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McGorry PD, Mei C, Dalal N, Alvarez-Jimenez M, Blakemore SJ, Browne V, Dooley B, Hickie IB, Jones PB, McDaid D, Mihalopoulos C, Wood SJ, El Azzouzi FA, Fazio J, Gow E, Hanjabam S, Hayes A, Morris A, Pang E, Paramasivam K, Quagliato Nogueira I, Tan J, Adelsheim S, Broome MR, Cannon M, Chanen AM, Chen EYH, Danese A, Davis M, Ford T, Gonsalves PP, Hamilton MP, Henderson J, John A, Kay-Lambkin F, Le LKD, Kieling C, Mac Dhonnagáin N, Malla A, Nieman DH, Rickwood D, Robinson J, Shah JL, Singh S, Soosay I, Tee K, Twenge J, Valmaggia L, van Amelsvoort T, Verma S, Wilson J, Yung A, Iyer SN, Killackey E. The Lancet Psychiatry Commission on youth mental health. Lancet Psychiatry 2024; 11:731-774. [PMID: 39147461 DOI: 10.1016/s2215-0366(24)00163-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 05/01/2024] [Accepted: 05/08/2024] [Indexed: 08/17/2024]
Affiliation(s)
- Patrick D McGorry
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia.
| | - Cristina Mei
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Mario Alvarez-Jimenez
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Vivienne Browne
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Barbara Dooley
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Cathrine Mihalopoulos
- Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Stephen J Wood
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia; School of Psychology, University of Birmingham, Birmingham, UK
| | | | | | - Ella Gow
- Orygen, Melbourne, VIC, Australia; Melbourne, VIC, Australia
| | | | | | | | - Elina Pang
- Hong Kong Special Administrative Region, China
| | | | | | | | - Steven Adelsheim
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Matthew R Broome
- Institute for Mental Health, University of Birmingham, Birmingham, UK; Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Mary Cannon
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Andrew M Chanen
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Eric Y H Chen
- Institute of Mental Health, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; LKS School of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Andrea Danese
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; National and Specialist Child and Adolescent Mental Health Service Clinic for Trauma, Anxiety, and Depression, South London and Maudsley NHS Foundation Trust, London, UK
| | - Maryann Davis
- Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Pattie P Gonsalves
- Youth Mental Health Group, Sangath, New Delhi, India; School of Psychology, University of Sussex, Brighton, UK
| | - Matthew P Hamilton
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia; Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Jo Henderson
- Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Ann John
- Swansea University Medical School, Swansea University, Swansea, UK
| | | | - Long K-D Le
- Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Christian Kieling
- Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Ashok Malla
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada; ACCESS Open Minds and Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Verdun, QC, Canada
| | - Dorien H Nieman
- Amsterdam University Medical Centers, location AMC, Amsterdam, The Netherlands
| | - Debra Rickwood
- Faculty of Health, University of Canberra, Canberra, ACT, Australia; headspace National Youth Mental Health Foundation, Melbourne, VIC, Australia
| | - Jo Robinson
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Jai L Shah
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada; ACCESS Open Minds and Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Verdun, QC, Canada
| | - Swaran Singh
- Mental Health and Wellbeing, Warwick Medical School, University of Warwick and Coventry and Warwickshire Partnership Trust, Coventry, UK
| | - Ian Soosay
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Karen Tee
- Foundry, Providence Health Care, Vancouver, BC, Canada
| | - Jean Twenge
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Lucia Valmaggia
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | | | - Jon Wilson
- Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| | - Alison Yung
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia; Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia; School of Health Sciences, The University of Manchester, Manchester, UK
| | - Srividya N Iyer
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada; ACCESS Open Minds and Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Verdun, QC, Canada
| | - Eóin Killackey
- Orygen, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
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Liles SM, Olsavsky AL, Chen D, Grannis C, Hoskinson KR, Leibowitz SF, Nelson EE, Stanek CJ, Strang JF, Nahata L. Depression and anxiety in transgender and non-binary adolescents: prevalence and associations between adolescent and caregiver reports. Eur J Pediatr 2024:10.1007/s00431-024-05723-z. [PMID: 39196327 DOI: 10.1007/s00431-024-05723-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: 05/22/2024] [Revised: 07/26/2024] [Accepted: 08/06/2024] [Indexed: 08/29/2024]
Abstract
Transgender/non-binary (TNB) adolescents are at increased risk for mental health concerns, and caregiver awareness is important to facilitate access to care. Yet, limited research has examined caregiver awareness of TNB mental health. Thus, we examined (1) the prevalence of internalizing symptoms (depression, generalized anxiety, separation anxiety, social anxiety) among TNB adolescents and (2) associations between adolescent and caregiver reports of adolescent mental health symptoms. TNB adolescents (N = 75) aged 12-18 and a caregiver were recruited from a multidisciplinary gender clinic in Ohio. Adolescents self-reported their mental health symptoms via the CDI and SCARED. Caregivers reported their perceptions of the adolescent's mental health symptoms via the CASI-5. Descriptive statistics assessed participant characteristics, adolescent self-reported mental health symptoms, and caregiver proxy reports of adolescent mental health symptoms. Pearson's correlations and scatterplots were used to compare adolescent and caregiver reports and McNemar tests assessed if the differences were statistically significant. Most TNB adolescents reported elevated symptoms of depression (59%), generalized anxiety (75%), separation anxiety (52%), and social anxiety (78%). Caregiver and adolescent reports were significantly correlated for depression (r = .36, p = .002), separation anxiety (r = .39, p < .001), and social anxiety (r = .47, p < .001). Caregiver and adolescent reports of generalized anxiety were not significantly correlated (r = .21, p = .08). McNemar tests were significant (all p < .001), such that adolescents' reports met clinical cutoffs far more than their caregivers' reports. CONCLUSIONS Though adolescent and caregiver reports were low to moderately correlated, youth reports were consistently higher, suggesting the importance of interventions to increase caregiver understanding of TNB adolescent mental health. WHAT IS KNOWN • Transgender/non-binary adolescents are at high risk for mental health concerns and caregivers are essential to coordinate care. WHAT IS NEW • This study expands the diagnostic mental health sub-categories examined in transgender/non-binary adolescents, noting elevated symptoms of separation and social anxiety. • Transgender/non-binary adolescents reported more symptoms of depression, generalized anxiety, separation anxiety, and social anxiety than caregivers.
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Affiliation(s)
- Sophia M Liles
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, 431 S 18th St,, Columbus, OH, 43205, USA
| | - Anna L Olsavsky
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, 431 S 18th St,, Columbus, OH, 43205, USA
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Diane Chen
- Ann and Robert H. Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Connor Grannis
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, 431 S 18th St,, Columbus, OH, 43205, USA
| | - Kristen R Hoskinson
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, 431 S 18th St,, Columbus, OH, 43205, USA
- The Ohio State University College of Medicine, Columbus, OH, USA
- Nationwide Children's Hospital, Columbus, OH, USA
| | - Scott F Leibowitz
- The Ohio State University College of Medicine, Columbus, OH, USA
- Nationwide Children's Hospital, Columbus, OH, USA
| | - Eric E Nelson
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, 431 S 18th St,, Columbus, OH, 43205, USA
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Charis J Stanek
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, 431 S 18th St,, Columbus, OH, 43205, USA
| | - John F Strang
- Center for Neuroscience, Children's National Research Institute, Children's National Hospital, Washington, DC, USA
- Department of Pediatrics, Neurology, and Psychiatry, George Washington University School of Medicine, Washington, DC, USA
| | - Leena Nahata
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, 431 S 18th St,, Columbus, OH, 43205, USA.
- The Ohio State University College of Medicine, Columbus, OH, USA.
- Nationwide Children's Hospital, Columbus, OH, USA.
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3
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Walker SC, Wissow L, Gubner NR, Ngo S, Szatmari P, Servili C. Scale-up of Global Child and Youth Mental Health Services: A Scoping Review. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024:10.1007/s10488-024-01400-3. [PMID: 39105972 DOI: 10.1007/s10488-024-01400-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2024] [Indexed: 08/07/2024]
Abstract
Numerous influential policy and scientific bodies are calling for more rapid advances in the scale-up of child and youth mental health services (CYMHS). A number of CYMHS innovations hold promise for advancing scale-up but little is known about how real-world efforts are progressing. We conducted a scoping review to identify promising approaches to CYMHS scale-up across the globe. Searches were completed in six databases (Academic Search Complete, CINAHL, MEDLINE, PsychInfo, PubMed, and Web of Science). Article selection and synthesis were conducted in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) checklist. A second search focused on low-and-middle-income countries (LMIC) was conducted based on the Cochrane Library recommended search filters of the World Bank listed LMIC countries. Authors used a double coding strategy during the title/abstract and full-text review. Twenty-eight articles meeting the eligibility criteria were identified that described 22 initiatives (in 11 different countries). Our review found the majority of published scale-up studies in CYMHS were not informed by scale-up frameworks in design or reporting. The methods and outcomes used in the identified articles were highly variable and limited our ability to draw conclusions about comparative effectiveness although promising approaches emerged. Successes and failures identified in our review largely reflect consensus in the broader literature regarding the need for strategies to better navigate the complexities of system and policy implementation while ensuring CYMHS interventions fit local contexts.
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Affiliation(s)
- Sarah Cusworth Walker
- University of Washington, 4333 Brooklyn Ave NE, Box 359457, Seattle, WA, 98195-9457, USA.
| | - Lawrence Wissow
- University of Washington, 4800 Sand Point Way NE, MS OA.5.154, Seattle, WA, 98105, USA
| | - Noah R Gubner
- University of Washington, 4333 Brooklyn Ave NE, Box 359457, Seattle, WA, 98195-9457, USA
| | - Sally Ngo
- University of Washington, 4333 Brooklyn Ave NE, Box 359457, Seattle, WA, 98195-9457, USA
| | - Peter Szatmari
- University of Toronto, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
| | - Chiara Servili
- World Health Organization, Avenue Appia 20, 1201, Geneva, Switzerland
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van den Broek M, Agondeze S, Greene MC, Kasujja R, Guevara AF, Kisakye Tukahiirwa R, Kohrt BA, Jordans MJD. A community case detection tool to promote help-seeking for mental health care among children and adolescents in Ugandan refugee settlements: a stepped wedge cluster randomised trial. THE LANCET. CHILD & ADOLESCENT HEALTH 2024; 8:571-579. [PMID: 39025558 DOI: 10.1016/s2352-4642(24)00130-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/24/2024] [Accepted: 05/14/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Strategies to promote mental health care help-seeking among children are needed, especially in low-income and middle-income countries and in complex settings. The aim of this trial was to compare a vignette-based, community-level, proactive case detection tool (CCDT) against standard awareness raising for promoting mental health help-seeking among children and adolescents. METHODS This stepped wedge cluster randomised trial was conducted in the Bidi Bidi, Kyaka II, Kyangwali, Omugo, and Rhino refugee settlements in Uganda. Community gatekeepers received a 2-day training session on using the CCDT to proactively detect children with mental health concerns and encourage children (or their caregivers) to use the mental health-care service run by Transcultural Psychosocial Organization Uganda. At baseline, organisations implemented routine detection or mental health awareness-raising activities. At cross-over to CCDT implementation, gatekeepers used the tool in their daily activities. The primary outcome was mental health-care service use by children and adolescents. Child population size estimates at the zone level were not available. Therefore, service use was calculated using total population size. We report the effect of CCDT implementation as an incidence rate ratio (IRR), which we produced from a model that accounts for calendar time, exposure time, and person-time. IRRs were estimated for the analysis of effect over time in the per-protocol and intention-to-treat populations. The trial is registered with the ISRCTN registry, number ISRCTN19056780. FINDINGS 28 administrative zones were selected for trial participation by October, 2021. Between Jan 1, and Nov 8, 2022, seven clusters of four zones sequentially crossed over from routine care to CCDT implementation in 1-month intervals. The CCDT was implemented by 177 trained community gatekeepers. In 9 months, 2385 children visited a mental health-care service; of these, 1118 (47%) were girls and 1267 (53%) were boys (mean age 12·18 years [SD 4.03]). 1998 children made a first or re-entry visit to a service; of these, 937 (47%) were girls and 1061 (53%) were boys (mean age 12·08 years [SD 4·06]). Compared to standard awareness-raising activities, CCDT implementation was associated with an increase in mental health-care service use in the first month after implementation (20·91-fold change [95% CI 12·87-33·99]). Despite a slight decline in service use over time in both the CCDT and pre-CCDT zones, CCDT zones maintained a time-average 16·89-fold increase (95% CI 8·15-34·99) in mental health service use. INTERPRETATION The CCDT enabled community gatekeepers to increase mental health-care service use by children and adolescents. Vignette-based strategies rooted in the community could become a valuable contribution towards reducing the mental health-care gap among children, especially when accompanied by accessible mental health-care services. FUNDING Sint Antonius Stichting Projects. TRANSLATIONS For the Arabic, French and Spanish translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Myrthe van den Broek
- Research and Development, War Child Alliance, Amsterdam, Netherlands; Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Netherlands
| | - Sandra Agondeze
- Research and Development, War Child Alliance, Kampala, Uganda
| | - M Claire Greene
- Program on Forced Migration and Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Rosco Kasujja
- Department of Mental Health, Makerere University, Kampala, Uganda
| | - Anthony F Guevara
- Research and Development, War Child Alliance, Amsterdam, Netherlands
| | | | - Brandon A Kohrt
- Center for Global Mental Health Equity, Department of Psychiatry and Behavioral Health, George Washington University, Washington, DC, USA
| | - Mark J D Jordans
- Research and Development, War Child Alliance, Amsterdam, Netherlands; Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Netherlands; Center for Global Mental Health, King's College London, London, UK.
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5
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Ward-Smith C, Sorsdahl K, van der Westhuizen C. An investigation into symptoms of depression and anxiety and emotion regulation among older adolescents from low-income settings in South Africa. Compr Psychiatry 2024; 132:152476. [PMID: 38552349 DOI: 10.1016/j.comppsych.2024.152476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 02/20/2024] [Accepted: 03/16/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Mental health conditions (MHC) among adolescents in low- and middle-income countries, including South Africa, are estimated to be high. Adaptive emotion regulation (ER) skills can protect against MHC among adolescents. In South Africa, there is limited adolescent mental health prevalence data as well as little understanding of the associations between MHC and ER among adolescents. This study aimed to address these gaps by describing the psychosocial characteristics of older South African adolescents from low-income settings as well as investigating associations between depression and anxiety symptoms and ER. METHODS We selected 12 schools in collaboration with two NGOs. Learners aged 15-18-years were recruited to complete a tablet-based survey. ER, depression, anxiety, and other psychosocial measures were included. Two multiple linear regression models were used to determine associations between depression symptoms, anxiety symptoms, other psychosocial factors, and ER. RESULTS Of the 733 participants from 12 Western Cape schools, 417 (56.90%) screened at risk for clinically significant anxiety symptoms, 423 (57.70%) participants for depression symptoms, 229 (31.40%) participants for PTSD symptoms and 263 (35.90%) for risky alcohol use. Depression and anxiety scores were found to be significantly positively correlated with ER difficulties and adolescents struggled most with identifying and utilizing adaptive ER strategies. The adjusted linear regression model reported that female gender, clinically significant depressive, anxiety, post-traumatic stress symptoms and risky-alcohol use were all significantly associated with poorer ER scores, while self-esteem was significantly associated with better ER scores. CONCLUSION These findings contribute to the South African adolescent mental health literature and to the research gap on the links between depression and anxiety and ER. Future research should consider further exploration of the relationships between psychosocial factors and ER to inform the urgent development and testing of appropriate adolescent interventions in this setting.
