Coronary heart disease (CHD) is frequently accompanied by anxiety and depression, conditions that markedly worsen cardiovascular outcomes. Increasing evidence indicates that immune dysregulation, driven by gut microbiota alterations, plays a central role in linking psychological disorders with cardiovascular pathology through the gut-brain-cardiovascular axis. This narrative review systematically summarizes recent advances in the immunological mechanisms underlying CHD complicated by anxiety and depression. We focus on gut microbiota-immune interactions, inflammatory signaling pathways, immune-related microbial metabolites, and neuroimmune communication that collectively shape cardiovascular and mental health. Relevant studies addressing immune biomarkers, cytokine profiles, intestinal barrier dysfunction, and immune-modulating therapeutic strategies were critically analyzed. Gut microbiota dysbiosis contributes to intestinal barrier impairment and translocation of microbial products, leading to activation of innate and adaptive immune responses. Elevated pro-inflammatory cytokines, including interleukin 6 and tumor necrosis factor α, serve as key mediators linking systemic inflammation with atherosclerosis and neuropsychiatric symptoms. Microbial metabolites, such as trimethylamine N-oxide, exacerbate immune-driven vascular inflammation, whereas short-chain fatty acids exert immunoregulatory and anti-inflammatory effects. Neuroimmune mechanisms, including hypothalamic-pituitary-adrenal (HPA) axis activation and immune modulation of autonomic function, further integrate psychological stress with cardiovascular immune injury. Immune dysregulation represents a unifying mechanism connecting gut microbiota imbalance, neuropsychiatric disorders, and coronary heart disease. Targeting immune-microbiota interactions within the gut-brain-cardiovascular axis may offer novel diagnostic biomarkers and immunomodulatory therapeutic strategies for CHD patients with comorbid anxiety and depression. This immunological perspective provides a translational framework for future research and integrated clinical management.

Peripheral hormonal dysfunction is associated with multiple neurological disorders, yet how astrocytes sense circulating stress-related hormones to influence depression pathogenesis remains incompletely understood. Here, we showed that disruption of secretin receptor (SCTR) signaling in dorsal raphe nucleus (DRN) astrocytes promotes depression-like behaviors. We identified AMPKα1 as a key downstream effector of astrocytic SCTR signaling and demonstrate its role in regulating astrocytic secretion of metallothionein-1 (Mt1) and downstream megalin-mediated AMPKα2 signaling in serotonergic neurons. We further identified the transcription factor Foxc2 as a downstream target of neuronal AMPKα2 that modulates depressive-like behaviors through suppression of serotonergic activity and reduced neuronal excitability. Mechanistically, AMPKα2 regulates phosphorylation of the acetyltransferase KAT7, thereby modulating histone H4 acetylation and Foxc2 transcription. Together, these findings delineate an astrocyte-neuron signaling axis linking SCTR-AMPKα1 signaling in astrocytes to epigenetic regulation of Foxc2 by AMPKα2-KAT7/H4ac signaling in serotonergic neurons, providing fundamental insight into circuit-level mechanisms underlying depression.

Fatigue and depressive symptoms are common among individuals with multiple sclerosis (MS) and impose a substantial burden on daily functioning and overall well-being. Lifestyle factors, including dietary patterns, may contribute to symptom burden, although evidence remains inconsistent. This cross-sectional study aimed to examine fatigue and depressive symptoms in adults with MS and explore their associations with adherence to the Mediterranean diet and individual dietary components. Mediterranean diet adherence was assessed using the Mediterranean Diet Adherence Screener (MEDAS). Fatigue severity was measured with the Fatigue Severity Scale (FSS), and depressive symptoms with the Center for Epidemiologic Studies Depression Scale (CES-D). Associations were examined using non-parametric tests, Spearman correlation, and multivariable linear regression. A total of 112 adults with MS (mean age 45.26 ± 9.9 years) were included. Clinically significant fatigue (FSS ≥ 4) was present in 92.0%, while 89.9% were at high risk for depressive symptoms (CES-D ≥ 16). Low adherence to the Mediterranean diet was observed in 51.8% of participants. Fatigue severity differed according to Mediterranean diet adherence, with lower adherence associated with greater fatigue severity (p = 0.035). Depressive symptoms were not associated with dietary adherence but were strongly correlated with fatigue severity (ρ = 0.600, p < 0.001) and remained independently associated with fatigue severity in multivariable analysis, while female sex was associated with lower fatigue severity. Additional associations were observed between specific dietary components, including red meat, fruit juice, and olive oil, and symptom severity. The study revealed a high burden of depressive symptoms and fatigue among individuals with MS, alongside generally suboptimal adherence to the Mediterranean diet. Lower adherence was associated with higher fatigue severity. Fatigue and depressive symptoms were strongly interrelated. These findings underscore the importance of addressing both overall well-being and diet in the comprehensive management of individuals with MS.

