Lipid metabolism is a key physiological process in the human body, and its disruption is closely omected with the onset and development of depression. Nevertheless, a systematic collation of these associations is currently inadequate. This article comprehensively explored the changes in lipid metabolism in patients with depression and elaborates on disorders in which disorders of lipid metabolism were co-morbidly associated with depression, such as overweight, obesity and metabolic syndrome. In addition, the article summarised five intrinsic mechanisms by which abnormalities in lipid metabolism were associated with the development of depression: overexpression of SNCA genes and abnormal accumulation of α-Syn, iron death, dysbiosis of gut microbiota, impairment of mitochondrial quality control systems, and chronic stress. Finally, this article suggested future research directions aimed at providing a new perspective and research basis for the early diagnosis and treatment of depression.

Diabetes and depression are global public health issues. There is a significant correlation between diabetes and depression. Therefore, monitoring and intervening in diabetes, depression, and their comorbidity among middle-aged and elderly people is crucial.

To explores the prevalence of diabetes and depression, as well as their comorbidity, among the elderly population, and the impact of sleep, exercise, and social activities on these conditions.

Based on the 2018 China Health and Retirement Longitudinal Study, 11 177 participants who met the research criteria were included as subjects. A multifactorial Logistic regression analysis model was employed to investigate the association between sleep, exercise, and social activities with the comorbidity of diabetes and depression. Subsequently, the product of nap duration and nighttime sleep duration was incorporated into the regression model for interaction analysis.

A total of 11 177 subjects were included in the study, with a prevalence of diabetes of 13.95% (1 559/11 177), a prevalence of depressive status of 24.85% (2 777/11 177), and a comorbidity prevalence of both diabetes and depressive status of 14.64% (1 636/11 177). The results of the multinomial Logistic regression analysis indicated that a nighttime sleep duration of 7 to 9 hours (OR=0.337, 95%CI=0.296-0.384), a nighttime sleep duration greater than 9 hours (OR=0.509, 95%CI=0.374-0.692), and a nap duration greater than 90 minutes (OR=0.792, 95%CI=0.666-0.941) were all protective factors for the comorbidity of diabetes and depressive status. High levels of social interaction were also found to reduce the risk of comorbidity (OR=0.778, 95%CI=0.686-0.882, P<0.05). The interaction analysis results showed that maintaining a nighttime sleep duration of 7 to 9 hours, regardless of nap duration, was effective in preventing the comorbidity of diabetes and depressive status (P<0.001). If the nighttime sleep duration is less than 7 hours, a nap duration of 60 to 90 minutes can also reduce the risk of comorbidity (OR=0.740, 95%CI=0.577-0.950, P<0.05). In the case of a nighttime sleep duration greater than 9 hours, not taking a nap (OR=0.270, 95%CI=0.125-0.581) or maintaining a nap duration of 60 to 90 minutes (OR=0.165, 95%CI=0.040-0.674) can also reduce the risk of comorbidity.

The comorbidity prevalence of diabetes and depressive status among middle-aged and elderly people in China is relatively high (14.64%). Nighttime sleep duration of more than 7 hours, nap duration of more than 90 minutes, and a high level of social interaction can all effectively reduce the risk of comorbidity of diabetes and depressive status. Moderate levels of physical activity can reduce the risks of diabetes and depressive status respectively. Napping serves as a compensatory mechanism, helping to make up for insufficient nighttime sleep. If nighttime sleep is less than 7 hours, controlling the nap duration to 60 to 90 minutes can also reduce the risk of comorbidity of diabetes and depressive status.

Postpartum depression may occur not only in the mother but also in spouses, which affects their quality of life, increases the social and family economic burden, and is not conducive to the growth and development of the child. Therefore, it is important to identify the factors that influence its occurrence at an early stage.

To clarify the incidence of postpartum depression in Chinese maternal spouses through meta-analysis.

A computerized search was performed for cohort studies, case-control studies, and cross-sectional studies on the incidence of postpartum depression in Chinese maternal spouses in the databases of CNKI, Wanfang Data, VIP, CBM, PubMed, Web of Science, CINAHL, Embase, and Cochrane Library, with the time of search being from the establishment of the databases to March 2024. The search was conducted from the time of database construction to 2024-03-19. Two researchers independently screened the literature, and the included studies were subjected to data extraction, literature quality assessment, and meta-analysis by Stata 14.0 software.

39 papers were finally included, with a total sample size of 12 162 cases. Meta-analysis results showed that the prevalence of postpartum depression among maternal spouses in China was 14% (95%CI=12%-17%). The results of subgroup analysis showed that the incidence of postpartum depression in spouses was 17% (95%CI=13%-22%) within 1 month postpartum and 13% (95%CI=10%-15%) within 1 month-1 year postpartum; the incidence was 17% (95%CI=11%-23%) in inland areas and 13% (95%CI=11%-16%) in coastal regions; the measurement tool EPDS showed an incidence of 13% (95%CI=11%-16%) for spouses in studies using the EPDS and 18% (95%CI=10%-29%) for other study instruments; the incidence of postpartum depression was 15% (95%CI=11%-21%) for spouses of primiparous women and 14% (95%CI=11%-18%) for spouses of multiparous mothers. For the year of publication, the incidence was 16% (95%CI=10%-22%) for studies published from 2007 to 2016 and 14% (95%CI=12%-16%) for studies published from 2017 to 2023. Sensitivity analyses were performed by excluding literature one by one, and the combined effect sizes did not change significantly, suggesting that the meta-merged results were relatively robust. The distribution of each study point on both sides of the funnel plot was symmetrical, and the results of Egger's test showed t=1.79, P=0.082, suggesting that there was no significant publication bias.

The incidence of postpartum depression in Chinese maternal spouses is high, with an overall incidence of 14%, of which the incidence is as high as 17% within 1 month postpartum. Early screening and prevention should be emphasized.

In 2022, the United States Preventive Services Task Force (USPSTF) published a recommendation statement on Screening for Depression and Suicide Risk in Children and Adolescents: US Preventive Services Task Force Recommendation Statement in JAMA with an updated evidence report and results of a systematic evaluation (USPSTF statement). The statement suggested screening for major depressive disorder in adolescents aged 12 to 18 years. However, the evidence regarding the risks and benefits of suicide screening for children and adolescents is insufficient, making it challenging to determine its overall impact. This article interprets the content of the USPSTF statement in the context of the national and international literature, including the concepts of major depressive disorder and suicidal behaviours, risk factors, early screening tools, pros and cons of early screening, treatment and interventions, and the value of the USPSTF statement in guiding primary care providers. Intending to serve as a reference for clinical healthcare professionals involved in the screening of children and adolescents for depression and suicide risk.

The elderly population in our country is large and growing rapidly, and depression is a common emotional disorder and mental health problem among the elderly population. The mental health of the female elderly population is increasingly becoming a focus of social concern.

To explore the influencing factors of depression symptoms in the female elderly population from a multi-level and comprehensive perspective of health ecology, and provide theoretical basis for identifying and intervening in depression symptoms in the elderly female population in China.

In January 2024, we extracted for the 2020 survey data from the China Health and Retirement Longitudinal Survey (CHARLS), and a group of female elderly adults aged 60 years and above were selected for the study (n=4 594). Based on the health ecology model, the influencing factors were divided into five levels: personal characteristics layer, behavioural characteristics layer, interpersonal network layer, living and working conditions layer, and policy environment layer. The χ² test and binary Logistic regression model were used to explore the influencing factors of depression symptoms and to establish a health ecology model of depression symptoms in the Chinese female elderly population.

The detection rate of depression symptoms in the Chinese female elderly population was 48.06% (2 208/4 595). Logistic regression analysis showed that age of ≥80 years (OR=0.601, 95%CI=0.449-0.804), sleep duration of≥6 h (OR=0.561, 95%CI=0.493-0.639), satisfaction with life (OR=0.256, 95%CI=0.199-0.330), better self-rated physical health (OR=0.459, 95%CI=0.395-0.533), urban household registration (OR=0.717, 95%CI=0.603-0.853), satisfaction with children (OR=0.666, 95%CI=0.472-0.940), education level of junior high school and above (OR=0.712, 95%CI=0.582-0.871), family income >50 000 yuan (OR=0.822, 95%CI=0.704-0.959) and the per capita GDP of the city is 50 000 to 100 000 yuan (OR=0.841, 95%CI=0.730-0.970) were the protective factors for the development of depression symptoms in the Chinese female elderly population (P<0.05). Having become disabled (OR=1.786, 95%CI=1.556-2.050), suffering from chronic diseases (OR=1.159, 95%CI=1.014-1.324), central region (OR=1.298, 95%CI=1.107-1.522) and western region (OR=1.407, 95%CI=1.183-1.675) were the risk factors for depression symptoms in the Chinese female elderly population (P<0.05) .

The detection rate of depression symptoms in the Chinese female elderly population is relatively high, and there are many influencing factors, including: age in the personal characteristics layer; sleep time, satisfaction with life, self-related of physical health, disability, and chronic disease in the behavioral characteristics layer; household registration type, satisfaction with children, and geographical distribution in the interpersonal network layer; education and family income in the living and working conditions layer; the per capita GDP of the city in the policy environment layer. Effective intervention measures should be taken at all layers, targeting key populations, in order to reduce the incidence of depression symptoms among the Chinese elderly women.

Childhood trauma is a risk factor for suicidal ideation in patients with depressive disorder, and plasma vitamin D level is also related to suicidal ideation. However, there is still insufficient research on the relationship between them in adolescent patients with depressive disorder.

To explore the relationship between suicidal ideation and childhood trauma and to analyze the mediating role of depressive symptom severity and low vitamin D levels.

