Search Results (5,838)

Background: The depressed population needs to be treated and they do not have access to evidenced-based psychological practices (EBPPs). The consequences lead to significant daily impairments and huge economical costs. A large amount of research has focused on the demand for a more extensive use of EBPPs. However, despite these practices being essential to the mental health system, EBPPs are poorly applied in clinical settings. This situation has led to the development of Implementation Research (IR), a scientific field that aims to address the challenge of translation and identify the factors involved in the implementation process. Several implementation studies have been carried out in the field of health. However, the evidence from implementation studies of psychological treatments addressing depression has not yet been summarized. The aim of this study is to conduct a systematic review to assess implementation studies that use EBPPs to address depression. Methods: A systematic review was conducted following the PRISMA guidelines, including implementation studies that applied EBPPs to address depressive disorders. The following databases were used: PubMed, Embase, APA PsycInfo, Cochrane Central, Scopus, and Web of Science. Two independent reviewers revised the studies to determine whether the eligibility criteria were met. Results: A total of 8797 studies were identified through database searches. After removing duplicates, a total of 3757 studies were screened based on titles and abstracts. Finally, 127 full-text articles were reviewed, yielding 31 studies that satisfied the inclusion criteria. Conclusions: This review offers valuable insights into the current state of IR in the implementation of EBPPs for treating depressive disorders. It underlines the necessity for a standardized nomenclature for study designs within the realm of IR and emphasizes the potential of hybrid efficacy–implementation studies to help close the gap between research and clinical practice. Despite the challenges encountered, this review points to a positive outlook for the use of IR in clinical psychology. A gradual adoption of IR is likely to strengthen its role in psychology and support the development of more effective strategies for implementing evidence-based interventions in clinical settings. Full article

Depressive disorder is the most prevalent mental illness, and increasing evidence suggests its potential bidirectional relationship with metabolic disorders. Given the limited efficacy of conventional antidepressants (including Selective Serotonin Reuptake Inhibitors; SSRIs) and the growing prevalence of treatment-resistant depression, there is a significant need to identify alternative molecular pathways underlying the pathophysiology of depressive disorder, which may represent novel therapeutic targets for other agents. Emerging evidence indicates that metabolic dysfunction and depressive disorder share a common pathophysiological molecular mechanism and increase each other’s risk. Targeting peripheral metabolic pathways and their interactions with the central nervous system may alleviate depressive symptoms. Glucagon-Like Peptide-1 agonists (GLP-1 RAs) and Sodium–Glucose Cotransporter-2 (SGLT2) inhibitors, widely used in the treatment of type 2 diabetes and obesity, exhibit neurotrophic and anti-inflammatory effects, ameliorate oxidative stress, and enhance mitochondrial function, collectively contributing to the antidepressant-like effects observed in preclinical studies. Peroxisome Proliferator-Activated Receptor (PPAR) α agonists primarily regulate lipid and glucose metabolism, which may potentially improve neuronal plasticity and mood regulation. Moreover, agents such as Angiotensin Receptor Blockers (ARBs) and Angiotensin Receptor-Neprilysin Inhibitors (ARNIs), used in hypertension treatment, exert central anti-inflammatory and neuroprotective effects via the modulation of the renin–angiotensin–aldosterone system (RAAS), implicated in affective disorders. Nevertheless, long-term, head-to-head trials are required to establish their efficacy, safety, and therapeutic positioning within current treatment paradigms. The aim of this review is to summarize current evidence on metabolic modulators as potential antidepressant strategies, focusing on their molecular mechanisms, preclinical and clinical findings, and prospects for integration into future therapies for depression. Full article

Background: Parkinson’s disease (PD) in advanced stages becomes, over time, a significant challenge, as oral medication becomes ineffective, and it may become necessary to switch to device-assisted therapy (DAT). This should be personalized according to the stage of the disease, the cognitive status of the patients, the association of frailty syndrome or other comorbidities, the support in care from the family, etc. Levodopa–carbidopa–entacapone intestinal gel can significantly improve the status of patients, provided that they are correctly selected for this type of treatment. Materials and Methods: We conducted a single-center prospective study including 20 advanced PD patients, who received a levodopa–carbidopa–entacapone gel through an intestinal pump, within the Parkinson’s Disease Multimodal Treatment Center of the Neurology Clinic of the “St. Ap. Andrew” County Emergency Clinical Hospital in Galați, Romania. The evaluations were performed at baseline (T0), after intestinal pump insertion (T1), and 6 months after the procedure (T2). Results: In the study group, the administration of the levodopa–carbidopa–entacapone intestinal gel, using the device for intestinal administration, had significant benefits, especially for motor symptoms. The periods of off, no-on, freezing, sudden-off, as well as dyskinesia and morning akinesia, were significantly reduced. Among the non-motor symptoms, depression and sleep disorders improved, with no changes in cognitive status and psychotic disorders. Conclusions: Adding new data for the use of device-assisted therapy in advanced PD, our study also highlights the need to further research this challenging patient profile. Full article

