1
|
Borg ME, Heffer T, Willoughby T. Generational Shifts in Adolescent Mental Health: A Longitudinal Time-Lag Study. J Youth Adolesc 2024:10.1007/s10964-024-02095-3. [PMID: 39395919 DOI: 10.1007/s10964-024-02095-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Accepted: 09/22/2024] [Indexed: 10/14/2024]
Abstract
There is concern that adolescents today are experiencing a "mental health crisis" compared to previous generations. Research has lacked a longitudinal time-lag design to directly compare depressive symptoms and social anxiety of adolescents in two generations. The current study surveyed 1081 adolescents in the current generation (Mage = 14.60, SD = 0.31, 49% female) and 1211 adolescents in a previous generation (Mage = 14.40, SD = 0.51, 51% female) across the high school years (grades 9-12), 20 years apart. Mixed-effects analysis revealed that the Current-Sample reported higher and increasing mental health problems over time compared to the Past-Sample. Although most adolescents reported consistently low mental health problems, the Current-Sample had a higher proportion of adolescents who were consistently at risk across the high school years compared to the Past-Sample. These findings highlight while most adolescents in both generations do not report elevated mental health problems, there may be a small, yet growing, group of adolescents today at risk for experiencing a "mental health crisis".
Collapse
|
2
|
Nilsen SA, Stormark KM, Bang L, Brunborg GS, Larsen M, Breivik K. Time trends in adolescent depressive symptoms from 2010 to 2019 in Norway: real increase or artifacts of measurements? Psychol Med 2024:1-13. [PMID: 39370997 DOI: 10.1017/s0033291724002447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/08/2024]
Abstract
BACKGROUND Whether the recent rise in adolescent self-reported depressive symptoms is influenced by changing reporting behavior is much debated. Most studies use observed sum scores to document trends but fail to assess whether their measures are invariant across time, a prerequisite for meaningful inferences about change. We examined whether measurement noninvariance, indicative of changing perceptions and reporting of symptoms, may influence the assessment of time trends in adolescent depressive symptoms. METHODS Data stem from the nationwide repeated cross-sectional Ungdata-surveys (2010-2019) of 560 712 responses from adolescents aged 13 to 19 years. Depressive symptoms were measured with the Kandel and Davies' six-item Depressive Mood Inventory. Using structural equation modeling, we examined measurement invariance across time, gender and age, and estimated the consequences of noninvariance on cross-cohort time trends. RESULTS Across most conditions, the instrument was found measurement invariant across time. The few noninvariant parameters detected had negligible impact on trend estimates. From 2014, latent mean depressive symptom scores increased among girls. For boys, a U shaped pattern was detected, whereby an initial decrease in symptoms was followed by an increase from 2016. Larger issues of noninvariance were found across age in girls and between genders. CONCLUSIONS From a measurement perspective, the notion that changed reporting of symptoms has been an important driver of secular trends in depressive symptoms was not supported. Thus, other causes of these trends should be considered. However, noninvariance across age (in girls) and gender highlights that depressive symptoms are not necessarily perceived equivalently from early to late adolescence and across gender.
Collapse
Affiliation(s)
- Sondre Aasen Nilsen
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | - Kjell Morten Stormark
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | - Lasse Bang
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Geir Scott Brunborg
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Marit Larsen
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | - Kyrre Breivik
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| |
Collapse
|
3
|
Ranøyen I, Wallander JL, Lydersen S, Thomsen PH, Jozefiak T. Promotive factors associated with reduced anxiety and depression across three years in a prospective clinical cohort of adolescents: Examining compensatory and protective models of resilience. Dev Psychopathol 2024:1-16. [PMID: 39370531 DOI: 10.1017/s0954579424001469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2024]
Abstract
The rates of anxiety and depression increase across adolescence, many experience recurrence after treatment, yet longitudinal studies examining promotive factors are scarce. We prospectively examined the role of the promotive factors structured style, personal and social competencies, family functioning, and social resources in homotypic and heterotypic continuity and discontinuity of anxiety and depression across three years in a clinical sample. Participants were adolescents with anxiety or depressive disorders aged 13-18 years at T1 (N = 717, 44% initial participation rate) and aged 16-21 years at T2 (N = 549, 80% follow-up participation rate). At T1, diagnoses were collected from medical records and participants responded to questionnaires. At T2, semi-structured diagnostic interviews were conducted. Higher levels of all promotive factors were associated with reduced probability of anxiety or depression three years later. The promotive factors were not associated with homotypic continuity of anxiety, whereas personal competence beliefs, social competence, and, less strongly, family functioning were associated with reduced homotypic continuity of depression and heterotypic continuity from depression to anxiety. Analyses with interaction terms did not indicate moderation by the promotive factors. Our findings suggest that bolstering promotive factors may be vital for increasing treatment success and preventing recurrence of anxiety and depression in the transition toward adulthood.
Collapse
Affiliation(s)
- Ingunn Ranøyen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Child and Adolescent Psychiatry, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Jan L Wallander
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Psychological Sciences and Health Sciences Research Institute, University of California, Merced, CA, USA
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Per Hove Thomsen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Thomas Jozefiak
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| |
Collapse
|
4
|
Hurst LE, Tengelitsch E, Bruni T, Lee J, Marcus S, Quigley J. Psychiatry Consultation in Primary Care: Examining Treatment Access for Adolescent Depression. J Adolesc Health 2024:S1054-139X(24)00409-9. [PMID: 39365233 DOI: 10.1016/j.jadohealth.2024.08.018] [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: 01/29/2024] [Revised: 07/24/2024] [Accepted: 08/20/2024] [Indexed: 10/05/2024]
Abstract
PURPOSE Youth in the United States are experiencing mental health concerns at an unprecedented level. Child Psychiatry Access Programs offer an innovative approach to close the gap between the need for care and insufficient mental health workforce. This study examined whether primary care provider consultation with a Child Psychiatry Access Program, Michigan Clinical Consultation & Care (MC3), was associated with greater access to treatment for adolescents with moderate to severe depression symptoms. METHODS A retrospective chart review was conducted of primary care visits between 2017 and 2021 for adolescent patients with first-time positive scores on the Patient Health Questionnaire-9. Descriptive statistics and logistic regression were used to examine if patients whose primary care provider used MC3 psychiatric consultations had improved access to depression treatment compared to those who did not. RESULTS Four hundred seventy nine patients reported Patient Health Questionnaire-9 scores indicating moderate to severe depression symptoms. Compared to non-MC3 consult patients (n = 409), MC3 consult patients (n = 70) had higher odds of being prescribed antidepressant medications (odds ratio [OR], 2.16; 95% confidence interval [CI] [1.11-4.22], p = .05), 4 times higher odds of having a primary care follow-up visit to monitor depression symptoms (OR, 4.56, 95% CI [2.56-8.14], p < .001), and higher odds of accessing mental health therapy (OR, 2.14; 95% CI [1.13-4.05], p = .05). DISCUSSION Use of MC3 consultations was associated with increased utilization of evidence-based depression treatments including medication, therapy, and follow-up care. Greater adoption of models such as MC3 may increase the capacity for addressing mental health needs in children.
Collapse
Affiliation(s)
- Laura E Hurst
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
| | | | - Teryn Bruni
- Department of Psychology, University of Michigan, Ann Arbor, Michigan; Department of Psychology, Algoma University, Sault Sainte Marie, Ontario, Canada
| | - Joyce Lee
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
| | - Sheila Marcus
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Joanna Quigley
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| |
Collapse
|
5
|
Chavez LJ, Teferra AA, Hardy R, Yilmazer T, Cooper J. The effect of the US Child Tax Credit advance payments in 2021 on adolescent mental health: Changes in depression symptoms and suicidality. Prev Med Rep 2024; 46:102811. [PMID: 39238783 PMCID: PMC11372612 DOI: 10.1016/j.pmedr.2024.102811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 06/28/2024] [Accepted: 06/30/2024] [Indexed: 09/07/2024] Open
Abstract
Objective Child poverty is associated with poor adolescent mental health. Changes to the Child Tax Credit (CTC) in 2021 in the U.S. were historic and introduced a new model of distributing the credit in advance of tax filing, providing families with stable, supplemental monthly income. This policy shift offers a unique opportunity to examine the mental health effects for adolescents. Methods We use electronic health record data from a large pediatric primary care network in Columbus, Ohio, which collected adolescent depression screening scores in real time as the CTC advance payments were introduced. We utilized differences in age of eligibility for the CTC to examine the changes in the probability of depression screening outcomes (positive depression screen, any depression symptom, any suicidal ideation), for adolescents eligible for the credit (turned 18 first quarter of 2022), relative to those not eligible (turned 18 last quarter of 2021) (n = 1,423). Results We did not observe a significant association between the policy change and study outcomes in the overall sample. However, the percentage of adolescents with a positive depression screen significantly declined for Non-Hispanic Black (13.4 percentage point reduction, p = 0.01) and publicly insured (9.7 percentage point reduction, p = 0.04) adolescents. Conclusions Our findings suggest reductions in depression symptoms for subgroups of adolescents who were age-eligible for the CTC compared to their counterparts who were not eligible. The CTC advance payments were a brief experiment in universal basic income and may offer a policy solution for addressing both poverty and a growing adolescent mental health crisis.
Collapse
Affiliation(s)
- Laura J Chavez
- Center for Child Health Equity and Outcomes Research at the Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA
- College of Medicine, Department of Pediatrics, The Ohio State University, 370 W 9th Ave, Columbus, OH 43210, USA
| | - Andreas A Teferra
- Center for Child Health Equity and Outcomes Research at the Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA
| | - Rose Hardy
- Center for Child Health Equity and Outcomes Research at the Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA
| | - Tansel Yilmazer
- College of Education and Human Ecology, Department of Human Sciences, The Ohio State University, 1945 North High Street, Columbus, OH 43210, USA
| | - Jennifer Cooper
- Center for Child Health Equity and Outcomes Research at the Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA
- College of Medicine, Department of Pediatrics, The Ohio State University, 370 W 9th Ave, Columbus, OH 43210, USA
| |
Collapse
|
6
|
Boamah SA, Olarte-Godoy J, Jack SM, Root F, Halladay JE. Past the tipping point: Understanding and addressing burnout among nursing students. NURSE EDUCATION TODAY 2024; 141:106319. [PMID: 39094221 DOI: 10.1016/j.nedt.2024.106319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/13/2024] [Accepted: 07/21/2024] [Indexed: 08/04/2024]
Abstract
Burnout is a widespread concern in healthcare, with nurses bearing a disproportionate burden among healthcare professionals. This epidemic of occupational stress has also affected nursing students, who face the external demands inherent in the profession. In this call-to-action paper, we conducted an extensive literature review exploring strategies aimed at mitigating burnout among nursing students, and offer recommendations for academic institutions, healthcare leaders, research funders, and political leaders, including both the civil service and elected leaders to support the advancement and sustainability of the nursing profession and its workforce.
Collapse
Affiliation(s)
- Sheila A Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, ON, Canada.
| | - Jennifer Olarte-Godoy
- School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, ON, Canada.
| | - Susan M Jack
- School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, ON, Canada.
| | - Faith Root
- School of Nursing, Faculty of Health, York University, 198 York Blvd., HNES 320, North York, ON, Canada.
| | - Jillian E Halladay
- School of Nursing, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, ON, Canada.
| |
Collapse
|
7
|
Risbud RD, Guyer AE, Robins RW, Hastings PD. Development of Comorbid Alcohol Use and Depressive Symptoms During Late Adolescence: Examining the Roles of Emotion Regulation and Gender Differences. Res Child Adolesc Psychopathol 2024:10.1007/s10802-024-01251-4. [PMID: 39340743 DOI: 10.1007/s10802-024-01251-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2024] [Indexed: 09/30/2024]
Abstract
Depression and alcohol use are highly comorbid, and often emerge during adolescence. Depressive symptoms may precede alcohol use, via the self-medication pathway, or alcohol use may precede depressive symptoms, via the alcohol induced disruption pathway. Yet little is known about other risks for developing comorbidity via either path. The present study hypothesized that poor cognitive and physiological emotion regulation (ER) are risk factors implicated in the development of comorbid depression and alcohol use during late adolescence. Participants were 229 (113 girls) Mexican-origin youth who reported on depressive symptoms and alcohol use at ages 17 (Time 1) and 19 years (Time 2). At age 17, cognitive reappraisal (CR), an adaptive ER strategy, and baseline respiratory sinus arrhythmia (RSA), a physiological index of ER capacity, were assessed. CR, RSA and gender were examined as predictors and moderators of the developing comorbidity of alcohol use and depression in cross-lagged panel models. Lower use of CR was concurrently associated with more depressive symptoms at age 17 and predicted greater depression at age 19. Age 17 alcohol use predicted age 19 depressive symptoms for boys. Lower RSA at age 17 also predicted more depressive symptoms at age 19 for boys. Neither CR nor RSA moderated the predicted relations between depression and alcohol use. Findings supported the alcohol induced disruption model of comorbidity for boys, and showed that poor cognitive and physiological ER increased risk for exacerbating depressive symptoms in late adolescence.
Collapse
Affiliation(s)
- R D Risbud
- Department of Psychology, University of California Davis, Davis, CA, USA.
- Center for Mind & Brain, University of California Davis, Davis, CA, USA.
| | - A E Guyer
- Center for Mind & Brain, University of California Davis, Davis, CA, USA
- Department of Human Ecology, University of California Davis, Davis, CA, USA
| | - R W Robins
- Department of Psychology, University of California Davis, Davis, CA, USA
| | - P D Hastings
- Department of Psychology, University of California Davis, Davis, CA, USA
- Center for Mind & Brain, University of California Davis, Davis, CA, USA
| |
Collapse
|
8
|
Pigatto F, Grant C, Marks E, Walker C, Fletcher B, Waldie KE. Perinatal cumulative risk scores for depression symptoms in young people from the Growing Up in New Zealand longitudinal study. J Affect Disord 2024; 369:303-311. [PMID: 39341293 DOI: 10.1016/j.jad.2024.09.143] [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: 06/18/2024] [Revised: 08/29/2024] [Accepted: 09/21/2024] [Indexed: 10/01/2024]
Abstract
BACKGROUND Adolescent depression has increased markedly over the last decade and often persists into adulthood with a range of adverse outcomes. Identifying the perinatal risk factors contributing to adolescent depression is crucial to advise early interventions. METHODS The study included 4563 young people from the Growing Up in New Zealand (GUiNZ) longitudinal study who completed a questionnaire on depression symptoms at age 12 years (Centre for Epidemiological Studies Depression Scale for Children (CESD-10). Cumulative Risk (CR) scores were created by combining the perinatal risk factors significantly associated with depression symptoms. Then, these CR scores were grouped into three levels and their association with depression symptoms was investigated in univariable and multivariable analyses. RESULTS We found a statistically significant association between the CR scores (from one to six perinatal risk factors) and depression score at age 12, compared to the no-risk factor group, suggesting a dose-response relationship. In the adjusted analysis, young people exposed to the lower CR score (1-3 risk factors) had a 0.85 unit increase in depression score (p- < .001), and those exposed to the higher CR (4 ≥ risk factors) had a 1.70 unit increase (p < .001) compared to no perinatal risk factors. LIMITATIONS Our model was focused on the perinatal CR score without including the effects of childhood risk factors. CONCLUSIONS The perinatal CR score is a valuable approach to identifying the subgroup of young people who are most at risk for depression symptoms. As such, early interventions that simultaneously address multiple perinatal risk factors for depression are recommended.
