A systematic review of depressed mood and anxiety by SES in youth aged 10-15 years

Parental control and adolescent social anxiety: A focus on emotional regulation strategies and socioeconomic influences in China

An individual's social adaptation, which is influenced by both internalizing and externalizing factors, depends on social anxiety. We proposed that the connection between parental psychological control and social anxiety among middle school students was mediated by negative emotion response-focused strategies and moderated by socioeconomic status (SES). We collected data from 1343 Chinese students from 12 to 16 years old (M = 13.3, SD = 0.96) by applying the questionnaire of parental psychological control scale, social anxiety scale and negative emotion response-focused strategies scale. The findings demonstrated that parental psychological control, including father and mother psychological control, was positively associated with social anxiety and that the relationship between parental psychological control and children's social anxiety was mediated by negative emotion response-focused strategies. Meanwhile, SES played a moderating role in the relationship between children's negative emotion response-focused strategies and social anxiety. The findings also suggest that we should pay more attention to the psychological status and social interaction of children with lower SES.

Could a Growth Mindset Attenuate the Link Between Family Socioeconomic Status and Depressive Symptoms? Evidence from Chinese Adolescents

Purpose

The alleviating effects of a growth mindset on depression are promising. However, whether a growth mindset can attenuate the effect of low family socioeconomic status (SES) on depressive symptoms among adolescents remains unknown. Based on the Family Stress Model, the current study explores whether a growth mindset could moderate the associations between family SES, interparental conflict, and adolescent depressive symptoms.

Methods

The participants were 1572 Chinese adolescents (Mage = 13.35 years, SD = 1.16, 51.84% female). They completed the family SES questionnaire, Children's Perceptions of Interparental Conflict scale, Growth Mindset scale, and Center for Epidemiologic Studies Depression scale. We tested the moderation, mediation, and moderated mediation models using the SPSS macro program PROCESS.

Results

A growth mindset moderated the association between family SES and depressive symptoms. Family SES was significantly related to depressive symptoms in adolescents with a lower growth mindset, but not in those with a higher growth mindset. After incorporating the mediating effect of interparental conflict, the growth mindset did not exert a significant moderating influence on the direct path; however, it significantly moderated the mediating effect of interparental conflict on depressive symptoms. Specifically, while a lower growth mindset in adolescents was associated with an increased risk of depressive symptoms due to interparental conflict, those with a higher growth mindset showed a less pronounced effect.

Conclusion

A growth mindset attenuates the link between family SES and depressive symptoms among adolescents. These findings highlight the benefits of a growth mindset on mental health, especially for low-SES adolescents.

Does maternal education moderate the relationship between adolescent cannabis use and mental health in early adulthood?

INTRODUCTION

Socioeconomic disadvantage has been associated with cannabis use and poor mental health. It is therefore hypothesised that lower maternal education, a proxy for socioeconomic disadvantage, may increase the risk of cannabis-related mental health and substance use consequences.

METHODS

A total of 5099 participants from the Avon Longitudinal Study of Parents and Children reported cannabis use via questionnaires at 16 or 18. Logistic regression was used to examine the relationship between any and regular (weekly or more) adolescent cannabis use with depression, anxiety, psychotic experiences, and problematic cannabis use at age 24. Maternal education was included as an effect modifier. Missing data were addressed through multiple imputation using chained equations.

RESULTS

In total, 36.5% of participants reported adolescent cannabis use and, of these, 14% reported regular use. Adolescent cannabis use was associated with an increased likelihood of anxiety and problematic cannabis use; however, there was little evidence of moderation by maternal education. Regular cannabis use was associated with an increased likelihood of problematic cannabis use, with little evidence of moderation by maternal education. There was weak evidence that the association between regular cannabis use and depression (interaction p-value = 0.024) and anxiety (interaction p-value = 0.056) was stronger in people with high maternal education.

DISCUSSION AND CONCLUSIONS

Adolescent cannabis use is associated with increased risk of anxiety and cannabis use disorder, but there was insufficient evidence that childhood socioeconomic position (proxied by maternal education) modifies this relationship. Improved public health messages for all adolescents about these risks may be warranted.

Associations Between Social Determinants of Health and Cardiovascular Health of U.S. Adult Cancer Survivors

Background

Relationships between the social determinants of health (SDOH) and cardiovascular health (CVH) of cancer survivors are underexplored.

Objectives

This study sought to investigate associations between the SDOH and CVH of adult cancer survivors.

Methods

Data from the U.S. National Health Interview Survey (2013-2017) were used. Participants reporting a history of cancer were included, excluding those with only nonmelanotic skin cancer, or with missing data for any domain of SDOH or CVH. SDOH was quantified with a 6-domain, 38-item score, consistent with the Centers for Disease Control and Prevention recommendations (higher score indicated worse deprivation). CVH was quantified based on the American Heart Association's Life's Essential 8, but due to unavailable detailed dietary data, a 7-item CVH score was used, with a higher score indicating worse CVH. Survey-specific multivariable Poisson regression was used to test associations between SDOH quartiles and CVH.

Results

Altogether, 8,254 subjects were analyzed, representing a population of 10,887,989 persons. Worse SDOH was associated with worse CVH (highest vs lowest quartile: risk ratio 1.30; 95% CI: 1.25-1.35; P < 0.001), with a grossly linear relationship between SDOH and CVH scores. Subgroup analysis found significantly stronger associations in younger participants (P interaction = 0.026) or women (P interaction = 0.001) but without significant interactions with race (P interaction = 0.051). Higher scores in all domains of SDOH were independently associated with worse CVH (all P < 0.001). Higher SDOH scores were also independently associated with each component of the CVH score (all P < 0.05 for highest SDOH quartile).

Conclusions

An unfavorable SDOH profile was independently associated with worse CVH among adult cancer survivors in the United States.

Depressed mood as a transdiagnostic target relevant to anxiety and/or psychosis: a scoping review protocol

INTRODUCTION

Depressed mood is a psychological state characterised by sadness or loss of interest in activities. Depressed mood is a highly prevalent symptom across major mental disorders. However, there is limited understanding of the burden and management of comorbid depressed mood across major mental disorders. Therefore, this scoping review aims to summarise knowledge on depressed mood among persons with anxiety and/or psychosis. The specific aims are to describe the epidemiology and risk factors of depressed mood as a transdiagnostic target among persons with anxiety and/or psychosis, to identify commonly used outcome measures for depressed mood and to outline initial evidence of psychometric robustness and to identify and summarise the effectiveness of commonly applied depressed mood modification interventions. Our hope is that the proposed review will provide insights into the burden of depressed mood in persons with anxiety and psychosis and help to identify evidence gaps and recommendations for future research.

METHODS AND ANALYSIS

This scoping review will be conducted per Arksey and O'Malley's framework. We will first search for peer-reviewed articles and grey literature published from 2004 to 2023 in PubMed, Scopus, Web of Science, Africa-Wide Information, CINAHL, PsycINFO, Academic Search Premier, Humanities International Complete, Sabinet, SocINDEX, Open Grey and Google Scholar. We will include articles reporting depressed mood (subthreshold depression) among persons with anxiety and/or psychosis. Studies recruiting participants meeting depression diagnostic criteria and those published in non-English languages will be excluded. Two independent researchers will extract the data. We will analyse and chart data collaboratively with researchers with lived experiences of depressed mood.

ETHICS AND DISSEMINATION

This study does not require ethical approval as it is a literature review. The results will be submitted for publication in a peer-reviewed journal.

Comparing the number of outdoor sugar-sweetened beverage and caffeinated beverage advertisements near schools by school type and school-level economic advantage

INTRODUCTION

Sugar-sweetened beverage and caffeinated beverage consumption are associated with a variety of health issues among youth. Food and beverage marketing has been shown to affect youth's preferences, purchases, and consumption of marketed products. Previous research suggests that outdoor food and beverage marketing differs by community demographics, with more advertisements in lower-income communities and near schools. The purpose of this study is to examine the density of sugar-sweetened and caffeinated beverage advertisements near schools by school type (middle vs. high school) and by school-level SES.

METHODS

Data are from the Outdoor Measuring and Evaluating the Determinants and Influence of Advertising (MEDIA)study, which documented and described all outdoor food and beverage advertisements near 47 middle and high schools in 2012. Beverage advertisements were categorized as: sugar-sweetened/caffeinated, sugar-sweetened/non-caffeinated, non-sugar-sweetened/caffeinated, or non-sugar-sweetened/non-caffeinated. Schools were categorized by type (middle vs high) and by SES as determined by the percentage of students qualifying for free or reduced-price lunch. Bootstrapped non-parametric Mann-Whitney U tests compared the number of advertisements in each category by school type and school-level SES (higher vs lower).