Rates of suicide are 2-3 times higher among youth detained in the legal system (YD) compared to non-detained youth. A prior study found that 40% of YD endorsing a suicide attempt denied suicide ideation. These youth were characterized clinically by high rates of anger and low rates of depression, somatic complaints, and neglect. The present study seeks to replicate these findings in a substantially enlarged sample of YD. N = 1,250 YD endorsing a lifetime suicide attempt were administered an interview to assess mental health history. 45% of YD endorsing a lifetime suicide attempt denied suicide ideation. Youth denying suicide ideation endorsed a significantly higher rate of anger/irritability. This enlarged YD sample replicates results that a significant number of YD who attempted suicide denied ideation and that these youth were characterized by high anger/irritability. Implications for case identification and theory advancement for a comprehensive are discussed.

Latinx youth in the United States experience disproportionate exposure to community violence, which contributes to elevated rates of mental health symptoms. Research suggests that individual differences, such as cognitive flexibility (CF) and bilingualism, may serve as protective factors in the context of exposure to community violence. The present study examined associations among community violence exposure, bilingual proficiency, CF, and mental health symptoms among Latinx children. We also tested whether CF moderated associations between community violence exposure, bilingual proficiency, and mental health symptoms. Participants included 50 3rd -5th grade Latinx students (Mage = 9.84, age range = 8-12, SD = 1.04, 48% female) recruited from a charter school that serves a predominantly Latinx student body. CF was measured using the Wisconsin Card Sorting Test, bilingualism was assessed through the Woodcock-Muñoz Language Survey III, and mental health symptoms, including anxiety and depression, were measured using the Revised Child Anxiety and Depression Scale. Results demonstrated that greater exposure to community violence was associated with increased symptoms of anxiety and depression, and that CF moderated these effects, buffering against adverse mental health outcomes. Contrary to study hypotheses, bilingualism was not significantly associated with CF or mental health symptoms. These findings highlight CF as a potential marker of resilience among Latinx children exposed to community violence. Future research should explore interventions that enhance CF to mitigate the psychological impact of trauma in this population.

Major depressive disorder (MDD) is associated with alterations in large-scale brain networks, and variability in transcutaneous auricular vagus nerve stimulation (taVNS) parameters, particularly stimulation frequency, limits reproducibility and comparability across studies. Standardized strategies for systematic parameter selection are therefore needed. This protocol presents a reproducible, neuroimaging-guided workflow for mapping individual cortical responses to multiple taVNS frequencies using functional near-infrared spectroscopy (fNIRS). The approach combines continuous fNIRS acquisition with within-session delivery of multiple stimulation frequencies and network-level analysis of default mode network activity. Frequency-specific responses are quantified using distance-based metrics, followed by algorithmic ranking to identify candidate stimulation parameters within each participant. The workflow enables direct within-subject comparison of stimulation conditions and provides a structured framework for exploratory parameter mapping based on network-level responses rather than fixed-frequency designs. Representative results demonstrate the feasibility of acquiring stable fNIRS signals across conditions and generating interpretable participant-specific frequency rankings. Although demonstrated in MDD, this protocol is adaptable to other neuromodulation paradigms and disorders involving network-level dysfunction and may support future studies aimed at individualized parameter selection.

Brailovskaia et al. identified problematic social media use as a partial mediator between daily stress and suicide-related outcomes and found that positive mental health weakened the association between problematic social media use and such outcomes. This commentary argues that the moderating role of positive mental health warrants greater attention because it points to a preventive strategy beyond reducing problematic online engagement. Strengthening emotional, psychological, and social well-being may buffer individuals from the effects of stress and maladaptive digital behaviors, particularly in settings where stigma, financial limitations, and restricted service availability hinder access to formal mental health care. Future research should therefore examine positive mental health as a direct target of suicide prevention interventions and evaluate culturally responsive approaches that promote resilience, adaptive coping, and psychological flourishing.

