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Carlsson IM, Bräutigam Ewe M, Nymberg P, Jormfeldt H. Building up bit by bit, parent's experiences of equine-assisted intervention among children and adolescents with mental illness: a grounded theory study. Int J Qual Stud Health Well-being 2024; 19:2354945. [PMID: 38758980 PMCID: PMC11104696 DOI: 10.1080/17482631.2024.2354945] [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: 01/02/2024] [Accepted: 05/09/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Mental ill health among children and adolescents has increased worldwide. Mental health difficulties from a young age are associated with school absence and educational underachievement. A holistic perspective of treatments besides medical treatment is essential Thus, there is a need for research regarding equine-assisted intervention (EAI). PURPOSE The present study aimed to understand the outcomes of an equine-assisted intervention for children and adolescents with mental ill health from the perspectives of parents and close relatives. METHODS This study used a qualitative research design informed by Charmaz's Grounded Theory, with a purposive sample including six in-depth interviews. RESULTS The theory "building up bit by bit" was constructed, explaining the recognition that their children/adolescents were built up bit by bit and created a stronger self-identity. The participants referred to changes in the child's or adolescent's way of being and emotional regulation, which constituted building blocks leading to the child's or adolescent's 1. increased Harmony. 2. enhanced Self-identity, and 3. improved Capability. CONCLUSION Parents and close relatives experienced that their child or adolescent was built up bit by bit and gained a stronger foundation to stand on. This led to increased harmony in everyday life with stronger self-worth, better performance, and reduced school absenteeism.
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Affiliation(s)
| | | | - Peter Nymberg
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Center for Primary Health Care Research, Region Skåne: Helsingborg/Malmö, Skåne, Sweden
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Soriano V, Ramos JM, López-Ibor MI, Chiclana-Actis C, Faraco M, González-Cabrera J, González-Fraile E, Mestre-Bach G, Pinargote H, Corpas M, Gallego L, Corral O, Blasco-Fontecilla H. Trends in suicidal behavior among hospitalized adolescents in Spain over two decades. J Affect Disord 2024; 363:106-111. [PMID: 39025445 DOI: 10.1016/j.jad.2024.07.081] [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: 04/04/2024] [Revised: 06/25/2024] [Accepted: 07/14/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Suicide ranks as a leading cause of premature death among adolescents globally. Understanding the trends and key determinants of suicidal behavior in youth are critical for implementing educational policies and supporting preventive strategies in schools. METHODS This retrospective study examined all hospitalizations due to suicidal behavior in children and adolescents aged 11 to 18 years in Spain, using data from the Spanish National Registry of Hospital Discharges spanning 2000 to 2021. RESULTS Over the 22-year study period, there were 2,015,589 hospitalizations among adolescents in Spain, with 118,609 (5.9 %) cases involving mental disorders. There were 2855 admissions with suicidal behavior, constituting 2.4 % of the hospitalizations among youth with mental disorders. Girls represented 73.4 % of all hospitalizations, with a median age of 16 years. Admissions for suicidal behavior saw a four-fold increase during the last decade (p < 0.001). The in-hospital mortality rate for adolescents with suicidal behavior doubled that of those hospitalized for other mental disorders. During the first year of the COVID-19 pandemic, admissions of adolescents with suicidal behavior decreased, only to surge by 2.5-fold during 2021. CONCLUSION Hospital admissions for suicidal behavior among adolescents have risen in Spain over the last two decades. Girls represented 73.4 % of these admissions, yet in-hospital mortality was more frequent in boys.
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Affiliation(s)
- Vicente Soriano
- Universidad Internacional de La Rioja, UNIR-itei & Health Sciences School, Madrid, Spain.
| | | | - María Inés López-Ibor
- Universidad Internacional de La Rioja, UNIR-itei & Health Sciences School, Madrid, Spain; Universidad Complutense, Madrid, Spain
| | - Carlos Chiclana-Actis
- Universidad Internacional de La Rioja, UNIR-itei & Health Sciences School, Madrid, Spain; Consulta Dr. Carlos Chiclana, Madrid, Spain
| | - Manuel Faraco
- Universidad Internacional de La Rioja, UNIR-itei & Health Sciences School, Madrid, Spain; Centro Adalmed, Madrid, Spain
| | | | | | - Gemma Mestre-Bach
- Universidad Internacional de La Rioja, UNIR-itei & Health Sciences School, Madrid, Spain
| | | | - Manuel Corpas
- Universidad Internacional de La Rioja, UNIR-itei & Health Sciences School, Madrid, Spain; Westminster University, London, UK
| | - Lucía Gallego
- Universidad Internacional de La Rioja, UNIR-itei & Health Sciences School, Madrid, Spain; Universidad Complutense, Madrid, Spain
| | - Octavio Corral
- Universidad Internacional de La Rioja, UNIR-itei & Health Sciences School, Madrid, Spain
| | - Hilario Blasco-Fontecilla
- Universidad Internacional de La Rioja, UNIR-itei & Health Sciences School, Madrid, Spain; Center of Biomedical Network Research on Mental Health (CIBERSAM), Madrid, Spain
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Byg LM, Bilenberg N, Glintborg D, Andersen MS, Wesselhoeft R. The longitudinal relationship between prenatal maternal cortisol and preschool internalising problems. Psychoneuroendocrinology 2024; 168:107141. [PMID: 39059226 DOI: 10.1016/j.psyneuen.2024.107141] [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: 03/15/2024] [Revised: 07/02/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024]
Abstract
INTRO Prenatal exposure to synthetic glucocorticoids may increase the risk of emotional symptoms in childhood partly by reducing fetal growth. We explored if physiological levels of prenatal maternal cortisol were associated with internalising problems in boys and girls and if this was mediated by birth weight. METHODS Mother-child dyads from the prospective Odense Child Cohort (n=1162) were included if maternal serum cortisol (3rd trimester), offspring birth weight, and Child Behaviour Checklist (CBCL) assessments in preschool age were available. Crude and adjusted associations between cortisol and internalising problems were determined in linear mixed models stratified by offspring sex. Covariates included parental psychiatric history, parity, maternal age, education, smoking during pregnancy, and gestational age at birth. In the presence of significant associations, we evaluated the potential mediating role of birth weight. RESULTS The study sample included 601 boys and 561 girls and internalising problems were assessed at mean ages 2.3 (±0.4) and 5 (±0.5) years. In the crude analysis, cortisol was positively associated with internalising problems in boys (p-value 0.017) and in girls (p-value < 0.0001). In the adjusted analyses, there was no statistically significant association between cortisol and offspring internalising problems in boys or girls (all p-values > 0.15). There was no mediation by birth weight. DISCUSSION Maternal serum cortisol was positively associated with offspring internalising problems in boys and girls, but there was no association following adjustment for potential confounders and no mediation through birth weight. Maternal third-trimester cortisol levels do not predict preschool offspring internalising problems in our study.
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Affiliation(s)
- Lars Meinertz Byg
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia; Child and Adolescent Mental Health Southern Denmark, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Niels Bilenberg
- Child and Adolescent Mental Health Southern Denmark, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Dorte Glintborg
- Department of Endocrinology and Metabolism, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Marianne Skovsager Andersen
- Department of Endocrinology and Metabolism, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Rikke Wesselhoeft
- Child and Adolescent Mental Health Southern Denmark, Mental Health Services in the Region of Southern Denmark, Odense, Denmark; Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark.
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Pines A, Tozzi L, Bertrand C, Keller AS, Zhang X, Whitfield-Gabrieli S, Hastie T, Larsen B, Leikauf J, Williams LM. Psychiatric Symptoms, Cognition, and Symptom Severity in Children. JAMA Psychiatry 2024:2822689. [PMID: 39196567 PMCID: PMC11359114 DOI: 10.1001/jamapsychiatry.2024.2399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 06/07/2024] [Indexed: 08/29/2024]
Abstract
Importance Mental illnesses are a leading cause of disability globally, and functional disability is often in part caused by cognitive impairments across psychiatric disorders. However, studies have consistently reported seemingly opposite findings regarding the association between cognition and psychiatric symptoms. Objective To determine if the association between general cognition and mental health symptoms diverges at different symptom severities in children. Design, Setting, and Participants A total of 5175 children with complete data at 2 time points assessed 2 years apart (aged 9 to 11 years at the first assessment) from the ongoing Adolescent Brain and Cognitive Development (ABCD) study were evaluated for a general cognition factor and mental health symptoms from September 2016 to August 2020 at 21 sites across the US. Polynomial and generalized additive models afforded derivation of continuous associations between cognition and psychiatric symptoms across different ranges of symptom severity. Data were analyzed from December 2022 to April 2024. Main Outcomes and Measures Aggregate cognitive test scores (general cognition) were primarily evaluated in relation to total and subscale-specific symptoms reported from the Child Behavioral Checklist. Results The sample included 5175 children (2713 male [52.4%] and 2462 female [47.6%]; mean [SD] age, 10.9 [1.18] years). Previously reported mixed findings regarding the association between general cognition and symptoms may consist of several underlying, opposed associations that depend on the class and severity of symptoms. Linear models recovered differing associations between general cognition and mental health symptoms, depending on the range of symptom severities queried. Nonlinear models confirm that internalizing symptoms were significantly positively associated with cognition at low symptom burdens higher cognition = more symptoms) and significantly negatively associated with cognition at high symptom burdens. Conclusions and Relevance The association between mental health symptoms and general cognition in this study was nonlinear. Internalizing symptoms were both positively and negatively associated with general cognition at a significant level, depending on the range of symptom severities queried in the analysis sample. These results appear to reconcile mixed findings in prior studies, which implicitly assume that symptom severity tracks linearly with cognitive ability across the entire spectrum of mental health. As the association between cognition and symptoms may be opposite in low vs high symptom severity samples, these results reveal the necessity of clinical enrichment in studies of cognitive impairment.
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Affiliation(s)
- Adam Pines
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Leonardo Tozzi
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Claire Bertrand
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Arielle S. Keller
- Penn Lifespan Informatics and Neuroimaging Center, University of Pennsylvania, Philadelphia
- Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - Xue Zhang
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | | | - Trevor Hastie
- Department of Statistics, Stanford University, Stanford, California
- Department of Biomedical Data Science, Stanford University, Stanford, California
| | - Bart Larsen
- Penn Lifespan Informatics and Neuroimaging Center, University of Pennsylvania, Philadelphia
- Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - John Leikauf
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Leanne M. Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
- Sierra-Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
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Xiong W, Wang B, Han F, Tong J, Gao H, Ding P, Liu K, Wu X, Huang K, Geng M, Tao F. Association between maternal antibiotic exposure and emotional and behavioural problems in children at four years of age: A biomonitoring-based prospective study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 284:116949. [PMID: 39208579 DOI: 10.1016/j.ecoenv.2024.116949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 08/24/2024] [Accepted: 08/24/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Maternal exposure to multiple antibiotics exposure during pregnancy has attracted extensive attention, but biomonitoring studies linking prenatal antibiotic exposure to emotional and behavioural problems in children are limited. METHODS A total of 2475 pregnant women from the Ma'anshan Birth Cohort were included, and the Strengths and Difficulties Questionnaire was completed when their children turned four years of age. The levels of 41 maternal urinary antibiotics and two metabolites were measured during the first, second and third trimesters. Generalized estimating equations and binary logistic regression models were applied to analyse the associations between maternal antibiotic exposure and emotional and behavioural problems in children and to determine the sensitive period, respectively. A quantile-based g-computation (QGC) approach was employed to examine the combined effects of multiple antibiotics on emotional and behavioural problems in children. RESULTS Overall, florfenicol and preferred-as-veterinary antibiotic (PVA) exposure during pregnancy increased the risk of emotional problems in children, and ofloxacin exposure increased the risk of hyperactivity-inattention. Maternal exposure to trimethoprime, ciprofloxacin, florfenicol, other antibiotics and PVA exposure during the first trimester was positively associated with emotional problems in children. Second-trimester trimethoprime concentrations and third-trimester ciprofloxacin concentrations were positively associated with hyperactivity-inattention. Third-trimester veterinary antibiotic (VA) exposure was negatively associated with hyperactivity-inattention, and second-trimester VA and PVA exposure was negatively associated with peer problems. The QGC model revealed that mixed antibiotic exposure in the first trimester exacerbated the risk of childhood emotional problems (the contribution of ciprofloxacin is prominent), and mixed antibiotic exposure in the second trimester increased the risk of hyperactivity-inattention (the contribution of trimethoprime is prominent). CONCLUSION Maternal mixed antibiotic exposure during the first and second trimesters increases the risk of emotional problems and hyperactivity-inattention in children at four years of age.
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Affiliation(s)
- Wanhong Xiong
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Baolin Wang
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Feifei Han
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Juan Tong
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, Anhui 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, Anhui 230032, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China; Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Hui Gao
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, Anhui 230032, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China; Department of Pediatric, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, Anhui 230022, China
| | - Peng Ding
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, Anhui 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, Anhui 230032, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China; Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Kaiyong Liu
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, Anhui 230032, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Xiaoyan Wu
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, Anhui 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, Anhui 230032, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Kun Huang
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, Anhui 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, Anhui 230032, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Menglong Geng
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, Anhui 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, Anhui 230032, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China; Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China.
| | - Fangbiao Tao
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, Anhui 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, Anhui 230032, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China.
