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18 pages, 371 KB  
Article
Sleep-Related Factors in Shift Workers: A Cross-Sectional Cohort Pilot Study to Inform Online Group Therapy for Insomnia
by Tanja Grünberger, Christopher Höhn, Manuel Schabus and Anton-Rupert Laireiter
Int. J. Environ. Res. Public Health 2025, 22(11), 1681; https://doi.org/10.3390/ijerph22111681 - 6 Nov 2025
Viewed by 324
Abstract
Shift workers face a heightened risk of insomnia. Recent research has yielded promising insights, but further progress is necessary to better treat insomnia in this group. The present pilot study evaluates how different characteristics impact sleep in shift workers to develop an innovative [...] Read more.
Shift workers face a heightened risk of insomnia. Recent research has yielded promising insights, but further progress is necessary to better treat insomnia in this group. The present pilot study evaluates how different characteristics impact sleep in shift workers to develop an innovative therapeutic approach. An online survey was administered to an ad hoc sample of N = 225 (112 shift workers), and correlations were calculated between sleep variables and specific characteristics (e.g., psychological impairment, personality traits, sleep-related behavior, attitudes towards sleep and shift work). Group differences between good/poor sleepers and day/shift work were determined using Mann–Whitney U-tests and Kruskal–Wallis H-tests. Regression was used to identify appropriate predictors. All factors (except perfectionism, chronotype, and importance of sleep) yielded significant results in both correlations and group differences (good/poor sleepers). The two groups of day/shift workers showed only minor differences. Dysfunctional beliefs about sleep, pre-sleep arousal, and depression were identified as predictors of poorer sleep. We conclude that interventions on psychological constraints (anxiety and depression), personality traits (anxiety, concern, emotional instability, and tension), social integration, sleep-related factors (dysfunctional beliefs, especially cognitive pre-sleep-arousal, sleep hygiene) and the attitude toward shiftwork, can replace those on regularity and will build an innovative therapy for shift workers on this basis. Once the newly developed treatment manual is finalized, its efficacy will be assessed through a randomized controlled trial. Full article
(This article belongs to the Special Issue Digital Innovations for Health Promotion)
50 pages, 1979 KB  
Review
Circadian Regulation of Neuronal Membrane Capacitance—Mechanisms and Implications for Neural Computation and Behavior
by Agnieszka Nowacka, Maciej Śniegocki, Dominika Bożiłow and Ewa Ziółkowska
Int. J. Mol. Sci. 2025, 26(21), 10766; https://doi.org/10.3390/ijms262110766 - 5 Nov 2025
Viewed by 355
Abstract
Neuronal membrane capacitance (Cm) has traditionally been viewed as a static biophysical property determined solely by the geometric and dielectric characteristics of the lipid bilayer. Recent discoveries have fundamentally challenged this perspective, revealing that Cm exhibits robust circadian oscillations that profoundly influence neural [...] Read more.
Neuronal membrane capacitance (Cm) has traditionally been viewed as a static biophysical property determined solely by the geometric and dielectric characteristics of the lipid bilayer. Recent discoveries have fundamentally challenged this perspective, revealing that Cm exhibits robust circadian oscillations that profoundly influence neural computation and behavior. These rhythmic fluctuations in membrane capacitance are orchestrated by intrinsic cellular clocks through coordinated regulation of molecular processes including transcriptional control of membrane proteins, lipid metabolism, ion channel trafficking, and glial-mediated extracellular matrix remodeling. The dynamic modulation of Cm directly impacts the membrane time constant (τm = RmCm), thereby altering synaptic integration windows, action potential dynamics, and network synchronization across the 24 h cycle. At the computational level, circadian Cm oscillations enable neurons to shift between temporal summation and coincidence detection modes, optimizing information processing according to behavioral demands throughout the day–night cycle. These biophysical rhythms influence critical aspects of cognition including memory consolidation, attention, working memory, and sensory processing. Disruptions in normal Cm rhythmicity are increasingly implicated in neuropsychiatric and neurodegenerative disorders, including depression, schizophrenia, Alzheimer’s disease, and epilepsy, where altered membrane dynamics compromise neural circuit stability and information transfer. The integration of circadian biophysics with chronomedicine offers promising therapeutic avenues, including chronotherapeutic strategies that target membrane properties, personalized interventions based on individual chronotypes, and environmental modifications that restore healthy biophysical rhythms. This review synthesizes evidence from molecular chronobiology, cellular electrophysiology, and systems neuroscience to establish circadian Cm regulation as a fundamental mechanism linking molecular timekeeping to neural computation and behavior. Full article
