Weill Cornell Psychiatry
Publications
Perinatal depression and anxiety are common yet underdiagnosed and undertreated. There is limited data on screening rates, severity, and treatment, and thus an urgent need to accurately estimate perinatal depression and anxiety over time, to inform timely and efficacious interventions. The present study evaluates screening and treatment rates, prevalence, and symptom trajectories over time for perinatal depression and anxiety in a large urban medical center.
Uncovering the Heterogeneity in Young Adult Anxiety: Subtypes Predict Outcomes of a CBT Mobile App
App-based interventions are scalable and effective in reducing anxiety in young adults. Still, two-thirds of young adults remain symptomatic. The present study aims to (a) identify subtypes of young adult anxiety; (b) examine whether subtype membership predicted response to Maya, a self-guided cognitive behavioral therapy (CBT) app for young adult anxiety and depression, to guide precision interventions that match individuals’ profiles.
Most older adults with depression lack access to efficacious psychotherapies due to a critical clinician shortage. Even when treated, response rates are limited to approximately 50%. The present study aims to develop a scalable treatment decision rule (TDR) for assignment to a psychotherapy or usual care intervention for late-life depression that can be delivered easily in community settings.
Advances in neuroscience can inform simplified interventions that target key brain networks impacted by depression. Engage & Connect is an example for a scalable and simple neuroscience-informed psychotherapy, aimed to improve Positive Valence System functions and social reward responsivity by increasing engagement in rewarding social activities.
Course of Subtypes of Late-Life Depression Identified by Bipartite Network Analysis During Psychosocial Interventions
In this prognostic study, bipartite network clustering identified 3 subtypes of late-life depression. Knowledge of patients’ clinical characteristics may inform treatment selection. Identification of discrete subtypes of late-life depression may stimulate the development of novel, streamlined interventions targeting the clinical vulnerabilities of each subtype.
This systematic review of 409 studies on social reward processing in depressed and healthy individuals found that social rewards elicit increased activation in subcortical reward regions in healthy and depressed individuals; and decreased activation in prefrontal reward regions among depressed individuals. Processing of social stimuli elicits activation of key brain regions involved in affective and social information processing. Interventions for depression can increase social reward responsivity to improve outcomes.
Perception of Social Support and Cognitive Performance in Older Adults With Depression
In this cross-sectional study among older adults with depression, higher perceived social support was associated with phonemic verbal fluency but not other executive processes or cognitive domains. Results indicate that perceived social isolation may be selectively associated with executive processes that support the initiation and persistence of behavior, underscoring the important role of social support in this population. Older adults with poorer cognitive performance may be less likely to feel supported by others and thus may benefit from interventions that increase social engagement.
Resting State Functional Connectivity and Outcomes of Psychotherapies for Late-Life Depression
Results suggest that patients who present with higher resting state functional connectivity between the subgenual anterior cingulate cortex and a structure within the DMN may benefit from behavioral psychotherapies for late-life depression. "Engage" therapy may lead to increased resting state functional connectivity within the reward system reflecting a reconditioning of the reward systems by reward exposure.
Modifiable Predictors of Non-response to Psychotherapies for Late-life Depression with Executive Dysfunction: A Machine Learning Approach
The strongest modifiable predictors of the persisting depression trajectory were low perceived social support, followed by high neuroticism, low treatment expectancy, and low perception of the therapist as accepting. Our results suggest that modifiable risk factors of early non-response to psychotherapy can be identified at the outset of treatment and addressed with targeted personalized interventions.