Cyber victimization is among the most consistent predictors of depression (DEP) in adolescence, yet research has largely treated both constructs as unidimensional totals, obscuring which specific victimization experiences activate which depressive symptoms and for whom. This study applied a person-centered and network psychometric approach to map these pathways in a cross-sectional community sample of 622 Turkish adolescents (55.0% female; M aɡe = 13.90 years). Latent profile analysis (LPA) identified three distinct subgroups based on self-esteem (SE), family affluence, and social media (SM) use: a low SE/moderate SM group (n = 395, 63.5%), a high SE/high DEP group (n = 115, 18.5%), and a high SM use group (n = 112, 18.0%). Depressive symptom networks differed significantly in global strength across profiles; the high SM use group showed the densest intersymptom connections. A bipartite bridge network analysis revealed that self-harm/suicidal ideation was the strongest cross-community bridge node (bridge expected influence = 0.143), despite being the most peripheral symptom within the DEP network itself. This dissociation suggests that the symptom is linked mainly to cyber victimization rather than to other depressive symptoms. Embarrassing messages was the strongest victimization-side bridge node (EI = 0.095). These findings challenge the assumption that intranetwork centrality predicts intervention priority: Peripheral symptoms may function as critical entry points when external stressors drive activation.

The South African flag sign (SAFS) is a non-contiguous electrocardiographic pattern defined by ST-segment elevation (STE) in leads I, aVL, and V2 with reciprocal inferior ST-segment depression (STD), classically associated with first diagonal branch (D1) occlusion. We report a 58-year-old female presenting with acute chest pain and atrial fibrillation (AF), whose 12-lead electrocardiogram (ECG) demonstrated a SAFS phenotype. Automated ECG interpretation generated no ST-segment elevation myocardial infarction (STEMI)-specific alert, classifying the tracing as AF with possible subendocardial injury. This failure may have resulted from AF-induced RR variability combined with non-contiguous STE distribution outside standard algorithmic thresholds. Visual pattern recognition prompted STEMI pathway activation before hospital arrival. Coronary angiography confirmed acute thrombotic total occlusion of the proximal left anterior descending artery (LAD) with Thrombolysis in Myocardial Infarction (TIMI) 0 flow. Primary percutaneous coronary intervention restored TIMI 3 flow. The hospital course was complicated by severe left ventricular dysfunction, acute heart failure, and extensive microvascular obstruction. This case confirms SAFS as a rare but clinically meaningful phenotype and provides new diagnostic and angiographic insight by associating it with isolated proximal LAD occlusion, AF, and failed automated STEMI recognition. It suggests SAFS is not restricted to D1 occlusion, and visual ECG interpretation remains essential when automated systems fail.

The evolution of alternative migratory strategies can lead to the establishment of ecologically and genetically distinct morphs; however, the forces that maintain these differences are often unclear. Here we assessed how migratory strategy may affect gene flow and adaptation in Atlantic Salmon (Salmo salar) in a setting where a migratory barrier was removed, and migratory and non-migratory salmon have been brought into contact through a program to initiate a migratory population. We used whole genome sequencing to characterize genetic variation in resident and anadromous salmon in this experimental system, as well as in the original source of the migratory individuals and a proximate source of strays into the system. Our results suggest that resident and anadromous salmon populations are highly divergent genetically, but that introgression from the resident population into the introduced migratory morph is widespread. However, despite a general trend of introgression into the migratory form, localized genomic regions appear resistant to gene flow, potentially highlighting adaptive divergence between resident and anadromous salmon. Additionally, we compared how the proportion of ancestry associated with migratory type changed between out migrating smolts and returning adults across two cohorts. Our results show a significant reduction in resident ancestry consistent with outbreeding depression during the marine migratory phase. Genomic comparisons between smolts and adults also identify several localized regions potentially under selection in the marine environment, possibly related to immune function. Together, these results suggest that introgression between divergent migratory forms in this system is unidirectional and is resulting in outbreeding depression and reduced migratory success. In the context of supplementation, our results suggest that enhancement activities aimed at boosting anadromous Atlantic Salmon populations could be impacted by introgression with resident populations. Additionally, interbreeding may present a demographic threat to resident populations, as anadromous-resident hybrids appear to follow a migratory life history.

[This corrects the article DOI: 10.1002/hsr2.2235.].