Adolescent patients with depressive disorder who attended Chaohu Hospital of Anhui Medical University and the Fourth People's Hospital of Hefei City in 2021 were used as the depressive disorder group (n=168), and adolescents with no history of mental illness recruited during the same period were used as the control group (n=89). Childhood trauma, depressive symptoms, and suicidal ideation were assessed using the Childhood Abuse Questionnaire (CTQ), the Current Evaluation of Depression Scale (CES-D), and the Suicidal Ideation Scale (PANSI), and plasma 25-hydroxyvitamin D[25 (OH) D] levels were also tested. Differences between adolescents with depressive disorders and control adolescents in suicidal ideation, depressive symptoms, childhood trauma, and vitamin D levels were compared; Pearson correlation analyses were used to test the correlation of scores on each scale, and the mediating roles of depression and vitamin D levels between childhood trauma and suicidal ideation were analyzed by the PROCESS macro program.

Adolescents in the depressive disorder group had higher PANSI scores, CTQ subscale scores, and total scores than those in the control group (P<0.05), and lower 25 (OH) D levels than those in the control group (P<0.5). Pearson correlation analyses showed that there were correlations between the PANSI scores and the CTQ total scores, the CES-D scores, and the 25 (OH) D levels of adolescents in the depressive disorder group (P< 0.05), and the PANSI scores of adolescents in the control group were correlated with total CTQ scores, CES-D scores (P<0.05), and no correlation with 25 (OH) D levels (P>0.05). The mediation benefit analysis showed that the CES-D score and 25 (OH) D level in the adolescent group with depressive disorder played a partial mediating role between the CTQ total score and PANSI score, with mediation effects accounting for 61.8% and 5.3%, respectively; and a partial mediating role between the CTQ affective abuse subscale score and PANSI score, with mediation effects accounting for 58.9% and 6.5%; a partial mediating role between CTQ emotional neglect subscale scores and PANSI scores, with mediating effect percentages of 67.2% and 5.6%, respectively; and a full mediating role between CTQ somatic neglect subscale scores and PANSI scores, with mediating effect percentages of 92.2% and 7.8%. None of the mediating effects of 25 (OH) D levels were significant for control adolescents; CES-D scores played a fully mediating role between CTQ total scores and PANSI scores, and between CTQ emotional maltreatment subscale scores and PANSI scores; and a partially mediating role between CTQ emotional maltreatment subscale scores and PANSI scores, with a direct effect percentage of 41.5% and a mediating effect accounted for 58.5%; the mediating effect between CTQ somatic neglect subscale scores and PANSI scores was not significant.

The severity of depressive symptoms and low vitamin D levels in patients with adolescent depressive disorder are potential mechanisms of childhood trauma leading to suicidal ideation. In view of the disorder of childhood trauma of adolescent depression in clinical should be timely and effective control and improvement of patient, improve their vitamin D levels and actively carry out mental health education, in order to reduce the occurrence of suicidal ideation, improve clinical outcomes.

The majority of caregivers of left-behind children in rural China are their mothers and grandmothers. The mental health of children's caregivers is one of the significant factors affecting the early development of children. Currently, there is a lack of research and comparison on the factors influencing depression among mothers and grandmothers of left-behind children in rural China.

To investigate the determinants of depression among female caregivers of left-behind children in rural China.

Data were collected from the baseline survey of the Home Visit Intervention Evaluation Segment of the Health and Development Promotion Program for Left-behind Children, conducted by UNICEF from April to July in 2018. The villages were selected through multi-stage stratified sampling. 1 or 2 towns were chosen as program towns in each of the 5 impoverished counties in 5 provinces. Villages in program towns were stratified by number of under-3-year-old children except Pingshan, where all villages from the program town were included. Three villages were randomly selected in each stratum as intervention villages, matched with control villages of similar number of under-3-year-old children, socioeconomic status and the distance from county. Ultimately 113 villages in 27 towns were included in the survey. This study focused on the mothers and grandmothers of left-behind children under 3. Questionnaire was used to collect the data of left-behind children under 3 years old and their main caregivers participating in the survey, and Zung Self-rating Depression Scale (ZSDS) was used to assess the depression status of caregivers. Multivariate Logistic regression was used to analyze the determinants of depression in the main caregivers of left-behind children.

A total of 728 subjects were included in this study, including 282 mothers and 446 grandmothers. The overall incidence of depressive symptoms was 32.8% (239/728) . The prevalence of depression among mothers and grandmothers of left-behind children was 29.8% (84/282) and 34.8% (115/446) respectively, with no statistical significance between two groups (P>0.05) . Multivariate Logistic analysis revealed that for mothers, caring for 1-year-old children (OR=2.041, 95%CI=1.065-3.913) , 2-3-year-old children (OR=2.128, 95%CI=1.023-4.425) , and experiencing caregiving stress (OR=4.043, 95%CI=2.152-7.594) were risk factors for depression (P<0.05) . A mean communication time ≥10 minutes per time with absent fathers (OR=0.396, 95%CI=0.175-0.898) was a protective factor against maternal depression (P<0.05) . For grandmothers, looking after girls rather than boys (OR=0.506, 95%CI=0.331-0.772) was a protective factor for depression (P<0.05) . Conversely, being 60 years or older (OR=1.879, 95%CI=1.082-3.261) , self-rated health status affecting caregiving (OR=2.402, 95%CI=1.364-4.231) and children's mothers cumulative longer absence from home (OR=2.468, 95%CI=1.059-5.751) were the risk factors for depression (P<0.05) .

The incidence of depression among female caregivers of left-behind children in rural China is high. Mothers and grandmothers, as the primary caregivers of most left-behind children, experience different factors affecting depression. Older children, high caregiving stress are risk factors for maternal depression, whereas greater communication with the children's fathers is protective factor for maternal depression. Grandmothers face a higher risk of depression when advanced age, self-report health status affacts caregiving, and children's mothers are absent from home for extended period, while caring for a granddaughter is a protective factor against grandmother's depression.

Perinatal depression, which affects both maternal and child health, is a significant public health issue that requires urgent and effective management. Since 2021, Shenzhen has been promoting city-wide perinatal depression screening and intervention using a mobile healthcare platform.

This study utilises routine data from the Shenzhen perinatal depression screening and intervention programme to assess the impact of the mobile platform on programme implementation and identify the most prominent implementation bottlenecks.

This retrospective study included pregnant and postpartum women who delivered in one of Shenzhen's 82 midwifery institutions across 10 districts between June 2020 and May 2022. Eligible participants were divided into two groups: the routine service group (delivered between June 2020 and May 2021) and the mobile platform group (delivered between June 2021 and May 2022) . Depression screening rates, screening positive rates, referral rates, and intervention rates during early pregnancy, mid-pregnancy, late pregnancy, and postpartum were observe.

A total of 311 719 pregnant and postpartum women were included in the study, of which 166 832 were in the routine service group and 144 887 in the mobile platform group. Screening rates, referral rates, and intervention rates in all stages of pregnancy and postpartum were significantly higher in the mobile platform group than in the routine service group (P<0.05) . Screening positive rates in early and mid-pregnancy were higher in the mobile platform group (P<0.05) , while rates in late pregnancy and postpartum were lower than in the routine service group (P<0.05) .

The mobile platform offers an effective tool for routine perinatal depression management. However, the low intervention rate among screening-positive women represents the most prominent implementation bottleneck. Future research should focus on optimising platform functionality, identifying the most effective combination of intervention measures, enhancing health education, and developing innovative, sustainable, and widely applicable implementation strategies.

There are a large number of middle-aged and elderly patients with chronic diseases. However, there is currently limited research on the depression status and influencing factors of middle-aged and elderly patients with chronic diseases nationwide.

By exploring the depression status and influencing factors of middle-aged and elderly patients with chronic diseases in China, to provide a reference for improving their mental health status.

According to the fifth round of national survey data conducted by the China Health and Retirement Longitudinal Study (CHARLS) in 2020, a total of 12 551 middle-aged and elderly patients with chronic diseases were selected as the study objects. The depression status of the study objects was measured using the Center for Epidemiologic Studies Depression Scale (CES-D), and the main factors affecting the depression status of middle-aged and elderly patients with chronic diseases were analyzed using the chi-square test and multivariate Logistic regression.

Among middle-aged and elderly patients with chronic diseases, the proportion of those with depressive symptoms was 40.7% (5 111/12 551). The results of multivariate Logistic regression analysis showed that: gender (male: OR=0.613, 95%CI=0.553-0.680), age (65-<75 years old: OR=0.862, 95%CI=0.769-0.965; ≥75 years old: OR=0.604, 95%CI=0.510-0.716), presence of spouse/partner living together or not (have OR=0.730, 95%CI=0.648-0.822), places of residence (rural: OR=1.515, 95%CI=1.387-1.654), educational levels (junior high school: OR=0.727, 95%CI=0.657-0.805; senior high school and above: OR=0.561, 95%CI=0.488-0.646), social status (1 item: OR=0.870, 95%CI=0.793-0.956; ≥ 2 items: OR=0.866, 95%CI=0.779-0.963), satisfaction with child relationships (satisfaction: OR=0.266, 95%CI=0.218-0.324), smoking (OR=1.131, 95%CI=1.014-1.263), alcohol consumption (OR=0.873, 95%CI=0.795-0.959), nighttime sleep duration (6-<8 h: OR=0.539, 95%CI=0.493-0.590; ≥8 h: OR=0.443, 95%CI=0.396-0.495), BADL (damaged: OR=1.875, 95%CI=1.692-2.077), IADL (damaged: OR=2.251, 95%CI=2.030-2.496), number of chronic diseases (2 types: OR=1.202, 95%CI=1.076-1.342; 3 types: OR=1.452, 95%CI=1.289-1.636; ≥ 4 types: OR=1.954, 95%CI=1.749-2.183) were the influencing factors of depression symptoms in middle-aged and elderly patients with chronic diseases (P<0.05) .

The incidence of depressive symptoms in middle-aged and elderly patients with chronic diseases is 40.7%, and the situation is not optimistic. Their depression is influenced by various factors. Healthcare institutions and policymakers should pay attention to their mental health and take targeted measures from personal, family, community, and other aspects to improve.

Limited research currently exists on the relationship between remnant cholesterol (RC) and maternal depression as well as pregnancy stress.

To explore the relationship between factors such as RC and maternal depression and pregnancy stress in the second trimester, providing a scientific foundation for clinical identification and intervention strategies.