Collapse
Affiliation(s)
- Francesca Pigatto
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Cameron Grant
- Department of Paediatrics: Child & Youth Health, School of Medicine, The University of Auckland, Auckland, New Zealand; General Paediatrics, Starship Children's Hospital, Auckland, New Zealand
| | - Emma Marks
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Caroline Walker
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Benjamin Fletcher
- Social and Community Health, The University of Auckland, Auckland, New Zealand
| | - Karen E Waldie
- School of Psychology, The University of Auckland, Auckland, New Zealand.
| |
Collapse
|
9
|
Slimovitch R, Lee SY, Vergara-Lopez C, Bublitz MH, Stroud LR. Reactivity to Peer Rejection Moderates the Effect of Victimization on Adolescent Girls' Depressive Symptoms: A Prospective Study. Res Child Adolesc Psychopathol 2024:10.1007/s10802-024-01243-4. [PMID: 39287770 DOI: 10.1007/s10802-024-01243-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2024] [Indexed: 09/19/2024]
Abstract
Peer victimization and bullying behaviors are prevalent during adolescence and have been linked to depression. This study examined whether peer rejection reactivity, defined as physiological responses to peer exclusion, moderated the associations of victimization and bullying behaviors with depressive symptoms 12 months later in a sample of female youths (N = 79, Mage = 13.37 ± 2.31). Participants underwent the Yale Interpersonal Stressor-Child, during which systolic and diastolic blood pressure and heart rate were continuously measured. Parent and youth reports of the youth's depressive symptoms were utilized. Our results demonstrate that peer rejection reactivity moderates the relationship between victimization and subsequent depressive symptoms but does not moderate the relationship between bullying behaviors and subsequent depressive symptoms. Higher victimization was associated with increased youth-reported depressive symptoms among girls with high reactivity but decreased depressive symptoms among girls with low reactivity. Future research can explore whether reducing emotional and physiological reactivity to peer rejection, as well as increasing interpersonal effectiveness in peer relationships, can reduce depressive symptoms in adolescent girls experiencing victimization.
Collapse
Affiliation(s)
- Rachel Slimovitch
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA, 02118, USA.
| | - Sharon Y Lee
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Chrystal Vergara-Lopez
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Margaret H Bublitz
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Lifespan Physicians Group, Rhode Island Hospital, Providence, RI, USA
| | - Laura R Stroud
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| |
Collapse
|
10
|
Mojtabai R, Olfson M. Trends in Mental Disorders in Children and Adolescents Receiving Treatment in the State Mental Health System. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)01357-1. [PMID: 39214290 DOI: 10.1016/j.jaac.2024.08.008] [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: 02/07/2024] [Revised: 06/29/2024] [Accepted: 08/21/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE To examine recent trends in clinical diagnoses of children and adolescents receiving treatment in publicly funded mental health treatment services in the United States. METHOD Data on children and adolescents (≤17 years) receiving treatment from publicly funded mental health treatment services recorded in Mental Health Client-Level Data 2013-2021 (total number of records = 13,684,154) were used to examine temporal trends in the proportion of different child and adolescent psychiatric disorders. Trends were examined overall and in age, sex, racial/ethnic, and service strata focusing on community-based programs. RESULTS The analyses revealed increases in the proportion of anxiety disorders from 9.6% in 2013 to 19.2% in 2021 (adjusted odds ratio [AOR] 2.17, 95% CI 1.85-2.55, p < .001), trauma- and stressor-related disorders from 22.7% to 27.4% (AOR 1.31, 95% CI 1.09-1.57, p = .004), and depressive disorders from 13.4% to 17.0% (AOR 1.20, 95% CI 1.03-1.41, p = .04). During this same period, the proportion of bipolar disorders declined almost 8-fold from 10.0% to 1.3% (AOR 0.07, 95% CI 0.06-0.09, p < .001). The proportion of conduct disorder and oppositional defiant disorder also declined from 9.7% to 4.4% (AOR 0.42, 95% CI 0.32-0.55, p < .001) and from 11.1% to 7.8% (AOR 0.79, 95% CI 0.65-0.98, p = .03), respectively. Trends varied across sex, age, and racial/ethnic strata. CONCLUSION The composition of childhood psychiatric diagnoses in patients within publicly funded mental health treatment settings changed over the past decade. While some of the trends may reflect changes in diagnostic practices of clinicians, increases in anxiety and depressive disorders parallel trends in the prevalence of these conditions in the general population and highlight a growing need for identifying and treating these conditions in this age group.
Collapse
Affiliation(s)
- Ramin Mojtabai
- Tulane University School of Medicine, New Orleans, Louisiana.
| | - Mark Olfson
- Vagelos College of Physicians and Surgeons and Mailman School of Public Health, Columbia University, New York, New York
| |
Collapse
|
11
|
Wang YQ, Wu TT, Li Y, Cui SE, Li YS. Global research trends and hotspots in overweight/obese comorbid with depression among children and adolescents: A bibliometric analysis. World J Psychiatry 2024; 14:1267-1284. [PMID: 39165557 PMCID: PMC11331393 DOI: 10.5498/wjp.v14.i8.1267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 07/21/2024] [Accepted: 07/29/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Overweight/obesity combined with depression among children and adolescents (ODCA) is a global concern. The bidirectional relationship between depression and overweight/obesity often leads to their comorbidity. Childhood and adolescence represent critical periods for physical and psychological development, during which the comorbidity of overweight/obesity and depression may increase the risk of adverse health outcomes. AIM To evaluate the relationship between ODCA, we conduct a bibliometric analysis to aid in formulating prevention and treatment strategies. METHODS From 2004 to 2023, articles related to ODCA were selected using the Science Citation Index Expanded from the Web of Science Core Collection. Bibliometric analysis of relevant publications, including countries/regions, institutions, authors, journals, references, and keywords, was conducted using the online bibliometric analysis platforms, CiteSpace, VOSviewer, and bibliometrix. RESULTS Between 2004 and 2023, a total of 1573 articles were published on ODCA. The United States has made leading contributions in this field, with Harvard University emerging as the leading contributor in terms of research output, and Tanofsky being the most prolific author. The J Adolescent Health has shown significant activity in this domain. Based on the results of the keyword and reference analyses, inequality, adverse childhood experiences, and comorbidities have become hot topics in ODCA. Moreover, the impact of balanced-related behavior and exploration of the biological mechanisms, including the potential role of key adipocytokines and lipokines, as well as inflammation in ODCA, have emerged as frontier topics. CONCLUSION The trend of a significant increase in ODCA publications is expected to continue. The research findings will contribute to elucidating the pathogenic mechanisms of ODCA and its prevention and treatment.
Collapse
Affiliation(s)
- Ya-Qi Wang
- College of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou 310051, Zhejiang Province, China
| | - Tao-Tao Wu
- College of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou 310051, Zhejiang Province, China
| | - Yan Li
- National Institute of Traditional Chinese Medicine Constitution and Preventive Treatment of Diseases, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Shi-En Cui
- National Institute of Traditional Chinese Medicine Constitution and Preventive Treatment of Diseases, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Ying-Shuai Li
- National Institute of Traditional Chinese Medicine Constitution and Preventive Treatment of Diseases, Beijing University of Chinese Medicine, Beijing 100029, China
| |
Collapse
|
12
|
Halladay J, Sunderland M, Chapman C, Teesson M, Slade T. The InterSECT Framework: a proposed model for explaining population-level trends in substance use and emotional concerns. Am J Epidemiol 2024; 193:1066-1074. [PMID: 38400654 PMCID: PMC11299025 DOI: 10.1093/aje/kwae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 02/06/2024] [Accepted: 02/20/2024] [Indexed: 02/25/2024] Open
Abstract
Across high-income countries, adolescent emotional concerns have been increasing in prevalence over the past two decades and it is unclear why this is occurring, including whether and how substance use relates to these changing trends. On the other hand, substance use has been generally declining, and little is known about the role of emotional concerns in these trends. Several studies have explored the changes in co-occurring substance use and emotional concerns among adolescents over time, with mixed results and inconsistent messaging about the implications of the findings. In response, we developed a theoretical framework for exploring the intersection between trends in substance use and emotional concerns (InterSECT Framework). This framework includes a discussion and related examples for 3 core hypotheses: (1) strengthening of co-occurrence, or the "hardening" hypothesis; (2) co-occurrence staying the same, or the "consistency" hypothesis; and (3) weakening of co-occurrence, or the "decoupling" hypothesis. This framework seeks to guide the conceptualization, evaluation, and understanding of changes in the co-occurrence of substance use and emotional concerns over time, including outlining a research agenda informed by pre-existing research and youth perspectives.
Collapse
Affiliation(s)
- Jillian Halladay
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney 2006, Camperdown 2006, New South Wales, Australia
- School of Nursing, McMaster University, Hamilton, Ontario L8S 4K1, Canada
- Peter Boris Centre for Addictions Research, McMaster University / St. Joseph's Healthcare Hamilton, Hamilton, Ontario L8P 3P2, Canada
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney 2006, Camperdown 2006, New South Wales, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney 2006, Camperdown 2006, New South Wales, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney 2006, Camperdown 2006, New South Wales, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney 2006, Camperdown 2006, New South Wales, Australia
| |
Collapse
|
13
|
Wright N, Hill J, Sharp H, Refberg-Brown M, Crook D, Kehl S, Pickles A. COVID-19 pandemic impact on adolescent mental health: a reassessment accounting for development. Eur Child Adolesc Psychiatry 2024; 33:2615-2627. [PMID: 38170282 PMCID: PMC11272811 DOI: 10.1007/s00787-023-02337-y] [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: 03/29/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024]
Abstract
Current prospective reports suggest a pandemic-related increase in adolescent mental health problems. We examine whether age-related change over 11-14 years accounts for this increase. Mothers and adolescents in a UK-based birth cohort (Wirral Child Health and Development Study; WCHADS; N = 737) reported on adolescent depression and behavioural problems pre-pandemic (December 2019-March 2020), mid-pandemic (June 2020-March 2021) and late pandemic (July 2021-March 2022). Analysis used repeated measures models for over-dispersed Poisson counts with an adolescent-specific intercept with age as a time-varying covariate. Maturational curves for girls, but not for boys, showed a significant increase in self-reported depression symptoms over ages 11-14 years. Behavioural problems decreased for both. After adjusting for age-related change, girls' depression increased by only 13% at mid-pandemic and returned to near pre-pandemic level at late pandemic (mid versus late - 12%), whereas boys' depression increased by 31% and remained elevated (mid versus late 1%). Age-adjusted behavioural problems increased for both (girls 40%, boys 41%) and worsened from mid- to late pandemic (girls 33%, boys 18%). Initial reports of a pandemic-related increase in depression in young adolescent girls could be explained by a natural maturational rise. In contrast, maturational decreases in boys' depression and both boys' and girls' behavioural problems may mask an effect of the pandemic.
Collapse
Affiliation(s)
- N Wright
- Department of Psychology, Manchester Metropolitan University, Manchester, UK.
| | - J Hill
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - H Sharp
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
| | - M Refberg-Brown
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
| | - D Crook
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
- Cheshire and Wirral Partnership NHS Foundation Trust, Chester, UK
| | - S Kehl
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
| | - A Pickles
- Department of Biostatics & Health Informatics, King's College London, London, UK
| |
Collapse
|
14
|
Richardson BT, Jackson J, Marable G, Barker J, Gardiner H, Igarabuza L, Leasy M, Matthews E, Zisman-Ilani Y. The Role of Black Churches in Promoting Mental Health for Communities of Socioeconomically Disadvantaged Black Americans. Psychiatr Serv 2024; 75:740-747. [PMID: 38595118 DOI: 10.1176/appi.ps.20230263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVE Churches in socioeconomically disadvantaged neighborhoods serve as safe havens in many Black communities. Churches provide faith and charitable services but often have limited resources to address the mental health needs of their communities. This article reports on a collaborative effort, driven by members of a Black church, to understand mental health needs, coping strategies, and resilience factors in a community of socioeconomically disadvantaged Black Americans. METHODS A community-based participatory research effort was established among a church, a community mental health organization, clinicians, and researchers to interview and survey individuals residing near the church. RESULTS The sample consisted of 59 adults, most of whom were ages 46-65 years, men (N=34, 58%), and unemployed (N=46, 78%). Mean scores on the Patient Health Questionnaire-9 (9.2±7.7) and Generalized Anxiety Disorder-7 scale (9.4±6.7) were almost three times higher than those reported by studies of other Black populations in the United States. Five themes emerged: prolonged poverty and daily exposure to violence trigger emotional distress, mental health stigma affects help seeking, spirituality promotes mental relief and personal recovery, spirituality helps in coping with poverty and unsafe neighborhoods, and church-based programs are needed. CONCLUSIONS Uptake of traditional mental health services was low, and reliance on faith and resource distribution by the church was high. Church-led interventions are needed to promote mental health at the individual and community levels. Mental health stigma, and negative attitudes toward mental health promotion in the community, may be addressed by integrating traditional mental health services in church-based recreational and leisure activities.