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Moslemi H, Fatemian H, Hosseini Y, Moshfeghinia R. C-reactive protein (CRP) level in depressed patients with suicidal behavior: A systematic review and meta-analysis. J Affect Disord 2024:S0165-0327(24)01368-5. [PMID: 39187188 DOI: 10.1016/j.jad.2024.08.135] [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: 06/04/2024] [Revised: 07/30/2024] [Accepted: 08/23/2024] [Indexed: 08/28/2024]
Abstract
INTRODUCTION Suicidal behavior necessitates prompt diagnosis due to its severe consequences. C-reactive protein (CRP) levels may offer insights into its pathophysiology and aid in risk assessment, potentially enhancing preventive interventions and treatment strategies. The aim of this study is to assess the CRP levels in depressed patients with and without suicidal behavior. METHODS Our systematic review was registered in Prospero (#CRD42024518477). We searched five databases (PubMed, Scopus, PsycINFO, Web of Science, and CINAHL Complete) for records in English from inception to February 2024. We included observational studies that measured CRP in depressed patients with and without suicidal behavior. We used the Newcastle-Ottawa Scale (NOS) to assess the quality of the included studies. We employed a random-effects model, and the statistical analysis was conducted using Stata software version 17. RESULTS Initial 632 articles narrowed to 15 for systematic review. Fifteen studies with 3652 participants included. Fourteen studies involving 3387 depressed patients, 1269 with suicidal behavior, analyzed CRP levels. Suicidal patients exhibited higher CRP levels (SMD: 0.80 [0.37, 1.23]). Analysis of seven studies with 465 participants, including 200 depressed patients with suicidal behavior and 265 healthy controls, showed higher CRP levels in depressed patients (SMD: 1.58 [0.97, 2.19]). CONCLUSION In summary, our systematic review and meta-analysis of CRP levels in suicidal patients revealed that those with suicidal behavior exhibited higher CRP levels, suggesting possible implications for treatment approaches.
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Affiliation(s)
- Hossein Moslemi
- Department of Science and Technology Studies, AJA University of Command and Staff, Tehran, Iran
| | - Hossein Fatemian
- Medical doctor, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Yasaman Hosseini
- Cognitive Neuroscience Research Center, AJA University of Medical Sciences, Tehran, Iran.
| | - Reza Moshfeghinia
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran; Research Center for Psychiatry and Behavior Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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Lawrence-Sidebottom D, Huffman LG, Beam AB, McAlister K, Guerra R, Parikh A, Roots M, Huberty J. Using a Digital Mental Health Intervention for Crisis Support and Mental Health Care Among Children and Adolescents With Self-Injurious Thoughts and Behaviors: Retrospective Study. JMIR Form Res 2024; 8:e54816. [PMID: 39151166 PMCID: PMC11364954 DOI: 10.2196/54816] [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: 11/22/2023] [Revised: 02/16/2024] [Accepted: 06/17/2024] [Indexed: 08/18/2024] Open
Abstract
BACKGROUND Self-injurious thoughts and behaviors (SITBs) are increasing dramatically among children and adolescents. Crisis support is intended to provide immediate mental health care, risk mitigation, and intervention for those experiencing SITBs and acute mental health distress. Digital mental health interventions (DMHIs) have emerged as accessible and effective alternatives to in-person care; however, most do not provide crisis support or ongoing care for children and adolescents with SITBs. OBJECTIVE To inform the development of digital crisis support and mental health care for children and adolescents presenting with SITBs, this study aims to (1) characterize children and adolescents with SITBs who participate in a digital crisis response service, (2) compare anxiety and depressive symptoms of children and adolescents presenting with SITBs versus those without SITBs throughout care, and (3) suggest future steps for the implementation of digital crisis support and mental health care for children and adolescents presenting with SITBs. METHODS This retrospective study was conducted using data from children and adolescents (aged 1-17 y; N=2161) involved in a pediatric collaborative care DMHI. SITB prevalence was assessed during each live session. For children and adolescents who exhibited SITBs during live sessions, a rapid crisis support team provided evidence-based crisis support services. Assessments were completed approximately once a month to measure anxiety and depressive symptom severity. Demographics, mental health symptoms, and change in the mental health symptoms of children and adolescents presenting with SITBs (group with SITBs) were compared to those of children and adolescents with no SITBs (group without SITBs). RESULTS Compared to the group without SITBs (1977/2161, 91.49%), the group with SITBs (184/2161, 8.51%) was mostly made up of adolescents (107/184, 58.2%) and female children and adolescents (118/184, 64.1%). At baseline, compared to the group without SITBs, the group with SITBs had more severe anxiety and depressive symptoms. From before to after mental health care with the DMHI, the 2 groups did not differ in the rate of children and adolescents with anxiety symptom improvement (group with SITBs: 54/70, 77% vs group without SITBs: 367/440, 83.4%; χ21=1.2; P=.32) as well as depressive symptom improvement (group with SITBs: 58/72, 81% vs group without SITBs: 255/313, 81.5%; χ21=0; P=.99). The 2 groups also did not differ in the amount of change in symptom severity during care with the DMHI for anxiety (t80.20=1.37; P=.28) and depressive (t83.75=-0.08; P=.99) symptoms. CONCLUSIONS This study demonstrates that participation in a collaborative care DMHI is associated with improved mental health outcomes in children and adolescents experiencing SITBs. These results provide preliminary insights for the use of pediatric DMHIs in crisis support and mental health care for children and adolescents presenting with SITBs, thereby addressing the public health issue of acute mental health crisis in children and adolescents.
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Affiliation(s)
| | | | | | | | | | - Amit Parikh
- Mental Fitness Clinic, Los Angeles, CA, United States
| | | | - Jennifer Huberty
- Bend Health, Inc, Madison, WI, United States
- FitMinded Inc, LLC, Phoenix, AZ, United States
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Soriano V, Ramos JM, López-Ibor MI, Chiclana-Actis C, Faraco M, González-Cabrera J, González-Fraile E, Mestre-Bach G, Pinargote H, Corpas M, Gallego L, Corral O, Blasco-Fontecilla H. Hospital admissions in adolescents with mental disorders in Spain over the last two decades: a mental health crisis? Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02543-2. [PMID: 39097852 DOI: 10.1007/s00787-024-02543-2] [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: 02/09/2024] [Accepted: 07/29/2024] [Indexed: 08/05/2024]
Abstract
Mental disorders account for a large and increasing health burden worldwide. Characterizing the spectrum of mental disorders and trends over time in adolescents should influence education policies and support preventative strategies at schools. Retrospective study of all hospitalizations in Spain in adolescents 11-18-years old, including mental disorders as diagnosis using the Spanish National Registry of Hospital Discharges. Information was retrieved from 2000 to 2021. During the 22-year study period there were 2,015,589 hospitalizations in adolescents in Spain, of which 118,609 (5.9%) had mental disorders. The rate of psychiatric diagnoses significantly increased from 3.9% in 2000 to 9.5% in 2021. Females accounted for 55.1% of admissions. Mean age at admission declined from 17 to 15 years-old from 2000 to 2021. Mean hospital stay was 10.6 days. Mean in-hospital mortality was 0.24%. By rate order, diagnoses were: substance use disorders (SUD) (40%) > eating disorders (15%) > anxiety/posttraumatic stress disorder (PTSD) (13%) > attention deficit hyperactivity disorder (ADHD) (9%) > major depression (8%) > schizophrenia/psychosis (6%) > autism spectrum disorder (ASD) (6%) > sleep disorder (3%) > suicidal behavior (2%) > sexual disorders (1%). A significant gender dichotomy was noticed, with female predominance for internalizing disorders (i.e., anxiety, depression, suicidal behavior and eating disorders) whereas externalizing disorders (i.e., SUD, ADHD, ASD, schizophrenia and other psychoses) predominated in males. Suicidal behavior and male sex were independent predictors of in-hospital death in multivariate analysis. After the first year of the COVID-19 pandemic, hospitalizations due to mental disorders in adolescents increased by 51% in 2021. There is a growing crisis of mental health among adolescents in Spain. Although the COVID-19 pandemic has unveiled the high rate and severity of psychiatric disorders among youth, a steadily increase has occurred since the beginning of the millennium. Primary preventative strategies should be adapted to distinct and more prevalent mental disorders in adolescents.
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Affiliation(s)
- Vicente Soriano
- UNIR-Itei & Health Sciences School, Universidad Internacional de La Rioja, C/ Zurbano 73, 28010, Madrid, Spain.
| | | | - María Inés López-Ibor
- UNIR-Itei & Health Sciences School, Universidad Internacional de La Rioja, C/ Zurbano 73, 28010, Madrid, Spain
- Universidad Complutense, Madrid, Spain
| | - Carlos Chiclana-Actis
- UNIR-Itei & Health Sciences School, Universidad Internacional de La Rioja, C/ Zurbano 73, 28010, Madrid, Spain
- Consulta Dr. Carlos Chiclana, Madrid, Spain
| | - Manuel Faraco
- UNIR-Itei & Health Sciences School, Universidad Internacional de La Rioja, C/ Zurbano 73, 28010, Madrid, Spain
- Centro Adalmed, Madrid, Spain
| | - Joaquín González-Cabrera
- UNIR-Itei & Health Sciences School, Universidad Internacional de La Rioja, C/ Zurbano 73, 28010, Madrid, Spain
| | - Eduardo González-Fraile
- UNIR-Itei & Health Sciences School, Universidad Internacional de La Rioja, C/ Zurbano 73, 28010, Madrid, Spain
| | - Gemma Mestre-Bach
- UNIR-Itei & Health Sciences School, Universidad Internacional de La Rioja, C/ Zurbano 73, 28010, Madrid, Spain
| | | | - Manuel Corpas
- UNIR-Itei & Health Sciences School, Universidad Internacional de La Rioja, C/ Zurbano 73, 28010, Madrid, Spain
- Westminster University, London, UK
| | - Lucía Gallego
- UNIR-Itei & Health Sciences School, Universidad Internacional de La Rioja, C/ Zurbano 73, 28010, Madrid, Spain
- Universidad Complutense, Madrid, Spain
| | - Octavio Corral
- UNIR-Itei & Health Sciences School, Universidad Internacional de La Rioja, C/ Zurbano 73, 28010, Madrid, Spain
| | - Hilario Blasco-Fontecilla
- UNIR-Itei & Health Sciences School, Universidad Internacional de La Rioja, C/ Zurbano 73, 28010, Madrid, Spain
- Center of Biomedical Network Research on Mental Health (CIBERSAM), Madrid, Spain
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9
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Zhang Y, Jia X, Yang Y, Sun N, Shi S, Wang W. Change in the global burden of depression from 1990-2019 and its prediction for 2030. J Psychiatr Res 2024; 178:16-22. [PMID: 39106579 DOI: 10.1016/j.jpsychires.2024.07.054] [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: 04/18/2024] [Revised: 07/25/2024] [Accepted: 07/31/2024] [Indexed: 08/09/2024]
Abstract
OBJECTIVE Depression is a global health challenge, but only a few studies have fully assessed and predicted the disease burden. This study described the trend of global depression burden from 1990 to 2019 through age-standardized incidence rate (ASIR), age-standardized disability-adjusted life rate (ASDR), and predicted the number of cases of depression during 2020-2030. METHODS Linear regression analysis was used to calculate the estimated annual percentage change (EAPC) in the age-standardized rates. The trends of global depression burden from 1990 to 2019 were analyzed by age, sex, and socio-demographic index (SDI) across various regions. Finally, we used the Bayesian age-period-cohort (BAPC) model to predict the disease burden in the coming 10 years. RESULTS Globally, the ASIR of depression decreased from 3681.24 per 100,000 population in 1990 to 3588.25 per 100,000 population in 2019 and the EAPC was -0.29%. ASDR also decreased, following a similar trend as the ASIR. The highest ASDR was observed in adults aged 60-64 years. The burden of depressive illness was higher in women, with the greatest increase in incidence in low SDI areas. BAPC predicted that the worldwide ASIR and ASDR of depression would stabilize from 2020 to 2030, with an increasing number of cases. By 2030, the ASIR was estimated to be 2519.88 per 100,000 men and 3835.11 per 100,000 women. CONCLUSION From 1990 to 2019, the global burden of depression remained significant, especially among women. It is important to address depression in older people, and it is therefore necessary to develop measures for prevention.
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Affiliation(s)
- Ying Zhang
- Department of Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Xiaocan Jia
- Department of Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Yongli Yang
- Department of Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Na Sun
- Department of Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Shuyan Shi
- Department of Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Wei Wang
- Department of Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China; Henan Medical Association, Zhengzhou, 450003, China.
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10
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Roman-Urrestarazu A, van Kessel R. Testing the Concerns Regarding the Global Burden of Disease-Reply. JAMA Pediatr 2024; 178:838. [PMID: 38829658 DOI: 10.1001/jamapediatrics.2024.1385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Affiliation(s)
- Andres Roman-Urrestarazu
- Mental Health | Policy | Economics Group, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Robin van Kessel
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
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11
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Mateo-Orcajada A, Abenza-Cano L, Molina-Morote JM, Vaquero-Cristóbal R. The influence of physical activity, adherence to Mediterranean diet, and weight status on the psychological well-being of adolescents. BMC Psychol 2024; 12:410. [PMID: 39068446 PMCID: PMC11282856 DOI: 10.1186/s40359-024-01906-3] [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: 07/10/2023] [Accepted: 07/15/2024] [Indexed: 07/30/2024] Open
Abstract
The mental health of adolescents is a determining factor for their adequate development, but is influenced by factors such as physical activity, nutrition, gender, and weight status. However, previous research has not analysed differences in psychological status, mainly in basic psychological needs and life satisfaction, among male and female adolescents with different levels of physical activity, weight status and adherence to the Mediterranean diet (AMD). For this reason, the objectives of the present investigation were to establish whether the differences between active and inactive adolescents in basic psychological needs and life satisfaction depend on gender; and to determine the differences in basic psychological needs and life satisfaction of active and inactive adolescents with different weight status and AMD. A total of 791 adolescents aged between twelve and sixteen years old participated in the study. All the participants were measured for basic psychological needs, life satisfaction, and level of physical activity, AMD, and height and body mass. The results showed a higher score in basic psychological needs and life satisfaction for active adolescents in both the males' and females' groups. No differences were found in the psychological variables when comparing adolescents with different weight status. Adolescents with a higher AMD showed higher scores in satisfaction of basic psychological needs and satisfaction with life than adolescents with a worse AMD. Therefore, it can be concluded that the level of physical activity and AMD are factors to be considered for the mental health of adolescents, but the relevance of weight status will have to be confirmed in future research.