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Affiliation(s)
- C Ward-Smith
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry & Mental Health, University of Cape Town, South Africa.
| | - K Sorsdahl
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry & Mental Health, University of Cape Town, South Africa
| | - C van der Westhuizen
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry & Mental Health, University of Cape Town, South Africa
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Zhang Y, Tian L, Chen J, Liu X, Li K, Liu H, Lai W, Shi Y, Lin B, Xi Z. Selective bioaccumulation of polystyrene nanoplastics in fetal rat brain and damage to myelin development. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 278:116393. [PMID: 38714083 DOI: 10.1016/j.ecoenv.2024.116393] [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: 10/18/2023] [Revised: 04/13/2024] [Accepted: 04/22/2024] [Indexed: 05/09/2024]
Abstract
Micro(nano)plastic, as a new type of environmental pollutant, have become a potential threat to the life and health of various stages of biology. However, it is not yet clear whether they will affect brain development in the fetal stage. Therefore, this study aims to explore the potential effects of nanoplastics on the development of fetal rat brains. To assess the allocation of NPs (25 nm and 50 nm) in various regions of the fetal brain, pregnant rats were exposed to concentrations (50, 10, 2.5, and 0.5 mg/kg) of PS-NPs. Our results provided evidence of the transplacental transfer of PS-NPs to the fetal brain, with a prominent presence observed in several cerebral regions, notably the cerebellum, hippocampus, striatum, and prefrontal cortex. This distribution bias might be linked to the developmental sequence of each brain region. Additionally, we explored the influence of prenatal exposure on the myelin development of the cerebellum, given its the highest PS-NP accumulation in offspring. Compared with control rats, PS-NPs exposure caused a significant reduction in myelin basic protein (MBP) and myelin oligodendrocyte glycoprotein (MOG) expression, a decrease in myelin thickness, an increase in cell apoptosis, and a decline in the oligodendrocyte population. These effects gave rise to motor deficits. In conclusion, our results identified the specific distribution of NPs in the fetal brain following prenatal exposure and revealed that prenatal exposure to PS-NPs can suppress myelin formation in the cerebellum of the fetus.
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Affiliation(s)
- Yaping Zhang
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China; School of Public Health and Management, Binzhou Medical University, Yantai 264003, China
| | - Lei Tian
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Jiang Chen
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China; School of Public Health, North China University of Science and Technology, Tangshan 063200, China
| | - Xuan Liu
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Kang Li
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Huanliang Liu
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Wenqing Lai
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Yue Shi
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China
| | - Bencheng Lin
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China.
| | - Zhuge Xi
- Tianjin Institute of Environmental and Operational Medicine, Tianjin 300050, China.
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7
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Yang Y(S, Law M, Vaghri Z. New Brunswick's mental health action plan: A quantitative exploration of program efficacy in children and youth using the Canadian Community Health Survey. PLoS One 2024; 19:e0301008. [PMID: 38848408 PMCID: PMC11161078 DOI: 10.1371/journal.pone.0301008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/09/2024] [Indexed: 06/09/2024] Open
Abstract
In 2011, the New Brunswick government released the New Brunswick Mental Health Action Plan 2011-2018 (Action Plan). Following the release of the Action Plan in 2011, two progress reports were released in 2013 and 2015, highlighting the implementation status of the Action Plan. While vague in their language, these reports indicated considerable progress in implementing the Action Plan, as various initiatives were undertaken to raise awareness and provide additional resources to facilitate early prevention and intervention in children and youth. However, whether these initiatives have yielded measurable improvements in population-level mental health outcomes in children and youth remains unclear. The current study explored the impact of the Action Plan by visualizing the trend in psychosocial outcomes and service utilization of vulnerable populations in New Brunswick before and after the implementation of the Action Plan using multiple datasets from the Canadian Community Health Survey. Survey-weighted ordinary least square regression analyses were performed to investigate measurable improvements in available mental health outcomes. The result revealed a declining trend in the mental wellness of vulnerable youth despite them consistently reporting higher frequencies of mental health service use. This study highlights the need for a concerted effort in providing effective mental health services to New Brunswick youth and, more broadly, Canadian youth, as well as ensuring rigorous routine outcome monitoring and evaluation plans are consistently implemented for future mental health strategies at the time of their initiation.
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Affiliation(s)
- Yuzhi (Stanford) Yang
- Department of Psychology, Faculty of Science, Applied Science, and Engineering, University of New Brunswick, Saint John, New Brunswick, Canada
| | - Moira Law
- Department of Psychology, Faculty of Science, St. Mary’s University, Halifax, Nova Scotia, Canada
| | - Ziba Vaghri
- Global Child Program, Integrated Health Initiative, Faculty of Business, University of New Brunswick, Saint John, New Brunswick, Canada
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8
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McAtee D, Abdelmoneim A. A zebrafish-based acoustic motor response (AMR) assay to evaluate chemical-induced developmental neurotoxicity. Neurotoxicology 2024; 103:60-70. [PMID: 38851595 DOI: 10.1016/j.neuro.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 05/20/2024] [Accepted: 06/05/2024] [Indexed: 06/10/2024]
Abstract
Behavioral assays using early-developing zebrafish (Danio rerio) offer a valuable supplement to the in vitro battery adopted as new approach methodologies (NAMs) for assessing risk of chemical-induced developmental neurotoxicity. However, the behavioral assays primarily adopted rely on visual stimulation to elicit behavioral responses, known as visual motor response (VMR) assays. Ocular deficits resulting from chemical exposures can, therefore, confound the behavioral responses, independent of effects on the nervous system. This highlights the need for complementary assays employing alternative forms of sensory stimulation. In this study, we investigated the efficacy of acoustic stimuli as triggers of behavioral responses in larval zebrafish, determined the most appropriate data acquisition mode, and evaluated the suitability of an acoustic motor response (AMR) assay as means to assess alterations in brain activity and risk of chemical-induced developmental neurotoxicity. We quantified the motor responses of 120 h post-fertilization (hpf) larvae to acoustic stimuli with varying patterns and frequencies, and determined the optimal time intervals for data acquisition. Following this, we examined changes in acoustic and visual motor responses resulting from exposures to pharmacological agents known to impact brain activity (pentylenetetrazole (PTZ) and tricaine-s (MS-222)). Additionally, we examined the AMR and VMR of larvae following exposure to two environmental contaminants associated with developmental neurotoxicity: arsenic (As) and cadmium (Cd). Our findings indicate that exposure to a 100 Hz sound frequency in 100 ms pulses elicits the strongest behavioral response among the acoustic stimuli tested and data acquisition in 2 s time intervals is suitable for response assessment. Exposure to PTZ exaggerated and depressed both AMR and VMR in a concentration-dependent manner, while exposure to MS-222 only depressed them. Similarly, exposure to As and Cd induced respective hyper- and hypo-activation of both motor responses. This study highlights the efficiency of the proposed zebrafish-based AMR assay in demonstrating risk of chemical-induced developmental neurotoxicity and its suitability as a complement to the widely adopted VMR assay.
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Affiliation(s)
- Demetrius McAtee
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Ahmed Abdelmoneim
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA.
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Mulraney M, de Silva U, Joseph A, Sousa Fialho MDL, Dutia I, Munro N, Payne JM, Banaschewski T, de Lima CB, Bellgrove MA, Chamberlain SR, Chan P, Chong I, Clink A, Cortese S, Daly E, Faraone SV, Gladstone M, Guastella AJ, Järvdike J, Kaleem S, Lovell MG, Meller T, Nagy P, Newcorn JH, Polanczyk GV, Simonoff E, Szatmari P, Tehan C, Walsh K, Wamithi S, Coghill D. International Consensus on Standard Outcome Measures for Neurodevelopmental Disorders: A Consensus Statement. JAMA Netw Open 2024; 7:e2416760. [PMID: 38869906 DOI: 10.1001/jamanetworkopen.2024.16760] [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: 06/14/2024] Open
Abstract
Importance The use of evidence-based standardized outcome measures is increasingly recognized as key to guiding clinical decision-making in mental health. Implementation of these measures into clinical practice has been hampered by lack of clarity on what to measure and how to do this in a reliable and standardized way. Objective To develop a core set of outcome measures for specific neurodevelopmental disorders (NDDs), such as attention-deficit/hyperactivity disorder (ADHD), communication disorders, specific learning disorders, and motor disorders, that may be used across a range of geographic and cultural settings. Evidence Review An international working group composed of clinical and research experts and service users (n = 27) was convened to develop a standard core set of accessible, valid, and reliable outcome measures for children and adolescents with NDDs. The working group participated in 9 video conference calls and 8 surveys between March 1, 2021, and June 30, 2022. A modified Delphi approach defined the scope, outcomes, included measures, case-mix variables, and measurement time points. After development, the NDD set was distributed to professionals and service users for open review, feedback, and external validation. Findings The final set recommends measuring 12 outcomes across 3 key domains: (1) core symptoms related to the diagnosis; (2) impact, functioning, and quality of life; and (3) common coexisting problems. The following 14 measures should be administered at least every 6 months to monitor these outcomes: ADHD Rating Scale 5, Vanderbilt ADHD Diagnostic Rating Scale, or Swanson, Nolan, and Pelham Rating Scale IV; Affective Reactivity Index; Children's Communication Checklist 2; Colorado Learning Disabilities Questionnaire; Children's Sleep Habits Questionnaire; Developmental-Disability Children's Global Assessment Scale; Developmental Coordination Disorder Questionnaire; Family Strain Index; Intelligibility in Context Scale; Vineland Adaptive Behavior Scale or Repetitive Behavior Scale-Revised and Social Responsiveness Scale; Revised Child Anxiety and Depression Scales; and Yale Global Tic Severity Scale. The external review survey was completed by 32 professionals and 40 service users. The NDD set items were endorsed by more than 70% of professionals and service users in the open review survey. Conclusions and Relevance The NDD set covers outcomes of most concern to patients and caregivers. Use of the NDD set has the potential to improve clinical practice and research.
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Affiliation(s)
- Melissa Mulraney
- Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Umanga de Silva
- International Consortium of Health Outcome Measures, Boston, Massachusetts
| | - Andria Joseph
- International Consortium of Health Outcome Measures, Boston, Massachusetts
| | | | - Iain Dutia
- School of Allied Health, Australian Catholic University, Brisbane, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Natalie Munro
- Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | | | - Tobias Banaschewski
- Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Cláudia Bandeira de Lima
- Institute for Evidence Based Healthcare at University of Lisbon School and Medicine, Lisbon, Portugal
| | - Mark A Bellgrove
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK
- Department of Neuroscience and Physiology, Norton College of Medicine at SUNY Upstate Medical University, Syracuse, New York
| | - Phyllis Chan
- Department of Psychiatry, Queen Mary Hospital, Hong Kong
| | - Ivy Chong
- May Institute Inc, Randolph, Massachusetts
| | | | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Tees, Esk, and Wear Valleys NHS Foundation Trust, Middlesbrough, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, New York
- Department of Precision and Regenerative Medicine and Ionian Area, University of Studies of Bari Aldo Moro, Bari, Italy
| | - Eileen Daly
- Department of Forensic and Neurodevelopmental Sciences, King's College London, London, UK
| | - Stephen V Faraone
- Department of Neuroscience and Physiology, Norton College of Medicine at SUNY Upstate Medical University, Syracuse, New York
- Department of Psychiatry and Behavioral Sciences, Norton College of Medicine at SUNY Upstate Medical University, Syracuse, New York
| | - Melissa Gladstone
- Department of Women and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Adam J Guastella
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | | | - Sidra Kaleem
- Department of Pediatrics and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Mark G Lovell
- Tees, Esk, and Wear Valleys NHS Foundation Trust, Middlesbrough, UK
- Royal College of Psychiatrists, London, UK
| | - Tamasin Meller
- Northern Beaches Child and Family Health Service, Sydney, Australia
| | - Peter Nagy
- Division of Neurodevelopmental Disorders, Bethesda Children's Hospital, Budapest, Hungary
| | - Jeffrey H Newcorn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Guilherme V Polanczyk
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, King's College London, London, UK
| | - Peter Szatmari
- Centre for Addiction and Mental Health University of Toronto, Toronto, Ontario, Canada
| | | | - Karin Walsh
- Division of Neuropsychology, Children's National Hospital and The George Washington University School of Medicine, Washington, DC
| | - Susan Wamithi
- Department of Paediatrics, Child & Adolescent Health, Aga Khan University Medical College, Nairobi, Kenya
| | - David Coghill
- Department of Paediatrics, University of Melbourne, Parkville, Australia
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10
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Johnson M, Johnels JÅ, Östlund S, Jakobsson K, Högstedt J, Larsson PJ, Gillberg C, Billstedt E. Long-term medication for ADHD (LMA) trial: 2-year prospective observational study in children and adolescents. Core symptoms, daily functioning, and comorbidity outcomes. Eur Arch Psychiatry Clin Neurosci 2024; 274:879-890. [PMID: 38280948 PMCID: PMC11127865 DOI: 10.1007/s00406-023-01744-1] [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: 04/12/2023] [Accepted: 12/11/2023] [Indexed: 01/29/2024]
Abstract
More knowledge is needed about long-term ADHD medication and symptom, daily functioning, comorbidity, and tolerability outcomes. This "Long-term Medication for ADHD (LMA) trial" was a prospective observational 2-year trial in children and adolescents aged 6-18 years (extension of 1-year trial). Participants met criteria for DSM-5 ADHD (inattentive or combined), with complex comorbidities; autism spectrum disorder (31%), autistic traits (24%), oppositional symptoms (59%), anxiety (32%), dyslexia/language disorder (16%), borderline intellectual functioning (17%). Medication was individually tailored and followed-up at clinical visits (1, 2, 3, 6, 12, 18, 24 months). Primary outcome: Clinical Global Impression-Severity and Improvement scales (CGI-S, CGI-I). Secondary outcomes: Investigator-rated ADHD-Rating Scale, Weiss Functional Impairment Rating Scale-Parent report (WFIRS-P; Family, School Learning and Behavior, Life Skills, Self-Concept, Social Activities, and Risky Activities domains), comorbidity symptoms and adverse events (AEs). One hundred twenty-eight participants were enrolled (1-year trial only n = 27, LMA trial n = 101). Of these 29 (23%) discontinued, mainly due to AEs (n = 7), moving (n = 7), or no longer needing medication (n = 6). Main AEs were poor appetite, low mood, anxiety, irritability, fatigue. Improvements from baseline to 2 years were large in CGI-S (effect size (ES) 2.28), ADHD-RS (ES 2.06), and moderate to large in WFIRS-P (ES total 0.73, learning 0.4, family 0.67). Overall, the trial showed robust and sustained improvements in ADHD symptom severity and daily functioning over a period of 2 years of ADHD medication in children and adolescents with ADHD and complex comorbidities. Most AEs were mild. Comorbidity symptoms were improved after 1 year, particularly oppositional symptoms, depression, and anxiety.
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Affiliation(s)
- M Johnson
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - J Åsberg Johnels
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - S Östlund
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - K Jakobsson
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - J Högstedt
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - P Javid Larsson
- Habilitation and Health, Region Västra Götaland, Gothenburg, Sweden
| | - C Gillberg
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - E Billstedt
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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11
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Poirier M, Lemelin JP, Déry M, Crescenzi O, Temcheff CE. An examination of the relationship between conduct problems and depressive symptoms comorbidity and temperament among elementary school children. Child Psychiatry Hum Dev 2024; 55:655-666. [PMID: 36138302 DOI: 10.1007/s10578-022-01421-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 03/06/2022] [Accepted: 08/09/2022] [Indexed: 11/03/2022]
Abstract
Although the comorbidity between conduct problems (CP) and depressive symptoms (DS) is associated with a host of negative outcomes, the factors, such as temperament, that might explain this comorbidity in school-aged boys and girls are poorly understood. This study compared elementary school children presenting co-occurring CP and DS to children with DS only, CP only, and those with low-level symptoms on temperament dimensions, and explored the moderating role of child sex in the associations. Participants are 487 children (M = 8.38 years, SD = 0.92, 52.2% girls) divided into four groups (CP + DS, DS only, CP only, control). Findings suggest that boys with CP and DS presented a lower level of fear than boys with DS and boys from the control group. They also presented higher levels of activity than boys with DS. Girls with CP and DS presented lower levels of fear than girls with DS, lower levels of approach and activity than girls with CP, and higher levels of shyness than girls from the control group. These findings suggest that temperament may discriminate children with comorbid CP and DS from those presenting only CP or DS.
