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Depression and Anxiety welcomes original research and review articles covering neurobiology (genetics and neuroimaging), epidemiology, experimental psychopathology, and treatment (psychotherapeutic and pharmacologic) aspects of mood and anxiety disorders and related phenomena in humans.
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Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders in Group Format in Spain: Results of a Noninferiority Randomized Controlled Trial at 15 Months after Treatment Onset
Evidence-based psychological treatments (EBPT) are an effective and efficient solution for the treatment of emotional disorders (EDs). However, their implementation and dissemination are not yet widespread. The Unified Protocol for Transdiagnostic Treatment of EDs (UP), applied in a group format, could be an effective option to be implemented in specialized public mental health services in Spain. The sample consisted of 533 users of public specialized mental health centers (77.3% women), with a mean age of 42.0 years (), who were randomized to the UP in group format condition () or treatment as usual (specific cognitive behavioral therapy for each disorder in individual format, ). Assessments were performed at preintervention (T1) and at 3, 6, 9 and 15 months after treatment onset (T2, T3, T4, and T5, respectively). The results showed a main effect of time in both conditions for all primary outcomes () and no statistically significant TimeCondition interaction. Similarly, the noninferiority tests showed that UP results were statistically noninferior compared to TAU. Effect sizes for psychological variables were higher in the UP condition at T5, even though the differences were not statistically significant. Statistically significant differences () in the evolution of the diagnostic criteria and comorbidity were found, with the highest percentage of patients no longer meeting main and secondary diagnosis criteria in the UP condition at all assessment moments (except for secondary diagnosis at T3). The results showed statistically significant differences in treatment retention between conditions at T5, being the UP condition the one with less dropouts. Finally, participants in the group UP condition showed high satisfaction with the treatment. The UP is an EBPT that has been shown to be effective when applied in groups and may represent an efficient option for its implementation in public mental health services in Spain. This trial is registered with NCT03064477.
Advances in Zebrafish as a Comprehensive Model of Mental Disorders
As an important part in international disease, mental disorders seriously damage human health and social stability, which show the complex pathogenesis and increasing incidence year by year. In order to analyze the pathogenesis of mental disorders as soon as possible and to look for the targeted drug treatment for psychiatric diseases, a more reasonable animal model is imperious demands. Benefiting from its high homology with the human genome, its brain tissue is highly similar to that of humans, and it is easy to realize whole-body optical visualization and high-throughput screening; zebrafish stands out among many animal models of mental disorders. Here, valuable qualified zebrafish mental disorders models could be established through behavioral test and sociological analysis, which are simulated to humans, and combined with molecular analyses and other detection methods. This review focuses on the advances in the zebrafish model to simulate the human mental disorders; summarizes the various behavioral characterization means, the use of equipment, and operation principle; sums up the various mental disorder zebrafish model modeling methods; puts forward the current challenges and future development trend, which is to contribute the theoretical supports for the exploration of the mechanisms and treatment strategies of mental disorders.
Math Anxiety and Financial Anxiety Predicting Individuals’ Financial Management Behavior
Background. In managing finances, people need to process various financial texts containing math (e.g., amount of money and mathematical concepts) and financial information (e.g., funds and bonds). Such information could trigger anxiety related to math and finance; however, previous literature has rarely investigated the prediction role of contextual anxiety on financial management behavior. Therefore, the current study examined how math anxiety and financial anxiety are related to individuals’ financial management behavior assessed by self-report and objective observation, respectively. Methods. Study 1 investigated 186 employees with the math anxiety scale, financial anxiety scale, and financial management behavior scale to explore how math anxiety and financial anxiety predicted financial management behavior. Study 2 used a “choice/no choice” paradigm to observe how the high () and low () financial anxiety groups chose (or avoided) between a math task and a finance task (as a measurement of financial avoidance). Results. Study 1 showed that financial anxiety fully mediated the negative relationship between math anxiety and financial management behavior and the mediating effect size was −0.24, . And compared to math anxiety (, ), financial anxiety (, ) was a stronger negative predictor of financial management behavior. Study 2 revealed that, compared to people with low financial anxiety, those with high financial anxiety were 2.75 times more likely to choose financial avoidance. Conclusions. People’s financial management behavior can be predicted by financial anxiety and math anxiety (especially the former), and the two types of anxiety seem to derive more from an irrational self-perception rather than actual ability. So, reducing financial anxiety and math anxiety should come first to motivate people to manage finances.