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Affiliation(s)
| | - Lucía Abenza-Cano
- Facultad de Deporte. UCAM, Universidad Católica de Murcia, Murcia, Spain.
| | | | - Raquel Vaquero-Cristóbal
- Research Group Movement Sciences and Sport (MS&SPORT), Department of Physical Activity and Sport, Faculty of Sport Sciences, University of Murcia, Murcia, Spain
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12
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Lv M, Zheng B. Global burden of skin and subcutaneous diseases and its association with socioeconomic status in children and adolescents: an analysis of the Global Burden of Diseases Study 2019. Arch Dermatol Res 2024; 316:457. [PMID: 38967834 DOI: 10.1007/s00403-024-03212-9] [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: 12/19/2023] [Revised: 06/25/2024] [Accepted: 06/26/2024] [Indexed: 07/06/2024]
Abstract
Skin and subcutaneous diseases are one of the most common problems affecting the health of children and adolescents. The purpose of this study was to investigate the burden of skin and subcutaneous diseases among children and adolescents and its association with socioeconomic status. Data was obtained from the Global Burden of Disease Study 2019. The number of cases, incidence rate, number of deaths, and death rate in 204 countries and territories from 1990 to 2019 were extracted and stratified by age, sex, and socioeconomic status. In 2019, the global incidence and death rates of skin and subcutaneous diseases in children and adolescents were 57966.98 (95% Uncertainty Interval [UI] 53776.15 to 62521.24) per 100,000 and 0.21 (95% UI 0.13 to 0.26) per 100,000, respectively. From 1990 to 2019, the global incidence rate increased by 5.80% (95% UI 4.82-6.72%) and the death rate decreased by 43.68% (95% UI 23.04-65.27%). The incidence and death rates were negatively correlated with socioeconomic status. Incidence rates were not different between females and males, but death rates were higher among females than males. The highest incidence and death rates were found in the 1-4-year age group and < 1-year age group, respectively. The global burden of skin and subcutaneous diseases in children and adolescents was characterized by regional imbalances. The global burden of skin and subcutaneous diseases in children and adolescents from poorer regions requires more attention. This study provides strong evidence for global policymaking for childhood and adolescent diseases.
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Affiliation(s)
- Meina Lv
- Department of Pharmacy, Fujian Medical University Union Hospital, #29 Xinquan Road, Fuzhou, 350001, Fujian, China
| | - Bin Zheng
- Department of Pharmacy, Fujian Medical University Union Hospital, #29 Xinquan Road, Fuzhou, 350001, Fujian, China.
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13
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Murray Hurtado M, Martín Rivada Á, Pestano García S, Ramallo Fariña Y. Influence of the COVID-19 pandemic on the incidence of eating disorders. An Pediatr (Barc) 2024; 101:21-28. [PMID: 38981817 DOI: 10.1016/j.anpede.2024.04.019] [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: 01/24/2024] [Accepted: 04/29/2024] [Indexed: 07/11/2024] Open
Abstract
INTRODUCTION Eating disorders (EDs) develop more frequently in young females. Following the COVID-19 pandemic, there has been evidence of an increase in children and adolescents, with an earlier onset and a worse body weight and nutritional status. The aim of this study was to determine whether this trend has also been observed in our region over the past 6 years. MATERIAL AND METHODS We conducted a retrospective and descriptive cohort study in paediatric patients with a diagnosis of ED, referred during the 3 years preceding and following the declaration of the state of alarm due to the pandemic. We analysed and compared clinical, anthropometric and laboratory variables and bioelectrical impedance and bone density data. RESULTS Of the 129 patients in the sample, 28 were referred before the lockdown period and 101 after. When we compared these groups, we found a longer time elapsed from onset to the initial assessment (mean delay, 11.87 [SD, 6.75] vs. 6.64 [SD, 4.36] months), a greater hospitalization rate (14.1% vs. 10.1%), and lower vitamin D values (mean level, 28.19 [SD, 9.95] vs. 34.39 [SD, 11.87] ng/mL) in the post-lockdown group. We also found a greater frequency of self-harm suicide attempts in these patients. CONCLUSIONS This study confirms the increasing trend in EDs in children and adolescents in our area. Moreover, we found differences in the clinical characteristics and time elapsed to diagnosis compared to the patients referred to the hospital before the pandemic.
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Affiliation(s)
- Mercedes Murray Hurtado
- Sección Nutrición y Errores Innatos del Metabolismo, Complejo Hospitalario Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - Álvaro Martín Rivada
- Sección Nutrición y Errores Innatos del Metabolismo, Complejo Hospitalario Universitario de Canarias, Santa Cruz de Tenerife, Spain.
| | | | - Yolanda Ramallo Fariña
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Colegio Oficial de Médicos de Tenerife, Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Santa Cruz de Tenerife, Spain
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14
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Rao WW, He F, Qi Y, Lok GKI, Jackson T, Zheng Y, Xiang YT. Mental health among school children and adolescents in China: A comparison of one-child and multiple-children families from a nationwide survey. Asian J Psychiatr 2024; 100:104130. [PMID: 39083955 DOI: 10.1016/j.ajp.2024.104130] [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: 11/23/2023] [Revised: 04/05/2024] [Accepted: 05/25/2024] [Indexed: 08/02/2024]
Abstract
The influence of China's "one-child" policy on the mental health of children and adolescents is still unclear. This study examined the associations between number of children and children's mental health using data from the national school children and adolescents survey of China. Mental health was measured using the Achenbach's Child Behavior Checklist (CBCL). Linear regression models were used to explore the relationship between number of children per family and children's mental health. A total of 64,017 students were enrolled, with 68.60 % from one-child families. Compared with children from one-child families, those from multiple-children families had significantly higher scores on the total CBLC and each of its subscales (all P<0.001). Analyses suggested children from multiple-child families have a higher risk of mental health problems (total problems on the CBCL: adjusted B=2.217, 95 %CI=1.883-2.550, P<0.001). Regular mental health assessments should be implemented and effective interventions should be developed for those in need.
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Affiliation(s)
- Wen-Wang Rao
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, China
| | - Fan He
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yanjie Qi
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Grace Ka In Lok
- Macao Polytechnic University, Peking University Health Science Center, Macao Polytechnic University Nursing Academy, Macao SAR, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao SAR, China
| | - Yi Zheng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognition and Brain Science, University of Macau, Macao SAR, China.
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15
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Jiang X, Zhang K. Family Environmental Risk and Perceived Stress in Adolescent Depressive Symptoms: A Network Analysis. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01719-w. [PMID: 38782807 DOI: 10.1007/s10578-024-01719-w] [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] [Accepted: 05/16/2024] [Indexed: 05/25/2024]
Abstract
This study, grounded in the Process-Person-Context-Time framework, investigates the complex interplay of family environmental factors and their influence on adolescent depressive symptoms, focusing on the role of 'perceived stress'. Using network analysis, we examined data from 735 junior high students (52.1% female adolescents) from three provinces in China (Jiangsu, Shandong, and Henan), with an average age of 13.81 ± 0.92 years, ranging from 12 to 16 years, exploring the relationships between depressive symptoms, perceived stress, and seven family risk factors. The analysis identified three distinct communities. The incorporation of perceived stress led to its integration into a community that included depressive symptoms, parental restrictive monitoring, and family economic strain. Perceived stress emerged as the strongest predictor of depressive symptoms, surpassing parental restrictive monitoring. Furthermore, it overtook depressive symptoms as the node with the strongest bridging connection within its community. These findings underscore the importance of interventions targeting both family conditions and the internal processing of these stressors by adolescents, especially in challenging family environments, to mitigate the risk of depression and promote resilience.
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Affiliation(s)
- Xiaoliu Jiang
- Department of Social Psychology, School of Sociology, Nankai University, No. 38 Tongyan Road, Haihe Education Park, Tianjin, China
| | - Kuo Zhang
- Department of Social Psychology, School of Sociology, Nankai University, No. 38 Tongyan Road, Haihe Education Park, Tianjin, China.
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16
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Bouter DC, Ravensbergen SJ, de Neve-Enthoven NGM, Zarchev M, Mulder CL, Hoogendijk WJG, Roza SJ, Grootendorst-van Mil NH. Five-year follow-up of the iBerry Study: screening in early adolescence to identify those at risk of psychopathology in emerging adulthood. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02462-2. [PMID: 38772966 DOI: 10.1007/s00787-024-02462-2] [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: 11/07/2023] [Accepted: 04/30/2024] [Indexed: 05/23/2024]
Abstract
The iBerry Study, a Dutch population-based high-risk cohort (n = 1022) examines the transition from subclinical symptoms to psychiatric disorders in adolescents. Here, we present the first follow-up measurement, approximately 3 years after baseline assessment and 5 years after the screening based on self-reported emotional and behavioral problems (SDQ-Y). We give an update on the data collection, details on the (non)response, and the results on psychopathology outcomes. The first follow-up (2019-2022) had a response rate of 79% (n = 807). Our results at baseline (mean age 15.0 years) have shown the effectiveness of using the SDQ-Y to select a cohort oversampled for the risk of psychopathology. At first follow-up (mean age 18.1 years), the previously administered SDQ-Y remains predictive for selecting adolescents at risk. At follow-up, 47% of the high-risk adolescents showed significant mental health problems based on self- and parent reports and 46% of the high-risk adolescents met the criteria for multiple DSM-5 diagnoses. Compared to low-risk adolescents, high-risk adolescents had a sevenfold higher odds of significant emotional and behavioral problems at follow-up. Comprehensive assessment on psychopathology, substance abuse, psychotic symptoms, suicidality, nonsuicidal self-injury, addiction to social media and/or video gaming, and delinquency, as well as social development, and the utilization of healthcare and social services were conducted. This wave, as well as the ones to follow, track these adolescents into their young adulthood to identify risk factors, elucidate causal mechanisms, and discern pathways leading to both common and severe mental disorders. Results from the iBerry Study will provide leads for preventive interventions.
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Affiliation(s)
- D C Bouter
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands
| | - S J Ravensbergen
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands
| | - N G M de Neve-Enthoven
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands
| | - M Zarchev
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands
| | - C L Mulder
- Epidemiological and Social Psychiatric Research Institute (ESPRi), Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Parnassia Psychiatric Institute, Rotterdam, The Netherlands
| | - W J G Hoogendijk
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands
| | - S J Roza
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands
| | - N H Grootendorst-van Mil
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands.
- Epidemiological and Social Psychiatric Research Institute (ESPRi), Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
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17
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Gallinella F, Trotta F, Fortinguerra F. Impact of COVID-19 pandemic on prescription of psychotropic medications in the Italian paediatric population during 2020. Ital J Pediatr 2024; 50:102. [PMID: 38764095 PMCID: PMC11103882 DOI: 10.1186/s13052-024-01670-5] [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: 01/19/2024] [Accepted: 05/04/2024] [Indexed: 05/21/2024] Open
Abstract
BACKGROUND There is a global perception that psychotropic utilization in children and adolescents is increasing, especially with the onset of COVID-19 pandemic. Available literature data on paediatric psychotropic medication prescriptions in Italy are limited to one or few regions and not updated. The aim of this study was to provide updated data on psychotropic prescriptions referred to the whole Italian paediatric population, as overall and by subgroups of medications and to evaluate if the COVID-19 pandemic during 2020 had an impact on prescription rates. METHODS A descriptive study on psychotropic drug utilization in children and adolescents (< 18 years) resident in all Italian regions during 2020 was performed. Patients registered in the Pharmaceutical Prescriptions database with at least one prescription/dispensing of a psychotropic medication (antipsychotics-N05A), (antidepressants-N06A) and (psychostimulants-N06BA) during the study period were considered. The indicators used were the prescription rate (number of prescriptions per 1000 children) and prevalence of use (proportion of the paediatric population with at least one prescription in the relevant year). RESULTS During the 2020 the prevalence of psychotropic drug use in the paediatric population was 0.3%, increased of 7.8% if compared to 2019. The same trend was observed for the prescription rate, which recorded an average of 28.2 per 1000 children with an increase of 11.6% if compared to previous year, representing the 0.6% of the overall drug use in this age group. The data showed a growing trend prescription by age, reaching the peak in adolescents aged 12-17 years old, with a prescription rate of 65 per 1000 children and a prevalence of 0.71%. Considering the subgroups of psychotropic medications, the highest prevalence of use was found for antipsychotic drugs, received by the 0.19% of the paediatric population during 2020. CONCLUSIONS Psychotropic drug utilization in children and adolescents has grown during 2020 in Italy and worldwide, raising alarms from health care clinicians and patient advocates about the increase of burden of mental diseases in paediatric population during the COVID-19 pandemic. A more systematic monitoring of the use of psychotropic medications should be implemented in all countries for collecting relevant information about children and adolescents taking psychotropic drugs, in order to address the present and the future of the mental health of the paediatric population.