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Affiliation(s)
- Martine Poirier
- Département des sciences de l'éducation, Université du Québec à Rimouski, 300, allée des Ursulines, C. P. 3300, succ. A Rimouski, G5L 3A1, Québec, Canada.
| | - Jean-Pascal Lemelin
- Département de psychoéducation, Université de Sherbrooke Sherbrooke, Québec, Canada
| | - Michèle Déry
- Département de psychoéducation, Université de Sherbrooke Sherbrooke, Québec, Canada
| | - Olivia Crescenzi
- Educational & Counselling Psychology, McGill University, Montréal, Québec, Canada
| | - Caroline E Temcheff
- Educational & Counselling Psychology, McGill University, Montréal, Québec, Canada
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12
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Otika D, Odongo G, Muzaki RM, Lamwaka BO, Bongomin F, Pebolo PF. Depression and suicidal ideation among adolescent girls in refugee settlements in northern Uganda. Medicine (Baltimore) 2024; 103:e38077. [PMID: 38728480 PMCID: PMC11081608 DOI: 10.1097/md.0000000000038077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 04/10/2024] [Indexed: 05/12/2024] Open
Abstract
Depression is a leading cause of disability, morbidity, and mortality among adolescent girls in Africa, with varying prevalence across different populations. However, there is paucity of data on the burden of depression among priority groups in unique settings like adolescent girls living in refugee settlements, where access to mental health services including psychosocial support and psychiatric consultation is scarce. We conducted a cross-sectional, descriptive, observational study among adolescent girls from 4 selected refugee settlements in Obongi and Yumbe districts, Uganda. A multi-stage sampling, and cluster sampling techniques, where each settlement represented 1 cluster was done. Prevalence of depression was assessed using the patient health questionnaire-9 modified for adolescents, followed by the P4 screener assessment tool for suicidal risks. We performed modified Poisson regression analysis to establish predictors of depression. P < .05 was considered statistically significant. We included 385 participants with a mean age of 17 (IQR: 15-18) years. The prevalence of depression was 15.1% (n = 58, 95% confidence interval [CI]: 11.6-19.0). Overall, 8.6% (n = 33) participants had recent suicidal thoughts (within 1 month) and 2.3% (n = 9) attempted suicide. Participants who experienced pregnancy (adjusted prevalence ratio [aPR]: 2.4, 95% CI: 1.00-5.94, P = .049), sexual abuse (aPR: 2.1, 95% CI: 1.19-3.76, P = .011), and physical abuse (aPR: 1.7, 95% CI: 1.01-2.74, P = .044) were independently associated with depression. In this study, we found about one in every 6 adolescents living in refugee settlements of northern Uganda to suffer from depression, particularly among those who experienced adolescent pregnancy and various forms of abuses. Incorporating mental health care in the existing health and social structures within the refugee settlements, exploring legal options against perpetrators of sexual abuse and encouraging education is recommended in this vulnerable population.
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Affiliation(s)
- Donald Otika
- Faculty of Medicine, Gulu University, Gulu, Uganda
| | | | | | | | - Felix Bongomin
- Faculty of Medicine, Gulu University, Gulu, Uganda
- Department of Internal Medicine, Gulu Regional Referral Hospital, Gulu, Uganda
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13
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Gill J, Jones A, Price K, Goodison E, Tyson P. A mixed-method systematic review of the perspectives of young people, carers and professionals on psychiatric diagnosis in childhood and adolescence. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2024; 37:e12459. [PMID: 38522014 DOI: 10.1111/jcap.12459] [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: 08/17/2023] [Revised: 02/22/2024] [Accepted: 03/01/2024] [Indexed: 03/25/2024]
Abstract
PROBLEM The significance and complexities of a psychiatric diagnosis have been well-documented in existing literature. Despite the reliability and accuracy of such diagnoses, the impact and use of diagnostic labelling on young people remains unclear. METHODS A systematic review was conducted using six databases, identifying 13 studies that explored psychiatric diagnosis experiences in professionals, caregivers, and young people. FINDINGS This review focuses on three main themes related to psychiatric diagnosis in young people. The first theme is diagnostic subjectivity, which explores the accuracy, usefulness, potential harm and alternatives (e.g. psychological formulation) to psychiatric diagnosis in this population. The second theme is the utility of psychiatric diagnosis, which considers whether it helps young people access appropriate support and gain a better understanding of themselves and their presenting issues. The third theme is stigma, which examines the negative experiences and discrimination that young people may face due to their psychiatric diagnosis. CONCLUSIONS There is relatively limited literature which discusses the experience of psychiatric diagnosis in young people, caregivers and professionals. The available literature is difficult to compare due to discrepancies between methodologies and services, and there are several gaps i.e. a limited focus on the experience of young people themselves. Different views and experiences of psychiatric diagnosis among professionals, caregivers, and young people could impact young people's quality of life, access to healthcare, and identity development. The current literature needs to be more comprehensive to draw firm conclusions about young people's experiences with psychiatric diagnosis.
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Affiliation(s)
- Jodie Gill
- School of Psychology and Therapeutic Studies, University of South Wales, Treforest Campus, Pontypridd, Wales, United Kingdom
| | - Alexis Jones
- School of Psychology and Therapeutic Studies, University of South Wales, Treforest Campus, Pontypridd, Wales, United Kingdom
| | - Klara Price
- School of Psychology and Therapeutic Studies, University of South Wales, Treforest Campus, Pontypridd, Wales, United Kingdom
| | - Egan Goodison
- School of Psychology and Therapeutic Studies, University of South Wales, Treforest Campus, Pontypridd, Wales, United Kingdom
| | - Philip Tyson
- School of Psychology and Therapeutic Studies, University of South Wales, Treforest Campus, Pontypridd, Wales, United Kingdom
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14
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Bezborodovs Ņ, Krēgers R, Vētra L, Rancāns E, Villeruša A. Psychometric properties and normative data of the Latvian and Russian language versions of the strengths and difficulties questionnaire (SDQ) in the Latvian general adolescent population. Nord J Psychiatry 2024; 78:301-311. [PMID: 38421351 DOI: 10.1080/08039488.2024.2319662] [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: 05/30/2023] [Accepted: 01/24/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVES Mental health screening instruments are essential in population health research and clinical practice. The strengths and difficulties questionnaire (SDQ) self-report version has been widely used across the globe to screen for mental health problems in adolescent populations. This study aimed to explore the psychometric properties of the Latvian and Russian language versions of the SDQ in a representative sample of a general population of Latvian adolescents and establish the population-based normative scores. MATERIALS AND METHODS This analysis was based on data from the international Health Behaviour in School-aged Children study year 2017/2018 Latvian database. The sample comprised 2683 Latvian and 1321 Russian-speaking 11-, 13-, and 15-year-old adolescents. RESULTS Significant language-based variance was observed in the mean scores of the externalising subscales of the SDQ, with Latvian-speaking adolescents reporting higher levels of conduct problems and hyperactivity. The reliability was satisfactory (ordinal alpha >0.7) only for the prosocial behaviour, emotional, internalising problems, and total difficulties subscales, while conduct, hyperactivity, peer, and externalising problems scales demonstrated lower internal consistency (ordinal alpha 0.5-0.7). Confirmatory factor analysis (CFA) did not support the hypothesised narrow-band five-factor or broad-band three-factor structure of the SDQ. The normative banding scores were calculated for both language variants. CONCLUSIONS This study suggests that the self-report SDQ must be used cautiously in Latvian adolescents because some SDQ subscales lack reliability. When used in population research, the internalising subscales seem more reliable than the externalising ones. More research is needed regarding the reliability of the SDQ in clinical adolescent populations.
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Affiliation(s)
- Ņikita Bezborodovs
- Department of Psychiatry and Narcology, Faculty of Medicine, Riga Stradins University, Riga, Latvia
- Child and Youth Mental Health Centre, Children's Clinical University Hospital, Riga, Latvia
| | - Rūdolfs Krēgers
- Department of Mathematics, Faculty of Physics, Mathematics and Optometry, University of Latvia, Riga, Latvia
| | - Lelde Vētra
- Child and Youth Mental Health Centre, Children's Clinical University Hospital, Riga, Latvia
| | - Elmārs Rancāns
- Department of Psychiatry and Narcology, Faculty of Medicine, Riga Stradins University, Riga, Latvia
| | - Anita Villeruša
- Department of Public Health and Epidemiology, Faculty of Public Health and Social Welfare, Riga Stradins University, Riga, Latvia
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15
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Onie S. Assessing adolescent mental disorders in low-income and middle-income countries. Lancet 2024; 403:1609-1611. [PMID: 38588688 DOI: 10.1016/s0140-6736(23)02711-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 11/30/2023] [Indexed: 04/10/2024]
Affiliation(s)
- Sandersan Onie
- Black Dog Institute, UNSW Sydney, Sydney, NSW 2031, Australia; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
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16
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Erskine HE, Maravilla JC, Wado YD, Wahdi AE, Loi VM, Fine SL, Li M, Ramaiya A, Wekesah FM, Odunga SA, Njeri A, Setyawan A, Astrini YP, Rachmawati R, Hoa DTK, Wallis K, McGrath C, Shadid J, Enright ME, Blondell SJ, Lawrence D, Fisher PW, Whiteford HA, Vinh ND, Wilopo SA, Kabiru CW, Blum RW, Scott JG. Prevalence of adolescent mental disorders in Kenya, Indonesia, and Viet Nam measured by the National Adolescent Mental Health Surveys (NAMHS): a multi-national cross-sectional study. Lancet 2024; 403:1671-1680. [PMID: 38588689 DOI: 10.1016/s0140-6736(23)02641-7] [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: 08/29/2023] [Revised: 11/14/2023] [Accepted: 11/22/2023] [Indexed: 04/10/2024]
Abstract
BACKGROUND Mental disorders are the leading global cause of health burden among adolescents. However, prevalence data for mental disorders among adolescents in low-income and middle-income countries are scarce with often limited generalisability. This study aimed to generate nationally representative prevalence estimates for mental disorders in adolescents in Kenya, Indonesia, and Viet Nam. METHODS As part of the National Adolescent Mental Health Surveys (NAMHS), a multinational cross-sectional study, nationally representative household surveys were conducted in Kenya, Indonesia, and Viet Nam between March and December, 2021. Adolescents aged 10-17 years and their primary caregiver were interviewed from households selected randomly according to sampling frames specifically designed to elicit nationally representative results. Six mental disorders (social phobia, generalised anxiety disorder, major depressive disorder, post-traumatic stress disorder, conduct disorder, and attention-deficit hyperactivity disorder) were assessed with the Diagnostic Interview Schedule for Children, Version 5. Suicidal behaviours and self-harm in the past 12 months were also assessed. Prevalence in the past 12 months and past 4 weeks was calculated for each mental disorder and collectively for any mental disorder (ie, of the six mental disorders assessed). Prevalence of suicidal behaviours (ie, ideation, planning, and attempt) and self-harm in the past 12 months was calculated, along with adjusted odds ratios (aORs) to show the association with prevalence of any mental disorder in the past 12 months. Inverse probability weighting was applied to generate national estimates with corresponding 95% CIs. FINDINGS Final samples consisted of 5155 households (ie, adolescent and primary caregiver pairs) from Kenya, 5664 households from Indonesia, and 5996 households from Viet Nam. In Kenya, 2416 (46·9%) adolescents were male and 2739 (53·1%) were female; in Indonesia, 2803 (49·5%) adolescents were male and 2861 (50·5%) were female; and in Viet Nam, 3151 (52·5%) were male and 2845 (47·4%) were female. Prevalence of any mental disorder in the past 12 months was 12·1% (95% CI 10·9-13·5) in Kenya, 5·5% (4·3-6·9) in Indonesia, and 3·3% (2·7-4·1) in Viet Nam. Prevalence in the past 4 weeks was 9·4% (8·3-10·6) in Kenya, 4·4% (3·4-5·6) in Indonesia, and 2·7% (2·2-3·3) in Viet Nam. The prevalence of suicidal behaviours in the past 12 months was low in all three countries, with suicide ideation ranging from 1·4% in Indonesia (1·0-2·0) and Viet Nam (1·0-1·9) to 4·6% (3·9-5·3) in Kenya, suicide planning ranging from 0·4% in Indonesia (0·3-0·8) and Viet Nam (0·2-0·6) to 2·4% (1·9-2·9) in Kenya, and suicide attempts ranging from 0·2% in Indonesia (0·1-0·4) and Viet Nam (0·1-0·3) to 1·0% (0·7-1·4) in Kenya. The prevalence of self-harm in the past 12 months was also low in all three countries, ranging from 0·9% (0·6-1·3) in Indonesia to 1·2% (0·9-1·7) in Kenya. However, the prevalence of suicidal behaviours and self-harm in the past 12 months was significantly higher among those with any mental disorder in the past 12 months than those without (eg, aORs for suicidal ideation ranged from 7·1 [3·1-15·9] in Indonesia to 14·7 [7·5-28·6] in Viet Nam). INTERPRETATION NAMHS provides the first national adolescent mental disorders prevalence estimates for Kenya, Indonesia, and Viet Nam. These data can inform mental health and broader health policies in low-income and middle-income countries. FUNDING The University of Queensland in America (TUQIA) through support from Pivotal Ventures, a Melinda French Gates company.
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Affiliation(s)
- Holly E Erskine
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
| | - Joemer C Maravilla
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia; Institute of Health Sciences and Nursing, Far Eastern University, Manila, Philippines
| | | | - Amirah Ellyza Wahdi
- Center for Reproductive Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Vu Manh Loi
- Institute of Sociology, Vietnam Academy of Social Sciences, Hanoi, Viet Nam
| | - Shoshanna L Fine
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Mengmeng Li
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Astha Ramaiya
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Frederick Murunga Wekesah
- African Population and Health Research Center, Nairobi, Kenya; Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | | | - Anne Njeri
- African Population and Health Research Center, Nairobi, Kenya
| | - Althaf Setyawan
- Center for Reproductive Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Yufan Putri Astrini
- Center for Reproductive Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Rizka Rachmawati
- Center for Reproductive Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Krystina Wallis
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - Cartiah McGrath
- Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - Jamileh Shadid
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Meaghan E Enright
- Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - Sarah J Blondell
- Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - David Lawrence
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Prudence W Fisher
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Harvey A Whiteford
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Nguyen Duc Vinh
- Institute of Sociology, Vietnam Academy of Social Sciences, Hanoi, Viet Nam
| | - Siswanto Agus Wilopo
- Center for Reproductive Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Robert Wm Blum
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - James G Scott
- Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia; Child and Youth Mental Health Service, Children's Health Queensland, Brisbane, QLD, Australia
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17
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Xiang Z, Wang H, Zhu K, Jiang Q, Feng Y, Tang J, Song R. Longitudinal Associations Between Physical Activity and Depressive Symptoms in Chinese Children: Evidence from the Tongji Mental Health Cohort Study. Int J Behav Med 2024:10.1007/s12529-024-10281-7. [PMID: 38658437 DOI: 10.1007/s12529-024-10281-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND We aimed to examine the associations between depressive symptoms and physical activity parameters (e.g., intensity, frequency, and duration) among Chinese school-aged children. METHOD Participants in this study were extracted from the Tongji Mental Health Cohort Study. The baseline survey was conducted in June 2020 involving 2588 school-aged children from two primary schools in Hubei Province, China. A total of 2435 children were followed up successfully in December 2020. The Children's Depression Inventory Short Form (CDI-S) was applied to evaluate depressive symptoms among school-aged children. The Physical Activity Rating Scale-3 (PARS-3) was adopted to estimate children's physical activity parameters including the intensity, frequency, and duration. Generalized estimation equation models were used to explore the longitudinal associations between physical activity and depressive symptoms among school-aged children. RESULTS Engaging in moderate levels of physical activity (OR, 0.800; 95%CI, 0.692-0.924) or high levels of physical activity (OR, 0.808; 95%CI, 0.689-0.947) in the baseline survey was associated with a reduced risk of developing depressive symptoms in the follow-up survey compared with children engaging in low levels of physical activity. Stratified analyses revealed that the associations between physical activity and depressive symptoms exhibited a significant correlation among boys and children in the older age group (11-12 years). Our findings showed that engaging in physical activity more than once a week, with each session lasting 20 min or longer, was related to significant reductions in depressive symptoms by 43.8% and 22.3%, respectively. CONCLUSION Self-reported physical activity is positively associated with improved mental health among Chinese school-aged children, especially when considering parameters such as frequency and duration. The association between vigorous-intensity physical activity and depressive symptoms in children should be cautiously interpreted. Future research should continue to explore the effects of vigorous-intensity physical activity on depressive symptoms in children.
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Affiliation(s)
- Zhen Xiang
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Wuhan, Hubei, China
| | - Haoxue Wang
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Wuhan, Hubei, China
| | - Kaiheng Zhu
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Wuhan, Hubei, China
| | - Qi Jiang
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Wuhan, Hubei, China
| | - Yanan Feng
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Wuhan, Hubei, China
| | - Jun Tang
- Department of Children's Rehabilitation, Wuhan Psychology Hospital, Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Ranran Song
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Wuhan, Hubei, China.
