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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 36041

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Dr. Lucia Carboni

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Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, 40126 Bologna, Italy
Interests: major depression; antidepressants; addiction; Alzheimer’s disease; biomarkers; animal models; gene expression; psychopharmacology

Special Issue Information

Dear Colleagues,

Major depressive disorder is a widespread and highly disabling mental health disorder that exerts a heavy toll on public health. The global burden of disease is affected by direct suffering and increased death rates since depressed patients are more likely to commit suicide. In addition, comorbid depression is the cause of the worst outcomes in several diseases, including cardiovascular diseases, cancer, metabolic disorders, autoimmune disorders, and neurodegenerative disorders. Major depression is widespread all over the world, and its impact is projected to be increased in the future.

Although major depression has been described since ancient times, its etiology is largely unknown, and the neurobiological underpinnings of the disease are actively investigated. We are aware that the contribution of genetic components is critical, and we are just starting to identify this polygenic contribution. We also know that environmental challenges can trigger disease onset, with a prominent impact exerted by exposure to stressful conditions, especially in early childhood. However, more research is needed to increase the comprehension of these components and to reveal how they interact, with the contribution of epigenetic changes. We need the discovery of trait and state biomarkers to aid in establishing a correct diagnosis and to support drug discovery. Moreover, we need new targets to expand the categories of available pharmacological tools, since treatment-resistant cases amount to one third to one half of all patients, and a few interventions are endowed with rapidity of action. Their limitations notwithstanding, animal models have provided essential contributions to disease understanding and to drug discovery.

Therefore, papers addressing these topics are invited for this Special Issue, as new research in all these lines is crucial to increase our comprehension of major depression.

Dr. Lucia Carboni
Guest Editor

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Keywords

major depressive disorder
mood disorders
biomarkers
antidepressants
antidepressant drug discovery
stress
mental health
depression vulnerability
animal models of depression

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Published Papers (10 papers)

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Research

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17 pages, 1754 KiB

Open AccessArticle

Effects of Transcranial Pulse Stimulation (TPS) on Adults with Symptoms of Depression—A Pilot Randomized Controlled Trial

by Teris Cheung, Tim Man Ho Li, Yuen Shan Ho, Georg Kranz, Kenneth N. K. Fong, Sau Fong Leung, Simon Ching Lam, Wing Fai Yeung, Joyce Yuen Ting Lam, Kwan Hin Fong, Roland Beisteiner, Yu-Tao Xiang and Calvin Pak Wing Cheng

Int. J. Environ. Res. Public Health 2023, 20(3), 2333; https://doi.org/10.3390/ijerph20032333 - 28 Jan 2023

Cited by 13 | Viewed by 4872

Abstract

Transcranial pulse stimulation (TPS) is a recent development in non-invasive brain stimulations (NIBS) that has been proven to be effective in terms of significantly improving Alzheimer patients’ cognition, memory, and execution functions. Nonetheless, there is, currently, no trial evaluating the efficacy of TPS on adults with major depression disorder (MDD) nationwide. In this single-blinded, randomized controlled trial, a 2-week TPS treatment comprising six 30 min TPS sessions were administered to participants. Participants were randomized into either the TPS group or the Waitlist Control (WC) group, stratified by gender and age according to a 1:1 ratio. Our primary outcome was evaluated by the Hamilton depression rating scale-17 (HDRS-17). We recruited 30 participants that were aged between 18 and 54 years, predominantly female (73%), and ethnic Chinese from 1 August to 31 October 2021. Moreover, there was a significant group x time interaction (F(1, 28) = 18.8, p < 0.001). Further, when compared with the WC group, there was a significant reduction in the depressive symptom severity in the TPS group (mean difference = −6.60, p = 0.02, and Cohen’s d = −0.93). The results showed a significant intervention effect; in addition, the effect was large and sustainable at the 3-month follow-up. In this trial, it was found that TPS is effective in reducing depressive symptoms among adults with MDD. Full article