(This article belongs to the Special Issue The Importance of Molecular Circadian Rhythms in Health and Disease)
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20 pages, 675 KB  
Article
Changes in Anxiety Symptoms and Eating Patterns Among Emerging Adult Students in a Non-Traditional School Program During a Mathematics Examination
by Gustavo A. Hernandez-Fuentes, Laura A. Larios-Gomez, Jessica C. Romero-Michel, Kayim Pineda-Urbina, José M. Flores-Álvarez, Mario A. Corona-Arroyo, Daniel Tiburcio-Jiménez, Karmina Sánchez-Meza, Nomely S. Aurelien-Cabezas, Karen A. Mokay-Ramirez, Karla B. Carrazco-Peña, Alejandro Figueroa-Gutiérrez, Marina Delgado-Machuca and Iván Delgado-Enciso
Healthcare 2025, 13(20), 2600; https://doi.org/10.3390/healthcare13202600 - 15 Oct 2025
Viewed by 382
Abstract
Background/Objectives: The semi-school-based model (SSBM) has gained momentum in Mexico post-COVID-19, providing flexibility for students managing work, family, and academics. However, little is known about how high-stakes academic evaluations affect the emotional well-being and lifestyle habits of students in this alternative setting. This [...] Read more.
Background/Objectives: The semi-school-based model (SSBM) has gained momentum in Mexico post-COVID-19, providing flexibility for students managing work, family, and academics. However, little is known about how high-stakes academic evaluations affect the emotional well-being and lifestyle habits of students in this alternative setting. This study aims to assess two key research questions: (1) Does exposure to a high-stakes academic exam increase anxiety and depression levels in SSBM students? (2) Does exam-related stress affect dietary habits and physiological stress markers in these students? Methods: A prospective, longitudinal, quantitative study was conducted in September 2023 with 94 fourth-term high school students in an SSBM program in Mexico Assessments. Evaluations were conducted at two specific time points; Pre-exam Assessment Day (RCD): ~30–50 min before normal Saturday classes, and Exam-day Assessment (ED): ~30–50 min before the mathematics exam. Data included sociodemographic, HADS scores, dietary habits, and physiological measures (blood pressure, heart rate, oxygen saturation). Analyses were conducted in SPSS v28. Normality was tested using Kolmogorov–Smirnov. Paired continuous and categorical variables were compared with Wilcoxon signed-rank and McNemar’s or Fisher’s exact tests, respectively. Relative risks (RR) and multivariate logistic regression identified factors associated with anxiety and depression. Significance was set at p < 0.05. Results: Anxiety prevalence increased significantly on the exam day (from 22.3% to 59.6%, p < 0.001; RR = 14.281, 95% CI: 2.620–161.296), with no significant change in depression. Wilcoxon tests confirmed higher anxiety scores across both sexes. Systolic and diastolic blood pressure and heart rate increased significantly, particularly among females (p < 0.001), whereas oxygen saturation remained stable. Eating patterns shifted on ED, with higher consumption of fried foods, sweet bread, and sugar-sweetened beverages (p < 0.001), especially among males, and decreased intake of meat protein and vegetables, particularly among females. Meat consumption was significantly associated with increased anxiety (adjusted RR = 3.405; 95% CI: 1.035–11.194; p = 0.044). Conclusions: High-stakes academic exams in SSBM settings are associated with acute increases in anxiety and unhealthy dietary changes, even without significant depressive symptoms. These findings highlight the need for interventions supporting emotional regulation and healthy lifestyle behaviors among students facing academic stress in non-traditional educational environments. Full article
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18 pages, 3052 KB  
Article
Classifying Major Depressive Disorder Using Multimodal MRI Data: A Personalized Federated Algorithm
by Zhipeng Fan, Jingrui Xu, Jianpo Su and Dewen Hu
Brain Sci. 2025, 15(10), 1081; https://doi.org/10.3390/brainsci15101081 - 6 Oct 2025
Viewed by 648
Abstract
Background: Neuroimaging-based diagnostic approaches are of critical importance for the accurate diagnosis and treatment of major depressive disorder (MDD). However, multisite neuroimaging data often exhibit substantial heterogeneity in terms of scanner protocols and population characteristics. Moreover, concerns over data ownership, security, and privacy [...] Read more.