RESULTS

Compared to schools with higher SES, schools with lower SES had significantly more advertisements for sugar-sweetened/non-caffeinated beverages (Medianlow = 28.5 (IQR 17-69), vs Medianhigh = 10.5 (IQR 4-17) (p = 0.002)., sugar-sweetened non-caffeinated (Medianlow = 46 (IQR 16-99) vs Medianhigh = 13.5 (IQR 6-25), p = 0.002), -sugar-sweetened caffeinated (Medianlow = 12 (IQR 8-19) vs Medianhigh = 6 (IQR 2-8), p = 0.000), and non-sugar-sweetened non-caffeinated (Medianlow = 30 (IQR 13-65) vs Medianhigh = 14 (IQR 4-29), p = 0.045).There were no significant differences by school type.

CONCLUSION

This study adds to the literature demonstrating pervasive marketing of unhealthy products in lower-income communities. Disproportionate exposure to sugar-sweetened and caffeinated beverage advertisements in lower-income communities may contribute to the disparities in associated health outcomes by economic status.

Association of healthy eating index (2015) with depression and anxiety symptoms among Iranian adolescent girls

Adolescence is a period of rapid growth, with changes in body composition and cognitive and psychosocial development. Teenagers who eat properly and participate in daily physical activities have a healthy lifestyle. Healthy living promotes optimal growth and performance at school and in the workplace and minimizes the risk of chronic nutrient-related diseases. Therefore, the present study was conducted to determine the relationship between the healthy eating index (2015) (HEI-2015) and depression and anxiety among Iranian adolescent girls. This cross-sectional study was designed based on the updated version of HEI-2015. The study population consisted of 412 high school girls aged 12-17 years old. Data were collected about the diet, sociodemographic, and anthropometric characteristics of the participants. HEI and anthropometric characteristics of the participants were measured. The depression, anxiety, and stress scale 42 (DASS-42) questionnaire was used to detect adolescents suffering from depression and anxiety. The relationships of the HEI and anthropometric measures with depression and anxiety were also assessed. The results showed that the HEI is inversely correlated with depression and anxiety in Iranian adolescent girls. HEI was greater in the healthy participants than in those suffering from depression and anxiety (P < 0.0001).

Social inequality in the association between life transitions into adulthood and depressed mood: a 27-year longitudinal study

Background

Few studies have considered the life-course development of depressive symptoms in relation to life transitions in early-adulthood and whether these might affect depressive trajectories differently depending on specific indicators of parental socioeconomic status (SES). In the present work, we explore these questions using the adolescent pathway model as a guiding framework to test socially differential exposure, tracking and vulnerability of the effects of life transitions on depressed mood across different socioeconomic backgrounds.

Methods

Latent growth modeling was used to estimate the associations between indicators of parental SES (parental education and household income) and depressed mood from age 13 to 40 with life transitions (leaving the parental home, leaving the educational system, beginning cohabitation, attaining employment) as pathways between the two. Our analyses were based on a 27-year longitudinal dataset (n = 1242) of a Norwegian cohort with 10 time points in total. To make socioeconomic comparisons, three groups (low, mid, and high) were made for parental education and income respectively.

Results

Depressed mood decreased from age 13 to 40. The low and high parental education groups showed a stable difference in depressed mood during early adolescence, which decreased in young adulthood and then increased slightly in mid-adulthood. The low household income group showed higher depressed mood across young adulthood compared to the medium and higher household income groups. For life transitions, leaving the parental home and beginning cohabitation was associated with an added downturn of the trajectory of depressed mood when adjusting for other transitions. However, adolescents with high parental education showed a relatively stronger decrease in depressed mood when leaving the parental home. Similarly, adolescents with a high household income showed a relatively stronger decrease in depressed mood when leaving the educational system.

Conclusions

Depressed mood decreased over time and developed differently depending on parental education and household income. Life transitions were generally associated with reductions in depressed mood across time, but lower SES youths were not found to be more socially vulnerable these effects.

The Prevalence of Illness Anxiety Disorder Among Adults in Taif City, Saudi Arabia: A Cross-Sectional Study

Introduction Illness Anxiety Disorder (IAD), characterized by intense fear of serious illness, has been associated with performance issues at work, frequent absences, financial burdens from medical expenses, impaired daily functioning, and the onset and recurrence of coronary heart disease. This study aimed to assess the prevalence of IAD and explore its cardiac manifestations in residents of Taif City, Saudi Arabia. Methods A descriptive cross-sectional study was conducted among adults in Taif City, excluding those with psychiatric illnesses. Participants completed an online self-administered questionnaire, including sociodemographic information and the validated Short Version Health Anxiety Inventory (SHAI) scale. Results Among 415 participants, predominantly females (60%), the study found a 25.3% prevalence of IAD. Of those with IAD, 3% were diagnosed with cardiac diseases, and 27% were hospitalized due to cardiac symptoms. Twenty-five percent exhibited normal examination results after hospitalization. Factors such as female gender (p=0.006), younger age (p=0.006), single marital status (p=0.012), and a history of hospitalization due to heart symptoms (p=0.003) were associated with higher IAD scores. Married participants had a lower risk of IAD compared to singles (OR: -2.2, 95% CI: -3.9, -0.48), while a history of hospitalization due to heart symptoms increased the risk of IAD (OR: 2.8, 95% CI: 0.94, 4.7). Conclusion This study revealed a substantial prevalence of IAD in Taif City. Female gender, younger age, being single, and having a history of hospitalization due to heart symptoms were identified as determinants of IAD. Healthcare providers must recognize these disorders to prevent unnecessary investigations and treatments, redirecting patients to psychiatry for more cost-effective and beneficial interventions.

Socioeconomic status and access to mental health care: The case of psychiatric medications for children in Ontario Canada

We examine differences in the prescribing of psychiatric medications to lower-income and higher-income children in the Canadian province of Ontario using rich administrative data that includes diagnosis codes and physician identifiers. Our most striking finding is that conditional on diagnosis and medical history, low-income children are more likely to be prescribed antipsychotics and benzodiazepines than higher-income children who see the same doctors. These are drugs with potentially dangerous side effects that ideally should be prescribed to children only under narrowly proscribed circumstances. Lower-income children are also less likely to be prescribed SSRIs, the first-line treatment for depression and anxiety conditional on diagnosis. Hence, socioeconomic differences in the prescribing of psychotropic medications to children persist even in the context of universal public health insurance and universal drug coverage.

Social Determinants of Mental and Behavioral Health

Both mental illness and overall mental health are determined by a complicated interplay of life experiences and genetic predisposition. While genetic predisposition is difficult to modify, many of the life experiences that worsen mental health and exacerbate serious mental illness are associated with social policies and cultural norms that are changeable. Now that we have identified these associations, it is time to rigorously test scalable interventions to address these risks. These interventions will need to focus on high-impact stages in life (like childhood) and will need to address risk beyond the individual by focusing on the family and community.

Examining the role of maternal religiosity in offspring mental health using latent class analysis in a UK prospective cohort study

BACKGROUND

Previous research has examined the role of parental religious belief in offspring mental health, but has revealed inconsistent results, and suffered from a number of limitations. The aim of this study is to examine the prospective relationship between maternal religiosity and offspring mental health and psychosocial outcomes.

METHODS

We used latent classes of religious belief (Highly religious, Moderately religious, Agnostic, Atheist) in mothers from the Avon Longitudinal Study of Parents and Children from 1990, and examined their association with parent-reported mental health outcomes and self-reported psychosocial outcomes in their children at age 7-8 (n = 6079 for mental health outcomes and n = 5235 for psychosocial outcomes). We used inverse probability weighted multivariable logistic regression analysis adjusted for maternal mental health, adverse childhood experience, and socioeconomic variables.

RESULTS

There was evidence for a greater risk of internalising problems among the offspring of the Highly religious and Moderately religious classes [e.g. for depression; OR 1.40. 95% CI (1.07-1.85), OR 1.48, 95% CI (1.17-1.87)], and greater risk of externalising problems in the offspring of the Atheist class [e.g. for ADHD; OR 1.41, 95% CI (1.08-1.85)], compared to the offspring of the Agnostic class.

CONCLUSIONS

These novel findings provide evidence associations between maternal religiosity and offspring mental health differ when examined using a person-centred approach, compared to the previously used variable-centred approaches. Our findings also suggest that differences may exist in the relationship between religious (non)belief and mental health variables when comparing the UK and US.

