Cognitive neuropsychological models propose that antidepressants exert their therapeutic effects by modifying negative emotional processing biases early in treatment. However, evidence from large, long-term clinical samples is limited.

We conducted a mechanistic analysis within the Antidepressants to Prevent Relapse in Depression randomized controlled trial, which compared maintenance antidepressant treatment with placebo substitution in adults with recurrent depression who were currently well (N = 478). Participants completed a computerized facial emotion recognition task at baseline, 12 weeks, and 52 weeks, in which faces morphed from happy to sad. The primary outcome was the number of faces classified as happy (0–45). Linear and longitudinal mixed-effects models were used to compare treatment groups and examine associations with depressive (PHQ-9) and anxiety (GAD-7) symptoms.

Of the 462 participants completing at least one task, there was no evidence that discontinuing antidepressants altered performance compared with maintenance at 12 weeks (adjusted mean difference = 0.23, 95% CI –0.5 to 1.0, p = 0.5) or 52 weeks (0.29, –0.5 to 1.2, p = 0.5). Depressive symptoms were negatively associated with happy face classifications both cross sectionally (β = –0.20 per PHQ-9 point, p = 0.02) and longitudinally (β = –0.09, p = 0.05). Anxiety symptoms were positively associated with happy classifications (β = 0.11, p = 0.047).

Maintenance antidepressant treatment did not sustain positive emotional processing biases as indexed by facial emotion recognition, despite robust associations between such biases and depressive symptoms. These findings challenge the generalizability of laboratory evidence on emotional bias modification to long-term clinical treatment and highlight the need for further mechanistic research on antidepressant action.

Cognitive complaints are common in multiple sclerosis, but their relationship to non-cognitive symptoms such as fatigue, sleep dysfunction and psychopathology has not been systematically examined in patients referred for specialist cognitive evaluation. These potentially modifiable symptoms may warrant attention in a clinical context.

This study aimed to characterise common patterns of cognitive and non-cognitive symptoms in a referred patient cohort and determine whether cognitive complaints are associated with clinically significant fatigue, sleep dysfunction and psychopathology.

Cognitive complaints were captured using (a) a binary classification derived from clinical impression and (b) a severity rating from a self-report instrument. Objective cognitive performance was measured across five cognitive domains. Patients also completed self-report measures of fatigue, sleep dysfunction and psychopathology.

Fifty-one patients were included. Although 98% had cognitive complaints, only 29% had objective cognitive impairment. Most (90%) had significant non-cognitive symptoms, primarily fatigue (86%), sleep dysfunction (28%) and depression (26%). Pattern analysis revealed that the most common symptom phenotype was cognitive complaints with significant non-cognitive symptoms, occurring in the absence of objective cognitive impairment. More severe cognitive complaints were associated with greater psychopathology (r = 0.57, BF10 = 2188.48), fatigue (r = 0.53, BF10 = 366.44) and sleep dysfunction (r = 0.47, BF10 = 69.27).

Cognitive complaints in multiple sclerosis may reflect broader non-cognitive symptom burden rather than objective cognitive impairment, even among patients referred for specialist evaluation. Their presence should prompt consideration of fatigue, sleep disturbance and psychopathology as potential targets for intervention.

The present study aimed to investigate the association between adherence to the DASH diet and the risk of depression and anxiety severity in a large group of Iranian adults.

In this cross-sectional study, dietary intakes were assessed using a validated 65-item food frequency questionnaire. The Beck Anxiety Inventory and the Beck Depression Inventory II were used to assess anxiety and depression, respectively. Ordinal logistic regression was applied to evaluate the association between DASH diet and depression and anxiety severity.

Mashhad stroke and heart atherosclerosis disorder (MASHAD) study.

6537 and 6539 adults aged 35-65 years for depression and anxiety, respectively.