Pregnant women in early pregnancy (6 to 13⁺⁶ weeks of gestation) who attended regular prenatal check-ups at the Obstetrics Department of the Second Affiliated Hospital of Xinjiang Medical University from June 2020 to April 2024 were recruited as study participants. A longitudinal study design was adopted to collect baseline data and blood lipid indicators of pregnant women, followed up until the second trimester, and used the Edinburgh Postpartum Depression Scale (EPDS) and Pregnancy Pressure Scale (PPS) to evaluate the depression and stress of pregnant women. Multi-factor Logistic regression analysis was used to construct a prediction model for maternal depression and pregnancy stress. In order to further determine the factors that have the greatest impact on the outcome, the random forest (RF) algorithm was used to build the model again, and the SHAP tool was used to visually analyze the RF model results.

This study followed 403 pregnant women from the first trimester to the second trimester, with 323 valid responses collected, resulting in a follow-up loss rate of 19.9%. After excluding inaccurate baseline data, 279 pregnant women were included in the final analysis. Results indicated that the incidence of depression was 38.7% (108/279), and the incidence of pregnancy stress was 20.8% (58/279). RC levels were significantly higher in pregnant women with depression and pregnancy stress than in those without (P<0.05). Multivariate Logistic regression identified pregnancy planning (OR=0.441, 95%CI=0.251-0.775), breakfast frequency (OR=5.086, 95%CI=2.105-12.270), and RC (OR=2.759, 95%CI=1.157-6.580) as significant factors influencing depression during the second trimester (P<0.05). Additionally, taking a midday rest (OR=0.513, 95%CI=0.276-0.953) and RC (OR=3.747, 95%CI=1.519-9.246) were significant factors associated with pregnancy stress (P<0.05). The SHAP analysis indicated that RC was the most influential factor affecting maternal depression and pregnancy stress in the second trimester.

Elevated RC levels may increase the risk of depression and stress-related events in pregnant women during the second trimester. Future research involving larger cohort studies or clinical trials is necessary to confirm these findings and elucidate causal relationships.

In recent years, mental health problems among middle school students in China have become increasingly prominent.

To explore the research hotspots, frontiers of research related to the mental health among middle school students, and provide reference for scholars involved in the research of middle school students' mental health in the future.

Papers related to the mental health of middle school students both at home and abroad from 2000 to September 30, 2022, by using Web of Science and CNKI as data sources. CiteSpace 6.1.R3 was applied to visualize and analyze the publication volume, countries, institutions, authors, literature co-citation, and keywords of the included literature.

A total of 1 963 articles were eligible, including 653 articles in English and 1 310 in Chinese. The publication volume in the field of mental health among middle school students showed an increasing trend from 2000 to 2022. The research hotspots and frontiers of mental health among middle school students were mainly focused on suicidal ideation, mobile phone and internet addiction, academic achievement, psychological resilience, psychological intervention and COVID-19 epidemic. The future research trends may focus on the relationships of traditional bullying and cyberbullying with middle school students' mental health, health risk behaviors with mental health among middle school students.

Research hotspots about mental health among middle school students encompass suicidal ideation, mobile phone and internet addiction, academic achievement, psychological resilience, psychological interventions, as well as the impact of the COVID-19 epidemic. Future research trends will concentrate on exploring the relationships between bullying, health risk behaviors and mental health.

The incidence of major depressive disorder (MDD) in adolescents is annually elevated. Non-suicidal self-injury (NSSI) is a common clinical manifestation of MDD. Evidence suggested that vitamin D and lipid levels are associated with MDD, but whether they are related to NSSI is unclear.

To compare the levels of 25 (OH) D₃ and blood lipids in MDD adolescents with or without NSSI behavior, and to explore their diagnostic value for NSSI.

A total of 129 MDD adolescents who received treatment in the Department of Psychiatry, Chaohu Hospital of Anhui Medical University and the Fourth People's Hospital of Hefei from October 2020 to March 2022 were recruited. They were assigned into NSSI group (n=77) and non-NSSI group (n=52) based on the diagnostic criteria of NSSI in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) . The Positive and Negative Suicide Ideation (PANSI) , Insomnia Severity Index (ISI) , and Center for Epidemiological Survey, Depression Scale (CES-D) were used to evaluate the clinical symptoms. Fasting venous blood samples were collected to measure the levels of 25 (OH) D₃ and blood lipids, and compared between groups. In addition, multivariate Logistic regression analysis was performed to identify influencing factors for NSSI behavior in MDD adolescents. The diagnostic value of 25 (OH) D₃ and lipid levels in NSSI behaviors was assessed by plotting the receiver operating characteristic (ROC) curves.

The age of the NSSI group was significantly lower than that of the non-NSSI group, whereas the total scores of PANSI, ISI, and CES-D were significantly higher than those of the non-NSSI group (P<0.05) . The level of 25 (OH) D₃ in the NSSI group was significantly lower than that in the non-NSSI group, whereas the levels of total cholesterol (TC) , high-density lipoprotein cholesterol (HDL-C) , and low-density lipoprotein cholesterol (LDL-C) were significantly higher than those in the non-NSSI group (P<0.05) . Multivariate Logistic regression analysis showed that both LDL-C (OR=5.695, 95%CI=2.422-13.388, P<0.001) and 25 (OH) D₃ (OR=0.871, 95%CI=0.768-0.987, P<0.05) were the influencing factors of MDD adolescents with NSSI. The area under curve (AUC) of LDL-C and 25 (OH) D₃ levels in assessing the risk of developing NSSI behavior in MDD adolescents was 0.73 (95%CI=0.65-0.82, P<0.001) and 0.62 (95%CI=0.52-0.72, P=0.023) , respectively. Their optimal cut-off value was 1.89 mmol/L and 19.15 μg/L, respectively. The AUC of 25 (OH) D₃ combined with LDL-C levels [ln (p/1-p) =1.364X1-0.143X2-0.161, where X1 and X2 was LDL-C and 25 (OH) D₃, respectively] in diagnosing NSSI behavior in MDD adolescents was 0.77 (95%CI=0.69-0.85, P<0.001) , with 77.92% of sensitivity and 67.31% of specificity.

25 (OH) D₃ and lipid levels are out of normal ranges in MDD adolescents with NSSI. Measurement of LDL-C combined with 25 (OH) D₃ levels may provide information to predict the occurrence of NSSI behaviors in MDD adolescents. A regular measurement of LDL-C and 25 (OH) D₃ and a dynamic monitor is valuable to provide symptomatic supports.

As China enters a moderately aging society, the mental health problems of the elderly are increasing year by year, and lifestyle habits are closely related to the mental health of the elderly.

Exploring the relationship between nap time, nighttime sleep, and depressive symptoms among elderly people in China, and determining recommended sleep time based on lifestyle habits, providing scientific basis for early prevention and control of depression in the elderly.

Based on the publicly released fifth round (2020) of the China Health and Retirement Longitudinal Study (CHARLS) on November 16, 2023, 8 233 eligible individuals were included as research subjects. The Depression Rating Scale (CSE-D10) was used to assess depressive symptoms in elderly individuals, with nap duration divided into 5 levels: no nap, <30 min, 30-59 min, 60-89 min, ≥90 min. Nighttime sleep was divided into 5 levels: ≥8 h, 7-<8 h, 6-<7 h, 5-<6 h, <5 h. Multivariate Logistic regression analysis was used to explore the factors that affect the occurrence of depression symptoms in elderly people. Random forest model was used to analyze the importance of nap duration and nighttime sleep in the occurrence of depression symptoms in elderly people. Restrictive cubic spline curves were used to further explore the dose-response relationship between nap duration, nighttime sleep duration, and the risk of depression symptoms.

During the 2020 survey period, the incidence of depressive symptoms among elderly people in China was 24.84% (2 045/8 233) . The results of multivariate Logistic regression analysis showed that a nap duration of 30-59 minutes was a protective factor for depression symptoms in the elderly (OR=0.814, 95%CI=0.673-0.985, P=0.034) , and a nighttime sleep duration of less than 5 hours was a risk factor for depression symptoms in the elderly (OR=1.705, 95%CI=1.435-2.027, P<0.001) . Women, unmarried/separated/divorced/widowed, disabled, physically painful, physically active, self-rated health status decreased, life satisfaction decreased, stroke, and Parkinson's disease increased the risk of depression symptoms in the elderly (P<0.05) . The random forest model showed that the duration of nap time and nighttime sleep time had a significant impact on depressive symptoms. There was a non-linear relationship between the duration of nap time and the occurrence of depressive symptoms (P_nonlinear<0.05) . The risk of depression in elderly people continued to decrease with increasing time after nap time of 30 minutes, with the lowest level being about 50 minutes. The risk of depression symptoms increased after nap time exceeded 75 minutes. The risk of depression in elderly people decreased continuously with time after 6 hours of sleep at night, with a minimum level of about 7 hours. The risk of depression increased after more than 9 hours of sleep (P_overall<0.05) .

The incidence of depression (24.84%) is higher in the elderly population in China, and there is a J-shaped relationship between the duration of nap time and nighttime sleep and depression. It is recommended that elderly people nap for 30-75 minutes every day, and moderate nap time can effectively reduce the risk of depression symptoms in the elderly. At the same time, sleeping for 6-9 hours at night can reduce the risk of depression symptoms, which has certain significance for early prevention and control of depression in the elderly population.

The aging of our population is a growing problem, and depression is one of the more common psychiatric disorders in the elderly population, leading to a significantly increased risk of disability and death. The studies found a significant association between depression and cognitive disorders, and that this association may be influenced by sex. Sex differences in the associations between depression with cognitive functions and different cognitive domains are not clear in the elderly population.

Population ageing has become a common global phenomenon, and psychiatric problems associated with ageing are of great concern. This study investigated the status of depression and cognitive function in the urban elderly and examined the associations and sex differences between depression and cognitive function.

