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Joshua Lowe, San Antonio Military Medical Center,Rachel Bridwell, Uniformed Services University of Health Sciences,John Patrick, San Antonio Military Medical Center,Alec Pawlukiewicz, Carl R. Darnall Army Medical Center,Gillian Schmitz, Uniformed Services University of Health Sciences,Michael Yoo, University of Texas Health San Antonio
This case addresses the evaluation and emergency management of a 22-year-old female presenting with suicidal ideation and a concrete plan to overdose on her antidepressant medication. Although she ultimately did not ingest the pills, she endorsed ongoing hopelessness, lack of safety, and social isolation. Physical exam and laboratory evaluation revealed no signs of ingestion, trauma, or metabolic derangement. Psychiatry was consulted after medical clearance, and the patient was placed on 1:1 observation and transferred for inpatient psychiatric care. This case emphasizes empathetic communication, suicide risk stratification, the role of medical clearance, and the importance of early psychiatric involvement for patients at high risk of self-harm.
Accurate trauma recollections are essential in legal and research contexts; however, studies frequently reveal significant inconsistencies in trauma reporting over time.
Aims
To investigate the trauma-reporting patterns among healthcare workers (HCWs) following their exposure to the Beirut port blast.
Method
This longitudinal study examined trauma memory alteration among 296 HCWs at 6 months (wave 3) and 2–2.5 years (wave 4) post-blast. Participants reported trauma exposure prior to the event, and probable post-traumatic stress disorder (PTSD) secondary to the Beirut port blast. Depression and psychological distress were analysed as potential predictors of memory alteration using multinomial models.
Results
The majority of participants (72.4%) exhibited inconsistent trauma reporting, with 36.43% exaggerating and 35.71% diminishing their trauma accounts over time. Developing probable depression and screening positive for PTSD at wave 4 were predictors of memory exaggeration (respectively odds ratio 5.71, 95% CI: 1.19–27.32; odds ratio 8.04, 95% CI: 0.98–65.73), while remitted psychological distress was protective (odds ratio 0.08, 95% CI: 0.01–0.99). No significant predictors were found for memory diminishment.
Conclusions
A substantial portion of HCWs exposed to the Beirut port blast demonstrated inconsistent trauma reporting, with mental health conditions such as depression and PTSD influencing memory exaggeration. These findings underscore the importance of considering memory reliability in trauma research, particularly in populations with mental health disorders and exposed to major disasters.
Parkinson’s disease is a chronic neurodegenerative disorder with a range of movement-related and non-movement symptoms. Depression is a frequent complication and linked to faster cognitive decline, reduced daily functioning and poorer quality of life. This review looks at how often depression occurs in Parkinson’s disease, possible reasons behind it and the diverse ways it can be treated. A thorough evaluation using a biopsychosocial approach, supported by tools like the Patient Health Questionnaire, is essential. Treatment options include medications (e.g. selective serotonin reuptake inhibitors, tricyclic antidepressants and serotonin–noradrenaline reuptake inhibitors), talking therapies (e.g. cognitive–behavioural therapy and problem-solving therapy) and electroconvulsive therapy. Techniques such as transcranial magnetic stimulation and vagus nerve stimulation are being explored for individuals who do not respond to standard treatments. The findings highlight the importance of personalised, evidence-based care to improve the mental health and independence of people with Parkinson’s disease.
Adolescent mental health has worsened, and prevention efforts have become increasingly important. The purpose of this study was to examine longitudinal symptom trajectories of depression and anxiety throughout adolescence, in a contemporary sample. The stress–diathesis model was used to inform potential vulnerability factors and stressors associated with these trajectories.
Methods
Symptoms of depression and generalized anxiety were assessed in a school-based population sample of N = 6102 adolescents (aged 13–14 at baseline). Growth mixture models across four time points were used to model longitudinal trajectories of symptoms. Multinomial regression was used to examine factors associated with each trajectory class.
Results
Of the full sample, 49.5% were female, 45.9% were male, and 4.6% were gender diverse. Four discrete classes for both depression and anxiety trajectories were identified, which comprised consistently low symptoms (‘low’; 72.5% depression; 66.9% anxiety), consistently high symptoms (‘high’; 11.5% depression; 18.4% anxiety), elevated symptoms that reduced over time (‘decreasing’; 8.3% depression; 6.9% anxiety), and low-moderate symptoms that increased over time (‘increasing’; 7.7% depression; 7.8% anxiety). Factors associated with poorer trajectories were being female or gender diverse, lower socioeconomic status, higher levels of neuroticism and lower levels of conscientiousness, greater adverse childhood experiences, higher levels of peer problems, bullying victimization, and negative family interactions.
