Exploratory study of the association between blood immune markers and clinical symptoms in adolescent depression: Stratified by body mass index.

Association between systemic inflammation response index and depression in U.S. adults

Inflammatory dysregulation has been implicated in depression; however, the association between the systemic inflammation response index (SIRI), a composite inflammatory marker derived from peripheral neutrophil, monocyte, and lymphocyte counts, and depression in the general adult population remains unclear. This study aimed to examine the association between SIRI and depression among adults from the National Health and Nutrition Examination Survey 2005 to 2016. This cross-sectional study included 24,188 adults with available data on the Patient Health Questionnaire-9 (PHQ-9), blood cell counts, and relevant covariates. SIRI was calculated as neutrophil count × monocyte count/lymphocyte count. Depression was assessed using the PHQ-9, with a score ≥10 indicating clinically relevant depressive symptoms. Multivariable logistic regression, restricted cubic spline analysis, threshold effect analysis, and receiver operating characteristic curve analysis were performed to evaluate the association, nonlinear relationship, and incremental discriminatory value of SIRI. Among 24,188 participants, 2055 (8.50%) had clinically relevant depressive symptoms. Higher SIRI was associated with increased odds of depression after multivariable adjustment (odds ratio = 1.07, 95% confidence interval: 1.02–1.13, P = .004). Compared with the lowest quartile, participants in the highest SIRI quartile had higher odds of depression (odds ratio = 1.26, 95% confidence interval: 1.10–1.44, P < .001). Restricted cubic spline analysis demonstrated a significant nonlinear association between SIRI and depression (P for nonlinear = .007). Threshold analysis identified an inflection point at approximately 2.58, below which higher SIRI was associated with increased odds of depression, whereas the association plateaued thereafter. Adding SIRI to the basic model slightly improved discrimination (area under the curve: 0.716 vs 0.725). Higher SIRI levels were associated with higher odds of clinically relevant depressive symptoms among adults from the National Health and Nutrition Examination Survey 2005 to 2016, with a nonlinear dose-response pattern. Given the modest effect size and limited improvement in discrimination, SIRI should be interpreted as an auxiliary peripheral inflammatory marker rather than a standalone screening or diagnostic tool. Further prospective studies are required to clarify causality and clinical relevance.

Associations Between Anxiety, Depression, and Disease Activity in Newly Diagnosed Patients with Inflammatory Bowel Disease: A Prospective Cohort Study

Background/Objectives: Psychological distress, including symptoms of anxiety and depression, is common among individuals with inflammatory bowel disease (IBD) and may adversely affect well-being and disease management. However, routine assessment of mental health is not consistently integrated into clinical care. This study assessed the prevalence of anxiety and depression among patients newly diagnosed with IBD at diagnosis and after three months of treatment and explored associations between psychological symptoms, disease activity, and clinical characteristics. Methods: This prospective cohort study included 304 adults newly diagnosed with IBD and treated at Stavanger University Hospital between 2012 and 2019. Symptoms of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale at baseline and after three months. Disease activity was evaluated using the Harvey–Bradshaw Index and Partial Mayo Score. Clinical variables included C-reactive protein, faecal calprotectin, folate, cobalamin, and body mass index. Multivariable regression analyses were conducted to identify factors associated with psychological symptoms. Results: The prevalence of anxiety decreased from 29.8% at diagnosis to 21.6% after three months, while the prevalence of combined anxiety and depression declined from 22.2% to 16.3%. The prevalence of depression alone remained stable over time. Higher disease activity, particularly as measured by the Harvey–Bradshaw Index, showed the strongest association with anxiety and depressive symptoms. However, after adjustment for potential confounders, no significant improvement in psychological symptoms was observed, suggesting that the association between time and HADS scores may be explained by changes in one or more measured covariates. Conclusions: Psychological symptoms remained common during the first months following an IBD diagnosis and were closely associated with disease activity. Medical treatment alone was insufficient to achieve meaningful improvements in mental health outcomes. These findings highlight the importance of systematic psychological assessment, early identification of emotional distress, and integrated multidisciplinary care, including nursing-led screening and supportive interventions, for individuals newly diagnosed with IBD.

Exploratory analysis of the relationships of sleep disorders, emotional symptoms and blood inflammatory markers with suicidal ideation in major depressive disorder.

