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Visual-stress-related cortical excitability as a prospective marker for symptoms of depression and anxiety in young people

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European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

Visual stress is thought to reflect cortical excitability and has been associated with many neurological, neuropsychiatric, and neurodevelopmental conditions. However, its relationships with symptoms of depression and anxiety have not yet been elucidated. We conducted two separate studies to first examine visual stress in a longitudinal community sample of 104 participants (aged 12–24) in association with prospective symptoms of depression, anxiety, and distress after 3 months, and subsequently in a cross-sectional epidemiological sample of 530 participants (aged 15–24) to validate its associations with current mood and distress symptoms. The Pattern Glare Test was used to examine visual stress to three grating patterns with the spatial frequencies (SF) of 0.3, 2.3, and 9.4 cycles per degree (cpd). Other known factors of mental health, including functioning, as well as resilience, hopelessness, and loneliness, were also assessed at baseline. In both studies, we showed that perceptual distortions were highest toward the pattern with mid-SF (2.3 cpd). Multiple linear regression analyses revealed that greater visual stress was significantly associated with not only baseline but also 3-month symptom outcomes, even when accounting for age, years of education, days of no functioning, resilience, hopelessness, and loneliness. Our findings suggest the importance of visual stress in understanding and predicting poor mental health outcomes. As mental health can lead to far-reaching consequences that extend to adulthood, our findings may inform state-of-the-art innovative strategies for the prediction of poor mental health outcomes and suggest visual stress as a potential marker for early risk detection among young people.

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Acknowledgements

We would like to thank and acknowledge the support and contribution from all participating young people, carers, and staff, as well as six collaborating community organizations (The Boys’ & Girls’ Club Association of Hong Kong, Caritas Hong Kong, The Hong Kong Federation of Youth Groups, Hong Kong Playground Association, St James’ Settlement, and Hong Kong Children & Youth Services) of the LevelMind@JC project. We also thank all the young people and staff of the HK-YES project. 

Funding

This work was supported by funding from the Hong Kong Jockey Club Charities Trust (Funding Reference Number 2020/0012/001), as well as from the Food and Health Bureau, HKSAR Government (Funding Reference Number MHS-PI (Part2)).

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  1. Stephanie Ming-Yin Wong: co-first author.

Authors and Affiliations

  1. Department of Psychiatry, School of Clinical Medicine, Faculty of Medicine, Li Ka Shing, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, China

    Christy Lai-Ming Hui, Stephanie Ming-Yin Wong, Terrence Yat-To Yu, Terry Tak-Yee Lau, Olivia Choi, Samantha Tsang, Yi-Nam Suen, Bess Yin-Hung Lam, Corine Sau-Man Wong, Simon Sai-Yu Lui, Kai-Tai Chan, Michael Tak-Hing Wong, Sherry Kit-Wa Chan, Edwin Ho-Ming Lee, Wing-Chung Chang & Eric Yu-Hai Chen

  2. Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China

    Gloria Hoi-Yan Wong

  3. State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, China

    Sherry Kit-Wa Chan, Wing-Chung Chang & Eric Yu-Hai Chen

  4. Department of Psychology, University of Essex, Essex, UK

    Arnold Wilkins

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Contributions

EYHC conceived and designed the study. TYTY, TTYL, OCYC, and ST performed data collection. EYHC, CLMH, SMYW, and TYTY analyzed the data. EYHC, CLMH, SMYW, TYTY, and AW interpreted the results. All authors reviewed and validated the data. CLMH, SMYW, and TYTY wrote the initial draft and completed initial revisions of the manuscript. All authors provided critical input to the drafts of the manuscript and approved the final manuscript.

Corresponding author

Correspondence to Eric Yu-Hai Chen.

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Conflict of interest

EYHC reports having received speaker honoraria from Otsuka and DSK BioPharma; received research funding from Otsuka; participated in paid advisory boards for Jansen and DSK BioPharma; received funding to attend conferences from Otsuka and DSK BioPharma. The remaining authors declare no competing interests.

Ethics approval

Both studies were approved by the Institutional Review Boards of the University of Hong Kong/Hospital Authority Hong Kong West Cluster and carried out in accordance with Good Clinical Practice and the Declaration of Helsinki.

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Written informed consent was obtained from all participants.

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Hui, C.LM., Wong, S.MY., Yu, T.YT. et al. Visual-stress-related cortical excitability as a prospective marker for symptoms of depression and anxiety in young people. Eur Arch Psychiatry Clin Neurosci 273, 1051–1060 (2023). https://doi.org/10.1007/s00406-022-01469-7

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