Background: Neuroimaging-based diagnostic approaches are of critical importance for the accurate diagnosis and treatment of major depressive disorder (MDD). However, multisite neuroimaging data often exhibit substantial heterogeneity in terms of scanner protocols and population characteristics. Moreover, concerns over data ownership, security, and privacy make raw MRI datasets from multiple sites inaccessible, posing significant challenges to the development of robust diagnostic models. Federated learning (FL) offers a privacy-preserving solution to facilitate collaborative model training across sites without sharing raw data. Methods: In this study, we propose the personalized Federated Gradient Matching and Contrastive Optimization (pF-GMCO) algorithm to address domain shift and support scalable MDD classification using multimodal MRI. Our method incorporates gradient matching based on cosine similarity to weight contributions from different sites adaptively, contrastive learning to promote client-specific model optimization, and multimodal compact bilinear (MCB) pooling to effectively integrate structural MRI (sMRI) and functional MRI (fMRI) features. Results and Conclusions: Evaluated on the Rest-Meta-MDD dataset with 2293 subjects from 23 sites, pF-GMCO achieved accuracy of 79.07%, demonstrating superior performance and interpretability. This work provides an effective and privacy-aware framework for multisite MDD diagnosis using federated learning. Full article
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13 pages, 1888 KB  
Article
Femtosecond-Laser Direct Writing of Double-Line and Tubular Depressed-Cladding Waveguides in Ultra-Low-Expansion Glass
by Yuhao Wu, Sixuan Guo, Guanghua Cheng, Feiran Wang, Xu Wang and Yunjie Zhang
Photonics 2025, 12(8), 797; https://doi.org/10.3390/photonics12080797 - 8 Aug 2025
Viewed by 2048
Abstract
Addressing the stability requirements of photonic integrated devices operating over wide temperature ranges, this work achieves controlled fabrication of femtosecond-laser direct-written Type II double-line waveguides and Type III depressed-cladding tubular waveguides within ultra-low-expansion LAS glass-ceramics. The light-guiding mechanisms were elucidated through finite element [...] Read more.
Addressing the stability requirements of photonic integrated devices operating over wide temperature ranges, this work achieves controlled fabrication of femtosecond-laser direct-written Type II double-line waveguides and Type III depressed-cladding tubular waveguides within ultra-low-expansion LAS glass-ceramics. The light-guiding mechanisms were elucidated through finite element modeling. The influences of laser writing parameters and waveguide geometric structures on guiding performance were systematically investigated. Experimental results demonstrate that the double-line waveguides exhibit optimal single-mode guiding performance at 30 μm spacing and 120 mW writing power. For the tubular depressed-cladding waveguides, both single-mode and multi-mode fields are attainable across a broad processing parameter window. Large-mode-area characteristics manifested in the 50 μm core waveguide, exhibiting an edge-shifted intensity profile for higher-order modes that generated a hollow beam, enabling applications in atom guidance and particle trapping. Full article
(This article belongs to the Special Issue Direct Ultrafast Laser Writing in Photonics and Optoelectronics)
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12 pages, 306 KB  
Article
Health Problems, Unhealthy Behaviors and Occupational Carcinogens Exposures Among Night Shift Brazilian Workers: Results from National Health Survey, 2019
by Fernanda de Albuquerque Melo Nogueira, Giseli Nogueira Damacena, Ubirani Barros Otero, Débora Cristina de Almeida Mariano Bernardino, Christiane Soares Pereira Madeira, Marcia Sarpa and Celia Landmann Szwarcwald
Int. J. Environ. Res. Public Health 2025, 22(8), 1215; https://doi.org/10.3390/ijerph22081215 - 1 Aug 2025
Viewed by 848
Abstract
Introduction: Night shift work (NSW) has been increasingly addressed in the scientific literature, as it is considered a probable carcinogen. In this study, we investigated the association of NSW with health problems, unhealthy behaviors, and occupational carcinogens. Methods: Cross-sectional study with a sample [...] Read more.