Background: Major depressive disorder (MDD) is a prevalent and disabling psychiatric illness with complex etiologies involving both genetic and environmental factors. While environmental stress is a known risk factor of MDD, the molecular mechanisms linking stress exposure to persistent depressive phenotypes remain incompletely understood. Methods: We established a 24-hour restraint stress-induced depression model in mice and performed integrated transcriptomic and proteomic analyses of the medial prefrontal cortex (mPFC) to investigate stress-related molecular alterations. Results: Behavioral assessments confirmed persistent depression-like phenotypes, including anhedonia and behavioral despair, lasting up to 35 days post-stress. RNA sequencing identified differentially expressed genes related to dopaminergic signaling and oxidative stress. Proteomic analysis identified 105 differentially expressed proteins involved in immune response and energy metabolism. Integrated multi-omics analysis highlighted convergent disruptions in immune regulation, metabolism, and epigenetic processes. Notably, clemastine exerts its antidepressant-like effects in part by mitigating neuroinflammation and preserving mitochondrial function. Conclusions: These findings provide novel insights into the molecular basis of stress-induced depression and suggest that clemastine is a potential therapeutic candidate. Full article

Mitochondrial dysfunction is a key factor in the pathophysiology of major depressive disorder (MDD) and treatment-resistant depression (TRD), connecting oxidative stress, neuroinflammation, and reduced neuroplasticity. Physical exercise induces specific mitochondrial changes linked to improvements in mental health. The aim of this paper was to examine emerging evidence regarding the effects of physical exercise on mitochondrial function and treatment-resistant depression, highlighting the clinical importance of the use of mitochondrial biomarkers to personalize exercise prescriptions for patients with depression, particularly those who cannot tolerate standard treatments. Physical exercise improves mitochondrial function, enhances biogenesis and neuroplasticity, and decreases oxidative stress and neuroinflammation. Essential signaling pathways, including brain-derived neurotrophic factor, AMP-activated protein kinase, active peroxisome proliferator-activated receptor-γ coactivator-1α, and Ca²⁺/calmodulin-dependent protein kinase, support these effects. Most studies have concentrated on the impact of low- and moderate-intensity aerobic exercise on general health. However, new evidence suggests that resistance exercise and high-intensity interval training also promote healthy mitochondrial adaptations, although the specific exercise intensity required to achieve this goal remains to be determined. There is strong evidence that exercise is an effective treatment for MDD, particularly for TRD, by promoting specific mitochondrial adaptations. However, key gaps remain in our understanding of the optimal exercise dose and which patient subgroups are most likely to benefit from it (Graphical Abstract). Full article

Introduction: Myotonic dystrophies (DM) are progressive genetic disorders with multisystemic involvement, particularly affecting the muscular, respiratory, and neuropsychological systems. Myotonic dystrophy type 1 (DM1), or Steinert’s disease, may lead to severe respiratory complications, including sleep-disordered breathing and hypercapnia, often requiring noninvasive ventilation to manage respiratory failure. However, adherence to NIV remains a major challenge, often influenced by cognitive and psychological factors such as apathy and depression. This study aims to investigate the presence of depression and SDB in patients with DM1 initiating NIV, and to evaluate factors influencing adherence to ventilatory support. Materials and Methods: We selected 13 adult patients (≥18 years) with diagnosis of Steinert’s disease with respiratory impairment who needed to start respiratory support. Dysphagia was assessed in all patients at baseline by a videofluoroscopic swallow study. Beck’s Depression Inventory II was administered for measuring the severity of depression. The Montreal Cognitive Assessment was used as a screening tool to detect signs of neurocognitive disorders. We evaluated adherence to NIV. Results: The study population presented with sleep-disordered breathing, as indicated by a median apnea–hypopnea index (AHI) of 24 events per hour (IQR: 14.2–34.5) and an oxygen desaturation index (ODI) of 25 events per hour (IQR: 18–33). Adherence to NIV was obtained in seven patients. No difference in baseline lung function was observed. Adherent subjects had moderate hypercapnia at baseline; pCO2 was 52 vs. 49 mmHg. Non-adherent patients showed a higher prevalence of depression with a median BDI-II score of 18 vs. 6 in adherent patients. The findings highlight that psychological factors, especially depression, play a crucial role in adherence to NIV. Interestingly, depression was not linked to initial respiratory measurements but showed a significant association with nocturnal oxygen desaturation. This suggests that relying solely on clinical and respiratory assessments may not be adequate to predict or improve treatment adherence. Conclusions: Incorporating psychological evaluations and addressing mental health issues, such as depression, are essential steps to enhance NIV compliance and overall DM1 patient outcomes. A multidisciplinary approach combining respiratory and psycho-emotional interventions is crucial for effective disease management. Full article