Protocol for secondary data analysis of 4 UK cohorts examining youth adversity and mental health in the context of intersectionality

BACKGROUND

Youth adversity (e.g., abuse and bullying victimisation) is robust risk factor for later mental health problems (e.g., depression and anxiety). Research shows the prevalence of youth adversity and rates of mental health problems vary by individual characteristics, identity or social groups (e.g., gender and ethnicity). However, little is known about whether the impact of youth adversity on mental health problems differ across the intersections of these characteristics (e.g., white females). This paper reports on a component of the ATTUNE research programme (work package 2) which aims to investigate the impact and mechanisms of youth adversity on depressive and anxiety symptoms in young people by intersectionality profiles.

METHODS

The data are from 4 UK adolescent cohorts: HeadStart Cornwall, Oxwell, REACH, and DASH. These cohorts were assembled for adolescents living in distinct geographical locations representing coastal, suburban and urban places in the UK. Youth adversity was assessed using a series of self-report questionnaires and official records. Validated self-report instruments measured depressive and anxiety symptoms. A range of different variables were classified as possible social and cognitive mechanisms.

RESULTS AND ANALYSIS

Structural equation modelling (e.g., multiple group models, latent growth models) and multilevel modelling will be used, with adaptation of methods to suit the specific available data, in accord with statistical and epidemiological conventions.

DISCUSSION

The results from this research programme will broaden our understanding of the association between youth adversity and mental health, including new information about intersectionality and related mechanisms in young people in the UK. The findings will inform future research, clinical guidance, and policy to protect and promote the mental health of those most vulnerable to the negative consequences of youth adversity.

Associations between error-related negativity and childhood anxiety risk differ based on socioeconomic status

Children from lower socioeconomic status (SES) families are at increased risk for anxiety problems, though knowledge of the pathways by which SES predicts children's anxiety outcomes remains scant. Limited work suggests SES as a moderator of links between early development and anxiety outcomes but has not used a longitudinal framework or a multimethod approach. In this preregistered study, SES was tested as a simultaneous moderator of putatively biologically (error-related negativity [ERN]) and contextually (authoritarian parenting) based pathways of anxiety risk from ages 3 (Mage = 3.59), 4 (Mage = 4.57), and 5 (Mage = 5.52) [N = 121; 59% female]. Families were largely White and Non-Hispanic and reported a broad range of income (less than $15,000 to $90,001 or greater) from 2014 to 2017. We hypothesized that putatively biological pathways would be the strongest predictors of child outcomes at high SES and that putatively contextual pathways would be the strongest predictors of child outcomes at low SES. Consistent with expectations, smaller ERN across ages 3 and 4 was associated with greater anxious behaviors at age 5, but only at high SES. SES did not moderate parenting-based pathways of risk. Results are partially consistent with previous work suggesting that putatively biological pathways are more robust predictors of child outcomes at high SES than at low SES. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Perceived Occupational Noise Exposure and Depression in Young Finnish Adults

We investigated the association between perceived occupational noise exposure and depressive symptoms in young Finnish adults and whether noise sensitivity moderates this association. This study was based on an ongoing longitudinal twin study. We included those who had been working daily (n = 521) or weekly (n = 245) during the past 12 months (mean age 22.4, SD 0.7, 53% female). We asked about occupational noise exposure at age 22 and assessed depressive symptoms using the General Behavior Inventory (GBI) at age 17 and 22. Noise sensitivity and covariates were used in linear regression models. Perceived daily occupational noise exposure was associated, as a statistically independent main effect with depressive symptoms at age 22 (beta 1.19; 95% CI 0.09, 2.29) among all, and separately for females (beta 2.22; 95% CI 0.34, 4.09) but not males (beta 0.22; 95% CI -1.08, 1.52). Noise sensitivity was independently associated with depressive symptoms among all (beta 1.35; 95% CI 0.54, 2.17), and separately for males (beta 1.96; 95% CI 0.68, 3.24) but not females (beta 1.05; 95 % CI -0.04, 2.13). Noise sensitivity was independent of perceived occupational noise exposure. Pre-existing depressive symptoms at age 17 were predictive of perceived occupational noise exposure, suggesting complex interactions of noise and depression.

Symptoms of Depression and Anxiety and Subsequent Use of Nicotine and THC in Electronic Cigarettes

BACKGROUND

This study examines whether symptoms of depression, anxiety, or comorbid depression and anxiety are associated with future use of nicotine or THC in e-cigarettes.

METHODS

Data were from an online survey of youth and young adults in urban areas of Texas with complete data (n = 2,307) in spring 2019 (baseline) and spring 2020 (12-month follow-up). Multivariable logistic regression models examined associations between self-reported symptoms of depression, anxiety, or comorbid depression and anxiety at baseline and past 30-day e-cigarette use with nicotine or THC at 12-month follow-up. Analyses adjusted for baseline demographics and baseline past 30-day e-cigarette, combustible tobacco, marijuana, and alcohol use and stratified by race/ethnicity, gender, grade level, and SES.

RESULTS

Participants were 16-23 years old, 58.1% female and 37.9% Hispanic. At baseline, 14.7% reported symptoms of comorbid depression and anxiety, 7.9% depression, and 4.7% anxiety. Prevalence of past 30-day e-cigarette use at 12-month follow-up was 10.4% with nicotine and 10.3% with THC. Symptoms of depression and comorbid depression and anxiety at baseline were significantly associated with both nicotine and THC use in e-cigarettes 12 months later. Symptoms of anxiety were associated with nicotine use in e-cigarettes 12 months later.

CONCLUSIONS

Symptoms of anxiety and depression may be important indicators of future nicotine and THC vaping among young people. Clinicians should be aware of groups most at risk who may benefit from substance use counseling and intervention.

[On the Ideological Function of a Traditional Criticism of Psychiatry in Neoliberalism]

Social isolation and discrimination play a major role in the development and maintenance of mental disorders. This could motivate a critical public to demand improved treatment facilities for persons with mental illness. Instead, the media and a critical public tend to repeat a traditional critique of psychiatry, which was articulated before psychiatry reform in the 1970s and which tends to romanticize or neglect mental illness. The replication of this traditional critique of psychiatry today has an ideological function: it reassures a neoliberal public that it is emancipated from traditional authoritarian patterns of dominance, rejects demands for increased funding of mental health treatment facilities, and emphasizes individual autonomy at the price of blaming the victims for homelessness and social impoverishment.

Longitudinal assessment of anxiety and depression symptoms in U.S. adolescents across six months of the coronavirus pandemic

BACKGROUND

The present study aimed to describe anxiety and depression symptoms at two timepoints during the coronavirus pandemic and evaluate demographic predictors.

METHODS

U.S. high school students 13-19 years old completed a self-report online survey in May 2020 and November 2020-January 2021. The Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Depression and Anxiety short forms queried depression and anxiety symptoms.

RESULTS

The final sample consisted of 694 participants (87% White, 67% female, 16.2 ± 1.1 years). Nearly 40% of participants reported a pre-pandemic depression diagnosis and 49% reported a pre-pandemic anxiety diagnosis. Negative affect, defined as both moderate to severe depression and anxiety PROMIS scores, was found in ~ 45% of participants at both timepoints. Female and other gender identities and higher community distress score were associated with more depression and anxiety symptoms. Depression symptoms T-score decreased slightly (- 1.3, p-value  ≤ 0.001).

CONCLUSION

Adolescent mental health screening and treatment should be a priority as the pandemic continues to impact the lives of youth.

Associations of cardiorespiratory fitness, screen time and mental health among Chinese school children

To assess the independent and joint associations between cardiorespiratory fitness (CRF), screen time and mental health among Chinese school-aged children, a cross-sectional study was conducted in 3 primary schools in Wuhan city, China. Children self-reported ST, and their height, weight and CRF were measured. Mental health (anxiety, depressive symptom, and self-esteem) was assessed by self-administered questionnaires. A total of 805 children aged 9.1 ± 0.6 years participated in this study. High ST was associated with significantly increased risk for anxiety and low self-esteem, while high CRF was associated with a decreased risk of low self-esteem. In the joint model, children with low ST and high CRF showed the lowest risk for anxiety (OR: 0.42, 95%CI: 0.20-0.89) and low self-esteem (OR:0.44, 95%CI: 0.24-0.82). High ST and low CRF were negatively associated with mental health in Chinese schoolchildren. Health care and interventions on limiting ST and improving CRF level are warranted to promote the mental health in this population.

