditions occur individually or in combination.

Food insecurity (FIS) affects around 25% of Bangladesh's population, and data from developed nations report higher FIS rates among individuals with type 2 diabetes (T2D), potentially worsening glycemic control. The importance of FIS to T2D has not been studied in developing countries such as Bangladesh, with substantial disparities in healthcare access, especially between rural and urban areas. We evaluated the relationships between food insecurity and glycemic control in the context of area of residence among individuals with T2D in Bangladesh.

A total of 849 individuals with T2D attending diabetes clinics in four districts of Bangladesh completed a validated questionnaire to assess the FIS (a score ≥ 3 is indicative of FIS), which was compared with their sociodemographic and biochemical data. Two-way anova and multiple linear and binary logistic regression analyses were performed.

Both HbA1c levels (10.8% vs 9.5, P < 0.001) and the prevalence of FIS (45.8% vs 31.4%, P < 0.001) were higher in rural areas. According to two-way anova (0.87-1.78% mean difference, P < 0.05) and multiple linear regression model (β = 1.4, P < 0.001), HbA1c levels were also higher among rural than urban dwellers, irrespective of their FIS status. Rural dwellers were also more than twice as likely to have suboptimal glycemic control (HbA1c ≥7%; AOR: 2.26 (1.35-3.97), P < 0.05), irrespective of their food security status (AOR: 1.19 (0.78-1.84, P > 0.05)).

In Bangladesh, rural residence is associated with poor glycemic control, irrespective of food security status, and thus is an important social determinant of diabetes care that warrants further exploration.

Background/Objectives: the COVID-19 pandemic accelerated the adoption of remote work, blurring the boundaries between professional and personal life. This shift resulted in longer working hours, negative emotional outcomes, and health issues, particularly among Generation Z employees. This study investigates the links between working overtime, tobacco dependence, night shifts, and chronic disease risk in Generation Z employees during the pandemic while also examining the roles of depression risk and health awareness. A quantitative research approach was used to administer a questionnaire and employ the chi-square test, t-test, and logistic regression analysis to compare overtime-related factors and chronic disease risks. Results: the overtime workers are 1.39 times more likely to develop chronic diseases than those who do not work overtime. The odds ratio (OR) for overtime workers is 1.41, indicating that working overtime is a major risk factor for chronic disease. Among overtime workers, tobacco dependence and depression risk are significantly correlated with the risk of chronic disease, while night shift work is not. Overtime workers' health awareness is significantly correlated with chronic disease risk and has a partial mediating effect on the relationship between tobacco dependence and chronic disease risk. This is due to the strong correlation (p < 0.001) between tobacco dependence and chronic disease, which limits the extent to which health consciousness can mitigate the negative effects of tobacco dependence. Conclusions: these findings highlight the importance of smoking cessation and mental health interventions in reducing the risk of chronic disease for Generation Z workers, particularly in the post-pandemic era.

Although glucagon-like peptide-1 receptor agonists (GLP-1RAs) have shown potential antidepressant effects, population studies yield inconsistent results.

To compare the risk for depression in older adults with type 2 diabetes (T2D) initiating treatment with GLP-1RAs versus sodium-glucose cotransporter-2 inhibitors (SGLT2is) or dipeptidyl peptidase-4 inhibitors (DPP4is).

Target trial emulation study.

U.S. National Medicare administrative data from January 2014 to December 2020.

Adults aged 66 years or older with T2D initiating treatment with a GLP-1RA were matched 1:1 on propensity score with those initiating treatment with either an SGLT2i or a DPP4i.

The primary end point was incident depression. Cox proportional hazards regression models were used to estimate the hazard ratio (HR) with 95% CI within matched groups.

A total of 14 665 matched pairs of older adults were included in the cohort for GLP-1RAs versus SGLT2is; the rate difference of depression between GLP-1RA users and SGLT2i users was 3.48 (95% CI, -0.81 to 7.78) per 1000 person-years, with an HR of 1.07 (CI, 0.98 to 1.18). In the cohort for GLP-1RAs versus DPP4is (13 711 matched pairs), the rate difference was -5.78 (CI, -10.49 to -1.07) per 1000 person-years, with an HR of 0.90 (CI, 0.82 to 0.98).

Unmeasured confounders (such as hemoglobin A1c levels and body mass index), outcome misclassification, and limited generalizability to all GLP-1RA users (for example, younger populations or those without T2D receiving the drug for obesity treatment).

Among older adults with T2D, the incidence of depression was relatively low. Use of GLP-1RAs was associated with a modestly lower risk for depression compared with use of DPP4is, but not SGLT2is.

National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health.

People with depression have increased premature mortality and elevated prevalence of diabetes-mellitus compared to general population. However, risk of mortality and diabetes-related complications among patients with depression and co-occurring diabetes is under-studied. This population-based propensity score-matched (1:10) cohort study identified 12,175 patients with pre-existing depression and incident-diabetes (depression-diabetes group) and 117,958 patients with incident-diabetes only (diabetes-only group) between 2002 and 2021 in Hong-Kong, using territory-wide medical-record database of public-healthcare services, to investigate whether depression increased the risk of overall mortality, complications and post-complication mortality in people with diabetes. Associations of depression with all-cause mortality, complication and post-complication all-cause mortality rates were examined by Cox proportional-hazards model. Complications were assessed by Diabetes-Complications-Severity-Index (DCSI). Associations of complications, in terms of DCSI scores (complication burden), specific types and two-way combinations of complications (complication patterns) with all-cause mortality rate in depression were also examined. Our results showed that depression-diabetes group exhibited increased all-cause mortality risk (adjusted hazards-ratio: 1.06 [95 %CI: 1.02-1.10]) relative to diabetes-only group, particularly among men and older age group, with significantly higher rate of experiencing neuropathy (1.44 [1.27-1.62]) and metabolic complications (1.30 [1.09-1.56]) and lower likelihood of peripheral-vascular complications, retinopathy and nephropathy, albeit comparable macrovascular and microvascular complication rates. The mortality-rate-ratio for patients with depression and diabetes was significantly higher than patients with diabetes-only at a low level of complication burden. In conclusion, depression patients with co-occurring diabetes are at increased risk of excess mortality. Further research is warranted to improve diabetes-related outcomes and reduce mortality gap in this vulnerable population.