Conclusions
A range of background vulnerabilities and specific stressors were associated with poorer depression and anxiety trajectories over a 3-year period. Prevention approaches may require policy and practice changes that promote more supportive family, school, and societal environments from childhood to adolescence.
Major depressive disorder (MDD), smoking, and drinking frequently co-occur, with evidence suggesting these relationships may differ by sex. However, the direction of causality and the extent of sex-specific associations remain unclear. We investigated sex-specific genetic relationships between MDD and substance use phenotypes using genome-wide association studies (GWAS) from the UK Biobank and publicly available sex-stratified GWAS for MDD and problematic alcohol use (PAU). Causal effects were assessed using bidirectional, sex-stratified Mendelian randomization (MR). We further applied multivariable MR (MVMR) to evaluate the influence of socioeconomic status (SES). Genetic correlation analyses indicated significant shared genetic architecture between MDD and all substance use traits in sex-combined GWAS. In sex-specific analyses, the correlation between cigarettes per day and MDD was significantly stronger in females, and drinks per week were correlated with MDD only in females. MR analyses showed that genetic liability to MDD increased the risk of smoking initiation and PAU in females, and was associated with reduced alcohol drinking frequency in males. In contrast, no tested substance use trait showed evidence of a causal effect on MDD in either sex. MVMR adjusting for SES attenuated the association between MDD and smoking initiation. The effect on PAU in females remained. In males, the negative association between MDD and drinking frequency became non-significant after SES adjustment. These findings reveal sex-specific genetic and causal relationships between smoking, drinking, and MDD, and highlight the role of SES as a potential confounder. Incorporating sex and socioeconomic context is critical when examining these associations.
To examine the relationships between patient activation, depressive symptoms, and quality of life among older adults receiving palliative oncology care.
Methods
A cross-sectional correlational study was conducted among 145 adults aged ≥60 years receiving palliative oncology care at King Khalid Hospital, Saudi Arabia, using stratified random sampling. Data were collected via a demographic and clinical questionnaire, the Patient Activation Measure-13 (PAM-13), the Patient Health Questionnaire-9 (PHQ-9), and the McGill Quality of Life Questionnaire–Revised (MQOL-R). Descriptive statistics, Pearson correlation, independent t-tests, one-way ANOVA, and multiple linear regression were performed using SPSS version 26.
Results
All participants demonstrated Level 2 patient activation, with a mean PAM-13 score of 50.83 (SD = 1.04). Moderate depressive symptoms were prevalent (mean PHQ-9 = 13.56, SD = 3.48), and overall quality of life was moderate (mean MQOL-R = 55.21, SD = 10.14). Patient activation was weakly but significantly inversely correlated with depressive symptoms (r = −0.179, p < 0.05). No significant associations were found between patient activation and quality of life, or between depressive symptoms and quality of life. Regression analysis showed that patient activation, depressive symptoms, and demographics accounted for only 3.2% of the variance in quality of life (R2 = 0.032, p = 0.714).
Significance of results
Patient activation may modestly reduce depressive symptoms but is not sufficient to improve quality of life in older adults receiving palliative oncology care. Quality of life appears influenced by broader multidimensional factors beyond activation and mood, highlighting the need for comprehensive interventions in palliative care settings.
Social anxiety is a common and impairing condition that often emerges in adolescence.
Aims
This study aimed to examine the prevalence and severity of social anxiety among Chinese youths in the post-COVID-19 era, and to develop a predictive model identifying key factors associated with social anxiety severity.
Method
A total of 555 youths aged 15–25 years completed an online survey via WeChat on social anxiety (Social Phobia Inventory), depressive symptoms (Patient Health Questionnaire), sleep problems (Pittsburgh Sleep Quality Index), social support (Multidimensional Scale of Perceived Social Support) and internalised stigma (Internalized Stigma of Mental Illness Scale). Social anxiety severity and rates were described, and comparisons were made across sociodemographic groups. Hierarchical multiple regression was used to predict social anxiety severity from depression, sleep, social support and stigma. An additional regression examined which components of social anxiety (fear, avoidance, physical symptoms) predict internalised stigma.
