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Ferrara M, Domenicano I, Marchi A, Zaffarami G, Onofrio A, Benini L, Sorio C, Gentili E, Murri MB, Toffanin T, Little J, Grassi L. First episode psychoses in people over-35 years old: uncovering potential actionable targets for early intervention services. Psychiatry Res 2024; 339:116034. [PMID: 38906051 DOI: 10.1016/j.psychres.2024.116034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/25/2024] [Accepted: 06/13/2024] [Indexed: 06/23/2024]
Abstract
The traditional youth-oriented design of Early Intervention Services (EIS) may lead to the exclusion of patients who have their psychotic onset later in life. A retrospective study was conducted to compare first-episode psychosis (FEP) patients who accessed treatment when aged ≤ 35 years with those ≥36+. A total of 854 patients were identified among 46,222 individuals who had access to community psychiatric services from 1991 to 2021. FEP were aged 18-65, received care between 2012 and 2021 and had a diagnosis of affective or non-affective FEP. Two groups were identified (FEP diagnosed at age ≤ 35 vs ≥ 36) and compared for sociodemographic and clinical characteristics. Most patients were diagnosed when aged ≥ 36+ (61.8%). Compared to the ≤ 35 group, older patients were more likely to be women, married and diagnosed with affective psychosis, and they were less frequently hospitalized. Long-acting injectables antipsychotics (LAI) were less frequently prescribed in the ≥ 36+ group, whereas antidepressants were more frequently prescribed compared to those aged ≤ 35. In both age groups, women were less frequently prescribed LAIs compared to men. These findings highlight the need to reorient EIS to accommodate the needs of older FEP, especially women.
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Affiliation(s)
- Maria Ferrara
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; Department of Psychiatry, Yale School of Medicine, New Haven CT, USA; Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy.
| | - Ilaria Domenicano
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Aurora Marchi
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Giulia Zaffarami
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Alice Onofrio
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Lorenzo Benini
- Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Cristina Sorio
- Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | | | - Martino Belvederi Murri
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Tommaso Toffanin
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Julian Little
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Luigi Grassi
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
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Talarico F, Metes D, Wang M, Hayward J, Liu YS, Tian J, Zhang Y, Greenshaw AJ, Gaskin A, Janus M, Cao B. Six-year (2016-2022) longitudinal patterns of mental health service utilization rates among children developmentally vulnerable in kindergarten and the COVID-19 pandemic disruption. PLOS DIGITAL HEALTH 2024; 3:e0000611. [PMID: 39288186 PMCID: PMC11407640 DOI: 10.1371/journal.pdig.0000611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 08/12/2024] [Indexed: 09/19/2024]
Abstract
INTRODUCTION In the context of the COVID-19 pandemic, it becomes important to comprehend service utilization patterns and evaluate disparities in mental health-related service access among children. OBJECTIVE This study uses administrative health records to investigate the association between early developmental vulnerability and healthcare utilization among children in Alberta, Canada from 2016 to 2022. METHODS Children who participated in the 2016 Early Development Instrument (EDI) assessment and were covered by public Alberta health insurance were included (N = 23 494). Linear regression models were employed to investigate the association between service utilization and vulnerability and biological sex. Separate models were used to assess vulnerability specific to each developmental domain and vulnerability across multiple domains. The service utilization was compared between pre- and post-pandemic onset periods. RESULTS The analysis reveals a significant decrease in all health services utilization from 2016 to 2019, followed by an increase until 2022. Vulnerable children had, on average, more events than non-vulnerable children. There was a consistent linear increase in mental health-related utilization from 2016 to 2022, with male children consistently experiencing higher utilization rates than females, particularly among vulnerable children. Specifically, there was a consistent linear increase in the utilization of anxiety-related services by children from 2016 to 2022, with females having, on average, 25 more events than males. The utilization of ADHD-related services showed different patterns for each group, with vulnerable male children having more utilization than their peers. CONCLUSION Utilizing population-wide data, our study reveals sex specific developmental vulnerabilities and its impact on children's mental health service utilization during the COVID-19 pandemic, contributing to the existing literature. With data from kindergarten, we emphasize the need for early and targeted intervention strategies, especially for at-risk children, offering a path to reduce the burden of childhood mental health disorders.
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Affiliation(s)
- Fernanda Talarico
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Dan Metes
- Government of Alberta, Ministry of Health, Edmonton, Alberta, Canada
| | - Mengzhe Wang
- Government of Alberta, Ministry of Health, Edmonton, Alberta, Canada
| | - Jake Hayward
- Department of Emergency Medicine, University of Alberta Alberta, Canada
| | - Yang S Liu
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Julie Tian
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Yanbo Zhang
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Andrew J Greenshaw
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Ashley Gaskin
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada
| | - Magdalena Janus
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada
| | - Bo Cao
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
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McGorry PD, Mei C, Dalal N, Alvarez-Jimenez M, Blakemore SJ, Browne V, Dooley B, Hickie IB, Jones PB, McDaid D, Mihalopoulos C, Wood SJ, El Azzouzi FA, Fazio J, Gow E, Hanjabam S, Hayes A, Morris A, Pang E, Paramasivam K, Quagliato Nogueira I, Tan J, Adelsheim S, Broome MR, Cannon M, Chanen AM, Chen EYH, Danese A, Davis M, Ford T, Gonsalves PP, Hamilton MP, Henderson J, John A, Kay-Lambkin F, Le LKD, Kieling C, Mac Dhonnagáin N, Malla A, Nieman DH, Rickwood D, Robinson J, Shah JL, Singh S, Soosay I, Tee K, Twenge J, Valmaggia L, van Amelsvoort T, Verma S, Wilson J, Yung A, Iyer SN, Killackey E. The Lancet Psychiatry Commission on youth mental health. Lancet Psychiatry 2024; 11:731-774. [PMID: 39147461 DOI: 10.1016/s2215-0366(24)00163-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 05/01/2024] [Accepted: 05/08/2024] [Indexed: 08/17/2024]
Affiliation(s)
- Patrick D McGorry
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia.
| | - Cristina Mei
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Mario Alvarez-Jimenez
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Vivienne Browne
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Barbara Dooley
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Cathrine Mihalopoulos
- Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Stephen J Wood
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia; School of Psychology, University of Birmingham, Birmingham, UK
| | | | | | - Ella Gow
- Orygen, Melbourne, VIC, Australia; Melbourne, VIC, Australia
| | | | | | | | - Elina Pang
- Hong Kong Special Administrative Region, China
| | | | | | | | - Steven Adelsheim
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Matthew R Broome
- Institute for Mental Health, University of Birmingham, Birmingham, UK; Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Mary Cannon
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Andrew M Chanen
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Eric Y H Chen
- Institute of Mental Health, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; LKS School of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Andrea Danese
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; National and Specialist Child and Adolescent Mental Health Service Clinic for Trauma, Anxiety, and Depression, South London and Maudsley NHS Foundation Trust, London, UK
| | - Maryann Davis
- Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Pattie P Gonsalves
- Youth Mental Health Group, Sangath, New Delhi, India; School of Psychology, University of Sussex, Brighton, UK
| | - Matthew P Hamilton
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia; Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Jo Henderson
- Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Ann John
- Swansea University Medical School, Swansea University, Swansea, UK
| | | | - Long K-D Le
- Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Christian Kieling
- Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Ashok Malla
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada; ACCESS Open Minds and Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Verdun, QC, Canada
| | - Dorien H Nieman
- Amsterdam University Medical Centers, location AMC, Amsterdam, The Netherlands
| | - Debra Rickwood
- Faculty of Health, University of Canberra, Canberra, ACT, Australia; headspace National Youth Mental Health Foundation, Melbourne, VIC, Australia
| | - Jo Robinson
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Jai L Shah
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada; ACCESS Open Minds and Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Verdun, QC, Canada
| | - Swaran Singh
- Mental Health and Wellbeing, Warwick Medical School, University of Warwick and Coventry and Warwickshire Partnership Trust, Coventry, UK
| | - Ian Soosay
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Karen Tee
- Foundry, Providence Health Care, Vancouver, BC, Canada
| | - Jean Twenge
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Lucia Valmaggia
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | | | - Jon Wilson
- Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| | - Alison Yung
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia; Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia; School of Health Sciences, The University of Manchester, Manchester, UK
| | - Srividya N Iyer
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada; ACCESS Open Minds and Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Verdun, QC, Canada
| | - Eóin Killackey
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
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Ladwig G, Tanck JA, Quittkat HL, Vocks S. Risks and benefits of social media trends: The influence of "fitspiration", "body positivity", and text-based "body neutrality" on body dissatisfaction and affect in women with and without eating disorders. Body Image 2024; 50:101749. [PMID: 38850713 DOI: 10.1016/j.bodyim.2024.101749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 04/30/2024] [Accepted: 05/28/2024] [Indexed: 06/10/2024]
Abstract
This online experimental study investigates the effects of the social media trends "fitspiration" (images of thin-muscular women promoting health and fitness), "body positivity" (images of larger female bodies motivating women to love their bodies), and "body neutrality" (illustrations encouraging women to appreciate the body's functions) on body dissatisfaction and affect in women with and without eating disorders (ED). Women with (n = 172) and women without ED (n = 210) were randomly assigned to the conditions "fitspiration", "body positivity", and text-based "body neutrality", each comprising the presentation of 30 Instagram posts. Before and after viewing the posts, participants answered state questionnaires on body dissatisfaction and affect. The results revealed that body dissatisfaction increased after viewing "fitspiration" images and decreased after viewing "body positivity" and text-based "body neutrality" posts. Positive affect decreased following exposure to "fitspiration" and text-based "body neutrality" but remained unchanged following "body positivity". Negative affect decreased following "body positivity" and text-based "body neutrality" content but did not change following exposure to "fitspiration". There was no differential effect on women with versus without ED. This study demonstrates harmful effects of "fitspiration" on body image and affect, indicating the need for prevention programs for both women with and without ED.
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Affiliation(s)
- Gritt Ladwig
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Osnabrück University, Osnabrück, Germany.
| | - Julia A Tanck
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Osnabrück University, Osnabrück, Germany
| | - Hannah L Quittkat
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Osnabrück University, Osnabrück, Germany
| | - Silja Vocks
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Osnabrück University, Osnabrück, Germany
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105
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Adams RA, Zor C, Mihalik A, Tsirlis K, Brudfors M, Chapman J, Ashburner J, Paulus MP, Mourão-Miranda J. Voxelwise Multivariate Analysis of Brain-Psychosocial Associations in Adolescents Reveals 6 Latent Dimensions of Cognition and Psychopathology. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:915-927. [PMID: 38588854 DOI: 10.1016/j.bpsc.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 03/15/2024] [Accepted: 03/28/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Adolescence heralds the onset of considerable psychopathology, which may be conceptualized as an emergence of altered covariation between symptoms and brain measures. Multivariate methods can detect such modes of covariation or latent dimensions, but none specifically relating to psychopathology have yet been found using population-level structural brain data. Using voxelwise (instead of parcellated) brain data may strengthen latent dimensions' brain-psychosocial relationships, but this creates computational challenges. METHODS We obtained voxelwise gray matter density and psychosocial variables from the baseline (ages 9-10 years) Adolescent Brain Cognitive Development (ABCD) Study cohort (N = 11,288) and employed a state-of-the-art segmentation method, sparse partial least squares, and a rigorous machine learning framework to prevent overfitting. RESULTS We found 6 latent dimensions, 4 of which pertain specifically to mental health. The mental health dimensions were related to overeating, anorexia/internalizing, oppositional symptoms (all ps < .002) and attention-deficit/hyperactivity disorder symptoms (p = .03). Attention-deficit/hyperactivity disorder was related to increased and internalizing symptoms related to decreased gray matter density in dopaminergic and serotonergic midbrain areas, whereas oppositional symptoms were related to increased gray matter in a noradrenergic nucleus. Internalizing symptoms were related to increased and oppositional symptoms to reduced gray matter density in the insular, cingulate, and auditory cortices. Striatal regions featured strongly, with reduced caudate nucleus gray matter in attention-deficit/hyperactivity disorder and reduced putamen gray matter in oppositional/conduct problems. Voxelwise gray matter density generated stronger brain-psychosocial correlations than brain parcellations. CONCLUSIONS Voxelwise brain data strengthen latent dimensions of brain-psychosocial covariation, and sparse multivariate methods increase their psychopathological specificity. Internalizing and externalizing symptoms are associated with opposite gray matter changes in similar cortical and subcortical areas.
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Affiliation(s)
- Rick A Adams
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom; Max Planck Centre for Computational Psychiatry and Ageing Research, University College London, London, United Kingdom.
| | - Cemre Zor
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom
| | - Agoston Mihalik
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom; Max Planck Centre for Computational Psychiatry and Ageing Research, University College London, London, United Kingdom; Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Konstantinos Tsirlis
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom; Max Planck Centre for Computational Psychiatry and Ageing Research, University College London, London, United Kingdom
| | - Mikael Brudfors
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom; School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - James Chapman
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom; Max Planck Centre for Computational Psychiatry and Ageing Research, University College London, London, United Kingdom
| | - John Ashburner
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
| | | | - Janaina Mourão-Miranda
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom; Max Planck Centre for Computational Psychiatry and Ageing Research, University College London, London, United Kingdom
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106
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Camargo Júnior EB, Noivo IS, Gouvea TCC, Fernandes MNDF, Gherardi-Donato ECDS. Depression and Substance Use Among Brazilian University Students During the COVID-19 Pandemic. J Psychoactive Drugs 2024; 56:541-550. [PMID: 37551709 DOI: 10.1080/02791072.2023.2244499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 08/09/2023]
Abstract
The prevalence of depression and substance use changed significantly during the COVID-19 pandemic. The present study explored the association between the use of psychoactive substances and depression in Brazilian university students. This cross-sectional study was conducted between 2021 and 2022. A sample of 1271 students were assessed using the Patient Health Questionnaire-9 (PHQ-9) and Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Hierarchical multivariate logistic regression models were used to assess the association between tobacco use, alcohol consumption, illicit substance use, and depression. Among the participants, 424 (33.4%; 95%CI 30.7-36) screened positive for depression (PHQ-9 ≥ 10). Alcohol was the most consumed substance. Recent use of illicit substances was associated with depression (adjusted odds ratio [aOR] 1.59; CI 1.02-2.50). The pattern of moderate or high-risk tobacco use (aOR 2.11; CI 1.31-3.42), alcohol use (aOR 3.40; CI 2.29-5.06), and illicit substances (aOR 1.82; CI 1.15-2.89) were associated with higher chances of depression in adjusted models. Findings highlight the importance of implementing support for mental health among university students. These policies are crucial for addressing maladaptive behaviors, such as substance use, and for mitigating psychological distress, such as depression, which has been exacerbated during the pandemic.