Background/Objectives: Several studies indicate that physical activity is both safe and beneficial for most cancer survivors—before, during and after treatment. These benefits include improved mental health and a subsequent positive impact on quality of life. This study aimed to (1) assess the mental health of cancer survivors in terms of depression and anxiety, (2) analyze levels of physical activity within the sample, and (3) explore the relationship between psychopathological symptoms, physical activity, and perceived quality of life. Methods: This is a cross-sectional study of 55 cancer survivors, with a mean age of 62.27 ± 11.91, living in inland of Portugal and not undergoing palliative care. Data were collected using a sociodemographic, clinical and physical activity questionnaire, the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder scale (GAD-7), the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30), and the Godin Leisure-Time Exercise Questionnaire (GLTEQ). Data was analyzed using descriptive statistics, Cronbach’s coefficient to assess the internal consistency, Spearman’s correlation, and multiple linear regression. Results: The results revealed significant associations between physical activity, psychopathological symptomatology, and quality of life. Specifically, the interaction between depression and physical activity had a negative impact on quality of life (B = −0.181; 95% CI −0.291 to −0.070; p = 0.002), whereas the interaction between anxiety and physical activity showed a positive effect (B = 0.165; 95% CI 0.037 to 0.293; p = 0.013). Conclusions: Physical activity enhances the quality of life of cancer survivors and moderates the negative impact of psychopathological symptoms. This highlights the importance of promoting healthy lifestyles and empowering healthcare professionals to recommend supervised physical activity as part of integrated and personalized care. Further studies should explore the relationship between other psychopathological symptoms, such as somatization, and physical activity in relation to quality of life. Full article

Background: Mood disorders, including anxiety, depression, and seasonal affective disorder (SAD), are often comorbid and can be exacerbated by the misalignment of an individual’s circadian rhythm with their social timing. Single-nucleotide polymorphisms (SNPs) in circadian clock genes have been associated with both internalizing disorders and sleep disturbances, and some clock polymorphisms, including those in the Period3 (PER3) gene, likely function via delaying or advancing circadian period and affecting sleep–wake patterns. Methods: Here, we explore associations of multiple SNP haplotypes in the PER3 gene with anxiety, depression, internalizing disorder (ID), chronotype, and sleep disturbance in young adults (n = 1109 individuals). Results: We report novel, sex-specific associations of single PER3 SNPs with mood and sleep disorders and highlight strong multi-SNP haplotype associations, revealing a greater risk of mood and sleep disorders in university students with specific PER3 haplotypes. Conclusions: Our results suggest that the additive effects of multiple risk variants amplify the prevalence of mood disorders and sleep disruptions in young adults. Understanding how polymorphisms within circadian genes interact to alter clock function, sleep-wake behavior and downstream physiological changes in the brain may help explain the comorbidity of mood and sleep syndromes and provide future therapeutic targets to combat these debilitating disorders. Full article

Quality of life represents a key area of concern in every stage of life. It is necessary to pay more attention to the factors or conditions that can negatively affect quality of life. From adolescence until postmenopause, women face a series of gynecological conditions that can significantly reduce their quality of life and which also represent economic problems. We conducted a literature review to present the impact of gynecological pathologies on patients’ quality of life and the tools used to assess these effects. The goals were to increase the attention given to this topic and to encourage health care providers to prioritize patients’ quality of life in the management of gynecological pathologies. Most of the time, gynecological pathologies reduce self-esteem, cause fear, anxiety, and depression, and the feeling of a lack of control may appear. Social life, professional and university activities, relationships, and daily or recreational activities can be negatively influenced by gynecological pathologies. Sexual life and relationships with partners are often affected by the presence of gynecological conditions, especially if they cause infertility. From the effects of dysmenorrhea that occur since the teenage and until the onset of menopause symptoms, women frequently present throughout life a series of gynecological disorders such as endometriosis, infertility, uterine fibromatosis, polycystic ovary syndrome, pelvic organ prolapse, or urinary incontinence. Understanding the negative effects that these conditions have on quality of life can contribute to more efficient and personalized management of cases. Full article