From September to October 2022, a stratified sampling method was used to select elderly residents aged 65 years and above in a community within the city of Hefei, Anhui province as the participants. General information was collected and depression and cognitive function status were assessed using the Geriatric Depression Scale (GDS) and the Brief Screening Scale for Dementia (BSSD), respectively. We explored the factors associated with depression in the elderly and analyzed the effects of depression, sex factors and their interactions on cognitive functioning.

A total of 328 older adults were included and the overall detection rate for depression was 14.9 %. Regression analyses showed that drinking (OR=0.362, 95%CI=0.155-0.847), and living with children (OR=2.445, 95%CI=1.021-5.853) were independently associated with depression (P<0.05). Factorial design analysis of variance showed that the total score of BSSD and scores of language (command) comprehension, attention and computation, orientation in place, orientation in time, and immediate memory factors were lower in the depressed group of the elderly than in the non-depressed group. Females had a lower total score of BSSD, lower scores of general knowledge and picture and orientation in place, and a higher score of language (command) comprehension than males (P<0.05). Depression and sex had significant interactions in general knowledge and picture, language (command) comprehension, and orientation in place (P<0.05) .

The urban elderly are at a higher risk of depression, and those with comorbid depression may have a certain degree of cognitive decline, with sex differences. Increased attention should be paid to psychiatric problems such as depression and dementia among the elderly, especially for the female geriatric population. It is necessary to develop individualised and comprehensive interventions to improve the mental health and quality of life of the elderly.

Heart failure patients are prone to depression, and interact with each other, leading to lower quality of life and poor prognosis of patients. As the largest microecosystem in the human body, changes in the composition, structure and function of the gut microbiota are closely related to the physiological and pathological states of the host. Currently, the "gut-heart/brain axis" has been used to explain the link between gut microbiota, cardiovascular diseases, and mood states, which is an important comorbid basis for heart failure and depression. In this paper, we reviewed the mechanisms of gut microbiota, metabolites, and vagus nerve in the development of heart failure and depression, and propose that mediterranean diet, probiotics, and microbiota transplantation have the potential to improve the "microbiota-gut-heart/brain axis", providing a new perspective for the treatment of heart failure patients comorbid with depression.

Test anxiety disorder is a group of symptoms related to stress caused by tests, exams, evaluations, and others. It is among the severe psychological problems in exams. Long-term test anxiety is likely to cause tension, fear, irritability, depression, and other negative emotions, and it disturbs working memory, attention, and other cognitive abilities and even leads to suicidal ideation. In order to standardize the clinical diagnosis and treatment of test anxiety disorder, under the organization of the Test Anxiety Disorder Collaboration of the Chinese Society of Psychosomatic Medicine, this expert consensus was formulated by 13 experts in the field of psychiatry and psychology. We collaborate and announce the expert consensus based on current research and clinical experience. We hope the consensus can provide clinicians with scientific and comprehensive guidance on test anxiety disorder, including epidemiology, etiology, clinical manifestations, evaluation, and treatment.

HIV/AIDS is associated with depression, which increases the risk of HIV-associated neurocognitive disorders (HAND) and reduces patient compliance with antiretroviral therapy (ART), exacerbating the risk of HIV transmission. Few domestic studies have reported on the effectiveness of psychological intervention for depressed patients of people living with HIV/AIDS (PLWHA) newly diagnosed and its correlation with CD₄⁺ T cell counts.

To explore the effectiveness of psychological intervention for newly diagnosed PLWHA with depression and its correlation with CD₄⁺ T cell counts, providing a reference for AIDS clinical diagnosis and treatment.

From April 2020 to June 2022, a convenient sampling method was used to select newly diagnosed PLWHA with depression from some ART-designated hospitals in Jiangxi Province. While they were diagnosed, ART and psychological intervention were immediately initiated, and the total period of intervention was 12 weeks. Before and after the intervention, the Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA) were used for evaluation, and CD₄⁺ T cell counts were calculated for analysis.

A total of 200 newly diagnosed PLWHA with depression were included, 178 cases of which were effectively followed up with an effective rate of 89.0%. Among 178 cases, 88 were mild to moderate depression (49.4%), 90 were major depressive disorder (50.6%), and 173 cases were accompanied by anxiety (97.2%). The mean CD₄⁺ T cell count before intervention was (346.39±156.87) cells/μL, and it was (421.93±149.61) cells/μL after intervention. After intervention, the CD₄⁺ T cell counts of newly diagnosed PLWHA with depression were higher than before intervention (t=10.971, P<0.05), and the total and factor scores of HAMD, HAMA were all lower than before intervention (P<0.05). Before the intervention, the total scores of HAMD were correlated with the grades of CD₄⁺ T cell counts negatively (500 cells/μL as the cutoff value) (r_s=-0.157, P=0.036) and the scores of HAMA positively (r_s=0.764, P<0.001). After the intervention, the total scores of HAMD were correlated with post-intervention CD₄⁺ T cell counts negatively (r_s=-0.150, P=0.046) and the total scores of HAMA strongly positively (r_s=0.939, P<0.001). In newly diagnosed PLWHA with depression, the total scores of HAMD and HAMA of patients with CD₄⁺ T cell counts <500 cells/μL were higher than those with CD₄⁺ T cell counts≥500 cells/μL (P<0.05) before intervention.

The severity of depression in newly diagnosed PLWHA is associated with CD₄⁺ T cell counts, which could be significantly improved by professional psychological intervention.

With the increase of the aging population, age-related health problems have garnered increasing attention. Compared to physiologic diseases with significant clinical symptoms, the mental health issues of the elderly are often overlooked. The underlying depressive states and high incidence of chronic diseases collectively contribute to a decline in quality of life in old age. Moreover, metabolic diseases, more prevalent in the elderly, significantly impact brain health, potentially leading to neurological damage and cognitive decline.

This study aims to investigate the relationship between depression, cognitive status, and nutritional and metabolic status among elderly individuals in the community.

We selected 3 767 elderly individuals who participated in physical examinations at the Youyi Street Community Health Service Center in Baoshan District, Shanghai. The demographic data on sex, age, BMI and waist-to-hip ratio were collected. The evaluations included the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Mini Nutritional Assessment (MNA), and Activities of Daily Living Scale (ADL). Metabolic syndrome-related diseases and the 10-year cardiovascular disease risk were assessed using clinical metabolic indicators, and Pearson correlation analysis was used to explore the correlations among these indicators.

This research showed that significant differences were found in age, MNA, MMSE scores, the proportion of people at high risk of cardiovascular disease and the 10-year cardiovascular disease risk grade among the different groups (P<0.05). Correlation analysis indicated that the GDS score was negatively correlated with the total MMSE score and its sub-item scores, except for the repetition ability score. MNA and ADL were positively correlated with the total MMSE score (P<0.05). Additionally, GLU and HbA_1c levels were negatively correlated with immediate recall ability in the MMSE (P<0.05) .

Our findings suggest that depression in the elderly is associated with cognitive decline, while better nutritional status is linked to improved cognitive performance. Focusing on and improving metabolic health in the elderly may enhance their mental state and overall mental health.

The number of migrant elderly in China and abroad is rising, and their mental health problems can no longer be ignored due to mobility-related adversities.

To analyze the current situation, research hotspots and trends in the field of mental health of migrant elderly at home and abroad in the past 10 years based on CiteSpace, and provide reference for research in related fields.

CNKI, Wanfang Data, VIP, CBM, Scopus, PubMed and Web of Science Core Collection were used as data sources, and CiteSpace was used for visualization and analysis, including publication volume, authors, institutions and keywords.

A total of 1 023 papers were obtained, 726 in English and 297 in Chinese. Domestic authors mainly collaborated with the same institution, while there were more inter-institutional collaborations abroad. The current research hotspots mainly focused on the elderly with migration, elderly immigrants, old migrants, depression, psychological distress and social support.

Compared with abroad, there are fewer publications in China currently, with looser cooperation among research authors and institutions, and a lack of core authors, needing more diversification of disciplines and research methods. Focusing on hotspots and cutting-edge content, exploring the mechanism of the role of mental health of migrant elderly, implementing psychological interventions, strengthening health education, and improving the psychological resilience and subjective well-being of migrant elderly are the main trends of future research.

Geriatric depression is a severe mental illness distinct from depression in other age groups, characterized by significant heterogeneity. Subclinical hypothyroidism (SCH) is a state of hypothyroidism with subtle clinical signs. The impact of SCH on elderly depression is easily overlooked, and the association between SCH and elderly depression is not well understood.

To explore the clinical characteristics of hospitalized elderly depression patients with SCH.

Depressed patients hospitalized in the Fourth People's Hospital of Hefei from April 2019 to March 2023 were included in the study and divided into the subclinical hypothyroidism depression (SCHD) group (n=108) and control depression (CD) group (n=110). General data of the subjects was collected, fasting venous blood samples were collected for testing biochemical markers, and the Hamilton Depression Rating Scale (HAMD-24) was used to assess depressive symptoms.

The SCHD group showed a higher number of antipsychotic drug use, comorbid somatic diseases, days of hospitalization, and duration of the disease than the CD group (P<0.05). There was a statistically significant difference between the two groups in terms of the types of antidepressants used and the number of hospitalizations (P<0.05). The sleep disorder scores of patients in the SCHD group were higher than those in the CD group (P<0.05), and there was a significant difference in body mass and diurnal variation scores between the two groups (P<0.05). The SCHD group had higher levels of thyrotropin and lower levels of serum free triiodothyronine and free thyroxine than the CD group (P<0.05) .

Elderly depression patients with SCH exhibit unique clinical characteristics, including longer hospitalization, more frequent episodes, greater difficulty to cure, and poorer prognosis, making interventions for SCH essential.

Lawyer is one of the most stressful jobs, but lawyers' occupational stress is rather under-researched in China. Previous studies have shown that occupational stress and mental health are related to self-regulatory fatigue and health literacy in lawyers, but there is a lack of research on their interaction mechanism.

To explore the association of occupational stress and mental health in lawyers and the internal mechanism of action of self-regulatory fatigue and health literacy between them.

