Delays in diagnosis and treatment of depressive disorder among young adults: A national online survey-based cross-sectional study

by Rena Xu, David Pletta, Caitlynn Feng, Cassandra Morrow, Maya C. Clark, Badar Omar, Alex S. Keuroghlian, Sari L. Reisner

Background

Depression is highly prevalent among U.S. young adults and associated with long-term functional impairment and increased suicide risk. While delays in diagnosis and treatment of depression are well documented among older adults, the magnitude and predictors of such delays in the younger population are poorly understood.

Objective

To characterize the time to diagnosis and treatment of depressive disorder and predictors of diagnostic and treatment delay among young adults.

Methods

This cross-sectional study used a self-reported survey conducted via the online research platform Prolific in May 2025. Eligible participants were U.S. adults aged 18–35 years with a history of at least one depressive episode. Sociodemographic, clinical, and psychosocial characteristics, including age of depressive symptom onset, degree of social support, and frequency of social group engagement, were assessed. Primary outcomes were probability of not receiving a depressive disorder diagnosis despite symptoms, time from symptom onset to diagnosis, probability of not seeking treatment, and time from symptom onset to treatment. Secondary outcomes were perceived treatment effectiveness and current symptom control.

Results

In total, 871 respondents met inclusion criteria. Of those with one or more lifetime depressive episodes, 46.2% reported never receiving a depressive disorder diagnosis. Median time from symptom onset to diagnosis was 3 years (IQR: 0–7). Over a quarter (27.4%) never sought treatment; among those who did, 93.5% received care, but 31.4% experienced a delay of 1–4 years, and 28.8% experienced a delay of 5 + years. Symptom onset in childhood (ages 0–12) or adolescence (ages 13–17) was associated with longer time to diagnosis and treatment and lower perceived treatment effectiveness. Greater social support was associated with shorter time to diagnosis; lower probability of never receiving a diagnosis, never seeking treatment, or experiencing prolonged treatment delay; and higher perceived treatment effectiveness and current symptom control. Frequent engagement in social groups was also associated with greater perceived treatment effectiveness.

Conclusions

Among U.S. young adults, prolonged delays in depression diagnosis and treatment are common. Early symptom onset is associated with longer delays and worse outcomes, whereas greater social support is associated with shorter delays and more favorable outcomes. These findings highlight the need for further research to clarify causal mechanisms and for interventions to promote timely diagnosis and treatment among young adults at risk for depression.

Genetic association and computational analysis of <i>CYP2R1</i> gene polymorphisms rs2060793 and rs12794714 with vitamin D deficiency and acute myocardial infarction in the Bangladeshi population: A case control study

by Sadia Akter, Md. Nazid Bin Ibrahim, Zimam Mahmud, Sonia Tamanna, Md. Shakhawat Hossain Shawon, Farzana Ansari, Md. Zakir Hossain Howlader

Acute myocardial infarction (AMI) remains a leading cause of cardiovascular morbidity and mortality worldwide. Emerging evidence highlights vitamin D as a critical determinant of cardiovascular health. The CYP2R1 gene encodes the key 25-hydroxylase enzyme responsible for converting vitamin D to its principal circulating metabolite, 25-hydroxyvitamin D. However, the influence of CYP2R1 polymorphisms on AMI susceptibility, particularly within South Asian populations, has not been well characterized. This study investigates the association of two CYP2R1 variants, rs2060793 and rs12794714, with AMI risk and their relationship with serum vitamin D levels in a Bangladeshi cohort. A total of 502 participants comprising 251 AMI patients and 251 age- and sex-matched controls were analyzed. Genomic DNA was extracted and genotyped using PCR-RFLP, while serum 25-hydroxyvitamin D₃ levels were quantified by HPLC. AMI patients exhibited markedly lower vitamin D concentrations (23.92 ± 0.94 ng/mL) than controls (30.3 ± 0.86 ng/mL; p p = 0.0064). The dominant model (TC + CC vs. TT) further confirmed this relationship (OR = 2.53, 95% CI: 1.39–4.61, p = 0.0016). In contrast, rs12794714 showed no significant association with AMI in this population. Stratified analysis indicated that rs2060793 was significantly linked to AMI in males but not females, while both variants were associated with increased risk in individuals aged ≤60 years, but not in those >60 years. Bioinformatic and molecular docking analyses (RegulomeDB, JASPAR, HADDOCK 2.4, DNAproDB) further demonstrated potential regulatory effects of these variants on CYP2R1 function. Collectively, our findings reveal a novel association between CYP2R1 rs2060793 and vitamin D deficiency with AMI risk in the Bangladeshi population, underscoring the interplay of genetic and metabolic determinants in the molecular pathogenesis of AMI.