Results
In total, 69.55% of participants reported at least mild social anxiety, with 20% reaching severe or very severe levels. Female, younger participants and those with fewer close friends reported significantly higher anxiety. Depressive symptoms (β = 0.31, P < 0.05) and internalised stigma (β = 0.40, P < 0.05) were strong predictors of anxiety severity, while sleep problems and social support were not significant after controlling for these factors. Among social anxiety dimensions, only avoidance significantly predicted higher stigma (β = 0.17, P < 0.01).
Conclusions
The high post-pandemic prevalence of social anxiety among youths highlights the need for early identification, stigma reduction and interventions targeting depression and avoidance to prevent long-term impairments.
Maternal depressive symptoms during pregnancy have consequences for offspring brain development, likely mediated via biological signals. However, gestational biological correlates of maternal depression may differ depending on childhood maltreatment (CM) history. We investigated the association of maternal depressive symptoms in pregnancy and CM history with newborn global white matter microstructure. In a sample of N = 90 mother–infant dyads from two cohorts, maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale. CM was assessed with the Childhood Trauma Questionnaire or the Adverse Childhood Experiences scale. Diffusion-weighted imaging was performed in the infants within 90 days of birth. Fiber profiles of fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD) were determined, and a global mean for each metric was computed. In adjusted models, there was a significant interaction effect of maternal depression and CM on newborn global FA (β = −0.523, p = .029) and RD (β = 0.590, p = .014) but not AD (β = 0.367, p = .120). In infants of women with CM history, maternal depressive symptoms were correlated negatively with FA and positively with RD. In contrast, infants of women without CM exhibited the reverse pattern of associations between depressive symptoms and diffusion metrics. These findings suggest that the impact of prenatal exposures, such as maternal depressive symptoms, on offspring brain development may be conditional on the presence or absence of maltreatment history. These findings highlight the importance of assessing trauma history and monitoring psychosocial well-being during pregnancy.
Assessing depression symptoms in people with a chronic illness is challenging due to possible bias from overlapping somatic symptoms associated with both depression and chronic illnesses. Previous studies, however, have found that people with a chronic illness do not report more somatic symptoms on depression measures than people without a chronic illness with similar levels of mood and cognitive symptoms. The reason for this surprising finding is unknown. Our primary objective was to evaluate differences in mean sum scores of Patient Health Questionnaire-8 (PHQ-8) somatic symptom items (sleep disturbances, fatigue, appetite changes) in people with a chronic illness when the items were administered outside the context of a depression questionnaire versus as part of the PHQ-8. Secondary objectives were to evaluate individual somatic item scores. We hypothesised that people who completed somatic items outside of a depression assessment would have significantly higher scores than those who completed items as part of a depression assessment.
Methods
We conducted a randomised controlled experiment within the Scleroderma Patient-centred Intervention Network (SPIN) Cohort, a multinational cohort of people with systemic sclerosis. SPIN Cohort participants were randomly allocated to complete the PHQ-8 with somatic items (sleep disturbances, fatigue, appetite changes) presented separately from psychological items and without any indication that they were part of a depression questionnaire (Reordered Items arm) or in standard format (Standard PHQ-8 arm). Participants were automatically randomised when they logged into the SPIN Cohort platform to complete routine research assessments. The primary outcome was the mean sum score of PHQ-8 somatic items. Secondary outcomes were the mean scores of individual somatic items. Differences were assessed using between-groups t-tests.
Results
In total, 851 participants were included (N = 428 in Reordered Items arm, N = 423 in Standard PHQ-8 arm). Mean (SD) PHQ-8 score was 6.0 (5.3) for all participants. We found no statistically significant differences in PHQ-8 somatic item sum scores (0.05 points; 95% confidence interval [CI]: −0.29 to 0.38) or in mean scores for item 3 (sleep disturbances; 0.04 points; 95% CI: −0.09 to 0.19), item 4 (fatigue; 0.03 points; 95% CI: −0.11 to 0.16) and item 5 (appetite changes; −0.03 points; 95% CI: −0.15 to 0.10).
Conclusions
We did not find evidence that responses to PHQ-8 somatic items were influenced by whether participants were aware they were responding to items about depression. This finding supports the validity of self-reported questionnaires for depression symptom assessment in people with chronic medical conditions.