Factors associated with symptom severity in Canadian youth with mental health and/or addictions concerns accessing service navigation

This study investigated the factors associated with clinical symptoms and level of functioning at baseline and after 4 months of navigation, in youth with mental health and/or addiction concerns involved with a family navigation service. Participants in this pre-post study were caregivers who accessed a mental health and addictions navigation service between March 2018 and July 2019 on behalf of their youth aged 13-26 who had mental health and/or addiction concerns. Evaluations were conducted at baseline and at 4 months after entering navigation. The dependent variable, youth mental health symptoms and functioning, was assessed by caregivers using the Symptoms and Functioning Severity Scale. The sample included 345 caregivers of youth (youth: mean age 18 years, 57% male). At intake, using multiple linear regression, caregiver strain (β = 0.481, p < 0.001), youth completion of ADLs (β = -0.156, p = 0.002) and youth motivation (β = -0.110, p = 0.021) contributed significantly to variance in symptoms and functioning (R²  = 0.373, p < 0.001). Using ANOVA to compare complete pre/post data (n = 115), there was a significant main effect of time on the youth symptoms and functioning score (F[1, 107] = 9.278, p = 0.003). Furthermore, the interaction of time, youth completion of ADLs (low vs. high at baseline) and youth motivation (low vs. high at baseline) was significant (F[1, 107] = 4.699, p = 0.032). Youth with low motivation and low completion of ADLs at baseline experienced the largest improvements in symptoms and functioning after 4 months of navigation. These findings suggest that this group of youth should be a primary target in mental health and addiction navigation.

State negative affect in relation to loss-of-control eating among children and adolescents in the natural environment

Affect regulation theory proposes that loss-of-control (LOC)-eating is preceded by increases and followed by decreases in negative affect (NA), but empirical tests of this theory among pediatric samples in the natural environment are needed. Using an ecological momentary assessment approach, we conducted post-hoc analyses to examine LOC-eating severity reported during post-meal surveys in relation to the intensity of composite NA and NA components (anger, anxiety, depression, guilt) throughout the day for two weeks in a cohort of healthy children and adolescents. Multilevel models tested the associations among LOC-eating severity and NA components reported at pre-meal surveys (t-1), post-meal surveys (t), and lagged post-meal surveys (t+1). Models were adjusted for sex, age, race/ethnicity, height, fat mass, socioeconomic status, and time between the occurrence and report of eating episodes; post-meal analyses were also adjusted for pre-meal NA. Participants age 8-17 (N = 100; 55% female; 45% male; 12.83 ± 2.73y; 24% with overweight/obesity) recorded 2410 eating episodes. Pre-meal composite NA and NA components were not associated with LOC-eating severity at the subsequent meal. LOC-eating severity was positively associated with post-meal depression (β = 0.042, 95% CI = 0.007, 0.076) and guilt (β = 0.056, 95% CI = 0.017, 0.095), but not composite negative affect, anger, or anxiety. The positive association among LOC-eating severity and guilt persisted in lagged post-meal analyses (β = 0.075, 95% CI = 0.021, 0.128). Contrary to affect regulation theory and laboratory data, but consistent with prior ecological momentary assessment data in children and adolescents, pre-meal NA was not linked to subsequent LOC-eating. Increased guilt following meals may be a mechanism for the development of exacerbated disordered eating. Longitudinal studies may elucidate how NA is implicated in the etiology of pediatric eating disorders.

Screening for Anxiety in Children and Adolescents: US Preventive Services Task Force Recommendation Statement

IMPORTANCE

Anxiety disorder, a common mental health condition in the US, comprises a group of related conditions characterized by excessive fear or worry that present as emotional and physical symptoms. The 2018-2019 National Survey of Children's Health found that 7.8% of children and adolescents aged 3 to 17 years had a current anxiety disorder. Anxiety disorders in childhood and adolescence are associated with an increased likelihood of a future anxiety disorder or depression.

OBJECTIVE

The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for anxiety disorders in children and adolescents. This is a new recommendation.

POPULATION

Children and adolescents 18 years or younger who do not have a diagnosed anxiety disorder or are not showing recognized signs or symptoms of anxiety.

EVIDENCE ASSESSMENT

The USPSTF concludes with moderate certainty that screening for anxiety in children and adolescents aged 8 to 18 years has a moderate net benefit. The USPSTF concludes that the evidence is insufficient on screening for anxiety in children 7 years or younger.

RECOMMENDATION

The USPSTF recommends screening for anxiety in children and adolescents aged 8 to 18 years. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for anxiety in children 7 years or younger. (I statement).

Socioeconomic status and depressive symptoms: An individual-participant data meta-analysis on range restriction and measurement in the United States

INTRODUCTION

The association between socioeconomic status (SES) and depressive symptoms is well documented, yet less attention has been paid to the methodological factors contributing to between-study variability. We examined the moderating role of range restriction and the depressive-symptom measurement instrument used in estimating the correlation between components of SES and depressive symptoms.

METHODS

We conducted an individual participant data meta-analysis of nationally-representative, public-access datasets in the United States. We identified 123 individual datasets with a total of 1,655,991 participants (56.8 % female, mean age = 40.33).

RESULTS

The presence of range restriction was associated with larger correlations between income and depressive symptoms and with smaller correlations between years of education and depressive symptoms. The measurement instrument of depressive symptoms moderated the association for income, years of education, and occupational status/prestige. The Center for Epidemiological Studies-Depression scale consistently produced larger correlations. Higher measurement reliability was also associated with larger correlations.

LIMITATIONS

This study was not a comprehensive review of all measurement instruments of depressive symptoms, focused on datasets from the United States, and did not examine the moderating role of sample characteristics.

DISCUSSION

Methodological characteristics, including range restriction of SES and instrument of depressive symptoms, meaningfully influence the observed magnitude of association between SES and depressive symptoms. Clinicians and researchers designing future studies should consider which instrument of depressive symptoms is suitable for their purpose and population.

The short and long-term impact of the healthy kids initiative on depressed mood in youth living with obesity

PURPOSE

The purpose of this study is to determine the effect of a free, comprehensive program with social support on depressed mood in youth (aged 11-17 years) living with obesity in a prospective, longitudinal, community-based study.

METHODS

Youth living with obesity (BMI > 30), residing in three cities in Saskatchewan, Canada, were eligible to participate in a 12-week program designed to facilitate behavioural change with five physical activity sessions a week, one dietary session a week, and one group cognitive behavioural session per week offered by health care professionals. Baseline data were collected on depressed mood (Centre for Epidemiological Studies-Depression 12 or CES-D 12), health-related quality of life (SF-12), and self-esteem (NLSCY) at baseline, 12-weeks, and at 52-weeks RESULTS: Overall, 2598 youth started and 2292 (88.2 %) completed the 12-week program with 1703 (74.3 %) of participants presenting for 52-week follow-up. Depressed mood improved significantly over the course of the program: 79.2 % of participants had depressed mood at the start of the program and this decreased to 64.7 % at the end of 12-weeks; which was an overall relative reduction of 18.4 % (Cohen's d = 0.94). The mean CES-D 12 score at one-year was significantly lower than the mean baseline score (17.90 compared to 21.11, p < .001). By depressed mood severity, 58.7 % of participants had severe depressed mood at baseline, which reduced to 31.6 % at 12 weeks, and 27.9 % at 52 weeks. Age and maternal occupation were initially significantly associated with depressed mood at 52-week follow-up (unadjusted). However, after binary logistic regression was used to determine the independent risk factors for having depressed mood at 52-week follow up, only older age (OR 1.88, 95 % CI 1.52-2.34, p < .001) was significant.

CONCLUSION

The Healthy Kids Initiative lends more evidence that healthy behavioural interventions can have a positive impact on depressed mood among youth living with obesity.

Anxiety and Depression in a Non-Clinical Sample of Young Polish Adults: Presence of Meaning in Life as a Mediator

Early adulthood, between 18 and 25, is viewed as a decisive period of life for the prevention and treatment of anxiety and depression. Although the topic of their mutual relationship is well-known, little has been uncovered about the mechanism underlying this connection. To understand the indirect pathways between anxiety and depression, we chose the sense of meaning of life as a mediator because people's beliefs that their lives are or can be purposeful may protect against depression. The sample was composed of 277 Polish young adults. A small majority of the participants were women (58.8%). The mean age was M = 22.11 (SD = 1.72). We used in the research the Direct Behavior Rating-Scale Items Scale, the Meaning in Life Questionnaire, and the Brief Screen for Depression. Correlational analysis showed that, consistent with past findings, anxiety correlated positively with depression and searching for meaning. It was also negatively associated with presence of meaning. Moreover, depression was negatively linked to presence of meaning and positively with searching for meaning. Regression-based mediation analyses (PROCESS macro 3.4) proved that the relationship between anxiety and depression was mediated by presence of meaning in life, suggesting that having a sense of meaning may be a pathway by which feelings of tension relative to adverse events protect against depression.

