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The presence of severe life stress, a prior history of depression or psychotropic medication use further elevates the likelihood of progression to major depressive episodes, which may carry an increased risk of suicidal ideation and behavior (37,38)

The ceramide-1-phosphate (C1P), a phosphorylated derivative of ceramide, favors cell survival, proliferation, and anti-apoptotic signaling through the activation of PI3K/Akt, ERK1/2, and NF-B pathways

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The downregulated genes are primarily involved in fatty acid synthesis and energy metabolism, particularly enzymes critical to cell membrane composition and function

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