The USA has among the highest levels of mental illness of all countries, together with the most treatment. We seek happiness through mechanisms that produce pleasure, most of which are not effective. Those lower down in the hierarchy use more destructive means to gain gratification, thereby becoming worse off. Americans may suffer more pain than people in other rich nations, especially social pain in response to chronic stressors present here. We consume 80% of the world’s opioids Smartphone use, especially among youth, may be harmful for mental health. Evolutionary pressures make us live to reproduce and nurture the progeny until they can have children. Various mental illnesses that don’t impact propagation can manifest, especially in later life, such as anxiety to cope with danger. Mental health is political, like other aspects of health
Women’s mental health is commonly regarded as worse than that of men across most cultures and countries, although the pronounced female disparity for affective disorders, particularly depression and anxiety, is reversed for other mental conditions such as addiction, alcoholism, or autism. Here we probe this puzzle within a life-history adaptationist framework, focusing on the high prevalence of mood disorders among women with the goal to evaluate their adaptive rather than pathological qualities. First, we characterize gender disparities in mental health, particularly mood disorders among women, and review their phenomenology. Then we survey known risks for mood disorder on cultural, ecological, experiential, and physical/physiological dimensions. Next we consider adaptationist explanations for depression, and map women’s life history in non-industrial societies, plotting resources, demands, and selection pressures. Thence we turn to how life-course selection pressures and female adaptive responses to them operate and intersect, illustrated by an example of low birthweight effects. Affective disorders vary in phenotype and prevalence within and across societies and through time, arising from an array of context-sensitive cost–benefit trade-offs for females that operate from birth onwards. Available evidence suggests that the general preponderance of mood disorder among females is adaptive overall albeit via multiple pathways.
Entry to higher education coincides with a period of accelerated psychosocial and brain development. Student need for acceptable and accessible well-being and mental health support is straining university resources.
Aims
To evaluate the acceptability and impact of a digital mental health literacy course tailored for undergraduates and delivered as an accredited interdisciplinary elective.
Method
Analyses included pre–post course survey data from enrolled students and longitudinal U-Flourish Well-Being Survey data from a comparison sample of non-course takers over the same period (2021–2024). Linear mixed-effects models examined associations between course participation and 12-week changes in mental health literacy, psychosocial risk factors, well-being and common mental health concerns.
Results
Pre–post course survey data (N = 2884) supported high acceptability, improvements in resilience (+0.06; 95% CI 0.03–0.08, p < 0.001) and self-compassion (+0.65; 95% CI 0.46–0.84, p < 0.001), and a reduction in brooding (−0.31; 95% CI −0.44 to−0.18, p < 0.001). Taking the course was associated with a reduction in anxiety (β = −0.41; 95% CI −0.55 to −0.27, p < 0.001) and cannabis use (proportional odds ratio 0.82; 95% CI 0.75–0.90, p < 0.001), improvement in sleep quality (β = 0.79; 95% CI 0.61–0.97, p < 0.001) and evidence of a protective effect on well-being (β = 0.24; 95% CI 0.11–0.36, p < 0.001) and depressive symptoms (β = −0.37; 95% CI −0.52 to −0.21, p < 0.001), compared with non-course takers. Effects differed by gender, with women benefitting most, but were comparable across minoritised student subgroups.
Conclusions
Mental health literacy delivered as an accredited undergraduate interdisciplinary course is highly acceptable and associated with improvement in psychological coping and positive effects on student mental health and well-being. Future research should focus on more diverse student samples, underlying mechanisms and sustained effects.
Considerable effort has been devoted to investigate the neuroimaging correlates and predictors of antidepressant response to ketamine, yet inconsistency in the location and nature of the regional brain effects makes it difficult to unify this research. Despite the revolutionary notion that psychiatric therapeutics show network-level brain representations, investigations into network localization of brain functional effects of ketamine treatment are still lacking.
Methods
We initially identified the locations of longitudinal brain functional alterations (increase and decrease separately) induced by ketamine treatment from 16 published studies with 508 depressed patients. By integrating these affected brain locations with large-scale functional MRI datasets from 1113 healthy and 255 depressed individuals, we then leveraged a novel functional connectivity network mapping approach to construct ketamine-induced hyper-functional and hypo-functional networks respectively.
Results
The hyper-functional network mainly involved the subcortical (caudate nucleus and thalamus) and default (medial prefrontal cortex) networks, while its hypo-functional counterpart predominantly implicated the limbic (temporal pole), subcortical (hippocampus and amygdala), and default (lateral temporal cortex) networks.
Conclusion
Our findings may shed light on the neurobiological effects of ketamine from a network perspective, which might represent a crucial step toward fostering the clinical application of ketamine in antidepressant treatment.