Domestic and international migrants along the United States-Mexico border are at increased risk for diabetes due to structural and psychosocial adversities.

This study assessed the prevalence of diabetes and prediabetes in a low-income United States-Mexico border community; examined the relationships between depression, anxiety, andadverse childhood experiences (ACEs) and diabetes prevalence and glucose regulation; and explored indirect effects of social support on these relationships. Results. Participants were 220 adults ages 19-83 years (M.47.2, SD.11.9) of majority Mexican nationality (89.1%). Over 70% reported history of migration to the United States; 56.8% reported deportation from the United States to Mexico. Prevalences of clinically significant depression and anxiety symptoms were 36.9% and 33.3%, respectively. Prevalences of diabetes and prediabetes were 17.3% and 29.1%, respectively. Psychological variables were not associated with diabetes or glucose regulation. Indirect effects were found from depression and ACEs through social support to hemoglobin A1c.

Results suggest the need for diabetes prevention interventions with an integrated biopsychosocial approach.

Aims: This study aims to explore the mutual mechanisms and distinct pathogenic factors between fasting blood glucose (FBG) abnormalities and thyroid dysfunction (TD) in major depressive disorder (MDD) patients of different onset ages. Methods: One thousand seven hundred eighteen first-episode and drug-naïve (FEDN) MDD patients were selected. Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), Positive and Negative Syndrome Scale (PANSS) positive subscale, Clinical Global Impression (CGI), FBG, and thyroid-stimulating hormone (TSH) were measured, along with other relevant biochemical indicators. Results: TD prevalence was 86.69% in early-onset MDD patients with abnormal FBG while in late-onset was 86.86%. No significant difference was found. The area under the curve (AUC) values of FBG detecting TD were all over 0.700. Depressive symptoms and lipid metabolites were significant risk factors and were more specific indicators for late-onset MDD patients with FBG abnormalities. Further binary logistic regression and receiver operating characteristic (ROC) curves revealed that depression severity, high-density lipoprotein cholesterol (HDL-C) predicted TD well in MDD patients with FBG abnormalities, making this predictive effect more significant in the late-onset group. Conclusions: Insulin resistance and lipid metabolism abnormalities based on FBG abnormalities significantly impact TD in late-onset MDD. Specificity and regular monitoring should be considered for different onset ages of MDD patients with abnormal metabolism. Further research should clarify the interactions among insulin resistance, lipid metabolism, and TD. The First Hospital of Shanxi Medical University Ethics Committee reviewed and approved this study (No. 2016-Y27).

The positive relationship between higher delay discounting, an indicator of increased impulsivity, and reduced engagement in diabetes care has been investigated. However, the association between delay discounting and diabetes onset, likely linked through unhealthy behaviors, has not been well investigated. Additionally, although depression has been linked to an increased risk of diabetes and greater delay discounting, studies examining associations among all three factors are scarce. The present study aimed to determine the association between depressive symptoms and the onset of diabetes, with delay discounting as a mediator of this relationship.

Using data from a three-phase online prospective survey of a community sample, cross-sectional and longitudinal mediation analyses were conducted to examine diabetes prevalence from Phase 1 and incidence from Phases 2 and 3 as the outcomes, with depressive symptoms at Phase 1 as the independent variable and delay discounting at Phase 1 as the mediator.

Delay discounting was positively associated both with diabetes prevalence (coefficient = 0.170; 95% confidence interval [CI] = 0.066 to 0.278; P = 0.002) and incidence (coefficient = 0.306; 95% CI = 0.098 to 0.540; P = 0.006). Furthermore, through delay discounting, depressive symptoms were indirectly associated with diabetes prevalence (indirect coefficient = 0.091; 95% bootstrap CI = 0.034 to 0.149) and incidence (indirect coefficient = 0.138; 95% bootstrap CI = 0.037 to 0.256), respectively.

Delay discounting may increase the risk of diabetes onset by mediating the positive association between depressive symptoms and diabetes onset.

Diabetes and depression have a bidirectional relationship, with negative impacts on glycemia, self-care, long-term complications, quality of life, and mortality. This review highlights key aspects of the interconnected and complex relationship between diabetes and depression, including how it affects health outcomes, depression duration and recurrence, age-specific manifestations, and recommendations for screening and nonpharmacological treatment.

To improve further the management of the nutritional status and dietary habits of depressed patients.

This study investigated the effect of different severity states of depressive symptoms on serum and erythrocyte folate levels using the Nutrition Examination Survey (NHANES) database from 2017 to 2020. We comprised a sample of 4,872 cases from NHANES database. We developed 3 linear regression models to assess the effect of depressive symptoms on erythrocyte folate and serum folate by collating and analyzing the data. The relationship between depression severity and erythrocyte folate as well as serum folate was also mutually validated by the results of multiple logistic regression. Finally, we made restricted cubic spline plots using the glm function of R.

Depression remained negatively correlated with serum folate levels with a OR value of -0.02, 95% CI of -0.05 ~ -0.00. Moderate depression was negatively correlated with folate, with a OR value of -0.03, 95% CI of -0.05 ~ -0.00. When exploring the association between different degrees of depressive symptoms and erythrocyte folate, it was unexpectedly found that major depression was negatively associated with erythrocyte folate with a OR value of -0.18, 95% CI of -0.31 ~ -0.04 after adjusting for all covariates.