(This article belongs to the Special Issue Advances in Major Depressive Disorder Research)

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14 pages, 733 KiB

Open AccessArticle

Adjunctive Bright Light Therapy for Non-Seasonal Major Depressive Disorder: A Randomized Controlled Trial

by I-Peng Chen, Chun-Chao Huang, Hui-Chun Huang, Fan-Pei Gloria Yang, Kai-Ting Ko, Yun-Tse Lee, Fang-Ju Sun and Shen-Ing Liu

Int. J. Environ. Res. Public Health 2022, 19(19), 12430; https://doi.org/10.3390/ijerph191912430 - 29 Sep 2022

Cited by 4 | Viewed by 2731

Abstract

This double-blind, randomized controlled trial assessed bright light therapy (BLT) augmentation efficacy compared with placebo light in treating non-seasonal major depressive disorder. The study participants belonged to a subtropical area (24.5°–25.5°N) with extensive daylight and included outpatients who had received stable dosages and various regimens of antidepressive agents for 4 weeks before enrollment. The outcomes were the 17-item Hamilton Depression Rating Scale, Montgomery–Asberg Depression Rating Scale, and Patient Health Questionnaire-9, which were assessed at weeks 1, 2, and 4. A total of 43 participants (mean age 45 years, ranging from 22–81) were randomized into the BLT [n = 22] and placebo light groups [n = 21]. After a 4-week administration of morning light therapy (30 min/day), depressive symptoms did not reduce significantly, which might be due to the small sample size. Nonetheless, this study had some strengths because it was conducted in warmer climates, unlike other studies, and examined diverse Asians with depression. Our findings suggest that several factors, such as poor drug response, different antidepressive regimens, duration of BLT, and daylength variability (i.e., natural daylight in the environment) may influence the utility of add-on BLT. Researchers may consider these important factors for future non-seasonal depression studies in subtropical environments. Full article

(This article belongs to the Special Issue Advances in Major Depressive Disorder Research)

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17 pages, 9359 KiB

Open AccessArticle

Attempting to Increase the Effectiveness of the Antidepressant Trazodone Hydrochloride Drug Using π-Acceptors

by Walaa F. Alsanie, Majid Alhomrani, Abdulhakeem S. Alamri, Hussain Alyami, Sonam Shakya, Hamza Habeeballah, Heba A. Alkhatabi, Raed I. Felimban, Abdulwahab Alamri, Abdulhameed Abdullah Alhabeeb, Bassem M. Raafat, Moamen S. Refat and Ahmed Gaber

Int. J. Environ. Res. Public Health 2022, 19(18), 11281; https://doi.org/10.3390/ijerph191811281 - 8 Sep 2022

Viewed by 2388

Abstract

Major depressive disorder is a prevalent mood illness that is mildly heritable. Cases with the highest familial risk had recurrence and onset at a young age. Trazodone hydrochloride is an antidepressant medicine that affects the chemical messengers in the brain known as neurotransmitters, which include acetylcholine, norepinephrine, dopamine, and serotonin. In the present research, in solid and liquid phases, the 1:1 charge-transfer complexes between trazodone hydrochloride (TZD) and six different π-acceptors were synthesized and investigated using different microscopic techniques. The relation of dative ion pairs [TZD+, A−], where A is the acceptor, was inferred via intermolecular charge-transfer complexes. Additionally, a molecular docking examination was utilized to compare the interactions of protein receptors (serotonin-6BQH) with the TZD alone or in combination with the six distinct acceptor charge-transfer complexes. To refine the docking results acquired from AutoDock Vina and to better examine the molecular mechanisms of receptor-ligand interactions, a 100 ns run of molecular dynamics simulation was used. All the results obtained in this study prove that the 2,6-dichloroquinone-4-chloroimide (DCQ)/TZD complex interacts with serotonin receptors more efficiently than reactant donor TZD only and that [(TZD)(DCQ)]-serotonin has the highest binding energy value of all π-acceptor complexes. Full article