Collapse
Affiliation(s)
- Briana T Richardson
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Jacqueline Jackson
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Grace Marable
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Jessica Barker
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Heather Gardiner
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Laura Igarabuza
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Menachem Leasy
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Elizabeth Matthews
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Yaara Zisman-Ilani
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| |
Collapse
|
15
|
Gordon AM, Magruder ML, Schwartz J, Ng MK, Erez O, Mont MA. Preoperative Depression Screening for Primary Total Knee Arthroplasty: An Evaluation of Its Modifiability on Outcomes in Patients Who Have Depression. J Arthroplasty 2024; 39:2040-2046. [PMID: 38382629 DOI: 10.1016/j.arth.2024.02.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 01/24/2024] [Accepted: 02/13/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Few studies have evaluated preoperative depression screenings in patients who have depression. We studied whether depression screenings before total knee arthroplasty (TKA) were associated with lower: 1) medical complications; 2) emergency department (ED) utilizations and readmissions; 3) implant complications; and 4) costs. METHODS A nationwide sample from January 1, 2010, to April 30, 2021, was collected using an insurance database. Depression patients were 1:1 propensity-score matched based on those who had (n = 29,009) and did not have (n = 29,009) preoperative depression screenings or psychotherapy visits within 3 months of TKA. A case-matched population who did not have depression was compared (n = 144,994). A 90-day period was used to compare complications and health-care utilization and 2-year follow-up for periprosthetic joint infections (PJIs) and implant survivorship. Costs were 90-day reimbursements. Logistic regression models computed odds ratios (ORs) of depression screening on dependent variables. P values less than .001 were significant. RESULTS Patients who did not receive preoperative screening were associated with higher medical complications (18.7 versus 5.2%, OR: 4.15, P < .0001) and ED utilizations (11.5 versus 3.2%, OR: 3.93, P < .0001) than depressed patients who received screening. Patients who had screening had lower medical complications (5.2 versus 5.9%, OR: 0.88, P < .0001) and ED utilizations compared to patients who did not have depression (3.2 versus 3.8%, OR: 0.87, P = .0001). Two-year PJI incidences (3.0 versus 1.3%, OR: 2.63, P < .0001) and TKA revisions (4.3 versus 2.1%, OR: 2.46, P < .0001) were greater in depression patients who were not screened preoperatively versus screened patients. Depression patients who had screening had lower PJIs (1.3 versus 1.8%, OR: 0.74, P < .0001) compared to nondepressed patients. Reimbursements ($13,949 versus $11,982; P < .0001) were higher in depression patients who did not have screening. CONCLUSIONS Preoperative screening was associated with improved outcomes in depression patients. LEVEL OF EVIDENCE III.
Collapse
Affiliation(s)
- Adam M Gordon
- Department of Orthopaedic Surgery and Rehabilitation, Maimonides Medical Center, Brooklyn, New York; Questrom School of Business, Boston University, Boston, Massachusetts
| | - Matthew L Magruder
- Department of Orthopaedic Surgery and Rehabilitation, Maimonides Medical Center, Brooklyn, New York
| | - Jake Schwartz
- Department of Orthopaedic Surgery and Rehabilitation, Maimonides Medical Center, Brooklyn, New York
| | - Mitchell K Ng
- Department of Orthopaedic Surgery and Rehabilitation, Maimonides Medical Center, Brooklyn, New York
| | - Orry Erez
- Department of Orthopaedic Surgery and Rehabilitation, Maimonides Medical Center, Brooklyn, New York
| | - Michael A Mont
- Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland
| |
Collapse
|
16
|
Keyes KM, Kreski NT, Patrick ME. Depressive Symptoms in Adolescence and Young Adulthood. JAMA Netw Open 2024; 7:e2427748. [PMID: 39141383 PMCID: PMC11325205 DOI: 10.1001/jamanetworkopen.2024.27748] [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] [Indexed: 08/15/2024] Open
Abstract
Importance Depressive symptoms have increased among US adolescents since 2010. It remains unclear as to what extent this increase will persist into young adulthood, potentially turning the youth mental health crisis into a young adult mental health crisis. Objective To test the association between birth cohort and adolescent depressive symptoms at ages 18, 19 to 20, and 21 to 22 years and changes in these symptoms by cohort. Design, Setting, and Participants This panel cohort study analyzed data from the Monitoring the Future longitudinal survey from 1990 to 2019, including birth cohorts from 1972 to 2001. Survey respondents were recruited from US high schools in 12th grade and were approximately aged 18 years (at baseline) through age 21 to 22 years (during mail and web follow-up). Data analysis was conducted from April to October 2023. Exposure Depressive symptoms score (>12 vs ≤12, with >12 representing top-decile scores) on a scale examining affective items (eg, "Life often seems meaningless"). Main Outcomes and Measures High (vs lower) depressive symptoms at ages 19 to 20 years and 21 to 22 years. Results The 36 552 respondents included 18 597 females (50.5%), and most reported having a parent who graduated from college (44.8%). Among females, 19.1% (95% CI, 16.7%-21.4%) of the most recent birth cohort (born: 1997-2001) had high depressive symptoms at age 18 years, higher than any previous birth cohort. While prevalence declined by age 21 to 22 years, it remained higher than previous cohorts at that age. Among males, 13.4% (95% CI, 11.2%-15.6%) of the most recent birth cohort had high depressive symptoms at age 18 years, and prevalence increased through young adulthood. Males with high baseline depressive symptoms had 10.24 (95% CI, 7.01-14.97) times the odds of symptoms at age 19 to 20 years and 6.20 (95% CI, 3.93-9.78) times the odds of symptoms at age 21 to 22 years. Females with high baseline depressive symptoms had 9.16 (95% CI, 6.57-12.76) times the odds of symptoms at age 19 to 20 years and 7.28 (95% CI, 4.92-10.78) times the odds of symptoms at age 21 to 22 years. The magnitude of the associations did not vary over time. Population attributable fractions indicated that the total proportion of young adult symptoms associated with depressive symptoms at age 18 years among females has increased; in the most recent birth cohort, 55.25% (95% CI, 38.11%-65.13%) of depressive symptoms at age 21 to 22 years were associated with symptoms at age 18 years. Conclusions and Relevance This panel cohort study found that increases in depressive symptoms in adolescence persisted into young adulthood, suggesting the need for primary prevention and mental health resources during the adolescent years.
Collapse
Affiliation(s)
- Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Noah T Kreski
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Megan E Patrick
- Institute for Social Research, University of Michigan, Ann Arbor
| |
Collapse
|
17
|
Halladay J, Sunderland M, Chapman C, Repchuck R, Georgiades K, Boak A, Hamilton HA, Slade T. Examining temporal trends in psychological distress and the co-occurrence of common substance use in a population-based sample of grade 7-12 students from 2013 to 2019. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1367-1377. [PMID: 38311705 PMCID: PMC11291599 DOI: 10.1007/s00127-024-02619-z] [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: 04/04/2023] [Accepted: 01/01/2024] [Indexed: 02/06/2024]
Abstract
PURPOSE Characterizing trends and correlates of adolescent psychological distress is important due to observed global increases over the last 20 years. Substance use is a commonly discussed correlate, though we lack an understanding about how co-occurrence of these concerns has been changing over time. METHODS Data came from repeated, representative, cross-sectional surveys of grade 7-12 students across Ontario, Canada conducted biennially from 2013 to 2019. Poisson regression with robust standard errors was used to examine changes in the joint association between psychological distress (operationalized as Kessler-6 [K6] scores ≥ 13) and substance use over time. Weighted prevalence ratios (PR) and their 99% confidence intervals were estimated, where p < 0.01 denotes statistical significance. RESULTS The prevalence of psychological distress doubled between 2013 and 2019, with adjusted increases of about 1.2 times each survey year. This biennial increase did not differ based on sex, perceived social standing, school level, or any substance use. Students using substances consistently reported a higher prevalence of psychological distress (between 1.2 times and 2.7 times higher). There were similarly no differential temporal trends based on substance use for very high distress (K6 ≥ 19) or K6 items explored individually. CONCLUSION Psychological distress steeply increased among adolescents and substance use remains important to assess and address alongside distress. However, the magnitude of temporal increases appears to be similar for adolescents reporting and not reporting substance use.
Collapse
Affiliation(s)
- J Halladay
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Level 6, Jane Foss Russell Building, G02, Camperdown, NSW, 2006, Australia.
| | - M Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Level 6, Jane Foss Russell Building, G02, Camperdown, NSW, 2006, Australia
| | - C Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Level 6, Jane Foss Russell Building, G02, Camperdown, NSW, 2006, Australia
| | - R Repchuck
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| | - K Georgiades
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| | - A Boak
- The Centre for Addiction and Mental Health (CAMH), University of Toronto, Toronto, Canada
| | - H A Hamilton
- The Centre for Addiction and Mental Health (CAMH), University of Toronto, Toronto, Canada
| | - T Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Level 6, Jane Foss Russell Building, G02, Camperdown, NSW, 2006, Australia
| |
Collapse
|
18
|
Liu C, Xu Y, Sun H, Yuan Y, Lu J, Jiang J, Liu N. Associations between left-behind children's characteristics and psychological symptoms: a cross-sectional study from China. BMC Psychiatry 2024; 24:510. [PMID: 39020309 PMCID: PMC11256512 DOI: 10.1186/s12888-024-05932-8] [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: 10/28/2023] [Accepted: 06/25/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Parent-child separation poses a significant challenge for left-behind children (LBC). However, limited empirical evidence exists regarding the correlation between left-behind characteristics and the psychological symptoms of LBC. This study investigated psychological symptoms among LBC and explored associations between left-behind characteristics and those symptoms. METHODS Using stratified cluster sampling, 1,832 LBC aged 13-18 years from three cities in East China were selected for analysis. Participants' depression and anxiety symptoms were assessed with the Patient Health Questionnaire 9 and the General Anxiety Disorder 7, respectively. Chi-square tests were used to compare differences in detection rates of psychological symptoms among LBC in different groups. Binary logistic regression analysis was used to infer associations between left-behind characteristics and psychological symptoms. RESULTS Depression and anxiety symptoms were detected in 32.86% and 33.24%, respectively, of participating LBC. Univariate analysis showed statistically significant differences in detection rates of depression symptoms by sex, grade, and timing of parent-child separation. Statistically significant differences were observed in anxiety symptom rates by sex, grade, type of caregiver, and timing of mother-child separation. Multivariate analysis indicated a positive association between LBC's anxiety symptoms and mother-child separation that occurred during post-primary school, and type of caregiver (father only or mother only). Our findings confirm a positive association between left-behind characteristics and anxiety symptoms among LBC. CONCLUSION The timing of mother-child separation and type of caregiver are potential risk factors for the development of anxiety symptoms in this population.
Collapse
Affiliation(s)
- Cong Liu
- Physical Education College, Jiangxi Normal University, Nanchang, China
| | - Yan Xu
- School of Physical Education, Gannan Normal University, Ganzhou, China
| | - Hao Sun
- Physical Education College, Jiangxi Normal University, Nanchang, China
| | - Yan Yuan
- Physical Education College, Jiangxi Normal University, Nanchang, China
| | - Jinkui Lu
- School of Physical Education, Shangrao Normal University, Shangrao, China.
| | - Jing Jiang
- Boyue Science Center, Jiangxi Medical College, Shangrao, China
| | - Ningling Liu
- School of Physical Education, Shangrao Normal University, Shangrao, China
| |
Collapse
|
19
|
Newson JJ, Sukhoi O, Thiagarajan TC. MHQ: constructing an aggregate metric of population mental wellbeing. Popul Health Metr 2024; 22:16. [PMID: 39020379 PMCID: PMC11256620 DOI: 10.1186/s12963-024-00336-y] [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: 11/22/2023] [Accepted: 07/05/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND According to the World Health Organization (WHO), mental health is 'a state of wellbeing in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community'. Any population metric of mental health and wellbeing should therefore not only reflect the presence or absence of mental challenges but also a person's broad mental capacity and functioning across a range of cognitive, social, emotional and physical dimensions. However, while existing metrics of mental health typically emphasize ill health, existing metrics of wellbeing typically focus on happiness or life satisfaction, indirectly infer wellbeing from a selection of social and economic factors, or do not reflect a read out of the full spectrum of mental functioning that impacts people's everyday life and that spans the continuum from distress and the inability to function, through to the ability to function to one's full potential. METHODS We present the Mental Health Quotient, or MHQ, a population metric of mental wellbeing that comprehensively captures mental functioning, and examine how it relates to functional productivity. We describe the 47-item assessment and the life impact rating scale on which the MHQ metric is based, as well as the rationale behind each step of the nonlinear algorithm used to construct the MHQ metric. RESULTS We demonstrate a linear relationship between the MHQ metric and productive life function where movement on the scale from any point or in any direction relates to an equivalent shift in productive ability at the population level, a relationship that is not borne out using simple sum scores. We further show that this relationship is the same across all age groups. Finally, we demonstrate the potential for the types of insights arising from the MHQ metric, offering examples from the Global Mind Project, an initiative that aims to track and understand our evolving mental wellbeing, and since 2020 has collected responses from over 1 million individuals across 140 + countries. CONCLUSION The MHQ is a metric of mental wellbeing that aligns with the WHO definition and is amenable to large scale population monitoring.
Collapse
Affiliation(s)
| | - Oleksii Sukhoi
- Sapien Labs, 1201 Wilson Blvd, 27th floor, Arlington, Virginia, USA
| | | |
Collapse
|
20
|
Kiviruusu O. Excessive internet use among Finnish young people between 2017 and 2021 and the effect of COVID-19. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02723-0. [PMID: 38985326 DOI: 10.1007/s00127-024-02723-0] [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: 04/13/2023] [Accepted: 06/24/2024] [Indexed: 07/11/2024]
Abstract
PURPOSE An increase in excessive Internet use (EIU) among adolescents during the COVID-19 pandemic was suggested in many studies. However, these studies were mostly based on cross-sectional and/or unrepresentative samples. METHODS Using data from a nationwide Finnish school survey in the years 2017, 2019 and 2021 (N = 450,864; aged 13-20 years), changes in the prevalence of EIU (EIUS, 5-item) were assessed. The effects of COVID-19 (year 2021 vs. 2017/2019 combined) and linear trend were analyzed in logistic regression models. Models were adjusted for loneliness, depression, anxiety, and sociodemographic factors. RESULTS Among males, EIU prevalence varied minimally (7.8-8.1%) from 2017 to 2021. Among females, the prevalence increased from 6.8 to 11.7% and the effect of COVID-19 was significant (OR = 1.53; p < 0.001). Including the linear trend in the model turned the COVID-19 effect on EIU among females non-significant (p = 0.625), whereas the trend was significant (OR = 1.17; p < 0.001). Adjusting the models with mental health-related factors attenuated the effect of COVID-19 to some extent, but not the effect of linear trend. CONCLUSIONS There is a sex difference in the way the prevalence of EIU developed from 2017 to 2021 among Finnish adolescents. In males, there was no indication of increased prevalence of EIU and among females, while the effect of COVID-19 was first found, it was also suggested to be a product of a trend already started before the COVID-19 pandemic. These results are in contrast with some earlier studies suggesting an effect of COVID-19 on EIU.