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Affiliation(s)
| | - Francesco Trotta
- Italian Medicines Agency (AIFA), Via del Tritone, 181, Rome, 00187, Italy
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18
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Choi M, Sempungu JK, Lee EH, Lee YH. Differential trends and patterns of sociodemographic disparities in burden of mental disorders, substance use disorder and self-harm across age groups: ecological study in 204 countries using the Global Burden of Disease Study 2019. BJPsych Open 2024; 10:e89. [PMID: 38639211 PMCID: PMC11060086 DOI: 10.1192/bjo.2024.26] [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: 11/09/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND It is well-known that socioeconomic status is associated with mental illness at both the individual and population levels, but there is a less clear understanding of whether socioeconomic development is related to poor mental health at the country level. AIMS We aimed to investigate sociodemographic disparities in burden of mental disorders, substance use disorders and self-harm by age group. METHOD Estimates of age-specific disability-adjusted life years (DALY) rates for mental disorders, substance use disorders and self-harm from 1990 to 2019 for 204 countries were obtained. The sociodemographic index (SDI) was used to assess sociodemographic development. Associations between burden of mental health and sociodemographic development in 1990 and 2019 were investigated, and sociodemographic inequalities in burden of mental health from 1990 to 2019 by age were estimated using the concentration index. RESULTS Differential trends in sociodemographic disparities in diseases across age groups were observed. For mental disorders, particularly depressive disorder and substance use disorders, DALY rates in high SDI countries were higher and increased more than those in countries with other SDI levels among individuals aged 10-24 and 25-49 years. By contrast, DALY rates for those over 50 years were lower in high SDI countries than in countries with other SDI levels between 1990 and 2019. A higher DALY rate among younger individuals accompanied a higher SDI at the country level. However, increased sociodemographic development was associated with decreased disease burden for adults aged ≥70 years. CONCLUSIONS Strategies for improving mental health and strengthening mental health system should consider a broader sociocultural context.
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Affiliation(s)
- Minjae Choi
- Institute for Future Public Health, Graduate School of Public Health, Korea University, Seoul, Republic of Korea; and Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Joshua Kirabo Sempungu
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea; and Program in Public Health, Graduate School, Korea University, Seoul, Republic of Korea
| | - Eun Hae Lee
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea; and Program in Public Health, Graduate School, Korea University, Seoul, Republic of Korea
| | - Yo Han Lee
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea
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Wang H, Du H, Guan Y, Zhong J, Li N, Pan J, Yu M. Association Between Frequency of Muscle-Strengthening Exercise and Depression Symptoms Among Middle and High School Students: Cross-Sectional Survey Study. JMIR Public Health Surveill 2024; 10:e50996. [PMID: 38630529 PMCID: PMC11063876 DOI: 10.2196/50996] [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: 07/19/2023] [Revised: 02/19/2024] [Accepted: 03/15/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Existing literature on the association between the frequency of muscle-strengthening exercise (MSE) and depression among adolescents is limited and contradictory. OBJECTIVE This study aimed to elucidate the association of MSE frequency with depression symptoms among middle and high school students in China. METHODS A total of 27,070 students in grades 7-12 from 376 middle and high schools were surveyed using an anonymous self-administered questionnaire between April and June 2022. Information on engaging in MSE was self-reported, and depression symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Poisson regression was used to examine the association between MSE frequency and depression symptoms. RESULTS Among the 27,006 eligible students, 51.6% (n=13,933) were boys, and the mean age was 15.6 (SD 1.7) years. The overall prevalence of meeting MSE recommendations (ie, engaging in MSE ≥3 days/week) was 34.6% (95% CI 32.6%-36.6%; n=9145); the prevalence was higher in boys (43.8%, 95% CI 41.8%-45.8%; 6067/13,933) than in girls (24.3%, 95% CI 22%-26.6%; 3078/13,073; P<.001). A total of 5882 (21.8%) students reported having depression symptoms. After adjustment for sociodemographic status, lifestyle factors, academic performance, and experience of physical fighting, compared to students who did not engage in MSE, the prevalence ratios (PRs) for depression symptoms were 0.98 (95% CI 0.97-0.99) for those engaging in MSE once a week, 0.95 (95% CI 0.93-0.97) for 2 days/week, 0.93 (95% CI 0.90-0.96) for 3 days/week, 0.90 (95% CI 0.87-0.94) for 4 days/week, 0.88 (95% CI 0.84-0.93) for 5 days/week, 0.86 (95% CI 0.81-0.92) for 6 days/week, and 0.84 (95% CI 0.78-0.90) for 7 days/week, respectively. CONCLUSIONS The overall prevalence of meeting MSE recommendations among Chinese adolescents is low. The frequency of MSE was inversely associated with depression symptoms.
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Affiliation(s)
- Hao Wang
- Department of Noncommunicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Huaidong Du
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Yunqi Guan
- Department of Noncommunicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jieming Zhong
- Department of Noncommunicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Na Li
- Department of Noncommunicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jin Pan
- Department of Noncommunicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Min Yu
- Department of Noncommunicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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Strand M, Welch E, Bäärnhielm S. The Cultural Formulation Interview as a clinical tool in the assessment of eating disorders: a pilot study. Front Psychiatry 2024; 15:1371339. [PMID: 38680782 PMCID: PMC11046472 DOI: 10.3389/fpsyt.2024.1371339] [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: 01/16/2024] [Accepted: 03/27/2024] [Indexed: 05/01/2024] Open
Abstract
Background The Cultural Formulation Interview (CFI) in the DSM-5 is a person-centered instrument for systematically appraising the impact of sociocultural factors in psychiatric assessment. The CFI has been shown to be feasible, acceptable, and useful in various clinical contexts. However, to this date there is only one published report describing the use of the CFI with patients with eating disorders. Aims To explore the potential benefits and challenges of utilizing the CFI in the assessment of eating disorders. Methods As an addendum to an ongoing qualitative study about barriers to treatment for eating disorders for individuals with a migration background in Sweden, we utilized the CFI in the assessment of adult patients (n=8) in specialist eating disorder treatment. Interview data were analyzed employing a thematic analysis framework. Participants provided feedback using a standard form for evaluation of the CFI. Results Certain CFI questions proved especially meaningful in this context. In response to the CFI question about patient explanatory models, previously unrecognized ideas about causation emerged. These included perfectionism-a known risk factor for eating disorders-based on immigrant parents' career expectations and experiences of strict family control over life choices. In response to the CFI questions on cultural identity and its impact, the participants provided rich descriptions including important themes such as religion, racism, and ambiguities associated with being a second-generation immigrant. The final CFI question, eliciting concern about the patient-clinician relationship, revealed numerous examples of prejudice and unfamiliarity with migrant groups among healthcare providers. Implications The CFI can be useful in the assessment of patients with eating disorders and should be further explored as a standard tool in specialist eating disorder services.
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Affiliation(s)
- Mattias Strand
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Transcultural Centre, Northern Stockholm Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Elisabeth Welch
- Global Health and Migration Unit, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Sofie Bäärnhielm
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Transcultural Centre, Northern Stockholm Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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21
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Hua Y, Jiang W, He Y, Zheng X, Huang C, Guo L, Guo Y, Guo L. Associations of recent stressful life events with anxiety symptoms among Chinese adolescents with a consideration of family functioning. Eur J Psychotraumatol 2024; 15:2337577. [PMID: 38597558 PMCID: PMC11008314 DOI: 10.1080/20008066.2024.2337577] [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: 10/31/2023] [Accepted: 03/25/2024] [Indexed: 04/11/2024] Open
Abstract
Background: The association between stressful life events (SLEs) and adolescent anxiety symptoms has been extensively studied, but the specific impacts of different SLEs domains remain inconclusive. Moreover, limited research has examined the role of family functioning in these associations.Objective: This study aimed to investigate the associations between various recent SLEs and adolescent anxiety symptoms and explore the role of family functioning.Methods: Data were obtained from the second phase of the Longitudinal Study of Adolescents' Mental and Behavioral Well-being Research in Guangzhou, China. A total of 10,985 students (51.9% boys; mean [SD] age, 15.3 [1.5] years) from forty middle schools participated in the study in 2022 and completed a self-report questionnaire assessing anxiety symptoms, SLEs, and family functioning using the Generalized Anxiety Disorder-7 (GAD-7), Adolescent Self-rating Life Events Checklist (ASLEC; including five subscales: interpersonal stress, academic stress, punishment-related stress, loss-related stress, and adaptation-related stress), and the adapted Chinese version of the Family Assessment Device (FAD), respectively. Linear mixed-effects models were performed and the moderation role of family functioning was also examined.Results: The fully adjusted model revealed that a 1-SD increase in the overall ASLEC score was associated with higher levels of anxiety symptoms (β = 2.23, 95%CI: 2.15-2.32). Among various SLEs domains, the academic domain shows the most significant association (β = 2.25, 95%CI: 2.17-2.33). Family functioning exerted an independent protective influence on anxiety symptoms, with each 1-SD increase in FAD scores negatively associated with anxiety symptoms (β = -2.11, 95%CI: - 2.29 to - 1.93) in the adjusted model. Moreover, family functioning significantly buffered the impacts of overall SLEs and each domain, except for adaptation-related SLEs, on anxiety symptoms.Conclusion: Higher recent SLEs levels were associated with increased anxiety symptoms among adolescents, with academic SLEs showing the greatest association. Positive family functioning had both direct and buffering influences on anxiety symptoms.
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Affiliation(s)
- Yilin Hua
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Weiqing Jiang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Yitong He
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Xinyu Zheng
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Cuihong Huang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Liling Guo
- Department of Prevention and Treatment of Common Diseases among Students, Health Promotion Center for Primary and Secondary Schools in Guangzhou, Guangzhou, People's Republic of China
| | - Yangfeng Guo
- Department of Prevention and Treatment of Common Diseases among Students, Health Promotion Center for Primary and Secondary Schools in Guangzhou, Guangzhou, People's Republic of China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
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Kieling C, Buchweitz C, Caye A, Silvani J, Ameis SH, Brunoni AR, Cost KT, Courtney DB, Georgiades K, Merikangas KR, Henderson JL, Polanczyk GV, Rohde LA, Salum GA, Szatmari P. Worldwide Prevalence and Disability From Mental Disorders Across Childhood and Adolescence: Evidence From the Global Burden of Disease Study. JAMA Psychiatry 2024; 81:347-356. [PMID: 38294785 PMCID: PMC10831630 DOI: 10.1001/jamapsychiatry.2023.5051] [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: 08/07/2023] [Accepted: 11/03/2023] [Indexed: 02/01/2024]
Abstract
Importance The period from childhood to early adulthood involves increased susceptibility to the onset of mental disorders, with implications for policy making that may be better appreciated by disaggregated analyses of narrow age groups. Objective To estimate the global prevalence and years lived with disability (YLDs) associated with mental disorders and substance use disorders (SUDs) across 4 age groups using data from the 2019 Global Burden of Disease (GBD) study. Design, Setting, and Participants Data from the 2019 GBD study were used for analysis of mental disorders and SUDs. Results were stratified by age group (age 5 to 9, 10 to 14, 15 to 19, and 20 to 24 years) and sex. Data for the 2019 GBD study were collected up to 2018, and data were analyzed for this article from April 2022 to September 2023. Exposure Age 5 to 9 years, 10 to 14 years, 15 to 19 years, and 20 to 24 years. Main Outcomes and Measures Prevalence rates with 95% uncertainty intervals (95% UIs) and number of YLDs. Results Globally in 2019, 293 million of 2516 million individuals aged 5 to 24 years had at least 1 mental disorder, and 31 million had an SUD. The mean prevalence was 11.63% for mental disorders and 1.22% for SUDs. For the narrower age groups, the prevalence of mental disorders was 6.80% (95% UI, 5.58-8.03) for those aged 5 to 9 years, 12.40% (95% UI, 10.62-14.59) for those aged 10 to 14 years, 13.96% (95% UI, 12.36-15.78) for those aged 15 to 19 years, and 13.63% (95% UI, 11.90-15.53) for those aged 20 to 24 years. The prevalence of each individual disorder also varied by age groups; sex-specific patterns varied to some extent by age. Mental disorders accounted for 31.14 million of 153.59 million YLDs (20.27% of YLDs from all causes). SUDs accounted for 4.30 million YLDs (2.80% of YLDs from all causes). Over the entire life course, 24.85% of all YLDs attributable to mental disorders were recorded before age 25 years. Conclusions and Relevance An analytical framework that relies on stratified age groups should be adopted for examination of mental disorders and SUDs from childhood to early adulthood. Given the implications of the early onset and lifetime burden of mental disorders and SUDs, age-disaggregated data are essential for the understanding of vulnerability and effective prevention and intervention initiatives.
