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Mood Disorders: Diagnosis, Management and Future Opportunities
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Mood Disorders: Diagnosis, Management and Future Opportunities

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: 20 October 2025 | Viewed by 12100

Special Issue Editor

Dr. Natalia Lagunas

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Guest Editor
Department of Legal Medicine, Psychiatry and Pathology, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
Interests: behavioral psychology; cognitive neuroscience; mental illness; cognition disorders; sex differences

Special Issue Information

Dear Colleagues,

Over the last decade, the World Health Organization has reported a 13% increase in mental health problems, primarily mood disorders in adolescents and young adults, increasing suicidal thoughts and other suicide-related outcomes. In parallel, there have been important advances in the pharmacology, psychotherapy and neurobiology of mood disorders, improving their diagnosis and treatment.

New perspectives take into account sex differences, comorbidity, risk and protective factors, the transdiagnostic approach, the effects of digital media, and even genomic and epigenetic changes.

This Special Issue aims to expand the information on advances in the diagnosis and treatment of mood disorders, with a special interest in the most recent perspectives.

The topics of interest for publication include, among others, advances in diagnosis and clinical tools, as well as the treatment of these disorders from an integrative, biopsychosocial perspective.

Dr. Natalia Lagunas
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • mood disorders
  • depression
  • anxiety
  • stress, trauma
  • suicide
  • mental health diagnosis and treatment

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Published Papers (9 papers)