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107
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Gaiha SM, Wang M, Baiocchi M, Halpern-Felsher B. Depression screening outcomes among adolescents, young adults, and adults reporting past 30-day tobacco and cannabis use. Addict Behav 2024; 156:108076. [PMID: 38838604 PMCID: PMC11208074 DOI: 10.1016/j.addbeh.2024.108076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 05/02/2024] [Accepted: 05/26/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Few studies examine the relationship between depression and use of specific tobacco and/or cannabis products among adolescents, young adults, and adults. We determined whether the odds of depression are greater among those who used specific tobacco and/or cannabis products and among co-users of tobacco and cannabis. METHOD Cross-sectional online survey of a national convenience sample of 13-40-year-olds (N = 6,038). The survey included depression screening and past 30-day use of specific tobacco and cannabis products (cigarettes; e-cigarettes, vaped cannabis, little cigars, cigarillos, cigars, hookah, chewing tobacco, smoked cannabis, edible cannabis, blunts). Analyses correspond to the total sample, and 13-17-, 18-24-, and 25-40-year-olds. RESULTS Among 5,281 individuals who responded to the depression screener and nine product use questions, 1,803 (34.1 %) reported co-use of at least one tobacco product and one cannabis product in the past 30 days. Past 30-day co-use was associated with higher likelihood of screening positive for depression compared to past 30-day use of tobacco-only (aOR = 1.32, 1.06-1.65; 0.006) or cannabis-only (aOR = 1.94, 1.28-2.94; <0.001). Screening positive for depression was more likely among those who reported past 30-day use of e-cigarettes (aOR = 1.56; 1.35-1.80; <0.001), cigarettes (aOR = 1.24, 1.04-1.48; 0.016), chewed tobacco (aOR = 1.91, 1.51-2.42; <0.001), and blunts (aOR = 1.22, 1.00-1.48; 0.053) compared to those who did not report past 30-day use of these products. Among the 2,223 individuals who screened positive for depression, the most used two-product combination was nicotine e-cigarettes and smoked cannabis (614 individuals, 27.6 %). CONCLUSIONS Screening positive for depression was more likely among past 30-day co-users versus past 30-day users of tobacco-only or cannabis-only. Findings suggest that prevention programs for depression and substance use address tobacco and cannabis co-use.
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Affiliation(s)
- Shivani Mathur Gaiha
- Stanford REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University School of Medicine, CA, United States; Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, United States; Faculty of Pediatrics, Harvard Medical School, Boston, United States
| | - Maggie Wang
- Department of Biomedical Data Science, Stanford University, CA, United States
| | - Mike Baiocchi
- Stanford REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University School of Medicine, CA, United States
| | - Bonnie Halpern-Felsher
- Stanford REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University School of Medicine, CA, United States.
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Reed H, Thapar A, Riglin L, Collishaw S, Eaton CB. The unequal impacts of the COVID-19 pandemic on young adults' mental health. Predictors of vulnerability and resilience using longitudinal birth cohort data in the UK. J Adolesc 2024. [PMID: 39205604 DOI: 10.1002/jad.12400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 04/28/2024] [Accepted: 08/21/2024] [Indexed: 09/04/2024]
Abstract
INTRODUCTION Previous studies have demonstrated deteriorations in young adult mental health during the COVID-19 pandemic, but evidence suggests heterogeneity in the mental health impacts of the pandemic. We sought to identify factors which may predict changes in psychological distress and wellbeing during the COVID-19 pandemic in UK young adults. METHODS A total of 2607 young adults from the Millennium Cohort Study were included. Psychological distress and mental wellbeing were measured using the Kessler-6 and Short Warwick-Edinburgh Mental Wellbeing Scale, respectively. Assessment occurred at three timepoints between the ages of 17-19: 2018/19 (pre-COVID Baseline), May 2020 (COVID Wave 1) and September/October 2020 (COVID Wave 2). Latent change score models were used to study change in distress and wellbeing across the study period, as well as the impact of sex, relative family poverty, parental education, preexisting mental health difficulties and perceived social support on these changes. RESULTS The latent change score models suggested both distress and wellbeing tended to increase across the study period. Being female and in relative poverty predicted greater increases in distress and/or poorer wellbeing. Higher levels of parental education and greater perceived social support were protective against increased distress and associated with improved wellbeing. CONCLUSIONS The impact of the COVID-19 pandemic on UK young adult mental health is complex. We provide further evidence for a distinction between symptoms of poor mental health and wellbeing. Research is urgently needed to assess the long-term impacts of the COVID-19 pandemic on the mental health and wellbeing of young people, particularly in more vulnerable groups.
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Affiliation(s)
- Harriet Reed
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Ajay Thapar
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Lucy Riglin
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Stephan Collishaw
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Christopher B Eaton
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
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Cavelti M, Ruppen NA, Sele S, Moessner M, Bauer S, Becker K, Krämer J, Eschenbeck H, Rummel-Kluge C, Thomasius R, Diestelkamp S, Gillé V, Baldofski S, Koenig J, Kaess M. An examination of sociodemographic and clinical factors influencing help-seeking attitudes and behaviors among adolescents with mental health problems. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02568-7. [PMID: 39190155 DOI: 10.1007/s00787-024-02568-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 08/15/2024] [Indexed: 08/28/2024]
Abstract
This study investigated sociodemographic and clinical factors influencing help-seeking attitudes and behavior among adolescents with mental health problems. As part of the ProHEAD ("Promoting Help-seeking using E-technology for ADolescents") consortium a school-based, online assessment of sociodemographic information, psychopathology, risk-taking and self-harming behavior, help-seeking attitudes and behavior, and barriers to help-seeking was conducted in adolescents aged ≥ 12 years recruited from randomly selected schools in five regions of Germany. Linear regression analyses with the LMG formula were performed to explore predictors of help-seeking attitudes and behavior and assess their relative importance. Nine thousand five hundred and nine participants (95.5%) completed the online assessment (mean age: 15.1 years, 58.6% female). In total, 1606 participants (16.9%) showed relevant mental health problems (e.g., depressive and eating disorder symptoms, alcohol problems, and thoughts of self-harming behavior). Among them, 895 (55.7%) reported having sought help (lifetime), with higher rates for informal (n = 842, 52.4%) compared to professional (n = 380, 23.7%) sources. High help-seeking propensity emerged as the most important factor contributing to professional help-seeking, followed by elevated levels of psychopathology and perceived barriers, with sociodemographic factors being less impactful. Psychopathological severity also outweighed sociodemographic factors in predicting negative help-seeking attitudes. These findings indicate that attitudes towards seeking professional help, perceived barriers, and psychopathology severity critically influence limited adolescent help-seeking behavior. This emphasizes the need for initiatives that promote help-seeking, reduce negative attitudes, and address structural barriers in adolescent mental health care.
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Affiliation(s)
- Marialuisa Cavelti
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000, Bern 60, Switzerland
| | - Noemi Anne Ruppen
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000, Bern 60, Switzerland
| | - Silvano Sele
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000, Bern 60, Switzerland
| | - Markus Moessner
- Centre for Psychotherapy Research, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Stephanie Bauer
- Centre for Psychotherapy Research, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Katja Becker
- Department for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, University of Marburg, Marburg, Germany
| | - Jennifer Krämer
- Department for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, University of Marburg, Marburg, Germany
| | - Heike Eschenbeck
- Department of Educational Psychology and Health Psychology, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Rainer Thomasius
- German Center for Addiction Research in Childhood and Adolescence, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Silke Diestelkamp
- German Center for Addiction Research in Childhood and Adolescence, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Vera Gillé
- Department of Educational Psychology and Health Psychology, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Sabrina Baldofski
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Julian Koenig
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000, Bern 60, Switzerland.
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
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110
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Fusar-Poli L, Avanzato C, Maccarone G, Di Martino E, Avincola G, Grasso S, Rapisarda G, Guarnieri F, Signorelli MS. The Association between Attention-Deficit-Hyperactivity Disorder and Autistic Traits with Psychotic-like Experiences in Sample of Youths Who Were Referred to a Psychiatric Outpatient Service. Brain Sci 2024; 14:844. [PMID: 39199535 PMCID: PMC11352529 DOI: 10.3390/brainsci14080844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 08/15/2024] [Accepted: 08/20/2024] [Indexed: 09/01/2024] Open
Abstract
The aim of this study is to identify autism spectrum disorder (ASD) and attention-deficit-hyperactivity disorder (ADHD) traits in adolescents who experience psychotic-like experiences (PLEs), often ignored in clinical practice but widely prevalent in the general population. A total of 57 adolescents and young adults (aged between 16 and 24 years old) were recruited consecutively in the outpatient services. A total of 37 were females (64.9%), 18 were males (31.6%), and two participants (3.5%) were non-binary or gender non-conforming, with a mean age at referral of 18.26 ± 2.06. To investigate these symptoms, three sets of standardized questionnaires were used, as follows: the Autism Spectrum Quotient-short form (AQ-10), the Community Assessment of Psychic Experiences (CAPE-42), and the Adult ADHD Self-Report Scale (ASRS). We found significant associations between the ASRS and AQ-10 total scores and all CAPE scales. The model which explained the highest variance was CAPE Score's Total Frequency score (p < 0.001). Our findings underline the importance of investigating the presence of subthreshold ASD and ADHD symptoms in clinical populations, particularly in the period of adolescence and young adulthood, to promptly identify the presence of PLEs and, thus, prevent the onset of a frank psychotic disorder, particularly in the presence of a comorbid psychopathological condition, leading to better diagnosis and treatment for individuals with two or more of these conditions.
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Affiliation(s)
- Laura Fusar-Poli
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy;
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (C.A.); (G.M.); (E.D.M.); (G.A.); (S.G.)
| | - Chiara Avanzato
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (C.A.); (G.M.); (E.D.M.); (G.A.); (S.G.)
| | - Giuliana Maccarone
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (C.A.); (G.M.); (E.D.M.); (G.A.); (S.G.)
| | - Elide Di Martino
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (C.A.); (G.M.); (E.D.M.); (G.A.); (S.G.)
| | - Gabriele Avincola
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (C.A.); (G.M.); (E.D.M.); (G.A.); (S.G.)
| | - Stefania Grasso
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (C.A.); (G.M.); (E.D.M.); (G.A.); (S.G.)
| | - Giovanni Rapisarda
- Territorial Unit of Child and Adolescent Neuropsychiatry, 95125 Catania, Italy; (G.R.); (F.G.)
| | - Francesco Guarnieri
- Territorial Unit of Child and Adolescent Neuropsychiatry, 95125 Catania, Italy; (G.R.); (F.G.)
| | - Maria Salvina Signorelli
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (C.A.); (G.M.); (E.D.M.); (G.A.); (S.G.)
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111
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Monk NJ, Cunningham R, Stanley J, Crengle S, Fitzjohn J, Kerdemelidis M, Lockett H, McLachlan AD, Waitoki W, Lacey C. The physical health and premature mortality of Indigenous Māori following first-episode psychosis diagnosis: A 15-year follow-up study. Aust N Z J Psychiatry 2024:48674241270981. [PMID: 39169471 DOI: 10.1177/00048674241270981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
BACKGROUND People experiencing psychosis are at greater risk of physical health conditions and premature mortality. It is likely that Indigenous Māori youth, who experience additional systemic inequities caused by settler-colonisation, face even greater physical health and mortality risks following a diagnosis of first-episode psychosis. OBJECTIVE Compare Māori and non-Māori for risk of hospitalisation and mortality for up to 15 years following first-episode psychosis diagnosis. METHODS A cohort (N = 14,122) of young people (16-24 years) with first-episode psychosis diagnosis between 2001 and 2019 were identified. Using crude Kaplan-Meier and adjusted Cox proportional hazards models, Māori (n = 5211) and non-Māori (n = 8911) were compared on hospitalisation and mortality outcomes for up to 15 years. RESULTS In the 15 years following first-episode psychosis diagnosis, Māori had higher adjusted risk of all-cause mortality (hazard ratio = 1.21, 95% confidence interval = [1.01, 1.45]), hospitalisation with diabetes (hazard ratio = 1.44, 95% confidence interval = [1.15, 1.79]), injury/poisoning (hazard ratio = 1.11, 95% confidence interval = [1.05, 1.16]), general physical health conditions (hazard ratio = 1.07, 95% confidence interval = [1.02, 1.13]) and also appeared to be at greater risk of cardiovascular hospitalisations (hazard ratio = 1.34, 95% confidence interval = [0.97, 1.86]). Kaplan-Meier plots show hospitalisation and mortality inequities emerging approximately 4-7 years following first-episode psychosis diagnosis. CONCLUSIONS Māori are at greater risk for hospitalisation and premature mortality outcomes following first-episode psychosis. Early screening and intervention, facilitated by culturally safe health service delivery, is needed to target these inequities early.
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Affiliation(s)
- Nathan J Monk
- Department of Māori/Indigenous Health Innovation, University of Otago, Christchurch, New Zealand
| | - Ruth Cunningham
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - James Stanley
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Sue Crengle
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Christchurch, New Zealand
| | - Julie Fitzjohn
- Specialist Mental Health Service, Te Whatu Ora - Waitaha Canterbury, Christchurch, New Zealand
| | - Melissa Kerdemelidis
- Population Health Gain, Service Improvement and Innovation, Te Whatu Ora - Waitaha Canterbury, Christchurch, New Zealand
| | - Helen Lockett
- Department of Public Health, University of Otago, Wellington, New Zealand
- Te Pou, Wellington, New Zealand
| | - Andre D McLachlan
- Centre for Health and Social Practice, Waikato Institute of Technology, Hamilton, New Zealand
| | - Waikaremoana Waitoki
- Faculty of Māori and Indigenous Studies, The University of Waikato, Hamilton, New Zealand
| | - Cameron Lacey
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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Grummitt L, Bailey S, Kelly EV, Birrell L, Gardner LA, Halladay J, Chapman C, Andrews JL, Champion KE, Hunter E, Egan L, Conroy C, Tiko R, Nguyen A, Teesson M, Newton NC, Barrett EL. Refining the Universal, School-Based OurFutures Mental Health Program to Be Trauma Informed, Gender and Sexuality Diversity Affirmative, and Adherent to Proportionate Universalism: Mixed Methods Participatory Design Process. JMIR Pediatr Parent 2024; 7:e54637. [PMID: 39167794 PMCID: PMC11375394 DOI: 10.2196/54637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 07/04/2024] [Accepted: 07/08/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Mental disorders are the leading cause of disease burden among youth. Effective prevention of mental disorders during adolescence is a critical public health strategy to reduce both individual and societal harms. Schools are an important setting for prevention; however, existing universal school-based mental health interventions have shown null, and occasionally iatrogenic, effects in preventing symptoms of common disorders, such as depression and anxiety. OBJECTIVE This study aims to report the adaptation process of an established, universal, school-based prevention program for depression and anxiety, OurFutures Mental Health. Using a 4-stage process; triangulating quantitative, qualitative, and evidence syntheses; and centering the voices of young people, the revised program is trauma-informed; lesbian, gay, bisexual, transgender, nonbinary, queer, questioning, and otherwise gender and sexuality diverse (LGBTQA+) affirmative; relevant to contemporary youth; and designed to tailor intervention dosage to those who need it most (proportionate universalism). METHODS Program adaptation occurred from April 2022 to July 2023 and involved 4 stages. Stage 1 comprised mixed methods analysis of student evaluation data (n=762; mean age 13.5, SD 0.62 y), collected immediately after delivering the OurFutures Mental Health program in a previous trial. Stage 2 consisted of 3 focus groups with high school students (n=39); regular meetings with a purpose-built, 8-member LGBTQA+ youth advisory committee; and 2 individual semistructured, in-depth interviews with LGBTQA+ young people via Zoom (Zoom Video Communications) or WhatsApp (Meta) text message. Stage 3 involved a clinical psychologist providing an in-depth review of all program materials with the view of enhancing readability, improving utility, and normalizing emotions while retaining key cognitive behavioral therapy elements. Finally, stage 4 involved fortnightly consultations among researchers and clinicians on the intervention adaptation, drawing on the latest evidence from existing literature in school-based prevention interventions, trauma-informed practice, and adolescent mental health. RESULTS Drawing on feedback from youth, clinical psychologists, and expert youth mental health researchers, sourced from stages 1 to 4, a series of adaptations were made to the storylines, characters, and delivery of therapeutic content contained in the weekly manualized program content, classroom activities, and weekly student and teacher lesson summaries. CONCLUSIONS The updated OurFutures Mental Health program is a trauma-informed, LBGTQA+ affirmative program aligned with the principles of proportionate universalism. The program adaptation responds to recent mixed findings on universal school-based mental health prevention programs, which include null, small beneficial, and small iatrogenic effects. The efficacy of the refined OurFutures Mental Health program is currently being tested through a cluster randomized controlled trial with up to 1400 students in 14 schools across Australia. It is hoped that the refined program will advance the current stalemate in universal school-based prevention of common mental disorders and ultimately improve the mental health and well-being of young people in schools.