We found no significant association between adherence to the DASH diet and depression severity, in the total participants as well as both gender in either crude (total: OR: 0.98; 95% CI: 0.87-1.09, men: OR: 0.88; 95% CI: 0.73-1.07, and women: OR: 1.01; 95% CI: 0.88-1.17) or fully adjusted models (total: OR: 1.03; 95% CI: 0.91-1.16, men: OR: 0.95; 95% CI: 0.78-1.17, and women: OR: 1.04; 95% CI: 0.90-1.21). Regarding anxiety, we found that men in the third tertile of DASH diet score had lower risk of experiencing more severe anxiety compared to those in the first tertile (OR: 0.80; 95% CI: 0.67-0.96). However, after controlling for potential confounders, this relationship became non-significant (OR: 0.89; 95% CI: 0.74-1.07). In the total participants as well as women, we failed to find any significant association between adherence to the DASH diet and anxiety severity either before (total: OR: 0.97; 95% CI: 0.87-1.09, women: OR: 1.05; 95% CI: 0.92-1.21) or after controlling for possible confounders (total: OR: 1.01; 95% CI: 0.90-1.12, women: OR: 1.06; 95% CI: 0.92-1.22).

We found no significant association between adherence to DASH diet and depression and anxiety severity among adults.

Occupational stress triggers psychological/physical health issues, elevating the risk of burnout and depression. This study explored the interrelationships among these constructs via network analysis (undirected/directed graphs).

A total of 1363 participants from Beijing hospitals and a university completed House and Rizzo’s Work Stress Scale, Zung’s Self-Report Depression Scale, and Maslach Burnout Inventory-General Survey. Graphical Gaussian Model and directed acyclic graphs (DAG) identified core/bridge/upstream nodes and causal pathways.

Emotional exhaustion (EE) was the core node (expected influence = 2.11). The strongest edge was D11–D12 (weight = 0.46). EE, occupational stress 11, cynicism (CY), and personal accomplishment (PA) served as key bridging nodes. The network showed high stability (0.75). DAG identified upstream occupational stress 1/7/8, confirming direct occupational stress to depression pathways (emotional dysregulation model) and CY/PA mediated pathways (burnout structural theory).

Targeted interventions on core/bridge/upstream nodes may prevent depression onset and progression in occupational settings.

Anxiety disorders are highly prevalent yet lack objective biomarkers. Whereas threat-related attentional biases are well documented, less is known about broader eye movement alterations that may characterise anxiety.

To characterise multi-paradigm eye movement profiles in anxiety disorders and evaluate their potential as behavioural markers for disorder differentiation.

Eye movements were recorded in 91 patients with anxiety disorders, 118 with depressive disorders and 98 healthy controls during free viewing of neutral-stimuli, smooth-pursuit and fixation-stability tasks. Principal component analysis was applied to derive latent eye movement dimensions, which were then tested for group differences, associations with symptom severity and classification performance.

Compared with both patients with depression and healthy controls, patients with anxiety disorders exhibited hyper-scanning during free viewing, characterised by increased saccade frequency and path length, and hyper-pursuit during smooth pursuit, reflected in increased velocity gain, fewer intrusive saccades and more catch-up saccades. Principal component analysis identified six latent components, among which active visual exploration, pupillary arousal and smooth-pursuit control demonstrated robust group differences. Machine learning models trained on 6 components yielded areas under the receiver operating characteristic curve of 0.82 for anxiety versus healthy controls, 0.83 for depression versus healthy controls and 0.61 for anxiety versus depression.

Hyper-scanning and hyper-pursuit emerge as defining eye movement signatures of anxiety, linking core mechanisms of vigilance and prediction with measurable behavioural markers. These insights position eye-tracking as a promising behavioural modality for mechanism-informed differentiation across affective disorders.

Clinically relevant anxiety can be detected in patients with amyotrophic lateral sclerosis (ALS), but its prevalence and determinants have not yet been fully assessed.