Collapse
Affiliation(s)
- Olli Kiviruusu
- Mental Health Team, Department of Public Health and Welfare, Finnish Institute for Health and Welfare, P.O. Box 30, Helsinki, 00271, Finland.
| |
Collapse
|
21
|
Gilbert W, Eltanoukhi R, Morin AJS, Salmela-Aro K. Achievement Goals as Mediators of the Links Between Self-Esteem and Depressive Symptoms From Mid-Adolescence to Early Adulthood. J Youth Adolesc 2024:10.1007/s10964-024-02045-z. [PMID: 38963580 DOI: 10.1007/s10964-024-02045-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 06/20/2024] [Indexed: 07/05/2024]
Abstract
Numerous studies have sought to determine whether low self-esteem acts as a risk factor for depressive symptoms (i.e., a vulnerability model) or whether depressive symptoms lead to a decrease in self-esteem (i.e., a scar model). Although both models have received some support, very little research has: (a) addressed this question across critical life transitions likely to modify this pattern of associations, such as the transition to adulthood; (b) sought to identify the psychological mechanisms (i.e., mediators) underpinning these associations. The present study was designed to address these two limitations, focusing on the directionality of the associations between depressive symptoms and self-esteem from mid-adolescence to early adulthood while considering the role of motivational factors, namely mastery (intrinsic/extrinsic) and performance (approach/avoidance) goals as conceptualized in achievement goal theory. A sample of 707 Finnish adolescents aged 15-16 (52.1% boys) was surveyed six times up to the age of 25. Results from a cross-lagged panel model (CLPM) revealed that depressed individuals were more likely to have low self-esteem, although self-esteem protected against depressive symptoms between ages 16-17 to 20-21. Moreover, while self-esteem promoted mastery-extrinsic goals which in turn reinforced self-esteem, depressive symptoms promoted performance-avoidance goals which led to more depressive symptoms and lower self-esteem. Overall, these findings highlight (1) the long-lasting negative consequences of depressive symptoms on self-esteem and (2) the crucial role played by academic motivation in explaining the development of depressive symptoms and self-esteem over time. In turn, these results help refine the vulnerability and scar models, and suggest that motivational factors should be considered in prevention and intervention efforts among young populations.
Collapse
Affiliation(s)
- William Gilbert
- Department of Health Sciences, Université du Québec à Rimouski, Rimouski, QC, Canada.
| | - Rayana Eltanoukhi
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Alexandre J S Morin
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Montreal, QC, Canada
- Optentia Research Unit, North-West University, Vanderbijlpark, South Africa
| | | |
Collapse
|
22
|
Rogers EM, Melde C, Williams J, Heinze J, McGarrell E. Adolescent Mental Health and Resilience Before and During the COVID-19 Pandemic. J Adolesc Health 2024; 75:43-50. [PMID: 38493399 DOI: 10.1016/j.jadohealth.2024.02.023] [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: 07/19/2023] [Revised: 02/15/2024] [Accepted: 02/15/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE We aimed to assess levels of depression, anxiety, and resilience factors before and during the COVID-19 pandemic in a school sample of adolescents. We also aimed to examine the compensatory and protective effects of individual, family, and school resilience factors on adolescent mental health. METHODS We used fall 2019 and fall 2020 survey responses from a cluster randomized controlled trial implemented in 20 schools in a Midwestern county. The sample consisted of 3,085 responses from students in grades 5 and 6. Multilevel mixed-effects models with cluster robust standard errors were used to investigate the associations between exposure to the COVID-19 pandemic, mental health (anxiety, depression), and resilience factors (future orientation, family engagement, and having a caring school adult). RESULTS Anxiety, but not depression, was higher in fall 2020 compared to fall 2019. Family engagement increased during the pandemic, while future orientation of the student body was lower during that time and the prevalence of having a caring adult at school was unchanged. A positive future orientation was associated with lower levels of anxiety and depression, while having a caring school adult was associated with lower depression. Adolescents with less positive future orientations, low family engagement, and no caring school adults experienced the greatest increases in anxiety. DISCUSSION Positive future orientations, family engagement, and supportive nonparental adult relationships had compensatory and protective effects on adolescent mental health during the COVID-19 pandemic. Adding these measures to the inventory of modifiable resilience factors during natural disasters may promote healthy adaptation among adolescents.
Collapse
Affiliation(s)
- Ethan M Rogers
- Public Policy Center, University of Iowa, Iowa City, Iowa.
| | - Chris Melde
- School of Criminal Justice, Michigan State University, East Lansing, Michigan
| | - Jalena Williams
- School of Criminal Justice, Michigan State University, East Lansing, Michigan
| | - Justin Heinze
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Edmund McGarrell
- School of Criminal Justice, Michigan State University, East Lansing, Michigan
| |
Collapse
|
23
|
Byrne SJ, Swords L, Nixon E. Depression Literacy and Self-Reported Help-Giving Behaviour in Adolescents in Ireland. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01727-w. [PMID: 38916697 DOI: 10.1007/s10578-024-01727-w] [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] [Accepted: 06/07/2024] [Indexed: 06/26/2024]
Abstract
This questionnaire-based study aimed to explore depression literacy (DL) and help-giving experiences in 12-18-year-old adolescents (N = 535, Mage = 14.9 years, 51.8% male) in Ireland. In response to a vignette depicting a character displaying symptoms of depression, 46.7% labelled these symptoms 'depression', with increasing age and empathy associated with increased likelihood of labelling as such. Almost all (92.1%) believed the character needed help, but the perceived helpfulness of potential responses varied. Over one-third (38.2%) indicated they knew someone who had displayed similar symptoms in the past year, with 85.2% of these reporting having helped this person. Reported help-giving responses included comforting the person, encouraging professional help-seeking, and informing an adult. The findings suggest adolescent DL can be best supported by developmentally-sensitive interventions that encourage empathy and the importance of engaging adults' assistance.
Collapse
Affiliation(s)
- Sadhbh J Byrne
- Department of Psychology, Maynooth University, Maynooth, Ireland.
- School of Psychology, Trinity College Dublin, Dublin, Ireland.
| | - Lorraine Swords
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Elizabeth Nixon
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
24
|
Olisaeloka L, Udokanma E, Ashraf A. Psychosocial interventions for depression among young people in Sub-Saharan Africa: a systematic review and meta-analysis. Int J Ment Health Syst 2024; 18:24. [PMID: 38909254 PMCID: PMC11193191 DOI: 10.1186/s13033-024-00642-w] [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: 02/21/2023] [Accepted: 06/12/2024] [Indexed: 06/24/2024] Open
Abstract
BACKGROUND Depression among young people is a global health problem due to its rising prevalence and negative physical and social outcomes. The prevalence of depression and the treatment gap among young people in Sub-Saharan Africa (SSA) is higher than global estimates. Most psychosocial interventions for adolescent and youth depression were developed in high-income countries and less is known about their effectiveness in SSA. Due to contextual differences, findings from High-Income Countries (HICs) are less applicable to SSA. Yet, no systematic review of psychosocial interventions for depression among young people in SSA has been conducted. METHODS A systematic literature search of four databases (Medline, Web of Science, PsycInfo, and Cochrane library) was conducted. Experimental studies published before May 2024 that evaluated the effect of psychosocial interventions on depressive symptoms among young people (aged 10-24 years) in SSA were included in the systematic review. Effect sizes (Hedge's g (g)) indicating differences between intervention and control groups were calculated using a random effects model. RESULTS Twenty-two eligible studies were identified for the systematic review, of which eighteen randomized control trials (RCTs) involving 2338 participants were included in the meta-analysis. The findings revealed that psychosocial interventions significantly reduced depressive symptoms (g = -1.55, 95% CI -2.48, -0.63), although heterogeneity was high (I2 = 98.8%). Subgroup analysis revealed that efficacy differed significantly by intervention type, with Cognitive Behavioural Therapy (9 studies) showing the strongest effect (g = -2.84, 95% CI -4.29; -1.38). While Wise Interventions (a form of positive psychology interventions; 2 studies) had a moderate effect (g = -0.46, 95% C.I -0.53, -0.39), Interpersonal Psychotherapy (2 studies; g = -0.08, 95% CI -1.05, 0.88) and Creative Psychological Interventions (3 studies; g = -0.29, 95% CI -1.38, 0.79) showed smaller, non-significant effects. Sensitivity analysis excluding studies at high risk of bias strengthened the effect size. Few studies assessed factors affecting intervention efficacy and showed mixed effects of age, gender, and adherence levels. CONCLUSION Psychosocial interventions, particularly CBT, significantly reduced depressive symptoms among young people in SSA. However, it is crucial to acknowledge the high heterogeneity which likely stems from variations in study populations and intervention delivery modalities. This highlights the need for further research to identify the specific intervention components and delivery methods that work best for distinct subpopulations. Future research should also explore how long intervention effects are maintained and factors affecting efficacy.
Collapse
Affiliation(s)
| | - Echezona Udokanma
- School of Nursing, Midwifery, and Health, Coventry University, Coventry, UK
| | - Asma Ashraf
- Department of Nursing, City University of London, London, UK
| |
Collapse
|
25
|
Soleimanpour S, Simmons C, Saphir M, Ng S, Jenks K, Geierstanger S. Equity in Mental Health Care Receipt among Youth Who Use School-Based Health Centers. Am J Prev Med 2024:S0749-3797(24)00195-8. [PMID: 38876296 DOI: 10.1016/j.amepre.2024.06.004] [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: 01/12/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 06/16/2024]
Abstract
INTRODUCTION Youth experience significant mental health (MH) needs, and gender- and racially/ethnically-diverse youth are less likely than peers to receive care. School-based health centers (SBHCs) are a healthcare delivery model that may decrease disparities. This study examined the role of SBHCs in reducing disparities in MH care receipt among SBHC clients. METHODS Data from electronic health records of 5,396 youth ages 12 to 21 years who visited 14 SBHCs in one California county from 2021 to 2023 were analyzed in 2023-2024 using multiple logistic regression to assess disparities in MH care receipt and depression screenings. RESULTS Receipt of MH care from SBHCs varied significantly by gender but not age, sexual orientation, or race/ethnicity. Compared to female clients, males had reduced odds (AOR: 0.50) and gender-diverse clients had higher odds (AOR: 2.70) of receiving MH care. For receipt of depression screenings, male clients had reduced odds (AOR: 0.86); Latino clients had higher odds than white clients (AOR: 1.80); and older adolescents and young adults had higher odds than younger adolescents (AORs: 1.44 and 1.45, respectively). Receipt of follow-up MH care after a positive depression result varied only by gender, with male clients having reduced odds (AOR: 0.63). DISCUSSION SBHCs may reach youth who are traditionally less likely to seek care in other settings, including racially/ethnically- and gender-diverse youth. As in other settings, engaging males in healthcare is an area for improvement. These findings help to demonstrate the potential of SBHCs for decreasing disparities in mental health care.
Collapse
Affiliation(s)
- Samira Soleimanpour
- Philip R. Lee Institute for Health Policy Studies & Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
| | - Cailey Simmons
- Public Health and Preventive Medicine Residency Program, California Department of Public Health, Berkeley, California
| | - Melissa Saphir
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California
| | - Sandy Ng
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California
| | - Kale Jenks
- Center for Healthy Schools and Communities, Alameda County Health Care Services Agency, San Leandro, California
| | - Sara Geierstanger
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California
| |
Collapse
|
26
|
Wang H, Lu J, Zhao H, Li L, Zhou X. Vulnerable conditions syndemic, depression, and suicidal ideation among school children in China: cross-sectional census findings. Child Adolesc Psychiatry Ment Health 2024; 18:59. [PMID: 38783340 PMCID: PMC11118994 DOI: 10.1186/s13034-024-00751-x] [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: 09/19/2023] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Mental health issues (depression and suicidal ideation) are increasingly common in children and emerge as escalating public health concerns. The syndemics that underline the importance of risk factor clustering provides a framework for intervention, but there is a lack of research on syndemics involving the adverse interactions of children's mental health problems. This study therefore examined the cumulative and synergistic effects of vulnerable conditions on depression and suicidal ideation among children in China. METHODS A mental health screening census of students in grades 5-12 was conducted from November 2022 to January 2023 in Nanling County, Anhui Province, China. The prevalence and co-occurrence of vulnerable conditions (unfavorable parental marital status, left-behind experience, bullying victimization, and self-harm behavior), depression, and suicidal ideation and the cumulative and synergistic effects of vulnerable conditions on depression and suicidal ideation were explored. RESULTS Nearly a quarter of students (24.8%) reported at least two syndemic conditions. Overall, the prevalence of depression and suicidal ideation were 20.2% and 24.2% respectively. The odds of depression and suicidal ideation were higher for children with one or more vulnerable conditions and were ten times higher for children with three or more vulnerable conditions compared with those without any vulnerable condition. These four vulnerable conditions can increase the odds of depression and suicidal ideation by interacting synergistically with each other. CONCLUSION Our findings signal the importance of addressing mental health syndemics among children in China by simultaneously considering concurrent vulnerable conditions.
Collapse
Affiliation(s)
- Hanqian Wang
- Institute of Social Medicine, School of Medicine, Zhejiang University, 866 Yuhangtang Road, 310058, Hangzhou, Zhejiang Province, China
| | - Jingjing Lu
- Institute of Social Medicine, School of Medicine, Zhejiang University, 866 Yuhangtang Road, 310058, Hangzhou, Zhejiang Province, China
| | - Honghui Zhao
- Institute of Social Medicine, School of Medicine, Zhejiang University, 866 Yuhangtang Road, 310058, Hangzhou, Zhejiang Province, China
| | - Lu Li
- Institute of Social Medicine, School of Medicine, Zhejiang University, 866 Yuhangtang Road, 310058, Hangzhou, Zhejiang Province, China.
- Zhejiang Shuren University, Hangzhou, China.
| | - Xudong Zhou
- Institute of Social Medicine, School of Medicine, Zhejiang University, 866 Yuhangtang Road, 310058, Hangzhou, Zhejiang Province, China.