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18
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Gebreegziabher ZA, Eristu R, Molla A. Determinants of adolescents' depression, anxiety, and somatic symptoms in Northwest Ethiopia: A non-recursive structural equation modeling. PLoS One 2024; 19:e0281571. [PMID: 38598540 PMCID: PMC11006201 DOI: 10.1371/journal.pone.0281571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 01/16/2024] [Indexed: 04/12/2024] Open
Abstract
INTRODUCTION In low and middle-income countries, adolescent mental health is not only a major public health challenge but also a development concern. Depression and anxiety are the most common mental health disorders and somatic symptoms often co-exist with them. Adolescents with common mental health problems are associated with an increased risk of suicide, future unemployment, and poor quality of life. However, little is known about the mental health of adolescents in Ethiopia. Thus, this study aimed to assess the determinants of depression, anxiety, and somatic symptoms among adolescents in Northwest Ethiopia, in 2022. METHODS An institution-based cross-sectional study was conducted from June 8 to 24, 2022. Two-stage stratified random sampling was used to select 1407 adolescents in Northwest Ethiopia. Structured and standardized self-administered questionnaires were used to collect the data. Non-recursive structural equation modeling was employed to assess the direct, indirect, and total effects of predictors. Adjusted regression coefficients and corresponding 95% confidence intervals were used to interpret the strength of the association. RESULTS The prevalence of depression, anxiety, and somatic symptoms were 28.21% (95% CI: 25.8, 31%), 25.05% (95%CI: 22.8, 27.5), and 25.24(95% CI: 23, 27.6%) respectively. Alcohol use had a significant positive effect on depression [β = 0.14, 95% CI: 0.073, 0.201], anxiety [β = 0.11, 95% CI: 0.041, 0.188], and somatic symptoms [β = 0.12, 95% CI: 0.062, 0.211]. Stress had a significant positive effect on depression [β = 0.76, 95% CI: 0.642, 0.900], anxiety [β = 1.10, 95% CI: 0.955, 1.264], and somatic symptoms [β = 086, 95% C: 0.700, 1.025]. Depression had a direct positive effect on anxiety [β = 0.74, 95% CI: 0.508, 1.010]. CONCLUSION In this study, the prevalence of depression, anxiety, and somatic symptoms was moderate. Alcohol use and stress were significantly related to depression, anxiety, and somatic symptoms. The bidirectional relationship between anxiety and depression was significant. Therefore, public health interventions should focus on the bidirectional relationship between depression and anxiety, as well as on identified factors to reduce the burden of mental illness in adolescents.
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Affiliation(s)
- Zenebe Abebe Gebreegziabher
- Department of Epidemiology and Biostatistics, School of Public Health, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Rediet Eristu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ayenew Molla
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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19
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Liu X, Yang F, Huang N, Zhang S, Guo J. Thirty-year trends of anxiety disorders among adolescents based on the 2019 Global Burden of Disease Study. Gen Psychiatr 2024; 37:e101288. [PMID: 38595856 PMCID: PMC11002340 DOI: 10.1136/gpsych-2023-101288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 02/25/2024] [Indexed: 04/11/2024] Open
Abstract
Background Anxiety disorders are the most common psychiatric problems, affecting approximately 1 in 12 children and 1 in 4 adolescents. Understanding the incidence, burden and correlated risks of anxiety disorders among children and adolescents can help identify areas of success, stagnation and emerging threats, thereby facilitating effective improvement strategies. Aims To estimate the incidence and burden trends of anxiety disorders in children and adolescents from 1990 to 2019 in 204 countries and compare the incidence and disease burden in different countries. To examine the association between anxiety disorders and social indicators (healthcare access and quality of life). Methods Data were obtained from the Global Burden of Disease Study 2019. The age-standardised incidence rates (ASIRs) and disability-adjusted life years (DALYs) were reported to assess the burden of anxiety disorders, and the estimated annual percentage change was calculated to quantify the temporal trends. Pearson's correlation was used to investigate country-level risk factors for incidence and DALYs. Results Globally, there were 932 million incident cases of anxiety disorders in children and adolescents, 739.29 per 100 000 ASIRs and 380.62 million DALYs in 2019. From 1990 to 2019, the estimated annual percentage change of incidence of anxiety disorders decreased by 2.2%. Significant variations were observed in the age-standardised burden rate and the changing trend of anxiety disorders among countries. Portugal reported the highest ASIR of anxiety disorders, while Mexico had the largest increase rate of ASIR. In 2019, Portugal reported the highest number of DALYs (1001.71 million), and India (212.09 million) reported the lowest number of DALYs. The burden of anxiety disorders was positively correlated with the average number of psychiatrists, psychologists and nurses in the mental health sector (per 100 000), and quality of life and the correlation coefficients were 0.58, 0.67, 0.43 and 0.53, respectively. Conclusions The incidence and global burden of anxiety disorders in adolescents have continued to decrease over the past 30 years. However, the incidence and disease burden in developed countries are still increasing steadily. Policymakers should design and implement mental health strategies for adolescents based on their specific developmental status, as well as the cultural and regional characteristics of each country.
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Affiliation(s)
- Xiaohan Liu
- School of Public Health, Peking University Health Science Center, No.38 Xueyuan Rd, Haidian District, Beijing, China
| | - Fan Yang
- School of Public Health, Peking University Health Science Center, No.38 Xueyuan Rd, Haidian District, Beijing, China
| | - Ning Huang
- School of Public Health, Peking University Health Science Center, No.38 Xueyuan Rd, Haidian District, Beijing, China
| | - Shan Zhang
- School of Public Health, Peking University Health Science Center, No.38 Xueyuan Rd, Haidian District, Beijing, China
| | - Jing Guo
- School of Public Health, Peking University Health Science Center, No.38 Xueyuan Rd, Haidian District, Beijing, China
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20
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Yirmiya K, Constantinou M, Simes E, Bateman A, Wason J, Yakeley J, McMurran M, Crawford M, Frater A, Moran P, Barrett B, Cameron A, Hoare Z, Allison E, Pilling S, Butler S, Fonagy P. The mediating role of reflective functioning and general psychopathology in the relationship between childhood conduct disorder and adult aggression among offenders. Psychol Med 2024:1-12. [PMID: 38563288 DOI: 10.1017/s003329172400062x] [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: 04/04/2024]
Abstract
BACKGROUND The nature of the pathway from conduct disorder (CD) in adolescence to antisocial behavior in adulthood has been debated and the role of certain mediators remains unclear. One perspective is that CD forms part of a general psychopathology dimension, playing a central role in the developmental trajectory. Impairment in reflective functioning (RF), i.e., the capacity to understand one's own and others' mental states, may relate to CD, psychopathology, and aggression. Here, we characterized the structure of psychopathology in adult male-offenders and its role, along with RF, in mediating the relationship between CD in their adolescence and current aggression. METHODS A secondary analysis of pre-treatment data from 313 probation-supervised offenders was conducted, and measures of CD symptoms, general and specific psychopathology factors, RF, and aggression were evaluated through clinical interviews and questionnaires. RESULTS Confirmatory factor analyses indicated that a bifactor model best fitted the sample's psychopathology structure, including a general psychopathology factor (p factor) and five specific factors: internalizing, disinhibition, detachment, antagonism, and psychoticism. The structure of RF was fitted to the data using a one-factor model. According to our mediation model, CD significantly predicted the p factor, which was positively linked to RF impairments, resulting in increased aggression. CONCLUSIONS These findings highlight the critical role of a transdiagnostic approach provided by RF and general psychopathology in explaining the link between CD and aggression. Furthermore, they underscore the potential utility of treatments focusing on RF, such as mentalization-based treatment, in mitigating aggression in offenders with diverse psychopathologies.
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Affiliation(s)
- Karen Yirmiya
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Matthew Constantinou
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Elizabeth Simes
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Anthony Bateman
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - James Wason
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Jessica Yakeley
- Portman Clinic, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Mary McMurran
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Mike Crawford
- Division of Psychiatry, Imperial College, London, UK
| | - Alison Frater
- School of Law, Royal Holloway, University of London, London, UK
| | - Paul Moran
- Centre for Academic Mental Health, Population Health Sciences Department, Bristol Medical School, University of Bristol, Bristol, UK
| | - Barbara Barrett
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Angus Cameron
- National Probation Service London Division, London, UK
| | - Zoe Hoare
- NWORTH Clinical Trials Unit, School of Health Sciences, Bangor University, Bangor, UK
| | - Elizabeth Allison
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Stephen Pilling
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Stephen Butler
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
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21
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Valtuille Z, Acquaviva E, Trebossen V, Ouldali N, Bourmaud A, Sclison S, Gomez A, Revet A, Peyre H, Delorme R, Kaguelidou F. Psychotropic Medication Prescribing for Children and Adolescents After the Onset of the COVID-19 Pandemic. JAMA Netw Open 2024; 7:e247965. [PMID: 38652474 DOI: 10.1001/jamanetworkopen.2024.7965] [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: 04/25/2024] Open
Abstract
Importance Numerous studies have provided evidence for the negative associations of the COVID-19 pandemic with mental health, but data on the use of psychotropic medication in children and adolescents after the onset of the COVID-19 pandemic are lacking. Objective To assess the rates and trends of psychotropic medication prescribing before and over the 2 years after the onset of the COVID-19 pandemic in children and adolescents in France. Design, Setting, and Participants This cross-sectional study used nationwide interrupted time-series analysis of outpatient drug dispensing data from the IQVIA X-ponent database. All 8 839 143 psychotropic medication prescriptions dispensed to children (6 to 11 years of age) and adolescents (12 to 17 years of age) between January 2016 and May 2022 in France were retrieved and analyzed. Exposure Onset of COVID-19 pandemic. Main outcomes and Measures Monthly rates of psychotropic medication prescriptions per 1000 children and adolescents were analyzed using a quasi-Poisson regression before and after the pandemic onset (March 2020), and percentage changes in rates and trends were assessed. After the pandemic onset, rate ratios (RRs) were calculated between estimated and expected monthly prescription rates. Analyses were stratified by psychotropic medication class (antipsychotic, anxiolytic, hypnotic and sedative, antidepressant, and psychostimulant) and age group (children, adolescents). Results In total, 8 839 143 psychotropic medication prescriptions were analyzed, 5 884 819 [66.6%] for adolescents and 2 954 324 [33.4%] for children. In January 2016, the estimated rate of monthly psychotropic medication prescriptions was 9.9 per 1000 children and adolescents, with the prepandemic rate increasing by 0.4% per month (95% CI, 0.3%-0.4%). In March 2020, the monthly prescription rate dropped by 11.5% (95% CI, -17.7% to -4.9%). During the 2 years following the pandemic onset, the trend changed significantly, and the prescription rate increased by 1.3% per month (95% CI, 1.2%-1.5%), reaching 16.1 per 1000 children and adolescents in May 2022. Monthly rates of psychotropic medication prescriptions exceeded the expected rates by 11% (RR, 1.11 [95% CI, 1.08-1.14]). Increases in prescribing trends were observed for all psychotropic medication classes after the pandemic onset but were substantial for anxiolytics, hypnotics and sedatives, and antidepressants. Prescription rates rose above those expected for all psychotropic medication classes except psychostimulants (RR, 1.12 [95% CI, 1.09-1.15] in adolescents and 1.06 [95% CI, 1.05-1.07] in children for antipsychotics; RR, 1.30 [95% CI, 1.25-1.35] in adolescents and 1.11 [95% CI, 1.09-1.12] in children for anxiolytics; RR, 2.50 [95% CI, 2.23-2.77] in adolescents and 1.40 [95% CI, 1.30-1.50] in children for hypnotics and sedatives; RR, 1.38 [95% CI, 1.29-1.47] in adolescents and 1.23 [95% CI, 1.20-1.25] in children for antidepressants; and RR, 0.97 [95% CI, 0.95-0.98] in adolescents and 1.02 [95% CI, 1.00-1.04] in children for psychostimulants). Changes were more pronounced among adolescents than children. Conclusions and Relevance These findings suggest that prescribing of psychotropic medications for children and adolescents in France significantly and persistently increased after the COVID-19 pandemic onset. Future research should identify underlying determinants to improve psychological trajectories in young people.
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Affiliation(s)
- Zaba Valtuille
- Center of Clinical Investigations, Inserm CIC1426, Robert Debré University Hospital, APHP.Nord, Paris, France
- Paris Cité University, EA7323 Perinatal and Pediatric Pharmacology and Therapeutic Assessment, Paris, France
| | - Eric Acquaviva
- Department of Child and Adolescent Psychiatry, Robert Debré University Hospital, APHP.Nord, Paris Cité University, Paris, France
| | - Vincent Trebossen
- Department of Child and Adolescent Psychiatry, Robert Debré University Hospital, APHP.Nord, Paris Cité University, Paris, France
| | - Naim Ouldali
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, APHP.Nord, Paris Cité University, Paris, France
| | - Aurelie Bourmaud
- Clinical Epidemiology Unit, Inserm CIC1426, Robert Debré University Hospital, APHP.Nord, Paris Cité University, Paris, France
| | - Stéphane Sclison
- Consulting Services & Analytics Department, IQVIA, Courbevoie, France
| | - Alexandre Gomez
- Consulting Services & Analytics Department, IQVIA, Courbevoie, France
| | - Alexis Revet
- Department of Child and Adolescent Psychiatry, Toulouse University Hospital, Toulouse, France
- CERPOP, UMR 1295, Inserm, Toulouse III - Paul Sabatier University, Toulouse, France
| | - Hugo Peyre
- Autism Reference Centre of Languedoc-Roussillon CRA-LR, Montpellier University Hospital, Montpellier, France
- Excellence Centre for Autism and Neurodevelopmental disorders- CeAND, MUSE University, Montpellier, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
| | - Richard Delorme
- Department of Child and Adolescent Psychiatry, Robert Debré University Hospital, APHP.Nord, Paris Cité University, Paris, France
- Human Genetics & Cognitive Functions, Institut Pasteur, Paris, France
| | - Florentia Kaguelidou
- Center of Clinical Investigations, Inserm CIC1426, Robert Debré University Hospital, APHP.Nord, Paris, France
- Paris Cité University, EA7323 Perinatal and Pediatric Pharmacology and Therapeutic Assessment, Paris, France
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22
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Penttilä S, Niemelä M, Hakko H, Keski-Säntti M, Ristikari T, Räsänen S. Child- and parent-related determinants for out-of-home care in a nationwide population with neurodevelopmental disorders: a register-based Finnish birth cohort 1997 study. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02406-w. [PMID: 38430236 DOI: 10.1007/s00787-024-02406-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: 05/16/2023] [Accepted: 02/20/2024] [Indexed: 03/03/2024]
Abstract
Neurodevelopmental disorders (NDDs) are among the most common health issues in childhood and adolescence. Psychiatric disorders are known to be overrepresented among children using child welfare services and placed in out-of-home care (OHC). Child- and parent-related determinants for OHC among a national population with NDDs were evaluated utilising longitudinal register data from the national Finnish Birth Cohort 1997 (n = 58,802) from birth to 18 years (1997-2015). The cohort members with NDDs (n = 5,143, 9% of total cohort) formed our study population. Based on their history of OHC, cohort members with NDD were categorised to OHC (n = 903) and non-OHC groups (n = 4,240). Of all cohort members with NDDs, 17.6% had a history of OHC. Within NDDs, a significant excess of ADHD diagnosis was observed in the OHC group compared to the non-OHC group (49% vs. 26%). The OHC group with NDDs was significantly characterised by having comorbid psychiatric diagnosis for conduct and oppositional disorders (adj. RR 2.21), substance use disorders (adj. RR 1.61) and depression and anxiety disorders (adj. RR 1.60). Of all parent-related determinants, the most prevailing in the OHC group compared to the non-OHC group, was social assistance received by parent (88% vs. 44.5%). The longer the period (in years) for received social assistance, the greater the likelihood for OHC (adj. RRs range from 2.41 for one year to 5.24 for over 4 years). Further, significantly associating determinants for OHC were parental psychiatric disorders (adj. RR 1.42) and parental death (adj. RR 1.23). Our findings from the population-based cohort of children and adolescents with NDDs highlight the importance of screening and assessment of family situation. Also, effective prevention and treating of comorbid psychiatric disorders, especially conduct and oppositional disorders is essential.