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16 pages, 264 KiB  
Article
Assessment of Depressive Symptoms in Patients with Type 1 and Type 2 Diabetes Mellitus and with Diagnosed Prediabetes in Poland: A Cross-Sectional Study
by Mariola Mroz, Dorota Sadowska, Mateusz Zarychta, Grazyna Iwanowicz-Palus, Adam Kretowski and Mateusz Cybulski
J. Clin. Med. 2025, 14(6), 2093; https://doi.org/10.3390/jcm14062093 - 19 Mar 2025
Viewed by 318
Abstract
Background/Objectives: Diabetes mellitus is one of the most common chronic diseases worldwide. In addition to short-term and long-term complications, diabetes has a detrimental effect on the patients’ mood. The main psychiatric disorder occurring among diabetic patients is depression. The rates of depression [...] Read more.
Background/Objectives: Diabetes mellitus is one of the most common chronic diseases worldwide. In addition to short-term and long-term complications, diabetes has a detrimental effect on the patients’ mood. The main psychiatric disorder occurring among diabetic patients is depression. The rates of depression in the developed and developing countries are 15% and 11%, respectively. This study aimed to determine the prevalence of depressive symptoms among patients with type 1 and type 2 diabetes and prediabetes in Poland using the example of the Podlaskie Province and taking into account selected sociodemographic variables. Methods: A total of 874 patients participated in the study, including 448 women (55.8%) and 386 men (44.2%). The study was conducted from July 2022 to July 2023 among the participants of the “Zatrzymaj cukrzycę! Polski Rejestr Diabetologiczny PolRed” (“Stop Diabetes! Polish Diabetes Registry (PolRed)”) project or those hospitalised in the Department of Endocrinology, Diabetology and Internal Medicine at the University Clinical Hospital in Bialystok. The study used a diagnostic survey method using a survey questionnaire developed by the authors and the Beck Depression Inventory (BDI). Results: The highest severity of depressive symptoms according to the Beck Depression Inventory was found in patients with type 2 diabetes (M = 12.18; SD ± 9.48) and the lowest in those with type 1 diabetes (M = 8.11; SD ± 7.55). The assessment of the differences in the severity of depressive symptoms according to the Beck Depression Inventory showed that participants with type 1 diabetes differed statistically significantly (p < 0.001) from those with type 2 diabetes and from those in a prediabetic state. In the group of type 2 diabetes (r = 0.336; p < 0.001) patients and prediabetic state patients (r = 0.231; p < 0.01), there were positive correlations of age with the severity of depressive symptoms. In the group of participants with type 2 diabetes, a statistically significant relationship (p < 0.001) was observed between age and the severity of depressive symptoms. Conclusions: The prevalence of mood disorders in patients with type 1 and type 2 diabetes and diagnosed prediabetes from the Podlaskie Province depends on the type of hyperglycaemic disorder. The prevalence of depressive symptoms among patients with type 1 and type 2 diabetes and prediabetes is determined by specific socio-demographic factors, including, above all, age and gender. The highest severity of a disturbed emotional state according to the Beck Depression Inventory is found in individuals with type 2 diabetes and the lowest in those with type 1 diabetes. Full article
(This article belongs to the Special Issue Mood Disorders: Diagnosis, Management and Future Opportunities)
19 pages, 1150 KiB  
Article
Limited Changes in Red Blood Cell Parameters After Probiotic Supplementation in Depressive Individuals: Insights from a Secondary Analysis of the PRO-DEMET Randomized Controlled Trial
by Agata Gajewska, Adam Wysokiński, Dominik Strzelecki and Oliwia Gawlik-Kotelnicka
J. Clin. Med. 2025, 14(1), 265; https://doi.org/10.3390/jcm14010265 - 5 Jan 2025
Viewed by 1114
Abstract
Background: Depression often coexists with anemia, potentially sharing common pathways, highlighting the need for treatments addressing both conditions simultaneously. This study evaluated the effect of probiotics on red blood cell (RBC) parameters in adults with depressive disorder. We hypothesized that probiotics would [...] Read more.