- The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
| |
Collapse
|
27
|
Doan TT, Hutton DW, Wright DR, Prosser LA. Estimating Transition Probabilities for Modeling Major Depression in Adolescents by Sex and Race or Ethnicity Combinations in the USA. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2024; 22:375-390. [PMID: 38253972 DOI: 10.1007/s40258-024-00872-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/04/2024] [Indexed: 01/24/2024]
Abstract
OBJECTIVE About one-fifth of US adolescents experienced major depressive symptoms, but few studies have examined longitudinal trends of adolescents developing depression or recovering by demographic factors. We estimated new transition probability inputs, and then used them in a simulation model to project the epidemiologic burden and trajectory of depression of diverse adolescents by sex and race or ethnicity combinations. METHODS Transition probabilities were first derived using parametric survival analysis of data from the National Longitudinal Study of Adolescent to Adult Health and then calibrated to cross-sectional data from the National Survey on Drug Use and Health. We developed a cohort state-transition model to simulate age-specific depression outcomes of US adolescents. A hypothetical adolescent cohort was modeled from 12-22 years with annual transitions. Model outcomes included proportions of youth experiencing depression, recovery, or depression-free cases and were reported for a US adolescent population by sex, race or ethnicity, and sex and race or ethnicity combinations. RESULTS At 22 years of age, approximately 16% of adolescents had depression, 12% were in recovery, and 72% had never developed depression. Depression prevalence peaked around 16-17 years-old. Adolescents of multiracial or other race or ethnicity, White, American Indian or Alaska Native, and Hispanic, Latino, or Spanish descent were more likely to experience depression than other racial or ethnic groups. Depression trajectories generated by the model matched well with historical observational studies by sex and race or ethnicity, except for individuals from American Indian or Alaska Native and multiracial or other race or ethnicity backgrounds. CONCLUSIONS This study validated new transition probabilities for future use in decision models evaluating adolescent depression policies or interventions. Different sets of transition parameters by demographic factors (sex and race or ethnicity combinations) were generated to support future health equity research, including distributional cost-effectiveness analysis. Further data disaggregated with respect to race, ethnicity, religion, income, geography, gender identity, sexual orientation, and disability would be helpful to project accurate estimates for historically minoritized communities.
Collapse
Affiliation(s)
- Tran T Doan
- Department of Pediatrics, University of Pittsburgh School of Medicine, 3414 Fifth Avenue, 1st Floor, Pittsburgh, PA, 15213-3205, USA.
| | - David W Hutton
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Davene R Wright
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Lisa A Prosser
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| |
Collapse
|
28
|
Bimerew M, Gebremeskel T, Beletew B, Ayaliew W, Wodaje M, Ayalneh M. Prevalence of major depressive disorder and its associated factors among adult patients with neurolathyrism in Dawunt District, Ethiopia; 2022: community-based cross-sectional study. BMC Psychiatry 2024; 24:282. [PMID: 38627754 PMCID: PMC11020178 DOI: 10.1186/s12888-024-05755-7] [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: 12/08/2023] [Accepted: 04/10/2024] [Indexed: 04/19/2024] Open
Abstract
INTRODUCTION Major Depressive Disorder (MDD) is one of the commonest mental disorders affecting more than 250 million people globally. Patients with chronic illnesses had higher risks for developing MDD than the general population. Neurolathyrism is a chronic illness characterized by lifelong incurable spastic paralysis of lower extremities; causing permanent disability. It is highly prevalent in Dawunt district, Ethiopia; with a point prevalence of 2.4%. Despite this, there were no previous studies assessing the prevalence of MDD among patients with neurolathyrism in Ethiopia. OBJECTIVE To assess the prevalence of MDD and to identify its associated factors among patients with neurolathyrism in Dawunt district, Ethiopia. METHODS A community based cross-sectional study was conducted on 260 samples in Dawunt district from February 01 to March 30/ 2021. Multistage sampling technique was used to select study participants. The patient Health Questionnaire-9 (PHQ-9) depression screening tool was used to diagnose MDD. PHQ-9 is a standardized depression screening tool and a PHQ-9 score of ≥ 10 has a sensitivity and specificity of 88.0% [95% CI (83.0-92.0%)] and 85.0% [95% CI (82.0-88.0%)] for screening MDD. Data were collected by interview; entered to EpiData version 4.2.0; exported to SPSS version 25.0 for analysis; descriptive statistics and binary logistic regression model were used; AOR with 95% CI was used to interpret the associations; and finally results were presented by texts, charts, graphs, and tables. RESULTS A total of 256 adult patients with neurolathyrism were participated; and the prevalence of MDD was found to be 38.7%. Being female [AOR = 3.00; 95% CI (1.15, 7.84)], living alone [AOR = 2.77; 95% CI (1.02-7.53)], being on neurolathyrism stage-3 [AOR = 3.22; 95% CI (1.09, 9.54)] or stage-4 [AOR = 4.00; 95% CI (1.28, 12.48)], stigma [AOR = 2.69; 95% CI (1.34, 5.39)], and lack of social/ family support [AOR = 3.61; 95% CI (1.80, 7.24)] were found to have statistically significant association with an increased odds of MDD; while regular exercise and ever formal counselling were found to have statistically significant association with a decreased odds of MDD. CONCLUSION The prevalence of MDD among neurolathyrism patients in Dawunt district was high. Lack of social support, stigma, not getting formal counselling, and not involving in regular exercise were modifiable risk factors. Therefore, social support, reducing stigma, formal counselling, and encouraging regular exercise might help to reduce the burden of MDD among neurolathyrism patients.
Collapse
Affiliation(s)
- Melaku Bimerew
- Department of Pediatric and Child Health Nursing, College of Medicine and Health Science, Injibara University, Injibara, Ethiopia.
| | - Teshome Gebremeskel
- Department of Human Anatomy, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Biruk Beletew
- Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Wondye Ayaliew
- Department of Plant Biotechnology, Woldia University, Woldia, Ethiopia
| | - Mulugeta Wodaje
- Department of Midwifery, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Manay Ayalneh
- Department of Pediatric and Child Health Nursing, College of Medicine and Health Science, Injibara University, Injibara, Ethiopia
| |
Collapse
|
29
|
Li Y, Yan X, Meng X, Yuan J. Focus on the sex-specific neural markers in the discrimination of various degrees of depression. PSYCHORADIOLOGY 2024; 4:kkae006. [PMID: 38666135 PMCID: PMC11043914 DOI: 10.1093/psyrad/kkae006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 03/22/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024]
Affiliation(s)
- Yaqin Li
- Sichuan Key Laboratory of Psychology and Behavior of Discipline Inspection and Supervision, Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610066, China
| | - Xinyu Yan
- Psychologie, Sciences de l'Education et Logopédie, Université libre de Bruxelles (ULB), Brussels 1050, Belgium
| | - Xianxin Meng
- School of Psychology, Fujian Normal University, Fuzhou 350117, China
| | - Jiajin Yuan
- Sichuan Key Laboratory of Psychology and Behavior of Discipline Inspection and Supervision, Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610066, China
| |
Collapse
|
30
|
Trivedi C, Rizvi A, Mansuri Z, Jain S. Mental health outcomes and suicidality in hospitalized transgender adolescents: A propensity score-matched Cross-sectional analysis of the National inpatient sample 2016-2018. J Psychiatr Res 2024; 172:345-350. [PMID: 38442450 DOI: 10.1016/j.jpsychires.2024.02.043] [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: 11/19/2023] [Revised: 01/17/2024] [Accepted: 02/20/2024] [Indexed: 03/07/2024]
Abstract
Transgender adolescents have unique mental health needs. This demographic has increased rates of mood disorders, anxiety, and depression compared to their cisgender peers. Large-scale studies focused on mental health outcomes, including suicidality, in the transgender adolescent population remain unknown. This study tries to fill these gaps in the literature. Data for this study was taken from the National Inpatient Sample 2016-2018. Transgender adolescents were identified using the ICD-10 codes related to transsexualism diagnoses. These individuals were compared to adolescents without transsexualism diagnoses. To mitigate imbalances in baseline characteristics, we utilized a 1:2 nearest neighbor propensity score matching with a caliper width of 0.0001, considering variables such as age, year of hospitalization, and psychiatric disorders. Following propensity score matching, the study cohort comprised 2635 transgender and 5270 non-transgender adolescents (Mean age 15.2 years). The transgender group demonstrated a notably higher prevalence of mood disorders (91%) and anxiety disorders (65%). Furthermore, the prevalence of suicidal ideation was significantly higher in the transgender group (52.4% vs. 39.2%, p < 0.001). However, there was no significant difference in the prevalence of suicide attempts between the groups. After controlling for psychiatric comorbidities, age, and gender, the odds ratio for the composite outcome of suicidal ideation or attempt was 1.99 (95% CI 1.58-2.12, p < 0.001). Our study identifies elevated mood and anxiety disorders and suicidality rates in hospitalized transgender adolescents compared to cisgender peers. Mood disorders notably amplify the risk of suicidal attempts. These findings urgently call for targeted mental health interventions and policy changes to serve this vulnerable population in healthcare settings better.
Collapse
Affiliation(s)
- Chintan Trivedi
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin, Odessa, TX, USA.
| | - Abid Rizvi
- Department of Behavioral Medicine & Psychiatry, West Virginia University, 936 Sharpe Hospital Road, Weston, WV, 26452, USA.
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Shailesh Jain
- Department of Psychiatry, Texas Tech University Health Science Center at Odessa/Permian Basin, Odessa, TX, USA.
| |
Collapse
|
31
|
Haddadi Barzoki M. School belonging and depressive symptoms: the mediating roles of social inclusion and loneliness. Nord J Psychiatry 2024; 78:205-211. [PMID: 38247289 DOI: 10.1080/08039488.2024.2304067] [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: 05/04/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Loneliness and depressive symptoms are prevalent among Finns. OBJECTIVES This study, which analyzes nationwide data from 149,986 students aged 13-18 years in Finland, focuses on the mediating effects of social inclusion and loneliness in the association between school belonging and depressive symptoms. METHOD AND RESULTS The analysis of variance showed that boys reported higher levels of school belonging and social inclusion, whereas girls reported higher levels of loneliness and depressive symptoms. Mediation analysis showed that social inclusion and loneliness partially mediated the effect of school belonging on depressive symptoms, but that social inclusion's effect was much greater than loneliness's. By focusing on the moderating role of sex, it was discovered that social inclusion significantly mediated depressive symptoms in girls more than boys. CONCLUSION The importance of social inclusion in preventing depressive symptoms was highlighted in the discussion.
Collapse
Affiliation(s)
- Meysam Haddadi Barzoki
- Department of Social Sciences and Business Studies, University of Eastern Finland | UEF, Kuopio, Finland
| |
Collapse
|
32
|
Bertuccio P, Amerio A, Grande E, La Vecchia C, Costanza A, Aguglia A, Berardelli I, Serafini G, Amore M, Pompili M, Odone A. Global trends in youth suicide from 1990 to 2020: an analysis of data from the WHO mortality database. EClinicalMedicine 2024; 70:102506. [PMID: 38440131 PMCID: PMC10911948 DOI: 10.1016/j.eclinm.2024.102506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/06/2024] [Accepted: 02/15/2024] [Indexed: 03/06/2024] Open
Abstract
Background Suicide is a serious but preventable public health concern at the global level, showing relevant geographical differences. This study aims to monitor global temporal and geographical patterns in suicide mortality in pre-adolescents, adolescents, and young adults (i.e., aged 10-24 years), from 1990 to 2020 or the most recent available year. Methods Using the World Health Organisation mortality database, we conducted an analysis on a subset of 52 countries with valid and high-quality data. We computed age-standardised suicide rates (ASR) by sex, country, and calendar year, and performed a joinpoint regression analysis to identify significant changes in the temporal suicide trends over the studied period. Findings High variability in suicide rates and trends was observed, with a male-to-female ratio of two to five. Between 1990 and 2020, most European countries reported declining suicide trends, with some exceptions. In particular, alarming trends emerged in the United Kingdom, with annual rises of 2.5% (95% CI: 1.6-3.5) since 2005 among males and 8.5% (95% CI: 4.7-12.6) since 2012 among females. The most favorable trends and lowest suicide rates were in Southern Europe, with 3.1/100,000 persons in Italy (2020) and 3.5/100,000 persons in Spain (2021) among males, and 0.9/100,000 persons in Italy (2020) and 1.1/100,000 persons in Romania (2019) among females. Conversely, the highest rates were in Central-Eastern Europe, with 10.2/100,000 males in the Russian Federation (2019) and 10.0/100,000 males in Poland (2002). Higher suicide rates and significant increases were reported in not European areas. The highest ASR was 15.5/100,000 males in the United States of America, with an annual increase of 3.8% (95% CI: 3.1-4.5) among males in 2009-2020 and 6.7% (95% CI: 5.6-7.8) among females in 2007-2017, followed by a levelling off. Interpretation Temporal and geographical comparisons of suicide mortality should be interpreted with caution due to potential misclassification or under-reporting of suicide deaths in some countries. Funding None.
Collapse
Affiliation(s)
- Paola Bertuccio
- School of Public Health, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Enrico Grande
- Integrated System for Health, Social Assistance and Welfare, National Institute of Statistics, Rome, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, Geneva University (UNIGE), Geneva, Switzerland
- Department of Psychiatry, Adult Psychiatry Service (SPA), University Hospitals of Geneva (HUG), Geneva, Switzerland
- Department of Psychiatry, Faculty of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Isabella Berardelli
- Department of Neuroscience, Mental Health and Sensory Organs, Sant’Andrea Hospital Sapienza University, Rome, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Maurizio Pompili
- Department of Neuroscience, Mental Health and Sensory Organs, Sant’Andrea Hospital Sapienza University, Rome, Italy
- International Consortium for Mood & Psychotic Disorder Research, Mailman Research Center, McLean Hospital, Belmont, MA, United States of America
| | - Anna Odone
- School of Public Health, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| |
Collapse
|
33
|
Chua KP, Volerman A, Zhang J, Hua J, Conti RM. Antidepressant Dispensing to US Adolescents and Young Adults: 2016-2022. Pediatrics 2024; 153:e2023064245. [PMID: 38404197 PMCID: PMC10904889 DOI: 10.1542/peds.2023-064245] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND Mental health worsened in adolescents and young adults after the coronavirus disease 2019 (COVID-19) outbreak in March 2020, but whether antidepressant dispensing to this population changed is unknown. METHODS We identified antidepressant prescriptions dispensed to US individuals aged 12 to 25 years from 2016 to 2022 using the IQVIA Longitudinal Prescription Database, an all-payer national database. The outcome was the monthly antidepressant dispensing rate, defined as the monthly number of individuals with ≥1 dispensed antidepressant prescription per 100 000 people. We fitted linear segmented regression models assessing for level or slope changes during March 2020 and conducted subgroup analyses by sex and age group. RESULTS Between January 2016 and December 2022, the monthly antidepressant dispensing rate increased 66.3%, from 2575.9 to 4284.8. Before March 2020, this rate increased by 17.0 per month (95% confidence interval: 15.2 to 18.8). The COVID-19 outbreak was not associated with a level change but was associated with a slope increase of 10.8 per month (95% confidence interval: 4.9 to 16.7). The monthly antidepressant dispensing rate increased 63.5% faster from March 2020 onwards compared with beforehand. In subgroup analyses, this rate increased 129.6% and 56.5% faster from March 2020 onwards compared with beforehand among females aged 12 to 17 years and 18 to 25 years, respectively. In contrast, the outbreak was associated with a level decrease among males aged 12 to 17 years and was not associated with a level or slope change among males aged 18 to 25 years. CONCLUSIONS Antidepressant dispensing to adolescents and young adults was rising before the COVID-19 outbreak and rose 63.5% faster afterward. This change was driven by increased antidepressant dispensing to females and occurred despite decreased dispensing to male adolescents.