Randomized controlled trials (RCTs) of the Collaborative Care Model demonstrate strong evidence for effectively managing depression in a stepped-care approach across diverse patient populations. Despite alignment with the American Society of Clinical Oncology guidelines, which recommend a stepped-care approach for managing depression and anxiety in cancer patients, implementation of collaborative care in cancer centers remains limited and sparse real-world data exist. The Supportive Oncology Collaborative, a program integrating behavioral health and palliative care, was developed at an NCI-designated academic cancer center. This study aims to evaluate depression outcomes within this collaborative care program.
Methods
A retrospective analysis was conducted on patients with at least 2 Patient Health Questionnaire-9 (PHQ-9) scores recorded within a 12-month period between January 2022 and December 2023 at 1 regional campus. Depression response, defined as a 50% reduction in PHQ-9 scores, was assessed at 12 and 24 weeks. Response rates were compared to those reported in RCTs of collaborative care.
Results
Mean PHQ-9 scores were 17.3 at baseline (n = 47), 11.1 at 12 weeks (n = 43), and 10.1 at 24 weeks (n = 22). Depression response rates were 34.9% at 12 weeks (n = 43) and 54.5% at 24 weeks (n = 22).
Significance of results
We observed depression response rates comparable to those reported in RCTs of collaborative care in individuals with cancer. However, the high proportion of missing data highlights the difficulty of tracking outcomes in real-world clinical settings and the need for further evaluation and strategies to improve data completeness.
Irritable bowel syndrome (IBS) commonly co-occurs with psychological distress, including depression and anxiety, but the temporal and bidirectional nature of this relationship remains unclear. Dysregulation of the gut–brain–microbiota axis has been proposed as a shared mechanism.
Methods
We conducted two retrospective, population-based cohort studies using Taiwan’s National Health Insurance Research Database (2000–2015). Cohort 1 assessed the risk of incident IBS among patients with newly diagnosed depression or anxiety, while Cohort 2 evaluated the risk of subsequent depression or anxiety among patients with newly diagnosed IBS. Propensity score matching, multivariable Cox regression, and Fine–Gray competing risk models were applied.
Results
IBS was associated with increased risks of depression (adjusted hazard ratio [aHR] = 1.55) and anxiety (aHR = 1.68). Conversely, depression and anxiety were associated with higher risks of developing IBS (aHR = 1.45 and 1.51, respectively). Associations were stronger among females and younger adults aged 18–39 years. Sleep disorders (SDs) showed the strongest modifying effect in both directions (sub-distribution HR ≈ 1.60). Results were consistent across sensitivity analyses.
Conclusions
This nationwide longitudinal study demonstrates a robust bidirectional association between IBS and psychological distress, supporting integrated screening and multidisciplinary care approaches targeting gut–brain interactions.
Depression affects over 280 million people worldwide. Long-chain n-3 fatty acids may relate to depression, but observational evidence is inconsistent. This cross-sectional analysis of the National Health and Nutrition Examination Survey 2021–2023 examined the association between dietary long-chain n-3 intake and depression severity in USA adults ≥ 18 years with complete dietary, Patient Health Questionnaire-9 (PHQ-9) and covariate data (n 3608). PHQ-9 severity categories (0–4 to 20–27) served as the main outcome. Total n-3 (α-linolenic acid (ALA), EPA, DPA and DHA) from 24-h recalls (Food and Nutrient Database for Dietary Studies 2021–2023) served as the exposure; supplements were excluded, and supplement use was a binary covariate. Survey-weighted ordinal logistic regression (svyolr) was used with all continuous variables centred/scaled (OR per 1 sd). Covariates included age, sex, race/ethnicity (collapsed for sparse cells), income:poverty ratio, BMI, smoking, alcohol, physical activity and n-3 supplement use. Higher total n-3 intake was inversely associated with depression severity (OR 0·865 per 1 sd, 95 % CI 0·761, 0·983, P = 0·026). EPA showed a significant inverse association (OR 0·907, 95 % CI 0·824, 0·998, P = 0·045); ALA, DPA and DHA were NS. No interaction by sex (P = 0·656) or race/ethnicity (P = 0·155). Sensitivity analyses: excluding supplement users (n 3093) OR 0·872 (95 % CI 0·773, 0·984, P = 0·026); two recalls only (n 3229) OR 0·847 (95 % CI 0·751, 0·955, P = 0·007). Dietary n-3 intake, particularly EPA, was modestly and inversely associated with depression severity. Residual confounding and reverse causation remain possible; longitudinal studies with biomarkers are needed.
Suicidal ideation following trauma exposure is frequently associated with depressive and post-traumatic stress disorder (PTSD) symptoms; however, the interactive effects of depression and distinct PTSD symptom clusters on suicidal ideation remain poorly understood.