Depression is associated with folate levels. The risk of serum folate insufficiency or erythrocyte folate insufficiency is higher after a positive depression. For different degrees of depressive symptoms, serum folate levels were significantly lower than normal in patients with moderate depression, while erythrocyte folate levels were lower than normal in patients with major depression. Therefore, attention should be paid to the dietary habits and nutritional status of patients with depression or depressive symptoms when they are undergoing long-term antidepressant treatment. Folic acid supplementation is recommended for patients with moderate or severe depression or for depressed patients who have developed unhealthy eating habits.

Mindfulness-Based (non-contact) Boxing Therapy (MBBT) is a novel intervention designed to empower and promote self-agency through behavioral interventions, while reducing barriers to exercise for individuals with mental disorders. MBBT is an instructor-led, manualized, non-contact boxing group-exercise program (delivered in 90 min sessions, twice a week, over 10 weeks) that blends principles of mindfulness, meditation and group therapy. The current study tested the acceptability and feasibility of delivering MBBT to adults with major depressive disorder (MDD) or generalized anxiety disorder (GAD).

Nine adult outpatients with MDD or GAD were recruited from a psychiatric outpatient clinic in Toronto, Canada in a 10-week feasibility trial of MBBT using a pre-post design. Feasibility was assessed through recruitment and retention rates, while acceptability was assessed through the CSQ-8, and self-questionnaires. Secondary clinical outcomes included the PHQ-9, GAD-7, K10, CGI, and MAAS. Trial registry: ISRCTN23023309.

Eight participants (5 female, 3 male) were included in the final analysis. Results indicated a high user retention (89%), attendance (84%), and satisfaction (98%). The study observed a statistically significant mean percent reduction in depression (54%), anxiety (51%) and distress (36%), alongside a mean percent increase in mindfulness (79%). Post intervention qualitative feedback from participants revealed themes of inclusivity and accessibility, cathartic release and control of emotions, improved self-esteem and confidence, self-agency, community, and trust in leadership.

Given the limitation of the study, MBBT appeared to be feasible and acceptable as an exercise/behavioural intervention. Further well-designed randomized clinical trials are warranted to confirm the clinical benefits of MBBT.

The use of antidepressants has been on the rise among adolescents and young adults, populations also increasingly at risk for type 2 diabetes. However, the relationship between antidepressant uses and diabetes incidence in these age groups remains poorly understood.

Adhering to PRISMA guidelines and the Cochrane Handbook, we conducted a comprehensive search in PubMed, Scopus, Embase, and Web of Science up to 21 February 2024, registering our protocol on PROSPERO (CRD42024516272).

Six studies, ranging from 16, 470 to 1, 582, 914 participants and spanning 2010 to 2023 across North America, Europe, and Asia, were included. The meta-analysis revealed a significant association between antidepressant use and diabetes onset, with 10 cases per 1, 000 observations (p < 0.01; I2 = 100%). Adolescents using high doses of antidepressants showed a 62% increased risk of developing diabetes compared to non-users or those on low doses (Risk ratio = 1.67; 95% CI 1.19-2.35; I2 = 87%; p < 0.01). The overall quality of the studies was high, with an average Newcastle-Ottawa Scale score of 7.66. Sensitivity analysis highlighted the robustness of these findings, except when removing specific studies, indicating potential sources of heterogeneity.

Antidepressant use in adolescents is associated with a significantly increased risk of diabetes onset, particularly at higher doses. This finding underscores the necessity for vigilant monitoring of glucose levels in this population and warrants further investigation into the underlying mechanisms and long-term outcomes.

The prevalence of type-2 diabetes mellitus (T2DM) has increased over 10-fold in the past 40 years in China, which now has the largest T2DM population in the world. Insulin resistance and β-cell dysfunction are the typical features of T2DM. Although both factors play a role, decreased β-cell function and β-cell mass are the predominant factors for progression to T2DM. Considering the differences between Chinese T2DM patients and those of other ethnicities, it is important to characterize β-cell dysfunction in Chinese patients during T2DM progression. Herein, we reviewed the studies on the relationships between β-cell function and T2DM progression in the Chinese population and discussed the differences among individuals of varying ethnicities. Meanwhile, we summarized the risk factors and current treatments of T2DM in Chinese individuals and discussed their impacts on β-cell function with the hope of identifying a better T2DM therapy.

The risk of non-communicable diseases (NCDs) in conflict and post-conflict settings in Northeastern Nigeria has not been evaluated to date. As this region undergoes recovery, understanding the prevalence of NCDs, such as hypertension, diabetes, depression, and obesity, and the associated behavioral coping mechanisms, is crucial for developing tailored healthcare solutions. Therefore, this study aimed to assess the impact of conflict on the prevalence of NCDs in conflict-exposed areas in Northeastern Nigeria compared with non-conflict regions.

This study was an unmatched cross-sectional study. The participants were selected from inpatients and outpatients at general hospitals in Mubi (conflict-exposed) and Jada (non-conflict), which are local government areas in Adamawa, a state in Northeastern Nigeria. The study was conducted over four months, and data on various health indicators were collected. Multivariable binary logistic regression and complementary log regression were performed to investigate the effects of individual risk factors and regional settings on the prevalence of NCDs.

A sample of 463 individuals from both locations was analyzed. The prevalence of hypertension, diabetes, abdominal obesity, and depression in the entire cohort was 22.92%, 5.04%, 44.19%, and 17.94%, respectively. The rates of hypertension and abdominal obesity in the conflict-exposed Mubi were lower, and the rate of depression was higher than those recorded in Jada. Females showed higher rates of hypertension, obesity, and depression than males. The residents of Mubi had lower odds of having abdominal obesity (adjusted odds ratio (aOR) = 0.18; 95% confidence interval (CI) [0.11-0.28]) but a higher risk of depression (incidence risk ratio (IRR) = 4.78; 95% CI [2.51-9.22]) than those in Jada. However, the participants affected by insurgency showed higher odds of having both abdominal obesity (aOR = 1.95; 95% CI [1.23-3.08]) and depression (IRR = 1.76; 95% CI [1.08-2.88]) than those who were not affected by the conflict.