Collapse
Affiliation(s)
- Kao-Ping Chua
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan
| | - Anna Volerman
- Departments of Medicine and Pediatrics, University of Chicago, Chicago, Illinois
| | - Jason Zhang
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Joanna Hua
- Departments of Medicine and Pediatrics, University of Chicago, Chicago, Illinois
| | - Rena M. Conti
- Department of Markets, Public Policy, and Law, Questrom School of Business, Boston University, Boston, Massachusetts
| |
Collapse
|
34
|
Singh MK, Gorelik AJ, Stave C, Gotlib IH. Genetics, epigenetics, and neurobiology of childhood-onset depression: an umbrella review. Mol Psychiatry 2024; 29:553-565. [PMID: 38102485 DOI: 10.1038/s41380-023-02347-x] [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: 05/16/2023] [Revised: 11/21/2023] [Accepted: 11/27/2023] [Indexed: 12/17/2023]
Abstract
Depression is a serious and persistent psychiatric disorder that commonly first manifests during childhood. Depression that starts in childhood is increasing in frequency, likely due both to evolutionary trends and to increased recognition of the disorder. In this umbrella review, we systematically searched the extant literature for genetic, epigenetic, and neurobiological factors that contribute to a childhood onset of depression. We searched PubMed, EMBASE, OVID/PsychInfo, and Google Scholar with the following inclusion criteria: (1) systematic review or meta-analysis from a peer-reviewed journal; (2) inclusion of a measure assessing early age of onset of depression; and (3) assessment of neurobiological, genetic, environmental, and epigenetic predictors of early onset depression. Findings from 89 systematic reviews of moderate to high quality suggest that childhood-onset depressive disorders have neurobiological, genetic, environmental, and epigenetic roots consistent with a diathesis-stress theory of depression. This review identified key putative markers that may be targeted for personalized clinical decision-making and provide important insights concerning candidate mechanisms that might underpin the early onset of depression.
Collapse
|
35
|
Gimbrone C, Packard SE, Finsaas MC, Sprague NL, Jacobowitz A, Leventhal AM, Rundle AG, Keyes KM. Sex-Specific Depressive Symptom Trajectories Among Adolescents in Los Angeles County, 2013 to 2017. JAACAP OPEN 2024; 2:55-65. [PMID: 38469457 PMCID: PMC10927262 DOI: 10.1016/j.jaacop.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Objective After remaining stable for many years, the prevalence of depression among adolescents increased over the past decade, particularly among girls. In this study, we used longitudinal data from a cohort of high school students to characterize sex-specific trajectories of depressive symptoms during this period of increasing prevalence and widening gender gap in adolescent depression. Method Using data from the Health and Happiness Cohort, a longitudinal 8-wave study of high school students residing in Los Angeles County from 2013 to 2017 (N = 3,393), we conducted a multiple-group, latent class growth analysis by sex to differentiate developmental trajectories in depressive symptoms scores measured by the Center for Epidemiological Studies- Depression (CES-D) scale (range, 0-60). Results A 4-class solution provided the best model fit for both girls and boys. Trajectories among girls included low stable (35.1%), mild stable (42.8%), moderate decreasing (16.2%), and high arching (5.9%). Trajectories among boys included low stable (49.2%), mild increasing (34.7%), moderate decreasing (12.2%), and high increasing (3.9%). Average scores consistently exceeded or crossed the threshold for probable depression (≥16). Across comparable sex-specific trajectory groups, the average CES-D scores of girls were higher than those of boys, whose average scores increased over time. Conclusion In a diverse cohort of students in Los Angeles County, depressive symptom trajectories were comparable to prior time periods but with a higher proportion of students in trajectories characterized by probable depression. Trajectories differed by sex, suggesting that future research should consider differential severity and onset of depression between boys and girls.
Collapse
Affiliation(s)
- Catherine Gimbrone
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
| | - Samuel E Packard
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
| | - Megan C Finsaas
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
| | - Nadav L Sprague
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
| | - Ahuva Jacobowitz
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
| | - Adam M Leventhal
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
| | - Andrew G Rundle
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
| | - Katherine M Keyes
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
| |
Collapse
|
36
|
García JR, Boden SA, Spaan J, Gonzalez Ayala S, Warrier AA, Allende F, Verma NN, Chahla J. Preoperative Depression Negatively Impacts Pain and Functionality Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review. Arthroscopy 2024:S0749-8063(24)00084-7. [PMID: 38320656 DOI: 10.1016/j.arthro.2024.01.030] [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: 10/16/2023] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/08/2024]
Abstract
PURPOSE To systematically investigate the influence of preoperative depression diagnosis and symptom severity on outcomes after anterior cruciate ligament reconstruction (ACLR). METHODS A literature search was performed using the PubMed, Scopus, and Embase databases according to the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Studies evaluating the impact of depression on clinical outcomes after ACLR were included. Clinical outcomes, changes in depression, and complications were aggregated. RESULTS Nine studies comprising 308,531 patients (mean age, 28.1 years; age range, 14-50 years) were included. The depression incidence ranged from 3.8% to 42%. Seven studies showed postoperative improvement in depression scores, with 5 reporting statistical significance. Assessment of depression exhibited substantial variability, with Patient-Reported Outcomes Measurement Information System (PROMIS) scores being the most common method. Patients with depression, despite showing greater improvements in scores, experienced significantly higher PROMIS Pain Interference scores preoperatively (range, 59.1-65.7 vs 56.8-59.2) and postoperatively (range, 46.3-52.3 vs 46.3-47.4) than patients without depression. They also showed significantly lower preoperative (range, 33-38.1 vs 39.7-41.5) and postoperative (range, 51.6-56.7 vs 56.7-57.6) PROMIS Physical Function scores, regardless of greater score improvement. Patients affected by depression had significantly higher rates of minimal clinically important difference achievement for the PROMIS Physical Function score (71%-100% vs 80%) and similar rates for the PROMIS Pain Interference score (71%-81% vs 68%) compared with patients without depression in 3 studies. Depression was associated with reduced adherence to rehabilitation protocols and increased postoperative complications, including infection, graft failure, arthrofibrosis, and readmission. CONCLUSIONS ACLR yields favorable outcomes for patients with and without preoperative depression. Individuals with preoperative depression may report inferior outcomes in terms of pain and functionality; nevertheless, despite these challenges, they exhibit significant improvements across all outcome measures after surgery, including reductions in depression levels. LEVEL OF EVIDENCE Level IV, systematic review of Level II to IV studies.
Collapse
Affiliation(s)
- José Rafael García
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Stephanie A Boden
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | | | | | | | - Felicitas Allende
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Nikhil N Verma
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Jorge Chahla
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A..
| |
Collapse
|
37
|
Mortazavi R, Grudin R, Jarbin H, Larsson I. Empowered and engaged: Group exercise for adolescent depression - perspectives from adolescents, parents and healthcare professionals. SAGE Open Med 2024; 12:20503121231225340. [PMID: 38313468 PMCID: PMC10838026 DOI: 10.1177/20503121231225340] [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: 10/14/2023] [Accepted: 12/19/2023] [Indexed: 02/06/2024] Open
Abstract
Objectives Depression is increasing and is a leading cause of disease burden among adolescents. Available evidence-based treatments with medication or psychotherapy have modest effects. Aerobic exercise is a hopeful alternative as an augmenter or a stand-alone treatment. Qualitative studies have shown that participants in group exercise for adolescent depression experienced improved mood and a sense of achievement, commitment and empowerment. This study aimed to explore not only adolescents' but also parents' and healthcare professionals' experiences of a group exercise intervention for adolescents with depression. Methods Nine adolescents who had participated in a group aerobic exercise intervention for 12 weeks, eight parents and two healthcare professionals were interviewed. We used a latent qualitative content analysis with an inductive approach that resulted in nine sub-categories, three categories and an overarching theme. Results The experiences of a group exercise intervention for adolescents with depression were expressed in the overarching theme 'Group exercise for adolescent depression promotes empowerment and engagement in everyday life', based on three categories: exercise alleviates depressive symptoms, exercise contributes to balance in life and exercise promotes self-esteem. However, there was variation in our results, in that not all participants experienced improvements from exercising. Adolescents described more varied experiences, while parents and healthcare professionals mainly expressed positive views. Conclusions Our findings suggest that group exercise for adolescent depression promotes empowerment and engagement in everyday life, according to adolescents, and more clearly so according to parents and healthcare professionals.
Collapse
Affiliation(s)
- Rebecca Mortazavi
- Faculty of Medicine, Department of Clinical Sciences, Child and Adolescent Psychiatry, Lund University, Lund, Sweden
- Child and Adolescent Psychiatric Clinic, Region Halland, Halmstad, Sweden
| | - Rebecca Grudin
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Håkan Jarbin
- Faculty of Medicine, Department of Clinical Sciences, Child and Adolescent Psychiatry, Lund University, Lund, Sweden
- Child and Adolescent Psychiatric Clinic, Region Halland, Halmstad, Sweden
| | - Ingrid Larsson
- Department of Health and Nursing, School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Spenshult Research and Development Centre, Halmstad, Sweden
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden
| |
Collapse
|
38
|
Mennis J, Mason MJ, Coatsworth JD, Russell M, Zaharakis NM. Young Adult Depression and Cannabis Use: Associations Before and After Recreational Legalization. Am J Prev Med 2024; 66:333-341. [PMID: 37778528 DOI: 10.1016/j.amepre.2023.09.023] [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: 05/12/2023] [Revised: 09/25/2023] [Accepted: 09/25/2023] [Indexed: 10/03/2023]
Abstract
INTRODUCTION The co-occurrence of depression with cannabis use worsens both mood and substance use disorder outcomes, with young adults particularly at risk of co-occurrence. This research investigates whether the association of state-level prevalence rates of young adult (age 18-25) depression and cannabis use in the U.S. changed following enactment of recreational (adult use) cannabis legalization between 2008 and 2019. METHODS Annual, state prevalence data on past-year major depressive episode (hereafter, depression) and past-month cannabis use were extracted from the National Survey on Drug Use and Health (N=600 state-year observations). Moderated regression models tested whether the association of depression with cannabis use differed before versus after recreational legalization by comparing prevalence rates of depression and cannabis use in states that enacted recreational legalization to those that did not, while fixing state, year, and medical legalization effects. Data were accessed and analyzed in 2023. RESULTS Prevalence rates of both depression and cannabis use increased throughout the study period. The positive statistical effect of depression on cannabis use more than doubled in magnitude after legalization (β=0.564, 95% CI=0.291, 0.838) as compared to before (β=0.229, 95% CI=0.049, 0.409), representing a significant change (β=0.335, 95% CI=0.093, 0.577). CONCLUSIONS These results suggest that the association between prevalence rates of young adult depression and cannabis use strengthened following recreational legalization in the U.S. This is potentially due to increases in cannabis accessibility and the acceptance of the health benefits of cannabis, which may enhance the use of cannabis as a coping mechanism among young adults with depression.
Collapse
Affiliation(s)
- Jeremy Mennis
- Department of Geography and Urban Studies, Temple University, Philadelphia, Pennsylvania.
| | - Michael J Mason
- Center for Behavioral Health Research, University of Tennessee, Knoxville, Tennessee
| | - J Douglas Coatsworth
- Center for Behavioral Health Research, University of Tennessee, Knoxville, Tennessee
| | - Michael Russell
- Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania
| | - Nikola M Zaharakis
- Center for Behavioral Health Research, University of Tennessee, Knoxville, Tennessee
| |
Collapse
|
39
|
Ren H, Wang X, Zhang Z, Zhong X, Luo Q, Qiu H, Huang Y. Electroconvulsive therapy for adolescents with severe depressive episode and suicidality: retrospective comparison between responders and non-responders. Child Adolesc Psychiatry Ment Health 2024; 18:13. [PMID: 38245725 PMCID: PMC10800036 DOI: 10.1186/s13034-023-00701-z] [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: 08/24/2023] [Accepted: 12/29/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND For adolescents with major depression who exhibit suicidal tendencies, Electroconvulsive Therapy (ECT) is increasingly adopted in clinical practice. Yet, the precise mechanisms behind its effectiveness remain elusive, and studies on factors that influence treatment outcomes are scarce. METHODS In this retrospective comparative study, we included all adolescent severe depressive episode patients with suicidal tendencies admitted to the Psychiatry Department of the First Affiliated Hospital of Chongqing Medical University between 2017 and 2021 and received ECT treatment. By collecting data on personal history, medical history, and standard treatment features, we established demographic, disease, medication, and ECT treatment factors variables. Patients were divided into effective and ineffective groups based on the Clinical Global Impressions-Improvement (CGI-I) scale scores, and differences between outcomes were compared. Logistic regression analyses were used to identify factors independently associated with ineffectiveness. RESULTS A total of 494 adolescent severe depressive episode patients with suicidal behavior who received ECT were included in this study. According to CGI-I scores, the treatment was effective in 361 patients (73.1%) and ineffective in 133 patients (26.9%). Logistic regression analyses showed that 8 to 12 and 12 to 16 ECT sessions reduced the risk of ineffectiveness compared to fewer than 4 sessions. The risk of ineffectiveness decreased with age and increased with comorbidity with obsessive-compulsive disorder (OCD). Compared to sertraline, escitalopram was associated with a heightened risk of futility, whereas olanzapine and aripiprazole demonstrated a reduced risk when contrasted with quetiapine. CONCLUSIONS ECT's ineffectiveness in treating adolescent severe depressive episode with suicidal behavior decreases with age, and comorbidity with OCD significantly increases the risk of treatment failure. Fewer than 8 ECT sessions may hinder achieving satisfactory results.