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Affiliation(s)
- Sanni Penttilä
- Faculty of Medicine, Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland.
| | - Mika Niemelä
- Faculty of Medicine, Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Helinä Hakko
- Faculty of Medicine, Research Unit of Population Health, University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | | | | | - Sami Räsänen
- Faculty of Medicine, Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
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23
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Zhu Y, Wang NN, Pan D, Wang S. Risk of Overweight and Obesity in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis. Child Obes 2024; 20:119-127. [PMID: 36952326 DOI: 10.1089/chi.2022.0230] [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: 03/24/2023]
Abstract
This study was performed to explore the association between attention-deficit/hyperactivity disorder (ADHD) and the risk of overweight/obesity in both children and adolescents. The PubMed, Web of Science, and Cochrane Library databases were searched for relevant studies published before July 12, 2022. Studies with data for calculating the odds ratio (OR) of childhood overweight/obesity and ADHD were included. The literature value was assessed by the cross-sectional evaluation criteria proposed by the Agency for Healthcare Research and Quality (AHRQ). All analyses were conducted using StataSE 11 and RevMan 5.3 software with random-effects models. This review included a total of 16 studies covering 14,981 cases and 128,916 controls.According to the meta-analysis, children with ADHD had a significant risk for co-occurring overweight and obesity [OR 1.56; 95% confidence intervals (CI) 1.32-1.85], especially boys (OR 1.45; 95% CI 1.10-1.90), people in Asia (OR 3.25; 95% CI 1.70-6.21) and Europe (OR 1.85; 95% CI 1.61-2.12), and patients not using medication (OR 1.54; 95% CI 1.22-1.94).ADHD has a significant association with overweight and obesity in both children and adolescents, which may be altered by factors such as geography, gender, and medication use. Timely treatment should be provided to children and adolescents diagnosed with ADHD to inhibit the emergence of overweight and obesity.
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Affiliation(s)
- Yixuan Zhu
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, P.R. China
| | - Nian-Nian Wang
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, P.R. China
| | - Da Pan
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, P.R. China
| | - Shaokang Wang
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, P.R. China
- Department of Public Health, School of Medicine, Xizang Minzu University, Xianyang, P.R. China
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24
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Fitch MI. Editorial: Reproductive health and mental health in LMICs: adolescent health. FRONTIERS IN REPRODUCTIVE HEALTH 2024; 6:1383170. [PMID: 38496789 PMCID: PMC10940534 DOI: 10.3389/frph.2024.1383170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 02/23/2024] [Indexed: 03/19/2024] Open
Affiliation(s)
- Margaret I. Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
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25
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Lawrence-Sidebottom D, Huffman LG, Beam AB, Guerra R, Parikh A, Roots M, Huberty J. Rates of Trauma Exposure and Posttraumatic Stress in a Pediatric Digital Mental Health Intervention: Retrospective Analysis of Associations With Anxiety and Depressive Symptom Improvement Over Time. JMIR Pediatr Parent 2024; 7:e55560. [PMID: 38412001 PMCID: PMC10933721 DOI: 10.2196/55560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND More than 2 out of 3 children and adolescents in the United States experience trauma by the age of 16 years. Exposure to trauma in early life is linked to a range of negative mental health outcomes throughout the lifespan, particularly co-occurring symptoms of posttraumatic stress (PTS), anxiety, and depression. There has been an increasing uptake of digital mental health interventions (DMHIs) among youths, particularly for anxiety and depression. However, little is known regarding the incidence of trauma exposure and PTS symptoms among youths participating in DMHIs and whether PTS symptoms impact anxiety and depressive symptom treatment response. Moreover, it is unclear whether participation in a DMHI for anxiety and depressive symptoms is associated with secondary effects on PTS symptoms among trauma-exposed youths. OBJECTIVE This study aims to use retrospective data from youths participating in a DMHI to (1) characterize rates of trauma, PTS, and comorbid anxiety and depressive symptoms; (2) determine whether trauma exposure and elevated PTS symptoms impact the improvement of comorbid anxiety and depressive symptoms throughout participation in care; and (3) determine whether participation in a non-posttraumatic DMHI is linked to reductions in PTS symptoms. METHODS This study was conducted using retrospective data from members (children ages 6 to 12 years) involved in a pediatric collaborative care DMHI. Participating caregivers reported their children's trauma exposure. PTS, anxiety, and depressive symptom severity were measured monthly using validated assessments. RESULTS Among eligible participants (n=966), 30.2% (n=292) reported at least 1 traumatic event. Of those with trauma exposure and elevated symptoms of PTS (n=119), 73% (n=87) exhibited elevated anxiety symptoms and 50% (n=59) exhibited elevated depressive symptoms. Compared to children with no trauma, children with elevated PTS symptoms showed smaller reductions per month in anxiety but not depressive symptoms (anxiety: F2,287=26.11; P<.001). PTS symptoms also decreased significantly throughout care, with 96% (n=79) of participants showing symptom reductions. CONCLUSIONS This study provides preliminary evidence for the frequency of trauma exposure and comorbid psychiatric symptoms, as well as variations in treatment response between trauma-exposed and nontrauma-exposed youths, among participants in a pediatric collaborative care DMHI. Youths with traumatic experiences may show increased psychiatric comorbidities and slower treatment responses than their peers with no history of trauma. These findings deliver compelling evidence that collaborative care DMHIs may be well-suited to address mental health symptoms in children with a history of trauma while also highlighting the critical need to assess symptoms of PTS in children seeking treatment.
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Affiliation(s)
| | | | | | | | | | | | - Jennifer Huberty
- Bend Health Inc, Madison, WI, United States
- FitMinded Inc LLC, Phoenix, AZ, United States
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Hannon E, Anselimus SM, Bardikoff N, Bulc B, Germann S, Gonsalves PP, Melendez-Torres GJ, Ospina-Pinillos L, Sinha M, Wanjiru M. Why cities matter for adolescent mental health and wellbeing. Lancet 2024; 403:708-710. [PMID: 37827186 DOI: 10.1016/s0140-6736(23)02238-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/04/2023] [Indexed: 10/14/2023]
Affiliation(s)
| | - Sweetbert M Anselimus
- Tanzania's Psychosocial Welfare Organization, and University of Dar es Salaam, Iringa, Tanzania
| | - Nicole Bardikoff
- Global Mental Health at Grand Challenges Canada, Toronto, ON, Canada
| | - Barbara Bulc
- Global Development and SDG CoLab, Geneva, Switzerland
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Meilsmeidth G, Trigueiro MJ, Simões-Silva V, Simões de Almeida R, Portugal P, Gomes PV, de Sousa S, Campos F, Monteiro P, Soutelo AP, Marques A. Assessing the efficacy of the 'Bicho De 7 Cabeças' B-learning school-based program in enhancing mental health literacy and reducing stigma. BMC Psychol 2024; 12:93. [PMID: 38395937 PMCID: PMC10893733 DOI: 10.1186/s40359-024-01591-2] [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: 10/04/2023] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
The prevalence of mental disorders in adolescents has a considerable impact on daily life, restricting tasks and diminishing overall quality of life while potentially leading to stigmatization. This study aims to measure the impact of a mental health literacy intervention program, called "Bicho de 7 Cabeças" project, in b-learning format, on the increase of knowledge and the decrease of stigma in young people from Póvoa de Varzim, in Portugal. A quasi-experimental study was conducted, from November 2022 to May 2023, involving an experimental group ("Bicho de 7 Cabeças" protocol) and an active control group (informational brochures), utilizing a pre-test/post-test design. Mental Health Literacy Measure-MHLM, Mental Health Promoting Knowledge Scale-MHPK-10, Mental Illness Knowledge Schedule-MAKS, Reported and Intended Behaviour Scale-RIBS, and Community Attitudes toward People with Mental Illness-CAMI were used. A total of 504 young students from the 9th grade enroll in this study, with a mean age around 14 years old. There is a significant difference between stigma (p <.001) and knowledge (p <.001) scores at baseline and follow-up. The results of this study shows that interventions aimed at young people for the promotion of mental health literacy and stigma reduction are needed and more initiatives should be implemented in schools to address these problems.
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Affiliation(s)
- Gislene Meilsmeidth
- LabRP- CIR, ESS, Polytechnic University of Porto, Rua Dr. António Bernardino de Almeida, 400 4200 - 072, Porto, Portugal
| | - Maria João Trigueiro
- LabRP- CIR, ESS, Polytechnic University of Porto, Rua Dr. António Bernardino de Almeida, 400 4200 - 072, Porto, Portugal
| | - Vítor Simões-Silva
- LabRP- CIR, ESS, Polytechnic University of Porto, Rua Dr. António Bernardino de Almeida, 400 4200 - 072, Porto, Portugal
| | - Raquel Simões de Almeida
- LabRP- CIR, ESS, Polytechnic University of Porto, Rua Dr. António Bernardino de Almeida, 400 4200 - 072, Porto, Portugal.
| | - Paula Portugal
- LabRP- CIR, ESS, Polytechnic University of Porto, Rua Dr. António Bernardino de Almeida, 400 4200 - 072, Porto, Portugal
| | - Paulo Veloso Gomes
- LabRP- CIR, ESS, Polytechnic University of Porto, Rua Dr. António Bernardino de Almeida, 400 4200 - 072, Porto, Portugal
| | - Sara de Sousa
- LabRP- CIR, ESS, Polytechnic University of Porto, Rua Dr. António Bernardino de Almeida, 400 4200 - 072, Porto, Portugal
| | - Filipa Campos
- LabRP- CIR, ESS, Polytechnic University of Porto, Rua Dr. António Bernardino de Almeida, 400 4200 - 072, Porto, Portugal
| | - Pedro Monteiro
- LabRP- CIR, ESS, Polytechnic University of Porto, Rua Dr. António Bernardino de Almeida, 400 4200 - 072, Porto, Portugal
| | - Ana Paula Soutelo
- LabRP- CIR, ESS, Polytechnic University of Porto, Rua Dr. António Bernardino de Almeida, 400 4200 - 072, Porto, Portugal
| | - António Marques
- LabRP- CIR, ESS, Polytechnic University of Porto, Rua Dr. António Bernardino de Almeida, 400 4200 - 072, Porto, Portugal
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Mihret AM, Heinrichs N. Intergenerational effects of child maltreatment on adolescents' anxiety and depression in Ethiopia: the important mediating and moderating roles of current psychological distress. BMC Psychiatry 2024; 24:126. [PMID: 38360563 PMCID: PMC10870629 DOI: 10.1186/s12888-024-05586-6] [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: 11/02/2023] [Accepted: 02/05/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Child abuse is widespread around the world, and one continent with particularly high rates is Africa. Research in high- and middle-income countries shows the cascading effect of parental history of child abuse and neglect on adolescents' maltreatment and, in turn, on mental health problems. This cascade has been reported in young children but has rarely been studied in parent-adolescent dyads or in low-income countries (LICs). The goal of this study was to test intergenerational associations of child abuse and neglect and to examine how these experiences are in turn associated with youth anxiety and depression in an LIC. METHODS A total of 231 adolescents (age: 13-21 years) and 185 of their parents (n = 90 fathers and n = 95 mothers) were recruited from secondary schools in Addis Abeba, Ethiopia. Using a cross-sectional design, participants completed a set of questionnaires assessing child maltreatment (in adolescence and own past history in parents), parental psychological distress, youth depression and anxiety, and sociodemographic factors. RESULTS The frequencies of child maltreatment exposure were 68% for adolescents and 65% for their parents (when they were a child). Fifty-one percent and 42% of adolescents had borderline to clinical levels of anxiety and depression symptoms, respectively. Adolescents of parents with a history of child abuse and neglect also reported higher exposure to maltreatment themselves (p < 0.001). Current paternal, but not maternal, psychological distress mediated this intergenerational association of maltreatment experiences (95% CI [1.164, 9.467]). We further found parents' psychological distress to be a significant moderator of the indirect pathways of the intergenerational effect of child maltreatment on adolescents' anxiety and depression (95% CI [- 0.770, - 0.012]). CONCLUSIONS We found child maltreatment to be intergenerationally associated, and this effect subsequently affected adolescents' anxiety and depression through different pathways supporting the cascading effects across generations. Intervention plans may be effective through an array of possible indirect pathways and encourage the implementation of multiple access points to facilitate change in the lives of affected youth in Africa.
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Affiliation(s)
- Amare Misganaw Mihret
- Clinical Psychology and Psychotherapy, Universität Bremen, Grazer Straße 6, 28359, Bremen, Germany.
- Department of Psychology, Clinical Child and Adolescent Psychology and Psychotherapy, Bielefeld University Universität Bielefeld, Universität Straße 25, 33615, Bielefeld, Germany.
| | - Nina Heinrichs
- Clinical Psychology and Psychotherapy, Universität Bremen, Grazer Straße 6, 28359, Bremen, Germany
- Department of Psychology, Clinical Child and Adolescent Psychology and Psychotherapy, Bielefeld University Universität Bielefeld, Universität Straße 25, 33615, Bielefeld, Germany
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Rangul V, Holmen TL, Langhammer A, Ingul JM, Pape K, Fenstad JS, Kvaløy K. Cohort Profile Update: The Young-HUNT Study, Norway. Int J Epidemiol 2024; 53:dyae013. [PMID: 38302751 PMCID: PMC10834360 DOI: 10.1093/ije/dyae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 01/17/2024] [Indexed: 02/03/2024] Open
Affiliation(s)
- Vegar Rangul
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Turid Lingaas Holmen
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Arnulf Langhammer
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Jo Magne Ingul
- 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, Trondheim, Norway
| | - Kristine Pape
- Department of Public Health and Nursing, Faculty and Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
| | - Jørn Søberg Fenstad
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Kirsti Kvaløy
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
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Valero-Moreno S, Montoya-Castilla I, Pérez-Marín M. Study of the emotional adjustment of the caregiver-patient dyad to bronchial asthma in adolescence. Int J Nurs Pract 2024; 30:e13171. [PMID: 37271579 DOI: 10.1111/ijn.13171] [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: 05/26/2022] [Revised: 02/22/2023] [Accepted: 05/22/2023] [Indexed: 06/06/2023]
Abstract
AIM This study aimed to investigate the impact of bronchial asthma-related factors on the emotional well-being of adolescents with bronchial asthma and their primary caregivers. BACKGROUND Bronchial asthma is a common chronic disease in childhood and adolescence that can have a psychological impact on both patients and their primary caregivers. METHODS The study used a cross-sectional design and included 150 patient-caregiver dyads diagnosed with bronchial asthma, aged between 12 and 16 years and collected between 2018 and 2020. It assessed the emotional adjustment of both patients and caregivers and recorded variables related to the disease. Qualitative and quantitative analyses were conducted to perform statistical analyses. RESULTS Caregivers had higher anxiety and depression scores than patients. Good adherence to treatment was necessary for the emotional adjustment of the dyad. Controlled asthma, good adherence to treatment and a reduction in medical treatment were the primary predictors of emotional adjustment. CONCLUSIONS The study highlights the importance of assessing anxiety and depression levels in both patients and caregivers because the presence of these symptoms can lead to the misuse of medication, inadequate inhalation techniques, the omission of medication and reduced confidence in controlling asthma symptoms.
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Affiliation(s)
- Selene Valero-Moreno
- Personality, Assessment and Psychological Treatments Department, Faculty of Psychology, Universitat de València, Valencia, Spain
| | - Inmaculada Montoya-Castilla
- Personality, Assessment and Psychological Treatments Department, Faculty of Psychology, Universitat de València, Valencia, Spain
| | - Marián Pérez-Marín
- Personality, Assessment and Psychological Treatments Department, Faculty of Psychology, Universitat de València, Valencia, Spain
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Schölin L, Tucker Z, Chopra A, Borschmann R, McKay C. Detention of children and adolescents under mental health legislation: a scoping review of prevalence, risk factors, and legal frameworks. BMC Pediatr 2024; 24:12. [PMID: 38178014 PMCID: PMC10765764 DOI: 10.1186/s12887-023-04464-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/05/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND For individuals with severe mental illness, involuntary assessment and/or treatment (hereafter detention) can be a necessary intervention to support recovery and may even be lifesaving. Despite this, little is known about how often these interventions are used for children and adolescents. METHODS This global scoping review set out to: (1) map the current evidence around mental health detentions of children and adolescents (< 18 years); (2) identify the clinical, sociodemographic, and behavioural factors associated with detention; and (3) document the views of professionals and young people on the implementation of mental health legislation. RESULTS After searching databases of peer-reviewed literature and citation chaining, 42 articles from 15 jurisdictions were included. About one fifth of psychiatric admissions in national register data were detentions, however trends were only available for a few high-income Western countries. The circumstances justifying detention and the criteria authorising detention varied between studies, with a mix of clinical factors and observed behaviours reported as the reason(s) warranting/precipitating a detention. Particular groups were more likely to experience detention, such as children and adolescents from minority ethnic communities and those with a documented history of abuse. There was a notable absence of qualitative research exploring the views of professionals or children and adolescents on detention. CONCLUSION Further research is needed to explore the impact of detention on those aged < 18 years, including national register-based studies and qualitative studies. This is particularly relevant in nations currently undergoing legislative reform.