A convenience sample of 660 lawyers from 7 leading Chinese law firms were surveyed from May to June 2022 using questionnaires including a self-compiled Demographic Questionnaire, the Lawyers' Occupational Stress Scale, Symptom Checklist-90 (SCL-90), Self-regulatory Fatigue Scale (SRF-S) and National Residents' Health Literacy Surveillance Rapid Assessment Questionnaire (HLSRAQ). Stepwise regression was used to explore the mediating effect of self-regulatory fatigue between occupational stress and mental health, and bootstrap method was used to test the mediating effect of self-regulatory fatigue. Model 5 in PROCESS 3.4 was used to explore the moderated mediating effect of health literacy between occupational stress and mental health. Bootstrap method was used to test the moderating mediating effect of health literacy, and further simple slope test was used to test the moderating effect, and the effects of occupational stress on the mental health of lawyers with different health literacy levels were analyzed.

Six hundred and fifty-six cases (99.39%) who effectively responded to the survey were included for final analysis. The average scores of occupational stress, SCL-90, SRF-S and HLSRAQ were (106.9±34.8), 39.0 (15.0, 84.0), (39.4±10.0) and (13.9±3.7), respectively. Stepwise regression analysis showed that occupational stress could positively predict mental health (β=0.36, t=13.40, P<0.01). Self-regulatory fatigue also had a significant positive predictive effect on mental health (β=0.55, t=20.32, P<0.01). Bootstrap analysis showed that 95%CI of the total effect, indirect effect and direct effect of occupational stress on mental health did not include 0 (P<0.01). The moderated mediating effect analysis showed that the product of occupational stress and health literacy had a significant predictive effect on mental health (β=-0.02, t=-2.00, P<0.05). The Bootstrap method showed that the 95%CI of the indirect effect of lawyer occupational stress on mental health did not include 0 (P<0.01). Simple slope test showed that the association between them was found to be statistically significant regardless of being moderated by different levels of health literacy (P<0.01), and the predictive effect of occupational stress showed a downward trend with the improvement of health literacy level (P<0.01) .

Occupational stress influenced mental health in lawyers medicated by self-regulatory fatigue with health literacy as a moderator.

In the current rehabilitation environment, emotional issues and cognitive dysfunctions in stroke patients are often overshadowed by physical, speech, and swallowing difficulties, leading to their underestimation in clinical rehabilitation. This oversight can result in adverse outcomes, impacting the overall success of rehabilitation. Currently, clinical treatments primarily rely on pharmacotherapy to alleviate symptoms, which has limited effectiveness and can cause a range of adverse reactions.

To observe the efficacy of precision exercise prescriptions on anxiety, depression, and cognitive functions in stroke patients and to preliminarily analyze the underlying mechanisms of action.

A total of 84 stroke patients hospitalized in the Rehabilitation Department of Changzhou Dean Hospital from January 2022 to March 2023 were selected. They were randomly divided into a control group (42 patients) and an experimental group (42 patients). The control group received standard rehabilitation treatment, while the experimental group received precision exercise prescriptions based on cardiopulmonary exercise testing (CPET) results in addition to standard rehabilitation, over 12 weeks. The Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Mini-mental State Examination (MMSE) scores, and Homocysteine (Hcy) levels were compared before and after rehabilitation training in both groups. A Pearson correlation analysis was conducted between pre-rehabilitation Hcy levels and SAS, SDS, MMSE scores.

All 42 patients in the experimental group completed the CPET and the 12-week precision exercise prescription rehabilitation without any adverse events. Before rehabilitation training, there were no statistically significant differences in SAS, SDS, MMSE scores, and Hcy levels between the two groups (P>0.05). After rehabilitation training, the scores of SAS, SDS, and Hcy levels in the experimental group were significantly lower compared to pre-treatment values (P<0.05), and which were significantly lower than those of the control group (P<0.05). The MMSE score in experimental groups increased significantly after interventions compared to pre-treatment value (P<0.05), and it was significantly higher than that of the control group (P<0.05). There were no significant differences in SAS, SDS, MMSE scores, and Hcy levels before and after rehabilitation training in the control group (P>0.05). Pearson correlation analysis revealed a positive correlation between Hcy levels and SAS, SDS scores (r-values of 0.420 and 0.507, respectively, P<0.05) and no correlation with MMSE scores (r=0.079, P=0.473) .

Our findings suggest that precision exercise prescriptions significantly improve anxiety, depression, and cognitive functions in stroke patients, suggesting their potential as a novel therapeutic approach in clinical applications. Hcy may be one of the mechanisms through which precision exercise prescriptions improve anxiety and depression in stroke patients. Further research is needed to determine whether Hcy is related to the improvement of cognitive functions through this prescription.

Respiratory problems in chronic obstructive pulmonary disease (COPD) patients are prone to poor sleep quality, anxiety and depression, but they are often ignored by medical staff and patients themselves. Understanding the sleep quality, anxiety and depression symptoms of patients with COPD and their influencing factors can help to improve the quality of life of patients, however, there are few relevant studies.

To investigate the sleep quality, anxiety and depression of patients with COPD and explore the influencing factors.

Convenience sampling was used to recruit COPD patients who visited the Department Respiratory Diseases and Critical Care Medicine of seven hospitals in Anhui Province from August to November 2022. Demographic characteristics, dyspnea grade, airflow restriction severity, risk of malnutrition, physical activity level, vaccination, and acute exacerbations in the last 1 year were collected. The Pittsburgh Sleep Quality Index (PSQI) and the Hospital Anxiety and Depression Scale (HADS) were used to evaluate the sleep quality and anxiety and depression symptoms of COPD patients, and the influencing factors were analyzed by multivariate Logistic regression.

A total of 248 patients with COPD were investigated, among which the incidence of poor sleep quality was 60.9% (151/248), only 8.9% (22/248) of the patients thought they had good sleep quality, and more than half of the patients actually had insufficient sleep time (54.4%) or low sleep efficiency (60.1%). 29.4% (73/248) of COPD patients had at least one of the symptoms of anxiety or depression, of which 35 had anxiety symptoms, 61 had depression symptoms, and 23 had both anxiety and depression symptoms. Multivariate Logistic regression analysis showed that older ages (OR=1.052, 95%CI=1.018-1.086) and risk of malnutrition (OR=3.393, 95%CI=1.855-6.206) were risk factors for poor sleep quality in COPD patients. Regular physical activity was a protective factor for poor sleep quality in COPD patients (OR=0.450, 95%CI=0.242-0.834) (P<0.05). Acute exacerbations ≥2 times (OR=2.220, 95%CI=1.093-4.510) and malnutrition risk (OR=1.961, 95%CI=1.044-3.683) were risk factors for anxiety and depression symptoms in COPD patients (P<0.04). In COPD patients, PSQI score was positively correlated with HADS-A (r_s=0.413) and HADS-D score (r_s=0.430), and there was a positive correlation between HADS-A score and HADS-D score (r_s=0.719, P<0.05) .

The incidence of poor sleep quality, anxiety and depression symptoms was high in COPD patients, and age, malnutrition risk, regular physical activity and number of acute exacerbations in the past year are important influencing factors. Medical staff, family members and patients themselves should improve the awareness of sleep quality, anxiety and depression, and actively carry out screening and intervention work for key patients to improve the sleep quality and mental health of patients.

Depression is a common psychiatric disorder with limited treatment options. Deep transcranial magnetic stimulation (dTMS), as a new non-invasive neuromodulation technique, has been utilized in the treatment of major depressive disorder (MDD), but there is less evidence from clinical studies.

To explore the clinical efficacy of dTMS combined with escitalopram oxalate (Esc) in the treatment of depression, and provide further reliable data reference for dTMS in the treatment of depression patients.

A total of 73 patients with depression who attended Department of Psychiatry, Affiliated Hospital of Guizhou Medical University from December 2021 to January 2023 were selected as the study subjects and divided into the control group (n=35) and combined treatment group (n=38) according to the random number table. Patients in the control group were given Esc ( 10 mg per day in the first week and 20 mg per day from the second week for 2 consecutive weeks). The combined treatment group received the treatment of dTMS (left DLPFC as the stimulation target, 18 Hz, 120%MT, 1 980 times per day for 2 weeks, 10 times in total) based on the same treatment for the control group. The depressive symptoms and cognitive improvement of patients in the two groups were evaluated before and after the two weeks of treatments by Hamilton depression scale (HAMD), Beck Scale for Suicide Ideation (BSS), Montreal Cognitive Assessment Scale (MoCA) and the mean oxygenated hemoglobin (oxy-Hb) concentration in the prefrontal cortex measured by functional near-infrared spectroscopy (fNIRS) based on the verbal fluency text (VFT) task.

The actual completion of the trial was 30 cases in the control group and 31 cases in the combined treatment group. After treatment, the HAMD and BSS scores of the combined treatment group were lower than those of the control group, and the MoCA score was higher than that of the control group (P<0.05). After treatment, the HAMD and BSS scores of patients in the two groups were lower than those before treatment, and the MoCA score was higher than that before treatment (P<0.05). There was no significant activation of the prefrontal cortex after treatment in both groups. The improvement of depression symptoms and cognitive function in the combined treatment group was better than that in the control group.

The combination of dTMS and Esc can improve the depressive symptoms and cognitive function better than Esc treatment alone in depression patients.

Whether considering the cumulative effect of sustained C-reactive protein (CRP) and distinguishing different aspects of depressive symptoms may be the reasons for the inconsistent conclusions of previous studies on the association between CRP and depressive symptoms among middle-aged and older adults. The relationship between cumulative effects of CRP elevations and different aspects of depressive symptoms in middle-aged and older adults in China is not well understood.

This study aims to examine the relationship between cumulative episodes of CRP elevations over two successive determinations and depressive symptoms, as well as somatic and non-somatic retardation, among Chinese middle-aged and older adults.