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Affiliation(s)
- Lucinda Grummitt
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Sasha Bailey
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Erin V Kelly
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Jillian Halladay
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
- School of Nursing, McMaster University, Ontario, ON, Canada
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, McMaster University, Ontario, ON, Canada
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Jack L Andrews
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Emily Hunter
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Lyra Egan
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Chloe Conroy
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Raaya Tiko
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - An Nguyen
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Emma L Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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Palmer ER, Morales-Muñoz I, Perry BI, Marwaha S, Warwick E, Rogers JC, Upthegrove R. Trajectories of Inflammation in Youth and Risk of Mental and Cardiometabolic Disorders in Adulthood. JAMA Psychiatry 2024:2822343. [PMID: 39167392 PMCID: PMC11339695 DOI: 10.1001/jamapsychiatry.2024.2193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 06/06/2024] [Indexed: 08/23/2024]
Abstract
Importance Research suggests that low-grade, nonresolving inflammation may predate adult mental and physical illness. However, evidence to date is largely cross-sectional or focuses on single disorder outcomes. Objectives To examine trajectories of inflammation as measured by C-reactive protein (CRP) levels in a large sample of children and adolescents, and to explore associations between different identified trajectories and mental and related cardiometabolic health outcomes in early adulthood. Design, Setting, and Participants In a longitudinal cohort study using data from the large UK-based Avon Longitudinal Study of Parents and Children (ALSPAC), latent class growth analysis (LCGA) was used to explore different trajectories of inflammation, with logistic regression exploring association with mental and physical health outcomes. Participants with measurable CRP data and associated mental and cardiometabolic health outcomes recorded were included in the analysis. Data analysis was performed from May 1, 2023, to March 30, 2024. Exposures Inflammation was assessed via CRP levels at ages 9, 15, and 17 years. LCGA was used to identify different trajectories of inflammation. Main Outcomes and Measures Outcomes assessed at age 24 years included psychotic disorders, depressive disorders, anxiety disorders, hypomania, and, as a measure of insulin resistance, Homeostasis Model Assessment (HOMA2) score. Results A total of 6556 participants (3303 [50.4%] female) were included. Three classes of inflammation were identified: persistently low CRP levels (reference class, n = 6109); persistently raised CRP levels, peaking at age 9 years (early peak, n = 197); and persistently raised CRP levels, peaking at age 17 years (late peak, n = 250). Participants in the early peak group were associated with a higher risk of psychotic disorder (odds ratio [OR], 4.60; 95% CI, 1.81-11.70; P = .008), a higher risk of severe depression (OR, 4.37; 95% CI, 1.64-11.63; P = .02), and higher HOMA2 scores (β = 0.05; 95% CI, 0.01-0.62, P = .04) compared with participants with persistently low CRP. The late peak group was not associated with any outcomes at age 24 years. Conclusions and Relevance Low-grade systemic inflammation peaking in midchildhood was associated with specific mental and cardiometabolic disorders in young adulthood. These findings suggest that low-grade persistent inflammation in early life may be an important shared common factor for mental-physical comorbidity and so could be relevant to future efforts of patient stratification and risk profiling.
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Affiliation(s)
- Edward R. Palmer
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Early Intervention Service, Birmingham Women’s and Children’s NHS Trust, Birmingham, United Kingdom
| | - Isabel Morales-Muñoz
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Benjamin I. Perry
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Steven Marwaha
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
- The Barberry National Centre for Mental Health, Birmingham and Solihull Mental Health NHS Trust, Birmingham, United Kingdom
| | - Ella Warwick
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Jack C. Rogers
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Rachel Upthegrove
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Early Intervention Service, Birmingham Women’s and Children’s NHS Trust, Birmingham, United Kingdom
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Zhang H, Liu Y, Gu R. Correlation between psychological traits and the use of smart medical services in young and middle-aged adults: An observational study. World J Psychiatry 2024; 14:1224-1232. [PMID: 39165550 PMCID: PMC11331391 DOI: 10.5498/wjp.v14.i8.1224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/28/2024] [Accepted: 07/10/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Psychological problems affect economic development. However, there is a huge gap between mental health service resources and mental health service needs. Existing mental health service technology and platforms cannot meet all the diverse mental health needs of people. Smart medicine is a new medical system based online that can effectively improve the quality and efficiency of medical services and make mental health services accessible. AIM To explore the level of intelligent medical use among young and middle-aged people and its correlation with psychological factors. METHODS Convenience sampling was used to select 200 young and middle-aged patients with medical experience at the Third People's Hospital of Chengdu between January 2022 and January 2023 as the research subjects. The general condition Questionnaire, Eysenck Personality Questionnaire, Symptom Checklist-90, General Health Questionnaire, and Smart Medical Service Use Intention Questionnaire were used to collect data. Pearson's correlation was used to analyze the correlation between the participants' willingness to use smart medical services and their personality characteristics, psychological symptoms, and mental health. RESULTS The results revealed that the mental health of young and middle-aged people was poor, and some had psychological problems such as anxiety, depression, and physical discomfort. Familiarity, acceptance, and usage of smart healthcare in this population are at a medium level, and these levels correlate with psychological characteristics. Acceptance was positively correlated with E, and negatively correlated with P, anxiety, fear, anxiety/insomnia, and social dysfunction. The degree of use was negatively correlated with P, obsessive-compulsive symptoms, depression, anxiety, hostility, paranoia, and somatic symptoms. CONCLUSION The familiarity, acceptance, and usage of smart medical services among the middle-aged and young groups are related to various psychological characteristics.
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Affiliation(s)
- Hu Zhang
- Department of Internet Hospital Management, The Third People's Hospital of Chengdu, Chengdu 610031, Sichuan Province, China
| | - Yan Liu
- Department of Neurology, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu 610031, Sichuan Province, China
| | - Rui Gu
- Department of Neurology, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu 610031, Sichuan Province, China
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Royer J, Kebets V, Piguet C, Chen J, Ooi LQR, Kirschner M, Siffredi V, Misic B, Yeo BTT, Bernhardt BC. MULTIMODAL NEURAL CORRELATES OF CHILDHOOD PSYCHOPATHOLOGY. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.03.02.530821. [PMID: 39185226 PMCID: PMC11343159 DOI: 10.1101/2023.03.02.530821] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
Complex structural and functional changes occurring in typical and atypical development necessitate multidimensional approaches to better understand the risk of developing psychopathology. Here, we simultaneously examined structural and functional brain network patterns in relation to dimensions of psychopathology in the Adolescent Brain Cognitive Development dataset. Several components were identified, recapitulating the psychopathology hierarchy, with the general psychopathology (p) factor explaining most covariance with multimodal imaging features, while the internalizing, externalizing, and neurodevelopmental dimensions were each associated with distinct morphological and functional connectivity signatures. Connectivity signatures associated with the p factor and neurodevelopmental dimensions followed the sensory-to-transmodal axis of cortical organization, which is related to the emergence of complex cognition and risk for psychopathology. Results were consistent in two separate data subsamples, supporting generalizability, and robust to variations in analytical parameters. Our findings help in better understanding biological mechanisms underpinning dimensions of psychopathology, and could provide brain-based vulnerability markers.
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Affiliation(s)
- Jessica Royer
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Valeria Kebets
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
- Centre for Sleep and Cognition & Centre for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore
- N.1 Institute for Health & Institute for Digital Medicine, National University of Singapore, Singapore
| | - Camille Piguet
- Young Adult Unit, Psychiatric Specialities Division, Geneva University Hospitals and Department of Psychiatry, Faculty of Medicine, University of Geneva, Switzerland
- Adolescent Unit, Division of General Paediatric, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals
| | - Jianzhong Chen
- Centre for Sleep and Cognition & Centre for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore
- N.1 Institute for Health & Institute for Digital Medicine, National University of Singapore, Singapore
| | - Leon Qi Rong Ooi
- Centre for Sleep and Cognition & Centre for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore
- N.1 Institute for Health & Institute for Digital Medicine, National University of Singapore, Singapore
| | - Matthias Kirschner
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
- Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Vanessa Siffredi
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne, Geneva, Switzerland
- Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Switzerland
| | - Bratislav Misic
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - B T Thomas Yeo
- Centre for Sleep and Cognition & Centre for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore
- N.1 Institute for Health & Institute for Digital Medicine, National University of Singapore, Singapore
- Integrative Sciences and Engineering Programme, National University Singapore, Singapore
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Boris C Bernhardt
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
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Chiu YM, Huang WL, Wang SH, Wu MS, Chen YL, Hsu CC, Wu CS. Estimating expected years of life lost of psychiatric disorders in Taiwan: A Nationwide cohort study. Gen Hosp Psychiatry 2024; 91:25-32. [PMID: 39260189 DOI: 10.1016/j.genhosppsych.2024.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 08/08/2024] [Accepted: 08/15/2024] [Indexed: 09/13/2024]
Abstract
OBJECTIVES This study employed a national longitudinal cohort to assess expected years of life lost (EYLL) in newly diagnosed psychiatric patients. METHODS Data from Taiwan's National Death Registry and Health Insurance Research Database were scrutinized to identify patients with various psychiatric disorders. Disorders were ranked hierarchically, and age groups were categorized as young, middle-aged, and older adults. We utilized the semiparametric survival extrapolation method to estimate life expectancy (LE) and EYLL. Modifying effect of comorbid conditions and socioeconomic characteristics were also explored. RESULTS Among the 5,757,431 cases, young adults with dementia, alcohol use disorder, schizophrenia, and bipolar disorder experienced an excess of 15 years of EYLL. Middle-aged adults faced approximately 9 years or more of EYLL, while older adults had lower EYLL values. Comorbid conditions, low income levels, and living in rural areas were associated with higher EYLL. CONCLUSIONS This study underscores the substantial EYLL among young adults with psychiatric disorders and the significant impact of specific disorders on EYLL. Early intervention, tailored support, and healthcare system readiness are imperative for improved outcomes. Resource allocation and targeted interventions focusing on early detection and comprehensive treatment can alleviate the economic burden.
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Affiliation(s)
- Ying-Ming Chiu
- Department of Allergy, Immunology, and Rheumatology, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan; Department of Nursing, Jen Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan
| | - Wei-Lieh Huang
- Department of Psychiatry, National Taiwan University Hospital, Yunlin Branch, Yunlin, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taiwan
| | - Shih-Heng Wang
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan City 350401, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Ming-Shiang Wu
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan City 350401, Taiwan
| | - Yu-Ling Chen
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan City 350401, Taiwan; Department of Physical Education, National Taiwan University of Sport, Taichung City, Taiwan
| | - Chih-Cheng Hsu
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan City 350401, Taiwan; Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Chi-Shin Wu
- Department of Psychiatry, National Taiwan University Hospital, Yunlin Branch, Yunlin, Taiwan; National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan City 350401, Taiwan.
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Beames JR, Han J, Shvetcov A, Zheng WY, Slade A, Dabash O, Rosenberg J, O'Dea B, Kasturi S, Hoon L, Whitton AE, Christensen H, Newby JM. Use of smartphone sensor data in detecting and predicting depression and anxiety in young people (12-25 years): A scoping review. Heliyon 2024; 10:e35472. [PMID: 39166029 PMCID: PMC11334877 DOI: 10.1016/j.heliyon.2024.e35472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 07/25/2024] [Accepted: 07/29/2024] [Indexed: 08/22/2024] Open
Abstract
Digital phenotyping is a promising method for advancing scalable detection and prediction methods in mental health research and practice. However, little is known about how digital phenotyping data are used to make inferences about youth mental health. We conducted a scoping review of 35 studies to better understand how passive sensing (e.g., Global Positioning System, microphone etc) and electronic usage data (e.g., social media use, device activity etc) collected via smartphones are used in detecting and predicting depression and/or anxiety in young people between 12 and 25 years-of-age. GPS and/or Wifi association logs and accelerometers were the most used sensors, although a wide variety of low-level features were extracted and computed (e.g., transition frequency, time spent in specific locations, uniformity of movement). Mobility and sociability patterns were explored in more studies compared to other behaviours such as sleep, phone use, and circadian movement. Studies used machine learning, statistical regression, and correlation analyses to examine relationships between variables. Results were mixed, but machine learning indicated that models using feature combinations (e.g., mobility, sociability, and sleep features) were better able to predict and detect symptoms of youth anxiety and/or depression when compared to models using single features (e.g., transition frequency). There was inconsistent reporting of age, gender, attrition, and phone characteristics (e.g., operating system, models), and all studies were assessed to have moderate to high risk of bias. To increase translation potential for clinical practice, we recommend the development of a standardised reporting framework to improve transparency and replicability of methodology.
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Affiliation(s)
- Joanne R. Beames
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Belgium
| | - Jin Han
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Artur Shvetcov
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Wu Yi Zheng
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Aimy Slade
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Omar Dabash
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Jodie Rosenberg
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Bridianne O'Dea
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Suranga Kasturi
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Leonard Hoon
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Australia
| | - Alexis E. Whitton
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | | | - Jill M. Newby
- Black Dog Institute and School of Psychology, University of New South Wales, Sydney, NSW, Australia
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Webb H, Griffiths M, Schmidt U. Experiences of intensive treatment for people with eating disorders: a systematic review and thematic synthesis. J Eat Disord 2024; 12:115. [PMID: 39143589 PMCID: PMC11323622 DOI: 10.1186/s40337-024-01061-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 07/09/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Eating disorders are complex difficulties that impact the individual, their supporters and society. Increasing numbers are being admitted to intensive treatment settings (e.g., for inpatient treatment, day-patient treatment or acute medical treatment). The lived experience perspectives of what helps and hinders eating disorder recovery during intensive treatment is an emerging area of interest. This review aims to explore patients' perspectives of what helps and hinders recovery in these contexts. METHODS A systematic review was conducted to identify studies using qualitative methods to explore patients' experiences of intensive treatment for an eating disorder. Article quality was assessed using the Critical Appraisal Skill Programme (CASP) checklist and thematic synthesis was used to analyse the primary research and develop overarching analytical themes. RESULTS Thirty articles met inclusion criteria and were included in this review. The methodological quality was mostly good. Thematic synthesis generated six main themes; collaborative care supports recovery; a safe and terrifying environment; negotiating identity; supporting mind and body; the need for specialist support; and the value of close others. The included articles focused predominantly on specialist inpatient care and were from eight different countries. One clear limitation was that ethnicity data were not reported in 22 out of the 30 studies. When ethnicity data were reported, participants predominantly identified as white. CONCLUSIONS This review identifies that a person-centred, biopsychosocial approach is necessary throughout all stages of eating disorder treatment, with support from a sufficiently resourced and adequately trained multidisciplinary team. Improving physical health remains fundamental to eating disorder recovery, though psychological support is also essential to understand what causes and maintains the eating disorder and to facilitate a shift away from an eating disorder dominated identity. Carers and peers who instil hope and offer empathy and validation are valuable additional sources of support. Future research should explore what works best for whom and why, evaluating patient and carer focused psychological interventions and dietetic support during intensive treatment. Future research should also explore the long-term effects of, at times, coercive and distressing treatment practices and determine how to mitigate against potential iatrogenic harm.