Introduction: Night shift work (NSW) has been increasingly addressed in the scientific literature, as it is considered a probable carcinogen. In this study, we investigated the association of NSW with health problems, unhealthy behaviors, and occupational carcinogens. Methods: Cross-sectional study with a sample of 47,953 workers from the 2019 National Health Survey. NSW prevalence was estimated according to sociodemographic characteristics. To investigate the associations of NSW with all study variables, gender stratified logistic regression models were used. The odds-ratio and 95% confidence intervals were estimated. Results: Among men, there was a significant association of NSW with sleep disorders (OR = 1.39; 95% CI: 1.17–1.65), tiredness (OR = 1.68; 95% CI: 1.41–2.00), obesity (OR = 1.41; 95% CI: 1.20–1.66), unhealthy food consumption (OR = 1.28; 95% CI: 1.12–1.46), handling of radioactive material (OR = 2.45; 95% CI: 1.61–3.72), and biological material (OR = 3.18; 95% CI: 3.15–4.80). Among females, NSW was associated with the same variables except obesity, but depressive feelings (OR = 1.35 95% CI: 1.09–1.67), frequent alcohol intake (OR = 1.48; 95% CI: 1.23–1.78), handling of chemical substances (OR = 1.54; OR = 1.54; 95% CI: 1.20–1.97), and passive smoking at work (OR = 1.45; 95% CI: 1.12–1.86) were highly significant. Conclusion: Night shift workers are more vulnerable to occupational carcinogen exposure, experience greater impacts on their well-being, and are more likely to engage in unhealthy behaviors. These findings should be considered in managing and organizing night work in the workplace. Actions to promote healthy work environments should be encouraged to protect workers’ health. Full article
15 pages, 388 KB  
Article
Nurses’ Best Friend? The Lived Experiences of Nurses Who Utilized Dog Therapy in the Workplace
by Valerie A. Esposito Kubanick and Joy Z. Scharfman
Nurs. Rep. 2025, 15(7), 246; https://doi.org/10.3390/nursrep15070246 - 3 Jul 2025
Viewed by 1579
Abstract
The aim of this work is to explore and understand the lived experience of nurses who chose to schedule visits with an Emotional Support Animal (ESA), i.e., a dog, during their working shift. Background/Objectives: Nursing practice is rigorous, weighted with intense responsibility that [...] Read more.
The aim of this work is to explore and understand the lived experience of nurses who chose to schedule visits with an Emotional Support Animal (ESA), i.e., a dog, during their working shift. Background/Objectives: Nursing practice is rigorous, weighted with intense responsibility that creates an environment conducive to stress and anxiety for the nurses, who have reported a higher level of work stress than other healthcare professionals. Knowing and addressing the factors impacting mental health/nurses’ well-being is crucial to providing care to patients. Stressful work environments result in burnout, compassion fatigue, depression, anxiety, suicide, and resignation. Understanding nurses’ perspectives on work related stress encourages hospitals to structure practices supporting nurses’ mental health and ability to provide quality care. Methods: A qualitative hermeneutic phenomenological approach was employed. Participants scheduled six weekly 10-min visits with Rex, a certified Service Dog for anxiety depression and PTSD, and registered ESA. A sample of 11 RNs participated in Rex visits at the workplace; field notes were taken during observations of visits. Semi-structured 30-min interviews conducted via Zoom, audio-recorded, and transcribed with NVivo were conducted. Results: Data were examined with Interpretative Phenomenological Analysis. Four main themes emerged: Preparing for the unknown, Doing the work, Refueling and resetting-Visits with Rex, What about nurses? Conclusions: This study highlights the need for nurses and hospital systems to incorporate self-care/self-reflection, including time/opportunities for nurses’ stress management during their practice. Knowledge of nurses receiving ESA interventions sheds light on how to protect/preserve the well-being of nurses practicing in this demanding profession. ESAs for nurses in the workplace offers an option to utilize dog therapy to re-energize and continue their shift renewed and refreshed. Full article
(This article belongs to the Section Mental Health Nursing)
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17 pages, 531 KB  
Article
Benzodiazepine Misuse Among Health Care Workers: The Effect of Sleep Disorders on Work Performance
by Carlos Roncero, José Lorenzo Bravo-Grande, Pilar Andrés-Olivera, Marta Peña, Carlos Treceño, Pilar González-Pelaez, Lourdes Aguilar, Diego Remón-Gallo and Armando González-Sánchez
J. Clin. Med. 2025, 14(12), 4266; https://doi.org/10.3390/jcm14124266 - 16 Jun 2025
Viewed by 2057
Abstract
Background: Benzodiazepines (BZDs), commonly used to treat insomnia and anxiety, are increasingly used in Spain, raising concerns due to their potential for abuse and dependence. This study investigates the use of BZDs and other psychotropic medications among healthcare workers, exploring their prevalence, [...] Read more.