This study used public data from the 2011-2018 Chinese Health and Retirement Longitudinal Study (CHARLS) and included 3 868 subjects. They were categorized based on the frequency of CRP elevations over two consecutive measurements: "elevated on zero occasion" (n=2 918), "elevated on one occasion" (n=763), and "elevated on two occasions" (n=187). Depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale (CESD-10) in 2011, 2015, and 2018, capturing both somatic and non-somatic dimensions. Multiple linear was used to explore the associations between cumulative episodes of CRP elevations over two successive determinations with depressive symptom scores in 2018, as well as the scores of somatic and non-somatic components separately. Multivariate Logistic regression was used to investigate the effects of cumulative episodes of CRP elevations on the risk of depressive symptoms in 2018.

The results of multiple linear regression analysis showed that after adjusting for all covariates, elevated on two occasions compared with elevated on zero occasion, which was an influential factor for the total score of depressive symptoms (β=1.22, P<0.05), the score of somatic depressive symptoms (β=0.51, P<0.05) and the score of non-somatic symptoms (β=0.71, P<0.05). Logistic regression analysis showed that after adjusting for all covariates, elevated on two occasions were associated with a higher risk of depressive symptoms than elevated on zero occasion (OR=1.64, 95%CI=1.18-2.29) .

Among Chinese middle-aged and older adults, there is a positive association between cumulative effects of CRP elevations and depressive symptoms, encompassing both somatic and non-somatic retardation. Addressing chronic inflammation and treating chronic inflammatory diseases promptly may help mitigate depression risk.

Anxiety disorders are the most common mental illnesses and are often overlooked in primary care settings, with delays in initial treatment and significant impairment on patients' social function and quality of life. In 2023, the U.S. Preventive Services Task Force (USPSTF) published a recommendation statement on adult anxiety disorder screening in JAMA, along with the latest evidence report and systematic review results. The USPSTF suggests screening for anxiety in adults, including pregnant and postpartum women. However, current evidence on the risks and benefits of screening for anxiety in older adults is insufficient to determine the pros and cons of screening. This article combines the USPSTF statement with domestic and international research to provide an overview of several aspects: the current state of adult anxiety disorders domestically and internationally, a summary of the USPSTF recommendation statement, risk factors, early screening tools and their pros and cons, treatment, and the value of the statement for general practice guidance.

Depression and suicide in adults have become significant public health issues in China and globally, imposing a heavy burden on patients and society. In 2023, the United States Preventive Services Task Force (USPSTF) published a recommendation statement on Screening for Depression and Suicide Risk in Adults in JAMA. The statement suggested screening for depression in adults, including pregnant and postpartum individuals, as well as the elderly. However, the evidence regarding the risks and benefits of suicide screening is insufficient, making it challenging to determine its overall impact. This article provides an overview of adult depression and suicide, including epidemiology, risk factors, early screening tools, pros and cons, treatments and interventions, and the guidance value of the USPSTF statement for general practitioners, combining insights from the USPSTF statement and current research both domestically and internationally.

As a common affective mental disorder, depressive disorder has currently become the second health burden worldwide, however, its pathogenesis remains to be further elucidated. The clinical treatment of depressive disorder primarily relies on western medicine. However, there is great clinical need for effective and rapid-onset antidepressants for the unsatisfactory effect, obvious treatment time-lag, and intolerable adverse reactions of current drug treatment. Ferroptosis is a novel form of cell death discovered in recent years, which has been found to be involved in the pathogenesis of numerous neurological disorders, including depressive disorder. Currently, some studies have shifted the focus of antidepressant treatment towards targeted inhibition of ferroptosis, and achieved positive outcomes. The present paper provides a comprehensive review of the involvement of ferroptosis in depressive disorder pathogenesis and its potential therapeutic implications, drawing on clinical and preclinical evidence that elucidates the underlying mechanisms linking depressive disorder with ferroptotic processes.

With the rapid development of economy and the change of fertility concept in modern population, the number of advanced maternal age is increasing year by year. Compared with appropriate maternal age, advanced maternal age is more likely to suffer from depressive symptoms due to personal, family, work, and other reasons.

To systematically evaluate the detection rate of postpartum depression in advanced maternal age (≥35 years at delivery) in China to provide relevant evidence for early prevention and intervention.

CNKI, Wanfang, VIP, CBM, PubMed, Cochrane Library, Embase, and Web of Science were searched for articles on the detection rate of postpartum depression in advanced maternal age in China by combining subject terms and free terms from inception to July 2023. The process of literature screening, data extraction and quality assessment were carried out by two researchers independently. Stata 16.0 software was used for data analysis.

A total of 21 studies were included, with a total sample size of 5 163. The results of Meta-analysis showed that the overall detection rate of postpartum depression in advanced maternal age in China was 20.0% (95%CI=17.4%-22.6%). The subgroup analysis revealed that the detection rate of postpartum depression was 19.5% (95%CI=13.8%-25.3%) in women < 40 years old, 40.3% (95%CI=11.4%-69.3%) in women ≥ 40 years old, 19.7% (95%CI=11.7%-27.7%) in women with high school education level or higher, 30.7% (95%CI=19.1%-42.3%) in women with high school education level or lower, 21.1% (95%CI=14.4%-27.9%) in primipara, 16.2% (95%CI=12.9%-19.6%) in multipara, 16.4% (95%CI=12.2%-20.6%) in natural childbirth, 27.8% (95%CI=20.9%-34.8%) in cesarean section, 20.7% (95%CI=15.6%-25.8%) in women with male newborn and 27.3% (95%CI=20.5%-34.0%) in women with female newborn; there were 38.7% (95%CI=22.6%-54.8%) women with pregnancy complications, 11.7% (95%CI=7.6%-15.8%) women without pregnancy complications, 29.5% (95%CI=17.9%-41.1%) women with adverse pregnancy and childbirth history, 27.7% (95%CI=16.6%-38.8%) women without adverse pregnancy and childbirth history, 18.0% (95%CI=16.5%-19.4%) published the year before 2020, 19.5% (95%CI=18.0%-21.0%) published the year after 2020, 20.4% (95%CI=18.2%-22.6%) in the north and 18.2% (95%CI=17.0%-19.4%) in the south, 20.0% (95%CI=18.5%-21.5%) in the Edinburgh Postnatal Depression Scale (EPDS) score ≥ 13 and 16.9% (95%CI=15.2%-18.5%) in the EPDS score ≥ 10. The Egger's test (t=1.76, P=0.095) and the Begg's test (Z=1.48, P=0.147) indicated no significant publication bias.

The detection rate of postpartum depression is higher for advanced maternal age in China, including women ≥ 40 years old, with high school education level or lower, primipara, cesarean section, female newborn, pregnancy complications and adverse pregnancy and childbirth history, publish year after 2020, areas of the north, EPDS score ≥ 13, attention should be paid to the psychological status of advanced maternal age, and corresponding prevention and intervention measures should be formulated.

The number of depression patients has exceeded 300 million worldwide, and its high disability rate has attracted global attention. However, the relationship between temperature-humidity index (Humidex) and depression remains to be explored.

To explore the relationship between Humidex of the twenty-four solar terms and depression.

Outpatient data of depression patients (n=18 289) admitted to the Psychology Department, Mental Health Center of Jiading District from 2016-10-08 to 2019-10-07 were collected, including gender, age, time of treatment, number of outpatient visits and specialist visits. The data of daily mean temperature, relative humidity, rainfall, air pressure and mean wind speed in Jiading District from 2016-10-08 to 2019-10-07 published by Shanghai Meteorological Bureau were collected to calculate Humidex. The included patients were divided into the groups of ≤18 years (n=157) , 19-44 years (n=3 099) , 45-59 years (n=4 848) , 60-74 years (n=6 270) and≥75 years (n=3 915) according to different ages. The relationship between Humidex of twenty-four solar terms and depression was estimated by using the combination of nonhomogeneous Poisson distribution and distributed-lag nonlinear model. Correlation between Humidex and meteorological variables was calculated using Pearson correlation analysis. Relative risk rates (RR) of Humidex and depression were calculated of twenty-four solar terms using median Humidex as control.

A total of 18 289 patients with depression were included from 2016-10-08 to 2019-10-07, including 6 900 males and 11 389 females. The Lesser Cold solar term corresponded to the lowest average Humidex and highest number of depression patients, the Great Heat solar term corresponded corresponded to the highest average Humidex and lowest number of depression patients from 2016-10-08 to 2017-10-07. The Great Cold solar term corresponded to the lowest average Humidex and highest number of depression patients, the Great Heat solar term corresponded to the highest average Humidex and lowest number of depression patients from 2017-10-08 to 2018-10-07. The Great Cold solar term corresponded to the lowest average Humidex and highest number of depression patients, the Great Heat corresponded to the highest average Humidex and lowest number of depression patients from 2018-10-08 to 2019-10-07. Humidex in 24 solar terms showed a nonlinear relationship with the overall population risk of depression. The top two solar terms corresponding to Humidex of depression risk distribution for total population, male, female, ≤18 years, 19-44 years, 45-59 years, 60-74 years, and ≥75 years were the Great Cold and Beginning of Spring solar terms, Great Heat solar term corresponded to the lowest depression risk distribution. The maximum lag effect was observed on the 10th day of the Great Cold and Beginning of Spring solar terms (RR=1.020, 95%CI=1.001-1.040) , and the lag effect was observed on the 8th day of Great Heat solar term and lasted to the 9th day. The lag effect was observed on the 7th day after the Great Cold and Beginning of Spring and the maximum lag effect was observed on the 9th day (RR=1.054, 95%CI=1.007-1.104) , which lasted until the 11th day in the 60-74 years group. The lag effect was observed on the 1st day and 8th day after the Great Heat, and lasted to the 2nd day and 10th day, respectively, with the maximum lag effect on the 10th day (RR=0.952, 95%CI=0.911-0.994) in male depression patients. The lag effect was observed on the 8th day after the Great Heat solar term and lasted to the 9th day in the 60-74 years group.

Humidex in the Great Cold and Beginning of Spring solar terms are risk factors for depression. Clinically, accurate diagnosis and treatment should be provided for different depression patients according to Humidex in different solar terms, and individualized intervention programs should be formulated.

Since the outbreak of COVID-19 infection, community medical personnel on the front lines of prevention and control of COVID-19 face the risk of direct contact with the virus, as well as problems such as high-intensity work, long working hours and high psychological pressure. Therefore, it is of great significance to explore the mental health status of community medical personnel and its internal relationship for the tailored implementation of mental health interventions.