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Affiliation(s)
- Hannah Webb
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, TN1 2YG, UK.
| | - Maria Griffiths
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, TN1 2YG, UK
| | - Ulrike Schmidt
- Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London, SE5 8AZ, UK
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Attard S, Valdez-Symonds S, Valdez-Symonds S, Iles A, Maclennan F. Good character: the implications of personality development and psychopathology for citizenship. BJPsych Bull 2024:1-5. [PMID: 39138921 DOI: 10.1192/bjb.2024.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/15/2024] Open
Abstract
The introduction of new legislation in 2006 brought about changes to the way citizenship applications were considered in the UK. Over the intervening years, several hundred children born in the UK have been denied British citizenship as a result of changes to the 'good character' requirement in the legislation - namely its extension to cover all those aged 10 years or older applying for citizenship, including individuals who were born in the UK. As a result of the formulaic way in which this requirement is assessed, citizenship can be denied on the basis of historical patterns of behaviour or offending from childhood. This article will consider whether the current approach to assessment of character in the context of applications for British citizenship is meaningful or appropriate, given developments in our understanding of normative psychological and neurological development and also the impact of psychosocial adversity, trauma, and broader psychopathological or neurodevelopmental conditions.
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Affiliation(s)
- Stephen Attard
- Central and North West London NHS Foundation Trust, London, UK
| | | | | | - Andrew Iles
- Surrey and Borders NHS Foundation Trust, Leatherhead, UK
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Saboor S, Medina A, Marciano L. Application of Positive Psychology in Digital Interventions for Children, Adolescents, and Young Adults: Systematic Review and Meta-Analysis of Controlled Trials. JMIR Ment Health 2024; 11:e56045. [PMID: 39141906 PMCID: PMC11358669 DOI: 10.2196/56045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 05/14/2024] [Accepted: 05/17/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND The rising prevalence of mental health issues in children, adolescents, and young adults has become an escalating public health issue, impacting approximately 10%-20% of young people on a global scale. Positive psychology interventions (PPIs) can act as powerful mental health promotion tools to reach wide-ranging audiences that might otherwise be challenging to access. This increased access would enable prevention of mental disorders and promotion of widespread well-being by enhancing self-efficacy, thereby supporting the achievement of tangible objectives. OBJECTIVE We aimed to conduct a comprehensive synthesis of all randomized controlled trials and controlled trials involving children, adolescents, and young adults, encompassing both clinical and nonclinical populations, to comprehensively evaluate the effectiveness of digital PPIs in this age group. METHODS After a literature search in 9 electronic databases until January 12, 2023, and gray literature until April 2023, we carried out a systematic review of 35 articles, of which 18 (51%) provided data for the meta-analysis. We included randomized controlled trials and controlled trials mainly based on web-based, digital, or smartphone-based interventions using a positive psychology framework as the main component. Studies included participants with a mean age of <35 years. Outcomes of PPIs were classified into indicators of well-being (compassion, life satisfaction, optimism, happiness, resilience, emotion regulation and emotion awareness, hope, mindfulness, purpose, quality of life, gratitude, empathy, forgiveness, motivation, and kindness) and ill-being (depression, anxiety, stress, loneliness, and burnout). PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used for the selection of studies and data extraction. Quality assessment was performed following the CONSORT (Consolidated Standards of Reporting Trials) guidelines. RESULTS For well-being outcomes, meta-analytic results showed that PPIs augmented the feeling of purpose, gratitude, and hope (Hedges g=0.555), compassion (Hedges g=0.447), positive coping behaviors (Hedges g=0.421), body image-related outcomes (Hedges g=0.238), and positive mindset predisposition (Hedges g=0.304). For ill-being outcomes, PPIs reduced cognitive biases (Hedges g=-0.637), negative emotions and mood (Hedges g=-0.369), and stress levels (Hedges g=-0.342). Of note, larger effect sizes were found when a waiting list control group was considered versus a digital control group. A funnel plot showed no publication bias. Meta-regression analyses showed that PPIs tended to show a larger effect size on well-being outcomes in studies including young adults, whereas no specific effect was found for ill-being outcomes. CONCLUSIONS Revised evidence suggests that PPIs benefit young people's well-being and mitigate ill-being symptoms. Digital platforms offer a unique way to address their mental health challenges, although not without limitations. Future research should explore how they work for the needs of the young population and further examine what specific PPIs or combination of interventions is most beneficial with respect to other digital control groups. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42023420092; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=420092.
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Affiliation(s)
- Sundas Saboor
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Adrian Medina
- Deptartment of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Laura Marciano
- Lee Kum Sheung Center for Health and Happiness, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Can B, Piskun V, Dunn A, Cartwright-Hatton S. The impact of treating parental bipolar disorder and schizophrenia on their children's mental health and wellbeing: an empty systematic review. Front Psychiatry 2024; 15:1425519. [PMID: 39193576 PMCID: PMC11347426 DOI: 10.3389/fpsyt.2024.1425519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 07/29/2024] [Indexed: 08/29/2024] Open
Abstract
Background Parental psychosis (bipolar disorder and schizophrenia) are major risk factors for mental health problems in offspring. Although interventions that focus on parenting and the family environment have shown effectiveness in mitigating this risk, no systematic review has examined the impact of simply treating adult bipolar disorder or schizophrenia on their dependent children's outcomes. Aims To systematically review the effects (in randomized controlled trials) of adult-based interventions for bipolar disorder and schizophrenia, on offspring mental health and wellbeing. Method Eligibility criteria included randomized controlled trials that examined the treatment of adults with bipolar disorder and schizophrenia that also included child mental health and wellbeing outcomes. PubMed, Scopus, PsycINFO, and PsychArticles databases were searched. Results 168,317 studies were reviewed; however, zero studies that met the inclusion criteria could be found. Conclusions The existing research aimed at treating adult bipolar disorder and schizophrenia has so far overlooked the potential advantages that these treatments could provide for their offspring. This is a missed opportunity to understand the mechanisms of intergenerational transmission. Researchers examining treatments for adults with bipolar disorder and schizophrenia should, where appropriate, consider including both adult and child mental health outcomes in their trials. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=431007, identifier CRD42023431007.
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Affiliation(s)
- Beril Can
- School of Psychology, University of Sussex, Falmer, Brighton, United Kingdom
| | - Victoria Piskun
- School of Psychology, University of Sussex, Falmer, Brighton, United Kingdom
| | - Abby Dunn
- School of Psychology, University of Surrey, Guilford, Surrey, United Kingdom
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Tymofiyeva O, Sipes BS, Luks T, Hamlat EJ, Samson TE, Hoffmann TJ, Glidden DV, Jakary A, Li Y, Ngan T, Henje E, Yang TT. Interoceptive brain network mechanisms of mindfulness-based training in healthy adolescents. Front Psychol 2024; 15:1410319. [PMID: 39193038 PMCID: PMC11348390 DOI: 10.3389/fpsyg.2024.1410319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 07/18/2024] [Indexed: 08/29/2024] Open
Abstract
Introduction This study evaluated changes in the white matter of the brain and psychological health variables, resulting from a neuroscience-based mindfulness intervention, the Training for Awareness, Resilience, and Action (TARA), in a population of healthy adolescents. Methods A total of 100 healthy adolescents (57 female, age ranges 14-18 years) were randomized into the 12-week TARA intervention or a waitlist-control group. All participants were imaged with diffusion MRI to quantify white matter connectivity between brain regions. Imaging occurred at baseline/randomization and after 12 weeks of baseline (pre- and post-intervention in the TARA group). We hypothesized that structural connectivity in the striatum and interoceptive networks would increase following the TARA intervention, and that, this increased connectivity would relate to psychological health metrics from the Strengths and Difficulties Questionnaire (SDQ) and the Insomnia Severity Index (ISI). The TARA intervention and all assessments, except for the MRIs, were fully remotely delivered using secure telehealth platforms and online electronic data capture systems. Results The TARA intervention showed high consistency, tolerability, safety, recruitment, fidelity, adherence, and retention. After 12 weeks, the TARA group, but not controls, also demonstrated significantly improved sleep quality (p = 0.02), and changes in the right putamen node strength were related to this improved sleep quality (r = -0.42, p = 0.006). Similarly, the TARA group, but not controls, had significantly increased right insula node strength related to improved emotional well-being (r = -0.31, p = 0.04). Finally, we used the network-based statistics to identify a white matter interoception network that strengthened following TARA (p = 0.009). Discussion These results suggest that the TARA mindfulness-based intervention in healthy adolescents is feasible and safe, and it may act to increase structural connectivity strength in interoceptive brain regions. Furthermore, these white matter changes are associated with improved adolescent sleep quality and emotional well-being. Our results suggest that TARA could be a promising fully remotely delivered intervention for improving psychological well-being in adolescents. As our findings suggest that TARA affects brain regions in healthy adolescents, which are also known to be altered during depression in adolescents, future studies will examine the effects of TARA on depressed adolescents. Clinical trial registration https://clinicaltrials.gov/study/NCT04254796.
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Affiliation(s)
- Olga Tymofiyeva
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Benjamin S. Sipes
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Tracy Luks
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Elissa J. Hamlat
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Langley Porter Psychiatric Institute, University of California, San Francisco, San Francisco, CA, United States
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Tara E. Samson
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Thomas J. Hoffmann
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - David V. Glidden
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Angela Jakary
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Yi Li
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Tiffany Ngan
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Eva Henje
- Department of Clinical Science/Child- and Adolescent Psychiatry, Umeå University, Umeå, Sweden
| | - Tony T. Yang
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Langley Porter Psychiatric Institute, University of California, San Francisco, San Francisco, CA, United States
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
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Redican E, Meade R, Harrison C, McBride O, Butter S, Murphy J, Shevlin M. The prevalence, characteristics, and psychological wellbeing of unpaid carers in the United Kingdom. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02745-8. [PMID: 39126515 DOI: 10.1007/s00127-024-02745-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 07/26/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND This study sought to describe the characteristics of unpaid carers in the UK and assess levels of depression, anxiety, and mental health treatment seeking behaviours in this population. METHODS Data was derived from Wave 9 (n = 2790) of the COVID-19 Psychological Research Consortium (C19PRC) study, a longitudinal survey of adults in the UK. Logistic regression analyses were conducted to examine the characteristics of unpaid carers, association between caregiver status and psychological wellbeing, and caregiver-specific factors associated with risk of poor psychological wellbeing. RESULTS Approximately 15% (n = 417) of the sample reported providing unpaid care. Younger age, having three or more children in the household, and lower income were identified as significant correlates of caregiver status. Unpaid caregivers were at increased risk of depression or anxiety and mental health help-seeking. Unpaid caregivers who were younger, lived in households with one or two children, and had a lower income were at greater risk of depression or anxiety and engaging in mental health help-seeking. Caring for an individual with a terminal illness, long-term illness, learning disability or difficulty, mental health problems, physical disability, and other were linked to increased risk of depression or anxiety, while caring for someone with a learning disability increased risk of mental health help-seeking. CONCLUSIONS This study indicates that at least one in eight people in the UK provide unpaid care, and that those who provide unpaid care have a far higher risk of experiencing depression or anxiety and seeking mental health treatment. The identification of risk factors associated with these mental health outcomes will facilitate the identification of those in most need of support.
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Affiliation(s)
- Enya Redican
- School of Psychology, Ulster University, Cromore Road, Coleraine, NI, BT52 1SA, UK.
| | | | | | - Orla McBride
- School of Psychology, Ulster University, Cromore Road, Coleraine, NI, BT52 1SA, UK
| | - Sarah Butter
- School of Psychology, Ulster University, Cromore Road, Coleraine, NI, BT52 1SA, UK
| | - Jamie Murphy
- School of Psychology, Ulster University, Cromore Road, Coleraine, NI, BT52 1SA, UK
| | - Mark Shevlin
- School of Psychology, Ulster University, Cromore Road, Coleraine, NI, BT52 1SA, UK
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Cosgrove JA, Rao N, George P, Hoey T, Taylor J, Marshall T, Ghose SS, Patel NA. Social and Emotional Learning Interventions for Preadolescents and Adolescents: Assessing the Evidence Base. Psychiatr Serv 2024:appips20240040. [PMID: 39118573 DOI: 10.1176/appi.ps.20240040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
OBJECTIVE The social and emotional learning (SEL) framework is widely recognized as being effective for developing social and emotional competencies among students of all ages. However, the evidence for specific intervention models with older student populations is less established. The objective of this systematic review was to rate the evidence supporting the effectiveness of SEL interventions aimed at improving mental health outcomes among preadolescents and adolescents. METHODS A search of major databases, gray literature, and evidence base registries was conducted to identify studies published from 2008 to 2022 that assessed the effects of SEL interventions on mental health outcomes among students ages 10-19 years. The authors rated the evidence for SEL interventions as high, moderate, or low based on established rating criteria. RESULTS In total, 25 articles reporting on 17 original research studies were reviewed. Sixteen intervention models were assessed, with 11 resulting in improved mental health symptoms; however, no intervention was evaluated in a large enough number of studies to surpass a low evidence rating. Some studies reported cost benefits and high effectiveness of an intervention with students from diverse racial-ethnic or low socioeconomic backgrounds. CONCLUSIONS SEL interventions can improve mental health outcomes among preadolescents and adolescents. Additional research is needed to strengthen the evidence base for specific intervention models.