The findings of this study underscore the urgent need for mental health support in conflict-affected regions and comprehensive healthcare strategies for the aging population. As adjustment of lifestyle factors is crucial for addressing NCDs, effective case management and food security are essential for reducing the risk of NCDs in conflict-exposed populations.

This study examined the association between specific depressive symptoms and incident diabetes, and whether overweight or obesity mediates this relationship among middle-aged and older adults in China.

In a nationally representative prospective cohort study of 11,893 middle-aged and older Chinese adults without baseline diabetes, we used Cox models to assess the association between depressive symptoms and diabetes. The quantile g-computation (qgcomp) model evaluated the contribution of 10 specific depressive symptoms to diabetes risk, and a two-stage regression method explored the mediation effect of overweight or obesity.

Over a median follow-up of 7.1 years, 1,314 cases of diabetes were identified. Elevated depressive symptoms were associated with increased diabetes risk (HR 1.23; 95 % CI 1.09-1.38). Eight out of 10 depressive symptoms were significantly associated to diabetes, with loneliness (weight = 18 %; HR 1.23; 95 % CI 1.10-1.39), restless sleep (weight = 17 %; HR 1.16; 95 % CI 1.04-1.29), and bother (weight = 15 %; HR 1.19; 95 % CI 1.07-1.33) being the primary contributors. Mediation analysis showed that overweight and obesity reduced the depression-diabetes risk association by 8.21 % and 12.61 %, respectively.

Diagnosis of diabetes was self-reported.

Eight out of ten specific depressive symptoms were associated to diabetes, overweight and obesity may partially mitigate the effect of depressive symptoms on diabetes among middle-aged and older adults in China.

Our results highlight the importance of tailoring diabetes prevention and management strategies according to specific depressive symptoms among middle-aged and older adults in China.

Depression co-occurs with diabetes at twice the rate, relative to the general population without diabetes but it is unknown whether depression is longitudinally associated with diabetes control in the general population.

To characterize the longitudinal association between depressive symptoms and joint achievement of glycemic, blood pressure (BP), and cholesterol control (ABC control) among middle-aged and older adults (≥50 years) with diabetes in United States.

Data of the nationally representative Health and Retirement Study 2006-2017 were pooled across study waves conducted every 2 years. Center for Epidemiological Studies Depression (CES-D8) scale was used to assess baseline depressive symptoms (≥3 points). Joint ABC control 4 years later was ascertained using HbA1c (<7.0% [53 mmol/mol] if <65 years, <7.5% [58 mmol/mol] if ≥65 years or <8.0% [64 mmol/mol] with comorbidities), BP (systolic < 140 and diastolic < 90 mm Hg), and non-HDL cholesterol (<130 mg/dL). Survey-weighted modified Poisson regressions were used to study the association (risk ratios [RR]) of depressive symptoms with ABC control.

The study sample consisted of 3 332 observations from 2 531 individuals (mean age: 64.4 years [SD: 8.8], 55.4% women). Depressive symptoms were neither associated with the achievement of joint ABC control (RR: 0.91 [95% CI, 0.76-1.09]) nor achievement of glycemic, BP or cholesterol control after adjusting for covariates. Findings were consistent across various subgroups defined by age, gender, baseline ABC control, medication use, and duration of diabetes.

Baseline depressive symptoms do not compromise future diabetes management. Care models should focus on both conditions independently to potentially improve overall health.

The increasing specialization and dispersion of healthcare systems have led to a shortage of resources to address comorbidities. Patients with coexisting mental and physical conditions are disadvantaged, as medical providers often only focus on the patient's mental illness while neglecting their physical needs, resulting in poorer health outcomes.

This study aimed to shed light on the systemic flaws in healthcare systems that contribute to suboptimal health outcomes in individuals with comorbid diseases, including depression and diabetes. This paper also discusses the clinical and economic benefits of collaborative methods for diagnosing and treating depressive disorders in primary care settings.

A comprehensive literature review of the relationship between depression and diabetes was conducted. The outcomes of the literature review were carefully analyzed. Several databases were searched using keywords such as "diabetes," "depression," "comorbidity," "prevalence," "epidemiology," and "risk factors" using Google Scholar and PubMed as search engines. The review and research papers written between 1961 and 2023 were our main focus.

This study revealed improved depressive symptoms and better blood sugar and blood pressure control. Additionally, individuals with comorbid depression and diabetes have higher direct and secondary medical costs. Antidepressants and psychological interventions are equally effective in treating depressive symptoms in patients with diabetes, although they have conflicting effects on glycemic control. For individuals with comorbid diabetes and depression, clear care pathways, including a multidisciplinary team, are essential for achieving the best medical and mental health outcomes.

Coordinated healthcare solutions are necessary to reduce the burden of illness and improve therapeutic outcomes. Numerous pathophysiological mechanisms interact with one another and may support the comorbidities of T2DM, and depressive disorders could exacerbate the course of both diseases.

Despite rising rates of depression and diabetes, assessments of depression's burden on diabetes management and its economic burden remain limited. In this study, we evaluate the burden of depression on diabetes management and quantify the financial implications of comorbid depression and diabetes.

We performed propensity score matching on Texas commercial claims data (2016-2019) to match type 2 diabetes patients with depression (n = 613) to those without (n = 583). Depression flagged in 2016/2017 indicated initial depression, and an A1C level of ≥8% in 2018/2019 indicated follow-up uncontrolled diabetes. Healthcare costs included total, diabetes-related, outpatient, and inpatient costs incurred during 2018/2019.

A depression flag in the initial period was linked to a 2.7 percentage point increase (P = .031) in the probability of having an A1C level of ≥8% in the follow-up, compared to individuals without a depression flag. Having both a depression flag and uncontrolled A1C in the initial period was associated with $2,037 higher total medical costs (P = .004), $494 higher diabetes-related costs (P = .020), and $336 higher outpatient costs (P = .008) in the follow-up, compared to the respective averages of $6,900, $474, and $583 for individuals without a depression flag or uncontrolled A1C.