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Affiliation(s)
- Christian Kieling
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Child and Adolescent Psychiatry Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Claudia Buchweitz
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Arthur Caye
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- National Center for Research and Innovation in Mental Health (CISM), São Paulo, Brazil
| | - Juliana Silvani
- Graduate Program in Epidemiology, Department of Social Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Stephanie H. Ameis
- Campbell Family Mental Health Research Institute, Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - André R. Brunoni
- Department of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, Universidade de São Paulo, São Paulo, Brazil
| | - Katherine T. Cost
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Darren B. Courtney
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences & Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Kathleen Ries Merikangas
- Section on Developmental Genetic Epidemiology, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Joanna L. Henderson
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Guilherme V. Polanczyk
- Department of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, Universidade de São Paulo, São Paulo, Brazil
| | - Luis Augusto Rohde
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Child and Adolescent Psychiatry Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- National Center for Research and Innovation in Mental Health (CISM), São Paulo, Brazil
| | - Giovanni A. Salum
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Child Mind Institute, New York, New York
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Division of Child and Youth Mental Health, Centre for Addiction and Mental Health & University of Toronto, University of Toronto, Toronto, Ontario, Canada
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23
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Gerstl B, Ahinkorah BO, Nguyen TP, John JR, Hawker P, Winata T, Brice F, Bowden M, Eapen V. Evidence-based long term interventions targeting acute mental health presentations for children and adolescents: systematic review. Front Psychiatry 2024; 15:1324220. [PMID: 38510802 PMCID: PMC10950959 DOI: 10.3389/fpsyt.2024.1324220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/12/2024] [Indexed: 03/22/2024] Open
Abstract
Background Long term intervention services have proven to be effective in improving mental health (MH) outcomes and the quality of life for children and young people (CYP). Aim To synthesize evidence on the effectiveness of long-term interventions in improving MH outcomes for CYP, 0-17 years, presenting with MH conditions. Methods A systematic search was carried out and the methodological quality of included long term MH intervention studies were assessed. Six databases were searched for peer-reviewed articles between January 2000 and September 2022. Results We found 30 studies that reported on the effectiveness of a range of long-term MH interventions in the form of (i) group therapy, (ii) multisystemic behavior therapy, (iii) general services, (iv) integrated services, (v) psychotherapy, (vi) intensive intervention services, (vii) comprehensive collaborative care, (viii) parent training, and (ix) home outreach service. Among the included studies, seven were rated as high level of evidence based on the National Health and Medical Research Council (NHMRC) levels of evidence hierarchy scale and seven were of moderate quality evidence. Others were rated as lower-quality evidence. Among the studies providing high quality evidence, most were reported for group therapy, general services, and psychotherapy studies demonstrating beneficial effects. Conclusion This systematic review provides evidence to demonstrate the benefits of a range of long-term interventions, in a range of settings, can be effective in improving MH outcomes for CYP and their families. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42022323324.
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Affiliation(s)
- Brigitte Gerstl
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Bright Opoku Ahinkorah
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
- School of Public Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Thomas P. Nguyen
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
- Mental Health, School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - James Rufus John
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Patrick Hawker
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Teresa Winata
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
- Infant, Child and Adolescent Mental Health Service (ICAMHS), South Western Sydney Local Health District, Sydney, NSW, Australia
| | - Febe Brice
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
| | - Michael Bowden
- Child and Youth Mental Health, NSW Ministry of Health, Sydney, NSW, Australia
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
- Psychological Medicine, Sydney Children’s Hospitals Network, Sydney, NSW, Australia
| | - Valsamma Eapen
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
- School of Public Health, University of Technology Sydney, Sydney, NSW, Australia
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Zhi Z, Yan S, Yijuan H, Jiahuan Z, Xiaohan J, Dandan C. Trends in the disease burden of anxiety disorders in middle-aged and older adults in China. BMC Psychol 2024; 12:83. [PMID: 38373999 PMCID: PMC10877872 DOI: 10.1186/s40359-024-01575-2] [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: 01/01/2024] [Accepted: 02/05/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Anxiety disorders in middle-aged and older adults are an important public health concern in China. Based on the data in the global disease burden (GDB) research database, this study evaluated and analyzed the trend of the disease burden of middle-aged and older patients living with anxiety in China in the past 30 years. METHODS The incidence and disability-adjusted life years (DALYs) data of anxiety disorders in China for individuals aged 45-89 years were collected from the Global Burden of Disease Study 2019, and the effects of age, period, and cohort on the incidence of and DALY rate for anxiety disorders were analysed using an age-period-cohort model. Because of the COVID-19 pandemic, the global disease burden research database has not been updated since 2019. However, this did not affect the analysis of future trends in this study, which combined data in the past three decades from 1990 to 2019. RESULTS (1) The overall age-standardised incidence rate (ASIR) and age-standardised DALY rate (ASDR) for anxiety disorders in middle-aged and older adults in China decreased by 4.0 and 7.7% from 1990 to 2019, respectively, and the ASIR and ASDR were always higher in women than in men. (2)Age-period-cohort analysis showed that the net drifts for incidence and DALY rate were - 0.27% and - 0.55% per year, respectively. For both genders, the local drifts for incidence were lower than zero in those aged 45-79 years and higher than zero in those aged 80-89 years; the local drifts for the DALY rate were lower than zero in all groups. (3) From the 1990-1994 to 2015-2019, the relative risks of anxiety disorder incidence and DALY decreased by 5.6 and 7.3% in men and 4.3 and 11.7% in women, respectively. CONCLUSION The disease burden of anxiety disorders in middle-aged and older adults in China has been relieved over the past 30 years; however, recent ASDR, ASDR, period, and cohort effects have shown adverse trends. The incidence and DALY rate decreased with age in women, while men showed a trend of increasing first and decreasing afterwards.
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Affiliation(s)
- Zeng Zhi
- School of Health and Economics Management, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
| | - Shi Yan
- Pukou Hospital of Traditional Chinese Medicine in Nanjing, Nanjing, 211899, China.
| | - He Yijuan
- School of Health and Economics Management, Nanjing University of Chinese Medicine, Nanjing, 210023, China
- Science and Education Department, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215400, Jiangsu Province, China
| | - Zheng Jiahuan
- School of Health and Economics Management, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Jiang Xiaohan
- School of Health and Economics Management, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Chen Dandan
- School of Health and Economics Management, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
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Zhao H, Li L, Zhang X, Shi J, Lai W, Wang W, Guo L, Gong J, Lu C. Global, regional, and national burden of depressive disorders among young people aged 10-24 years, 2010-2019. J Psychiatr Res 2024; 170:47-57. [PMID: 38103449 DOI: 10.1016/j.jpsychires.2023.11.047] [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: 10/20/2022] [Revised: 08/19/2023] [Accepted: 11/28/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE To describe the latest disease burden, temporal trends, and risk factors of depressive disorders among young people. METHODS Data from the Global Burden of Disease Study 2019 was utilized to analyze depressive disorders among individuals aged 10-24 years. The study focused on describing the incidence, prevalence, disability-adjusted life years (DALYs), and their attributable risk factors across 204 countries and territories from 2010 to 2019. The estimated annual percentage change (EAPC) was calculated to quantify the temporal trends. RESULTS Globally, the incidence, prevalence, and DALYs rate of depressive disorders per 100 000 young people increased from 3003.01, 2445.69, and 448.61 in 2010 to 3035.26, 2470.67, and 452.58 in 2019, indicating a slight upward trend (EAPC = 0.11 for incidence and prevalence; EAPC = 0.09 for DALYs rate). Notably, the percentage of DALYs of depressive disorders among young people increased substantially from 3.24% in 2010 to 3.66% in 2019, an increase of 13.06% (EAPC = 1.26, 95%CI: 1.08-1.44), and the burden of depressive disorders among young people rose from fouth to second in females, and from tenth to fifth in males. Social demographic index (SDI) and other indicators were positively correlated with the percentage of DALYs of depressive disorder and negatively correlated with the EAPC of DALYs. CONCLUSION The global burden of depressive disorders among young people is on the rise. The regional differences in depressive disorders among young people suggest the need for enhanced screening efforts in low-SDI areas, along with the adoption of more effective prevention and control measures.
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Affiliation(s)
- Hao Zhao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Li Li
- Maternity and Children Health Care Hospital of Luohu District, Shenzhen, China
| | - Xuening Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jingman Shi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Wenjian Lai
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Jianhua Gong
- Maternity and Children Health Care Hospital of Luohu District, Shenzhen, China.
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.
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Lo HKY, Tong CCHY, Chan JKN, Kam CTK, Wong CSM, Cheng CPW, Ho C, Leung BMH, Wong WSH, Yu ZHS, Chang WC. Temporal trends of antidepressant utilization patterns in children and adolescents in Hong Kong: A 14-year population-based study with joinpoint regression analysis. J Affect Disord 2024; 344:61-68. [PMID: 37827253 DOI: 10.1016/j.jad.2023.10.055] [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: 07/13/2023] [Revised: 09/27/2023] [Accepted: 10/09/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND There is limited research on real-world antidepressant utilization patterns in children and adolescents, particularly in non-western countries. We aimed to examine temporal trends of antidepressant prescribing practice among Chinese children and adolescents in Hong Kong over 14-year period. METHODS This population-based study identified 9566 patients aged 5-17 years who had redeemed at least one antidepressant prescription within 2005-2018, using data from health-record database of Hong Kong public healthcare services. We calculated annual prescription rates (per 1000 persons) for any antidepressant, antidepressant drug classes, and individual antidepressants. Joinpoint-regression analyses were performed to assess temporal antidepressant prescription trends, quantified by average annual-percent-change (AAPC), with 95 % confidence-intervals (CIs). RESULTS Overall antidepressant prescription rate significantly increased over time (AAPC: 7.30 [95 % CI: 6.70-7.90]), from 3.883 in 2005 to 9.916 in 2018. The use of selective-serotonin-reuptake-inhibitors (SSRIs), serotonin-norepinephrine-reuptake-inhibitors (SNRIs), and other antidepressants significantly increased over 14 years, while tricyclic-antidepressants remained stable. SSRI represented the most commonly-prescribed drug class. Fluoxetine and sertraline constituted the two most frequently-prescribed individual antidepressants, while desvenlafaxine (AAPC: 55.68 [30.74-85.39]) and bupropion (AAPC: 35.28 [23.68-47.98]) exhibited the sharpest increase in prescription rates over the study period. LIMITATIONS Medication adherence could not be assessed and actual drug use may be overestimated. CONCLUSIONS Our results affirm a significant rising trend of antidepressant prescriptions among Chinese children and adolescents over time. All antidepressant drug-classes, except TCA, demonstrated significantly increased use, with SSRI being the most frequently-prescribed drug class. Future investigation should clarify indications, hence off-label use, of antidepressant initiation in this vulnerable population.
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Affiliation(s)
- Heidi Ka Ying Lo
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Co Co Ho Yi Tong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Joe Kwun Nam Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | | | - Corine Sau Man Wong
- School of Public Health, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Calvin Pak Wing Cheng
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Chung Ho
- Child and Adolescent Psychiatry Unit, Department of Psychiatry, Queen Mary Hospital, Hospital Authority, Hong Kong
| | - Brian Man Ho Leung
- Child and Adolescent Psychiatry Unit, Department of Psychiatry, Queen Mary Hospital, Hospital Authority, Hong Kong
| | - Wilfred Shone Horn Wong
- Child and Adolescent Psychiatry Unit, Department of Psychiatry, Queen Mary Hospital, Hospital Authority, Hong Kong
| | - Zoe Hoi Shuen Yu
- Child and Adolescent Psychiatry Unit, Department of Psychiatry, Queen Mary Hospital, Hospital Authority, Hong Kong
| | - Wing Chung Chang
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, the University of Hong Kong, Hong Kong.
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Natali L, Cardi V, Lunghi M, Ferrara R, Marconi L, Bottesi G. The Acceptability of a Psychoeducation and Skill-Based Training for Carers and Teachers to Cope with Risky Behaviours in Adolescence. CHILDREN (BASEL, SWITZERLAND) 2023; 11:38. [PMID: 38255352 PMCID: PMC10814090 DOI: 10.3390/children11010038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/21/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024]
Abstract
Childhood and adolescence psychopathology is associated with an increased risk of psychological difficulties in adulthood. Early interventions for youth should provide carers and teachers with knowledge and skills to respond to adolescents' risky behaviours. This study evaluated the acceptability and effectiveness of a single 3-h workshop, combining psychoeducation and skills training to promote knowledge about, and confidence to address, adolescents' risky behaviours in carers and teachers of adolescents aged 10-14. Demographics and perceived self-efficacy in the parental or teaching role were collected at baseline using self-report questionnaires. Motivation and confidence to respond to adolescents' risky behaviours were measured before and after the workshop using motivational rulers. Participants provided written feedback about their experience about the workshop. Twenty-seven carers and 27 teachers attended the workshops. Teachers reported a significant increase in both importance (p = 0.021) and confidence (p < 0.001) to respond to risky behaviours following the workshop. This change was associated with baseline self-efficacy levels (importance: p = 0.011; confidence: p = 0.002). Carers also reported greater confidence to address risky behaviours following the workshop (p = 0.002). Participants found the contents and methods of the workshop highly acceptable. Online and multiple-session workshops might increase reach and effectiveness.
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Affiliation(s)
- Ludovica Natali
- Centro di Ateneo Servizi Clinici Universitari Psicologici, University of Padova, 35131 Padova, Italy; (L.N.); (V.C.); (M.L.); (R.F.); (L.M.)
- Department of General Psychology, University of Padova, 35131 Padova, Italy
| | - Valentina Cardi
- Centro di Ateneo Servizi Clinici Universitari Psicologici, University of Padova, 35131 Padova, Italy; (L.N.); (V.C.); (M.L.); (R.F.); (L.M.)
- Department of General Psychology, University of Padova, 35131 Padova, Italy
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Marco Lunghi
- Centro di Ateneo Servizi Clinici Universitari Psicologici, University of Padova, 35131 Padova, Italy; (L.N.); (V.C.); (M.L.); (R.F.); (L.M.)