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Affiliation(s)
- Lisa Schölin
- Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, UK.
| | - Zack Tucker
- Masters student at University of Edinburgh, Edinburgh, UK
| | - Arun Chopra
- Mental Welfare Commission for Scotland, Edinburgh, UK
| | - Rohan Borschmann
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX3 7JX, UK
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Colin McKay
- Centre for Mental Health and Capacity Law, Edinburgh Napier University, Edinburgh, UK
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Golden TL, Ordway RW, Magsamen S, Mohanty A, Chen Y, Ng TWC. Supporting youth mental health with arts-based strategies: a global perspective. BMC Med 2024; 22:7. [PMID: 38166923 PMCID: PMC10763059 DOI: 10.1186/s12916-023-03226-6] [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: 06/09/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024] Open
Abstract
The devastating impact of youth mental health concerns is increasingly evident on a global scale. This crisis calls for innovative solutions that are sufficiently accessible, scalable, and cost-effective to support diverse communities around the world. One such solution involves engagement in the arts: incorporating and building upon existing local resources and cultural practices to bolster youth mental health. In this article, we describe the global youth mental health crisis and note major gaps in the knowledge and resources needed to address it. We then discuss the potential for arts- and culture-based strategies to help meet this challenge, review the mounting evidence regarding art's ability to support mental health, and call for action to undertake critical research and its translation into accessible community practices. Four steps are suggested: (1) elevate and prioritize youth voice, (2) develop core outcome measures, (3) identify and analyze successful models around the globe, and (4) generate clear funding pathways for research and translational efforts. Worldwide implementation of arts- and culture-based strategies to address youth mental health will provide critical resources to support the health, wellbeing and flourishing of countless youth across the globe.
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Affiliation(s)
- Tasha L Golden
- International Arts + Mind Lab, Johns Hopkins University School of Medicine, 5801 Smith Ave, Ste #110, Baltimore, MD, 21209, USA.
| | - Richard W Ordway
- Department of Biology and Doctors, Kienle Center for Humanistic Medicine, Penn State University, University Park, PA, 16802, USA
| | - Susan Magsamen
- International Arts + Mind Lab, Johns Hopkins University School of Medicine, 5801 Smith Ave, Ste #110, Baltimore, MD, 21209, USA
| | - Aanchal Mohanty
- International Arts + Mind Lab, Johns Hopkins University School of Medicine, 5801 Smith Ave, Ste #110, Baltimore, MD, 21209, USA
| | - Yifan Chen
- International Arts + Mind Lab, Johns Hopkins University School of Medicine, 5801 Smith Ave, Ste #110, Baltimore, MD, 21209, USA
| | - T W Cherry Ng
- International Arts + Mind Lab, Johns Hopkins University School of Medicine, 5801 Smith Ave, Ste #110, Baltimore, MD, 21209, USA
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Kumar M, Njuguna S, Amin N, Kanana S, Tele A, Karanja M, Omar N, Yator O, Wambugu C, Bukusi D, Weaver MR. Burden and risk factors of mental and substance use disorders among adolescents and young adults in Kenya: results from the Global Burden of Disease Study 2019. EClinicalMedicine 2024; 67:102328. [PMID: 38204491 PMCID: PMC10776414 DOI: 10.1016/j.eclinm.2023.102328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 11/05/2023] [Accepted: 11/07/2023] [Indexed: 01/12/2024] Open
Abstract
Background Mental and substance use disorders are a major public health concern globally, with high rates of disability, morbidity, and mortality associated with these. In low- and middle-income countries, such as Kenya, mental health is often given low priority, and resources for the prevention and treatment of mental and substance use disorders are limited. Adolescence and young adulthood are critical periods for the development of mental and substance use disorders, with many disorders emerging during this time. In Kenya, the burden and risk factors of mental and substance use disorders among adolescents and young adults is not well understood. Methods The data used in this study were obtained from the Global Burden of Disease (GBD) Study 2019. We selected the data on the number of mental and substance use disorders among adolescents and young adults in Kenya from the GBD results tool. The data were extracted by mental health (MH) condition, by age group and by sex. We used descriptive statistical methods to summarise and present the data. Specifically, we calculated the disability-adjusted life-years (DALYs) rates, risk factors of mental and substance use disorders by age group and sex. Findings In 2019, among 10-24-year-olds in Kenya, mental disorders ranked as the second leading cause of disability, following unintentional injuries, and accounted for 248,936 [95% uncertainty interval 175,033; 341,680] DALYs or 9.4% of 2,656,546 total DALYs. Substance use disorders accounted 15,022 [9948; 20,710] DALYs. Depressive, anxiety, and conduct disorders accounted for the most DALYs of mental disorders accounting for 3.1%, 2.3% and 1.7% of the total DALYs, respectively. The main risk factors for incident DALYs in 10-24-year-olds were bullying and victimization (66.5%). Childhood sexual abuse accounted for 13.7% of the DALYs, lead exposure accounted for 8.5% of the DALYs, intimate partner violence accounted for 11.3% of the DALYs (2%) with all victims being females, and illicit drug use accounted for (52.7%) of DALYs. Interpretation Improved surveillance of mental health and substance use burden at national and county levels is needed. Focus on timely screening and intervention for idiopathic developmental intellectual disability, conduct disorder, and substance use disorder in young boys and depression, anxiety, and eating disorders in young girls and women is critically needed. Funding MK is funded by FIC/NIMH K43 TW 010716 and R33MH124149-03. The publication was made possible by funding from the Gates Foundation.
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Yu K, Wang L, Lv S, Ye X, Liu L, Zheng X, Jin R, Zhou D, Zhang Y, Min G, Wu S. Using functional near-infrared spectroscopy to study effects of virtual reality intervention for adolescents with depression in a clinical setting in China: study protocol for a prospective, randomised, controlled trial. BMJ Open 2023; 13:e074129. [PMID: 38101854 PMCID: PMC10729192 DOI: 10.1136/bmjopen-2023-074129] [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: 03/30/2023] [Accepted: 08/31/2023] [Indexed: 12/17/2023] Open
Abstract
INTRODUCTION Adolescent depression has been shown to be associated with many devastating psychosocial outcomes. However, there are many barriers that may prevent depressed individuals from receiving specialised treatment. Virtual reality (VR) technology has shown promise as one avenue for overcoming these challenges. This study first aims to evaluate the effectiveness of VR intervention on adolescent depression symptoms, and second, to determine the intervention's underlying mechanism of effect using functional near-infrared spectroscopy (fNIRS). METHODS AND ANALYSIS This is a single-centre, prospective, randomised controlled clinical trial. Sixty-six eligible adolescents aged 12-18 years with a diagnosis of depression will be randomised in a 1:1 ratio to either the VR treatment group or the conventional treatment group. All patients for both groups will receive usual treatment during a 4-week intervention period. In addition, patients randomised to VR treatment group (n=33) will complete three 20 min VR sessions including attention, executive function and relaxation training per week. Moreover, 33 healthy adolescents will be recruited as the general population. Primary outcome (ie, depressive symptoms) and secondary outcomes (ie, anxiety symptoms, executive function, treatment emergent symptoms, haemoglobin changes measured by fNIRS) will be collected at preintervention, immediately postintervention and at 4 weeks follow-up. The data assessor and analyst will be blinded to group membership. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Ethics Committee of Lishui Second People's Hospital. Written informed consent will be obtained for all participants. Results will be disseminated through peer-reviewed journals, national or international conference presentations, media outlets, the internet and various community activities. TRIAL REGISTRATION NUMBER ChiCTR2300067747.
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Affiliation(s)
- Kunqiang Yu
- Department of Mental Rehabilitation, The Second People's Hospital of Lishui, Lishui, Zhejiang, China
- Zhejiang Clinical Medical Research Centre for Psychiatric and Psychological Disorders, Lishui, Zhejiang, China
- Lishui Key Laboratory of Brain Health and Major Brain Diseases, Lishui, Zhejiang, China
| | - Lijun Wang
- Cixi Biomedical Research Institute, Wenzhou Medical University, Ningbo, Zhejiang, China
| | - Shiqiao Lv
- Department of Mental Rehabilitation, The Second People's Hospital of Lishui, Lishui, Zhejiang, China
| | - Xiaofang Ye
- Department of Mental Rehabilitation, The Second People's Hospital of Lishui, Lishui, Zhejiang, China
| | - Linhui Liu
- Psychological Counselling Center, The Second People's Hospital of Lishui, Lishui, Zhejiang, China
| | - Xiuxiu Zheng
- Lishui Key Laboratory of Brain Health and Major Brain Diseases, Lishui, Zhejiang, China
- Psychological Counselling Center, The Second People's Hospital of Lishui, Lishui, Zhejiang, China
| | - Ruomei Jin
- Department of Mental Rehabilitation, The Second People's Hospital of Lishui, Lishui, Zhejiang, China
- Lishui Key Laboratory of Brain Health and Major Brain Diseases, Lishui, Zhejiang, China
| | - Dongsheng Zhou
- Department of Mental Rehabilitation, Ningbo Kangning Hospital, Ningbo, Zhejiang, China
| | - Yan Zhang
- Psychological Counselling Center, The Second People's Hospital of Lishui, Lishui, Zhejiang, China
| | - Guoqing Min
- Department of Mental Rehabilitation, The Second People's Hospital of Lishui, Lishui, Zhejiang, China
- Lishui Key Laboratory of Brain Health and Major Brain Diseases, Lishui, Zhejiang, China
| | - Shaochang Wu
- Department of Mental Rehabilitation, The Second People's Hospital of Lishui, Lishui, Zhejiang, China
- Zhejiang Clinical Medical Research Centre for Psychiatric and Psychological Disorders, Lishui, Zhejiang, China
- Lishui Key Laboratory of Brain Health and Major Brain Diseases, Lishui, Zhejiang, China
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Ougrin D, Woodhouse E, Tucker G, Ronaldson A, Bakolis I. The Prevalence of Behavioural Symptoms and Psychiatric Disorders in Hadza Children. Sci Rep 2023; 13:22061. [PMID: 38086816 PMCID: PMC10716231 DOI: 10.1038/s41598-023-48114-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
The worldwide pooled prevalence of psychiatric disorders in children is 13.4%. Studying the prevalence of childhood psychiatric disorders across radically different economic systems and social structures could indicate universal factors leading to their development. The prevalence of childhood psychiatric disorders in a mixed-subsistence foraging society has not been studied. The Strengths and Difficulties Questionnaire and the Development and Well-Being Assessment were used to compare the prevalence of behavioural symptoms and psychiatric disorders in Hadza children aged 5-16 years (n = 113) to a nationally representative sample from England (n = 18,029) using a cross-sectional study design. Emotional problems, conduct problems and hyperactivity were lower in the Hadza children. Prosocial behaviour and peer problems were higher in Hadza children. 3.6% of Hadza children met the criteria for a psychiatric disorder compared to 11.8% of English children. All psychiatric disorders in Hadza children were co-morbid with autism spectrum disorder. No child from the Hadza group met the criteria for an emotional, behaviour or eating disorder. Further work should study the factors which lead to the different prevalence of psychiatric disorders in Hadza children.
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Affiliation(s)
- Dennis Ougrin
- Youth Resilience Unit, Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK.
| | - Emma Woodhouse
- Compass Psychology Services, Bromley, Kent, UK
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gavin Tucker
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Amy Ronaldson
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ioannis Bakolis
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Shawon MSR, Rouf RR, Jahan E, Hossain FB, Mahmood S, Gupta RD, Islam MI, Al Kibria GM, Islam S. The burden of psychological distress and unhealthy dietary behaviours among 222,401 school-going adolescents from 61 countries. Sci Rep 2023; 13:21894. [PMID: 38082022 PMCID: PMC10713667 DOI: 10.1038/s41598-023-49500-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 12/08/2023] [Indexed: 12/18/2023] Open
Abstract
We aimed to calculate the sex-specific prevalence of psychological distress and unhealthy eating habits among adolescents across countries and regions, and to explore their potential associations. We used data from the Global School-Based Health Survey (GSHS) for 61 countries. Psychological distress was defined based on the existence of ≥ 2 factors from the following: loneliness, anxiety, suicide ideation, suicide planning, and suicide attempt. Four unhealthy dietary behaviours were examined: inadequate fruit intake, inadequate vegetable intake, daily consumption of soft drinks, and weekly fast-food consumption. We used random-effects meta-analysis to estimate the overall and regional pooled prevalence. Mixed-effect multilevel logistic regressions were used to estimate adjusted odds ratios (aORs) of unhealthy dietary behaviours in relation to psychological distress. Among 222,401 school-going adolescents (53.3% girls), the prevalence of psychological distress was 17.9%, with girls reporting higher than boys (20.8% vs. 14.9%). Adolescents in the African region reported the highest prevalence (22.5%), while those in the South-East Asia region reported the lowest (11.3%). The prevalence of inadequate fruit intake, inadequate vegetable intake, daily soft drink consumption, and weekly fast-food consumption was 37.0%, 28.5%, 50.0%, and 57.4% respectively. Psychological distress was associated with inadequate fruit intake (pooled aOR = 1.19, 95% CI 1.17-1.23), inadequate vegetable intake (pooled OR = 1.19, 1.16-1.22), daily consumption of soft drinks (pooled aOR = 1.14, 1.12-1.17), and weekly consumption of fast food (pooled aOR = 1.12, 1.09-1.15). Our findings indicate a substantial variance in the burden of psychological distress and unhealthy dietary behaviours across different regions. Adolescents experiencing psychological distress were more likely to have unhealthy dietary habits.
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Affiliation(s)
- Md Shajedur Rahman Shawon
- Centre for Big Data Research in Health, University of New South Wales, Level 2, AGSM Building (G27), Sydney, NSW, 2052, Australia.
| | | | - Esrat Jahan
- Department of Health Systems and Populations, Macquarie University, Sydney, Australia
| | | | | | - Rajat Das Gupta
- Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Md Irteja Islam
- School of Public Health, University of Sydney, Sydney, Australia
| | | | - Shariful Islam
- Institute for Physical Activity and Nutrition (IPAN), Faculty of Health, Deakin University, Perth, Australia
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van Aswegen T, Samartzi E, Morris L, van der Spek N, de Vries R, Seedat S, van Straten A. Effectiveness of family-based therapy for depressive symptoms in children and adolescents: A systematic review and meta-analysis. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2023; 58:499-511. [PMID: 37409629 PMCID: PMC10946719 DOI: 10.1002/ijop.12926] [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: 03/08/2022] [Accepted: 06/06/2023] [Indexed: 07/07/2023]
Abstract
Early-onset depression contributes significantly to the global health burden and has long-term negative effects. This meta-analysis collates and examines the effectiveness of family-based interventions, where family members are involved in the treatment of depression in children and adolescents. A literature search was performed up to 8th March 2023. Randomised controlled trials of family-based interventions were included for participants aged 3-18 years with a diagnosis of major depressive disorder or dysthymia, according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013) or with a score above a cut-off on a standardised self-report depression measure. The overall effect size for treatment versus active control was g = 0.22 (95% confidence interval [CI]: -0.05-0.50) (nine studies; 659 participants), and for treatment versus non-active control it was g = 0.46 (95% CI: -0.09-1.01) (four studies; 385 participants). Effect sizes were not statistically significant, and heterogeneity was high, ranging between I2 = 64.3-81.1%. Subgroup analysis comparing attachment-based family therapy with family therapy using other theoretical frameworks did not yield a significant difference between the two. The effects of family-based therapies were larger than those in the comparison groups, but family-based therapy did not demonstrate a significant treatment benefit compared to the controls. More randomised controlled trials are warranted, considering that evidence for other psychotherapies for depression in children and adolescents, indicates modest effects. Family-based therapy may be an alternative for children and adolescents whose needs are not addressed by these treatments.