(This article belongs to the Special Issue Advances in Major Depressive Disorder Research)

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13 pages, 1996 KiB

Open AccessArticle

The Mereology of Depression—Networks of Depressive Symptoms during the Course of Psychotherapy

by Inken Höller, Dajana Schreiber, Fionneke Bos, Thomas Forkmann, Tobias Teismann and Jürgen Margraf

Int. J. Environ. Res. Public Health 2022, 19(12), 7131; https://doi.org/10.3390/ijerph19127131 - 10 Jun 2022

Cited by 5 | Viewed by 2092

Abstract

(1) Background: Research has shown that it is important to examine depressive symptoms in the light of the mereology (the ratio between one symptom and the whole disorder). The goal of this study was to examine changes in the symptom interrelations of patients undergoing cognitive behavioral therapy treatment (CBT) via network analyses. (2) Method: Outpatients with depressive symptoms (N = 401) were assessed with the Beck Depression Inventory three times (pretreatment, after 12 sessions, and post-treatment) during CBT. Gaussian graphical models were used to estimate the relationships among symptoms. (3) Results: The severity of depressive symptoms significantly decreased over the course of therapy, but connectivity in the networks significantly increased. Communities of symptoms changed during treatment. The most central and predictable symptom was worthlessness at baseline and after 12 sessions, and loss of energy and self-dislike at post-treatment. (4) Conclusion: The results indicate that the severity of depressive symptoms decreased during cognitive behavior therapy, while network connectivity increased. Furthermore, the associations among symptoms and their centrality changed during the course of therapy. Future studies may investigate individual differences and their impact on the planning of psychotherapeutic treatment. Full article

(This article belongs to the Special Issue Advances in Major Depressive Disorder Research)

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12 pages, 459 KiB

Open AccessArticle

Depression Symptoms among Family Members of Nyaope Users in the City of Tshwane, South Africa

by Maphuti Carol Madiga and Kebogile Mokwena

Int. J. Environ. Res. Public Health 2022, 19(7), 4097; https://doi.org/10.3390/ijerph19074097 - 30 Mar 2022

Cited by 8 | Viewed by 3767

Abstract

Substance abuse brings major negative social and health impacts in South Africa. Nyaope, a cocktail drug commonly used in the Tshwane townships, has been well documented to be highly addictive and very difficult to quit. The resultant difficulties include financial, social, and mental, specifically depression and anxiety. This study aims to quantify the depression levels among family members with nyaope users in Tshwane, South Africa. The study used a quantitative cross-sectional design to collect data in nine Tshwane communities. The patient health questionnaire-9 (PHQ-9) screening tool and demographic data collection questionnaires were used to collect data from a sample of 390 male and female family members who included mothers, fathers, grandparents, aunts, uncles, partners, and siblings of nyaope users, and who share a home with them. The ages of the participants ranged from 18 to 87 years, with a mean age of 47 years, while the ages of the nyaope users ranged from 17 to 55 years, with a mean age of 30 years. Depression scores ranged from 0 to 27 with a mean of 7. Depressive symptoms, as measured by the PHQ-9 scores of 5 and above, were reported by 49% of the sample. The levels of depression symptoms ranged from mild to severe, and the severity was higher among female, unemployed, and single participants. As with many others, these participants were not diagnosed and therefore were not treated. The study, therefore, identified that living with nyaope users is associated with the development of different levels of depression symptoms and has resulted in reduced quality of life among family members. The study recommends interventions that intentionally focus on families who live with individuals who are addicted to nyaope. Those interventions should focus on screening and treatment of depression and other mental disorders. Full article

(This article belongs to the Special Issue Advances in Major Depressive Disorder Research)

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13 pages, 370 KiB

Open AccessArticle

The Onset of Depression in Middle-Aged Presumed Healthy Slovenian Family Practice Attendees and Its Associations with Genetic Risk Assessment, Quality of Life and Health Status: A Contribution for Family Medicine Practitioners’ Early Detection

by Nina Jerala and Polona Selič-Zupančič

Int. J. Environ. Res. Public Health 2021, 18(15), 8197; https://doi.org/10.3390/ijerph18158197 - 3 Aug 2021

