Pregnancy-related inflammatory markers and their association with perinatal mental illness: a systematic review
Introduction
This study investigates the relationship between immune dysregulation and perinatal mental disorders by analyzing clinical data and biomarker profiles in pregnant individuals with varying severity of psychiatric symptoms. Understanding these associations may support the development of early screening tools and targeted interventions to improve maternal and infant mental health outcomes.
Material and methods
A comprehensive literature review was conducted using PubMed, MEDLINE, and Scopus, covering studies published through 2025. Key proinflammatory and anti-inflammatory cytokines, including IL-6, TNF-α, IL-1β, CRP, IL-8, and IL-10, were extracted from peer-reviewed articles. When numerical values were unavailable, data were estimated from published figures using digitization tools. Extracted data were standardized and analyzed using Python (Pandas, Matplotlib). Statistical procedures included correlation analysis, ROC curve modelling, and ANOVA testing to assess group differences and diagnostic performance of biomarkers.
Results
Analysis revealed strong associations between cytokine levels and perinatal depressive symptoms. In one dataset, nine cytokines were inversely correlated with postpartum depression severity (Pearson r = –0.79, p = 0.004; Spearman rₛ = –0.87, p = 0.00085; Kendall τ = –0.72, p = 0.0031), and ANOVA confirmed significant group differences (F = 5.8, p = 0.022). Other studies reported elevated IL-6 and TNF-α levels in postpartum depression (p < 0.05). Co-expression of IL-2, IL-6, IL-8, and TNF-α was very high (r = 0.9991, p = 0.00006), likely reflecting cytokine collinearity and limited sample size, with ANOVA indicating significant elevation in affected individuals (F = 45.42, p = 0.0151). ROC analyses identified IL-8, IL-6, CRP, and TNF-α as reliable markers of perinatal depression and psychosis. Tryptophan metabolites and MCP-1 were more specific for psychosis, while IFN-γ showed a regulatory rather than a diagnostic function.
Conclusions
Perinatal mental disorders are associated with significant immune alterations. IL-6, IL-8, IL-2, and TNF-α appear to play a central role in the pathophysiology of postpartum depression. The findings support the utility of cytokine profiling for early detection and differential diagnosis of perinatal psychiatric conditions.
Prevalence and severity of depression, anxiety, and cognitive impairment in acute ischemic stroke patients: a cross-sectional study
Introduction
Post-stroke depression (PSD) and anxiety are common neuropsychiatric sequelae of stroke, occurring in roughly one-third of survivors. Cognitive impairment is also frequently observed, affecting up to half of stroke patients. These conditions adversely impact rehabilitation and quality of life. This study aimed to determine the prevalence and severity of depression, anxiety, and cognitive deficits in patients with acute ischemic stroke.
Material and methods
We conducted an observational study involving 99 patients with acute ischemic stroke, assessed within approximately two weeks of symptom onset, who were admitted to a tertiary care unit. Depression and anxiety were assessed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scales, supplemented by the clinician-rated Hamilton Depression (HAM-D) and Anxiety (HAM-A) scales. Cognitive status was evaluated with the Mini-Mental State Examination (MMSE). Descriptive statistics (proportions, means ± SD) were used to summarize the prevalence and severity of each condition.
Results
The cohort had a mean age of 64.8 ± 8.1 years and was 63.5% male. Vascular risk factors were prevalent, with 88% of patients having hypertension and 33% having diabetes. Based on patient-reported measures, 16% of patients exhibited moderate depressive symptoms (PHQ-9 ≥10), while 42% reported moderate to severe anxiety (GAD-7 ≥10). Clinician-administered assessments identified 35% of patients with moderate to severe depression (HAM-D ≥17) and 35% with clinically significant anxiety (HAM-A ≥18). The vast majority of patients (~92%) reported at least mild depressive symptoms, although only 0–1% met the criteria for severe depression.
Conclusions
Depression, anxiety, and cognitive deficits are highly prevalent in the acute phase of ischemic stroke, with approximately one in three patients experiencing clinically significant depression or anxiety and one in four exhibiting cognitive impairment. These findings underscore the importance of early neuropsychological assessment and intervention as part of acute stroke care to improve rehabilitation outcomes.
Identifying core stigmatizing beliefs about depression: results from an item-level statistical approach
Introduction
Stigma surrounding depression continues to be a major barrier to treatment, social inclusion, and recovery. While general attitudes toward mental illness have been widely studied, fewer investigations have focused on the specific beliefs that drive stigma toward individuals with depression in a low- and middle-income country (LMIC) in Eastern European settings, particularly in Moldova.
Material and methods
A cross-sectional study was conducted with a sample of 460 participants from Moldova, who completed the Depression Stigma Scale. Each of the nine items reflected a different stigmatizing belief about depression. Descriptive statistics, including mean scores and standard deviations, were calculated for each item. An item-level comparative analysis was performed.
Results
The highest stigma scores were recorded for items such as: “I would not employ someone if I knew they had been depressed”, “Depression is not a real medical illness”, and “Depression is a sign of personal weakness.” The lowest scores were observed for beliefs related to dangerousness and avoidance, including “People with depression are dangerous” and “It is best to avoid people with depression so you don’t become depressed yourself.” These results suggest that stigma in Moldova is predominantly characterized by doubts about the medical legitimacy of depression and concerns over professional roles, rather than fear-based or exclusionary attitudes.
Conclusion
Anti-stigma interventions in LMICs, such as Moldova should prioritize improving public understanding of depression as a legitimate health condition and addressing discrimination in professional settings.