Background: Depression often coexists with anemia, potentially sharing common pathways, highlighting the need for treatments addressing both conditions simultaneously. This study evaluated the effect of probiotics on red blood cell (RBC) parameters in adults with depressive disorder. We hypothesized that probiotics would positively influence RBC parameters, potentially modulated by baseline inflammation or dietary intake, with improved RBC function correlating with better antidepressant outcomes. Methods: This secondary analysis of a two-arm, randomized, double-blind, controlled trial involved 116 adults with depressive disorder. Participants received a probiotic formulation containing Lactobacillus helveticus Rosell®-52 and Bifidobacterium longum Rosell®-175 or a placebo for 60 days. Data from 97 subjects were analyzed for RBC parameters, including hemoglobin (HGB), RBC count, hematocrit (HCT), mean corpuscular volume (MCV), mean hemoglobin concentration (MCH), mean corpuscular hemoglobin concentration (MCHC), and RBC distribution width (RDW). Results: Probiotic supplementation did not result in significant changes in RBC parameters compared to the placebo. However, probiotics may help stabilize HGB, HCT, MCH, and MCHC levels, potentially preventing fluctuations observed in the placebo group. Conclusions: While probiotics showed potential benefits for depressive symptoms, significant changes in RBC parameters were not observed. Larger studies are needed to clarify the mechanisms and clinical implications. Full article
(This article belongs to the Special Issue Mood Disorders: Diagnosis, Management and Future Opportunities)
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15 pages, 2488 KiB  
Article
Effects of Oral Ingestion of L-Ornithine on Mental Stress and Fatigue Based on the Trier Social Stress Test in Healthy Humans: A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Trial
by Kazuki Moriyasu, Atsushi Nakajima and Masahiko Morita
J. Clin. Med. 2024, 13(24), 7583; https://doi.org/10.3390/jcm13247583 - 13 Dec 2024
Cited by 1 | Viewed by 1575
Abstract
Background: With changes in the social environment typified by COVID-19, an increasing number of people are suffering from mental stress in interpersonal relationships and the resulting fatigue in recent years. L-ornithine oral ingestion reportedly suppresses the secretion of cortisol, a stress marker, through [...] Read more.
Background: With changes in the social environment typified by COVID-19, an increasing number of people are suffering from mental stress in interpersonal relationships and the resulting fatigue in recent years. L-ornithine oral ingestion reportedly suppresses the secretion of cortisol, a stress marker, through the hypothalamic–pituitary–adrenal (HPA) axis. However, there is insufficient research to determine whether L-ornithine exerts an ameliorative effect on social stress. Therefore, in this study, we investigated how L-ornithine affects mental stress and fatigue after social stress in healthy participants. Methods: We randomly assigned 65 participants into two groups, ingesting orally either 1600 mg of L-ornithine or a placebo for 7 days. On the day of the Trier Social Stress Test (TSST), participants took test products one hour before the testing. We evaluated the effects on saliva cortisol and mood states, including fatigue. Results: While L-ornithine did not affect saliva cortisol levels, it significantly improved the fatigue–inertia and anger–hostility scales of the Profile of Mood States on the morning after the TSST in the L-ornithine group compared to the placebo group. Conclusions: In conclusion, L-ornithine could potentially improve interpersonal social-stress-associated fatigue without involving the HPA axis. Trial registration: UMIN Clinical Trials Registry: UMIN000048949. Full article
(This article belongs to the Special Issue Mood Disorders: Diagnosis, Management and Future Opportunities)
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18 pages, 6024 KiB  
Article
Using the Complex Network Model to Associate Nutritional, Psychological, and Physical Parameters and Aspects of Sleep with Depression Symptoms
by Pedro Paulo Menezes Scariot, Ana Luiza Paula Garbuio, Andrea Corazzi Pelosi, Larissa Castro Pedroso, Larissa Albano Hipólito Silva, Stella Antunes Berigo, Ivan Gustavo Masselli dos Reis and Leonardo Henrique Dalcheco Messias
J. Clin. Med. 2024, 13(22), 6743; https://doi.org/10.3390/jcm13226743 - 9 Nov 2024
Cited by 1 | Viewed by 1191
Abstract
Background/Objectives: Major depressive disorder is a significant public health concern linked to factors such as a low-quality diet, a sedentary lifestyle, and poor sleep quality, all of which contribute to its development; nevertheless, the existing literature lacks a comprehensive framework to effectively [...] Read more.
Background/Objectives: Major depressive disorder is a significant public health concern linked to factors such as a low-quality diet, a sedentary lifestyle, and poor sleep quality, all of which contribute to its development; nevertheless, the existing literature lacks a comprehensive framework to effectively integrate these interrelated influences. Methods: To address this gap, we conducted a questionnaire-based study involving 411 individuals aged 18 to 74 and employed a weighted complex network model to clarify the associations among nutritional factors, physical activity levels, psychological parameters, and sleep profiles and depression. In addition to constructing networks that encompass distinct subgroups based on general context, sex differences (female vs. male), and four age categories, our network was designed with a clearly defined target: the score from the Beck Depression