The association between persistent low parental income during preschool age and mental disorder in adolescence and early adulthood: a Norwegian register-based study of migrants and non-migrants

BACKGROUND

Low socioeconomic status during childhood is associated with increased risk of mental disorders later in life. Yet, there is limited research on whether this association varies by migrant background, despite an overrepresentation of migrants among the economically disadvantaged.

METHODS

Using national register data on a study population of 577,072 individuals, we investigated the association between persistent low parental income during preschool, measured at age 3-5 years and mental disorder during adolescence and early adulthood, measured between ages 16-25. Outpatient mental healthcare (OPMH) service use was a proxy for mental disorder and was measured between 2006 and 2015. We applied discrete-time logistic regression analyses with interaction terms to study differences in the relationship between persistent low parental income and OPMH service use by migrant background and gender.

RESULTS

Persistent low parental income during preschool age was associated with increased odds of OPMH service use in adolescence and early adulthood (aOR = 1.99, 95% CI 1.90-2.08), even after adjusting for gender, migrant background, parental education and persistent lower income at later ages (aOR = 1.33, 95% CI 1.27-1.40). Statistically significant interactions between migrant background and persistent low parental income were recalculated and presented as marginal yearly probabilities. These results showed that the association was in the opposite direction for migrants; those in the higher income group had higher probability of OPMH service use, although the differences were non-significant for some groups. The relationship did not vary by gender.

CONCLUSIONS

Social inequalities in mental health, as measured by OPMH service use, may have an onset already in childhood. Interventions to reduce inequalities should therefore start early in the life course. Since the association differed for migrants, future research should aim to investigate the mechanisms behind these disparities.

Depression and anxiety among children and adolescents pre and post COVID-19: A comparative meta-analysis

BACKGROUND

Published studies in comparing pre and post the COVID-19 pandemic depression and anxiety levels among children and adolescents yielded incongruent results. Therefore, there is a necessity to perform a timely meta-analysis to synthesize existing evidence.

METHODS

A total of 10 digital databases (PubMed, Web of Science, PsycINFO, the Cochrane Library, Embase, Scopus, ScienceDirect, CNKI, WanFang, CQVIP) were fully searched for eligible studies published before November 6, 2021. Based on quality assessment results, relevant data were extracted for eligible studies of higher quality. We combined standardized mean difference (SMD) or prevalence ratio (RR) for anxiety and depression pre and post the COVID-19 pandemic by using random-effects models. Sensitivity analysis was further performed to evaluate heterogeneity of included studies.

RESULTS

14,508 articles were preliminarily identified, and after stepwise screening process, 8 articles were included eventually. The results showed that the SMD for post COVID-19 anxiety score measured by GAD-7 was 0.12 (95% CI: 0.08, 0.17), an significant increase compared with pre COVID-19 period; the SMDs and 95% CIs for post COVID-18 depression scores measured by PHQ-9, PHQ-8, and MFQ were 0.17 (95% CI: 0.10, 0.24), 0.23 (95% CI: 0.08, 0.38), and 0.11 (95% CI: 0.06, 0.17), respectively, also significantly increased compared with pre COVID-19 period. The RR for depression was 2.54 (95% CI: 2.48, 2.60) in post COVID-19 period when compared with pre-pandemic.

CONCLUSIONS

Children and adolescents reported deteriorated anxiety and depression levels after the COVID-19 pandemic. More attention should be paid to this vulnerable group. Effective, expedient, and practical intervention measures which are compatible with COVID-19 prevention and control policies should be developed and implemented to maintain mental health wellbeing of the youths.

Connectedness to Family, School, and Neighborhood and Adolescents' Internalizing Symptoms

In the U.S., there is a strong national interest in social connectedness as a key determinant in promoting positive well-being in adolescents through building strong bonds and creating protective relationships that support adolescent mental health. To this end, this study examined whether, and to what extent, specific types of connectedness to family, school, and neighborhood were associated with internalizing symptoms (i.e., depression and anxiety) among a diverse sample of adolescents from disadvantaged backgrounds. The sample (n = 2590) was majority male (51%), with an average age of 15.6 years, and identified as Black (49%) and Hispanic/Latino (26%). The results revealed that adolescents who reported strong connections to their parent (β = -0.128, p < 0.001), school (β = -0.222, p < 0.001), and neighborhood (β = -0.116, p = 0.003) were more likely to report lower levels of depressive symptomology, with school connectedness exerting a greater influence. In addition, parent connectedness (β = -0.157, p < 0.001) and school connectedness (β = -0.166, p < 0.001) were significantly related to teen anxiety; however, neighborhood connectedness was not (β = -0.123, p = 0.087). The findings have important implications, which are discussed.

Attitudes About COVID-19 and Health (ATTACH): Online Survey and Mixed Methods Study

BACKGROUND

Behavioral mitigation strategies to slow the spread of COVID-19 have resulted in sweeping lifestyle changes, with short- and long-term psychological, well-being, and quality of life implications. The Attitudes About COVID-19 and Health (ATTACH) study focuses on understanding attitudes and beliefs while considering the impact on mental and physical health and the influence of broader demographic and geographic factors on attitudes, beliefs, and mental health burden.

OBJECTIVE

In this assessment of our first wave of data collection, we provide baseline cohort description of the ATTACH study participants in the United Kingdom, the United States, and Mexico. Additionally, we assess responses to daily poll questions related to COVID-19 and conduct a cross-sectional analysis of baseline assessments collected in the UK between June 26 and October 31, 2020.

METHODS

The ATTACH study uses smartphone app technology and online survey data collection. Participants completed poll questions related to COVID-19 2 times daily and a monthly survey assessing mental health, social isolation, physical health, and quality of life. Poll question responses were graphed using 95% Clopper-Pearson (exact) tests with 95% CIs. Pearson correlations, hierarchical linear regression analyses, and generalized linear models assessed relationships, predictors of self-reported outcomes, and group differences, respectively.

RESULTS

By October 31, 2020, 1405, 80, and 90 participants had consented to participate in the UK, United States, and Mexico, respectively. Descriptive data for the UK daily poll questions indicated that participants generally followed social distancing measures, but worry and negative impacts on families increased as the pandemic progressed. Although participants generally reported feeling that the reasons for current measures had been made clear, there was low trust that the government was doing everything in its power to meet public needs. In the UK, 1282 participants also completed a monthly survey (94.99% [1326/1396] White, 72.22% [1014/1404] female, and 20.12% [277/1377] key or essential workers); 18.88% (242/1282) of UK participants reported a preexisting mental health disorder, 31.36% (402/1282) reported a preexisting chronic medical illness, and 35.11% (493/1404) were aged over 65; 57.72% (740/1282) of participants reported being more sedentary since the pandemic began, and 41.89% (537/1282) reported reduced access to medical care. Those with poorer mental health outcomes lived in more deprived neighborhoods, in larger households (Ps<.05), had more preexisting mental health disorders and medical conditions, and were younger than 65 years (all Ps<.001).

CONCLUSIONS

Communities who have been exposed to additional harm during the COVID-19 pandemic were experiencing worse mental outcomes. Factors including having a medical condition, or living in a deprived neighborhood or larger household were associated with heightened risk. Future longitudinal studies should investigate the link between COVID-19 exposure, mental health, and sociodemographic and residential characteristics.

Development and validation of a polysocial risk score for atherosclerotic cardiovascular disease

•

Social determinants of health may improve identification of atherosclerotic cardiovascular disease – beyond traditional risk factors.

•

We provide the first, validated, polysocial risk score – the PsRS – for atherosclerotic cardiovascular disease.

•

PsRS is a robust tool to quantify cumulative social disadvantage.

•

PsRS offers unique opportunities to improve cardiovascular risk prediction algorithms.

•

Our findings may help highlight, and address disparities in cardiovascular disease.

Objective

To date, the extent to which social determinants of health (SDOH) may help identify individuals with atherosclerotic cardiovascular disease (ASCVD) – beyond traditional risk factors – has not been quantified using a cumulative social disadvantage approach. The objective of this study was to develop, and validate, a polysocial risk score (PsRS) for prevalent ASCVD in a nationally representative sample of adults in the United States (US).

Methods

We used data from the 2013–2017 National Health Interview Survey. A total of 38 SDOH were identified from the database. Stepwise and criterion-based selection approaches were applied to derive PsRS, after adjusting for traditional risk factors. Logistic regression models were fitted to assign risk scores to individual SDOH, based on relative effect size magnitudes. PsRS was calculated by summing risk scores for individual SDOH, for each participant; and validated using a separate validation cohort.