To understand the mental health status of community medical personnel during the normalized prevention and control of COVID-19 and explore its influencing factors.

A total of 296 cases of community medical personnel in Zhongshan City were selected as the study subjects on December 2021 using a multi-stage random sampling method. The general information questionnaire, self-designed questionnaire of working pressure on COVID-19 prevention and control among community medical personnel, Generalized Anxiety Disorder 7 (GAD-7) and Patient Health Questionnaire 9 (PHQ-9) were administered for online investigation, and multivariate Logistic regression analysis was performed to explore the influencing factors of the perceived stress level on COVID-19 prevention and control, the presence of anxiety and depression of community medical personnel.

Among the community medical personnel in Zhongshan City, the detection rate of high perceived working pressure on COVID-19 prevention and control was 10.1% (30/296) . The prevalence of anxiety and depression at moderate level was 7.1% (21/296) and 9.5% (28/296) , respectively. Gender, the existence of depression and the level of perceived working pressure on COVID-19 prevention and control were influencing factors of the presence of anxiety among community medical personnel (P<0.05) . Performing daily diagnosis and treatment during the epidemic, engaging in three-member team for door-to-door screening, the presence of anxiety and level of perceived working pressure on COVID-19 prevention and control were factors associated with the presence of depression among community medical personnel (P<0.05) . The presence of anxiety and depression were factors associated with the level of perceived working pressure on COVID-19 prevention and control among community medical personnel (P<0.05) .

The perceived working pressure on COVID-19 prevention and control and negative emotions of anxiety and depression are related and interacted with each other, and the relative shortage of epidemic prevention and control tasks and human resources, as well as the imbalance between labor effort and labor income, have exacerbated the synergistic effect of negative emotions among community medical personnel. And health administration department should be dedicated to build up long-term investment and development mechanism for community health service institutions in the new situation and strengthen health administration department according to the development characteristics and problems exposed at community health service institutions during the normalized prevention and control of COVID-19.

Population aging in China is deepening, and the widowed rate of the elderly is also on the rise. Widower is one of the most stressful events in the human life course, and its impact also affects the mental health and economic level of widower. In many studies on the impact of widower on the mental health of the elderly at home and abroad, the proxy variables used are traditional indicators, such as subjective well-being, loneliness, depression level, and some studies do not consider the endogeneity between widowhood and health status.

To evaluate the impact of widowhood on the mental health of older adults in China, and provide a basis and reference for formulating the mental health intervention program for older adults in China.

Using the 2018 China Health and Retirement Longitudinal Study (CHARLS) as the data source, 4 694 older adults aged 60 years and above were selected as study subjects and divided into the widowed group (n=644) and non-widowed group (n=4 050) . The mental frailty index was used as a perspective for evaluating the mental health status of older adults. Using propensity score matching (PSM) model, the propensity score was calculated by using Logit regression analysis, the robustness was tested by using standard deviation variation, common support bar graph and nuclear density distribution, the impact of widowhood on the physical and mental health of older adults was analyzed by using K-nearest neighbor matching, radius matching and kernel matching, and the heterogeneity was tested based on gender, household type and age.

Compared to the non-widowed group, the mental health of older adults in the widowed group was impaired (P<0.05) . Logit regression model results showed that female (OR=2.274, 95%CI=1.917-2.698) , age (OR=0.975, 95%CI=0.972-0.978) , secondary education level (OR=0.618, 95%CI=0.505-0.756) and monthly family consumption (OR=1.000, 95%CI=1.000-1.000) were correlated with widowhood (P<0.05) . The robustness test results after matching were better. The results of PSM showed that widowhood significantly increased the mental frailty index level (ATT ranged from 0.054 to 0.055, P<0.05) . The results of heterogeneity test showed that there were significant differences between urban and rural areas and among different age groups in the impact of widowhood on the mental frailty index of older adults, but there was no significant difference between male and female in the impact of widowhood on the mental frailty index of older adults. Among them, the impact of widowhood on the older adults in rural areas was more significant (ATT ranged from 0.072 to 0.075, P<0.05) , but the impact on older adults in urban areas was not significant; the impact on older adults in the low age group and high age group was more significant (ATT ranged from 0.061 to 0.081, P<0.05; 0.067-0.078, P<0.05) , but the impact on older adults in the middle age group was not significant.

Widowhood has a negative impact on the mental health of the older adults. The impact varies among different older adults. The widowed older adults in rural areas, just entering old age and in their later years need attention and psychosocial support.

Primary care doctors in Shenzhen, China are increasingly expected to identify and prevent depressive disorder; however, they have received limited mental health training and community healthcare centres (CHCs) do not provide standardised protocols for the diagnosis and care of depressive disorder. The World Health Organization's mental health gap intervention guide, version 2 (mhGAP-IG.v2) is a decision support tool for non-specialists for the assessment, management and follow-up of mental, neurological and substance use disorders (including depressive disorder). Given that mhGAP-IG.v2 is a generic tool, it requires adaptation to take account of cultural differences in depression presentation and unique characteristics of China's emergent mental health system.

A two-round, web-based, Delphi survey was conducted. A panel of primary care doctors from Shenzhen, were invited to score their level of agreement with 199 statements (arranged across 10 domains) proposing changes to the content and structure of mhGAP-IG.v2 for use in Shenzhen. Consensus was predefined as 80% panelists providing a rating of either "somewhat agree/definitely agree", or "definitely disagree/somewhat disagree" on a five-point scale for agreement.

79% of statements received consensus with a mean score of 4.26 (i.e. "somewhat agree"). Agreed adaptations for mhGAP-IG.v2 included: an assessment approach which considers a broader spectrum of depression symptoms and reflects the life course of disease; incorporating guidance for screening tool usage; clarifying physicians' roles and including referral pathways for intersectorial care with strong family involvement; aligning drug treatment with national formularies; stronger emphasis of suicide prevention throughout all sections of the guide; contextualizing health education; reflecting a person-centred approach to care. Panelists chose to maintain diagnostic and treatment advice for bipolar patients experiencing a depressive episode as in the current guide.

An adapted mhGAP-IG.v2 for depression recognises China's cultural and contextual needs for assessment guidance; unique primary healthcare system organization, priorities and treatment availability; and diverse psychosocial educational needs. An adapted mhGAP-IG.v2 could both inform the future training programs for primary care in Shenzhen and also offer an additional mental health resource for non-specialists in other countries.

Postpartum depression (PPD) is one of the most common health problems among postpartum women worldwide, and it is also the most disabling disorder in reproductive period of women, which has a negative impact on the physical and mental health of mothers, infants and their families.

To analyze the causes of PPD, validate or revise the previous theoretical hypothesis "self-interpersonal model of PPD from the perspective of role transition", and provide intervention targets for the construction of effective prevention programs.

Using the explanatory case study method, based on the previous theoretical hypothesis, 15 women who experienced PPD symptoms and underwent routine postpartum checkups in the postpartum rehabilitation clinic of Obstetrics and Gynaecology Hospital of Fudan University from November 2022 to January 2023 were selected as the cases using the theoretical sampling method and following the "replication logic", who were interviewed by face-to-face, semi-structured in-depth personal interviews. Max QDA 2022 qualitative data analysis software was used to summarize the textual information, analytical method of constructive interpretation was used to analyze the results of each case in comparison to the previous theoretical hypotheses.

The causes of maternal PPD symptoms in this study did not go beyond the self and interpersonal aspects of the previous theoretical hypotheses and could be further summarized as four types of stressors, including "cannot take care of oneself" "cannot take care of the baby" "cannot manage the relationship with spouse" "cannot manage relationships with significant others".

The previous theoretical hypothesis of the "self-interpersonal model of PPD from the perspective of role transition" has been validated and concretized, in view of this, the four types of stressors can be used as targets for the development of PPD prevention programs to prevent PPD in the future.

China has been already in the stage of deeply aging society, and the health problems of the elderly are getting more and more attention. Depression in the elderly not only affects the quality of life in later life, but also increases the economic burden on society and families, so early identification of the influencing factors of its development is of great significance. However, the existing research conclusions are still controversial, and there are few relevant systematic reviews in China.

To explore the depression detection rate and its influencing factors in the elderly in China since 2018, provide reference for reducing the incidence of depression in the elderly and promoting healthy aging.

In January 2023, PubMed, EmBase, Web of Science, CNKI, Wanfang Date and VIP were searched for publicly available studies on factors influencing depression in Chinese elderly from 2018 to 2022. The data were extracted and the literature quality was evaluated according to the cross-sectional study quality assessment criteria of Agency for Healthcare Research and Quality (AHRQ) and Stata 15.0 was adopted for Meta-analysis.

Twenty-three papers were finally included, with a cumulative study population of 75 599, and a total of 13 815 depressed older adults were detected; the AHRQ quality assessment scores of the papers ranged from 5 to 7. Meta-analysis results showed that the detection rate of depression in the elderly in China was 20.6%〔95%CI (16.6%, 24.8%) 〕, female〔OR=1.46, 95%CI (1.30, 1.64) 〕, advanced age〔OR=1.48, 95%CI (1.13, 1.94) 〕, lower education level〔OR=1.52, 95%CI (1.32, 1.75) 〕, no spouse〔OR=1.60, 95%CI (1.35, 1.91) 〕, living in rural areas〔OR=1.38, 95%CI (1.14, 1.66) 〕, suffering from chronic diseases〔OR=2.75, 95%CI (2.07, 3.66) 〕, 2 chronic diseases〔OR=1.84, 95%CI (1.07, 3.14) 〕, 3 or more chronic diseases〔OR=3.86, 95%CI (2.89, 5.15) 〕, poor self-rated health〔OR=3.47, 95%CI (1.14, 10.53) 〕, insomnia〔OR=2.62, 95%CI (1.88, 3.66) 〕, living alone〔OR=1.86, 95%CI (1.56, 2.21) 〕, no exercise〔OR=1.88, 95%CI (1.60, 2.20) 〕, self-care needs or partial needs〔OR=2.96, 95%CI (1.12, 7.85) 〕were risk factors for depression in the elderly (P<0.05), while drinking〔OR=0.67, 95%CI (0.50, 0.88) 〕and having friends〔OR=0.52, 95%CI (0.38, 0.71) 〕were protective factors (P<0.05) .