BACKGROUND Suicidal ideation (SI) represents a severe consequence of major depressive disorder (MDD). While sleep disorders and immune dysregulation are associated with SI, the precise associations and complex mediating pathways involving sleep disturbances, inflammatory biomarkers, and anxiety and depression severity remain poorly understood. METHODS A total of 157 patients suffering from MDD were enrolled. Based on Item 3 of the 17-item Hamilton Depression Rating Scale (HAMD), participants were categorized into SI and non-suicidal ideation (NSI) groups. Sleep disorders were assessed using the Pittsburgh Sleep Quality Index (PSQI). Peripheral inflammatory markers were from complete blood counts. Spearman correlation analysis and multiple logistic regression methods were employed to analyze the associations of sleep disorders, emotional symptoms, and inflammatory markers with SI. Additionally, a bidirectional mediation analysis was conducted to explore the association of these variables with SI. RESULTS Patients with SI exhibited poorer sleep quality and altered inflammatory profiles. Significant correlations were observed among affective symptoms, sleep measures, and immune markers. The results showed that in models excluding emotional symptoms, the global PSQI score and sleep disturbances component were associated with SI. Mediation analysis indicates that the percentage of lymphocytes was indirectly associated with SI via the sleep disturbances and daytime dysfunction components. The daytime dysfunction component and HAMA score were associated with SI through bidirectional mediating pathways. CONCLUSIONS Sleep disorders, inflammatory dysregulation, and anxiety symptoms constitute an interconnected network associated with SI in MDD. These findings highlight the importance of comprehensive, integrated interventions.

Immune disturbances cluster around specific depressive phenotypes under conditions of structural adversity

Serum Ferritin and Vitamin B12 as Indicators of Mood Symptom Severity in Adult Women: Findings from a Cross-Sectional Study

Depressive mood disorders are highly prevalent among adult women and are influenced by nutritional, inflammatory, and neuroendocrine factors. Biomarkers including ferritin, vitamin B12, serotonin, cortisol, Creactive protein (CRP), and malondialdehyde (MDA) are important for neurotransmitter production, stress regulation, and brain function. This study investigated the relationship between micronutrient levels, oxidative stress markers, and severity of depressive symptoms in adult females. A cross-sectional study was conducted during the period between January 2022 and December 2024 on 125 women aged 18–45 years attending an outpatient clinic. Depression severity was assessed using the Beck Depression Inventory-II (BDI-II) and Hamilton Depression Rating Scale (HAM-D). Fasting blood samples were analyzed for serum ferritin, vitamin B12, total iron-binding capacity (TIBC), serotonin, cortisol, CRP, and MDA using immunoassay methods. Participants were grouped according to symptom severity. Statistical analyses included ANOVA, Pearson correlation, and logistic regression. Severe depressive symptoms were associated with significantly reduced ferritin, vitamin B12, and serotonin levels, along with elevated TIBC, cortisol, CRP, and MDA levels (p < 0.05). Ferritin and vitamin B12 showed negative correlations with depression scores, whereas cortisol and inflammatory markers showed positive correlations. Logistic regression identified ferritin, vitamin B12, TIBC, and cortisol as significant predictors of depression severity. Depression severity is closely linked to micronutrient imbalance, oxidative stress, and neuroendocrine dysfunction. Combined biomarker evaluation may aid diagnosis and therapeutic monitoring in women with depressive disorders.

The relationship between dietary nutrient intake and adolescent depression based on the dietary inflammation index: a case-control study

The global increase in adolescent Major Depressive Disorder (MDD) has profound implications for physical and mental development, contributing to a significant societal burden. Emerging evidence suggests that low-grade chronic inflammation, commonly observed in adolescents with MDD, is associated with the severity of the disorder. This study explores the relationship among dietary inflammation, dietary nutrients and adolescent depression, utilizing data from the Energy-adjusted Dietary Inflammatory Index (E-DII) in a population from northern China. A case-control study was conducted between March 2022 and October 2023, involving 172 treatment-naïve adolescents aged 10–23 years diagnosed with MDD and 172 age- and sex-matched healthy controls. Although the calculated minimum sample size was 174 per group, two matched pairs were excluded during data cleaning because extreme dietary reporting could have biased nutrient intake estimation. The E-DII was derived using data from a validated semi-quantitative Chinese food frequency questionnaire (FFQ). Logistic regression was employed to evaluate the association between E-DII and the risk of adolescent MDD, while restricted cubic spline (RCS) functions assessed the dose-response relationships between specific dietary nutrient intakes and MDD. A positive association was identified between the E-DII and the risk of adolescent MDD (OR = 3.24; 95% CI: 2.32–4.51; P  < 0.001), which persisted after adjusting for potential confounders (OR = 3.23; 95% CI: 2.22–4.69; P  < 0.001). Although an increase in E-DII score correlated with higher HAMD scores, intra-group differences were not statistically significant ( P  = 0.159). Several dietary nutrients, including Vitamin B12, dietary fiber, zinc, polyunsaturated fatty acids (PUFA), folate, and anthocyanins, were negatively associated with the risk of MDD in adolescents, whereas carbohydrates, selenium, and alcohol intake were positively associated with MDD risk (all P  < 0.05). RCS analysis showed nonlinear dose–response relationships for PUFA, anthocyanins, vitamin B12, and alcohol intake, whereas selenium, zinc, folate, carbohydrates, and dietary fiber showed linear associations with MDD risk. This study underscores a positive correlation between the E-DII and both the risk and severity of adolescent depression, emphasizing the critical role of dietary factors in the prevention and management of adolescent depression. From a clinical and public health perspective, early dietary assessment and promotion of anti-inflammatory dietary patterns may provide a feasible adjunctive strategy for reducing depression risk in adolescents.