Inventory. Results: In all networks studied, psychological parameters (e.g., tension, depression, hostility, fatigue, confusion, and total mood disturbance) emerged as the most influential nodes in relation to the targeted node (Eigenvector centrality of approximately 0.30). Additionally, sleep quality was identified as the next most relevant parameter for the general network (Eigenvector = 0.25), while nutritional factors—particularly carbohydrates—demonstrated greater prestige within the male network (Eigenvector = 0.06). Nutritional parameters had a stronger influence on depressive symptoms among individuals aged 29–39 years (Eigenvectors = 0.09, 0.09, and 0.14 for energy, carbohydrates, and fat, respectively). Conclusions: This novel approach allowed for a clearer visualization of how the studied parameters impact depressive symptoms, revealing significant differences when certain aspects are examined independently across distinct groups. Full article
(This article belongs to the Special Issue Mood Disorders: Diagnosis, Management and Future Opportunities)
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14 pages, 242 KiB  
Article
Opinions of Psychologists in Poland Regarding the Possibility of Prescribing Psychotropic Drugs—A Cross-Sectional Study
by Jolanta Banasiewicz, Hanna Rozenek, Monika Kos y Gonzales, Stanisław Wójtowicz and Kornelia Zaręba
J. Clin. Med. 2024, 13(21), 6560; https://doi.org/10.3390/jcm13216560 - 31 Oct 2024
Viewed by 1121
Abstract
Background/Objectives: Discussions about the possibility of psychologists prescribing medications have been ongoing for several years. The study aims to ascertain the opinion of the Polish professional community of psychologists on the right of psychologists to prescribe psychotropic drugs. Methods: The study [...] Read more.
Background/Objectives: Discussions about the possibility of psychologists prescribing medications have been ongoing for several years. The study aims to ascertain the opinion of the Polish professional community of psychologists on the right of psychologists to prescribe psychotropic drugs. Methods: The study was conducted on online forums (Porozumienie Psychologów) associated with psychologists from all over the world from 15 April 2023 to 30 September 2023. The participants were asked to fill out a Google survey consisting of 26 questions. Results: A total of 677 psychologists participated in the study, including 580 (85.7%) women and 97 (14.3%) men. The majority of the respondents were at the peak of their life activity, between 30 and 50 years of age. A large group of respondents believed that a psychologist should have the right to prescribe psychotropic drugs (46.5%) and declared their participation in activities to promote these rights (52.9%). The vast majority of respondents reported that psychologists authorized to prescribe drugs should complete additional courses as part of the pharmacology specialization (74.8%) and should pass an exam in this field (73.4%) or should complete additional courses in the field of pharmacology (74.8%). Such opinions were much more common in the group with psychological specializations. In this group, more people allowed for such a privilege for those who have completed studies, have documented five years of experience, or have a psychotherapist certificate (p < 0.0001). Conclusions: There may be many societal needs that could be successfully met by psychologists obtaining prescriptive privileges. However, psychologists ought to understand that our obligations need to transcend guild concerns and appropriate qualifications. Full article
(This article belongs to the Special Issue Mood Disorders: Diagnosis, Management and Future Opportunities)
16 pages, 682 KiB  
Article
The Indirect Effect of Future Anxiety on the Relationship between Self-Efficacy and Depression in a Convenience Sample of Adults: Revisiting Social Cognitive Theory
by Marta Szota, Aleksandra M. Rogowska, Aleksandra Kwaśnicka and Karolina Chilicka-Hebel
J. Clin. Med. 2024, 13(16), 4897; https://doi.org/10.3390/jcm13164897 - 19 Aug 2024
Cited by 2 | Viewed by 2580
Abstract
Background/Objectives: Depression and anxiety are prevalent disorders, particularly during emerging adulthood. Uncertainty about the future, exacerbated by unstable times, can lead to heightened future anxiety in this group. This study aimed to examine the complex associations of depression symptoms, future anxiety, and [...] Read more.