Insecticidal and knockdown resistance status of <i>Anopheles gambiae</i> s.l (Diptera: Culicidae) to pyrethroid and organophosphate insecticides in Osun State, Nigeria

by Lateef Oluwatoyin Busari, Zarat Oyindamola Iwalewa, Olabanji Ahmed Surakat, Adedapo Olufemi Adeogun, Akinlabi Mohammad Rufai, Kamilu Ayo Fasasi, Monsuru Adebayo Adeleke

Insecticide resistance in malaria vectors remains a global public health problem; however, little is known about resistance levels in Osun State, despite relatively high rates of malaria and distribution of insecticide-treated nets in the area. This study evaluates the resistance status of adult female Anopheles gambiae s.l to pyrethroids (permethrin, deltamethrin and alpha-cypermethrin) and an organophosphate (pirimiphos-methyl) insecticides and knockdown resistant (KDR) gene detection in six locations (Ido-Osun, Ipetumodu, Inisa, Ejigbo, Ijebu-Jesha and Ila) across the three senatorial districts in Osun State, Nigeria. Larval sampling was done between 0700hr and 1100hrs weekly between January and December 2022. Collected larvae were reared to the adult stage in the Department of Animal and Environmental Biology laboratory of Osun State University, Osogbo, Nigeria and then identified morphologically using morphological keys. Insecticide bioassay was conducted with permethrin (0.75%), deltamethrin (0.05%), alpha-cypermethrin (0.05%) and pirimiphos-methyl (0.25%) using WHO procedure. The mosquitoes were subjected to molecular analysis to detect the KDR gene. Pirimiphos-methyl showed significantly higher knockdown at 60 minutes (KD60) and achieved 100% mortality compared with the pyrethroids tested (p Anopheles gambiae s.l as compared to pyrethroids. Therefore, there is a need to intensify insecticide resistance surveillance of Anopheles in Osun State to plan indoor residual spraying with pirimiphos-methyl and explore the use of PBO or dual active ingredient insecticides treated nets (ITNs) to address the potential impacts of pyrethroid resistance.

The effects of increasing dosages of narasin on ruminal fermentation patterns, bacterial community composition, and nutrient digestibility in beef cattle receiving feedlot diets

by Ana Laura Januário Lelis, Leandro Aparecido Ferreira da Silva, Daniel Moretto Casali, Tiago Leiva, Murilo Chuba Rodrigues, José Paulo Roman Barroso, Pedro Veloso Facury Lasmar, Camila Lisboa Tomaz, Anabelle Jorge Barbosa, Camila Cesario Fernandes Sartini, Johnny Maciel de Souza, Danilo Domingues Millen

This study evaluated the effects of increasing narasin doses on ruminal fermentation, nutrient digestibility, ruminal pH stability, papillae histology, and microbial composition in Angus cattle fed feedlot diets. Three rumen-cannulated Angus steers (average body weight: 680 kg) were assigned to a 3 × 3 Latin square design and received diets containing 13, 20, or 27-ppm of narasin. Each experimental period consisted of 14 days of adaptation followed by seven days of sampling. Ruminal degradability was assessed on days 15–17, apparent digestibility on days 15–19, continuous ruminal pH on days 19–20, and samples for short-chain fatty acids (SCFA), microbiota, and ruminal histology were collected on days 20 and 21. Ruminal degradability was not affected by narasin dose. Digestibility of acid detergent fiber (ADF) was significantly influenced, with the greatest values observed at 27-ppm (P = 0.01). Increasing narasin doses improved ruminal pH stability, as indicated by a linear increase in minimum pH (P = 0.01) and a reduction in the duration of pH below 5.6 (P = 0.10). At 13 ppm, SCFA production, particularly acetate and propionate, increased (P P P = 0.02), and butyrate (P P P = 0.03). Narasin supplementation altered ruminal microbial composition, increasing the relative abundance of Lachnospiraceae and Isotricha while reducing lactic acid–producing bacteria. In terms of ruminal morphology, supplementation with 20-ppm of narasin increased the keratin layer thickness of ruminal papillae (P = 0.02), suggesting enhanced epithelial development. Overall, narasin supplementation modulated ruminal function and microbial ecology, with doses between 13 and 20-ppm providing the most favorable balance between fermentative efficiency and ruminal health in feedlot cattle.

Experiences of psychological mistreatment in older adults and promising practices: A scoping review protocol

by Sabrina Lessard, Annie Bernatchez, Houda Garrach, Mélanie Couture, Claire Godard-Sebillotte, Sarita Israel, Rym Zakaria

Objective

This project aims to gain a thoroughly understanding of the characteristics and experiences of psychological mistreatment among older adults, acknowledging the diversity within this population. It also seeks to identify clinical tools and practices for its detection and intervention. While there is extensive literature on mistreatment of older adults, specific studies focusing on psychological aspects and intersecting social and identity dimensions are scarce. The findings will provide valuable insights for policymakers and healthcare professionals, helping to shape interventions and policies aimed at countering mistreatment in the ageing population.