Our findings highlight the detrimental effect of depression on uncontrolled diabetes and the subsequent increase in healthcare costs. Further research is warranted to determine the effectiveness of proactive treatments for depression in managing diabetes, improving glycemic control, and reducing healthcare costs.

Increasing evidence suggests a complex interplay between psychiatric disorders and metabolic dysregulations. However, most research has been limited to specific disorder pairs, leaving a significant gap in our understanding of the broader psycho-metabolic nexus.

This study leveraged large-scale cohort data and genome-wide association study (GWAS) summary statistics, covering 8 common psychiatric disorders and 43 metabolic traits. We introduced a comprehensive analytical strategy to identify shared genetic bases sequentially, from key genetic correlation regions to local pleiotropy and pleiotropic genes. Finally, we developed polygenic risk score (PRS) models to translate these findings into clinical applications.

We identified significant bidirectional clinical risks between psychiatric disorders and metabolic dysregulations among 310,848 participants from the UK Biobank. Genetic correlation analysis confirmed 104 robust trait pairs, revealing 1088 key genomic regions, including critical hotspots such as chr3: 47588462-50387742. Cross-trait meta-analysis uncovered 388 pleiotropic single nucleotide variants (SNVs) and 126 shared causal variants. Among variants, 45 novel SNVs were associated with psychiatric disorders and 75 novel SNVs were associated with metabolic traits, shedding light on new targets to unravel the mechanism of comorbidity. Notably, RBM6, a gene involved in alternative splicing and cellular stress response regulation, emerged as a key pleiotropic gene. When psychiatric and metabolic genetic information were integrated, PRS models demonstrated enhanced predictive power.

The study highlights the intertwined genetic and clinical relationships between psychiatric disorders and metabolic dysregulations, emphasising the need for integrated approaches in diagnosis and treatment.

The National Key Research and Development Program of China (2023YFC2506200, SHH). The National Natural Science Foundation of China (82273741, SY).

Diabetes mellitus and depression are comorbidities that can be caused by each other. Brain-derived neurotrophic factor (BDNF) functions as a neuronal growth factor. It maintains the functional integrity of the nervous system.

To study the possible association between BDNF levels and gene polymorphism with depression in patients diagnosed with type 2 diabetes mellitus.

The Elisa technique measured BDNF, and rs6265 gene polymorphism was detected using real-time PCR. Depression was assessed utilizing a clinical interview tool designed to establish the diagnosis of depression and differentiate it from other psychiatric diseases.

BDNF levels were significantly lower in patients with type 2 diabetes mellitus and symptoms of depression than in patients with type 2 diabetes mellitus and no symptoms of depression (82.6±16.1. vs. 122± 17.47, P< 0.001). There was a statistically significant difference in BDNF levels in patients with diabetes among the three genotypes of the BDNF gene (P-value < 0.001). Val/ Val carriers had the highest serum BDNF levels, and Met/ Met carriers had the lowest serum BDNF levels. Subgroup analysis showed statistically significant genotype-related differences in serum BDNF levels among the three subgroups in the Depression group. Val/ Val carriers had the highest serum BDNF levels, and Met/ Met carriers had the lowest serum BDNF levels. BDNF Val66Met polymorphism had no significant association with the presence of depression, yet there was a trend towards significance (p = 0.05).

In this pilot, Low levels of BDNF were associated with depression in patients with type 2 diabetes. Carriers of the Met/ Met allele have the lowest serum BDNF levels. Multicenter studies with more participants are required.

Studies have shown that the presence of diabetes or depression may increase the risk for developing the other. The primary objective of this study is to describe the current prevalence of comorbid depression and the rate of screening and treatment for comorbid depression in US adult outpatients with diabetes compared to those without diabetes.

We analyzed data from the 2014-2019 National Ambulatory Medical Care Survey. Descriptive statistics, univariate analyses, and multivariable regression models were developed with weighting factors applied.

Depression prevalence is higher in those with diabetes than without diabetes. Females with diabetes have higher rates of depression (15.4%) compared to females without diabetes (13.7%) or males with diabetes (9.1%). Screening rates for depression are extremely low (<6%) in patients with diabetes and without diabetes. Patients with diabetes and depression are less likely to be screened than those with depression alone.

The cross-sectional design of the study cannot establish causality and has inherent limitations in capturing temporal relationships. The reliance on ICD codes limits the scope of diagnosis and underestimates rates of comorbidity if depression is not formally diagnosed. The NAMCS cohort only includes ambulatory visits to office-based physicians, so depression diagnoses and screening rates among patients who visit other health care settings or are not seeing physicians would be underestimated.

Depression is prevalent in people with diabetes. Screening rates are unacceptably low, indicating a gap in recommended care and underreporting of depression. More routine screening and treatment are necessary to align with guideline-recommended care.

Anodal transcranial direct current stimulation (tDCS) has been reported to modulate gamma-aminobutyric acid levels and cerebral energy consumption in the brain. This study aims to investigate long-term GABA and cerebral energy modulation following anodal tDCS over the primary motor cortex.

To assess GABA and energy level changes, proton and phosphorus magnetic resonance spectroscopy data were acquired before and after anodal or sham tDCS. In anodal stimulation, a 1 mA current was applied for 20 min, and the duration of ramping the current up/down at the start and end of the intervention was 10 s. In the sham-stimulation condition, the current was first ramped up over a period of 10 s, then immediately ramped down, and the condition was maintained for the next 20 min.

The GABA concentration increased significantly following anodal stimulation in the first and second post-stimulation measurements. Likewise, both ATP/Pi and PCr/Pi ratios increased after anodal stimulation in the first and second post-stimulation measurements.

The approach employed in this study shows the feasibility of measuring long-term modulation of GABA and high-energy phosphates following anodal tDCS targeting the left M1, offering valuable insights into the mechanisms of neuroplasticity and energy metabolism, which may have implications for applications of this intervention in clinical populations.