Cited by 1 | Viewed by 2543

Abstract

Despite depression being a major driver of morbidity and mortality, the majority of primary care patients remain undiagnosed, so this study aimed to assess the prevalence of depression and the association with demographic and clinical variables, genetic risk, and quality of life. The participants were presumably healthy model family medicine practice (MFMP) attendees between 30 and 65 years of age and recruited during a preventive check-up in 2019. Each of the 40 pre-selected MFMP pragmatically invited 30 attendees to voluntarily participate. They completed a questionnaire of demographic, clinical, and social determinants, as well as a three-generational family history. The results were analyzed using multivariable modelling to calculate the associations with signs of depression. A modified Scheuner method was used to calculate the level genetic risk level using family history. Of 968 participants, aged 42.8 ± 8.6 years, 627 (64.8%) were women. The prevalence of depression was 4.1%. Signs of depression were negatively associated with health-related quality of life score, in particular in the domains of self-care (p = 0.001) and anxiety/depression (p < 0.001). Depression was also associated with predicted high risk for comorbidities given the family history (p = 0.030). Primary care directed at improving patients’ quality of life should implement more widespread screening for mental health disorders. Family history for disease even beyond depression can be used by physicians as an important primary prevention tool. Full article

(This article belongs to the Special Issue Advances in Major Depressive Disorder Research)

13 pages, 500 KiB

Open AccessArticle

Working Conditions as Risk Factors for Depressive Symptoms among Spanish-Speaking Au Pairs Living in Germany—Longitudinal Study

by Bernarda Espinoza-Castro, Tobias Weinmann, Rossana Mendoza López and Katja Radon

Int. J. Environ. Res. Public Health 2021, 18(13), 6940; https://doi.org/10.3390/ijerph18136940 - 28 Jun 2021

Cited by 4 | Viewed by 2293

Abstract

Previous studies have shown poor working conditions and poor mental health among au pairs. However, there are limited longitudinal approaches to these conditions. Therefore, the main objectives of this study were to assess the occurrence of depressive symptoms longitudinally and to analyze the association between sociodemographic characteristics, working conditions and violence at work with depressive symptoms over time among Spanish-speaking au pairs living in Germany. A prospective cohort study was performed with three measurement intervals, which included 189 participants. Depressive symptoms were assessed by the Patient Health Questionnaire (PHQ-9). Generalized Estimating Equation (GEE) models were implemented to estimate the association between predictors and depressive symptoms. Au pairs who worked >40 h per week were more than three times more likely to experience depression than those who did not (OR: 3.47; 95% CI: 1.46–8.28). In addition, those exposed to physical violence were almost five times more likely to suffer from depression (OR: 4.95; 95% CI: 2.16–9.75), and au pairs who had bad schedule adaptation to social and family commitments had twice the risk of depression than those who did not (OR: 2.24; 95% CI: 0.95–5.28). This knowledge could be of interest for future au pairs, host families, au pair agencies and policy makers. Together, they could improve awareness and monitoring of au pair working conditions. Full article

(This article belongs to the Special Issue Advances in Major Depressive Disorder Research)

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11 pages, 3046 KiB

Open AccessArticle

Maternal Economic Well-Being and Mental Health among Young Adult Children: Race/Ethnicity

by Jaewon Lee

Int. J. Environ. Res. Public Health 2021, 18(11), 5691; https://doi.org/10.3390/ijerph18115691 - 26 May 2021