Background/Objectives: Depression and anxiety are prevalent disorders, particularly during emerging adulthood. Uncertainty about the future, exacerbated by unstable times, can lead to heightened future anxiety in this group. This study aimed to examine the complex associations of depression symptoms, future anxiety, and self-efficacy in adults from Poland. Additionally, we investigated age and gender differences in depression symptoms, future anxiety, and self-efficacy. Methods: A cross-sectional online survey study was performed in 2023 in Poland using snowball sampling. A convenience sample of 284 adults participated in this study, ranging in age between 18 and 65 years old (M = 32.18, SD = 11.87), including 95 men (33.45%) and 189 (66.55%) women, and also 157 (55.63%) emerging adults (18–28 years old) and 126 (44.37%) middle-aged adults (29–65 years old). The Patient Health Questionnaire (PHQ-9), Dark Future Scale (DFS-5), and Generalized Self-Efficacy Scale (GSES) were used to measure depression, future anxiety, and self-efficacy, respectively. Results: A 2-way ANOVA showed that both emerging adults and women scored significantly higher in depression symptoms and future anxiety than middle-aged adults and men, respectively. Furthermore, women scored lower in self-efficacy than men. Analyses revealed that there was a positive correlation between depression and future anxiety. Self-efficacy was negatively correlated with depression and future anxiety. Self-efficacy and future anxiety accounted for 48% of depression variance, controlling for age and gender. Future anxiety was found to be a partial mediator of the relationship between self-efficacy and depression. Conclusions: This study significantly advances the understanding of mental health in adults, grounded in social cognitive theories, revealing that low self-efficacy heightens future anxiety, thereby exacerbating depression symptoms in the Polish adult population, independent of age and gender. Emerging adults and women need psychological support to reduce depression and future anxiety. Women, in particular, should be the main focus of interventions to boost self-efficacy. Implementing targeted preventive measures and support systems can mitigate the challenges faced by emerging adults and women. Full article
(This article belongs to the Special Issue Mood Disorders: Diagnosis, Management and Future Opportunities)
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17 pages, 1024 KiB  
Review
Postpartum Depression Epidemiology, Risk Factors, Diagnosis, and Management: An Appraisal of the Current Knowledge and Future Perspectives
by Zaituna Khamidullina, Aizada Marat, Svetlana Muratbekova, Nagima M. Mustapayeva, Gulnar N. Chingayeva, Abay M. Shepetov, Syrdankyz S. Ibatova, Milan Terzic and Gulzhanat Aimagambetova
J. Clin. Med. 2025, 14(7), 2418; https://doi.org/10.3390/jcm14072418 - 1 Apr 2025
Viewed by 1266
Abstract
Postpartum depression (PPD) is a severe mental health condition that affects women following childbirth and is marked by persistent sadness, anxiety, fatigue, and difficulty functioning. Unlike the temporary “baby blues”, PPD is more severe and long-lasting, potentially leading to negative consequences for mother [...] Read more.
Postpartum depression (PPD) is a severe mental health condition that affects women following childbirth and is marked by persistent sadness, anxiety, fatigue, and difficulty functioning. Unlike the temporary “baby blues”, PPD is more severe and long-lasting, potentially leading to negative consequences for mother and child. Globally, PPD impacts approximately 10–20% of postpartum women, with prevalence influenced by genetic, hormonal, psychological, and socio-environmental factors. Early detection is crucial, with screening tools such as the Edinburgh Postnatal Depression Scale (EPDS) commonly used in clinical practice. Treatment options include pharmacological interventions such as selective serotonin reuptake inhibitors (SSRIs), psychological therapies like cognitive behavioral therapy (CBT) and interpersonal therapy (IPT), and lifestyle modifications. Despite the growing awareness of PPD, stigma remains a significant barrier to treatment, discouraging many women from seeking help. In low-income countries, where mental health care is often underfunded, accessing professionals trained in perinatal mental health presents an even greater challenge. This gap underscores the urgent need for a collaborative, multidisciplinary approach involving obstetricians, psychiatrists, pediatricians, and midwives to ensure comprehensive support and care for affected individuals. Full article
(This article belongs to the Special Issue Mood Disorders: Diagnosis, Management and Future Opportunities)
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14 pages, 1142 KiB  
Project Report
A Dimensional Diagnostic Strategy for Depressive Disorders
by Scott B. Patten
J. Clin. Med. 2025, 14(3), 844; https://doi.org/10.3390/jcm14030844 - 27 Jan 2025
Viewed by 983
Abstract
Background/Objectives: Depressive disorders are diagnosed using categorical definitions provided by DSM-5 and ICD-11. However, categorization for diagnostic purposes fails to account for the inherently dimensional nature of depression. Artificial categorization may impede research and obstruct the achievement of optimal treatment outcomes. Methods: The [...] Read more.