Background: The postpartum period may predispose to a higher prevalence of mental health disorders. The aim of the study was to assess the prevalence of anxiety and depressive symptoms, life satisfaction, and quality of life in breastfeeding women in the maternity ward in relation to specific medical and social factors. Methods: The study group consisted of 304 female patients from the maternity ward of the Multispecialist District Hospital in Tarnowskie Góry, Poland. The research tool included four questionnaires: Hospital Anxiety Depression Scale, Edinburgh Postnatal Depression Scale, Satisfaction with Life Scale, and Euro-Quality of Life Questionnaire. Results: The majority of women in the maternity ward reported good psychological well-being. Anxiety symptoms affected 11.9% of postpartum women, depressive symptoms—7.3%, and symptoms of postpartum depression—5.9%. The COVID-19 pandemic caused an increase in anxiety and depressive disorders (relative differences-expressed as a percentage). Women who gave birth by cesarean section were more likely to declare problems that negatively impacted their quality of life and health than those who gave birth naturally (OR = 1.28, 95% CI: 0.77–2.11). The risk of experiencing anxiety and depressive symptoms, as well as postpartum depression symptoms decreased as self-rated health increased (OR = 0.96, 95% CI: 0.94–0.99; OR = 0.96, 95% CI: 0.94–0.99; OR = 0.96, 95% CI: 0.93–0.98, respectively). Higher level of life satisfaction was associated with higher levels of education and economic status, attendance at childbirth classes, and a higher self-assessment of health (OR = 4.1, 95% CI: 1.6–10.51; OR = 2.96, 95% CI: 1.41–6.24; OR = 1.99, 95% CI: 1.13–3.49; OR = 1.01, 95% CI: 1.01–1.04, respectively). Conclusions: Screening for mental disorders during the postpartum period enables the early identification of symptoms and the implementation of appropriate treatment. Women who give birth by cesarean section and have medical complaints should be given special follow-up care. Health policy should ensure wider access to psychological and psychiatric care during the postpartum period. Full article

Background: Central sensitization syndromes (CSSs) are associated with a high incidence of traumatic events; however, few studies have examined the potential mechanisms linking post-traumatic stress disorder (PTSD) and pain. Objectives: The present research aims to clarify this association by exploring the presence of trauma, PTSD, and related clinical variables in participants with CSSs compared to healthy controls and those with medical problems. Methods: A large sample of both sexes of the Spanish general population (n = 1542; aged 18–84 years) completed an online survey assessing the presence of traumatic experiences (psychological trauma, physical trauma, physical and sexual abuse), PTSD, and other clinical measures (central sensitization, pain, sleep quality, anxiety, depression, perceived stress, and emotional regulation). Results: The CSS group (n = 467) showed a higher incidence of repeated trauma, PTSD, and dissociative symptoms compared to the medical pathologies (n = 214) and healthy (n = 861) groups. The CSS group also showed greater clinical impairment than the other groups, especially the CSS subgroup with PTSD. In this subgroup, PTSD symptoms were significantly correlated with the remaining clinical measures, and sleep dysfunction, pain catastrophizing, and emotional dysregulation mediated the relationship between PTSD and pain, accounting for 55.3% of the variance. Conclusions: CSS represents a major therapeutic challenge. An integrated treatment addressing both trauma and pain, with an emphasis on sleep quality, pain catastrophizing, and emotional regulation, could improve the effectiveness of the current therapeutic approaches. Full article

Background: Orthognathic surgery using the Surgery-First approach (SFA) has gained increasing attention not only for its functional and aesthetic benefits but also for its potential psychological impact. Aim: This study aimed to evaluate the effects of SFA on the psychological well-being of patients with dentofacial anomalies and temporomandibular disorders (TMD), using validated tools for assessing anxiety (GAD-7), depression (PHQ-9), and pain catastrophizing (PCS). Materials and methods: A longitudinal observational study was conducted on 27 patients treated between 2022 and 2025. TMD was assessed using the DC/TMD clinical criteria. Psychological status was evaluated preoperatively and 6 months postoperatively using the GAD-7, PHQ-9, and PCS standardized questionnaires. Results: Significant reductions were observed in all three domains: GAD-7 scores dropped from 13.8 to 4.1 (p < 0.001), PHQ-9 from 15.5 to 5.3 (p < 0.001), and PCS from 26.2 to 12.7 (p < 0.001). These are raw total scores; corresponding normalized mean scores (per item) decreased from 2.78 to 1.08 for GAD-7, from 3.00 to 0.36 for PHQ-9, and from 1.22 to 1.06 for PCS. The greatest improvements were seen in Class III patients with TMD. Psychological scores did not significantly predict persistent TMD. Conclusions: These findings support the psychological benefits of SFA and underline the importance of integrating psychological screening into orthognathic treatment planning. Full article