Results

Final sample comprised 164,696 adults. PsRS included 7 SDOH: unemployment, inability to pay medical bills, low income, psychological distress, delayed care due to lack of transport, food insecurity, and less than high school education. PsRS ranged from 0–20 and exhibited excellent calibration and discrimination. Individuals with the highest PsRS (5^th quintile) had nearly 4-fold higher ASCVD prevalence, relative to those with the lowest risk scores (1^st quintile). Area under receiver operating curve (AU-ROC) for PsRS with SDOH alone was 0.836. Addition of SDOH to the model with only demographic and clinical risk factors (AU-ROC=0.852) improved overall discriminatory power, with AU-ROC for final PsRS (demographics + clinical + SDOH) = 0.862.

Conclusions

Cumulatively, SDOH may help identify individuals with ASCVD, beyond traditional cardiovascular risk factors. In this study, we provide a unique validated PsRS for ASCVD in a national sample of US adults. Future study should target development of similar scores in diverse populations, and incorporate longitudinal study designs.

Impact of socioeconomic status on depression clinical outcomes at six months in a Midwestern, United States community

INTRODUCTION

Lower socioeconomic status (SES) has been associated with poor healthcare outcomes in depression. However, reliable individual-level SES data rarely exists for clinical research. The HOUSES index relies on publicly available data allowing for evaluation of individual-level SES on patient outcomes.

HYPOTHESIS

Primary care patients with depression within the lower SES quartile (Quartile 1 vs. Quartile 4, of the HOUSES index) would experience worse clinical outcomes of their symptoms six months after diagnosis.

STUDY DESIGN

A retrospective cohort study which followed 4313 adult primary care patients that were diagnosed with depression during the study period of 2008-2015. The outcome measures were the six month PHQ-9 scores.

RESULTS

At six months, a higher HOUSES quartile was associated with greater odds of remission of depressive symptoms (RDS) and lower odds of persistent depressive symptoms (PDS), after controlling for covariates. Patients in Quartile 4 had 27% more likelihood of RDS and a 24% lower likelihood of PDS at six months compared to a Quartile 1 patient.

LIMITATIONS

As a retrospective study only can observe associations but not causation. Only one institution participated and not all treatments were readily available, limiting the generalizability of these findings.

CONCLUSIONS

Lower SES as demonstrated by a lower HOUSES quartile (Quartile 1 versus 4) was associated with lower odds of RDS and increased odds of PDS at six months. HOUSES index is a useful tool for identifying patients at risk for worse clinical outcomes and may help health care systems plan resource allocation for depression care.

Screening, Brief Intervention, and Referral to Treatment/Motivational Interviewing School-Based Therapy Pilot Study

ABSTRACT

Substance abuse and comorbid psychological disorders are significant problems among adolescents. Hence, school-based interventions could be a promising approach for tackling substance use and mental health symptoms in at-risk youth. This pilot study was aimed at determining the effectiveness of interventions like Screening, Brief Intervention, and Referral to Treatment and motivational interviewing (MI) on depressive anxiety and substance use symptoms in middle school participants. Student psychiatric nurse practitioners who were trained and competent in MI conducted a combined Screening, Brief Intervention, and Referral to Treatment/MI intervention with 19 participants using measurement tools such as the Patient Health Questionnaire-9, the Generalized Anxiety Disorders-7, and the Car, Relax, Alone, Forget, Friends, Trouble Screening Test. Depressive and anxiety symptoms decreased after the intervention. Because the pre-post Car, Relax, Alone, Forget, Friends, Trouble screening period was 4 weeks, there were no significant pre-post differences.

Common mental health problems among adolescents in sub-Saharan Africa: A systematic review and meta-analysis

Background and aim: This review examined the prevalence of mental health problems among adolescents in sub-Saharan Africa.Methods: The review included studies indexed in the MEDLINE, EMBASE, and PsycINFO databases, supplemented by a search on Google Scholar and tracking of references from articles identified. A total of 725 articles were found, of which 28 met the inclusion criteria. Finally, 22 eligible studies were reviewed.Findings: The pooled current prevalence of mental health problems was 23% (95% CI: 18; 28, I2 = 99.41%). Any depression, 19% (95% CI: 9; 30, I2 = 99.64%), and anxiety, 20% (95% CI: 01; 31, I2 = 99.64%), were the most common mental health problems reported. Attention deficit hyperactivity disorder, 5% (95% CI: 3; 7, I2 = 97.60%), and conduct disorders, 15% (95% CI: 8; 22, I2 = 99.58%), were also significant mental health problems among adolescents in the region.Conclusion: About one in five adolescents in sub-Saharan Africa suffer from one or more mental health problems. The findings have important implications for policy and practice as they indicate that mental health problems are a major public health issue among adolescents in sub-Saharan Africa and that there is a need for effective and context-specific interventions that address mental health.

Can Money Buy Happiness for a Family? Family Income, Parenting Style, and Life Satisfaction in Parents and Adolescents

This study investigated the associations among family income and life satisfaction in parents, and parenting styles, income, and overall happiness and depression in their adolescents. A total of 1,913 participants comprising adolescents (aged 14-16) and their parents were recruited for this study. Participants were assessed using self-report questionnaires. Monthly household income was recorded by an open-ended question item. The life satisfaction of parents and overall happiness of adolescents were assessed by one item each, rated on a 4-point Likert scale. Three subtypes of parenting style (affectionate, monitoring, over-control) were evaluated by adolescents using an inventory consisting of 21 items on a 4-point Likert scale. Adolescents' depression was assessed with a checklist rated by the adolescents, consisting of 10 items on a 4-point Likert scale. The odds ratio (OR) for life dissatisfaction in adults was significantly higher in the lower (1st and 2nd) quintile groups of household income, by 9.94 (p < .001) and 3.50 (p < .001) folds, respectively, compared to the highest (5th) group. In contrast, household income had no significant association with life unhappiness in adolescents. Further, total household income had no significant association with the adolescent's depression score in linear regression analysis, but parenting style did. While affectionate (β = -0.260; p < .001) and monitoring (β = -0.100; p < .001) parenting styles showed negative associations with adolescents' depression scores, over-control style (β = 0.120; p < .001) showed a positive association. The results indicate the differences in factors impacting the life satisfaction of adults and happiness of adolescents, and the importance of effective parenting for adolescents' mental health.

Odds of Anxiety and Depression Symptoms in School-Aged Children From Official Language Minority Communities

Objectives: The aim of this paper is to assess the odds of suffering from anxiety or depression symptoms based on the presence of certain determinants of health for youth living in the province of New Brunswick, Canada, and in two linguistically different Official Language Minority Communities (OLMCs) in the same province.

Methods: With a sample of 22,329 students from grades 7 to 12 in the province of New Brunswick, Canada, logistic regressions were performed to assess each determinant of health's effect on symptoms of anxiety and depression.

Results: Some social determinants, like family support, social support and food insecurity, were identified as important determinants of mental health status regardless of linguistic group membership or community membership, while other determinants, such as alcohol use, cannabis use and natural environment, were more prominent in one OLMC than the other.

Discussion: Social psychology and public health theories are used in an attempt to explain the results. Limitations and recommendations are also brought forward.

Anxiety and Depression Correlates at Age 10 in Children Born Extremely Preterm

Objective  Anxiety and depression rates are known to be elevated in prematurely-born children and adolescents. This prospective study examines demographic, academic, and physical health correlates of anxiety and depression symptoms in a sample of 10-year-old children who were born extremely preterm. Methods  Participants were 889 (51.2% male; 62.3% White) children who were born <28 weeks gestation. Child and family demographic data were collected at birth. When the children were 10, parents (n = 871) and teachers (n = 640) rated the level of anxiety and depression in children through the Child Symptom Inventory-4. Child academic functioning was assessed via the Wechsler Individual Achievement Test-III. Parents completed questionnaires about child academic functioning and physical health issues. Data analyses were conducted with multivariate linear modeling. Results  Level of prematurity was significantly related to both parent and teacher reports of anxiety. Public health insurance and individualized education program (IEP) status were associated with both parent and teacher reports of depression. Hispanic ethnicity, public insurance, IEP status, and asthma were significantly associated with both parent-reported anxiety and depression. Gross motor impairment was associated with parent-reported anxiety and teacher-reported depression. Child obesity was associated with teacher reports of anxiety, while male sex was significantly related to teacher reports of depression. Conclusion  This pattern of findings may suggest hypotheses for future research on models of the development and persistence of anxiety and depression within this particularly vulnerable group of children.

Mental health and socioeconomic status impact adherence to youth activity and dietary programs: a meta-analysis

PURPOSE

Substantial efforts have gone into reducing the physiological and psychological harm of obesity in youth, but few studies have reviewed the factors contributing to adherence to pediatric weight management programs. The attrition rates to programs offering multiple components to address BMI improvement and healthy lifestyle change among youth are quite high. The purpose of this study is to review the literature for factors contributing to adherence to these programs among children and youth with obesity and determine pooled effect of these factors.