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Affiliation(s)
- John A Cosgrove
- Westat (Cosgrove, Rao, George, Hoey, Taylor, Marshall, Ghose) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland
| | - Neha Rao
- Westat (Cosgrove, Rao, George, Hoey, Taylor, Marshall, Ghose) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland
| | - Preethy George
- Westat (Cosgrove, Rao, George, Hoey, Taylor, Marshall, Ghose) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland
| | - Tabitha Hoey
- Westat (Cosgrove, Rao, George, Hoey, Taylor, Marshall, Ghose) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland
| | - Jeffrey Taylor
- Westat (Cosgrove, Rao, George, Hoey, Taylor, Marshall, Ghose) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland
| | - Tina Marshall
- Westat (Cosgrove, Rao, George, Hoey, Taylor, Marshall, Ghose) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland
| | - Sushmita Shoma Ghose
- Westat (Cosgrove, Rao, George, Hoey, Taylor, Marshall, Ghose) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland
| | - Nikhil A Patel
- Westat (Cosgrove, Rao, George, Hoey, Taylor, Marshall, Ghose) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland
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Vita G, Nöhles VB, Ostuzzi G, Barbui C, Tedeschi F, Heuer FH, Keller A, DelBello MP, Welge JA, Blom TJ, Kowatch RA, Correll CU. Systematic Review and Network Meta-Analysis: Efficacy and Safety of Antipsychotics vs Antiepileptics or Lithium for Acute Mania in Children and Adolescents. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)01316-9. [PMID: 39128561 DOI: 10.1016/j.jaac.2024.07.920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 07/02/2024] [Accepted: 08/02/2024] [Indexed: 08/13/2024]
Abstract
OBJECTIVE To compare second-generation antipsychotics (SGAs) and mood stabilizers (MSs) in youth with a bipolar disorder type I (BD-I) manic/mixed episode. METHOD A systematic PubMed/Embase/PsycInfo literature search until December 31, 2023, for randomized trials of SGAs or MSs in patients ≤18 years of age with BD-I manic/mixed episode was conducted. The study included a network meta-analysis comparing treatments regarding mania symptoms and mania response (co-primary outcomes), and secondary efficacy and tolerability outcomes. RESULTS Eighteen studies (n = 2844, mean age = 11.74, female participants = 48.0%, mean study duration = 5.4 weeks) comparing 6 SGAs (aripiprazole, asenapine, olanzapine, quetiapine, risperidone, and ziprasidone) and 4 MSs (lithium, oxcarbazepine, topiramate, and valproate) were meta-analyzed. All 6 SGAs outperformed placebo in reducing manic symptomatology, including risperidone (standardized mean difference [SMD] = -1.18, 95% CI = -0.92, -1.45, Confidence in Network Meta-Analysis [CINeMA] = moderate confidence), olanzapine (SMD = -0.77, 95% CI = -0.36, -1.18, low confidence), aripiprazole (SMD = -0.67, 95% CI = -0.33, -1.01, moderate confidence), quetiapine (SMD = -0.60, 95% CI = -0.32, -0.87, high confidence), asenapine (SMD = -0.54, 95% CI = -0.19, -0.89, moderate confidence), and ziprasidone (SMD = -0.43, 95% CI = -0.17, 0.70, low confidence), whereas no mood stabilizer outperformed placebo. Concerning mania response, risperidone (Risk ratio [RR] = 2.58, 95% CI = 1.88, 3.54, low confidence), olanzapine (RR = 2.42, 95% CI = 1.33, 3.54, very low confidence), aripiprazole (RR = 2.05, 95% CI = 1.44, 2.92, low confidence), quetiapine (RR = 1.89, 95% CI = 1.45n 2.47, moderate confidence), asenapine (RR = 1.81, 95% CI = 1.28, 2.55, very low confidence) and lithium (RR = 1.35, 95% CI = 1.00, 1.83, p = .049, very low confidence) outperformed placebo, without superiority of other MSs vs placebo. Individually, risperidone was more efficacious in reducing manic symptomatology than all other comparators, except olanzapine and topiramate, yet with low/very low confidence, and was associated with increased prolactin and glucose. Pooled together, SGAs outperformed both placebo and MSs for mania symptom reduction (SMD = -0.68, 95% CI = -0.86, -0.51 and SMD = -0.61, 95% CI = -0.82, -0.40, moderate confidence), and mania response (RR = 1.85, 95% CI = 1.53, 2.24 and RR = 1.65, 95% CI = 1.33, 2.04, moderate confidence) without differences between MSs and placebo. There were no significant treatment-placebo differences for all-cause discontinuation, whereas lithium, ziprasidone, and oxcarbazepine were associated with more adverse event-related drop-outs than placebo. Most SGAs were associated with more sedation, weight gain, and metabolic issues vs placebo and MSs. CONCLUSION SGAs were more efficacious than placebo and MSs in treating acute mania symptoms, however, their use must be carefully weighed against important side effects.
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Affiliation(s)
- Giovanni Vita
- Charité Universitätsmedizin, Berlin, Germany; WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | | | - Giovanni Ostuzzi
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Federico Tedeschi
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | | | | | | | - Jeffrey A Welge
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Thomas J Blom
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Robert A Kowatch
- Ohio State University Wexner Medical Center / Nationwide Children's Hospital, Columbus, Ohio
| | - Christoph U Correll
- Charité Universitätsmedizin, Berlin, Germany; Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, New York; Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.
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Hirsig A, Häfeli XA, Schmidt SJ. Efficacy of a transdiagnostic Internet prevention approach in adolescents (EMPATIA study): study protocol of a randomized controlled trial. Trials 2024; 25:530. [PMID: 39118136 PMCID: PMC11308397 DOI: 10.1186/s13063-024-08241-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 06/10/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Most mental disorders have their onset in adolescence. Preventive interventions during this period are important; however, help-seeking behavior is generally poor in this age group resulting in low treatment rates. Internet interventions are expected to be an effective, low-threshold, and scalable approach to overcome barriers to help-seeking, particularly for individuals experiencing subclinical symptoms. Internet-delivered indicated prevention seems promising as it targets individuals with minimal symptoms of mental disorders who might need care but are not help-seeking yet. Previous indicated prevention-approaches have mainly targeted specific risk-syndromes. However, this contradicts the increasing recognition of emerging psychopathology as a complex system characterized by co-occurrence and rapid shifts of subclinical symptoms cutting across diagnostic categories. Therefore, this study will investigate the efficacy, mediators, moderators, and core symptomatic changes of a transdiagnostic Internet-delivered indicated prevention program (EMPATIA program) for adolescents. METHODS This randomized controlled trial (RCT) will be conducted in a general population sample (planned n = 152) of adolescents aged 12-18 years with subclinical symptoms but without any current or past mental disorder. Participants will be randomly assigned to the EMPATIA program or a care as usual (CAU) control condition. The 8-week guided EMPATIA program encompasses 8 modules targeting the following transdiagnostic mechanisms: repetitive negative thinking, self-perfectionism, emotion regulation, intolerance of uncertainty, rejection sensitivity, and behavioral avoidance. Participants will be asked to answer online self-report questionnaires at baseline, after 8 weeks, and at 6-, 9-, and 12-month follow-up. Diagnostic telephone interviews will be conducted at baseline and at 12-month follow-up. Additionally, intervention-specific constructs (motivation, alliance, negative effects, satisfaction, adherence) will be assessed during and after the EMPATIA program. The level of self-reported general psychopathology post-intervention is the primary outcome. DISCUSSION Results will be discussed considering the potential of Internet interventions as a scalable, low-threshold option for indicated prevention in adolescents experiencing subclinical symptoms. The EMPATIA program introduces a novel Internet prevention program targeting six transdiagnostic mechanisms associated with various mental health outcomes. Thereby, this trial pursues a very timely and important topic because it may contribute to narrow the current care gap for adolescents, to prevent mental health problems and related negative consequences, and to promote mental health in the long-term. TRIAL REGISTRATION The trial was approved by Swissmedic (Registration Number: 10001035, 08/22/2022) and the Ethics Committee of Bern (Registration Number: 2022-D0036, 08/22/2022). The trial was registered at ClinicalTrials.gov NCT05934019 on 07-03-2023.
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Affiliation(s)
- Anja Hirsig
- Division of Clinical Child and Adolescent Psychology, University of Bern, Fabrikstrasse 8, Bern, 3012, Switzerland.
| | - Xenia Anna Häfeli
- Division of Clinical Child and Adolescent Psychology, University of Bern, Fabrikstrasse 8, Bern, 3012, Switzerland
| | - Stefanie Julia Schmidt
- Division of Clinical Child and Adolescent Psychology, University of Bern, Fabrikstrasse 8, Bern, 3012, Switzerland
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Bersia M, Charrier L, Zanaga G, Gaspar T, Moreno-Maldonado C, Grimaldi P, Koumantakis E, Dalmasso P, Comoretto RI. Well-being among university students in the post-COVID-19 era: a cross-country survey. Sci Rep 2024; 14:18296. [PMID: 39112645 PMCID: PMC11306340 DOI: 10.1038/s41598-024-69141-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 08/01/2024] [Indexed: 08/10/2024] Open
Abstract
University students have to handle crucial challenges for their future lives, such as succeeding in academic studies and finding attachment figures. These processes could potentially involve their well-being and mental health, with possible sociocultural differences based on the country of study. In order to explore such potential differences, a cross-sectional, multi-center survey was performed involving students from the University of Torino (Italy), Sevilla (Spain), and Lusòfona (Portugal). The survey, conducted from May to November 2023, investigated students' demographic and educational details, socioeconomic status, social support, mental health, academic environment, perceived COVID-19 pandemic impact, and future plans. Demographic profiles showed a predominance of female participants and straight sexual orientation, followed by bisexuality. Italian students showed the lowest levels of mental well-being and the highest rates of mental problems (anxiety and depression) and suicidal risk across the three countries despite the relatively similar profiles of social support. The prevalence of the students' confidence in their professional future is higher in Spain than in Italy and Portugal. This study provides a comprehensive examination of university students' mental health and well-being in three Southern European countries, addressing the major mental health challenges among university students and offering valuable insights for public health purposes.
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Affiliation(s)
- M Bersia
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126, Turin, Italy
| | - L Charrier
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126, Turin, Italy
| | - G Zanaga
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126, Turin, Italy
- Post Graduate School of Medical Statistics, University of Torino, Via Santena 5 bis, 10126, Turin, Italy
| | - T Gaspar
- HEI-LAB, Digital Human-Environment Interaction Labs, Lusófona University, Campo Grande 376, 1749-024, Lisbon, Portugal
| | - C Moreno-Maldonado
- Department of Developmental and Educational Psychology, University of Sevilla, C/Camilo José Cela, s/n., 41018, Seville, Spain
| | - P Grimaldi
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126, Turin, Italy
- Post Graduate School of Medical Statistics, University of Torino, Via Santena 5 bis, 10126, Turin, Italy
| | - E Koumantakis
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126, Turin, Italy.
- Post Graduate School of Medical Statistics, University of Torino, Via Santena 5 bis, 10126, Turin, Italy.
| | - P Dalmasso
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126, Turin, Italy
| | - R I Comoretto
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126, Turin, Italy
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Jirsaraie RJ, Gatavins MM, Pines AR, Kandala S, Bijsterbosch JD, Marek S, Bogdan R, Barch DM, Sotiras A. Mapping the neurodevelopmental predictors of psychopathology. Mol Psychiatry 2024:10.1038/s41380-024-02682-7. [PMID: 39107582 DOI: 10.1038/s41380-024-02682-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 07/13/2024] [Accepted: 07/22/2024] [Indexed: 08/10/2024]
Abstract
Neuroimaging research has uncovered a multitude of neural abnormalities associated with psychopathology, but few prediction-based studies have been conducted during adolescence, and even fewer used neurobiological features that were extracted across multiple neuroimaging modalities. This gap in the literature is critical, as deriving accurate brain-based models of psychopathology is an essential step towards understanding key neural mechanisms and identifying high-risk individuals. As such, we trained adaptive tree-boosting algorithms on multimodal neuroimaging features from the Lifespan Human Connectome Developmental (HCP-D) sample that contained 956 participants between the ages of 8 to 22 years old. Our feature space consisted of 1037 anatomical, 1090 functional, and 192 diffusion MRI features, which were used to derive models that separately predicted internalizing symptoms, externalizing symptoms, and the general psychopathology factor. We found that multimodal models were the most accurate, but all brain-based models of psychopathology yielded out-of-sample predictions that were weakly correlated with actual symptoms (r2 < 0.15). White matter microstructural properties, including orientation dispersion indices and intracellular volume fractions, were the most predictive of general psychopathology, followed by cortical thickness and functional connectivity. Spatially, the most predictive features of general psychopathology were primarily localized within the default mode and dorsal attention networks. These results were mostly consistent across all dimensions of psychopathology, except orientation dispersion indices and the default mode network were not as heavily weighted in the prediction of internalizing and externalizing symptoms. Taken with prior literature, it appears that neurobiological features are an important part of the equation for predicting psychopathology but relying exclusively on neural markers is clearly not sufficient, especially among adolescent samples with subclinical symptoms. Consequently, risk factor models of psychopathology may benefit from incorporating additional sources of information that have also been shown to explain individual differences, such as psychosocial factors, environmental stressors, and genetic vulnerabilities.
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Affiliation(s)
- Robert J Jirsaraie
- Division of Computational and Data Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Martins M Gatavins
- Lifespan Brain Institute, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA
| | - Adam R Pines
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Sridhar Kandala
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Janine D Bijsterbosch
- Department of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Scott Marek
- Department of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- AI for Health Institute, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Ryan Bogdan
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
- Department of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | - Aristeidis Sotiras
- Department of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
- Institute for Informatics, Data Science & Biostatistics, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
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Herzberg MP, Nielsen AN, Luby J, Sylvester CM. Measuring neuroplasticity in human development: the potential to inform the type and timing of mental health interventions. Neuropsychopharmacology 2024:10.1038/s41386-024-01947-7. [PMID: 39103496 DOI: 10.1038/s41386-024-01947-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 06/17/2024] [Accepted: 07/15/2024] [Indexed: 08/07/2024]
Abstract
Neuroplasticity during sensitive periods, the molecular and cellular process of enduring neural change in response to external stimuli during windows of high environmental sensitivity, is crucial for adaptation to expected environments and has implications for psychiatry. Animal research has characterized the developmental sequence and neurobiological mechanisms that govern neuroplasticity, yet gaps in our ability to measure neuroplasticity in humans limit the clinical translation of these principles. Here, we present a roadmap for the development and validation of neuroimaging and electrophysiology measures that index neuroplasticity to begin to address these gaps. We argue that validation of measures to track neuroplasticity in humans will elucidate the etiology of mental illness and inform the type and timing of mental health interventions to optimize effectiveness. We outline criteria for evaluating putative neuroimaging measures of plasticity in humans including links to neurobiological mechanisms shown to govern plasticity in animal models, developmental change that reflects heightened early life plasticity, and prediction of neural and/or behavior change. These criteria are applied to three putative measures of neuroplasticity using electroencephalography (gamma oscillations, aperiodic exponent of power/frequency) or functional magnetic resonance imaging (amplitude of low frequency fluctuations). We discuss the use of these markers in psychiatry, envision future uses for clinical and developmental translation, and suggest steps to address the limitations of the current putative neuroimaging measures of plasticity. With additional work, we expect these markers will significantly impact mental health and be used to characterize mechanisms, devise new interventions, and optimize developmental trajectories to reduce psychopathology risk.
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Affiliation(s)
- Max P Herzberg
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA.
| | - Ashley N Nielsen
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA.
| | - Joan Luby
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | - Chad M Sylvester
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
- Taylor Family Institute for Innovative Psychiatric Research, Washington University in St. Louis, St. Louis, MO, USA
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130
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Martin F, Dahmash D, Wicker S, Glover SL, Duncan C, Anastassiou A, Docherty L, Halligan S. Psychological well-being and needs of parents and carers of children and young people with mental health difficulties: a quantitative systematic review with meta-analyses. BMJ MENTAL HEALTH 2024; 27:e300971. [PMID: 39103177 PMCID: PMC11298743 DOI: 10.1136/bmjment-2023-300971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/26/2024] [Indexed: 08/07/2024]
Abstract
QUESTION For parents of children and young people (CYP) with diagnosed mental health difficulties, what are the levels of parents' well-being and psychological need? STUDY SELECTION AND ANALYSIS Medline, PsycINFO, EMBASE, AMED, CINAHL, Web of Science and Cochrane Library of Registered Trials were searched from inception to June 2023. INCLUSION CRITERIA parents of CYP aged 5-18 years with formal mental health diagnosis. Data were extracted from validated measures of well-being or psychological needs with established cut-off points or from a controlled study. FINDINGS 32 of the 73 310 records screened were included. Pooled means showed clinical range scores for one measure of depression, and all included measures of anxiety, parenting stress and general stress. Meta-analyses showed greater depression (g=0.24, 95% CI 0.11 to 0.38) and parenting stress (g=0.34, 95% CI 0.20 to 0.49) in parents of CYP with mental health difficulties versus those without. Mothers reported greater depression (g=0.42, 95% CI 0.18 to 0.66) and anxiety (g=0.73, 95% CI 0.27 to 1.18) than fathers. Narrative synthesis found no clear patterns in relation to CYP condition. Rates of parents with clinically relevant levels of distress varied. Typically, anxiety, parenting stress and general stress scored above clinical threshold. Quality appraisal revealed few studies with a clearly defined control group, or attempts to control for important variables such as parent gender. CONCLUSIONS The somewhat mixed results suggest clinical anxiety, parenting and general stress may be common, with sometimes high depression. Assessment and support for parents of CYP with mental health problems is required. Further controlled studies, with consideration of pre-existing parental mental health difficulties are required. PROSPERO REGISTRATION NUMBER CRD42022344453.