Cited by 2 | Viewed by 2155

Abstract

This study aimed to examine the relationship between maternal economic well-being and children’s mental health outcomes in adulthood and to consider the moderating effect of race/ethnicity. This study used data from the National Longitudinal Survey of Youth 1979 and the National Longitudinal Survey of Youth 79 for Children and Young Adults. The two datasets were merged, and 4224 pairs were selected for the final sample. Ordinary linear regression and logistic regression analyses were used. Poverty and lower net worth among mothers were positively associated with their children’s depression in young adulthood. Race/ethnicity moderated the relationship between maternal poverty and children’s depression. Therefore, women’s economic resources may be an important factor in the development of mental health issues among their children in young adulthood. Developing anti-poverty policies that target women may assist in reducing depressive symptoms in their children once they reach young adulthood, specifically for non-Hispanic White children. Full article

(This article belongs to the Special Issue Advances in Major Depressive Disorder Research)

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Review

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12 pages, 530 KiB

Open AccessReview

Variation in Obsessive-Compulsive Disorder Symptoms and Treatments: A Side Effect of COVID-19

by Wuqianhui Liu, Haitao Zhang and Yuan He

Int. J. Environ. Res. Public Health 2021, 18(14), 7420; https://doi.org/10.3390/ijerph18147420 - 12 Jul 2021

Cited by 9 | Viewed by 4867

Abstract

The Coronavirus Disease 2019 (COVID-19) exerts variable impact on patients with obsessive compulsive disorders (OCD). There remains a challenge to determine the extent to which OCD is exacerbated due to the pandemic. Therefore, our aim is to explicate the latest researching progress of OCD under COVID-19 based on a review of 15 existing articles. Our review confirms the prevalence of OCD exacerbation in different age groups and particular symptoms. However, it also reveals nonconformity among research, lack of investigation in OCD treatment, and imbalance in OCD symptoms research. Further, we discuss the probable reasons of the exacerbation and current situation of OCD treatments. Finally, based on our discussion, we offer suggestions on how to manage OCD under the new circumstance, including the introduction of new policies, the use of communications technology, the improvement of researching methods, and possible angles for further research. Full article

(This article belongs to the Special Issue Advances in Major Depressive Disorder Research)

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Other

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25 pages, 2224 KiB

Open AccessSystematic Review

Adaptogens on Depression-Related Outcomes: A Systematic Integrative Review and Rationale of Synergism with Physical Activity

by Isabel A. Sánchez, Jaime A. Cuchimba, María C. Pineda, Yenny P. Argüello, Jana Kočí, Richard B. Kreider, Jorge L. Petro and Diego A. Bonilla

Int. J. Environ. Res. Public Health 2023, 20(7), 5298; https://doi.org/10.3390/ijerph20075298 - 28 Mar 2023

Cited by 5 | Viewed by 6473

Abstract

Depression is considered the most important disorder affecting mental health. The aim of this systematic integrative review was: (i) to describe the effects of supplementation with adaptogens on variables related to depression in adults; and (ii) to discuss the potential combination with physical exercise to aid planning and commissioning future clinical research. An integrative review was developed complementing the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement (PROSPERO registration: CRD42021249682). A total of 41 articles met the inclusion criteria. With a Price index of 46.4%, we found that: (i) Hypericum perforatum (St. John’s Wort) is the most studied and supported adaptogen (17/41 [41.46%], three systematic reviews with meta-analysis) followed by Crocus sativus L. or saffron (6/41 [14.63%], three systematic reviews with meta-analysis and two systematic reviews); (ii) it is possible that the significantly better performance of adaptogens over placebo is due to the reduction of allostatic load via the action of secondary metabolites on BDNF regulation; and, (iii) the number of studies reporting physical activity levels is limited or null for those that combine an exercise program with the consumption of adaptogens. Aware of the need for a multidisciplinary approach for depression treatment, this systematic integrative review provides an up-to-date view for supporting the use of St. John’s Wort and saffron as non-pharmacological strategies while also help commissioning future research on the efficacy of other adaptogens. It also contributes to the design of future clinical research studies that evaluate the consumption of herbal extracts plus physical exercise, mainly resistance training, as a potentially safe and powerful strategy to treat depression. Full article

(This article belongs to the Special Issue Advances in Major Depressive Disorder Research)

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