METHODS

A systematic literature search and meta-analysis was conducted through the PubMed database on pediatric weight management interventions offering at least physical activity and dietary support for obese youth aged 10-17 years, where variables contributing to adherence were reported. Only those studies achieving a threshold of methodological rigour were included.

RESULTS

Altogether, seven studies were included in the analysis. There was a pooled RR of lower socioeconomic status on non-adherence of 1.34 [95% confidence intervals 1.19-1.52] and poorer mental health on non-adherence of 1.12 [95% confidence intervals 1.08-1.17].

CONCLUSION

It is important to address barriers related to lower socioeconomic status in pediatric weight management programs to increase adherence. Further, addressing supports for those with poorer mental health can reduce the risk of non-adherence in multi-disciplinary programs targeting youth with obesity.

Exercise as a Mitigator of Poor Mental Health Among Lesbian, Gay, and Bisexual Adults

INTRODUCTION

There is a positive association between exercise and improved mental health in the general population. Although there is a greater burden of psychological distress among lesbian, gay, and bisexual (LGB) people, little is known about the association between exercise and mental health in this population. The authors explored the association between exercise and poor mental health reported by LGB adults in the United States.

METHODS

Our analyses used data from the 2017 Behavioral Risk Factor Surveillance System survey. Multiple regression analyses were used to determine the association between exercising and mental health days adjusting for sociodemographic characteristics.

RESULTS

Data were available for 6371 LGB participants. LGB adults who participated in any exercise reported almost 1.0 day less of poor mental health in the past 30 days compared with LGB adults who did not exercise (P ≤ .01). LGB adults who met one or both of the physical activity guidelines had between 1.2 and 1.7 days less of poor mental health compared with those who did not meet the guidelines (P ≤ .01).

CONCLUSION

Fewer days of poor mental health were reported by LGB adults who exercised. Determining whether physical activity interventions, including aerobic and strengthening exercises, could improve mental health outcomes in LGB adults should be studied.

Locus of Control and Negative Cognitive Styles in Adolescence as Risk Factors for Depression Onset in Young Adulthood: Findings From a Prospective Birth Cohort Study

Whilst previous observational studies have linked negative thought processes such as an external locus of control and holding negative cognitive styles with depression, the directionality of these associations and the potential role that these factors play in the transition to adulthood and parenthood has not yet been investigated. This study examined the association between locus of control and negative cognitive styles in adolescence and probable depression in young adulthood and whether parenthood moderated these associations. Using a UK prospective population-based birth cohort study: the Avon Longitudinal Study of Parents and Children (ALSPAC), we examined the association between external locus of control and negative cognitive styles in adolescence with odds of depression in 4,301 young adults using logistic regression models unadjusted and adjusted for potential confounding factors. Interaction terms were employed to examine whether parenthood (i.e., having become a parent or not) moderated these associations. Over 20% of young adults in our sample were at or above the clinical threshold indicating probable depression. For each standard deviation (SD) increase in external locus of control in adolescence, there was a 19% (95% CI: 8-32%) higher odds of having probable depression in young adulthood, after adjusting for various confounding factors including baseline mood and different demographic and life events variables. Similarly, for each SD increase in negative cognitive styles in adolescence, there was a 29% (95% CI: 16-44%) higher odds of having probable depression in the adjusted model. We found little evidence that parenthood status moderated the relationship between external locus of control or negative cognitive styles in adolescence and probable depression following adjustment for confounding factors. Effect estimates were comparable when performed in the complete case dataset. These findings suggest that having an external locus of control and holding negative cognitive styles in mid- to late adolescence is associated with an increased likelihood of probable depression in young adulthood.

Prescription medication use among Canadian children and youth, 2012 to 2017

BACKGROUND

Prescription medications are used throughout the life course, including among children and youth. Prescribing practices may be influenced by emerging medical conditions, the availability of new medications, changing clinical practices, and evolving knowledge of the safety and effectiveness of medications. The Canadian Health Measures Survey (CHMS) provides national-level information to help monitor the use of prescribed medications in the population.

DATA AND METHODS

Based on data from the CHMS (2012 to 2017), this article describes prescription medication use in the past month among those aged 3 to 19 years. Information on up to 45 prescription medications was recorded and classified according to Health Canada's Anatomical Therapeutic Chemical classification. Frequencies and bivariate analyses examined medication use by sociodemographic and health-related factors. The most common medication classes were identified for each age group.

RESULTS

An estimated 23% of Canadian children and youth (1.5 million) had used at least one prescription medication in the past month and 9% had used two or more prescription medications.Prescription medication use was more common among those who reported lower levels of general and mental health, as well as among those with asthma (51%), a mood disorder (71%), attention deficit disorder (60%) or a learning disability (43%). Medications for the respiratory and nervous systems were among those most commonly prescribed. Of youth aged 14 years or older, 4% had misused prescription medications for non-medicinal purposes, for the experience, for the feeling they cause or to get high.

DISCUSSION

Prescription medication use among children and youth is common in Canada. It is associated with lower levels of self-reported health and the presence of chronic conditions. The estimates provide a benchmark to help monitor prescription drug use in Canada.

McGrath J. Co-morbidity between mood and anxiety disorders: A systematic review and meta-analysis

There is consistent evidence that mood disorders often co-occur with anxiety disorders, however, the strength of the association of these two broad groups of disorders has been challenging to summarize across different studies. The aim was to conduct a meta-analysis of publications reporting on the pairwise comorbidity between mood and anxiety disorders after sorting into comparable study types. We searched MEDLINE, Embase, CINAHL, Web of Science, and the grey literature for publications between 1980 and 2017 regardless of geographical locations and languages. We meta-analyzed estimates from original articles after sorting by: (a) broad or narrow diagnostic criteria, (b) study time-frame, and (c) estimates with or without covariate adjustments. Over 43 000 unique studies were identified through electronic searches, of which 391 were selected for full-text review. Finally, 171 studies were eligible for inclusion, including 53 articles from additional snowball searching. In general, regardless of variations in diagnosis type, study time-frame, temporal order, or use of adjustments, there was substantial comorbidity between mood and anxiety disorders. Based on the entire 90 separate meta-analyses, the median OR was 6.1 (range 1.5-18.7). Of these estimates, all 90 were above 1, and 87 were significantly greater than 1 (i.e., the 95% confidence intervals did not include 1). Fourteen of the 90 pooled estimates had ORs that were greater than 10. This systematic review found robust and consistent evidence of comorbidity between broadly defined mood and anxiety disorders. Clinicians should be vigilant for the prompt identification and treatment of this common type of comorbidity.

What makes adolescents psychologically distressed? Life events as risk factors for depression and suicide

Adolescence is a vulnerable period for psychological distress. This study aimed to comprehensively investigate the distribution of major stress-causing factors and their correlates in a large population of adolescents. A computerized self-report questionnaire was completed by 291,110 participating adolescents over a 4-year period using a cross-sectional study design. The questionnaire included items assessing demographic variables, major stressors, severity of perceived stress, and mental health outcomes such as depressed mood, suicidal ideation, and attempts. Among the major stressors, schoolwork/career was the most predominant (54.7%). However, the odds ratios for depressed mood and suicidal ideation were the highest in the stressor of conflict with peers (OR = 1.97 for depressed mood and OR = 2.00 for suicidal ideation), followed by family circumstances (OR = 1.77 and 1.94 for depressed mood and suicidal ideation, respectively). Conversely, schoolwork/career presented significantly lower odds ratios of 0.87 and 0.87 for depressed mood and suicidal ideation, respectively. This study provides important information on psychological distress related to adolescents' mental health. Although school/career was the most prevalent source of psychological stress, the odds ratios for negative health outcomes of adolescents were higher in interpersonal problems such as conflicts with parents and peers and family circumstances. The present findings might help parents and clinicians understand the psychological distress of adolescents and improve their mental health.