Although the detection rate of depression among elderly in China has decreased, it is still at a high level, and the elderly in China who are female, elderly, less educated, without spouse, living in rural areas, suffering from chronic diseases and chronic disease comorbidity, with poor self-rated health, suffering from insomnia, living alone, without exercise, and living in need or partial need of self-care may be more likely to suffer from depression.

The relationship between fatigue and diseases continues to receive widespread attention and fatigue is becoming an important public health issue. The World Health Organization added overexertion to the International Classification of Diseases in May, 2019, which had took effect globally in 2022. The concept of chronic fatigue syndrome (CFS) was proposed earlier, while its etiology and pathogenesis still remain unclear till now, resulting in lacking of specific therapies, which may be due to the involvement of multiple systems and the difficulties in distinguishing CFS symptoms from anxiety/depression, the complexity of the diagnosis and treatment of the disease and researches on it are also increased. This review initially investigates the characteristics of CFS associated with anxiety/depression, further explores the similarities and differences in indicator change characteristics between CFS and anxiety/depression in terms of the current research status on biological indicators, imaging abnormalities and treatment, in order to provide new ideas for the diagnosis and typing of CFS, and provide suggestions for conducting clinical and basic researches on the disease.

Drug therapy is one of the main treatment approaches for depression, and a consideration of patient preferences can effectively improve patient compliance with medication. Several studies have been conducted to explore the medication choice preferences of patients with depression, but there is a lack of studies to systematically collect and summarize the medication choice preferences of patients with depression.

To systematically review the studies related to the application of discrete choice experiment (DCE) and best-worst scaling (BWS) to the medication choice preferences of patients with depression, in order to provide reference for clinical rational drug use of patients with depression and future studies of preferences.

CNKI, Wanfang Data Knowledge Service Platform, VIP, PubMed, Web of Science and EmBase were systematically searched for the studies related to the application of DCE and BWS to the medication choice preferences of patients with depression from inception to 2021-12-31, using "DCE" "BWS" "depression" "discrete choice experiment" "best-worst scaling" as keywords on January 2022. Data were extracted from the included literature, and the PREFS checklist was used for the quality assessment of all studies. The attributes included in the study were classified into three categories of outcome, process and cost, and their relative importance on the impact of medication preferences of patients was assessed.

A total of 7 papers were included, all of which were studies related to DCE, involving 47 attributes, among which 41 were classified as outcome attributes, 5 were classified as process attributes, and 1 was classified as a cost attribute. A total of 9 most important attribute results were obtained from the 7 studies, the outcome attribute was considered most important 8 times and the cost attribute was considered most important 1 time. Among the outcome attributes, adverse effects were considered most important 5 times and effectiveness was considered most important 3 times. Based on the PREFS checklist, one study received a score of four and six studies received a score of three. Most studies need further improvement in terms of respondents and findings.

Outcome attributes are most important in the medicine taking process of patients with depression, which needs attention of clinicians and policy makers. There is room for improvement in the dimensions of variance reporting and experimental design, it is recommended for further improvement of research design in terms of respondents interpretation of findings and experimental design in future research, in order to provide more high-quality evidence for research of medication preferences of patients with depression.

The period of junior high school age is a key development stage of adolescent mental health, during which mental maturity and physical and mental development imbalance may greatly increase the susceptibility of the students to depressed mood. Previous studies have shown that yin-deficiency constitution is a risk factor for depressed mood in adolescents, which has also been reported to be impacted by stressful life events and the time taken to fall asleep, but there is no systematic discussion about the mechanism of action in the relationships between the four factors.

To explore the relationship between yin-deficiency constitution and depressed mood in junior high school students, as well as the mediating effect of stressful life events and the time taken to fall asleep.

On March 2022, a convenient sample of junior high school students from a middle school in Meishan City, Sichuan Province were surveyed on their general data (gender, ethnicity, region of origin, grade), prevalence of yin-deficiency constitution assessed using the yin-deficiency Constitution subscale of the Traditional Chinese Medicine Constitution Scale for 7-14-year-olds, prevalence of stressful life events assessed using the Adolescent Self-Rating Life Events Checklist (ASLEC), and the time taken to fall asleep assessed using the items assessing how long it takes to fall asleep in the Munich Chronotype Questionnaire (MCTQ), and prevalence of depressed mood assessed using the Center for Epidemiologic Studies Depression (CES-D). The scores of yin-deficiency constitution, ASLEC and CES-D as well as the time taken to fall asleep were compared across the students by demographic characteristics. Spearman correlation analysis was used to explore the correlation between the variables. A multiple-mediator model was constructed to examine the mediating effect of stressful life events and the time taken to fall asleep on yin-deficiency constitution and depressed mood, and the significance of chain mediating effect was tested using bootstrap method.

The survey achieved a response rate of 98.1% (2 570/2 620) in the 2 620 surveyed students. The detection rate of depressed mood in the respondents was 32.8% (844/2 570). Female students had higher scores of yin-deficiency constitution, ASLEC and CES-D than male students (P<0.05). The yin-deficiency score, ASLEC score and CES-D score in grade 2 and grade 3 students was higher than that of grade 1 students (P<0.05). The ASLEC score in non-Han students was longer than that of Han students (P<0.05). The time taken to fall asleep in Han students was longer than that of non-Han students (P<0.05). The yin-deficiency constitution score, ASLEC score and CED-S score of students from rural areas was higher than that of those from towns (P<0.05). The average yin-deficiency constitution score, ASLEC score, the time taken to fall asleep and CES-D score in all respondents were 25.0 (15.0, 40.0) points, 36.0 (30.0, 44.0) points, 15.0 (8.6, 25.7) min and 11.0 (6.0, 18.0) points, respectively. The yin-deficiency constitution score was positively correlated with ASLEC score, the time taken to fall asleep and CES-D score (r_s=0.538, 0.151, 0.470, P<0.05). The ASLEC score was positively correlated with the time taken to fall asleep and CES-D score (r_s=0.224, 0.684, P<0.05). The time taken to fall asleep was positively correlated with CES-D score (r_s=0.289, P<0.05). Multiple mediator model-based analysis showed that yin-deficiency constitution positively predicted depressed mood (β=0.465, P<0.001). And it also positively predicted the level of stressful life events (β=0.511, P<0.001) and the time taken to fall asleep (β=0.066, P=0.004). The level of stressful life events positively predicted the time taken to fall asleep (β=0.228, P<0.001) and depressed mood (β=0.591, P<0.001). The time taken to fall asleep positively predicted depressed mood (β=0.139, P<0.001). The final results of Bootstrap test showed that significant effect of path dependence was found in the path of yin-deficiency constitution→stressful life events→the time taken to fall asleep→depressed mood〔mediating effect value =0.009, 95%CI (0.006, 0.012), P<0.001〕, indicating that the chain mediating effect of stressful life events and the time taken to fall asleep on yin-deficiency constitution and depressed mood was valid.

Yin-deficiency constitution can be used as a direct predictor of depressed mood in junior high school students, but it also can directly affect their depressed mood through its role played between stressful life events and the time taken to fall asleep as an independent mediator or a chain mediator. To reduce the incidence of depressed mood and improve mental health in this population, measures can be taken to improve the yin-deficiency constitution, improve the ability to cope with stressful life events and shorten the time taken to fall asleep.

With the population aging, mental health of the middle-aged and elderly adults is of great concern, especially in middle-aged and elderly women. Compared with urban women, rural women are more likely to suffer from mental diseases due to their poorer health status, lower education level and backward living conditions, however, the accessibility of mental health services among them is low.

To understand the prevalence of depression among middle-aged and elderly women in rural China and analyze its influencing factors, in order to provide empirical evidence for improving the mental health of middle-aged and elderly women.

From May to July 2021, the follow-up data of the 2018 China Health and Retirement Longitudinal Study (CHARLS) was extracted, and rural women aged 45 years and above were selected as the study subjects (n=6 736) . The scores of the simplified version of the Center for Epidemiologic Studies Depression Scale (CES-D) were used to determine the depression status of rural middle-aged and elderly women. Chi-square tests and multivariate Logistic regression model were used to analyze the influencing factors of the occurence of depressive symptoms among rural middle-aged and elderly women (including individual characteristics, health behaviors, social participation and utilization of medical services utilization) .

The CES-D score of 6 736 rural middle-aged and elderly women was (20.0±6.9) , 42.46% (2 860/6 736) of whom had depressive symptoms. The results of multivariate Logistic regression analysis showed that satisfication with health status〔OR (95%CI) =0.40 (0.36, 0.45) 〕, sleep duration ≥6 h〔OR (95%CI) =0.48 (0.43, 0.54) 〕, Internet use〔OR (95%CI) =0.63 (0.50, 0.80) 〕 and satisfication with life 〔OR (95%CI) =0.25 (0.21, 0.30) 〕 were correlated with lower risk of depression; hysical disability〔OR (95%CI) =1.41 (1.16, 1.71) 〕, suffering from chronic diseases〔OR (95%CI) =1.35 (1.21, 1.50) 〕, receiving outpatient services within 1 month〔OR (95%CI) =1.25 (1.09, 1.43) 〕 and hospitalization services within 1 year〔OR (95%CI) =1.31 (1.13, 1.52) 〕 were correlated with higher risk of depression.

Based on the results of this study, the depression status of middle-aged and elderly women in rural China is relatively severe and affected by individual characteristics, health behaviors, social participation, and the medical services utilization. It is recommended that governments and civil affairs departments at all levels pay close attention to the mental health of rural middle-aged and elderly women, especially through the intervention and prevention from multiple dimensions such as health promotion and education, medical service quality, and accessibility of information, in order to promote the construction of healthy villages and process of health aging in China.