Major Depressive Disorder (MDD) is a common, frequently chronic condition characterized by substantial molecular alterations and pathway dysregulations. Single metabolite and targeted metabolomics platforms have revealed several metabolic alterations in depression, including energy metabolism, neurotransmission, and lipid metabolism. More comprehensive coverage of the metabolome is needed to further specify metabolic dysregulations in depression and reveal previously untargeted mechanisms. Here, we measured 820 metabolites using the metabolome-wide Metabolon platform in 2770 subjects from a large Dutch clinical cohort with extensive clinical phenotyping (1101 current MDD, 868 remitted MDD, 801 healthy controls) at baseline, which were repeated in 1805 subjects at 6-year follow up (327 current MDD, 1045 remitted MDD, 433 healthy controls). MDD diagnosis was based on DSM-IV psychiatric interviews. Depression severity was measured with the Inventory of Depressive Symptomatology Self-report. Associations between metabolites and MDD status and depression severity were assessed at baseline and at 6-year follow-up. At baseline, 139 and 126 metabolites were associated with current MDD status and depression severity, respectively, with 79 overlapping metabolites. Adding body mass index and lipid-lowering medication to the models changed results only marginally. Among the overlapping metabolites, 34 were confirmed in internal replication analyses using 6-year follow-up data. Downregulated metabolites were enriched with long-chain monounsaturated (P = 6.7e-07) and saturated (P = 3.2e-05) fatty acids; upregulated metabolites were enriched with lysophospholipids (P = 3.4e-4). Mendelian randomization analyses using genetic instruments for metabolites (N = 14,000) and MDD (N = 800,000) showed that genetically predicted higher levels of the lysophospholipid 1-linoleoyl-GPE (18:2) were associated with greater risk of depression. The identified metabolome-wide profile of depression indicated altered lipid metabolism with downregulation of long-chain fatty acids and upregulation of lysophospholipids, for which causal involvement was suggested using genetic tools. This metabolomics signature offers a window on depression pathophysiology and a potential access point for the development of novel therapeutic approaches.

The relationship between diabetes, depressive symptoms, and mortality is well established. However, the effect of depressive symptoms on prediabetes and its relationship with mortality remains unclear. This study seeks to investigate the effects of depressive symptoms on mortality across different diabetic statuses.

The study analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018, with a final sample size of 36,246 participants. Mortality status and cause of death were determined by cross-referencing records with the publicly accessible National Death Index through 2019. Kaplan-Meier survival curves and Cox regression analysis were utilized to assess the relationship between depressive symptoms and mortality across different diabetic statuses from nondiabetic to prediabetic to diabetic.

In the non-diabetic group, no effect of depression severity on all-cause mortality or cardiovascular mortality was found in the final models. In the prediabetic group, however, the hazard ratios were increased for both mild depressive symptoms (HR = 1.349, 95% CI = 1.138-1.600) and moderate-to-severe depressive symptoms (HR = 1.651, 95% CI = 1.309-2.082). In the diabetic group, surprisingly, the risk was somewhat lower than in the pre-diabetic group (HR = 1.279, 95% CI = 1.084-1.509 for mild and HR = 1.285, 95% CI = 1.056-1.563 for moderate-to-severe depressive symptoms). Similar risk patterns were noted for cardiovascular disease (CVD) mortality, where risk of moderate-severe symptoms was even greater in the prediabetic group (HR = 1.834, 95% CI = 1.180-2.851).

In this prospective cohort study of a nationally representative sample of U.S. adults, a positive association was found between depressive symptoms and mortality across different diabetic statuses. These findings highlight the importance of evaluating depressive symptoms across the glycemic spectrum, especially among individuals with prediabetes.

Depression and memory loss are prevalent neurodegenerative disorders, with diabetic patients facing an elevated risk of brain dysfunction. Methylglyoxal (MGO) formation, which is heightened in diabetes owing to hyperglycemia and gut dysbiosis, may serve as a critical link between diabetes and brain diseases. Despite the high prevalence of MGO, the precise mechanisms underlying MGO-induced depression and memory loss remain unclear.

We investigated the effect of MGO stress on depression like-behavior and memory loss to elucidate the potential interplay between MGO-induced tryptophan (Trp) metabolism impairment and oxidative stress in the brain. It demonstrates that MGO induces depression-like behavior in mice, as confirmed by the OFT, TST, FST, SPT, and EPM behavioral tests. MGO led to the depletion of Trp and related neurotransmitters as 5-HT, EPI, and DA in the mouse brain. Additionally, MGO reduced the cell count in the DG, CA1, and CA3 hippocampal regions and modulated TPH2 levels in the brain. Notably, co-treatment with MGO and Trp mirrored the effects observed after Trp-null treatment in neurons, including reduced TPH1 and TPH2 levels and inhibition of neuronal outgrowth. Furthermore, MGO significantly altered the expression of key proteins associated with neurodegeneration, such as p-Tau, p-GSK-3β, APP, oAβ, BDNF, NGF, and p-TrkB. Concurrently, MGO activated MAPKs through ROS induction, triggering a redox imbalance by downregulating Nrf-2, Ho-1, TXNRD1, Trx, Sirt-3, and Sirt-5 expression levels, NAD+, and CAT activity in the mouse brain. This led to an accelerated neuroinflammatory response, as evidenced by increased expression of Iba-1, p-NF-κB, and the secretion of IL-6 and TNF-α. Importantly, Trp treatment ameliorated MGO-induced depression like-behavior and memory loss in mice and markedly mitigated increased expression of p-Tau, APP, p-ERK1/2, p-pJNK, and p-NF-κB in the brain. Likewise, Trp treatment also induced the expression of MGO detoxifying factors GLO-I and GLO-II and CAT activity, suggesting the induction of an antioxidant system and reduced inflammation by inhibiting IL-6 and TNF-α secretion.