Collapse
Affiliation(s)
- Hao Ren
- The First Affiliated Hospital of Chongqing Medical University, ChongQing, China
- Chongqing Changshou District, Mental Health Center, ChongQing, China
| | - Xinglian Wang
- The First Affiliated Hospital of Chongqing Medical University, ChongQing, China
| | - Zheng Zhang
- The First Affiliated Hospital of Chongqing Medical University, ChongQing, China
| | - Xiufen Zhong
- The First Affiliated Hospital of Chongqing Medical University, ChongQing, China
- Chongqing Mental Health Center, ChongQing, China
| | - Qinghua Luo
- The First Affiliated Hospital of Chongqing Medical University, ChongQing, China
| | - Haitang Qiu
- The First Affiliated Hospital of Chongqing Medical University, ChongQing, China.
| | - Yan Huang
- Chongqing Tradit Chinese Medicine Hospital, ChongQing, China.
| |
Collapse
|
40
|
Zhang X, Wang X, Hu H, Xu Y, Zhang J, Wang Z, Wei R, Li Q. Prevalence of self-reported thyroid disease among adults with depression. J Psychosom Res 2024; 176:111557. [PMID: 38056108 DOI: 10.1016/j.jpsychores.2023.111557] [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: 03/22/2023] [Revised: 10/29/2023] [Accepted: 11/25/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Thyroid disorders are a common comorbidity in patients with depression, yet there is limited information available about the clinical epidemiology of thyroid diseases in this specific population. This study aims to describe the prevalence of thyroid disease among US adults with depression from 2007 to 2018. METHODS This cross-sectional study used nationally representative data collected through the National Health and Nutrition Examination Survey (NHANES) between January 1, 2007, to December 31, 2018. Age-standardized prevalence of thyroid disease among depressed patients was calculated within 4-year survey periods (2007-2010, 2011-2014, and 2015-2018), and adjusted to the 2000 U.S. standard population. RESULTS In our weighed sample, 6.1% of depressed individuals and 4.3% of non-depressed individuals reported thyroid disease between 2007 and 2018 (P < 0.0001). The age-standardized prevalence of thyroid disease in patients with depression increased over time, from 5.4% (95%CI, 4.6%-6.2%) in 2007-2010 to 6.8% (95%CI, 5.8%-8.0%) in 2015-2018 (P for trend = 0.0270). Furthermore, thyroid disease prevalence was highest in non-Hispanic white individuals, increased with age, and tended to be higher in women. Mean depression scores in patients with thyroid disease (9.1; 95%CI, 8.7-9.5) did not significantly different from those without thyroid disease (9.1; 95%CI, 9.0-9.3) (P = 0.96). CONCLUSION The age-standardized prevalence of thyroid disease among US adults with depression exhibited a consistent increase from 2007 to 2018, with the highest rate occurring in older, non-Hispanic white individuals, and women.
Collapse
Affiliation(s)
- Xuexue Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China; China Academy of Chinese Medical Sciences, Beijing, China
| | - Xujie Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China; China Academy of Chinese Medical Sciences, Beijing, China
| | - Huanrong Hu
- Jiangxi Provincial People's Hospital, the First Affiliated Hospital of Nanchang Medical College, Jiangxi, China; The First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Yuying Xu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiwei Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zongxue Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Rui Wei
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qiuyan Li
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
| |
Collapse
|
41
|
Pattison KL, Lehman E, Molinari A, Costigan H, Pileggi F, Stuckey H, Sekhar DL. Evaluating the Impact of Aevidum on Mental Health Knowledge, Attitudes, and Help-Seeking Behaviors in High School Students: A Mixed-Methods Study. Am J Health Promot 2024; 38:53-67. [PMID: 37776315 PMCID: PMC10748452 DOI: 10.1177/08901171231204473] [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] [Indexed: 10/02/2023]
Abstract
PURPOSE To compare Aevidum's school mental health curriculum vs the curriculum plus Aevidum clubs in a mixed-methods study including pre/post surveys, a randomized clinical trial, and qualitative interviews. DESIGN Concurrent mixed-methods: Aim 1) pre-post surveys evaluated curriculum only vs curriculum plus club schools separately regarding changes in knowledge, help-seeking, and school culture; Aim 2) randomized clinical trial compared curriculum only to curriculum plus club schools; Aim 3) qualitative school staff interviews enhanced understanding of school culture changes. SETTING Curriculum delivered to 9th graders at ten Pennsylvania high schools; 5 schools randomized to start clubs. SUBJECTS Students (surveys), staff (interviews). INTERVENTION Aevidum curriculum plus/minus club. MEASURES Aim 1, mixed effects linear and logistic regression models for longitudinal data were used to analyze survey items at each time point. Aim 2, the same regression models were used, except models included a fixed-effect for group and group by time interaction effect. Aim 3, interviews were transcribed; a codebook was developed followed by thematic analysis. RESULTS Pre-survey 2557 respondents; 49% female, 86% non-Hispanic white. Post-survey 737 (29% response rate). Aim 1, pre-post (Likert responses, larger numbers favorable) demonstrated increased student knowledge to identify depression (4.26 [4.19-4.33] to 4.59 [4.47-4.71], P < .001) and help a friend access support (4.30 [4.21-4.38] to 4.56 [4.40-4.71], P = .001). Help-seeking increased for phone helplines (1.61 [1.57-1.66] to 1.78 [1.70-1.86], P < .001), crisis textlines (1.60 [1.55-1.64] to 1.78 [1.70-1.86], P < .001), internet/websites (1.80 [1.75-1.85] to 1.99 [1.90-2.08], P < .001), school counselors (P = .005) and teachers (.013). Aim 2, no significant differences in knowledge, help-seeking or culture between curriculum only vs curriculum plus club schools. Aim 3, staff (n = 17) interviews supported reduced stigma and increased mental health referrals. CONCLUSIONS Aevidum's curriculum improved mental health knowledge and help-seeking; adding the club did not significantly change responses. Staff identified positive school culture impacts. Limitations include the lower post-survey response.
Collapse
Affiliation(s)
- Krista L. Pattison
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA
| | - Erik Lehman
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Alissa Molinari
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA
| | - Heather Costigan
- Qualitative and Mixed Methods Core, Penn State College of Medicine, Hershey, PA, USA
| | | | - Heather Stuckey
- Qualitative and Mixed Methods Core, Penn State College of Medicine, Hershey, PA, USA
| | - Deepa L. Sekhar
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA
| |
Collapse
|
42
|
Goodman LC, Elmore JS, Mayes TL, Minhajuddin A, Slater H, Blader JC, Liberzon I, Baronia RB, Bivins EJ, LaGrone JM, Jackson S, Martin SL, Brown R, Soares JC, Wakefield SM, Trivedi MH. Linking trauma to mental health in the statewide Texas Youth Depression and Suicide Research Network (TX-YDSRN). Psychiatry Res 2024; 331:115620. [PMID: 38091894 DOI: 10.1016/j.psychres.2023.115620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 11/10/2023] [Accepted: 11/18/2023] [Indexed: 01/02/2024]
Abstract
Rates of youth depression and suicide are rising worldwide and represent public health crises. The present study examined the relationship between trauma history and symptoms of depression, suicidal ideation, and anxiety among suicidal and depressed youth. A diverse group of 1000 8-20-year-olds enrolled in the statewide Texas Youth Depression and Suicide Research Network (TX-YDSRN) reported their trauma history (Traumatic Events Screening Inventory for Children) and symptoms of depression (Patient Health Questionnaire for adolescents; PHQ-A), anxiety (Generalized Anxiety Disorder scale; GAD-7), and suicidality (Concise Health Risk Tracking scale; CHRT-SR). Nearly half of the sample reported exposure to multiple categories of traumatic experiences. Number of trauma exposure categories significantly predicted PHQ-A and GAD-7 scores. Exposure to interpersonal trauma and to sexual trauma were significantly associated with PHQ-A, GAD-7, and CHRT-SR scores. The number of trauma exposure categories was associated with increased levels of anxiety and depression; however, only exposure to interpersonal or sexual trauma was associated with more suicidality. Clinicians should assess trauma exposure in patients seeking psychiatric care, especially for interpersonal and sexual trauma, which may be predictive of increased risk for suicidality in depressed youth. Future work should disentangle the effects of specific trauma types from multiple trauma exposure.
Collapse
Affiliation(s)
- Lynnel C Goodman
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and the Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Joshua S Elmore
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and the Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Taryn L Mayes
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and the Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Abu Minhajuddin
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and the Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA; Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Holli Slater
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and the Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Joseph C Blader
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Israel Liberzon
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, Bryan, TX, USA
| | - Regina B Baronia
- Department of Psychiatry, Texas Tech University Health Science Center, Lubbock, TX, USA
| | - Emily J Bivins
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | | | - Sierra Jackson
- Office of Clinical Research, JPS Health Network, Fort Worth, TX, USA
| | - Sarah L Martin
- Department of Psychiatry, Texas Tech University Health Science Center El Paso, El Paso, USA
| | - Ryan Brown
- Department of Psychiatry & Behavioral Sciences, University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, UT Health Center of Excellence on Mood Disorders, UT Houston Medical School, Houston, TX, USA
| | - Sarah M Wakefield
- Department of Psychiatry, Texas Tech University Health Science Center, Lubbock, TX, USA
| | - Madhukar H Trivedi
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and the Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA.
| |
Collapse
|
43
|
Weigle PE, Shafi RMA. Social Media and Youth Mental Health. Curr Psychiatry Rep 2024; 26:1-8. [PMID: 38103128 DOI: 10.1007/s11920-023-01478-w] [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] [Accepted: 12/02/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE OF REVIEW We review recent evidence regarding the relationship between the social media (SM) habits, experiences, and the mental health of youth. We examine effects of social media use (SMU) on specific diagnoses including depression and anxiety. The relationship between psychiatric illness, specific SM experiences, and the issue of SM mental health contagion is also explored. RECENT FINDINGS Youth engagement in SMU has increased dramatically in recent years, concurrent with increases in prevalence of depression and anxiety. The relationship between SMU and mental illness is complex and depends on characteristics of the user (e.g., social comparison and fear of missing out (FOMO) and their SM habits and experiences (e.g., cyberbullying, and sexting,). SM engagement has distinct impacts on anxiety, depression, and suicidality. Growing evidence documents how SM may be a medium for psychiatric contagion. Research findings are largely correlational and dependent on subjective report, limiting their interpretation. The mental health of youth is increasingly tied to their SMU, depending greatly on how youth engage with SM and resultant feedback. Future research must look to establish causality in relationships between SM and mental illness.
Collapse
Affiliation(s)
- Paul E Weigle
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, 06032, USA.
- Quinnipiac University School of Medicine, North Haven, USA.
- Hartford Healthcare, 189 Storrs Road, Mansfield Center, CT, 06250, USA.
| | - Reem M A Shafi
- Department of Psychiatry and Psychology and Mayo Clinic, Rochester, MN, USA
- Cairns and Hinterland Hospital and Health Service, Cairns, QLD, Australia
| |
Collapse
|
44
|
Lien L, Bonsaksen T, Holte Stea T, Kleppang AL, Steigen AM, Leonhardt M. Time trends in self-reported depressive symptoms, prescription of antidepressants, sedatives and hypnotics and the emergence of social media among Norwegian adolescents. PLoS One 2023; 18:e0295384. [PMID: 38150420 PMCID: PMC10752533 DOI: 10.1371/journal.pone.0295384] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 11/20/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND Research has shown increased mental health problems and use of prescription drugs among adolescents in recent years and social media use has been linked to poorer mental health. However, trend studies concerning these topics are scarce. The purpose of this study was to analyze gender-specific trends in a) symptoms of depression and loneliness, and b) prescription of antidepressants, hypnotics and sedatives, in relation to the emergence of social media among adolescents in Norway. METHODS This is an ecological study using data from the 'Young in Oslo' surveys from 1996 to 2021. The surveys included approximately 110 000 students, 14-17 years of age, and yielded a response rate varying from 95% in 1996 to 64% in 2021. A self-report questionnaire was used to collect information on symptoms of depression and loneliness. Information on antidepressant and sleep medication prescription was retrieved from the Norwegian Prescription Database for the age group 15 to 19 years. A graphical approach and logistic regression models were used to examine gender-specific time-trends between 1996 to 2021. RESULTS We found a doubling in self-reported symptoms of depression and loneliness among girls between 1996 and 2021, with the steepest increase in the period from 2006 to 2012, when Facebook and other social media were introduced. A similar trend was observed in the prescription of antidepressants among girls, with the steepest increase between 2011 and 2013. Among both boys and girls, 'worried too much about things' and 'had sleep problems' were the two symptoms with the greatest changes. CONCLUSION A significant upward trend in self-reported depressive symptoms and medication use was observed over the past 25 years, with variations in the rate of increase, including a steeper trajectory during certain periods immediately after the introduction of social media platforms in Norway.
Collapse
Affiliation(s)
- Lars Lien
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
| | - Tore Bonsaksen
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
- Department of Health, Faculty of Health Studies, VID Specialized University, Stavanger, Norway
| | - Tonje Holte Stea
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Annette Løvheim Kleppang
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Anne Mari Steigen
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Marja Leonhardt
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
| |
Collapse
|
45
|
Zhang J, Liu D, Ding L, Du G. Prevalence of depression in junior and senior adolescents. Front Psychiatry 2023; 14:1182024. [PMID: 38152357 PMCID: PMC10752610 DOI: 10.3389/fpsyt.2023.1182024] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 11/23/2023] [Indexed: 12/29/2023] Open
Abstract
Background Depression affects the development of adolescents and makes it difficult for them to adapt to future life. The purpose of this study was to elucidate the population characteristics of adolescent depression. Methods This study measured depression based on the Patient Health Questionnaire-9 items and sociodemographic questionnaire. A total of 8,235 valid questionnaires were collected from six schools in Haikou and Qionghai, Hainan Province, covering the ages of 13 to 18. The questionnaires included high schools with multiple levels, including general high schools, key high schools, and vocational high schools. Latent category analysis (LCA) was used to identify potential categories of depressive symptoms among adolescents. Latent Class Analysis (LCA) was used for determining depressive symptom latent categories and their proportional distribution among adolescents. Results LCA analysis divided the data into 3 categories, namely no depression, low depression, and high depression groups. The percentage of the high depression group was 10.1%, and that of the low depression group was 48.4%. The Jorden index was greatest for a PHQ-9 score of 14.5. The 1st grade of junior middle school students entered the high and low depression groups 1.72 and 1.33 times more often than seniors. The number of the 1st grade of high school students included in the high and low depression groups was 1.55 and 1.42 times of the 3rd grade of high school students group. The detection rate of the high depression group of vocational school adolescents was 13.5%, which was significantly higher than that of key high schools (9.6%) and general high schools (9.0%). Conclusion This study found that 1st grade of junior middle school students and the 1st grade of high school students were more likely to fall into depressive conditions. Moreover, Adolescent girls require more attention than boys. Vocational school students need more psychological guidance.