- Department of Developmental Psychology and Socialisation, University of Padova, 35131 Padova, Italy
| | - Rosanna Ferrara
- Centro di Ateneo Servizi Clinici Universitari Psicologici, University of Padova, 35131 Padova, Italy; (L.N.); (V.C.); (M.L.); (R.F.); (L.M.)
| | - Linda Marconi
- Centro di Ateneo Servizi Clinici Universitari Psicologici, University of Padova, 35131 Padova, Italy; (L.N.); (V.C.); (M.L.); (R.F.); (L.M.)
| | - Gioia Bottesi
- Centro di Ateneo Servizi Clinici Universitari Psicologici, University of Padova, 35131 Padova, Italy; (L.N.); (V.C.); (M.L.); (R.F.); (L.M.)
- Department of General Psychology, University of Padova, 35131 Padova, Italy
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Allen KB, Tan PZ, Sullivan JA, Baumgardner M, Hunter H, Glovak SN. An Integrative Model of Youth Anxiety: Cognitive-Affective Processes and Parenting in Developmental Context. Clin Child Fam Psychol Rev 2023; 26:1025-1051. [PMID: 37819403 DOI: 10.1007/s10567-023-00458-z] [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] [Accepted: 09/14/2023] [Indexed: 10/13/2023]
Abstract
Multiple theoretical frameworks have been proposed to provide a more comprehensive picture of the risk factors that influence anxiety-related developmental trajectories. Nonetheless, there remains a need for an integrative model that outlines: (1) which risk factors may be most pertinent at different points in development, and (2) how parenting may maintain, exacerbate, or attenuate an affective style that is characterized by high negative emotional reactivity to unfamiliar, uncertain, and threatening situations. A developmentally informed, integrative model has the potential to guide treatment development and delivery, which is critical to reducing the public health burden associated with these disorders. This paper outlines a model integrating research on many well-established risk mechanisms for anxiety disorders, focusing on (1) the developmental progression from emotional reactivity constructs early in life to those involving higher-level cognitive processes later in youth, and (2) potential pathways by which parenting may impact the stability of youth's cognitive-affective responses to threat-relevant information across development.
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Affiliation(s)
- Kristy Benoit Allen
- Departments of Applied Behavioral Science and Psychology, University of Kansas, Lawrence, KS, USA.
| | - Patricia Z Tan
- Department of Psychiatry/Mental Health, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | | | - Megan Baumgardner
- Department of Psychology, University of Tennessee, Knoxville, TN, USA
| | - Hannah Hunter
- Department of Psychology, University of Tennessee, Knoxville, TN, USA
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Edwards J, Kurdyak P, Waddell C, Patten SB, Reid GJ, Campbell LA, Georgiades K. Surveillance of Child and Youth Mental Disorders and Associated Service Use in Canada. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:819-825. [PMID: 37357689 PMCID: PMC10590091 DOI: 10.1177/07067437231182059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Affiliation(s)
- Jordan Edwards
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Paul Kurdyak
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Institute of Mental Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada
| | - Charlotte Waddell
- Children's Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Scott B. Patten
- Cuthbertson & Fischer Chair in Pediatric Mental Health, Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Graham J. Reid
- Departments of Psychology & Family Medicine, The University of Western Ontario, London, Ontario, Canada
- Children's Health Research Institute, London, Ontario, Canada
| | - Leslie Anne Campbell
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
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Wong SM, Chen EY, Suen Y, Wong CS, Chang W, Chan SK, McGorry PD, Morgan C, van Os J, McDaid D, Jones PB, Lam T, Lam LC, Lee EH, Tang EY, Ip CH, Ho WW, McGhee SM, Sham P, Hui CL. Prevalence, time trends, and correlates of major depressive episode and other psychiatric conditions among young people amid major social unrest and COVID-19 in Hong Kong: a representative epidemiological study from 2019 to 2022. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 40:100881. [PMID: 37654623 PMCID: PMC10465929 DOI: 10.1016/j.lanwpc.2023.100881] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 07/30/2023] [Accepted: 08/06/2023] [Indexed: 09/02/2023]
Abstract
Background Hong Kong is among the many populations that has experienced the combined impacts of social unrest and the COVID-19 pandemic. Despite concerns about further deteriorations in youth mental health globally, few epidemiological studies have been conducted to examine the prevalence and correlates of major depressive episode (MDE) and other major psychiatric disorders across periods of population-level changes using diagnostic interviews. Methods We conducted a territory-wide household-based epidemiological study from 2019 to 2022 targeting young people aged 15-24 years. MDE, generalised anxiety disorder (GAD), panic disorder (PD), and bipolar disorder (BD) were assessed using the Composite International Diagnostic Interview-Screening Scales in 3340 young people. Psychotic disorders were assessed by experienced psychiatrists according to the DSM. Help-seeking patterns were also explored. Findings 16.6% had any mental disorder (13.7% 12-month MDE, 2.3% BD, 2.1% GAD, 1.0% PD, 0.6% psychotic disorder). The prevalence of MDE increased from 13.2% during period 1 (May 2019-June 2020) to 18.1% during period 2 (July-December 2020), followed by 14.0% during period 3 (January-June 2021) and 13.2% during period 4 (July 2021-June 2022). Different stressors uniquely contributed to MDE across periods: social unrest-related stressors during period 1, COVID-19 stressors during period 2, and personal stressors during periods 3-4. Lower resilience, loneliness, frequent nightmares, and childhood adversity were consistently associated with MDE. Compared to other conditions, those with MDE showed the lowest service utilisation rate (16.7%). Perceiving services to "cost too much" and "talked to friends or relatives instead" were among the major reasons for not seeking help. MDE was also significantly associated with poorer functioning and health-related quality of life. Interpretation MDE can be sensitive to population-level changes, although its persistently elevated prevalence across the study period is of concern. Efforts to mitigate their impacts on youth mental health alongside personal risk factors are needed. Further work is required to increase the availability and acceptability of youth-targeted mental health services. Funding Food and Health Bureau (HKSAR Government).
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Affiliation(s)
- Stephanie M.Y. Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Eric Y.H. Chen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Y.N. Suen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Corine S.M. Wong
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - W.C. Chang
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Sherry K.W. Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Patrick D. McGorry
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Craig Morgan
- Health Service & Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Jim van Os
- Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, United Kingdom
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - T.H. Lam
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Linda C.W. Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Edwin H.M. Lee
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Eric Y.H. Tang
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Charlie H. Ip
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Winky W.K. Ho
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Sarah M. McGhee
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - P.C. Sham
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Christy L.M. Hui
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
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Wang S, Li Q, Lu J, Ran H, Che Y, Fang D, Liang X, Sun H, Chen L, Peng J, Shi Y, Xiao Y. Treatment Rates for Mental Disorders Among Children and Adolescents: A Systematic Review and Meta-Analysis. JAMA Netw Open 2023; 6:e2338174. [PMID: 37851443 PMCID: PMC10585417 DOI: 10.1001/jamanetworkopen.2023.38174] [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: 06/30/2023] [Accepted: 09/03/2023] [Indexed: 10/19/2023] Open
Abstract
Importance Mental disorders among children and adolescents are global health concerns. Published studies have provided discordant results regarding treatment rates for mental disorders among youths. Objective To estimate combined treatment rates for several common psychiatric disorders among children and adolescents. Data Sources PubMed, Web of Science, PsycINFO, Scopus, and Embase were searched from database inception until September 23, 2022, and supplemented with hand-searching of reference lists. Study Selection Included studies were those that used validated methods to report treatment rates for any mental disorder, depressive disorders, anxiety disorders, attention-deficit/hyperactivity disorder (ADHD), and behavior disorders among children and adolescents. Data Extraction and Synthesis This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline. Two reviewers independently assessed study eligibility, extracted data, and scored quality. Studies with a Joanna Briggs Institute score of 5 or more were included in the meta-analysis. Treatment rates were pooled using random-effects models. Subgroup analyses were performed to investigate the association with treatment rates of factors, such as year of data collection, World Health Organization region, age, income level, timeframe of diagnosis, informant source, service type, sample origin, and internalizing or externalizing disorder. Main Outcomes and Measures Treatment rates for mental disorders among children and adolescents were the main outcomes, measured as percentage estimates. Results Forty studies were included in the analysis, comprising 310 584 children and adolescents, with boys accounting for 39% of participants (sex was not reported in 10 studies). The pooled treatment rate was 38% (95% CI, 30%-45%) for any mental disorder, 36% (95% CI, 29%-43%) for depressive disorders, 31% (95% CI, 21%-42%) for anxiety disorders, 58% (95% CI, 42%-73%) for ADHD, and 49% (95% CI, 35%-64%) for behavior disorders. Age, income level, and region were significantly associated with the combined treatment rates of mental disorders in children and adolescents. The treatment rate for depressive disorders was higher among adolescents than children (36% [95% CI, 25%-46%] vs 11% [95% CI, 0%-25%]), whereas the treatment rate for anxiety disorders was higher among children than adolescents (64% [95% CI, 52%-75%] vs 20% [95% CI, 9%-30%]). The treatment rate for any mental disorder in lower-middle income countries was 6% (95% CI, 2%-14%), in upper-middle income countries was 24% (95% CI, 2%-47%), and in high-income countries was 43% (95% CI, 35%-52%). For depressive disorders, treatment rates were higher in the Americas (40% [95% CI, 30%-51%]) than in Europe (28% [95% CI, 13%-43%]) and the Western Pacific region (6% [95% CI, 1%-16%]). Conclusions and Relevance This study suggests that, in general, the treatment rates for mental disorders among children and adolescents were low, especially for depression and anxiety. Targeted intervention policies and effective measures should be designed and implemented to improve treatment rates of psychiatric disorders among youths.
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Affiliation(s)
- Sifan Wang
- NHC Key Laboratory of Drug Addiction Medicine, Division of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Qiongxian Li
- NHC Key Laboratory of Drug Addiction Medicine, Division of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Jin Lu
- Psychiatry Department, The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
- Mental Health Institute of Yunnan, The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
- Yunnan Clinical Research Center for Mental Health, Kunming, Yunnan, China
| | - Hailiang Ran
- NHC Key Laboratory of Drug Addiction Medicine, Division of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Yusan Che
- NHC Key Laboratory of Drug Addiction Medicine, Division of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Die Fang
- NHC Key Laboratory of Drug Addiction Medicine, Division of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Xuemeng Liang
- NHC Key Laboratory of Drug Addiction Medicine, Division of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Hao Sun
- NHC Key Laboratory of Drug Addiction Medicine, Division of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Lin Chen
- NHC Key Laboratory of Drug Addiction Medicine, Division of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Junwei Peng
- NHC Key Laboratory of Drug Addiction Medicine, Division of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Yuanyu Shi
- NHC Key Laboratory of Drug Addiction Medicine, Division of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Yuanyuan Xiao
- NHC Key Laboratory of Drug Addiction Medicine, Division of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
- Key Library in Public Health and Disease Prevention and Control, Yunnan Provincial Department of Education, Kunming, Yunnan, China
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Zhang R, Zhang CQ, Gu D. Prospective associations between adherence to 24-hour movement guidelines and mental well-being in Chinese adolescents. J Sports Sci 2023; 41:1735-1743. [PMID: 38189370 DOI: 10.1080/02640414.2023.2292422] [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: 03/07/2023] [Accepted: 11/29/2023] [Indexed: 01/09/2024]
Abstract
Most evidence regarding the relationships between adherence to 24-hour movement guidelines and adolescent mental health have been derived from cross-sectional studies or have ignored positive mental health indicators. The current prospective study examined the associations between adherence to 24-hour movement guidelines and changes in mental well-being among Chinese adolescents over three months. 816 Chinese adolescents (Mage = 14.76 years; SD = 0.81) completed baseline and follow-up scales of 24-hour movement behaviours, mental well-being, and covariates. Linear mixed-effects models were used for data analyses, with adjustments for covariates and mental well-being at baseline. There was a significant improvement in mental well-being across the three months, and the improvement in mental well-being was positively associated with meeting any single guidelines and both physical activity and sleep guidelines but not adherence to all three guidelines. Meeting both physical activity and sleep recommendations appears to exert more significant benefits on mental well-being than meeting one or two other recommendations. An integrative approach to mental health promotion by focusing on 24-hour movement behaviours (at least physical activity and sleep) may be more effective than focusing on a single behaviour alone.
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Affiliation(s)
- Ru Zhang
- School of Physical Education & Sports Science, South China Normal University, Guangzhou, China
| | - Chun-Qing Zhang
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Dacheng Gu
- School of Physical Education & Health, Nanning Normal University, Nanning, China
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McLaughlin S, Staniland L, Egan SJ, Wheadon J, Munro C, Preece D, Furlong Y, Mavaddat N, Thompson A, Robinson S, Chen W, Myers B. Interventions to reduce wait times for adolescents seeking mental health services: a scoping review protocol. BMJ Open 2023; 13:e073438. [PMID: 37678945 PMCID: PMC10496663 DOI: 10.1136/bmjopen-2023-073438] [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: 03/08/2023] [Accepted: 08/20/2023] [Indexed: 09/09/2023] Open
Abstract
INTRODUCTION The demand for adolescent mental health services has increased significantly in recent years, leading to excessive wait times for adolescents seeking mental health services and poor mental health outcomes. Timely access to mental health services is critical to reducing the risk of symptom chronicity and progression to mental disorder. A better understanding of whether and how interventions to reduce wait times impact mental health outcomes is needed to guide mental health policymakers and service planners in their approach to reducing wait times. METHODS AND ANALYSIS The scoping review will use Arksey and O'Malley's six-stage framework for scoping reviews and Rayyan to support screening, data extraction and evidence synthesis. The review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. We will search the Cochrane Library, EBSCOhost, MEDLINE (Ovid), PsycArticles (Ovid), PsycINFO (Ovid), EMBASE (Ovid), Web of Science, ProQuest and Scopus databases for peer-reviewed texts published in English between 1 January 2000 and 28 February 2023. We will also search Google Scholar for additional grey literature. To be eligible for inclusion, studies must focus on adolescent populations aged 13-18 years and report on interventions to reduce wait times for any mental health service except crisis and emergency services. Title, abstract and full-text screening will be done by two reviewers. We will extract data describing the interventions and their effects on wait times and adolescent mental health outcomes, and we will identify strengths and limitations in the evidence base to inform recommendations for future research. A youth advisory group with lived experience of mental health difficulties will be consulted throughout the review process. ETHICS AND DISSEMINATION Ethics approval is not required. Findings will be disseminated via peer-reviewed publications and presented at conferences. STUDY REGISTRATION The protocol was registered with the Open Science Framework on 20 February 2023 (https://osf.io/qt4zy).