Psychosocial and biological risk factors of anxiety disorders in adolescents: a TRAILS report

Anxiety disorders are a common problem in adolescent mental health. Previous studies have investigated only a limited number of risk factors for the development of anxiety disorders concurrently. By investigating multiple factors simultaneously, a more complete understanding of the etiology of anxiety disorders can be reached. Therefore, we assessed preadolescent socio-demographic, familial, psychosocial, and biological factors and their association with the onset of anxiety disorders in adolescence. This study was conducted among 1584 Dutch participants of the TRacking Adolescents' Individual Lives Survey (TRAILS). Potential risk factors were assessed at baseline (age 10-12), and included socio-demographic (sex, socioeconomic status), familial (parental anxiety and depression), psychosocial (childhood adversity, temperament), and biological (body mass index, heart rate, blood pressure, cortisol) variables. Anxiety disorders were assessed at about age 19 years through the Composite International Diagnostic Interview (CIDI). Univariate and multivariate logistic regression analyses were performed with onset of anxiety disorder as a dependent variable and the above-mentioned putative risk factors as predictors. Of the total sample, 25.7% had a lifetime diagnosis of anxiety disorder at age 19 years. Anxiety disorders were twice as prevalent in girls as in boys. Multivariate logistic regression analysis showed that being female (OR = 2.38, p < .01), parental depression and anxiety (OR = 1.34, p = .04), temperamental frustration (OR = 1.31, p = .02) and low effortful control (OR = 0.76, p = .01) independently predicted anxiety disorders. We found no associations between biological factors and anxiety disorder. After exclusion of adolescents with an onset of anxiety disorder before age 12 years, being female was the only significant predictor of anxiety disorder. Being female was the strongest predictor for the onset of anxiety disorder. Psychological and parental psychopathology factors increased the risk of diagnosis of anxiety, but to a lesser extent. Biological factors (heart rate, blood pressure, cortisol, and BMI), at least as measured in the present study, are unlikely to be useful tools for anxiety prevention and intervention strategies.

Adolescent mental health problems, suicidality and seeking help from general practice: A cross-sectional study (Northern Ireland Schools and Wellbeing study)

BACKGROUND

Adolescent mental health problems and suicidality appear to be increasing in Western countries but contact with health services remains stubbornly low. While social disadvantage is often implicated in aetiology and help-seeking, evidence on the relative contribution of school and family life factors is limited. We sought (a) to examine the prevalence and factors associated with mental health problems in adolescent boys and girls; and (b) to examine factors associated with trust and contact with GPs for mental health problems.

METHOD

Cross-sectional study of adolescent pupils in Northern Ireland RESULTS: High rates of mental health problems and suicidality were recorded, especially among females. While social circumstances do not influence mental health outcomes, factors of interest were atheist/agnostic beliefs and having a bedroom to oneself. While overall trust in GPs was high, more than 36% of the sample reported low trust. GP Trust was associated with positive home life factors. Importantly, adolescents with mental health problems including suicidality were much less likely to seek help.

LIMITATIONS

Cross-sectional data CONCLUSIONS: This study confirms the high rates of mental health problems and suicidality among adolescents in Northern Ireland, particularly among young women. Those most in need of professional help appear least prepared to seek it. The influence of home life and environment on both poor mental health and trust and help-seeking from family doctors, is considerable and there is a need to find interventions that nurture appropriate levels of trust and help-seeking guidance for adolescents.

The Main and Interactive Associations between Demographic Factors and Psychopathology and Treatment Utilization in Youth: A Test of Intersectionality in the ABCD Study

Demographic factors may be associated with youth psychopathology due to social-contextual factors that may also pose barriers to intervention. Further, in line with intersectionality theory, youth with multiple non-dominant identities may be most likely to experience psychopathology and face barriers to care. This study examined rates of parent-reported psychopathology and mental health treatment utilization as a function of several demographic characteristics (in isolation and in concert) in a population-based, demographically diverse sample of 11,875 9- to 10-year-old youth. Results indicated most consistently that lower SES was associated with greater rates of psychopathology and greater likelihood of treatment utilization; that Asian American youth (relative to all other racial groups) and Hispanic/Latinx (relative to non-Hispanic/Latinx) youth were less likely to have a history of psychopathology or to have utilized treatment; and that male youth had greater rates of lifetime Obsessive Compulsive Disorder (OCD) and Oppositional Defiant Disorder (ODD) and were more likely to have utilized treatment. There was more modest support for interactive effects between demographic factors on psychopathology, which are discussed. The present study provides some support for differential rates of parent-reported psychopathology and treatment utilization as a function of demographic identities in youth. Potential explanations for these differences (e.g., cultural differences in symptom presentation; underreporting of symptoms) are discussed.

Assessing the impacts of the Agenda Gap intervention for youth mental health promotion through policy engagement: a study protocol

BACKGROUND

Mental health challenges are a leading health concern for youth globally, requiring a comprehensive approach incorporating promotion, prevention and treatment within a healthy public policy framework. However, the broad enactment of this vision has yet to be realized. Further, mental health promotion evidence specific to youth is still emerging and has not yet focused at a policy level. This is a critical gap, as policy is a key mental health promotion lever that can alter the social and structural conditions that contribute to shaping youth mental health outcomes for all youth, across the full spectrum of need. Responsive to this research and intervention priority, our prototype study intervention-the Agenda Gap-is comprised of an innovative, multi-media engagement intervention, developed in collaboration with youth. This intervention aims to equip youth and build capacity for them to lead meaningful policy change reflective of the mental health needs of diverse communities of youth, including those who experience structural vulnerability and who would not typically have had their voice represented in policymaking processes.

METHODS

This study will use a multiple case study design and mixed methods grounded in a realist approach and will be conducted in three sites across two Canadian provinces (British Columbia and Alberta). In an earlier phase of this research, we collaboratively designed the prototype intervention with youth, community and policy partners. In this phase of the study, the intervention will be implemented and further tested with new groups of youth collaborators (n = 10-15/site). Outcome data will be collected through realist qualitative interviews, validated questionnaires [i.e., Child and Youth Resilience Measure (CYRM-12), General Self-Efficacy (GSE) Scale, and the Critical Consiousness Scale (CCS)] and additional survey items developed by our study team. Analysis will focus on identification of key context-mechanism-outcome configurations to provide comprehensive insights into how this intervention works, for whom, and in what context.

DISCUSSION

This study is unique in its "upstream" focus on youth-engaged policymaking as a tool for improving the social and structural conditions that influence youth mental health across socioecological levels. Through the implementation and testing of the Agenda Gap intervention with diverse youth, this study will contribute to the evidence base on youth-engaged policymaking as a novel and innovative, mental health promotion strategy.

The Contribution of Neighborhood Socioeconomic Disadvantage to Depressive Symptoms Over the Course of Adult Life: A 32-Year Prospective Cohort Study

The association between socioeconomic disadvantage and increased risk of depressive symptoms in adulthood is well established. We tested 1) the contribution of early exposure to neighborhood socioeconomic disadvantage to later depressive symptoms throughout life, 2) the persistence of the potential association between early exposure and depressive symptoms, and 3) the contributions of other known risk factors to the association. Data were collected from the Young Finns Study, a prospective, population-based 32-year follow-up study that included participants aged 3-18 years at baseline in 1980. Participants were followed up with repeated measurements of depressive symptoms between 1992 and 2012 (n = 2,788) and linked to national grid data on neighborhood disadvantage via residential addresses. We examined the associations in mixed models separately for the 5-, 10-, 15-, and 20-year follow-ups. Living in a disadvantaged neighborhood during childhood and adolescence was associated with a higher level of depressive symptoms in adulthood during all follow-up periods (β = 0.07, P = 0.001) than living in a nondisadvantaged area. Individual adulthood socioeconomic status mediated the associations. These findings suggest that living in a socioeconomically disadvantaged area during childhood and adolescence has a long-lasting negative association with mental health irrespective of family-related risks, partially due to socioeconomic adversity later in life.

Depression, Anxiety, and Stress as a Function of Psychological Strains: Towards an Etiological Theory of Mood Disorders and Psychopathologies

BACKGROUND

The etiological factors of mood disorders and psychopathologies are understudied. In this paper, we explored whether social psychological strains are related to depression, anxiety, and stress in non-clinical populations.

METHODS

6,305 college students (39.3% men; 60.7% women) from six Chinese provincial-level jurisdictions completed a paper-and-pencil survey with Psychological Strain Scales (PSS-40) and Depression, Anxiety, and Stress Scales-21 (DASS-21), both validated in Chinese populations.

RESULTS

Both PSS-40 and DASS-21 have high internal consistency reliabilities, and are highly correlated with each other. Hence, Chinese college students with greater psychological strains (value, aspiration, deprivation, or coping) have greater depression, anxiety, and stress. These results still held after controlling for relevant socio-demographic variables in the multiple regression models.

LIMITATIONS

This was a cross-sectional study, and the sample only included several provinces in mainland China, not a representative sample of all of them.

CONCLUSIONS

Mood disorders and psychopathologies are linked to suicidal thoughts and behaviors. The results of this study extend the Strain Theory of Suicide from explaining the risk factors of suicidality to mood disorders and psychopathologies. Hence, these findings can inform prevention measures among college students, and possibly the general population.