Background: Benzodiazepines (BZDs), commonly used to treat insomnia and anxiety, are increasingly used in Spain, raising concerns due to their potential for abuse and dependence. This study investigates the use of BZDs and other psychotropic medications among healthcare workers, exploring their prevalence, associated factors, and their relationship with mental health issues following the COVID-19 pandemic. Methods: An anonymous online survey was conducted among healthcare workers at the Salamanca University Healthcare Complex (CAUSA) from March 2023 to January 2024. Of 1121 participants, 685 provided complete responses, which were analysed. Insomnia, anxiety, and depression were assessed using the Insomnia Severity Index (ISI) and Patient Health Questionnaire-4 (PHQ-4). Results: Of the respondents, 23.8% reported using sleep medication, with 27.8% doing so without a prescription. Additionally, 14.7% used medication for depression or anxiety, with only 0.6% without a prescription. Hypnotic medicine use was associated with older age, insomnia, anxiety, depression, psychological or psychiatric treatment, COVID-19 after-effects, and diagnosed sleep disorders. Night-shift work was associated with increased hypnotic medication use in men but not in women. The use of these medications was linked to a reduced quality of life and impaired work performance. Conclusions: The use of BZD and self-medication are prevalent among healthcare professionals, exceeding the rates observed in the general population. These findings highlight the urgent need for targeted interventions to address psychotropic medication use, promote other pharmacological and non-pharmacological alternatives for insomnia, and enhance mental health support for this vulnerable population. Full article
(This article belongs to the Section Pharmacology)
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27 pages, 2333 KB  
Review
The Ferroptosis–Mitochondrial Axis in Depression: Unraveling the Feedforward Loop of Oxidative Stress, Metabolic Homeostasis Dysregulation, and Neuroinflammation
by Xu Liu, Qiang Luo, Yulong Zhao, Peng Ren, Yu Jin and Junjie Zhou
Antioxidants 2025, 14(5), 613; https://doi.org/10.3390/antiox14050613 - 20 May 2025
Cited by 10 | Viewed by 4029
Abstract
Emerging evidence links ferroptosis–mitochondrial dysregulation to depression pathogenesis through an oxidative stress–energy deficit–neuroinflammation cycle driven by iron overload. This study demonstrates that iron accumulation initiates ferroptosis via Fenton reaction-mediated lipid peroxidation, compromising neuronal membrane integrity and disabling the GPx4 antioxidant system. Concurrent mitochondrial [...] Read more.
Emerging evidence links ferroptosis–mitochondrial dysregulation to depression pathogenesis through an oxidative stress–energy deficit–neuroinflammation cycle driven by iron overload. This study demonstrates that iron accumulation initiates ferroptosis via Fenton reaction-mediated lipid peroxidation, compromising neuronal membrane integrity and disabling the GPx4 antioxidant system. Concurrent mitochondrial complex I/IV dysfunction impairs ATP synthesis, creating an AMPK/mTOR signaling imbalance and calcium dyshomeostasis that synergistically impair synaptic plasticity. Bidirectional crosstalk emerges: lipid peroxidation derivatives oxidize mitochondrial cardiolipin, while mitochondrial ROS overproduction activates ACSL4 to amplify ferroptotic susceptibility, forming a self-reinforcing neurodegenerative loop. Prefrontal–hippocampal metabolomics reveal paradoxical metabolic reprogramming with glycolytic compensation suppressing mitochondrial biogenesis (via PGC-1α/TFAM downregulation), trapping neurons in bioenergetic crisis. Clinical data further show that microglial M1 polarization through cGAS-STING activation sustains neuroinflammation via IL-6/TNF-α release. We propose a “ferroptosis–mitochondrial fragmentation–metabolic maladaptation” triad as mechanistic subtyping criteria for depression. Preclinical validation shows that combinatorial therapy (iron chelators + SIRT3 agonists) rescues neuronal viability by restoring mitochondrial integrity and energy flux. This work shifts therapeutic paradigms from monoaminergic targets toward multimodal strategies addressing iron homeostasis, organelle dynamics, and metabolic vulnerability—a framework with significant implications for developing neuroprotective antidepressants. Full article
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23 pages, 1418 KB  
Article
Comparison of Tailored Versus Standard Group Cognitive Behavioral Therapy for Shift Worker Insomnia: A Randomized Controlled Trial
by Tanja Grünberger, Christopher Höhn, Manuel Schabus, Belinda Angela Pletzer and Anton-Rupert Laireiter
Clocks & Sleep 2025, 7(2), 24; https://doi.org/10.3390/clockssleep7020024 - 9 May 2025
Viewed by 2713
Abstract
Shift workers are at increased risk of insomnia. The standard treatment (cognitive behavioral therapy for insomnia) poses significant challenges for this demographic due to irregular work and sleep schedules. New approaches are still considered insufficient due to high attrition or insufficient effectiveness. Our [...] Read more.