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Affiliation(s)
- Tanya van Aswegen
- Department of Psychiatry, Faculty of Medicine and Health SciencesStellenbosch UniversityCape TownSouth Africa
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement SciencesVrije Universiteit Amsterdam & Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
| | - Eleonora Samartzi
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement SciencesVrije Universiteit Amsterdam & Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
| | - Linzette Morris
- Department of Physical Therapy and Rehabilitation Science, College of Health Sciences, QU HealthQatar UniversityDohaQatar
| | - Nadia van der Spek
- Department of Clinical, Neuro and Developmental PsychologyAmsterdam Public Health Research Institute (APH), Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Ralph de Vries
- Medical LibraryVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health SciencesStellenbosch UniversityCape TownSouth Africa
| | - Annemieke van Straten
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement SciencesVrije Universiteit Amsterdam & Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
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Babbott KM, Consedine NS, Roberts M. Eating behaviour, body image, and mental health: updated estimates of adolescent health, well-being, and positive functioning in Aotearoa New Zealand. J Prim Health Care 2023; 15:297-307. [PMID: 38112698 DOI: 10.1071/hc23048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/24/2023] [Indexed: 12/21/2023] Open
Abstract
Introduction Body image dissatisfaction and its associated challenges have been related to poorer health outcomes among adolescents worldwide, including disordered eating behaviour, depression, and anxiety. However, current prevalence estimates of these issues in Aotearoa New Zealand or, relatedly, the estimates of positive attitudes and behaviours, such as intuitive eating and body appreciation are dated. Aim The primary aim of this paper was to provide updated estimates for a variety of constructs related to eating behaviours and body image, sourced from a diverse range of early adolescent participants. Methods For this report, a brief online survey was advertised to adolescents throughout Aotearoa New Zealand (n = 893) via school and community noticeboards. Results Approximately one-in-three male participants and one-in-two female participants reported body image dissatisfaction. One in four participants reported clinically significant symptoms of depression and anxiety. Discussion Given such issues, there is clearly still much progress to be made in advancing positive health among early adolescents. Identifying potentially protective constructs such as intuitive eating and body appreciation may offer guidance into the best targets for prevention and early intervention.
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Affiliation(s)
- Katie M Babbott
- General Practice & Primary Healthcare, University of Auckland, Auckland, New Zealand. ; and Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Nathan S Consedine
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Marion Roberts
- General Practice & Primary Healthcare, University of Auckland, Auckland, New Zealand
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Feldmann L, Zsigo C, Mörtl I, Bartling J, Wachinger C, Oort F, Schulte-Körne G, Greimel E. Emotion regulation in adolescents with major depression - Evidence from a combined EEG and eye-tracking study. J Affect Disord 2023; 340:899-906. [PMID: 37591354 DOI: 10.1016/j.jad.2023.08.087] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/24/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Adolescent major depression (MD) is characterized by deficits in emotion regulation (ER). Little is known about the neurophysiological correlates that are associated with these deficits. Moreover, the additional examination of visual attention during ER would allow a more in-depth understanding of ER deficits but has not yet been applied simultaneously. METHODS N = 33 adolescents with MD and n = 35 healthy controls (HCs) aged 12-18 years performed an ER task during which they either a) down-regulated their negative affective response to negative images via cognitive reappraisal or b) attended the images without changing their affective response. During the task, the Late Positive Potential (LPP), gaze fixations on emotional image aspects, and self-reported affective responses were collected simultaneously. RESULTS Compared to HCs, adolescents with MD demonstrated reduced ER success based on self-report but did not differ in LPP amplitudes. Participants in both groups showed increased amplitudes in the middle LPP window when they reappraised negative pictures compared to when they attended them. Only in the HC group, increased LPP amplitudes during reappraisal were paralleled by more positive affective responses. LIMITATION The applied stimuli were part of picture databases and might therefore have limited self-relevance. CONCLUSIONS Increased LPP amplitude during ER in both groups might be specific to adolescence and might suggest that ER at this age is challenging and requires a high amount of cognitive resources. These findings provide an important starting point for future interventional studies in youth MD.
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Affiliation(s)
- Lisa Feldmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Hospital of the Ludwig-Maximilians-University (LMU) Munich, Munich, Germany.
| | - Carolin Zsigo
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Hospital of the Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
| | - Isabelle Mörtl
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Hospital of the Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
| | - Jürgen Bartling
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Hospital of the Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
| | - Christian Wachinger
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Hospital of the Ludwig-Maximilians-University (LMU) Munich, Munich, Germany; Institute of Radiology, Technical University of Munich, Germany
| | - Frans Oort
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
| | - Gerd Schulte-Körne
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Hospital of the Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
| | - Ellen Greimel
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Hospital of the Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
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Lima JFDB, Lima RJCP, Batalha MA, da Silva AAM, Ribeiro MRC, Batista RFL. Do childhood depressive symptoms interfere with intelligence in adulthood? Rev Saude Publica 2023; 57:64. [PMID: 37878850 PMCID: PMC10519686 DOI: 10.11606/s1518-8787.2023057004918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/19/2022] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVE To investigate the effects of depressive symptoms in childhood on the intellectual development of young adults. METHODS Study conducted with a birth cohort of São Luís, Maranhão, Brazil, composed of 339 participants evaluated between 7 and 9 years and between 18 and 19 years. Structural equation modeling (young adult education, sex, race/color) and childhood variables (nutritional status, depressive symptoms, cognitive function, head of household's and mother's education, family income) were used. In addition, head of household's occupation, mother's age, and presence of partner were tested as determinants of adults' intelligence quotient (IQ). RESULTS Presence of depressive symptoms in childhood triggered a reduction of 0.342 in standard deviation (SD) and -3.83 points in the average IQ of adults (p-value < 0.001). Cognitive function in childhood had a total and direct positive effect (standardized coefficient [SC] = 0.701; p-value < 0.001) on IQ, increasing 7.84 points with each increase in level. A positive indirect effect of child nutritional status (SC = 0.194; p-value = 0.045), head of household's (SC = 0.162; p-value = 0.036), and mother's education was identified, the latter mediated by cognitive function in childhood (SC = 0.215; p-value = 0.012) on the IQ of young people. CONCLUSION Presence of depressive symptoms in childhood triggered a long-term negative effect on intelligence, reducing the IQ score in adulthood.
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Affiliation(s)
- Janielle Ferreira de Brito Lima
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrazil Universidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil. São Luís, MA, Brazil.
| | - Raina Jansen Cutrim Propp Lima
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrazil Universidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil. São Luís, MA, Brazil.
| | - Mônica Araújo Batalha
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrazil Universidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil. São Luís, MA, Brazil.
| | - Antônio Augusto Moura da Silva
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrazil Universidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil. São Luís, MA, Brazil.
| | - Marizélia Rodrigues Costa Ribeiro
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrazil Universidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil. São Luís, MA, Brazil.
| | - Rosângela Fernandes Lucena Batista
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrazil Universidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil. São Luís, MA, Brazil.
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Li J, Zhou X, Huang Z, Shao T. Effect of exercise intervention on depression in children and adolescents: a systematic review and network meta-analysis. BMC Public Health 2023; 23:1918. [PMID: 37794338 PMCID: PMC10552327 DOI: 10.1186/s12889-023-16824-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 09/23/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVES To evaluate the effect of different exercise interventions on depressive symptoms in children and adolescents. METHODS Randomized controlled trials (RCT) published until May 2023 were screened in four databases. The Cochrane collaboration tool was used to assess the risk of bias for quality evaluation. Stata 16.0 software was used for both a pairwise meta-analysis and a series of frequentist network meta-analyses (NMA). RESULTS A total of 35 RCTs and 5393 participants were included. Aerobic exercise had the most significant effect on depressive symptoms (66.2%), followed by group training (62.5%), resistance exercise (59.0%), and aerobic combined with resistance exercise (57.9%). Furthermore, children and adolescents younger than 15 years showed significant improvement in depressive symptoms (SMD=-0.41, 95% CI (-0.63, -0.19), P < 0.01). The study also found a significant improvement in depression among healthy, obesity, and depressed populations (SMD=-0.25, 95% CI (-0.41, -0.08), P < 0.01); SMD=-0.15, 95% CI (-0.31, -0.00), P < 0.01; SMD=-0.75, 95% CI (-1.32, -0.19), P < 0.01). Additionally, 30 min of exercise had a significant effect (SMD=-0.14, 95% CI (-0,81, -0.01), P < 0.01), and 40-50 min of exercise had the best effect (SMD=-0.17, 95% CI (-0,33, -0.02), P < 0.01). Lastly, exercise frequency of three times per week was significant in children and adolescents (SMD=-0.42, 95% CI (-0,66, -0.18), P < 0.01). CONCLUSION Exercise significantly improves depressive symptoms in children and adolescents, with aerobic exercise having the most significant effect. A 12-week, three-times-a-week, 40-50-minute exercise intervention was found to be more effective in younger children and adolescents.
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Affiliation(s)
- Jiayu Li
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, 321004, Zhejiang, China
| | - Xianxian Zhou
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, 321004, Zhejiang, China
| | - Zan Huang
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, 321004, Zhejiang, China
| | - Tianyi Shao
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, 321004, Zhejiang, China.
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Munk Andreasen S, Frederiksen H, Bilenberg N, Andersson AM, Juul A, Kyhl HB, Kold Jensen T. Maternal concentrations of phthalates and Attention-Deficit Hyperactivity Disorder (ADHD-) related symptoms in children aged 2 to 4 years from Odense child cohort. ENVIRONMENT INTERNATIONAL 2023; 180:108244. [PMID: 37797478 DOI: 10.1016/j.envint.2023.108244] [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: 02/24/2023] [Revised: 08/11/2023] [Accepted: 09/28/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Phthalates are endocrine disrupting chemicals used in everyday consumer products. Several epidemiological studies have examined the association between prenatal phthalate concentration and Attention-Deficit Hyperactivity Disorder (ADHD) in offspring, but the findings have been inconclusive. OBJECTIVES To investigate the association between maternal urinary concentrations of phthalate metabolites during pregnancy and ADHD related symptoms in children at 2 to 4 years in a large prospective cohort. METHODS In the Odense Child Cohort from Denmark were women recruited in early pregnancy from 2010 to 2012. Phthalate concentrations were measured in urine samples collected in 3rd trimester and separated into low and high weight phthalates. Parents filled in the Child Behavior Checklist for ages 1.5 to 5 years (CBCL/1½-5), including a 6-item ADHD symptom scale at children aged 2 to 4 years. Data were analysed by use of adjusted negative binomial regression. RESULTS A total of 658 mother-child pairs were included. Urinary phthalate metabolite concentrations were generally low compared to previous cohorts. A doubling in maternal concentration of the low-weighted phthalate metabolite MCPP was significantly associated with lower ADHD symptoms score in children (IRR: 0.95 (95 % CI 0.91-0.98)), strongest in girls (IRR: 0.92 (0.87-0.98)). Sex differences were observed. High maternal phthalate metabolite concentrations were associated with lower ADHD symptom score in girls, significant trends across tertile of MCPP and MnBP (p = 0.018, p = 0.038, respectively). In boys, maternal concentrations of high-molecular-weight phthalates (MBzP, ∑DiNP and ∑DEHP) were associated with an almost significantly higher ADHD symptom score (IRR for a doubling in concentration: 1.04 (95 % CI: 0.99-1.10), IRR: 1.05 (95 % CI: 0.97-1.13), IRR: 1.04 (95 % CI: 0.99-1.10), respectively). CONCLUSION Maternal concentration of the low-weighted phthalate metabolite MCPP was significantly associated with a lower ADHD symptom score in children, strongest in girls. Maternal concentrations of high-molecular-weight phthalates were associated with non-significant increase in ADHD symptom score in boys.
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Affiliation(s)
- Sarah Munk Andreasen
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Hanne Frederiksen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen, Denmark
| | - Niels Bilenberg
- Department of Child and Adolescent Psychiatry, Odense, Mental Health Services in Region of Southern Denmark, University of Southern Denmark, Odense, Denmark
| | - Anna-Maria Andersson
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen, Denmark
| | - Anders Juul
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Henriette Boye Kyhl
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark; OPEN Patient data Explorative Network, Odense, Denmark
| | - Tina Kold Jensen
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark; Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark; OPEN Patient data Explorative Network, Odense, Denmark.
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Yu R, Perera C, Sharma M, Ipince A, Bakrania S, Shokraneh F, Sepulveda JSM, Anthony D. Child and adolescent mental health and psychosocial support interventions: An evidence and gap map of low- and middle-income countries. CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1349. [PMID: 37621301 PMCID: PMC10445093 DOI: 10.1002/cl2.1349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
Background Mental disorders affect about one in seven children and adolescents worldwide. Investment in effective child and adolescent mental health prevention, promotion and care is essential. To date, however, the evidence from this field is yet to be comprehensively collected and mapped. Objectives The objective of this evidence and gap map (EGM) is to provide an overview of the existing evidence on the effectiveness of interventions aimed at promoting mental health and reducing or preventing mental health conditions among children and adolescents in lower-middle-income countries (LMICs). Search Methods We searched for studies from a wide range of bibliographic databases, libraries and websites. All searches were conducted in December 2021 and covered the period between 2010 and 2021. Selection Criteria We included evidence on the effectiveness of any Mental Health and Psychosocial Support (MHPSS) interventions targeting children and adolescents from 0 to 19 years of age in LMICs. The map includes systematic reviews and effectiveness studies in the form of randomised control trials and quasi-experimental studies, and mixed-methods studies with a focus on intervention effectiveness. Data Collection and Analysis A total of 63,947 records were identified after the search. A total of 19,578 records were removed using machine learning. A total of 7545 records were screened independently and simultaneously by four reviewers based on title and abstract and 2721 full texts were assessed for eligibility. The EGM includes 697 studies and reviews that covered 78 LMICs. Main Results School-based interventions make up 61% of intervention research on child and adolescent mental health and psychosocial support. Most interventions (59%) focusing on treating mental health conditions rather than preventing them or promoting mental health. Depression (40%, N = 282) was the most frequently researched outcome sub-domain analysed by studies and reviews, followed by anxiety disorders (32%, N = 225), well-being (21%, N = 143), and post-traumatic stress disorder (18%, N = 125). Most included studies and reviews investigated the effectiveness of mental health and psychosocial support interventions in early (75%, N = 525) and late adolescence (64%, N = 448). Conclusions The body of evidence in this area is complex and it is expanding progressively. However, research on child and adolescent MHPSS interventions is more reactive than proactive, with most evidence focusing on addressing mental health conditions that have already arisen rather than preventing them or promoting mental health. Future research should investigate the effectiveness of digital mental health interventions for children and adolescents as well as interventions to address the mental health and psychosocial needs of children in humanitarian settings. Research on early childhood MHPSS interventions is urgently needed. MHPSS research for children and adolescents lacks diversity. Research is also needed to address geographical inequalities at the regional and national level. Important questions also remain on the quality of the available research-is child and adolescent MHPSS intervention research locally relevant, reliable, well-designed and conducted, accessible and innovative? Planning research collaborations with decision-makers and involving experts by experience in research is essential.