Our data revealed that MGO-induced depression like-behavior and memory deficits resulted from disturbances in Trp, 5-HT, BDNF, and NGF levels, increased p-Tau and APP expression, neuroinflammation, and impaired redox status (Nrf-2/Ho-1/TXNRD1/Sirt3/5) in the brain.

Physical activity has the potential to improve physical and mental health outcomes of persons with depression. However, feasible and acceptable strategies to integrate physical activity interventions into real-world settings are needed.

To assess the feasibility and acceptability of a manualized Behavioral Activation intervention aimed to increase physical activity in persons with depression (defined as a PHQ-9 score ≥ 10).

A single-arm pilot study was conducted. The intervention consisted of 8 tele-therapy sessions delivered over a 10-week period. Measures of feasibility included screening, enrollment, intervention adherence, outcome data availability, and intervention fidelity. Acceptability was assessed with a post-intervention survey and qualitatively through focus groups and interviews. Preliminary efficacy of the intervention was assessed by evaluating pre-to-post changes in physical activity and depressive symptoms.

All feasibility metrics exceeded predetermined feasibility goal metrics with the exception of Fitbit wear and screening rate, which was due to a greater than anticipated enrollment rate. Participants (n = 15) reported perceived benefits from the intervention and convenience in attending tele-therapy sessions. Depressive symptoms, as measured by the PHQ-9 improved (16.8 at enrollment to 10.1 post intervention, Cohen's d = 1.13). Self-reported moderate-to-vigorous physical activity (MVPA) increased from 22.0 min/week at baseline to 36.67 min/week post-intervention (d = 0.58). Physical activity as measured by the Fitbit showed little change (daily step 5543.29 during Week 1 to 6177.48 during Week 10, (d = 0.14); MVPA 21.23 min/week during Week 1 to 19.22 at Week 10 (d = 0.0.06).

Results of the pilot study suggest the intervention is feasible to deliver and acceptable to participants. Preliminary results suggest the intervention may be effective in improving depressive symptoms and increasing self-reported physical activity.

ClinicalTrials.gov NCT04990401, Registered July 21, 2021.

Previous studies demonstrated thyroid stimulating hormone (TSH) plays an important role in regulating lipid metabolism, but the relationship between the two is controversial. Meanwhile, it has not been reported in a population with major depressive disorder (MDD).

We divided 1718 first-episode and drug naïve patients with MDD into a TSH abnormal group (TSH-AB) and a TSH normal group (TSH-NOR). The participants in the two groups were assessed by the Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA) and the positive subscale of Positive and Negative Syndrome Scale. The patients' blood was tested for TSH, free T3, free T4, fasting blood glucose, lipid indexes and body mass index was recorded.

The participants in the TSH-AB group had significantly higher HAMD scores, HAMA scores and total scores of positive symptoms, as well as higher incidence of suicide attempts than those in the TSH-NOR group, accompanied by significantly higher thyroglobulin antibodies, thyroid peroxidase antibodies, fasting blood glucose values, total cholesterol (TC), triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) levels compared with those of TSH-NOR patients. However, the high-density lipoprotein cholesterol (HDL-C) of TSH-AB patients was lower than those of TSH-NOR patients. TSH values were positively correlated with TC, TG, and LDL-C values, and negatively correlated with HDL-C value.

TSH was highly correlated with abnormal lipid metabolism in patients with MDD. The specific molecular mechanism of the relationship between TSH, lipid metabolism and the development of depression needs to be further in-depth investigation.

Depression screening is an important first step to identifying patients who might benefit from depression treatment. Merit-based incentive payment system (MIPS) quality measures can yield financial benefits or losses for healthcare systems, including depression screening.

This study aims to (1) develop a team-based care workflow to improve MIPS depression screening in a specialty clinic and (2) modify the workflow to include a virtual nursing and behavioral health resource after the COVID-19 pandemic hit.

A quality improvement project, utilizing Lean Six Sigma process improvement methods, was implemented to improve team-based depression screening in a specialty clinic. A multidisciplinary team implemented plan-do-study-act cycles, created educational materials tailored to each role, developed electronic medical record (EMR) tools to alert and assist team members in screening, and ensured the EMR aligned with the MIPS criteria. The percentage of eligible visits where depression screening was performed was analyzed across four study periods: pre-intervention, post-intervention, COVID-19, and recovery. Recovery strategies included developing telehealth workflows, establishing centralized registered nurse triage groups, and using phone-based triage and support resources at virtual visits.

Utilizing team-based strategy and available or newly developed tools, the percentage of eligible visits with completed depression screening was as follows: 1.4% pre-intervention, 58.2% post-intervention, 3.5% COVID-19, and 64.0% recovery. With the COVID-19 pandemic outbreak, initially, improved screening performance declined sharply. Recovery was achieved through the revision of workflows, team members, and support tools.

A team-based care approach can successfully improve and maintain depression screening in a specialty clinic and was versatile enough to be readapted to virtual visits during the COVID-19 pandemic. In addition to impacting MIPS quality incentives, the depression screening workflows described in this article can be adapted to other uses, including virtual and in-person visits and in other specialty or chronic disease settings.

Estimating how type 2 diabetes (T2D) affects the rate of depression in cardiovascular disease (CVD) can help identify high-risk patients. The aim is to investigate how T2D affects the rate of depression according to specific subtypes of CVD.

Incident CVD patients, free of psychiatric disease, with and without T2D, were included from nationwide registries between 2010 and 2020. We followed patients from CVD diagnosis until the first occurrence of depression, emigration, death, 5 years, or end of study (December 31, 2021). We used time-dependent Poisson regression to estimate the incidence rates and rate ratios (IRR) of depression following subtypes of CVD with and without T2D. The model included age, sex, comorbidities, calendar year, T2D duration, educational level, and living situation as covariates.