Characterizing Unipolar and Bipolar Depression by Alterations in Inflammatory Mediators and the Prefrontal-Limbic Structural Network
Objective. The prefrontal-limbic system is closely associated with emotion processing in both unipolar depression (UD) and bipolar depression (BD). Evidence for this link is derived mostly from task-fMRI studies, with limited support from structural findings. Therefore, this study explores the differences in the emotional circuit in these two disorders on a structural, large-scale network basis, coupled with the highly noted inflammatory and growth factors. Methods. In this study, 31 BD patients, 37 UD patients, and 61 age-, sex-, and education-matched healthy controls (HCs) underwent diffusion-weighted imaging (DWI) scanning and serum cytokine sampling. The study compared cytokine levels and prefrontal-limbic network alterations among the three groups and explored potential biological and neurobiological markers to distinguish the two disorders using graph theory, network-based statistics (NBS), and logistic regression. Results. Compared to BD patients, UD patients showed greater s-100β protein levels, higher efficiency of the right amygdala, and significantly elevated prefrontal-cingulate-amygdala subnetwork intensity. Importantly, the altered prefrontal-cingulate-amygdala subnetwork, nodal efficiency of the right amygdala, IL-8, IL-17, and s-100β levels were risk factors for the diagnosis of UD, whereas anxiety symptoms tended to closely correlate with BD. Moreover, binary logistic regression manifested these factors achieved an area under the curve (AUC) of the receiver operating characteristics (ROC) of 0.949, with 0.875 sensitivity and 0.938 specificity in UD vs. BD classification. Conclusions. These findings narrow the gap in the structural network of emotional circuits in bipolar and unipolar depression, pointing to distinct emotion-processing mechanisms in both disorders.
Characterizing White Matter Changes along Fibers in Treatment-Naive Pediatric Posttraumatic Stress Disorder
Children and adolescents are more susceptible than adults to developing posttraumatic stress disorder (PTSD). Pediatric PTSD is characterized by functional alterations in brain fear circuitry, but little is known about the underlying microstructural changes; previous work has mainly focused on the corpus callosum. This study is aimed at investigating brain-wide microstructural abnormalities in pediatric PTSD, their relationship to age and sex, and their potential diagnostic value. The microstructure of major white matter tracts was assessed from diffusion tensor images acquired from 24 treatment-naive non-comorbid PTSD patients <18 years and 24 trauma-exposed non-PTSD controls (TENP) matched for age, sex, and years of education. Statistical analyses included pointwise comparisons, correlations with symptom severity, and diagnosis-by-age/sex interactions; support vector machine analyses were conducted to determine whether microstructure distinguishes PTSD from TENP. Compared with TENP, pediatric PTSD patients showed higher fractional anisotropy and lower radial diffusivity in right superior longitudinal fasciculus and lower axial diffusivity in right uncinate fasciculus. These white matter microstructural abnormalities were highly correlated with PTSD symptom severity. No significant diagnosis by age or sex interaction was observed. The pointwise axial diffusivity measurements presented the best PTSD vs. TENP classification performance. In summary, pediatric PTSD patients showed clinically relevant microstructural abnormalities in uncinate and superior longitudinal fasciculus, which extend understanding of pediatric PTSD neurobiology beyond the corpus callosum and have diagnostic potential in distinguishing stressed individuals with and without PTSD.
Poor Treatment Response in Panic Disorder Patients with Suicide Attempts and Their Symptom Network Characteristics
Background. Panic disorder (PD) is associated with suicidality. Depression has been suggested as a link between PD and suicide; however, this remains controversial. Comprehensive research on the history of suicide attempt (SA) in patients with PD is scarce. We investigated the clinical characteristics of SA in patients with PD using PD-related assessments and network approaches. Methods. A total of 1151 participants were enrolled, including 755 patients with PD (97 with SA (PD+SA) and 658 without SA (PD-SA)) and 396 healthy controls. The Scale for Suicide Ideation and Panic Disorder Severity, Anxiety Sensitivity Inventory, and other PD-related measures were also administered. We compared symptom severity and analyzed the pharmacological treatment response in patients with PD with and without SA. Network analysis was used to estimate the centrality, stability, and network structures of the nodes. Results. Our results revealed that the scores for panic and depressive symptoms, pathological worry, anxiety sensitivity, and the frequency of early trauma were significantly higher in the PD+SA group than in the PD-SA group. Multiple linear regression analysis revealed that short- and long-term pharmacological treatment responses were significantly poorer in the PD+SA group. Network analysis showed that fear of cognitive dyscontrol (FCD), as a cognitive aspect of anxiety sensitivity, was the central symptom through strength, expected influence (one and two steps), randomized shortest path betweenness, and eigenvector centrality measures in the PD+SA group. In contrast, depression was the central symptom of patients with PD-SA. Conclusion. Our study suggests that a history of SA could be associated with high panic-symptom severity and poor pharmacological treatment response in patients with PD and that FCD is the most central symptom in the PD+SA network. Central symptoms, such as cognitive aspects of AS in patients with PD+SA, may be clinically effective as potential targets for intervention in patients with PD at risk of or suffering from suicidality.