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Affiliation(s)
- Ruichuan Yu
- UNICEF Innocenti—Global Office of Research and Foresight, UNICEF HQFlorenceItaly
| | - Camila Perera
- UNICEF Innocenti—Global Office of Research and Foresight, UNICEF HQFlorenceItaly
| | - Manasi Sharma
- UNICEF Innocenti—Global Office of Research and Foresight, UNICEF HQFlorenceItaly
| | - Alessandra Ipince
- UNICEF Innocenti—Global Office of Research and Foresight, UNICEF HQFlorenceItaly
| | - Shivit Bakrania
- UNICEF Innocenti—Global Office of Research and Foresight, UNICEF HQFlorenceItaly
| | - Farhad Shokraneh
- UNICEF Innocenti—Global Office of Research and Foresight, UNICEF HQFlorenceItaly
| | | | - David Anthony
- UNICEF Innocenti—Global Office of Research and Foresight, UNICEF HQFlorenceItaly
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Wang H, Song Y, Ma J, Ma S, Shen L, Huang Y, Thangaraju P, Basharat Z, Hu Y, Lin Y, Peden AE, Sawyer SM, Zhang H, Zou Z. Burden of non-communicable diseases among adolescents and young adults aged 10-24 years in the South-East Asia and Western Pacific regions, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. THE LANCET. CHILD & ADOLESCENT HEALTH 2023; 7:621-635. [PMID: 37524095 DOI: 10.1016/s2352-4642(23)00148-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 05/30/2023] [Accepted: 06/06/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Although non-communicable diseases (NCDs) remain the leading causes of mortality and disability worldwide, little comprehensive or recent evidence of the burden of NCDs among adolescents and young adults in the South-East Asia and Western Pacific regions is available. We aimed to report population shifts in people aged 10-24 years and their NCD burden from 1990 to 2019 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. METHODS We retrieved data from GBD 2019 for people aged 10-24 years in the South-East Asia and Western Pacific regions from 1990 to 2019. We presented population shifts and analysed deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) for NCDs. We also quantified the associations of deaths and DALYs with the Socio-demographic Index (SDI) and Universal Health Coverage (UHC) effective coverage index using Spearman correlation and linear regression analyses. Percentages are reported to 1 decimal place and rates are reported to 2 decimal places. FINDINGS In 2019, there were 559·2 million young people aged 10-24 years in the South-East Asia region and 335·0 million in the Western Pacific region; India and China remained the countries with greatest number of this age group. In 1990-2019, India had an absolute increase of 139·4 million adolescents, while China had a decrease of 134·3 million. In 2019, NCDs accounted for 27·3% (95% uncertainty interval 25·1 to 29·2) and 34·6% (33·5 to 36·1) of total deaths, and 49·8% (45·3 to 54·4) and 65·1% (60·6 to 69·3) of total DALYs in the South-East Asia and the Western Pacific regions, respectively. Neoplasms, cardiovascular diseases, and mental disorders were the leading causes of NCD burden in 42 countries. Kiribati had the highest rates of deaths (62·82 [50·77 to 76·11] per 100 000 population), YLLs (4364·73 [3545·04 to 5275·63] per 100 000 population), and DALYs (9368·73 [7713·65 to 11340·99] per 100 000 population) for NCDs, whereas Australia (6976·51 [5044·46 to 9190·01] per 100 000 population) and New Zealand (6716·81 [4827·25 to 8827·69] per 100 000 population) had the largest rates of YLDs due to NCDs. From 1990 to 2019 across both regions, the rate of death due to NCDs declined by over a third (-32·8% [-41·1 to -22·9] in the South-East Asia region and -40·0% [-48·6 to -30·4] in the Western Pacific region), and DALYs decreased by about 12% (-12·0% [-16·8 to -7·7] in the South-East Asia region and -12·8% [-17·7 to -8·7] in the Western Pacific region), whereas the proportion of NCD burden relative to all-cause burden increased (45·7% [32·9 to 61·7] for deaths and 41·2% [35·2 to 48·8] for DALYs in the South-East Asia region; 11·8% [7·1 to 21·5] for deaths and 18·2% [14·6 to 22·0] for DALYs in the Western Pacific region). The rate of deaths and DALYs due to NCDs decreased monotonically alongside increases in SDI (rs=-0·57 [95% CI -0·81 to -0·32] for deaths and rs=-0·30 [-0·61 to 0·03] for DALYs). The rate of deaths (rs=-0·89 [95% CI -0·97 to -0·80]) and DALYs (rs=-0·67 [-0·93 to -0·41]) due to NCDs also decreased alongside increases in the UHC effective coverage index. INTERPRETATION Specific preventive and health service measures are needed for adolescents and young adults in countries with different levels of socioeconomic development to reduce the burden from NCDs. FUNDING National Natural Science Foundation of China. TRANSLATION For the Chinese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Huan Wang
- Institute of Child and Adolescent Health and National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Yi Song
- Institute of Child and Adolescent Health and National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Jun Ma
- Institute of Child and Adolescent Health and National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Sheng Ma
- Institute of Child and Adolescent Health and National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Lijuan Shen
- Institute of Child and Adolescent Health and National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Yangmu Huang
- School of Public Health, Peking University, Beijing, China
| | | | - Zarrin Basharat
- Jamil-ur-Rahman Center for Genome Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Yifei Hu
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China
| | - Yuan Lin
- Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Amy E Peden
- School of Population Health, University of New South Wales, Sydney, NSW, Australia; College of Public Health, Medical, and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Susan M Sawyer
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Hao Zhang
- Heart Center and Shanghai Institute of Pediatric Congenital Heart Disease, Shanghai Children's Medical Center, National Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhiyong Zou
- Institute of Child and Adolescent Health and National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China.
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Bahador RS, Farokhzadian J, Rafiee Sarbijan Nasab F, Abbasi M. Experiences of family caregivers of people with intellectual disabilities from rural areas in southeastern Iran: a qualitative study. BMC Psychiatry 2023; 23:613. [PMID: 37608274 PMCID: PMC10463806 DOI: 10.1186/s12888-023-05077-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Caring for people with intellectual disabilities can be a challenging task, but it can also bring about positive experiences for family caregivers. The present study aimed to explore these positive experiences and shed light on the ways in which family caregivers of people with intellectual disabilities can find meaning and fulfillment in their roles. METHODS This qualitative study used conventional content analysis to explore the positive experiences of family caregivers of people with intellectual disabilities. Sixteen family caregivers from rural areas in southeastern Iran were purposively selected to participate in the study. Semi-structured in-depth interviews were conducted to collect data. The interviews were audio-recorded and transcribed verbatim. The data were analyzed using the method proposed by Graneheim and Lundman. RESULTS The data analysis resulted in the emergence of a single theme, which was achievements of providing care for people with intellectual disabilities. This theme was comprised of four main categories: a new outlook on life, family caregivers' peace of mind, strengthening of family ties, and improvement of social status. The provision of care for people with intellectual disabilities created positive changes, affecting family functioning and care provision for people with intellectual disabilities. CONCLUSION It is recommended that families of people with intellectual disabilities focus on these positive experiences and share them with other families who may be struggling with a recent diagnosis of intellectual disability in their child.
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Affiliation(s)
- Raziyeh Sadat Bahador
- Department of Nursing, School of Nursing and Midwifery, Jiroft University of Medical Sciences, Jiroft, Iran
| | | | | | - Mohsen Abbasi
- Department of Nursing, School of Nursing and Midwifery, Jiroft University of Medical Sciences, Jiroft, Iran
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Srinivasan P, Rentala S, Kumar P. Self-esteem among heinous and non-heinous male delinquent adolescents- A descriptive comparative study from East India. Ind Psychiatry J 2023; 32:273-281. [PMID: 38161479 PMCID: PMC10756630 DOI: 10.4103/ipj.ipj_152_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/12/2022] [Accepted: 01/24/2023] [Indexed: 01/03/2024] Open
Abstract
Background Adolescence is the most complex stage of development that causes the greatest difficulties in their life because of frequent physical and emotional issues including deviated character and behavioral disorders. Aim This descriptive comparative study was intended to compare self-esteem between heinous and non-heinous male delinquent adolescents residing in observation homes. Materials and Methods A quantitative research approach with a non-experimental descriptive comparative design was adopted. One hundred and seventy-nine male delinquent adolescents (Heinous = 74, Non-Heinous = 105) residing in two observation homes were selected by convenience sampling technique based on the type of crime committed. The standardized Rosenberg's self-esteem scale was used to collect the data. Results We analyzed the data with Chi-square for homogeneity of sample characteristics, an independent t test for comparison of self-esteem between groups, an independent t test, one-way ANOVA for the association, and stepwise regression for predictors. There was a statistically significant difference in self-esteem between groups, a significant association of self-esteem with age and duration of stay in the heinous group and with the father's education in the non-heinous group, and the father's education, mother's occupation, substance use, and order of birth had predicted the self-esteem in non-heinous group. Conclusion The study concluded that self-esteem significantly varied between heinous and non-heinous group delinquents. This study is the first of its kind and provided initial evidence by filling the gap in the literature to understand the difference in the level of self-esteem among delinquent adolescents according to the type of crime committed.
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Affiliation(s)
- P Srinivasan
- Department of Psychiatric Nursing, College of Nursing, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Sreevani Rentala
- Department of Nursing, Dharwad Institute of Mental Health and Neurosciences, Dharwad, Karnataka, India
| | - Pragya Kumar
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
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Liverpool S, Prescod J, Pereira B, Trotman C. Prevalence of mental health and behaviour problems among adolescents in the English-speaking Caribbean: systematic review and meta-analysis. DISCOVER MENTAL HEALTH 2023; 3:11. [PMID: 37251635 PMCID: PMC10196301 DOI: 10.1007/s44192-023-00037-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/02/2023] [Indexed: 05/31/2023]
Abstract
Objective Children and young people (CYP) from low-and-middle-income and developing countries are at risk of poor mental health and wellbeing. Yet these regions are generally under-resourced in terms of mental health services. As a first step to inform service planning and delivery in the English-speaking Caribbean we pooled the available evidence to estimate the prevalence of common mental health problems. Methods A comprehensive search of CINAHL, Cochrane Library, EMBASE, MEDLINE, PsycINFO, LILACS, and Web of Science databases, supplemented by grey literature searches was performed until January 2022. Studies conducted in the English-speaking Caribbean that reported prevalence estimates of mental health symptomology or diagnoses in CYP were included. The Freeman-Tukey transformation was applied to calculate the weighted summary prevalence under a random-effects model. Subgroup analyses were also performed to observe emerging patterns in the data. Studies were quality assessed using the Joanna Briggs Institute Prevalence Critical Appraisal Checklist and the GRADE approach. The study protocol was registered with PROSPERO, CRD42021283161. Results 33 publications from 28 studies representing 65,034 adolescents from 14 countries met the eligibility criteria. Prevalence estimates ranged from 0.8 to 71.9% with most subgroup estimates between 20 and 30%. The overall pooled prevalence of mental health problems was 23.5% (95% CI 0.175-0.302; I2 = 99.7%). There was limited evidence of significant variation in prevalence estimates among subgroups. The quality of the body of evidence was judged as moderate. Conclusion It is estimated that between 1 in 4 and 1 in 5 adolescents in the English-speaking Caribbean experience symptoms of mental health problems. These findings highlight the importance of sensitisation, screening, and provision of appropriate services. Ongoing research identifying risk factors and validating outcome measures is also needed to inform evidence-based practice. Supplementary Information The online version contains supplementary material available at 10.1007/s44192-023-00037-2.
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Affiliation(s)
- Shaun Liverpool
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK
- Evidence Based Practice Unit, Anna Freud National Centre for Children and Families, London, UK
| | - Jamal Prescod
- Faculty of Social Sciences, The University of the West Indies, Cave Hill, St Michael, Barbados
| | - Brent Pereira
- Department of Counselor Education, The Chicago School of Professional Psychology, Chicago, USA
| | - Catherine Trotman
- Faculty of Social Sciences, The University of the West Indies, Cave Hill, St Michael, Barbados
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Dong Y, He X, Ye L, Sun L, Li J, Xu J, Cui Y, Li Z, Hu L, Bai G. Determinants of depression, problem behavior, and cognitive level of adolescents in China: Findings from a national, population-based cross-sectional study. Front Psychiatry 2023; 14:1159739. [PMID: 37091712 PMCID: PMC10119594 DOI: 10.3389/fpsyt.2023.1159739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/21/2023] [Indexed: 04/25/2023] Open
Abstract
Introduction We aimed to assess the associated factors for adolescent depression, problem behavior and cognitive level in China. Methods A total of 2,584 adolescents aged from 10 to 15 years old in 2018 were included for analyses. Information on a comprehensive set of potential determinants was collected by the questionnaire, including demographic, health-, school- and family-related factors. Differences in average scores of depression, problem behavior, and cognitive level across subgroups were assessed by two independent sample t-tests and one-way analysis of variance (ANOVA). The clinical relevance among subgroups was assessed by the effect size. Multivariate linear regression models were applied to identify the statistically significant determinants. Results School-related factors and parental depressive status were strongly associated with depression. Low maternal education, poor/bad health of adolescents, high academic pressure, and parental depression were significantly associated with behavior problems. The socioeconomic factors, poor academic performance and father's depression were significantly associated with adolescent cognitive level. Discussion Multiple associated factors were identified for depression, problem behavior, and cognition of Chinese adolescents, which will provide insights into developing more targeted public health policies and interventions to improve their mental health.
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Affiliation(s)
- Yusang Dong
- Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Xinyu He
- Department of Child Health Care, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Children’s Hospital, Hangzhou, Zhejiang, China
| | - Lizhen Ye
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Lidan Sun
- Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Jiabin Li
- Department of Pharmacy, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Children’s Hospital, Hangzhou, Zhejiang, China
| | - Jingfang Xu
- Department of Orthopaedics, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Children’s Hospital, Hangzhou, Zhejiang, China
| | - Yuechong Cui
- Yiwu Maternity and Children Hospital, Yiwu Branch of Children’s Hospital Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Ziqiao Li
- Department of Child Health Care, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Children’s Hospital, Hangzhou, Zhejiang, China
| | - Lidan Hu
- Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Guannan Bai
- Department of Child Health Care, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Children’s Hospital, Hangzhou, Zhejiang, China
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Bakhla AK, Pallavi P, Kisku RR, Goyal N, Kumar A, Prasad K. Prevalence of depression in visually impaired children and adolescents: A systematic review and meta-analysis. Indian J Psychiatry 2023; 65:396-403. [PMID: 37325100 PMCID: PMC10263097 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_647_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/27/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023] Open
Abstract
The prevalence of depression among visually impaired or blind children and adolescents has not been systematically reviewed. This study aims to provide the prevalence of depression among visually impaired or blind children and adolescents. This systematic review and meta-analysis were conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (PRISMA) (2020) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. A systematic search of various online databases was done to identify and include studies reporting the prevalence of depression among visually impaired or blind children and adolescents (aged up to 20 years). A random-effects meta-analysis was used to estimate the pooled prevalence of depression. Heterogeneity was assessed using I2 to explain heterogeneity meta-regressive analysis and subgroup analyses were done. With the finally selected 13 studies consisting of 822 participants, the overall pooled prevalence of depression or dysthymia among visually impaired children or adolescents was 14% (137/822 individuals, 95% CI = 9% to 20%), with high heterogeneity between studies (I2 = 80.11%; P < 0.001). Five studies that expressed gender distribution showed a cumulative prevalence of diagnosed depressive disorders was 6.85% and 18.96%, respectively, for male (n = 219, I2 = 47.52) and female (n = 116, I2 = 60.6%) participants. In this systematic review and meta-analysis, we selected and analyzed 13 studies and estimated pooled prevalence of depression was 14% (95% CI = 9% to 20%), among visually impaired or blind children and adolescents.
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Affiliation(s)
- Ajay Kumar Bakhla
- Department of Psychiatry, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand
| | - Puja Pallavi
- Department of Psychiatry, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand
| | - Ravi Rohan Kisku
- Department of Psychiatry, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand
| | | | - Amit Kumar
- Department of Laboratory Medicine, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand
| | - Kameshwar Prasad
- Department of Neurology and Director, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand
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Khan JR, Muurlink O, Hu N, Awan N, Lingam R. Pregnancy, spousal connectedness, and young married women's mental health: an analysis of the Bangladesh adolescent health and wellbeing survey. Arch Womens Ment Health 2023; 26:235-244. [PMID: 36930396 DOI: 10.1007/s00737-023-01302-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 02/17/2023] [Indexed: 03/18/2023]
Abstract
Mental health disorders are responsible for 125.3 million disability-adjusted life years (DALYs) lost globally, with depression in adolescents rising faster than in adults. In total, more than 90% of the 1.2 billion adolescents in the world live in low- and middle-income countries (LMICs). Despite the rise in teenage marriage and pregnancy in LMICs, there is a paucity of research on the role of pregnancy as a risk factor for adolescent mental health, and the role of spousal connectedness as a potential protective factor. This study aims to address this gap. A total of 2408 currently married adolescent (aged 15-19 years) women from the Bangladesh Adolescent Health and Wellbeing Survey 2019-2020 were analysed. Multivariable models were used to assess the factors associated with depression symptoms and major depressive disorder (MDD). The prevalence of moderate/severe depressive symptoms or MDD among adolescents was 14.6%, well ahead of south Asian levels. The odds of having moderate/severe depressive symptoms (adjusted odds ratio [AOR]=1.94, 95% confidence interval [CI] 1.37-2.76) or MDD (AOR=1.63, 95%CI 1.18-2.25) were higher in pregnant adolescent women than in non-pregnant adolescent women. A closer relationship with one's husband reduced the risk of developing moderate/severe depressive symptoms (AOR=0.90, 95% CI 0.84-0.96) or MDD (AOR=0.91, 95% CI 0.86-0.97). Pregnancy and connectedness had no statistically significant interaction effect on depression. There is an urgent need for affordable and scalable interventions to reduce the risk of mental health morbidity in pregnant adolescent women especially in low- and middle-income countries.
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Affiliation(s)
- Jahidur Rahman Khan
- Discipline of Paediatrics, School of Clinical Medicine, University of New South Wales, Sydney, Australia.
| | - Olav Muurlink
- School of Business and Law, Central Queensland University, Brisbane, Australia
| | - Nan Hu
- Discipline of Paediatrics, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Nabil Awan
- Department of Statistics, University of Wisconsin-Madison, Wisconsin, USA
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Raghu Lingam
- Discipline of Paediatrics, School of Clinical Medicine, University of New South Wales, Sydney, Australia
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