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Affiliation(s)
- Stella McLaughlin
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Lexy Staniland
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Sarah J Egan
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Jessica Wheadon
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Caitlin Munro
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - David Preece
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Yulia Furlong
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- School of Medicine, The University of Western Australia, Perth, Western Australia, Australia
| | - Nahal Mavaddat
- School of Medicine, The University of Western Australia, Perth, Western Australia, Australia
| | - Alexander Thompson
- Western Australia Country Health Service, Perth, Western Australia, Australia
| | - Suzanne Robinson
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
- Health Economics Unit, School of Health and Social Development, Deakin University, Burwood, Victoria, Australia
| | - Wai Chen
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Youth Mental Health and Developmental Neuropsychiatry, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Bronwyn Myers
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Tygerberg, South Africa
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Dooley N, Kennelly B, Arseneault L, Zammit S, Whelan R, Mosley O, Cotter D, Clarke M, Cotter DR, Kelleher I, McGorry P, Healy C, Cannon M. Functional Outcomes Among Young People With Trajectories of Persistent Childhood Psychopathology. JAMA Netw Open 2023; 6:e2336520. [PMID: 37773492 PMCID: PMC10543080 DOI: 10.1001/jamanetworkopen.2023.36520] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/25/2023] [Indexed: 10/01/2023] Open
Abstract
Importance Understanding which children in the general population are at greatest risk of poor functional outcomes could improve early screening and intervention strategies. Objective To investigate the odds of poor outcomes in emerging adulthood (ages 17 to 20 years) for children with different mental health trajectories at ages 9 to 13 years. Design, Setting, and Participants Growing Up in Ireland is a longitudinal, nationally representative population-based cohort study. Data collection began in August 2007 and was repeated most recently in September 2018. All results were weighted to account for sampling bias and attrition and were adjusted for socioeconomic factors. Data analysis took place from October 2022 to April 2023. Exposure Four latent classes captured variation in mental health in children aged 9 and 13 years, based on the parent-completed Strengths and Difficulties Questionnaire. Classes included no psychopathology, internalizing, externalizing, and high (comorbid) psychopathology. Those who remained in the same class from ages 9 to 13 years were included. Main Outcomes and Measures Poor functional outcomes in emerging adulthood were measured at approximate ages 17 years (range, 16 to 18 years) and 20 years (range, 19 to 21 years). Outcomes included poor mental health, poor physical health, social isolation, heavy substance use, frequent health service use, poor subjective well-being, and adverse educational/economic outcomes. Results Of 5141 included participants, 2618 (50.9%) were male. A total of 3726 (72.5%) were classed as having no childhood psychopathology, 1025 (19.9%) as having persistent externalizing psychopathology, 243 (4.7%) as having persistent internalizing psychopathology, and 147 (2.9%) as having persistent high psychopathology. Having any childhood psychopathology was associated with poorer functional outcomes in emerging adulthood. The internalizing group had elevated odds of most outcomes except for heavy substance use (range of odds ratios [ORs]: 1.38 [95% CI, 1.05-1.81] for frequent health service use to 3.08 [95% CI, 2.33-4.08] for poor mental health). The externalizing group had significantly elevated odds of all outcomes, albeit with relatively small effect sizes (range of ORs: 1.38 [95% CI, 1.19-1.60] for frequent health service use to 1.98 [95% CI, 1.67-2.35] for adverse educational/economic outcomes). The high psychopathology group had elevated odds of all outcomes (nonsignificantly for frequent health service use), though with wide confidence intervals (range of ORs: 1.53 [95% CI, 1.06-2.21] for poor physical health to 2.91 [95% CI, 2.05-4.12] for poor mental health). Female participants with any psychopathology had significantly higher odds of poor physical health and frequent health service use compared with male participants with any psychopathology. Conclusions and Relevance In this longitudinal cohort study, childhood psychopathology was associated with a widespread pattern of functional impairment in emerging adulthood. Findings point to the need for a wider range of preventive interventions in child and adolescent mental health services.
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Affiliation(s)
- Niamh Dooley
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Social, Genetic and Developmental Psychology, King’s College London, London, United Kingdom
| | - Brendan Kennelly
- School of Business and Economics, University of Galway, Galway, Ireland
| | - Louise Arseneault
- Social, Genetic and Developmental Psychology, King’s College London, London, United Kingdom
| | - Stanley Zammit
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
- Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Rob Whelan
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- School of Psychology, Trinity College Dublin, Dublin, Ireland
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Olivia Mosley
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Delia Cotter
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mary Clarke
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Health Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - David R. Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Ian Kelleher
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- NHS Lothian Child and Adolescent Mental Health Service, Edinburgh, United Kingdom
- School of Medicine, University College Dublin, Dublin, Ireland
- University of Oulu, Faculty of Medicine, Oulu, Finland
| | - Pat McGorry
- Centre for Youth Mental Health, Orygen, Melbourne, Australia
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
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Dobkins K, Dickenson J, Lindsay D, Bondi T. Changing the landscape of mental health among college students: a community case study of a course on learning sustainable well-being. Front Public Health 2023; 11:1175594. [PMID: 37575115 PMCID: PMC10413109 DOI: 10.3389/fpubh.2023.1175594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/10/2023] [Indexed: 08/15/2023] Open
Abstract
Our society is facing an unprecedented mental health crisis, with nearly one in two people being affected by mental health issues over their lifespan. This trend is especially noticeable among college students, who undergo significant shifts in social, familial, and academic responsibilities. Exacerbating the mental health crisis is the fact that students are facing other societal crises (e.g., climate change). And, in a reciprocal fashion, students experiencing poor mental health are less likely to feel resilient enough to tackle these other crises. In response to these colliding societal crises, we need a comprehensive solution that goes beyond the current models of college mental health services. We propose an alternative preventative mental health approach, which aims to prevent the onset of mental health concerns and build resilience in the face of colliding crises. Specifically, we argue that colleges can aid in building mental health resilience by creating for-credit courses that teach students the skills they need to be conscious, responsible, and resilient human beings. Toward this end, we created an experiential, workshop-style, 1 unit, P/NP course, entitled "Learning Sustainable well-being" (LSW), which guides students to explore, improve, and sustain their mental health. The principles taught in this course combine the wisdoms of several disciplines, including mindfulness, psychology, neuroscience, philosophy, religion, poetry, and cinema. The following community case study reflects on the journey of our "LSW initiative," starting from the creation of the course in 2014 to the current mission of scaling up the offering as part of an institution-wide LSW program. To this end, we describe the LSW course modules/content, our pedagogical approach, potential limitations, and then provide data demonstrating its efficacy in improving student well-being. As a final note, we present the challenges we have faced, and the lessons learned, while on this journey. We hope that presenting this community case study will facilitate the growing dialogue across colleges about creating (and perhaps requiring) courses like LSW in order to improve students' mental health and resilience in the context of other colliding crises.
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Affiliation(s)
- Karen Dobkins
- Human Experience and Awareness Laboratory (HEALab), Department of Psychology, University of California San Diego, San Diego, CA, United States
| | - Janna Dickenson
- Sexual Well-being and Gender (SWAG) Lab, Department of Psychology, University of California San Diego, San Diego, CA, United States
| | - Debra Lindsay
- Human Experience and Awareness Laboratory (HEALab), Department of Psychology, University of California San Diego, San Diego, CA, United States
| | - Taylor Bondi
- Human Experience and Awareness Laboratory (HEALab), Department of Psychology, University of California San Diego, San Diego, CA, United States
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Zahl-Olsen R, Severinsen L, Stiegler JR, Fernee CR, Simhan I, Rekdal SS, Bertelsen TB. Effects of emotionally oriented parental interventions: a systematic review and meta-analysis. Front Psychol 2023; 14:1159892. [PMID: 37519350 PMCID: PMC10374204 DOI: 10.3389/fpsyg.2023.1159892] [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: 02/06/2023] [Accepted: 06/26/2023] [Indexed: 08/01/2023] Open
Abstract
Objective This systematic review and meta-analysis investigates the effects of emotionally oriented parental interventions. Background Several emotionally oriented parental interventions have been developed during the last decade. Some of these have gained popularity and spread across several continents. The literature is growing and consists of qualitative studies; intervention only, quasi-experimental, case-control studies; and randomized controlled trials. They indicate effects for parents and children. However, no systematic review or meta-analysis has, to our knowledge, summarized the results. Method Using several search engines, we located 8,272 studies. After abstract and full-text screening, 33 studies were assessed for bias and included in the study. Outcomes for parents and children were extracted and combined into three constructs for parents and two for children. Meta-analyses were conducted for each construct to estimate the effect of the interventions using a robust Bayes meta-analysis. Results The results indicate the presence of a small to medium effect on parents' mental health, behavior, and use of emotionally oriented parenting, as well as on children's internalizing and externalizing difficulties. Most participants were recruited from the general population, and clinical settings were rare. The results show little evidence of publication bias. Conclusion There is evidence of a small to medium effect of emotionally oriented interventions on parents and children. Systematic review registration https://osf.io/un3q4/.
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Affiliation(s)
- Rune Zahl-Olsen
- Department of Child and Adolescent Mental Health, Sorlandet Hospital, Kristiansand, Norway
| | - Linda Severinsen
- Department of Child and Adolescent Mental Health, Sorlandet Hospital, Kristiansand, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | | | - Carina Ribe Fernee
- Department of Child and Adolescent Mental Health, Sorlandet Hospital, Kristiansand, Norway
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Indra Simhan
- Department of Child and Adolescent Mental Health, Sorlandet Hospital, Kristiansand, Norway
| | - Sondre Sverd Rekdal
- Department of Child and Adolescent Mental Health, Sorlandet Hospital, Kristiansand, Norway
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AlHamawi R, Khader Y, Abu Khudair S, Tanaka E, Al Nsour M. Mental Health and Psychosocial Problems among Children and Adolescents in Jordan: A Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1165. [PMID: 37508662 PMCID: PMC10377849 DOI: 10.3390/children10071165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/22/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023]
Abstract
Introduction: In Jordan, mental health morbidity among children and adolescents is on the rise. Several studies in Jordan have assessed mental health issues and their associated factors among adolescents; however, there remains a lack of a collation of data regarding such issues. Objectives: To review the prevalence rates of mental health problems among children and adolescents in Jordan to understand the evidence base concerning psychiatric morbidity. Methods: The PubMed database, Cochrane Library, Virtual Health Library (VHL) Lilac, and APA PsycArticles were searched for literature published between January 2010 and May 2023. Studies were included if they were conducted on children and adolescents (≤19 years), were observational studies that reported prevalence data regarding psychosocial problems, and were studies conducted in Jordan. Results: The search yielded 211 records, of which 33 studies were assessed for eligibility and 28 met the inclusion criteria. The sample age ranged from 6-19 years. The prevalence rates ranged from 7.1% to 73.8% for depression, 16.3% to 46.8% for anxiety, 13.0-40.6% for ADHD, 11.7-55.2% for overall emotional and behavioral difficulties, 16.2-65.1% for PTSD, and 12-40.4% for eating disorders. Conclusions: The findings highlight the magnitude of mental health problems among children and adolescents and the heterogeneity of the results. Further studies are needed to investigate the prevalence of eating disorders among refugees, as well as sleeping disorders and substance use disorders among all adolescents.
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Affiliation(s)
- Rana AlHamawi
- Eastern Mediterranean Public Health Network (EMPHNET), Amman 11196, Jordan
| | - Yousef Khader
- Department of Public Health, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Sara Abu Khudair
- Eastern Mediterranean Public Health Network (EMPHNET), Amman 11196, Jordan
| | | | - Mohannad Al Nsour
- Eastern Mediterranean Public Health Network (EMPHNET), Amman 11196, Jordan
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Gagliano A, Costanza C, Bazzoni M, Falcioni L, Rizzi M, Scaffidi Abbate C, Vetri L, Roccella M, Guglielmi M, Livio F, Ingrassia M, Benedetto L. Effectiveness of an Educational Filmmaking Project in Promoting the Psychological Well-Being of Adolescents with Emotive/Behavioural Problems. Healthcare (Basel) 2023; 11:1695. [PMID: 37372813 DOI: 10.3390/healthcare11121695] [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: 04/03/2023] [Revised: 06/07/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Evidence suggests that adolescents respond positively to simple, early interventions, including psychosocial support and educational interventions, even when offered in non-clinical settings. Cinematherapy can help manage life challenges, develop new skills, increase awareness, and offer new ways of thinking about specific problems. This pilot trial was conducted in Italy, aiming to investigate the effects of a six-week filmmaking course on the psychological well-being of adolescents (N = 52) with emotional/behavioural problems and neurodevelopmental disorders. At the end of the project, most participants showed improvements mostly in social skills, such as social cognition (p = 0.049), communication (p = 0.009), and motivation (p = 0.03), detected using the SRS Social Responsiveness Scale. In addition, social awareness (p = 0.001) increased in all patients. Statistically significant differences resulted in four sub-scales of Youth Self-Report Scale: withdrawn/depressed (p = 0.007), social problems (p = 0.003), thought problems (p < 0.001), and rule-breaking behaviour (p = 0.03); these results showed a decrease in emotional and behavioural problems. This study is an innovative therapeutic and educational approach based on the filmmaking art. This research can offer an empirical basis for the effectiveness of alternative therapeutic tools in child and adolescent psychiatric disorders. At the same time, it can be replicated in broader contexts (e.g., school and communities) to promote children's psychological well-being.