Collapse
Affiliation(s)
- Jing Zhang
- Hainan Provincial Anning Hospital, Haikou, China
| | - Dehuan Liu
- Hainan Provincial Bureau of Human Resources Development, Haikou, China
| | - Linwei Ding
- Institute of Gut Microecology and Health, Hainan Medical University, Haikou, China
- Department of Biochemistry and Molecular Biology, Hainan Medical University, Haikou, China
| | - Guankui Du
- Institute of Gut Microecology and Health, Hainan Medical University, Haikou, China
- Department of Biochemistry and Molecular Biology, Hainan Medical University, Haikou, China
- Biotechnology Laboratory, Hainan Medical University, Haikou, China
- Department of Breast Surgery, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| |
Collapse
|
46
|
Hankin BL, Griffith JM. What Do We Know About Depression Among Youth and How Can We Make Progress Toward Improved Understanding and Reducing Distress? A New Hope. Clin Child Fam Psychol Rev 2023; 26:919-942. [PMID: 37285011 PMCID: PMC10245370 DOI: 10.1007/s10567-023-00437-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2023] [Indexed: 06/08/2023]
Abstract
This paper summarizes many findings about depression among children and adolescents. Depression is prevalent, highly distressing, and exerts considerable burden worldwide. Rates surge from childhood through young adulthood and have increased over the last decade. Many risk factors have been identified, and evidence-based interventions exist targeting mostly individual-level changes via psychological or pharmacological means. At the same time, the field appears stuck and has not achieved considerable progress in advancing scientific understanding of depression's features or delivering interventions to meet the challenge of youth depression's high and growing prevalence. This paper adopts several positions to address these challenges and move the field forward. First, we emphasize reinvigoration of construct validation approaches that may better characterize youth depression's phenomenological features and inform more valid and reliable assessments that can enhance scientific understanding and improve interventions for youth depression. To this end, history and philosophical principles affecting depression's conceptualization and measurement are considered. Second, we suggest expanding the range and targets of treatments and prevention efforts beyond current practice guidelines for evidence-based interventions. This broader suite of interventions includes structural- and system-level change focused at community and societal levels (e.g., evidence-based economic anti-poverty interventions) and personalized interventions with sufficient evidence base. We propose that by focusing on the FORCE (Fundamentals, Openness, Relationships, Constructs, Evidence), youth depression research can provide new hope.
Collapse
Affiliation(s)
- Benjamin L Hankin
- Department of Psychology, University of Illinois Urbana Champaign, 603 E. Daniel Street, Champaign, IL, 61820, USA.
| | - Julianne M Griffith
- Department of Psychology, University of Illinois Urbana Champaign, 603 E. Daniel Street, Champaign, IL, 61820, USA
| |
Collapse
|
47
|
Wiglesworth A, Butts J, Carosella KA, Mirza S, Papke V, Bendezú JJ, Klimes-Dougan B, Cullen KR. Stress system concordance as a predictor of longitudinal patterns of resilience in adolescence. Dev Psychopathol 2023; 35:2384-2401. [PMID: 37434505 PMCID: PMC10784418 DOI: 10.1017/s0954579423000731] [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] [Indexed: 07/13/2023]
Abstract
Resilience promotes positive adaptation to challenges and may facilitate recovery for adolescents experiencing psychopathology. This work examined concordance across the experience, expression, and physiological response to stress as a protective factor that may predict longitudinal patterns of psychopathology and well-being that mark resilience. Adolescents aged 14-17 at recruitment (oversampled for histories of non-suicidal self-injury; NSSI) were part of a three-wave (T1, T2, T3) longitudinal study. Multi-trajectory modeling produced four distinct profiles of stress experience, expression, and physiology at T1 (High-High-High, Low-Low-Low, High-Low-Moderate, and High-High-Low, respectively). Linear mixed-effect regressions modeled whether the profiles predicted depressive symptoms, suicide ideation, NSSI engagement, positive affect, satisfaction with life, and self-worth over time. Broadly, concordant stress response profiles (Low-Low-Low, High-High-High) were associated with resilient-like patterns of psychopathology and well-being over time. Adolescents with a concordant High-High-High stress response profile showed a trend of greater reduction in depressive symptoms (B = 0.71, p = 0.052), as well as increased global self-worth (B = -0.88, p = 0.055), from T2 to T3 compared to the discordant High-High-Low profile. Concordance across multi-level stress responses may be protective and promote future resilience, whereas blunted physiological responses in the presence of high perceived and expressed stress may indicate poorer outcomes over time.
Collapse
Affiliation(s)
| | - Jessica Butts
- Public Health, Division of Biostatistics, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | | | - Salahudeen Mirza
- Psychology, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Victoria Papke
- Psychology, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | | | | | - Kathryn R Cullen
- Psychiatry and Behavioral Sciences, University of Minnesota Twin Cities, Minneapolis, MN, USA
| |
Collapse
|
48
|
Goodwin J, Savage E, O’Brien N, O’Donovan Á. "We're not educated on that enough, and we really should be": adolescents' views of mental health service education. Int J Qual Stud Health Well-being 2023; 18:2249287. [PMID: 37639463 PMCID: PMC10464535 DOI: 10.1080/17482631.2023.2249287] [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: 05/22/2023] [Accepted: 08/14/2023] [Indexed: 08/31/2023] Open
Abstract
PURPOSE Despite the susceptibility to the experience of mental distress during adolescence, this population often demonstrate poor help-seeking behaviours. Efforts have been made by schools to address adolescents' knowledge around mental health; less focus has been given to addressing their knowledge of mental health services and avenues for help-seeking. This study aimed to explore adolescents' views of mental health services education. METHODS An interpretive descriptive design was adopted. Thirty adolescents from Ireland participated in individual interviews. Data were analysed using content analysis. TWO THEMES WERE IDENTIFIED Recognizing Gaps in Knowledge about Mental Health Service Education, and Enhancing Mental Health Service Education for Young People. Participants reported gaps in their knowledge about mental health services and were uncertain how to access help. Current strategies (e.g., print media) were considered tokenistic and ineffective; instead, multimedia (film/TV) approaches were recommended. RESULTS Two themes were identified: Recognizing Gaps in Knowledge about Mental HealthService Education, and Enhancing Mental Health Service Education for YoungPeople. Participants reported gaps in their knowledge about mental healthservices and were uncertain how to access help. Current strategies (e.g., print media) were considered tokenistic and ineffective; instead, multimedia (film/TV) approaches were recommended. CONCLUSIONS Current mental health education programmes need to expand their focus beyond social/emotional well-being, providing adolescents with the knowledge they need to access appropriate supports. Considering traditional print media was viewed as ineffective, while film/TV had an influence on perceptions of mental health services, a multimedia approach to education may be an effective way of engaging this population.
Collapse
Affiliation(s)
- John Goodwin
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Eileen Savage
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Niamh O’Brien
- Department of Education, South East Technological University, Waterford, Ireland
| | - Áine O’Donovan
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| |
Collapse
|
49
|
Husky MM, Léon C, du Roscoät E, Vasiliadis HM. Prevalence of past-year major depressive episode among young adults between 2005 and 2021: Results from four national representative surveys in France. J Affect Disord 2023; 342:192-200. [PMID: 37730150 DOI: 10.1016/j.jad.2023.09.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 09/04/2023] [Accepted: 09/17/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND The objectives are to examine time trends in the prevalence of past year major depressive episode (MDE) among young adults, and to identify differences by occupational status comparing students, those employed, and those who are not in employment, education or training (NEET). METHODS Data were drawn from the Health Barometer survey, a cross-sectional computer-assisted telephone interview survey on a national representative sample of residents of metropolitan France and conducted approximately every 5 years. The surveys relied on the Composite International Diagnostic Interview-Short Form to determine the presence of DSM-IV past-year major depressive episode. Data from the 2005, 2010, 2017, and 2021 surveys were pooled and respondents aged 18 to 25 were selected (n = 7556) and categorized based on their occupational status: students, those employed, and NEET. RESULTS Overall, significant differences in the prevalence of MDE was observed by occupational status: NEET had the highest rate (18.5 %) followed by students (14.3 %) and those employed (11.0 %). The prevalence of MDE among young adults was 10.1 % in 2005, 9.7 % in 2010 and 11.3 % in 2017, reflecting a stable prevalence between 2005 and 2017. The prevalence then nearly doubled in 2021, with 20.9 % of MDE, with a significant increase of 9.6 points between 2017 and 2021. LIMITATIONS No assessment of lifetime psychopathology. CONCLUSIONS The prevalence of major depression among young adults significantly increased between 2005 and 2021, those at greatest risk are females and those not in employment, education or training. The contribution of pandemic-related factors may be elucidated in future national health surveys.
Collapse
Affiliation(s)
- Mathilde M Husky
- Bordeaux Population Health Research Center, ACTIVE Team, INSERM U1219, Université de Bordeaux, Bordeaux, France.
| | | | - Enguerrand du Roscoät
- Santé publique France, Saint-Maurice, France; Laboratoire Parisien de Psychologie Sociale (LAPPS), EA 4386, Université Paris Nanterre, France
| | - Helen-Maria Vasiliadis
- Département des sciences de la santé communautaire, Université de Sherbrooke, Canada; Centre de recherche Charles-Le Moyne, Campus de Longueuil Université de Sherbrooke, Canada
| |
Collapse
|
50
|
Flores MW, Sharp A, Carson NJ, Cook BL. Estimates of Major Depressive Disorder and Treatment Among Adolescents by Race and Ethnicity. JAMA Pediatr 2023; 177:1215-1223. [PMID: 37812424 PMCID: PMC10562990 DOI: 10.1001/jamapediatrics.2023.3996] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/08/2023] [Indexed: 10/10/2023]
Abstract
Importance The COVID-19 pandemic has contributed to poorer mental health and a greater need for treatment. Nationally representative estimates of major depressive disorder (MDD) and mental health treatment among US adolescents during the pandemic are needed. Objective To estimate MDD prevalence among adolescents, evaluate mental health treatment use among adolescents with MDD, and assess differences by race and ethnicity. Design, Setting, and Participants This cross-sectional analysis of the nationally representative 2021 National Survey on Drug Use and Health included noninstitutionalized US adolescents between the ages of 12 and 17 years (n = 10 743). Analytic weights were applied to all rates and model estimates to be nationally representative and account for sample design and survey nonresponse. Data were collected from January 14 to December 20, 2021, and analyzed from February 11 to April 3, 2023. Exposures Self-reported race and ethnicity. Main Outcomes and Measures Dichotomous outcomes of MDD as defined by the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition), MDD-specific mental health treatment, any type of mental health treatment, telehealth visits, and delays in mental health treatment. Results The sample included 10 743 adolescents (51.1% male). Self-reported race and ethnicity included 5.1% Asian, 14.1% Black, 23.3% Latinx, 51.2% White, and 6.3% more than 1 race. Ages were evenly distributed: 34.0% aged 12 to 13 years; 33.3% aged 14 to 15 years; and 32.7% aged 16 to 17 years. Adolescents of more than 1 race or ethnicity had the highest MDD rate (26.5%). Compared with White adolescents, the lowest rates of any MDD treatment overall were found among Latinx adolescents (29.2% [95% CI, 22.2%-36.2%]) and those of more than 1 race or ethnicity (21.1% [95% CI, 11.6%-30.7%]). Similar results were found for treatment by any clinician (Latinx, 25.6% [95% CI, 18.8%-32.4%]; >1 race or ethnicity, 19.1% [95% CI, 9.7%-28.6%]), treatment by a mental health specialist (Latinx, 22.9% [95% CI, 16.9%-28.9%]; >1 race or ethnicity, 16.7% [95% CI, 7.1%-26.3%]), treatment by a nonspecialist clinician (Latinx, 7.3% [95% CI, 3.3%-11.3%]; >1 race or ethnicity, 4.8% [95% CI, 1.9%-7.7%]), and use of any psychotropic medication prescription (Latinx, 11.6% [95% CI, 7.3%-15.9%]; >1 race or ethnicity, 8.3% [95% CI, 2.8%-13.7]). Compared with White adolescents, Black adolescents had lower rates of MDD treatment by any clinician (31.7% [95% CI, 23.7%-39.8%]) and by nonspecialist clinicians (8.4% [95% CI, 3.8%-13.2%]) and experienced lower prescription rates for any psychotropic medication (12.6 [95% CI, 4.6%-20.6%]). Asian (16.0% [95% CI, 5.0%-27.2%]) and Latinx (17.8% [95% CI, 12.6%-23.0%]) adolescents had lower rates of virtual mental health treatment compared with White adolescents. Black (19.1% [95% CI, 14.1%-24.2%]) and Latinx (17.9% [95% CI, 15.0%-21.1%]) adolescents had lower rates of appointments transition to telehealth, while Black adolescents (14.1% [95% CI, 10.7%-17.4%]) experienced delays getting their prescriptions. Conclusions and Relevance During the first full calendar year of the pandemic, approximately 1 in 5 adolescents had MDD, and less than half of adolescents who needed treatment had any mental health treatment. Adolescents in racial and ethnic minority groups, particularly Latinx, experienced the lowest treatment rates. Federal policy should target adolescents as a whole, and minority populations in particular, to ensure equitable treatment access. Efforts should consider the social, racial, ethnic, and cultural determinants of health.
Collapse
Affiliation(s)
- Michael William Flores
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Amanda Sharp
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, Massachusetts
| | - Nicholas J. Carson
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Benjamin L. Cook
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|