Treatment-resistant schizophrenia (TRS) affects up to one in three individuals with schizophrenia and is associated with a significant clinical, social, and economic burden. Different from treatment-responsive forms, TRS appears to involve other biological mechanisms extending beyond dopaminergic dysfunctions. This review outlines current knowledge on the molecular and cellular basis of TRS, focusing on alterations in glutamate signaling, imbalances between excitatory and inhibitory activity, disruptions in D-amino acid metabolism, and evidence of neuroinflammation, oxidative stress, and mitochondrial or endoplasmic reticulum dysfunction. Data from genomics, proteomics, metabolomics, preclinical models, and postmortem studies suggest that TRS may have a peculiar neurobiological substrate. Further, multimodal brain imaging studies reveal differences in brain structure, white matter integrity, and network connectivity when compared to treatment-responsive individuals. Altogether, these findings support a shift from the traditional dopamine hypothesis toward a more comprehensive model that includes multiple immune, metabolic, and synaptic factors. Understanding the possible interplay of these complex mechanisms may lead to the identification of potential biomarkers that may help to predict antipsychotic response, as well as the development of more targeted treatments. Early recognition and a deeper biological insight into TRS are essential for improving care and guiding personalized therapeutic strategies. Full article

Background/Objectives: Maternal depression, anxiety, perceived stress, and resilience are recognized determinants of perinatal health, yet routine psychological screening is still uncommon in Romanian obstetric practice. This study examined how these four psychological factors relate to preterm birth, gestational hypertension, intra-uterine growth restriction (IUGR), and low birth weight in primiparous women. Methods: In a cross-sectional study at a tertiary maternity center in Timișoara (February 2024–February 2025), 240 women at 20–28 weeks’ gestation completed the Edinburgh Postnatal Depression Scale (EPDS), Generalized Anxiety Disorder-7 (GAD-7), Perceived Stress Scale-10 (PSS-10), and Connor–Davidson Resilience Scale-25 (CD-RISC-25). Obstetric outcomes were abstracted from medical records. Pearson correlations described bivariate associations; multivariate logistic regression assessed independent effects after mutual adjustment. Results: Preterm birth occurred in 21% of pregnancies, gestational hypertension in 17%, IUGR in 15%, and low birth weight in 21%. Higher EPDS, GAD-7, and PSS-10 scores correlated positively with each complication (r = 0.19–0.36; p < 0.02), whereas CD-RISC-25 scores showed inverse correlations (r = −0.22 to −0.29; p ≤ 0.012). In the fully adjusted model, GAD-7 remained the only independent psychological predictor of the composite obstetric outcome (β = 0.047; 95% CI 0.010–0.083; p = 0.013). Perceived stress approached significance; depression and resilience were no longer significant after adjustment. Conclusions: Generalized anxiety was the most robust psychological determinant of adverse obstetric outcomes, with perceived stress, depression, and lower resilience showing contributory roles at the unadjusted level. Incorporating brief instruments such as the GAD-7, PSS-10, and CD-RISC-25 into routine prenatal care could facilitate early identification of at-risk pregnancies and inform targeted preventive interventions. Full article

This research examines the relationship between socio-demographic characteristics of the survivors and their changing social situations after the earthquake and post-traumatic stress disorder (PTSD) and survivor’s guilt. It also examines the mediating role of survivor guilt between early maladaptive schemas and PTSD severity. The study involved 127 people exposed to the 6 February 2023, southern and central Türkiye and northern and western Syria earthquake. Participants’ sociodemographic characteristics, changing living conditions due to the earthquake, and feelings and thoughts of survivor guilt were evaluated with online data forms. Young Schema-Short Form, Post-Traumatic Stress Disorder Symptom Control Checklist, Beck Depression Inventory, and Beck Anxiety Inventory were employed. There was a notable connection between survivor guilt, the pessimism schema, and the PTSD severity. Additionally, changes in the participants’ living conditions especially occurring during posttraumatic periods were associated with survivor guilt and PTSD levels. The mediation analysis indicated that survivor guilt partially mediates the relationship between the pessimism schema and PTSD severity. Focusing on the social conditions of survivors, pessimism schema, and survivor guilt will be beneficial in preventive interventions and treatment approaches for PTSD. Full article