A total of 165,096 patients were included; 45,845 had a myocardial infarction (MI), 63,691 had a stroke, 19,959 had peripheral artery disease (PAD), 35,568 had heart failure (HF), and 979 were diagnosed with 2 or more CVD subtypes (= > 2 CVD's). Baseline T2D in each CVD subtype ranged from 11 to 17%. The crude incidence rate of depression per 1000 person-years (95% confidence intervals) was: MI + T2D: 131.1 (109.6;155.6), MI: 82.1 (65.3;101.9), stroke + T2D: 287.4 (255.1;322.6), stroke: 222.4(194.1;253.6), PAD + T2D: 173.6 (148.7;201.4), PAD:137.5 (115.5;162.5), HF + T2D: 244.3 (214.6;276.9), HF: 199.2 (172.5;228.9), =  > 2 CVD's + T2D: 427.7 (388.1;470.2), =  > 2 CVD's: 372.1 (335.2;411.9). The adjusted IRR of depression in MI, stroke, PAD, HF, and =  > 2 CVD's with T2D compared to those free of T2D was: 1.29 (1.23;1.35), 1.09 (1.06;1.12), 1.18 (1.13;1.24), 1.05 (1.02;1.09), and 1.04 (0.85;1.27) (p-value for interaction < 0.001).

The presence of T2D increased the rate of depression differently among CVD subtypes, most notable in patients with MI and PAD.

Mental stress plagued type II diabetes (T2DM) patients. The psychological and emotional issues related to diabetes and its effects include depression, anxiety, poor diet, and hypoglycemia fear.

Compare the impact of diabetes on depression and anxiety in Egyptian and Saudi diabetics.

The diabetes, gastroenterology, and hepatology sections of University of Ha'il Clinic, KSA, and the Theodor Bilharz Research Institute, Egypt, conducted this retrospective study. Everyone gave informed consent before participating. Interviews with male and female outpatients and inpatients were conducted from June 2021 to December 2022. The self-administered validated Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9) scale measured sociodemographic characteristics and symptoms of depression and anxiety.

In patients with diabetes, the prevalence of depression was higher in KSA [34.8%] than in Egypt [18%], while anxiety was higher in Egypt [40%] than in KSA [29.1%]. Most depressed patients were 31-55 years old (61.2%) from KSA and 97.8% (41-55 years old) from Egypt. Female anxiety was 70.7% in KSA and 51.0% in Egypt, with no significant difference. The duration of diabetes in depressed patients was 5-10 years ([46.9%, Saudis] vs. [57.8%, Egyptians]), while anxious patients (5-10 years [39.0%, Saudis] vs. >20 years [65.0%, Egyptians]) were mainly type-2. Most depressive patients had an HbA1c (59.2%) from 7-10% (Saudis) and 77.8% [>10% Egyptians] compared to anxiety patients (46.3%) and 48.0% [>10% Egyptians]. Depressed and anxious patients from both nations had higher glucose, triglycerides, and cholesterol levels. Saudis and Egyptians with obesity had higher rates of sadness (75.5% vs. 68.9%) and anxiety (82.9% vs. 69.0%). Treatment adherence and serum glucose monitoring were not significantly different from depression in diabetes individuals in both ethnicities.

Anxiety was more common among Egyptian patients because of overcrowding, working whole days to fulfill life requirements, and the unavailability of health insurance to all citizens. Meanwhile, in KSA, obesity, unhealthy food, and less exercise reflect the high percentage of depression among patients with diabetes. The detection of depression and anxiety in the context of DM should be critical for the physical health and quality of life of Saudi and Egyptian diabetics. Further investigation is warranted to encompass anxiety and depression within the scope of future research.

Depression and anxiety are major public health issues; however, there is an unmet need for novel, effective, and accessible treatments, particularly in rural communities. Blueberries are an unexplored nutraceutical for these conditions due to their excellent nutritional profile, with particularly high levels of polyphenols and anthocyanins and benefits on mood, cognition, and health. Here, we present a narrative review of the literature concerning the etiology and treatments of major depressive disorder (MDD) and generalized anxiety disorder (GAD). In both animal and human studies, blueberry supplementation can ameliorate behavioral symptoms of both anxiety and depression. The mechanistic underpinnings of these behavioral improvements are not fully defined, but likely involve biochemical alterations in the gut-brain axis, including to inflammatory cytokines, reactive oxygen species, and growth factors. We also review the limitations of traditional therapies in rural settings. Finally, we assess the potential benefit of nutraceutical interventions, particularly blueberries, as novel therapeutics for these distinct, yet related mental health issues.

Mental health is affected by tryptophane (TRP) metabolism regulation. Diet-influenced gut microbiome regulates TRP metabolism. Thus, the present study aimed to explore the relationship between type of dietary protein intake, gut microbiota, TRP metabolites homeostasis, and mental well-being in healthy women. 91 healthy females aged 18-50 were recruited based on the study protocol. Validate and reliable questionnaires assessed dietary intake and mental health. Biochemical tests and gut microbiota composition were analyzed following the manufacturer's instructions for each enzyme-linked immune sorbent assay (ELISA) kit and Real-time quantitative polymerase chain reaction (qPCR) methods respectively. Regression methods were used to estimate the considered associations. The results show that in the fully adjusted model, plant protein consumption was partially inversely associated with depression risk (OR = 0.27; 95% CI: 0.06, 1.09; P = 0.06). Higher dietary animal protein intake was marginally associated with psychological distress (OR = 2.59; 95% CI: 0.91, 7.34; P = 0.07). KYN to serotonin ratio was inversely associated with animal protein consumption (ß = 1.10; 95% CI: -0.13, 2.33; P = 0.07). Firmicutes/Bacteriodetes ratio (β = -1.27 × 103, SE = 5.99 × 102, P = 0.03) was lower in the top tertile of plant protein. A partially negative correlation was found between dietary animal protein and Prevotella abundance (β = -9.20 × 1018, SE = 5.04 × 1018, P = 0.06). Overall, significant inverse associations were found between a diet high in plant protein with mental disorders, KYN levels, and Firmicutes to Bacteroidetes ratio while adhering to higher animal protein could predispose women to psychological stress.