Shift workers are at increased risk of insomnia. The standard treatment (cognitive behavioral therapy for insomnia) poses significant challenges for this demographic due to irregular work and sleep schedules. New approaches are still considered insufficient due to high attrition or insufficient effectiveness. Our preliminary study identified sleep-relevant state and trait factors (see secondary outcomes) for incorporation into an innovative manual that addresses sleep in an implicit manner. The objective was to reduce the focus on insomnia and to replace regularity-based interventions. With a sample of 55 insomniacs (67.74% male, mean age 41.62 years), standard and customized treatments were compared using pre-treatment, post-treatment, and three-month follow-up measurements (RCT, self-assessment data). Our linear mixed models revealed the main significant effects of the measurement point for the primary (insomnia severity, sleep quality, sleep onset latency, total sleep time, daytime sleepiness) and the secondary outcomes (selection: anxiety/depression, dysfunctional beliefs, arousal, emotional stability, concern). No main effects of the condition or interaction effects were identified. Non-inferiority and equivalence tests demonstrated that the customized treatment is equivalent to standard therapy, which is a favorable outcome in light of the implicit approach. Consequently, this innovative approach warrants further exploration, incorporating the present results. Full article
(This article belongs to the Section Disorders)
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8 pages, 213 KB  
Article
The Effects of Cognitive Behavioral Therapy for Insomnia on Physical Activity Before and After Time in Bed Among Shift Workers
by Marcin Sochal, Bernd Feige, Kai Spiegelhalder and Johanna Ell
J. Clin. Med. 2025, 14(9), 3206; https://doi.org/10.3390/jcm14093206 - 6 May 2025
Viewed by 1512
Abstract
Background: Sleep and physical activity (PA) are bidirectionally related, with PA having a positive effect on sleep, and sleep quality influencing PA the following day. However, little is known about the effects of clinical interventions for sleep disorders on PA. Therefore, the aim [...] Read more.
Background: Sleep and physical activity (PA) are bidirectionally related, with PA having a positive effect on sleep, and sleep quality influencing PA the following day. However, little is known about the effects of clinical interventions for sleep disorders on PA. Therefore, the aim of this secondary analysis is to evaluate the impact of cognitive behavioral therapy for insomnia (CBT-I), the first-line treatment for insomnia, on PA. Methods: Thirty-eight nurses with shift work disorder and insomnia were randomly assigned to either CBT-I or a waitlist control group. PA was measured for one week before (T0) and after the intervention/waiting period (T1) using actigraphy and sleep diary items. The impact of CBT-I on the PA parameters was analyzed using linear mixed models. In addition, correlations of pre-to-post-treatment changes in PA and pre-to-post-treatment changes in the clinical outcomes (insomnia severity, sleep efficiency, depression) were explored in the CBT-I group. Results: CBT-I increased actigraphy-derived PA during the two hours (β = 26.17, SE = 9.41, p = 0.009) and one hour (β = 13.24, SE = 4.57, p = 0.006) after time in bed, and resulted in a higher percentage of self-reported days with PA (β = 19.11, SE = 9.36, p = 0.049) compared to the waitlist control group. No significant correlations were found between the changes in PA and clinical outcomes, except for a moderate positive correlation between changes in self-reported sleep efficiency and changes in PA one hour before time in bed (r = 0.56, p = 0.013). Conclusions: This is the first study to investigate the impact of CBT-I on PA, providing preliminary evidence of the potential positive effects. Further studies with larger sample sizes and randomized controlled designs with continuous PA monitoring are needed to confirm these preliminary results. Full article
(This article belongs to the Special Issue Sleep Disorders: Advances in the Diagnosis and Treatment)
19 pages, 551 KB  
Article
Burnout, Associated Factors, and Mental Health Measures Among Ecuadorian Physicians: A Cross-Sectional Study
by Marina R. Ramírez, Mercy P. Ontaneda, Patricia Otero, David Ortega-Jiménez, Vanessa Blanco and Fernando L. Vázquez
J. Clin. Med. 2025, 14(7), 2465; https://doi.org/10.3390/jcm14072465 - 4 Apr 2025
Cited by 1 | Viewed by 2999
Abstract
Background: Physician burnout is a growing issue that affects both the quality of healthcare and the mental well-being of medical professionals. However, research on this phenomenon in Ecuador is limited and methodologically deficient. The objective of this study was to examine the [...] Read more.