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Affiliation(s)
- Faith Martin
- School of Psychology, Cardiff University, Cardiff, UK
| | | | - Sarah Wicker
- School of Psychology, Cardiff University, Cardiff, UK
| | | | - Charlie Duncan
- British Association for Counselling and Psychotherapy, Lutterworth, UK
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Bränström R, Pachankis JE. Sexual Orientation Differences in Age of First Treatment for a Mental Health Diagnosis: A Population-Based Study of Childhood and Adolescence. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)01312-1. [PMID: 39098721 DOI: 10.1016/j.jaac.2024.07.916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 06/26/2024] [Accepted: 07/26/2024] [Indexed: 08/06/2024]
Abstract
OBJECTIVE The aim of the current study was to identify the age at which sexual orientation disparity in mental health diagnoses can be first identified, as well as gender and sexual identity subgroup differences in such treatment, in a population-based sample. METHOD Young people aged 16 to 25 (N = 10,406) participating in the probability-based Swedish National Public Health Survey in 2018 were included. This sample was linked to physician-assessed mental health care treatment history data starting when all participants were 8 years old using national health care registries. RESULTS Participants reporting a sexual minority identity in adolescence and young adulthood were more than 3 times as likely to have been treated for an internalizing disorder diagnosis (eg, depression, anxiety) and more than twice as likely to have been treated for a neurodevelopmental disorder diagnosis during childhood than participants reporting a heterosexual identity. Sexual minority participants overall and women in particular were more likely to have been treated for an internalizing disorder diagnosis at an early age compared with heterosexual participants, with this disparity starting at age 13. The sexual orientation disparity in likelihood of treatment for a neurodevelopmental disorder diagnosis was particularly elevated among bisexual/pansexual women with this disparity starting in early/middle adolescence. CONCLUSION This population-based study linked to physician-assessed mental health diagnoses during childhood and adolescence identifies the age at which sexual orientation differences in treatment for common mental disorders emerge. The early emergence of this disparity suggests a potential benefit of interventions that facilitate social belonging for all youth.
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Affiliation(s)
| | - John E Pachankis
- Yale School of Public Health and the Yale School of Medicine, New Haven, Connecticut
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Morales-Muñoz I, Marwaha S, Upthegrove R, Cropley V. Role of Inflammation in Short Sleep Duration Across Childhood and Psychosis in Young Adulthood. JAMA Psychiatry 2024; 81:825-833. [PMID: 38717746 PMCID: PMC11079792 DOI: 10.1001/jamapsychiatry.2024.0796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/28/2024] [Indexed: 05/12/2024]
Abstract
Importance Short sleep duration over a prolonged period in childhood could have a detrimental impact on long-term mental health, including the development of psychosis. Further, potential underlying mechanisms of these associations remain unknown. Objective To examine the association between persistent shorter nighttime sleep duration throughout childhood with psychotic experiences (PEs) and/or psychotic disorder (PD) at age 24 years and whether inflammatory markers (C-reactive protein [CRP] and interleukin 6 [IL-6]) potentially mediate any association. Design, Setting, and Participants This cohort study used data from the Avon Longitudinal Study of Parents and Children. Data analysis was conducted from January 30 to August 1, 2023. Exposures Nighttime sleep duration was collected at 6, 18, and 30 months and at 3.5, 4 to 5, 5 to 6, and 6 to 7 years. Main Outcomes and Measures PEs and PD were assessed at age 24 years from the Psychosislike Symptoms Interview. CRP level at ages 9 and 15 years and IL-6 level at 9 years were used as mediators. Latent class growth analyses (LCGAs) were applied to detect trajectories of nighttime sleep duration, and logistic regressions were applied for the longitudinal associations between trajectories of nighttime sleep duration and psychotic outcomes at 24 years. Path analyses were applied to test CRP and IL-6 as potential mediators. Results Data were available on 12 394 children (6254 female [50.5%]) for the LCGA and on 3962 young adults (2429 female [61.3%]) for the logistic regression and path analyses. The LCGA identified a group of individuals with persistent shorter nighttime sleep duration across childhood. These individuals were more likely to develop PD (odds ratio [OR], 2.50; 95% CI, 1.51-4.15; P < .001) and PEs (OR, 3.64; 95% CI, 2.23-5.95; P < .001) at age 24 years. Increased levels of IL-6 at 9 years, but not CRP at 9 or 15 years, partially mediated the associations between persistent shorter sleep duration and PD (bias-corrected estimate = 0.003; 95% CI, 0.002-0.005; P = .007) and PEs (bias-corrected estimate = 0.002; 95% CI, 0-0.003; P = .03) in young adulthood. Conclusions and Relevance Findings of this cohort study highlight the necessity of addressing short sleep duration in children, as persistence of this sleep problem was associated with subsequent psychosis. This study also provides preliminary evidence for future targeted interventions in children addressing both sleep and inflammatory responses.
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Affiliation(s)
- Isabel Morales-Muñoz
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Steven Marwaha
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Specialist Mood Disorders Clinic, Zinnia Centre, Birmingham, United Kingdom
- The Barberry National Centre for Mental Health, Birmingham, United Kingdom
| | - Rachel Upthegrove
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Early Intervention Service, Birmingham Women’s and Children’s NHS Trust, Birmingham, United Kingdom
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Victoria, Australia
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Adams M, Gong C, Heinze JE. Firearm ownership and storage among US college students: results from the healthy minds study, 2021-2022. J Behav Med 2024; 47:662-671. [PMID: 38460062 DOI: 10.1007/s10865-024-00467-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 01/15/2024] [Indexed: 03/11/2024]
Abstract
The purpose of this study is to address a significant gap in knowledge on firearm ownership rates and storage characteristics in a national sample of college students. We used 2021-2022 survey data from the Healthy Minds Study, which included approximately 88,500 students at over 100 US colleges and universities. We conducted analyses using descriptive statistics and two-sample proportion tests. About 4% of respondents reported having a firearm on or around campus. Among firearm owners, 68.8% reported storing firearms at their permanent address within an hour's drive from campus, and 43.1% reported storing their firearms unloaded and locked. Firearm ownership rates were significantly higher for respondents who were positive for specific risk factors (i.e., in a relationship, suicide ideation, recent binge drinking, and having been physically assaulted) versus those who were negative. These findings support the need for targeted messaging and firearm safety training for college students to reduce firearm-related risks.
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Affiliation(s)
- Mackenzie Adams
- University of Michigan School of Public Health, Ann Arbor, MI, USA.
| | - Catherine Gong
- University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Justin E Heinze
- University of Michigan School of Public Health, Ann Arbor, MI, USA
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134
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Cattaneo A, Begni V, Zonca V, Riva MA. Early life adversities, psychopathologies and novel pharmacological strategies. Pharmacol Ther 2024; 260:108686. [PMID: 38969307 DOI: 10.1016/j.pharmthera.2024.108686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 06/05/2024] [Accepted: 07/02/2024] [Indexed: 07/07/2024]
Abstract
Exposure to adversities during early life stages (early life adversities - ELA), ranging from pregnancy to adolescence, represents a major risk factor for the vulnerability to mental disorders. Hence, it is important to understand the molecular and functional underpinning of such relationship, in order to develop strategies aimed at reducing the psychopathologic burden associated with ELA, which may eventually lead to a significant improvement in clinical practice. In this review, we will initially recapitulate clinical and preclinical evidence supporting the link between ELA and psychopathology and we will primarily discuss the main biological mechanisms that have been described as potential mediators of the effects of ELA on the psychopathologic risk, including the role for genetic factors as well as sex differences. The knowledge emerging from these studies may be instrumental for the development of novel therapeutic strategies aimed not only at correcting the deficits that emerge from ELA exposure, but also in preventing the manifestation of a full-blown psychopathologic condition. With this respect, we will specifically focus on adolescence as a key time frame for disease onset as well as for early therapeutic intervention. We believe that incorporating clinical and preclinical research data in the context of early life adversities can be instrumental to elucidate the mechanisms contributing to the risk for psychopathology or that may promote resilience. This will ultimately allow the identification of 'at risk' individuals who may benefit from specific forms of interventions that, by interfering with disease trajectories, could result in more benign clinical outcomes.
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Affiliation(s)
- Annamaria Cattaneo
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Via Balzaretti 9, 20133 Milan, Italy; Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Veronica Begni
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Via Balzaretti 9, 20133 Milan, Italy
| | - Valentina Zonca
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Via Balzaretti 9, 20133 Milan, Italy
| | - Marco A Riva
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Via Balzaretti 9, 20133 Milan, Italy; Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
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135
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Brouwer A, Carhart‐Harris RL, Raison CL. Psychotomimetic compensation versus sensitization. Pharmacol Res Perspect 2024; 12:e1217. [PMID: 38923845 PMCID: PMC11194300 DOI: 10.1002/prp2.1217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 05/08/2024] [Indexed: 06/28/2024] Open
Abstract
It is a paradox that psychotomimetic drugs can relieve symptoms that increase risk of and cooccur with psychosis, such as attention and motivational deficits (e.g., amphetamines), pain (e.g., cannabis) and symptoms of depression (e.g., psychedelics, dissociatives). We introduce the ideas of psychotomimetic compensation and psychotomimetic sensitization to explain this paradox. Psychotomimetic compensation refers to a short-term stressor or drug-induced compensation against stress that is facilitated by engagement of neurotransmitter/modulator systems (endocannabinoid, serotonergic, glutamatergic and dopaminergic) that mediate the effects of common psychotomimetic drugs. Psychotomimetic sensitization occurs after repeated exposure to stress and/or drugs and is evidenced by the gradual intensification and increase of psychotic-like experiences over time. Theoretical and practical implications of this model are discussed.
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Affiliation(s)
- Ari Brouwer
- Department of Human Development and Family Studies, School of Human EcologyUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Robin L. Carhart‐Harris
- Department of Neurology and PsychiatryUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Charles L. Raison
- Department of Psychiatry, School of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Vail Health Behavioral Health Innovation CenterVailColoradoUSA
- Center for the Study of Human HealthEmory UniversityAtlantaGeorgiaUSA
- Department of Spiritual HealthEmory University Woodruff Health Sciences CenterAtlantaGeorgiaUSA
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136
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Iannattone S, Schuiringa HD, Aleva A, Koster N, van Aken MAG, Hessels CJ, van der Heijden PT, Laceulle OM. Unravelling the Longitudinal Relations Between Developmental Milestones, General Psychopathology, and Personality Functioning in a Youth Clinical Sample. J Youth Adolesc 2024; 53:1887-1902. [PMID: 38499819 PMCID: PMC11226502 DOI: 10.1007/s10964-024-01971-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 02/16/2024] [Indexed: 03/20/2024]
Abstract
Personality functioning, general psychopathology, and developmental milestones achievement are critical domains in the field of young people's mental health; however, no prior research has considered these variables jointly or examined the temporal dynamics between them. To fill these gaps, the present study aimed to investigate the longitudinal associations between the above constructs in a clinical sample of Dutch youth. 525 outpatients (72.5% women; age range: 12-26 years, M = 18.8 ± 2.83) diagnosed with different psychological difficulties were recruited from specialized mental health care services in The Netherlands. They completed self-report measures assessing personality functioning, psychopathological symptoms, and the achievement of youth-specific developmental milestones. Data were collected on three occasions within a year and modelled using a Cross-Lagged Panel Model approach. The levels of personality dysfunction, general psychopathology, and developmental milestones achievement were found to fluctuate from one wave to the other. Personality dysfunction and general psychopathology were positively interrelated at each time point, while both constructs were negatively associated with developmental milestones achievement. Importantly, difficulties achieving developmental milestones predicted a worsening in personality functioning 6 months later. This result would suggest that the achievement of developmental milestones precedes personality functioning, supporting the importance of interventions promoting age-adequate functioning in youth.
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Affiliation(s)
- Sara Iannattone
- Department of General Psychology, University of Padova, Padova, Italy.
| | - Hilde D Schuiringa
- Department of Developmental Psychology, Utrecht University, Utrecht, The Netherlands
| | - Anouk Aleva
- Department of Developmental Psychology, Utrecht University, Utrecht, The Netherlands
- HYPE Centre of Expertise on Early Intervention for Borderline Personality Disorder, GGz Centraal, Amersfoort, The Netherlands
| | - Nagila Koster
- Reinier van Arkel Mental Health Institute, 's-Hertogenbosch, Noord-Brabant, The Netherlands
| | - Marcel A G van Aken
- Department of Developmental Psychology, Utrecht University, Utrecht, The Netherlands
| | - Christel J Hessels
- HYPE Centre of Expertise on Early Intervention for Borderline Personality Disorder, GGz Centraal, Amersfoort, The Netherlands
| | - Paul T van der Heijden
- Reinier van Arkel Mental Health Institute, 's-Hertogenbosch, Noord-Brabant, The Netherlands
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Odilia M Laceulle
- Department of Developmental Psychology, Utrecht University, Utrecht, The Netherlands
- Reinier van Arkel Mental Health Institute, 's-Hertogenbosch, Noord-Brabant, The Netherlands
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137
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Grimmond T, King T, LaMontagne AD, Oostermeijer S, Harrap B, Newberry-Dupé J, Reavley N. Workplace-related determinants of mental health in food and bar workers in Western, high-income countries: A systematic review. Am J Ind Med 2024; 67:696-711. [PMID: 38837271 DOI: 10.1002/ajim.23620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 05/08/2024] [Accepted: 05/17/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND This review synthesizes evidence from etiologic and intervention studies of workplace-related determinants of mental health in workers in food and bar workers in the hospitality industry in Western high-income countries. METHODS Peer-reviewed literature published between January 2000 and August 2023 was gathered from five bibliographic databases. Any study design was eligible. Study quality was assessed using the Joanna Briggs Institute tools for appraisal. RESULTS A narrative analysis was conducted for 26 included studies (total n = 15,069 participants) across Australia (3), Ireland (1), Norway (1), Spain (2), the United States (17) and the United Kingdom (2). Individual and task-related factors such as high emotional job demands and low job control were associated with high burnout and depression. Uncivil and hostile interpersonal interactions with customers, management, and colleagues were found to contribute to poor mental health outcomes, including depression, anxiety, and burnout. CONCLUSION Findings from included studies highlight the impact of workplace culture, including management practices and workplace social support, on mental health. Organization-level interventions may therefore be most effective for addressing individual, interpersonal, and organizational determinants of mental health in food and bar occupations, particularly when implemented as part of broader organizational efforts to support health and wellbeing. Industry-wide policy changes may also be necessary to address structural concerns, including job and financial insecurity, job strain and access to benefits, such as secure sick leave and minimum contract hours.