This study aimed at assessing the prevalence and clinical underpinnings of anxiety in ALS.

Non-demented ALS patients (N = 433) and healthy controls (N = 313) were administered the State- and Trait-Anxiety Inventory – Form Y (STAI-Y1 for state-anxiety and STAI-Y2 for trait-anxiety) and the Beck Depression Inventory (BDI). Patients were further assessed for cognition (Edinburgh Cognitive and Behavioural ALS Screen), behaviour (Frontal Behavioural Inventory) and motor status (disease duration, ALS Functional Rating Scale-Revised and progression rate). The prevalence of clinically significant state- and trait-anxiety were estimated by applying age-stratified cut-offs to STAI-Y1/-Y2 t-scores. Linear and logistic regressions were run to test the determinants of STAI-Y1/-Y2 scores.

STAI-Y1 and -Y2 scores above cut-off were detected in 18.2 and 13.9% of patients, respectively – with proportions being higher in cases versus controls (ps < 0.001). BDI, but neither cognitive/behavioural nor motor variables, was identified as a significant predictor of STAI-Y1/-Y2 scores (ps < 0.003). The cognitive–affective subscale of BDI was the sole predictor of scores above cut-off on both STAI-Y1 and STAI-Y2 (ps < 0.001).

Clinically significant levels of state- and trait-anxiety occur in ∼18 and ∼14% of non-demented ALS patients, respectively, mostly driven by cognitive and affective facets of depression, and are independent of motor and cognitive/behavioural features.

Intolerance of uncertainty (IU) – a dispositional inability to react effectively to uncertain situations – has been increasingly conceptualized as a transdiagnostic risk factor for internalizing problems such as generalized anxiety and depression. However, evidence for its temporal role in the development of these conditions remains limited, particularly in adolescents, a group at heightened risk for psychopathology.

A total of 5,291 adolescents (46.2% boys; M age = 14.40 ± 1.56, range = 10–18 years) completed self-report measures of IU, generalized anxiety and depressive symptoms at baseline, 6 months and 12 months. Linear and logistic regression analyses examined whether baseline IU predicted subsequent symptom severity and elevated (above-cut-off) symptom levels over time.

Higher baseline IU significantly predicted increases in generalized anxiety and depressive symptoms, as well as higher odds of elevated generalized anxiety and depressive symptom levels at both 6- and 12-month follow-ups, even after adjusting for baseline symptom severity or baseline elevated symptom status. Baseline IU also predicted the new-onset and persistence of elevated symptoms across both intervals. Stratified analyses revealed developmental and sex differences: IU’s predictive effects were strongest in early adolescence for girls and in middle-to-late adolescence for boys.

IU emerged as a transdiagnostic longitudinal predictor of generalized anxiety and depressive symptoms in adolescents, supporting its value as an early screening marker of vulnerability. Interventions targeting IU may offer an effective strategy for reducing broad internalizing risk during this critical developmental period.

Reducing stigma and discrimination towards people with mental ill-health is a key priority in Australian mental health policy. Population-based surveys conducted in Australia between 2003 and 2011 showed some improvement in stigmatising attitudes, but also a deterioration in attitudes about dangerousness and unpredictability, particularly in relation to schizophrenia. This study aimed to investigate whether stigmatising attitudes have changed since the 2011 national survey.

Two large, nationally representative samples of Australian adults were surveyed in 2011 (n = 1967) and 2024 (n = 1984). At each time point, participants were presented with vignettes of a person in the early stages of depression or schizophrenia and completed questionnaires about stigmatising attitudes towards the person in the vignette (Personal Stigma Scale) and willingness to interact with them (Social Distance Scale). Using weighted data, logistic regressions assessed change from 2011 to 2024 while controlling for sociodemographic characteristics. Results were considered significant at p < .01.