Background: Physician burnout is a growing issue that affects both the quality of healthcare and the mental well-being of medical professionals. However, research on this phenomenon in Ecuador is limited and methodologically deficient. The objective of this study was to examine the national prevalence of burnout among Ecuadorian physicians, its associated factors, and its impact on mental health. Methods: A cross-sectional study was conducted on 1976 physicians from all provincial capitals of Ecuador (51.8% women; mean age: 37.1 years). Results: It was found that 25.3% of physicians had high levels of emotional exhaustion and 23.8% had high levels of depersonalization. Factors associated with the higher levels of emotional exhaustion among physicians included part-time jobs, long working hours, work–family conflicts, psychological inflexibility, and perceived loneliness. Higher levels of depersonalization were associated with working shifts, having work–family conflicts, exhibiting psychological inflexibility, and perceived loneliness, while lower levels of depersonalization were associated with being female. Experiencing higher levels of depersonalization were associated with suffering from higher levels of depression, while having higher levels of emotional exhaustion were associated with suffering from higher levels of stress. Conclusions: A considerable proportion of Ecuadorian physicians suffer from burnout. Preventive programs and psychological interventions tailored to their specific needs should be developed. Full article
(This article belongs to the Section Mental Health)
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9 pages, 204 KB  
Article
Mental Health, Sleep, and Caffeine Intake Among Shift Workers in a Nationally Representative Sample of the Korean Adult Population
by Gyu-Lee Kim, Jinmi Kim, Jeong-Gyu Lee, Young-Jin Tak, Seung-Hun Lee, Young-Jin Ra, Sang-Yeoup Lee, Young-Hye Cho, Eun-Ju Park, Youngin Lee, Jung-In Choi and Yu-Hyeon Yi
Nutrients 2025, 17(7), 1155; https://doi.org/10.3390/nu17071155 - 26 Mar 2025
Cited by 1 | Viewed by 4023
Abstract
Background: Caffeine, a widely consumed stimulant, affects sleep and mental health. Shift work disrupts the circadian rhythm and has been associated with various mental health issues, such as depression, anxiety, and suicidal ideation. Objective: This study explored the associations between caffeine consumption, sleep [...] Read more.