Aims
To examine whether specific PTSD symptom clusters – namely intrusion, avoidance and hyperarousal – moderate the association between depressive symptoms and suicidal ideation, and whether these effects vary across different trauma types.
Method
Medical records of 127 psychiatric out-patients with a history of at least one traumatic event were analysed. All participants had completed the Hamilton Rating Scale for Depression, the Impact of Event Scale-Revised, and the suicidal ideation item of the Beck Depression Inventory II. Trauma types were categorised into early versus late, single versus multiple, and interpersonal versus non-interpersonal.
Results
Hierarchical regression analyses identified a significant moderating effect of avoidance symptoms on the relationship between depression and suicidal ideation (β = 0.19, P = 0.012), whereas intrusion and hyperarousal symptoms did not show such effects. Specifically, higher levels of avoidance were associated with a stronger positive relationship between depression and suicidal ideation. This moderating effect was observed only among individuals with late (β = 0.28, P = 0.002), single (β = 0.29, P = 0.002) or non-interpersonal trauma (β = 0.34, P = 0.018); it was not evident among those with early, multiple or interpersonal trauma.
Conclusions
These findings underscore the relevance of targeting avoidance symptoms to mitigate suicidal ideation, particularly in individuals with late-onset, single-incident or non-interpersonal trauma exposure. Exposure-based therapeutic interventions may offer particular benefit for reducing suicidal ideation among trauma-exposed individuals with depressive symptoms.
Depression is a common comorbidity in neuropsychiatric disorders, affecting a significant proportion of patients with neurodegenerative diseases. Traditional antidepressants show limited efficacy, particularly in cases involving comorbid depressive symptoms, highlighting the need for alternative treatments.
Methods
Here we provide the first data on possible benefits of add-on therapy with transcranial pulse stimulation (TPS). Based on the largest patient sample in the emerging field of focused ultrasound (FUS) neuromodulation to date, a retrospective analysis was conducted on 88 patients with various neuropsychiatric diagnoses to evaluate the impact of TPS on depressive symptoms, measured by the Beck Depression Inventory (BDI-II).
Results
The study revealed significant improvements in BDI-II scores posttreatment (N = 88), with the most substantial effects observed in more severely impacted patients: individuals with minimal to severe depression (BDI-II ≥9; N = 32) experienced an average reduction of 5.22 points (29.46%), while those with mild to severe depression (BDI-II ≥14; N = 15) showed an even greater mean improvement of 10.40 points (40.51%). These results surpassed established thresholds for clinical relevance and substantially exceeded placebo effect sizes observed in relevant brain stimulation studies. Moreover, depression score improvement was independent of diagnostic group (dementia, movement disorders, or other), improvement of the primary diagnosis, antidepressant medication, and baseline cognitive status, highlighting the potential of TPS as an effective therapeutic add-on intervention for patients receiving state-of-the-art treatments.
Conclusions
The study’s findings indicate that TPS enhances depression outcomes in neuropsychiatric patients, particularly in those with more severe depressive symptoms.
Hepatocellular carcinoma (HCC) is associated with high mortality and imposes substantial symptom and psychological burdens; however, the impact of different treatment modalities on quality of life (QoL) and mental health remains underexplored. This study aimed to examine the associations among symptom distress, depression, and QoL across various HCC treatments.
Methods
A cross-sectional study was conducted with 101 inpatients at a regional hospital in Taiwan (October 2020–December 2021). Patients received hepatic resection (HR), radiofrequency ablation (RFA), transarterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC), or immunotherapy (IT). Data were collected using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30), the Hospital Anxiety and Depression Scale (HADS), and the Brief Symptom Rating Scale (BSRS).
Results
RFA patients reported better functional scores (96.13 ± 7.55) and lower HADS scores (18.31 ± 4.92) than those treated with TACE, HAIC, or IT (function: 87.77 ± 17.77; HADS: 23.26 ± 7.66). These differences may reflect earlier disease stage and better baseline health in RFA recipients. Older age and advanced stage were associated with poorer global health (p < 0.05), while female gender (β = − 7.38, p = 0.014) and disease recurrence (β = − 6.48, p = 0.019) were associated with lower functional status.
Significance of results
Treatment type, disease stage, and demographics significantly shape QoL and mental health in HCC patients. Minimally invasive therapies like RFA may preserve QoL in early-stage disease, while invasive or palliative treatments necessitate greater psychosocial support.