Introduction

Psychological mistreatment involves a range of behaviors, expressions, and gestures—or the lack of appropriate actions—that negatively impact an individual's health and dignity. Often subtle and difficult to detect, this type of mistreatment is prevalent and can coexist with other types of abuse. Examination of psychological mistreatment, shaped by various social and identity dimensions, is lacking in current research, particularly regarding how it is experienced by older adults. This scoping review seeks to map the current knowledge on psychological mistreatment of older adults, while highlighting gaps and future directions for research.

Inclusion criteria

This scoping review will encompass studies that explore the characteristics and experiences of psychological mistreatment among older adults, including their experiences and those of perpetrators and witnesses. It will also identify clinical tools and practices for the detection and intervention of psychological mistreatment in this population.

Method

A scoping review will be undertaken by a multidisciplinary team, examining studies from post-2010, sourced from both bibliographic databases and grey literature, available in English or French. Employing an intersectional framework, the review will use Gender-Based Analysis Plus (GBA+) to examine how different forms of discrimination intersect and shape experiences of mistreatment. That is, this approach will help explore how social and identity dimensions—including gender, age, sexual orientation, ethnicity, socioeconomic status, and health conditions—shape the experiences and manifestations of psychological mistreatment.

Outcome of infants with bronchopulmonary dysplasia

by Dwi Kisworo Setyowireni, Roni Naning, Rina Triasih, Indah Kartika Murni, Madarina Julia, Ekawaty Luthfia Haksari

Background

Bronchopulmonary dysplasia (BDP) is the most common chronic lung disease in infants. The study aimed to evaluate the outcome of infants diagnosed with BPD in Yogyakarta, Indonesia.

Material and methods

A retrospective cohort study was conducted by reviewing the medical records of infants with BPD born between January 2015 and December 2020 at Dr. Sardjito General Hospital in Yogyakarta, Indonesia. Surviving children were invited for clinical assessment and echocardiogram. A multivariate logistic regression analysis was used to identify predictors of mortality.

Results

Among 8,490 newborns hospitalized in the Perinatal ward, 100 (1.2%) developed BPD, with neonatal sepsis and congenital heart disease as the most prevalent comorbidities. Of the 85 infants with complete data, 41 (48.2%) died within 7 months. Multivariate analysis revealed that post-menstrual age (PMA) Conclusions

Nearly half of the infants diagnosed with BPD died within the first seven months of life. PMA

Usability evaluation of the “Teen ‘n Fit” mobile health application: A formative study among Indonesian adolescent girls

by Dwi Sisca Kumala Putri, Kencana Sari, Nur Handayani Utami, Nazarina Nazarina, Tiara Amelia, Nadira Yuthie Salwa, Ning Sulistiyowati, Adindra Vickar Ega, Muhammad Azzumar, Rika Rachmawati, Salimar, Mieska Despitasari, Donny Kristanto Mulyantoro

Background

Mobile Health (mHealth) Applications offer a promising approach to promote the adoption of healthy nutrition and behavior among adolescent girls. A tailored mobile app, Teen ‘n Fit, was developed to support adolescent girls in Indonesia to assess their nutritional status, physical activity, and eating behavior; as a nutrition education media; and as a reminder of iron folic acid consumption. However, it is essential to measure the app’s usability prior to the release.

Objective

This study aimed to measure the usability of a mobile application designed to promote nutrition and healthy behavior of adolescent girls by modifying the mHealth App Usability Questionnaire (MAUQ).

Methods

A cross-sectional usability study was conducted on 64 adolescent girls aged 15–18 from a public high school in Depok, Indonesia. Participants completed app-based tasks and filled out a post-task usability questionnaire. The usability questionnaire was adapted from a validated MAUQ for a standalone mHealth app. The exploratory factor analysis was conducted to determine the items constituting each component in the modified MAUQ. Mann-Whitney analysis was employed to analyze the difference in usability score means based on participants’ characteristics.

Results

The modified MAUQ demonstrated strong reliability (Cronbach’s alpha = 0.945). The app achieves a strong usability score, 6.0 ± 0.8 out of 7, with 79.7 percent of participants reporting no prior mHealth experience. The score among participants who occasionally used mHealth applications was higher (p = 0.046) than those who had never made prior use.

Conclusion

The findings indicate strong usability potential of Teen ‘n Fit as a digital health promotion tool for adolescent girls; however, future efforts in conducting effectiveness tests and maintaining user engagement are needed.