Background: Caffeine, a widely consumed stimulant, affects sleep and mental health. Shift work disrupts the circadian rhythm and has been associated with various mental health issues, such as depression, anxiety, and suicidal ideation. Objective: This study explored the associations between caffeine consumption, sleep duration, and mental health outcomes, particularly suicidal ideation, among shift workers in Korea. Methods: Data from the 6th Korea National Health and Nutrition Examination Survey (2013, 2015), which comprised 4723 adults aged 19 and older, were analyzed. Participants were categorized into groups based on average daily coffee consumption and work patterns. Multiple logistic regression analyses were conducted to determine the impact of caffeine consumption and work patterns on mental health outcomes. Results: Participants worked longer hours, reported higher perceived stress levels, and slightly decreased sleep duration as daily coffee consumption increased. However, no significant differences were observed in depression or suicidal ideation across the coffee consumption groups. Logistic regression analysis indicated a trend towards higher suicidal ideation risk with increased coffee intake, particularly among those who consumed three or more cups per day (OR 5.67, 95% CI 1.82–17.59). Conclusion: This study suggests a complex relationship between caffeine consumption, work patterns, and mental health outcomes. Although caffeine intake is associated with increased work hours and stress, its impact on suicidal ideation is influenced by occupational factors. Full article
(This article belongs to the Special Issue Effects of Caffeine on Sleep and Mental Health)
34 pages, 1835 KB  
Review
Rethinking Depression—Beyond Neurotransmitters: An Integrated Psychoneuroendocrineimmunology Framework for Depression’s Pathophysiology and Tailored Treatment
by Anna Giulia Bottaccioli, Mauro Bologna and Francesco Bottaccioli
Int. J. Mol. Sci. 2025, 26(6), 2759; https://doi.org/10.3390/ijms26062759 - 19 Mar 2025
Cited by 2 | Viewed by 5953
Abstract
It is known that the effectiveness of drug treatment for depression, ammine deficit based, is largely unsatisfactory. In this review, we examine the proposal of a precision therapy has emerged and has received a strong push by the identification of the role of [...] Read more.
It is known that the effectiveness of drug treatment for depression, ammine deficit based, is largely unsatisfactory. In this review, we examine the proposal of a precision therapy has emerged and has received a strong push by the identification of the role of inflammation in depression. However, precision psychiatry risks being caught in the reductionist trap of searching for the molecular switch that resets the whole system and switches off the disease. This is an illusion since the human being is complex and depression is a systemic and variable disorder. In this study, we show the inadequacy of the reductionist paradigm, and, at the same time, illustrate the superiority of the systemic paradigm centered on psychoneuroendocrineimmunology (PNEI). According to the PNEI paradigm, depression is a disease of the whole human being, caused by different sources working together: psychological, biological, and behavioral. This means knowing the biological and psychological history of the subject, identifying relational and biological crisis factors, and building personalized treatments targeting those factors with the tools of medicine and psychology, which are not reducible to the combination of drugs and psychotherapy. Our proposal presents a paradigm shift that is both theoretical and practical, which enables clinicians to assess patients experiencing depression in a unified way and treat them in an integrated manner. Full article
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15 pages, 905 KB  
Article
The Impact of Night Shifts, Tobacco Dependence, Health Awareness, and Depression Risk on Chronic Disease Risk Among Generation Z Overtime Workers During the COVID-19 Pandemic
by Hui-Li Lin and Wen-Hsin Liu
Healthcare 2025, 13(5), 569; https://doi.org/10.3390/healthcare13050569 - 6 Mar 2025
Viewed by 1659
Abstract
Background/Objectives: the COVID-19 pandemic accelerated the adoption of remote work, blurring the boundaries between professional and personal life. This shift resulted in longer working hours, negative emotional outcomes, and health issues, particularly among Generation Z employees. This study investigates the links between [...] Read more.
Background/Objectives: the COVID-19 pandemic accelerated the adoption of remote work, blurring the boundaries between professional and personal life. This shift resulted in longer working hours, negative emotional outcomes, and health issues, particularly among Generation Z employees. This study investigates the links between working overtime, tobacco dependence, night shifts, and chronic disease risk in Generation Z employees during the pandemic while also examining the roles of depression risk and health awareness. A quantitative research approach was used to administer a questionnaire and employ the chi-square test, t-test, and logistic regression analysis to compare overtime-related factors and chronic disease risks. Results: the overtime workers are 1.39 times more likely to develop chronic diseases than those who do not work overtime. The odds ratio (OR) for overtime workers is 1.41, indicating that working overtime is a major risk factor for chronic disease. Among overtime workers, tobacco dependence and depression risk are significantly correlated with the risk of chronic disease, while night shift work is not. Overtime workers’ health awareness is significantly correlated with chronic disease risk and has a partial mediating effect on the relationship between tobacco dependence and chronic disease risk. This is due to the strong correlation (p < 0.001) between tobacco dependence and chronic disease, which limits the extent to which health consciousness can mitigate the negative effects of tobacco dependence. Conclusions: these findings highlight the importance of smoking cessation and mental health interventions in reducing the risk of chronic disease for Generation Z workers, particularly in the post-pandemic era. Full article
(This article belongs to the Section Healthcare in Epidemics and Pandemics)
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