There were significant reductions in endorsement of stigmatising attitudes towards depression and early schizophrenia. Notably, there were large reductions in beliefs about dangerousness (depression 22.5–4.8% and schizophrenia 37.1–18.1%). Conversely, the willingness to interact with a person with depression remained unchanged and had worsened for schizophrenia, with the odds of being unwilling to interact approximately doubling (11.0–26.9% unwilling to make friends and 18.8–33.2% unwilling to work closely with them).

The data show mixed findings regarding change in stigma in the Australian population. Despite negative beliefs diminishing over time, this has not translated into greater willingness to interact with people with depression or schizophrenia. Key action is needed on understanding the barriers to interacting with people with mental health conditions and reducing perceptions of unpredictability, particularly for schizophrenia, which remains more highly stigmatised.

The PReDicT study showed that predictive algorithm-guided antidepressant treatment reduces anxiety and improves functioning in patients with depression.

To estimate the costs, outcomes and cost-effectiveness of the PReDicT test compared with treatment as usual (TAU) for primary depression care in five European countries.

Within-trial economic analysis was conducted over 24 weeks from the health/social care and societal perspectives alongside the PReDicT trial (NCT02790970) in France, Germany, The Netherlands, Spain, and the UK, according to Consolidated Health Economic Evaluation Reporting Standards guidelines. We calculated quality-adjusted life-years (QALYs) based on the EQ-5D-5L, capability-weighted life-years based on the Oxford Capabilities Questionnaire – Mental Health (OxCAP-MH) (Germany and UK only), and costs for 2018 (€). Multiple imputation for missing data, multivariable regression for cost and outcome differences, and bootstrapping and sensitivity analyses for uncertainty were conducted.

There were significant outcome improvements (EQ-5D-5L PRedicT: +0.139; TAU: +0.140) and societal cost reductions (PRedicT: −€2589; TAU: −€2602) in both groups (N = 913) between the before and during trial periods. In the UK and Germany (n = 619), the PReDicT group showed significant additional capability well-being gains (OxCAP-MH: +2.127, p = 0.021). Cost-effectiveness probabilities ranged from 46 to 59% at trial level, but exceeded 80% in the UK. Results remained stable across different sensitivity analyses, with societal cost-effectiveness improved for those (self-)employed.

We observed potentially meaningful health and economic benefits of closely monitored antidepressant treatment, as implemented in both treatment and control arms of the PReDicT trial. The PReDicT test itself had some added benefits in improved capabilities and productivity, however, with great uncertainty and country-level variations in cost-effectiveness.

Providing care for children with life-limiting conditions(LLCs) is an emotionally challenging experience that often exposes caregivers, particularly mothers, to considerable risk of psychological distress. The purpose of this study was to examine the moderating effect of emotional dysregulation on the relationship between severity of anxiety and depressive symptoms and high caregiving intensity, controlling for sociodemographic characteristics among mothers caring for children diagnosed with life-limiting conditions.

Using a cross-sectional descriptive design, a convenience sample of 192 mothers caring for children with life-limiting conditions was recruited and filled out an online self-administered questionnaire. Data were collected using online self-administered questionnaires regarding the sociodemographic characteristics of mothers and their children, emotional regulation difficulties (DERS), and the levels of anxiety and depressive symptoms among the mothers (DASS-21).

The analysis showed that 21.4% and 7.8% of mothers had moderate and severe depressive symptoms, and 19.3% and 15.6% had moderate and severe anxiety symptoms, respectively. The analysis also showed that emotional dysregulation is associated with high levels of anxiety (β = 0.74, P < 0.001) and depression (β = 0.74, P < 0.001); however, there was no significant moderating effect.

Anxiety and depression are significant psychological distress among mothers caring for children with life-limiting conditions and can be aggravated by emotional dysregulation and caregiving burden. There is a need to integrate interdisciplinary teamwork and family-centered care to provide holistic care and offer early screening, detection, and emotional regulation-focused management programs for psychological distress at healthcare services that care for children with LLCs.