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Affiliation(s)
- Antonella Gagliano
- Department of Human and Pediatric Pathology "Gaetano Barresi", University of Messina, 98122 Messina, Italy
| | - Carola Costanza
- Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro", University of Palermo, 90128 Palermo, Italy
| | - Marzia Bazzoni
- University of Cagliari & "A. Cao" Pediatric Hospital, Brotzu Hospital Trust, 09047 Cagliari, Italy
| | - Ludovica Falcioni
- University of Cagliari & "A. Cao" Pediatric Hospital, Brotzu Hospital Trust, 09047 Cagliari, Italy
| | - Micaela Rizzi
- University of Cagliari & "A. Cao" Pediatric Hospital, Brotzu Hospital Trust, 09047 Cagliari, Italy
| | - Costanza Scaffidi Abbate
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90141 Palermo, Italy
| | - Luigi Vetri
- Oasi Research Institute-IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy
| | - Michele Roccella
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90141 Palermo, Italy
| | - Massimo Guglielmi
- Department of Human and Pediatric Pathology "Gaetano Barresi", University of Messina, 98122 Messina, Italy
| | - Filippo Livio
- Rehabilitation and Education Center "Dismed Onlus-Centro Studi per Le Disabilita' del Mediterraneo", 98100 Messina, Italy
| | - Massimo Ingrassia
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
| | - Loredana Benedetto
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
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Leung DYP, Leung SF, Zhang XL, Ruan JY, Yeung WF, Mak YW. Factors associated with severe depressive symptoms among Chinese secondary school students in Hong Kong: a large cross-sectional survey. Front Public Health 2023; 11:1148528. [PMID: 37346101 PMCID: PMC10281024 DOI: 10.3389/fpubh.2023.1148528] [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: 01/20/2023] [Accepted: 05/17/2023] [Indexed: 06/23/2023] Open
Abstract
Background Many adolescents were reported to have severe depressive symptoms, and a careful assessment of its correlates is essential for prevention and intervention programs. This study aimed to gain insight into the prevalence of severe depressive symptoms and its association with factors at four levels (individual, relationship, school and society) in a large sample of Hong Kong Chinese secondary school students. Methods Secondary school students from Secondary 1 through 7 were selected as participants using a cluster random sampling method. A questionnaire including inventories measuring 24 factors at the four levels (six individual factors, 11 relationship factors, three school factors, and four society factors) was completed by 8,963 participants (56.3% female) with a mean age of 15.1 (SD = 1.8) years. Students with a score of ≥15 on the Patient Health Questionnaire were defined as having severe depressive symptoms. The association between severe depressive symptoms and correlates were examined by t-test and χ2 test. Logistic regression models using a hierarchical approach then examined the individual contribution of these 24 factors to severe depressive symptoms with the control of other factors in the model. Results 7.4% of the students have severe depressive symptoms. Twenty-two of the 24 factors were significantly associated with severe depressive symptoms in bivariate analyses. In the logistic regression, 11 factors (three individual factors: age, self-esteem and self-mastery; six relationship factors: tobacco use, alcohol drinking, drug use, paternal psychological control, dinner with parents, and perceived social support from friends; one school factor: felt pressure from homework; and one society factor: number of sibling) were statistically significant. Felt pressure from homework, alcohol drinking, and perceived social support from friends were the strongest correlates of severe depressive symptoms. Conclusion The prevalence of self-reported severe depressive symptoms in Hong Kong Chinese secondary school students was high, and the identification of multiple associated factors at the four levels simultaneously provides a knowledge basis for the development of a comprehensive, multivariate model of factors influencing severe depressive symptoms in Chinese secondary school students. The factors identified in the present study may be helpful when designing and implementing preventive intervention programs.
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Affiliation(s)
| | | | | | | | | | - Yim-Wah Mak
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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Wang H, Bragg F, Guan Y, Zhong J, Li N, Pan J, Yu M. Association between duration of electronic screen use for non-educational purposes and depression symptoms among middle and high school students: a cross-sectional study in Zhejiang Province, China. Front Public Health 2023; 11:1138152. [PMID: 37261230 PMCID: PMC10229063 DOI: 10.3389/fpubh.2023.1138152] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 04/10/2023] [Indexed: 06/02/2023] Open
Abstract
Background Existing literature on the association of electronic screen use duration with depression among adolescents is contradictory. The current study aimed to elucidate the association between duration of electronic screen use for non-educational purposes and depression symptoms among middle and high school students in Zhejiang Province, China. Methods A cross-sectional study of 27,070 students in grades 7-12 from 376 middle and high schools was conducted through an anonymous self-administered questionnaire between April and June 2022. Poisson regression was utilized to examine the association between electronic screen use duration for non-educational purposes and depression symptoms. Results Of the 27,006 eligible students, 51.6% (13932) were boys and the mean (SD) age was 15.6(1.7) years. The overall prevalence of symptoms of depression was 22.4% (95%CI 21.4-23.4); girls (27.6%, 26.2-29.0) had a higher prevalence than boys (17.7%, 16.7-18.8). After adjustment for socio-demographic status, lifestyle factors, self-perceived health, academic performance, loneliness and sadness, compared to those who did not use electronic screens for non-educational purposes, the prevalence ratios (PRs) for depression symptoms were 1.03 (95% CI 1.02-1.04) for those exposed to electronic screens for <1 h/day, 1.07 (1.05-1.09) for 1.0-1.9 h/day, 1.10 (1.07-1.13) for 2.0-2.9 h/day, 1.14 (1.10-1.18) for 3.0-3.9 h/day, 1.18 (1.12-1.23) for 4.0-4.9 h/day, and 1.21 (1.15-1.29) for ≥5 h/day. Conclusion Duration of electronic screen use for non-educational purposes was positively associated with symptoms of depression among middle and high school students, even with a relatively short daily duration of use.
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Affiliation(s)
- Hao Wang
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Fiona Bragg
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Yunqi Guan
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jieming Zhong
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Na Li
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jin Pan
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Min Yu
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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Harrison L, Carducci B, Klein JD, Bhutta ZA. Indirect effects of COVID-19 on child and adolescent mental health: an overview of systematic reviews. BMJ Glob Health 2022; 7:bmjgh-2022-010713. [PMID: 36585030 PMCID: PMC9808753 DOI: 10.1136/bmjgh-2022-010713] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/07/2022] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION To control the spread of COVID-19, mitigation strategies have been implemented globally, which may have unintended harmful effects on child and adolescent mental health. This study aims to synthesise the indirect mental health impacts on children and adolescents globally due to COVID-19 mitigation strategies. METHODS We included relevant reviews from MEDLINE, Embase, PsycINFO, LILACS, CINAHL, The Cochrane Library and Web of Science until January 2022 that examined the impact of COVID-19-related lockdown and stay-at-home measures on the mental health of children and adolescents. Data extraction and quality assessments were completed independently and in duplicate by BC and LH. A Measurement Tool to Assess Systematic Reviews-2 was used to assess the methodological quality. RESULTS Eighteen systematic reviews, comprising 366 primary studies, found a pooled prevalence of 32% for depression (95% CI: 27 to 38, n=161 673) and 32% for anxiety (95% CI: 27 to 37, n=143 928) in children and adolescents globally following COVID-19 mitigation measures. Subgroup analyses also uncovered important differences for both depression and anxiety by World Health Organization regions with few studies from Africa and relative high burden of anxiety and depression in the Eastern Mediterranean region. CONCLUSIONS Our findings reveal a high prevalence of depression and anxiety in children and adolescents during the COVID-19 pandemic, globally, compared with prepandemic estimates. These findings highlight the urgency for governments and policymakers to strengthen mental health systems in the COVID-19 recovery, especially in low-and middle-income countries where compounding psychological stress, access and affordability of care and discrepant reporting of mental health in this population remains a challenge. We also provide insight into how to alter mitigation strategies to reduce the unintended negative consequences for the health and well-being of children and adolescents in future pandemics. PROSPERO REGISTRATION NUMBER CRD42022309348.
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Affiliation(s)
- Leila Harrison
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Bianca Carducci
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada,Department of Nutritional Sciences, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - Jonathan D Klein
- Pediatrics, University of Illinois Chicago, Chicago, Illinois, USA
| | - Zulfiqar Ahmed Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada,Department of Nutritional Sciences, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada,Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
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Wang D, Xu Y, Zhu Z, Li Y, Li X, Li Y, Shen H, Wu W, Liu Y, Han C. Changes in the global, regional, and national burdens of NAFLD from 1990 to 2019: A systematic analysis of the global burden of disease study 2019. Front Nutr 2022; 9:1047129. [PMID: 36618688 PMCID: PMC9811393 DOI: 10.3389/fnut.2022.1047129] [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: 09/17/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
Background Understanding the burdens and trends of non-alcoholic fatty liver disease (NAFLD) is necessary for developing effective intervention strategies. In this study, Global Burden of Disease (GBD) 2019 study data were extracted and analyzed to elucidate trends of NAFLD. Methods The prevalence, incidence, disability-adjusted life year (DALY), and death rates of NAFLD in geographic populations worldwide from 1990 to 2019 were extracted from the GBD 2019 study data. The global temporal trend of NAFLD from 1990 to 2019 was evaluated using estimated annual percentage changes (EAPCs) and age-standardized rates. Results Globally, between 1999 and 2019, the age-standardized prevalence rate of NAFLD increased, with EAPCs of 0.77 [95% CI (0.69, 0.85)], whereas the DALY and Death rates decreased, with EAPCs of -0.82 [95% CI (-0.92, -0.71)], and -0.67 [95% CI (-0.76, -0.58)], respectively. Geographically, the age-standardized prevalence rate showed the most serious upward trend in high-income North America with an EAPC of 0.98 [95% CI (0.95, 1.02)], and the age-standardized incidence rate showed an upward trend in Central Asia with an EAPC of 3.17 [95% CI (2.2, 2.49)]. The most significant upward trend of DALY and death rates appeared in Eastern Europe, with EAPCs of 4.06 [95% CI (3.31, 4.82)], and 3.36 [95% CI (2.77, 3.96)], respectively. At the country level, the age-standardized rates showed an upward trend in Armenia, Belarus, and Republic of Korea. Regarding age groups, the percentage change of prevalence was the highest in the 40 to 44 group [0.29 (0.26, 0.34)] from 1990 to 2019; the percentage change of incidence was the highest in the 85 to 89 group [0.46 (0.12, 0.71)] from 1990 to 2019; the percentage change of DALY was the highest in the 80 to 84 group [0.25 (0.11, 0.39)] from 1990 to 2019; and the percentage change of death rate was the highest in the 15 to 19 group [0.36 (0.17, 0.60)] from 1990 to 2019. The percentage change of prevalence of liver cancer due to NASH was the highest in the group of 85 to 89, whereas those of incidence, DALY, and death were the highest in the group above 95 from 1990 to 2019. Regarding the sociodemographic index (SDI), the highest age-standardized prevalence, incidence, and Death rates of NAFLD occurred in middle-SDI countries, and the highest DALY rates of NAFLD occurred in low-SDI countries. Conclusion Global NAFLD burdens have increased since 1990. Our findings provide a reference for policymakers to reduce the burden of NAFLD, especially in middle and low-SDI countries.
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Affiliation(s)
- Dan Wang
- Department of Clinical Nutrition and Metabolism, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Yanbing Xu
- Department of Clinical Nutrition and Metabolism, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Zizhao Zhu
- Department of General Surgery, The Sixth People’s Hospital of Shenyang, Shenyang, China
| | - Yanliang Li
- Departments of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Xiaowen Li
- Department of Clinical Nutrition and Metabolism, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Yike Li
- Department of Clinical Nutrition and Metabolism, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Hui Shen
- Department of Clinical Nutrition and Metabolism, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Wei Wu
- Department of General Surgery, The Sixth People’s Hospital of Shenyang, Shenyang, China
| | - Yazhuo Liu
- Department of Clinical Nutrition and Metabolism, Affiliated Zhongshan Hospital of Dalian University, Dalian, China,*Correspondence: Yazhuo Liu,
| | - Cheng Han
- Department of Clinical Nutrition and Metabolism, Affiliated Zhongshan Hospital of Dalian University, Dalian, China,Cheng Han,
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Micali N. What's weighing us down: closing the gap between the global burden of eating disorders and their representation. Eur Child Adolesc Psychiatry 2022; 31:1653-1654. [PMID: 36203071 PMCID: PMC9540099 DOI: 10.1007/s00787-022-02098-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Nadia Micali
- Mental Health Services of the Capital Region of Denmark, Eating Disorders Research Unit, Ballerup Psychiatric Centre, Copenhagen, Denmark.
- GOSH Institute of Child Health, University College London, London, UK.
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