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Affiliation(s)
- Tessa Grimmond
- Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Tania King
- Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Anthony D LaMontagne
- Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
- Institute for Health Transformation & School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Sanne Oostermeijer
- Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Benjamin Harrap
- Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Jackson Newberry-Dupé
- Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Nicola Reavley
- Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
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138
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Zainal NH, Soh CP, Van Doren N. Daily stress reactivity and risk appraisal mediates childhood parental abuse predicting adulthood psychopathology severity: An 18-year longitudinal mediation analysis. J Affect Disord 2024; 358:138-149. [PMID: 38663555 PMCID: PMC11283637 DOI: 10.1016/j.jad.2024.04.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/07/2024] [Accepted: 04/16/2024] [Indexed: 05/12/2024]
Abstract
Identifying mechanisms of childhood abuse-adulthood psychopathology relations could facilitate preventive efforts, but most prior studies used cross-sectional or two-wave designs and did not test the effects of childhood maternal and paternal abuse separately. Our 18-year three-wave study thus determined if Wave 2 daily stress reactivity and risk appraisal severity mediated Wave 1 retrospectively-reported childhood maternal and paternal abuse on Wave 3 generalized anxiety disorder (GAD), major depressive disorder (MDD), panic disorder (PD), alcohol (AUD), and substance use disorder (SUD) self-rated symptom severity. Longitudinal structural equation modeling was employed, adjusting for Wave 1 psychopathology severity. Higher childhood maternal and paternal abuse consistently predicted greater future daily stress reactivity and risk appraisal, and these mediators subsequently predicted increased GAD, MDD, and PD, but not AUD and SUD severity. Daily stress reactivity and risk appraisal consistently mediated the pathways between childhood maternal and paternal abuse predicting heightened adulthood GAD, MDD, and PD (Cohen's d = 0.333-0.888) but not AUD and SUD severity. Mediation effect sizes were stronger for childhood maternal (24.5-83.0%) than paternal (19.5-56.0%) abuse as the predictor. The latent interaction between Wave 1 childhood maternal and paternal abuse did not moderate the effect of Wave 1 maternal or paternal abuse on any Wave 3 adulthood psychopathology severity through Wave 2 daily stress reactivity and risk appraisal. Our research emphasizes the urgent requirement for continuous evaluation and intervention initiatives in trauma-informed care, both in inpatient and outpatient treatment settings.
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Affiliation(s)
- Nur Hani Zainal
- Harvard Medical School, Department of Health Care Policy, United States of America; National University of Singapore, Department of Psychology, Singapore.
| | - Chui Pin Soh
- National University of Singapore, Department of Psychology, Singapore
| | - Natalia Van Doren
- University of California at San Francisco, Department of Psychiatry and Behavioral Sciences, United States of America
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139
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Packard SE, Verzani Z, Finsaas MC, Levy NS, Shefner R, Planey AM, Boehme AK, Prins SJ. Maintaining disorder: estimating the association between policing and psychiatric hospitalization among youth in New York City by neighborhood racial composition, 2006-2014. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02738-7. [PMID: 39088094 DOI: 10.1007/s00127-024-02738-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 07/21/2024] [Indexed: 08/02/2024]
Abstract
PURPOSE To assess whether neighborhood-level measures of policing are spatio-temporally associated with psychiatric hospialization among adolescents and young adults in New York City, and whether this association varies by neighborhood racial composition. METHODS We derived population-based measures of policing from the New York City Police Department (NYPD), psychiatric hospitalization from Statewide Planning and Research Cooperative System (SPARCS) data, and socio-demographic data from the American Community Survey (ACS), aggregated by month and ZIP Code Tabulation Area (ZCTA) from 2006 to 2014. Multi-level negative binomial regression models assessed hospitalization-time of youth aged 10-24 as the dependent variable and the rate of policing events as the primary independent variable, adjusting for neighborhood poverty, unemployment, and educational attainment. Multiplicative interaction was assessed between policing and tertiles of the percentage of Black residents. RESULTS A total of 11,900,192 policing incidents and 2,118,481 person-days of hospitalization were aggregated to 19,440 ZCTA-months. After adjusting for neighborhood-level sociodemographic characteristics, an increase in one policing incident per 1,000 residents was associated with a 0.3% increase in the rate of youth psychiatric hospitalization time (IRR 1.003 [1.001-1.005]). Neighborhood racial composition modified this effect; not only was the rate of psychiatric hospitalization and policing higher in neighborhoods with a higher proportion of Black residents, but the association between these was also significantly higher in neighorhoods with a larger share of Black residents compared with predominantly non-Black neighborhoods. CONCLUSION Neighborhoods experiencing higher rates of policing during the study period experienced higher burdens of psychiatric hospitalization among adolescent and young adult residents. This association was larger in neighborhoods of color which have been disproportionately targeted by "hot spot" and order-maintenance policing practices and policies.
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Affiliation(s)
- Samuel E Packard
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Zoe Verzani
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Megan C Finsaas
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Natalie S Levy
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Ruth Shefner
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Arrianna M Planey
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Amelia K Boehme
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Neurology, Columbia University, New York, NY, USA
| | - Seth J Prins
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
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de Rooy FBB, Arnoldussen M, van der Miesen AIR, Steensma TD, Kreukels BPC, Popma A, de Vries ALC. Mental Health Evaluation of Younger and Older Adolescents Referred to the Center of Expertise on Gender Dysphoria in Amsterdam, The Netherlands. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:2883-2896. [PMID: 38980647 PMCID: PMC11335953 DOI: 10.1007/s10508-024-02940-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 06/09/2024] [Accepted: 06/10/2024] [Indexed: 07/10/2024]
Abstract
The present study aimed to investigate whether differences exist between younger and older presenting adolescents at the Center of Expertise on Gender Dysphoria regarding psychological functioning and autistic traits. A total of 1487 consecutively assessed adolescents between 2000 and 2018 were divided in younger presenters (age ≤ 13.9 years) and older presenters (age ≥ 14 years). Of younger presenters, 227 (41.1%) were assigned male at birth and 325 (58.9%) assigned female at birth. In older presenters, 279 (29.8%) were assigned male at birth and 656 (70.2%) assigned female at birth. Behavioral and emotional problems were assessed with the Child Behavior Checklist (CBCL) and the Youth Self-Report (YSR). For autism traits, the Social Responsiveness Scale (SRS) was used. Compared to younger presenters, on both the CBCL and YSR older presenters had higher Total Problem (β = 1.75, p = .005, CI 0.53-2.97, R2 = .04 and β = 4.20, p < .001, CI 2.99-5.40, R2 = .07, respectively) and Internalizing Problem (β = 4.43, p < .001, CI 3.13-5.74, R2 = .06 and β = 6.69, p < .001, CI 5.31-8.07, R2 = .12, respectively) scores. Regarding autistic traits, a higher mean SRS total score was found in older presenting assigned males at birth (β = 4.55, p = .036, CI 0.30-8.81, R2 = .34). In assigned females at birth, no statistically significant difference between older and younger presenters was found in mean SRS total score (β = 1.19, p = .063, CI - 0.07 to 2.45, R2 = .39). Differences in mental health exist between younger and older presenting adolescents and call for an individualized approach in the clinical care of transgender adolescents.
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Affiliation(s)
- Frédérique B B de Rooy
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands.
- Center of Expertise on Gender Dysphoria, De Boelelaan 1117, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - Marijn Arnoldussen
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
- Center of Expertise on Gender Dysphoria, De Boelelaan 1117, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Anna I R van der Miesen
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
- Center of Expertise on Gender Dysphoria, De Boelelaan 1117, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Thomas D Steensma
- Center of Expertise on Gender Dysphoria, De Boelelaan 1117, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Baudewijntje P C Kreukels
- Center of Expertise on Gender Dysphoria, De Boelelaan 1117, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Arne Popma
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | - Annelou L C de Vries
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
- Center of Expertise on Gender Dysphoria, De Boelelaan 1117, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
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141
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Gao Q, Niu L, Wang W, Zhao S, Xiao J, Lin D. Developmental Trajectories of Mental Health in Chinese Early Adolescents: School Climate and Future Orientation as Predictors. Res Child Adolesc Psychopathol 2024; 52:1303-1317. [PMID: 38625459 DOI: 10.1007/s10802-024-01195-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2024] [Indexed: 04/17/2024]
Abstract
There is growing support for the dual-continua model of mental health, which emphasizes psychopathology and well-being as related but distinct dimensions. Yet, little is known about how these dimensions co-develop from childhood to early adolescence and what factors predict their different trajectories. The current study aimed to identify distinct patterns of mental health in Chinese early adolescents, focusing on both psychopathological symptoms (i.e., depressive symptoms and self-harm behaviors) and subjective well-being (i.e., life satisfaction and affect balance). This study also examined the contributions of school climate and future orientation to these trajectories. A total of 1,057 students (Mage = 11.88, SDage = 1.67; 62.1% boys) completed four assessments over two years, with six-month intervals. Using parallel-process latent class growth modeling, we identified four groups: Flourishing (32.5%), Languishing (43.8%), Troubled with Stable Depressive Symptoms (16.1%), and Troubled with Increasing Self-Harm Risk (7.6%). Furthermore, school climate and future orientation contributed to adolescents' membership in these trajectories, either independently or jointly. Specifically, higher levels of future orientation combined with higher school climate were associated with a lower likelihood of belonging to the Troubled with Increasing Self-Harm Risk trajectory, compared to the Flourishing group. Our findings identified four distinct mental health trajectories consistent with the dual-continua model, and demonstrated that the development of psychopathology and well-being were not always inversely related (e.g., the Languishing group). Adolescents with unique developmental profiles may benefit from tailored intervention strategies that build on the personal and environmental assets of the adolescent.
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Affiliation(s)
- Qianqian Gao
- Institute of Developmental Psychology, Beijing Normal University, Beijing, 100875, China
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Li Niu
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Wei Wang
- Institute of Developmental Psychology, Beijing Normal University, Beijing, 100875, China
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Shan Zhao
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiale Xiao
- Institute of Developmental Psychology, Beijing Normal University, Beijing, 100875, China
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Danhua Lin
- Institute of Developmental Psychology, Beijing Normal University, Beijing, 100875, China.
- Faculty of Psychology, Beijing Normal University, Beijing, China.
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142
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Grimes PZ, Adams MJ, Thng G, Edmonson-Stait AJ, Lu Y, McIntosh A, Cullen B, Larsson H, Whalley HC, Kwong ASF. Genetic Architectures of Adolescent Depression Trajectories in 2 Longitudinal Population Cohorts. JAMA Psychiatry 2024; 81:807-816. [PMID: 38748406 PMCID: PMC11097103 DOI: 10.1001/jamapsychiatry.2024.0983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/10/2024] [Indexed: 05/18/2024]
Abstract
Importance Adolescent depression is characterized by diverse symptom trajectories over time and has a strong genetic influence. Research has determined genetic overlap between depression and other psychiatric conditions; investigating the shared genetic architecture of heterogeneous depression trajectories is crucial for understanding disease etiology, prediction, and early intervention. Objective To investigate univariate and multivariate genetic risk for adolescent depression trajectories and assess generalizability across ancestries. Design, Setting, and Participants This cohort study entailed longitudinal growth modeling followed by polygenic risk score (PRS) association testing for individual and multitrait genetic models. Two longitudinal cohorts from the US and UK were used: the Adolescent Brain and Cognitive Development (ABCD; N = 11 876) study and the Avon Longitudinal Study of Parents and Children (ALSPAC; N = 8787) study. Included were adolescents with genetic information and depression measures at up to 8 and 4 occasions, respectively. Study data were analyzed January to July 2023. Main Outcomes and Measures Trajectories were derived from growth mixture modeling of longitudinal depression symptoms. PRSs were computed for depression, anxiety, neuroticism, bipolar disorder, schizophrenia, attention-deficit/hyperactivity disorder, and autism in European ancestry. Genomic structural equation modeling was used to build multitrait genetic models of psychopathology followed by multitrait PRS. Depression PRSs were computed in African, East Asian, and Hispanic ancestries in the ABCD cohort only. Association testing was performed between all PRSs and trajectories for both cohorts. Results A total sample size of 14 112 adolescents (at baseline: mean [SD] age, 10.5 [0.5] years; 7269 male sex [52%]) from both cohorts were included in this analysis. Distinct depression trajectories (stable low, adolescent persistent, increasing, and decreasing) were replicated in the ALSPAC cohort (6096 participants; 3091 female [51%]) and ABCD cohort (8016 participants; 4274 male [53%]) between ages 10 and 17 years. Most univariate PRSs showed significant uniform associations with persistent trajectories, but fewer were significantly associated with intermediate (increasing and decreasing) trajectories. Multitrait PRSs-derived from a hierarchical factor model-showed the strongest associations for persistent trajectories (ABCD cohort: OR, 1.46; 95% CI, 1.26-1.68; ALSPAC cohort: OR, 1.34; 95% CI, 1.20-1.49), surpassing the effect size of univariate PRS in both cohorts. Multitrait PRSs were associated with intermediate trajectories but to a lesser extent (ABCD cohort: hierarchical increasing, OR, 1.27; 95% CI, 1.13-1.43; decreasing, OR, 1.23; 95% CI, 1.09-1.40; ALSPAC cohort: hierarchical increasing, OR, 1.16; 95% CI, 1.04-1.28; decreasing, OR, 1.32; 95% CI, 1.18-1.47). Transancestral genetic risk for depression showed no evidence for association with trajectories. Conclusions and Relevance Results of this cohort study revealed a high multitrait genetic loading of persistent symptom trajectories, consistent across traits and cohorts. Variability in univariate genetic association with intermediate trajectories may stem from environmental factors. Multitrait genetics may strengthen depression prediction models, but more diverse data are needed for generalizability.
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Affiliation(s)
- Poppy Z. Grimes
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Mark J. Adams
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Gladi Thng
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Amelia J. Edmonson-Stait
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Yi Lu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Andrew McIntosh
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Breda Cullen
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Heather C. Whalley
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Generation Scotland, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Alex S. F. Kwong
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
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143
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Rienecke RD, Trotter X, Jenkins PE. A systematic review of eating disorders and family functioning. Clin Psychol Rev 2024; 112:102462. [PMID: 38941693 DOI: 10.1016/j.cpr.2024.102462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 06/19/2024] [Accepted: 06/19/2024] [Indexed: 06/30/2024]
Abstract
The purpose of the current review was to address four questions: 1) Are there differences in family functioning or family environment among patients with different eating disorder (ED) diagnoses? 2) Are there differences in the perception of family functioning or family environment among different family members? 3) Is family functioning or family environment related to ED symptomatology? 4) Does family functioning or family environment change as a result of ED treatment? and 4a) If so, does this impact ED treatment outcome? Although most studies found no differences among ED diagnostic groups, those that did generally found worse family functioning among those with binge/purge symptoms than among those with the restricting subtype of anorexia nervosa. Differences in perceptions of family functioning among family members were found, with patients generally reporting worse functioning than their parents. Worse family functioning was generally found to be related to worse ED symptoms. The variety of treatment approaches and different assessments of outcome made it somewhat unclear whether family functioning consistently improves with ED treatment. More research is needed on family functioning and EDs, particularly in understudied groups such as males, and those with ED diagnoses other than anorexia nervosa or bulimia nervosa.