Background/Objectives: Depressive disorders are diagnosed using categorical definitions provided by DSM-5 and ICD-11. However, categorization for diagnostic purposes fails to account for the inherently dimensional nature of depression. Artificial categorization may impede research and obstruct the achievement of optimal treatment outcomes. Methods: The current study utilized a Canadian historical dataset called the National Population Health Survey (NPHS) to explore a simple alternative approach that does not depend on categorization. The NPHS collected complete data from 5029 participants through biannual interviews conducted in 1994–2010. Data collection included the K6 Distress Scale as well as the Composite International Diagnostic Interview Short Form for Major Depression. Data from the National Population Health Survey (NPHS) were used to quantify vulnerability to depressive symptoms through longitudinal K6 Distress Scale assessments. Variability of symptoms across this dimension of apparent vulnerability was quantified using ordinal regression, adjusting for age and sex. Results: Predicted probabilities from these models were used in simulations to produce a visualization of the epidemiology and to explore clinical implications. Conclusions: Consideration of these two dimensional factors (estimated overall level of vulnerability to depression and variability over time) is already a component of clinical assessment and is also accessible to repeated measurement in settings adopting measurement-based care. More formal consideration of these elements may provide a complementary approach to categorical diagnostic assessment and an opportunity for greater personalization of care and improved clinical outcomes. Future studies should validate these findings in diverse clinical settings to ensure their applicability in real-world contexts. Full article
(This article belongs to the Special Issue Mood Disorders: Diagnosis, Management and Future Opportunities)
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13 pages, 325 KiB  
Protocol
Prenatal Telepsychological Intervention for Preventing Anxiety: A Study Protocol
by Alba Val and M. Carmen Míguez
J. Clin. Med. 2024, 13(19), 5877; https://doi.org/10.3390/jcm13195877 - 2 Oct 2024
Viewed by 1074
Abstract
Background: Anxiety is one of the most frequent disorders during the perinatal stage that is associated with adverse health effects in women and their babies. In spite of this, preventive interventions during this stage are scarce. A long-distance intervention carried out during pregnancy [...] Read more.
Background: Anxiety is one of the most frequent disorders during the perinatal stage that is associated with adverse health effects in women and their babies. In spite of this, preventive interventions during this stage are scarce. A long-distance intervention carried out during pregnancy can be an effective and accessible resource to help improve women’s emotional state. The objective of this study is to present and assess the effectiveness of a telepsychology cognitive–behavioral preventive intervention during pregnancy to manage anxiety. Methods: A random clinical trial will be carried out among pregnant women in Spain. The psychological intervention will take place via videoconference in seven weekly sessions, lasting one hour each, with groups of 6–8 pregnant women. Study outcomes will be collected via online questionnaires at five points in time: pre-intervention (baseline: t0), post-intervention (baseline: t1), follow-up at 1 month (t2), follow-up at 3 months (t3) and follow-up at 6 months (t4). The control group will receive usual pregnancy care (attendance at pregnancy follow-up consultations and information and answers to frequently asked questions provided by the midwife). Our primary hypothesis is that the intervention will decrease the frequency of women who present anxious symptomatology during pregnancy. The second objective is to analyze the effectiveness of this intervention to prevent depressive symptomatology during pregnancy, as well as postpartum anxiety and depressive symptomatology. The primary outcome measure is the difference in the mean anxiety score between the intervention and control groups assessed by the Edinburgh Depression Scale-Anxiety Subscale (EDS-3A), the State–Trait Anxiety Inventory (STAI) and Generalized Anxiety Disorder Screener (GAD-7) at the end of the intervention and at 1, 3 and 6 months postpartum. Generalized anxiety disorder (GAD) will be evaluated with the SCID clinical interview at the same time points. The secondary outcome will be determined by using the EPDS at the same time points. Conclusions: The results will determine whether a cognitive behavioral therapy applied via videoconference is well accepted by pregnant women, and if it is effective in preventing anxiety and emotional symptoms during the perinatal stage. If this intervention is an effective and useful resource among pregnant women, it can be implemented as a tool in Spanish healthcare. Full article
(This article belongs to the Special Issue Mood Disorders: Diagnosis, Management and Future Opportunities)
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