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Affiliation(s)
- Renee D Rienecke
- Eating Recovery Center/Pathlight Mood & Anxiety Center, USA; Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA.
| | - Xanthe Trotter
- School of Psychology and Clinical Language Sciences, University of Reading, Reading RG6 6ES, United Kingdom
| | - Paul E Jenkins
- School of Psychology and Clinical Language Sciences, University of Reading, Reading RG6 6ES, United Kingdom
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144
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Clark CA, Nakhid D, Baldwin-Oneill G, LaPointe S, MacIsaac-Jones M, Raja S, McMorris CA. Prevalence of co-occurring diagnoses in people exposed to alcohol prenatally: Findings from a meta-analysis. J Affect Disord 2024; 358:163-174. [PMID: 38718944 DOI: 10.1016/j.jad.2024.05.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 05/03/2024] [Accepted: 05/04/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Individuals with prenatal alcohol exposure (PAE) commonly experience co-occurring diagnoses, which are often overlooked and misdiagnosed and have detrimental impacts on accessing appropriate services. The prevalence of these co-occurring diagnoses varies widely in the existing literature and has not been examined in PAE without an FASD diagnosis. METHOD A search was conducted in five databases and the reference sections of three review papers, finding a total of 2180 studies. 57 studies were included in the final analysis with a cumulative sample size of 29,644. Bayesian modeling was used to determine aggregate prevalence rates of co-occurring disorders and analyze potential moderators. RESULTS 82 % of people with PAE had a co-occurring diagnosis. All disorders had a higher prevalence in individuals with PAE than the general population with attention deficit hyperactivity disorder, learning disorder, and intellectual disability (ID) being the most prevalent. Age, diagnostic status, and sex moderated the prevalence of multiple disorders. LIMITATIONS While prevalence of disorders is crucial information, it does not provide a direct representation of daily functioning and available supports. Results should be interpreted in collaboration with more individualized research to provide the most comprehensive representation of the experience of individuals with PAE. CONCLUSIONS Co-occurring diagnoses are extremely prevalent in people with PAE, with older individuals, females, and those diagnosed with FASD being most at risk for having a co-occurring disorder. These findings provide a more rigorous examination of the challenges faced by individuals with PAE than has existed in the literature, providing clinicians with information to ensure early identification and effective treatment of concerns to prevent lifelong challenges.
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Affiliation(s)
- C A Clark
- Werklund School of Education, School and Applied Child Psychology, University of Calgary, Canada; Alberta Children's Hospital Research Institute (ACHRI), Canada.
| | - D Nakhid
- Alberta Children's Hospital Research Institute (ACHRI), Canada; Hotchkiss Brain Institute, University of Calgary, Canada
| | | | - S LaPointe
- Department of Psychology, University of Calgary, Canada
| | | | - S Raja
- Department of Psychology, University of Calgary, Canada
| | - C A McMorris
- Werklund School of Education, School and Applied Child Psychology, University of Calgary, Canada; Alberta Children's Hospital Research Institute (ACHRI), Canada; Department of Psychology, University of Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Canada
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145
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Wang J, Wang T, Cheng Y. Resilience as a moderator of the relationship between stress and different symptom dimensions of depression in adolescents with a history of childhood maltreatment: A multi-wave longitudinal study. CHILD ABUSE & NEGLECT 2024; 154:106888. [PMID: 38850746 DOI: 10.1016/j.chiabu.2024.106888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 05/21/2024] [Accepted: 06/03/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Although childhood maltreatment is a key risk factor for the development of psychopathology including depression in later life, not all children who have been maltreated subsequently become depressed. OBJECTIVE The study aimed to examine the potentially moderating influence of resilience on the relationship between daily stress and different symptom dimensions of depression in adolescents with a history of childhood maltreatment. PARTICIPANTS AND SETTING A sample of students (n = 999) aged 12-16 years from middle schools with a history of childhood maltreatment participated in this study. METHODS A multi-wave longitudinal study was conducted over 12 months. At baseline, adolescent participants completed standardized self-report measures of resilience, depression, and daily stress. The measures of depression and stress were re-administered every three months for the subsequent 12 months. Multi-level modeling was undertaken to analyze the data. RESULTS In adolescents with a history of childhood maltreatment, lower resilience scores were associated with greater increases in depressed affect, absence of positive affect and somatic symptom, but not the interpersonal concerns symptom dimensions of depression following daily stress. Resilience is therefore as one explanation for the discrepant findings regarding the relationship between stress and different symptom dimensions of depression, especially with regard to the stress-related depressive dimensions. CONCLUSION Resilience appears to moderate the relationship between daily stress and depression and protect against developing depression in children who have been maltreated. Findings provide potential explanation for the effectiveness of resilience-related therapy in treating depressive symptoms.
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Affiliation(s)
- Junyi Wang
- School of Teacher Education, Nanjing University of Information Science & Technology, Nanjing 210044, China.
| | - Tingting Wang
- Shanghai Xingzhi Experimental Middle School, Shanghai, China
| | - Yuqin Cheng
- Shenzhen Kangning Hospital, Shenzhen, Guangdong, China
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146
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Crump CJ, Abuelazm H, Ibrahim K, Shah S, El-Mallakh RS. An overview of the efficacy and safety of brexpiprazole for the treatment of schizophrenia in adolescents. Expert Rev Neurother 2024; 24:727-733. [PMID: 38864423 DOI: 10.1080/14737175.2024.2367695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 06/10/2024] [Indexed: 06/13/2024]
Abstract
INTRODUCTION The onset of psychotic symptoms occurs prior to age 19 in 39% of the patients with schizophrenia. There are limited approved treatment options for adolescents with schizophrenia. Brexpiprazole was approved by the United States Food and Drug Administration (FDA) for treatment of schizophrenia in adolescents in 2022. AREAS COVERED Extrapolation of adult data to youth and use of pharmacologic modeling coupled with open long-term safety data were used by the FDA to approve brexpiprazole for adolescent schizophrenia. They were all reviewed herein. EXPERT OPINION D2 receptor partial agonist antipsychotic agents are preferred in the early phase of treatment of psychotic disorders. Approval of brexpiprazole in adolescent schizophrenia provides an additional option. Brexpiprazole was approved by the FDA on the basis of extrapolation of adult data without controlled trials in adolescents. This reduces placebo exposure in young people. Two previous agents (asenapine and ziprasidone) approved for adult schizophrenia failed to separate from placebo in adolescent schizophrenia studies; this partially undermines the process of extrapolation. For brexpiprazole, the paucity of data in adolescents relegates it to a second-line agent. More research on brexpiprazole is needed to delineate its relative role in the management of adolescent schizophrenia.
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Affiliation(s)
- Chesika J Crump
- Mood Disorders Research Program, Depression Center, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA
| | - Hagar Abuelazm
- Mood Disorders Research Program, Depression Center, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA
| | - Kirolos Ibrahim
- Mood Disorders Research Program, Depression Center, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA
| | - Shaishav Shah
- Mood Disorders Research Program, Depression Center, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA
| | - Rif S El-Mallakh
- Mood Disorders Research Program, Depression Center, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA
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147
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Bogaert L, Hallford D, Loyen E, D'Argembeau A, Raes F. Recalling and anticipating positive events to improve the positive affect and mental health of adolescents: A cluster randomized controlled trial in secondary schools. Behav Res Ther 2024; 179:104543. [PMID: 38744140 DOI: 10.1016/j.brat.2024.104543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 05/16/2024]
Abstract
This cluster randomized controlled trial examined the effectiveness of Positive Events Training (PET), a combined group training aimed at simultaneously improving positive autobiographical memory (AM) and episodic future thinking (EFT) among adolescents (12-16 years). Delivered as a universal school-based program, PET was compared with an active (creative writing) control group (CREAT). Effects on resilience, wellbeing, positive emotions, emotional response styles towards positive emotions (savoring, dampening), anhedonia, depressive symptoms, and multiple AM and EFT indices were examined. Adolescents (NPET = 95, NCREAT = 93) completed self-report scales at baseline, post-training and two-month follow-up. Multilevel models revealed that PET led to significant improvements in certain AM and EFT skills. Moreover, a decrease in anhedonia was observed at post-training. However, this effect did not withstand correction for multiple testing. Absence of changes in the other outcomes should be interpreted within the context of the universal school-based approach and the potential limited scope for detectable changes. Exploratory analyses suggest the importance of further investigating PET's potential in addressing positive affect dysregulations in indicated samples, and exploring perceived likelihood of generated future events and dampening as potential underlying mechanisms. Study limitations and future directions to maximize the demonstrated potential of PET are discussed.
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Affiliation(s)
- L Bogaert
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; KU Leuven Child and Youth Institute, KU Leuven, Belgium.
| | - D Hallford
- School of Psychology, Deakin University, 1 Gheringhap Road, Geelong, Australia
| | - E Loyen
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; KU Leuven Child and Youth Institute, KU Leuven, Belgium
| | - A D'Argembeau
- Psychology and Neuroscience of Cognition Research Unit, Department of Psychology, University of Liège, Belgium
| | - F Raes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; KU Leuven Child and Youth Institute, KU Leuven, Belgium
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148
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Hartman-Munick SM, Allen S, Powell A. Disordered Eating/Eating Disorders in Adolescents. Pediatr Clin North Am 2024; 71:631-643. [PMID: 39003006 DOI: 10.1016/j.pcl.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/15/2024]
Abstract
The coronavirus disease 2019 pandemic was as tressful time for adolescents, with increased isolation, loss of routines, and changes in access to medical care. In this setting, the medical system saw a significant rise in the number of adolescents seeking care for eating disorders, as well as increased severity of patient presentation. Telehealth treatment for eating disorders was a unique shift during the pandemic, with some benefits but not universally positive experiences among patients, families and providers.
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Affiliation(s)
- Sydney M Hartman-Munick
- University of Massachusetts Memorial Children's Medical Center, UMass Chan Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
| | - Suzanne Allen
- University of Massachusetts Memorial Children's Medical Center, UMass Chan Medical School, Tan Chingfen Graduate School of Nursing, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Anne Powell
- University of Massachusetts Memorial Children's Medical Center, UMass Chan Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
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149
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Jiménez-López E, Mesas AE, Visier-Alfonso ME, Pascual-Morena C, Martínez-Vizcaíno V, Herrera-Gutiérrez E, López-Gil JF. Adherence to the Mediterranean diet and depressive, anxiety, and stress symptoms in Spanish adolescents: results from the EHDLA study. Eur Child Adolesc Psychiatry 2024; 33:2637-2646. [PMID: 38170283 DOI: 10.1007/s00787-023-02351-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024]
Abstract
Depression and anxiety are prevalent and disabling conditions among adolescents. The aim of this study was to examine the relationship between adherence to the Mediterranean diet (MD) and depressive, anxiety, and stress symptoms in adolescents. This cross-sectional study included a sample of 698 adolescent students from a region of Spain (mean age of 13.9 ± 1.5 years; 56.2% girls). Adherence to the MD was evaluated with the Mediterranean Diet Quality Index in children and adolescents (KIDMED). Mental health symptoms were measured with the Depression, Anxiety, and Stress Scale (DASS-21). Logistic regression models were performed, including a wide range of potential confounders. Compared to individuals with low adherence to the MD, those with moderate and high adherence had lower odds of experiencing depressive symptoms (odds ratio [OR] = 0.40, 95% confidence interval [CI] 0.24-0.65 and OR = 0.33, 95% CI 0.20-0.55, respectively), which were statistically significant even after adjustment. No significant associations were found regarding anxiety or stress symptoms. Therefore, according to our results, higher adherence to the MD is inversely related to having depressive symptoms among adolescents, regardless of socioeconomic, anthropometric, and lifestyle factors. Considering the deleterious effects of mental health problems in youths, further research on the role of nonpharmacological strategies for the prevention and treatment of depressive symptoms in adolescence is essential.
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Affiliation(s)
- Estela Jiménez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha, Santa Teresa Jornet s/n, 16071, Cuenca, Spain
- Department of Psychiatry, Hospital Virgen de La Luz, Cuenca, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
| | - Arthur Eumann Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha, Santa Teresa Jornet s/n, 16071, Cuenca, Spain.
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Paraná, 86057-970, Brazil.
| | - María Eugenia Visier-Alfonso
- Health and Social Research Center, Universidad de Castilla-La Mancha, Santa Teresa Jornet s/n, 16071, Cuenca, Spain
| | - Carlos Pascual-Morena
- Health and Social Research Center, Universidad de Castilla-La Mancha, Santa Teresa Jornet s/n, 16071, Cuenca, Spain
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Santa Teresa Jornet s/n, 16071, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, 1101, Talca, Chile
| | - Eva Herrera-Gutiérrez
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Murcia, Espinardo Campus, 30100, Murcia, Spain
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150
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Trott M, Bull C, Najman JM, Arnautovska U, Siskind D, Warren N, Kisely S. Hospital admissions and community health service contacts for mental illness following self-reported child maltreatment: Results from the Childhood Adversity and Lifetime Morbidity (CALM) study. CHILD ABUSE & NEGLECT 2024; 154:106912. [PMID: 38970858 DOI: 10.1016/j.chiabu.2024.106912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 06/06/2024] [Accepted: 06/12/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND Child maltreatment (CM) includes neglect, and several types of abuse, including physical, emotional, and sexual. CM has been associated with a wide range of mental illnesses. Literature examining these illnesses in mid-life is scarce, and the impact of these illnesses on mental health service use is currently unknown. OBJECTIVE To examine associations between self-reported CM and subsequent hospital admissions for mental illnesses, and/or community mental health service contacts. SETTING Birth cohort study data linked to administrative health data, including hospital admissions and community mental health service contacts, up to the age of 40. METHODS Associations between hospital admissions for mental health and community mental health contacts and CM subtypes (neglect, physical abuse, emotional abuse and sexual abuse) were examined using multivariate logistic regression. RESULTS Adjusted analyses showed that all subtypes of CM were significantly (p < 0.05) associated with admissions to hospital for any type of mental illness (aOR range 1.87-3.61), non-psychotic mental disorders (aOR range 1.98-3.61), alcohol and/or substance use (aOR range 2.83-5.43), and community mental health service contacts (aOR range 2.44-3.13). Hospital admissions for psychotic mental disorders were significantly associated with physical abuse, emotional abuse, and sexual abuse (aOR range 2.14-3.93). CONCLUSIONS The results of this study confirm the current knowledge around CM and subsequent mental health illnesses up to the age of 40, and extend this knowledge to hospital and mental health service use.
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Affiliation(s)
- Mike Trott
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba 4102, Queensland, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia.
| | - Claudia Bull
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba 4102, Queensland, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia; ALIVE National Centre for Mental Health Research Translation, Brisbane, Australia
| | - Jake Moses Najman
- School of Public Health, The University of Queensland, Public Health Building, Herston 4006, Queensland, Australia; School of Social Sciences, The University of Queensland, St Lucia 4072, Queensland, Australia
| | - Urska Arnautovska
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba 4102, Queensland, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia
| | - Dan Siskind
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba 4102, Queensland, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia
| | - Nicola Warren
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba 4102, Queensland, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia
| | - Steve Kisely
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba 4102, Queensland, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia; ALIVE National Centre for Mental Health Research Translation, Brisbane, Australia; Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Canada
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